[Federal Register Volume 59, Number 235 (Thursday, December 8, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-30139]
[[Page Unknown]]
[Federal Register: December 8, 1994]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
[Program Announcement No. OCS-95-01]
Office of Community Services; Request for Applications Under the
Office of Community Services' Fiscal Year 1995 National Youth Sports
Program
Agency: Office of Community Services, Administration for Children and
Families, Department of Health and Human Services.
ACTION: Request for applications under the Office of Community
Services' National Youth Sports Program.
-----------------------------------------------------------------------
SUMMARY: The Office of Community Services (OCS) announces that
competing applications will be accepted for new grants pursuant to the
Secretary's discretionary authority under Section 682 of the Community
Services Block Grant Act of 1981, as amended. This Program Announcement
contains forms and instructions for submitting an application.
CLOSING DATE: The closing date for submission of applications is
February 6, 1995.
FOR FURTHER INFORMATION CONTACT: Joseph D. Reid, Director, Division of
Community Discretionary Programs, Office of Community Services,
Administration for Children and Families, 370 L'Enfant Promenade, S.W.,
Washington, D.C. 20447, (202) 401-9345.
This announcement is accessible on the OCS Electronic Bulletin
Board for downloading through your computer modem by calling 1-800-627-
8886. For assistance in accessing the Bulletin Board, a Guide to
Accessing and Downloading is available from Ms. Minnie Landry at (202)
401-5309.
Table of Contents
Part A--Preamble
1. Legislative authority
2. Definitions of Terms
Part B--Application Prerequisites
1. Eligible applicants
2. Number of grants, grant amount and matching requirements
3. Project period and budget period
4. Administrative costs
5. Program beneficiaries
6. Multiple submittals
Part C--Purpose and Project Requirements
1. Purpose
2. Project Requirements
Part D--Review Criteria
Criteria for review and evaluation of applications submitted under
this Program Announcement.
Part E--Contents of Application and Receipt Process
1. Contents of Application
2. Acknowledgement of Receipt
Part F--Instructions for Completing Application Package
1. SF-424--``Application for Federal Assistance''
2. SF-424A--``Budget Information--Non-Construction Programs''
3. SF-424B--``Assurances--Non-Construction''
4. Restrictions on Lobbying Activities
5. Disclosure of Lobbying Activities--SF-LLL
6. Project Narrative
Part G--Application Procedures
1. Availability of Forms
2. Application Submission
3. Intergovernmental Review
4. Application Consideration
5. Criteria for screening applications
a. Initial screening
b. Pre-rating review
c. Evaluation criteria
Part H--Post Award Information and Reporting Requirements
Part A--Preamble
1. Legislative Authority
Section 682 of the Community Services Block Grant Act, as amended,
authorizes the Secretary of Health and Human Services to make a grant
to an eligible service provider to administer national or regional
programs designed to provide instructional activities for low-income
youth.
2. Definitions of Terms
For purposes of this Program Announcement the following definitions
apply:
--Low-income youth: a youth between the ages of 10 through 16 whose
family income does not exceed the DHHS Poverty Income Guidelines.
--Eligible Provider: A national private nonprofit organization, a
coalition of such organizations, or a private nonprofit organization
applying jointly with a business concern that has demonstrated
experience in operating a program providing instructions to low-income
youth.
--Budget period: The interval of time into which a grant period of
assistance is divided for budgetary and funding purposes.
--Project period: The total time for which a project is approved for
support, including any approved extensions.
Part B--Application Prerequisites
1. Eligible Applicants
OCS will only consider those applications received from entities
which are eligible applicants as specified in Part A 2. of this
announcement. Non-profit organizations must submit proof of their non-
profit status in their applications at the time of submission. Failure
to do so will result in rejection of their applications. The non-profit
agency can accomplish this by providing a copy of the applicant's
listing in the Internal Revenue Service's (IRS) most recent list of
tax-exempt organizations described in Section 501(c)(3) of the IRS code
or by providing a copy of the currently valid IRS tax exemption
certificate, and by providing a copy of the articles of incorporation
bearing the seal of the State in which the corporation or association
is domiciled.
2. Number of Grants, Grant Amount, and Matching Requirements
a. Number of Grants
One grant will be made under this program.
b. Grant Amounts
Twelve million dollars ($12,000,000) has been appropriated for this
program.
c. Matching Requirements
The grants require a match of either cash or third party in-kind of
one dollar for each dollar awarded. For any application requesting
Federal funds in excess of $9,400,000, the applicant must provide cash
or in-kind of one dollar for each Federal dollar requested up to
$9,400,000 and a cash match of 29% of the Federal funds requested in
excess of $9,400,000.
3. Project Period and Budget Period
The project and budget periods must not exceed 12 months, with
significant amount of program activities to be undertaken in the period
covering July and August 1995.
4. Administrative Costs/Indirect Costs
No funds from a grant made under this program may be used for
administrative expenses. To the extent that indirect costs are not
administrative in nature, such costs may be allowed provided the
grantee has negotiated an approved Indirect Cost Rate Agreement which
excludes administrative expenses. However, it should be understood that
indirect costs are part of, and not in addition to, the amount of funds
awarded in the subject grant.
5. Program Beneficiaries
Projects proposed for funding under this announcement must result
in direct benefits targeted toward 10-16 year olds from low-income
families.
Attachment A to this announcement is an excerpt from the most
recently published Poverty Income guidelines. Annual revisions of these
Guidelines are normally published in the Federal Register in February
or early March of each year and are applicable to projects being
implemented at the time of publication. Grantees will be required to
apply the most recent Guidelines throughout the project period. The
Federal Register may be obtained from public libraries, Congressional
offices, or by writing the Superintendent of Documents, U.S. Government
Printing Office, Washington, D.C. 20402. In addition, it may be
obtained by downloading from the OCS Electronic Bulletin Board. (See
instructions under ``Contact'' at the beginning of this document.)
No other government agency or privately defined poverty guidelines
are applicable to the determination of low-income eligibility for this
OCS program.
6. Multiple Submittals
An applicant organization should not submit more than one
application under this Program Announcement.
Part C--Purpose and Project Requirements
1. Purpose
The Department of Health and Human Services is committed to
improving the health and physical fitness of young people, particularly
those that are members of low-income families and residents of
economically disadvantaged areas of the United States.
The Department seeks to improve the lives of these young people
through sports skill instruction, counseling in good health practices,
and counseling related to anti-drug and anti-alcohol abuse.
2. Project Requirements
Any instructional activity carried out by an eligible service
provider receiving a grant under this program announcement shall be
carried out on the campus of an institution of higher education (as
defined in section 1201(a) of the Higher Education Act) and shall
include--
a. Access to the facilities and resources of such institution;
b. An initial medical examination and follow-up referral or
treatment, without charge, for youth during their participation in such
activity;
c. At least one nutritious meal daily, without charge, for
participating youth during each day of participation;
d. High quality instruction in a variety of sports (that shall
include swimming and that may include dance and any other high quality
recreational activity) provided by coaches and teachers from
institutions of higher education and from elementary and secondary
schools (as defined in sections 1471(8) and 1471(21) of the Elementary
and Secondary Education Act of 1965); and
e. Enrichment instruction and information on matters relating to
the well-being of youth, to include educational opportunities and study
practices, education for the prevention of drug and alcohol abuse,
health and nutrition, career opportunities, and family and job
responsibilities.
Part D--Review Criteria
Applications which pass the initial screening and pre-rating review
described in Part G 5. will be assessed and scored by reviewers. These
numerical scores will be supported by explanatory statements on a
formal rating form describing major strengths and weaknesses under each
applicable criterion published in this announcement.
The in-depth evaluation and review process will use the criteria
set forth below coupled with the specific requirements described in
Part G.
Applicants should write their project narrative according to the
review criteria using the same sequential order.
Criteria for Review and Evaluation of Applications Submitted Under This
Program Announcement
1. Criterion I: Location and number of institutions of Higher Education
(Maximum: 20 points)
a. Applicant must describe and document the number and location of
Institutions of Higher Education committed to participation in this
program, with special attention to documenting the accessibility of the
schools to economically disadvantaged communities (0-12 points).
b. Applicant must describe in the aggregate the facilities which
will be available on the campuses of the institutions to be used in the
program (swimming pools, medical facilities, food preparation
facilities, etc.) (0-8 points).
2. Criterion II: Adequacy of Work Program (Maximum: 20 Points)
a. Applicant must set forth realistic weekly time targets (for the
summer program) and quarterly time targets (for any extended-year
program activities). The time targets should specify the tasks to be
accomplished in the given timeframes. (0-8 points).
b. Applicant must address the legislatively-mandated activities
found in Part C.2., to include: (1) Project priorities and rationale
for selecting them; (2) project goals and objectives; and (3) project
activities. (0-12 points).
3. Criterion III: Significant and Beneficial Impact (Maximum: 20
points)
a. Applicant proposes to improve nutritional services to the
participating youths (0-5 points).
b. Project incorporates medical examinations along with follow-up
referral or treatment (0-5 points).
c. Project includes counseling, related to anti-drug and anti-
alcohol abuse, by counselors with experience in those areas as a major
element (0-5 points).
d. Project makes use of an existing outreach activity of a
community action agency or some other community-based organization (0-5
points).
4. Criterion IV: Organizational Experience in Program Area and Staff
Responsibilities (Maximum: 30 points)
a. Organizational experience in program area (0-10 points).
Documentation provided indicates that projects previously undertaken
have been relevant and effective and have provided significant benefits
to low-income youth. Information provided should also address the
achievements and competence of the participating institutions.
b. Management history (0-10 points). Applicants must fully detail
their ability to implement sound and effective management practices and
if they have been recipients of other Federal or other governmental
grants, they must also detail that they have consistently complied with
financial and program progress reporting and audit requirements.
Applicants should submit any available documentation on their
management practices and progress reporting procedures. Applicant
should also submit a statement by a Certified or Licensed Public
Accountant as to the sufficiency of the applicant's financial
management system to protect any Federal funds which may be awarded
under this program.
c. Staffing skills, resources and responsibilities (0-10 points).
Applicant must briefly describe the experience and skills of the
proposed project director showing that the individual is not only well
qualified but that his/her professional capabilities are relevant to
the successful implementation of the project. If the key staff person
has not been identified, the application should contain a comprehensive
position description which indicates that the responsibilities assigned
to the project director are relevant to the successful implementation
of the project.
The application must indicate that the applicant and the
subgrantees or delegate institutions have adequate facilities and
resources (i.e. space and equipment) to successfully carry out the work
plan. The application must clearly show that sufficient time of the
project director and other senior staff will be budgeted to assure
timely implementation and oversight of the project and that the
assigned responsibilities of the staff are appropriate to the tasks
identified for the project.
5. Criterion V: Adequacy of Budget (Maximum: 10 points)
Budget is adequate and funds requested are commensurate with the
level of effort necessary to accomplish the goals and objectives of the
program. The estimated cost of the project to the government is
reasonable in relation to the anticipated results.
Part E--Contents of Application and Receipt Process
1. Contents of Application
Each application package should include one signed original and two
additional copies of the following:
a. A signed Application for Federal Assistance (SF-424);
b. Budget Information--Non-Construction Programs (SF-424A);
c. A signed--Assurances--Non-construction Programs (SF-424B);
d. A Project Narrative consisting of the following elements
preceded by a consecutively numbered Table of Contents that describes
the project in the following order:
(i) Eligibility confirmation.
(ii) Number and location of Institutions of Higher Education
committed to the program and their accessibility to youth from
economically disadvantaged areas.
(iii) Organization experience and staff responsibilities.
(iv) Work program (including Executive Summary)
(v) Appendices, including Bylaws; Articles of Incorporation;
proof of non-profit status; resume of project director; statement by
a Certified or Licensed Public Accountant as to the sufficiency of
the applicant's financial management system to protect Federal
funds; Single Point of Contact comments, if available;
certifications regarding Lobbying, Debarment and Drug Free Workplace
activities.
The total number of pages for the entire application package should
not exceed 50 pages. Applications should be two holed punched at the
top and fastened separately with a compressor slide paper fastener or a
binder clip. The submission of bound applications, or applications
enclosed in binder, is especially discouraged.
Applications must be uniform in composition since OCS may find it
necessary to duplicate them for review purposes. Therefore,
applications must be submitted on white 8\1/2\ x 11 inch paper only.
They should not include colored, oversized or folded materials. Do not
include organizational brochures or other promotional materials,
slides, films, clips, etc. in the proposal. They may be discarded, if
included.
2. Acknowledgement of Receipt
All applicants will receive an acknowledgement postcard with an
assigned identification number. Applicants are requested to supply a
self-addressed mailing label with their application which can be
attached to this acknowledgement postcard. The assigned identification
number must be referred to in all subsequent communications with ACF
concerning the application. If an acknowledgement is not received
within three weeks after the deadline date, please notify ACF by
telephone (202) 401-9230.
Part F--Instructions for Completing Application Package
It is suggested that the applicant reproduce the SF-424 and SF-
424A, and type your application on the copies. If an item on the SF-424
cannot be answered or does not appear to be related or relevant to the
assistance requested write NA for ``Not Applicable''.
Prepare your application in accordance with the standard
instructions given in Attachments B and C corresponding to the forms,
as well as specific instructions set forth below:
1. SF-424 ``Application for Federal Assistance''
Item Numbers
1. For the purposes of this announcement, all projects are
considered ``Applications''; there are no ``Pre-applications''. All
projects are non-construction projects. Check the appropriate box under
``Application''.
5 and 6. The legal name of the applicant must match that listed as
corresponding to the Employer Identification Number. Where the
applicant is a previous Department of Health and Human Services
grantee, enter the Central Registry System Employee Identification
Number (EIN) and the Payment Identifying Number (PIN), if one has been
assigned, in the Block entitled ``Federal Identifier'' located at the
top right hand corner of the form.
7. If the applicant is a non-profit corporation, enter ``N'' in the
box and specify ``non-profit corporation'' in the space marked
``Other.'' Proof of non-profit status must be included in the
application at the time of submission. This can be accomplished by
providing a copy of the applicant's listing in the Internal Revenue
Services' (IRS) most recent list of tax-exempt organizations in section
501(c)(3) of the IRS code or by providing a copy of the articles of
incorporation bearing the seal of the State in which the corporation or
association is domiciled.
8. For the purposes of this announcement, all applications are
``New''.
9. Enter DHHS-ACF/OCS.
10. The Catalog of Federal Domestic Assistance number for OCS
programs covered under this announcement is 93.570. The title is ``CSBG
Discretionary Awards.''
2. SF-424A--``Budget Information--Non-Construction Programs''
See instructions accompanying this form as well as the instructions
set forth below:
In completing these sections, the ``Federal Funds'' budget entries
will relate to the requested OCS discretionary funds only, and ``Non-
Federal'' will include mobilized funds from all other sources--
applicant, state, local, and other. Federal funds other than requested
OCS discretionary funding should be included in ``Non-Federal''
entries.
The budget forms in SF-424A are only to be used to present grant
costs and major budget categories. Other internal project cost data
must be separate and should appear as part of other project
implementation data. Applicants are reminded that grant funds may not
be utilized for administrative expenses.
Sections A and D of SF-424A must contain entries for both Federal
(OCS) and Non-Federal (mobilized) funds. Section B contains entries for
Federal (OCS) funds only. Clearly identified continuation sheets in SF-
424A format should be used as necessary.
Section A--Budget Summary
Lines 1-4, Col. (a): Line 1 Enter ``CSBG Discretionary''; Col. (b):
Line 1 Enter ``93.570''; Col. (c): and (d); Applicants should leave
columns (c) and (d) blank.
Col. (e)-(g): For line 1, enter in columns (e), (f) and (g) the
appropriate amounts needed to support the project for the budget
period.
Line 5, Enter the figures from Line 1 for all columns completed as
required, (c), (d), (e), (f), and (g).
Section B--Budget Categories
Allowability of costs are governed by applicable cost principles
set forth in 45 CFR part 74.
Columns (1) and (5): In OCS applications, it is only necessary to
complete Columns (1) and (5). Column 1: Enter the total requirements
for OCS Federal funds by the Object Class Categories of this section:
Personnel-Line 6A: Enter the total costs of salaries and wages of
applicant/grantee staff only. Do not include costs of consultants or
personnel costs of delegate agencies or of specific project(s) or
businesses to be financed by the applicant.
Fringe Benefits-Line 6b: Enter the total costs of fringe benefits
unless treated as part of an approved indirect cost rate which is
entered on line 6j. Provide a breakdown of amounts and percentages that
comprise fringe benefit costs.
Travel-Line 6c: Enter total costs of all travel by employees of the
project. Do not enter costs for consultant's travel. Provide
justification for requested travel costs.
Equipment-Line 6d: Enter the total costs of all non-expendable
personal property to be acquired by the project. ``Non-expendable
personal property'' means tangible property having a useful life of
more than one year and an acquisition cost of $5,000 or more per unit.
An applicant may use its own definition of non-expendable personal
property, provided that such a definition would at least include all
tangible personal property as defined in the preceding sentence. (See
Line 21 for additional requirements).
Supplies-Line 6e: Enter the total costs of all tangible personal
property (supplies) other than that included on line 6d.
Contractual-Line 6f: Enter the total costs of all contracts,
including (1) procurement contracts (except those which belong on other
lines such as equipment, supplies, etc.) and (2) contracts with
secondary recipient organizations including delegate agencies and
specific project(s) to be financed by the applicant.
Other-Line 6h: Enter the total of all other costs. Such costs,
where applicable, may include but are not limited to insurance, food,
medical and dental costs (non-contractual), fees and travel paid
directly to individual consultants, space and equipment rentals,
printing and publication, computer use, training costs, including
tuition and stipends, training services costs including wage payments
to individuals and supportive services payments, and staff development
costs.
Total Direct Charges-Line 6i: Show the total of Lines 6a through
6h. Indirect Charges-Lines 6j: Enter the total amount of indirect
costs. This line should be used only when the applicant currently has
an indirect cost rate approved by the Department of Health and Human
Services or another Federal agency or is awaiting such approval.
Applicants should enclose a copy of the current rate agreement. If
the applicant organization is in the process of initially developing or
renegotiating a rate, it should immediately, upon notification that an
award will be made, develop a tentative indirect cost rate proposal
based on its most recently completed fiscal year in accordance with the
principles set forth in the pertinent DHHS Guide for Establishing
Indirect Cost Rates, and submit it to the appropriate DHHS Regional
Office. It should be noted that when an indirect cost rate is
requested, those costs included in the indirect cost pool should not be
also charged as direct costs to the grant.
Totals-Line 6k: Enter the total amounts of Lines 6i and 6j. The
total amount should be shown in Section B, Column 1: Carry totals from
Column 1 to Column 5 for all line items.
Section C--Non-Federal Resources
This section is to record the amounts of ``non-Federal'' resources
that will be used to support the project. ``Non-Federal'' resources
mean other than OCS funds for which the applicant is applying.
Therefore, mobilized funds from other Federal programs, such as the Job
Training Partnership Act Program, should be entered on these lines.
Provide a brief listing of the non-Federal resources on a separate
sheet and describe whether it is a grantee-incurred cost or a third-
party in-kind contribution.
Line 8: Column (a): Enter the project title. Column (b): Enter the
amount of contributions to be made by the applicant to the project.
Column (d): Enter the amount of cash and in-kind contributions to be
made from all other sources. Column (e): Enter the total of columns
(b), (c), and (d).
Line 9, 10, and 11 should be left blank.
Line 12: Carry the total of each column of lines 8, (b) through
(e). The amount in Column (e) should be equal to the amount on Section
A, Line 5, column (f).
Section F--Other Budget Information
Line 21: Use this space and continuation sheets as necessary to
fully explain and justify the major items included in the budget
categories shown in Section B. Include sufficient detail to facilitate
determination of allowability, relevance to the project, and cost
benefits. Particular attention must be given to the explanation of any
requested direct cost budget item which requires explicit approval by
the Federal agency. Budget items which require identification and
justification shall include, but not be limited to, the following:
1. Salary amounts and percentage of time worked for those key
individuals who are identified in the project narrative;
2. Any foreign travel;
3. A list of all equipment and estimated cost of each item to be
purchased wholly or in part with grant funds and which meet the
definition of nonexpendable personal property provided on Line 6d,
Section B. Need for equipment must be supported in the program
narrative.
4. Contractual: Major items or groups of smaller items; and
5. Other: Group into major categories all costs for consultants,
local transportation, space, rental, training allowances, staff
training, computer equipment, etc. Provide a complete breakdown of
all costs that make up this category.
Line 22: Enter the type of HHS or other Federal agency approved
indirect cost rate (provisional, predetermined, final or fixed that
will be in effect during the funding period, the estimated amount of
the base to which the rate is applied and the total indirect expense.
Also, enter the date the rate was approved, where applicable. Attach a
copy of the rate agreement if it was negotiated with a Federal agency
other than the Department of Health and Human Services.
Line 23: Provide any other explanations and continuation sheets
required or deemed necessary to justify or explain the budget
information.
3. SF-424B ``Assurances--Non-Construction''
Applicants requesting financial assistance for a non-construction
project must file the Standard Form 424B, ``Assurances: Non-
Construction Programs.'' Applicants must sign and return the Standard
Form 424B (Attachment D) with their applications.
4. Restrictions on Lobbying Activities
Certification for Contracts, Grants, Loans, and Cooperative
Agreements: Fill out, sign and date form found at Attachment H.
5. Disclosure of Lobbying Activities, SF-LLL
Fill out, sign and date form found at Attachment H, if applicable.
6. Project Narrative
The project narrative must address the specific concerns and
requirements mentioned under Parts C and D of this announcement. After
confirmation of eligibility (as required by Part B), the narrative
should follow the order and respond to the content of the criteria
detailed under Part D.
Part G--Application Procedures
1. Availability of Forms
Application for awards under this OCS program must be submitted on
Standard Forms (SF) 424, 424A, and 424B. Part F and Attachments B, C,
and D to this Program Announcement contain all the instructions and
forms required for submitting of applications. The forms may be
reproduced for use in submittal applications. Copies of the Federal
Register containing this Announcement are available at most local
libraries and Congressional District Offices for reproduction. If
copies are not available at these sources they may be obtained by
writing or telephoning the office listed in the section entitled
``Contact'' at the beginning of this Announcement.
2. Application Submission
The date by which applications must be received is indicated under
``Closing Date'' at the beginning of this Announcement.
a. Applications may be mailed to: Department of Health and Human
Services, Administration For Children and Families, Division of
Discretionary Grants, 6th Floor, 370 L'Enfant Promenade, S.W.
Washington, D.C. 20447, ATTN: Maiso Bryant, (Program Announcement No.
OCS-95-01)
b. Hand delivered applications are accepted during the normal
working hours of 8:00 a.m. to 4:30 p.m., Monday through Friday, on or
prior to the established closing date at: Administration for Children
and Families, Division of Discretionary Grants, 6th Floor, ACF Guard
Station, 901 D. Street, S. W., Washington, D. C. 20447.
An application shall be considered as meeting an announced deadline
if it is either:
a. Received on or before the deadline date at a place specified
in the program announcement, or
b. Sent on or before the deadline date and received by ACF in
time for the independent review. (Applicants are cautioned to
request a legibly dated U. S. Postal Service postmark or to obtain a
legibly dated receipt from a commercial carrier or U. S. Postal
service. Private Metered postmarks shall not be acceptable as proof
of timely mailing.)
Late applications: Applications which do not meet the criteria in
paragraphs a and b above are considered late applications. ACF shall
notify each late applicant that its application will not be considered
in the current competition.
Extension of deadlines: ACF may extend the deadline for all
applicants because of acts of God such as floods, hurricanes, etc., or
when there is a widespread disruption of the mails. However, if ACF
does not extend the deadline for all applicants, it may not waive or
extend the deadline for any applicants.
3. Intergovernmental Review
This program is covered under Executive Order 12372,
``Intergovernmental Review of Federal Programs,'' and 45 CFR part 100,
``Intergovernmental Review of Department of Health and Human Services
Programs and Activities.'' Under the Order, States may design their own
processes for reviewing and commenting on proposed Federal assistance
under covered programs.
All States and Territories except Alabama, Alaska, Colorado,
Connecticut, Hawaii, Idaho, Kansas, Louisiana, Minnesota, Montana,
Nebraska, Oklahoma, Oregon, Pennsylvania, South Dakota, Virginia,
Washington, American Samoa and Palau have elected to participate in the
Executive Order process and have established Single Points of Contacts
(SPOCs). Applicants from these nineteen jurisdictions need take no
action regarding E.O. 12372. Applicants for projects to be administered
by Federally-recognized Indian Tribes are also exempt from the
requirements of E.O. 12372. Otherwise, applicants should contact their
SPOCs as soon as possible to alert them of the prospective applications
and receive any necessary instructions. Applicants must submit any
required material to the SPOCs as soon as possible so that the program
office can obtain and review SPOC comments as part of the award
process. It is imperative that the applicant submit all required
materials, if any, to the SPOC and indicate the date of this submittal
(or the date of contact if no submittal is required) on the Standard
Form 424, item 16a.
Under 45 CFR 100.8(1)(2), a SPOC has 60 days from the application
deadline date to comment on proposed new or competing continuation
awards.
SPOCs are encouraged to eliminate the submission of routine
endorsements as official recommendations.
Additionally, SPOCs are requested to clearly differentiate between
mere advisory comments and those official State process recommendations
which may trigger the ``accommodate or explain'' rule.
When comments are submitted directly to ACF, they should be
addressed to: Department of Health and Human Services, Administration
for Children and Families, Division of Discretionary Grants, 6th Floor,
370 L'Enfant Promenade, S. W., Washington, D. C. 20447.
A list of the Single Points of Contact for each State and Territory
is included as appendix G of this announcement.
4. Application Consideration
Applications which meet the screening requirements in Section 5
below will be reviewed competitively. Such applications will be
referred to reviewers for a numerical score and explanatory comments
based solely on responsiveness to program guidelines and evaluation
criteria published in this announcement. Applications will be reviewed
by persons outside of the OCS unit which would be directly responsible
for programmatic management of the grant. The results of these reviews
will assist the Director and OCS program staff in considering competing
applications. Reviewers' scores will weigh heavily in funding decisions
but will not be the only factors considered. Applications will
generally be considered in order of the average scores assigned by
reviewers. However, highly ranked applications are not guaranteed
funding since the Director may also consider other factors deemed
relevant including, but not limited to, the timely and proper
completion of projects funded with OCS funds granted in the last five
(5) years; comments of reviewers and government officials; staff
evaluation and input; geographic distribution; previous program
performance of applicants; compliance with grant terms under previous
DHHS grants; audit reports; investigative reports; and applicant's
progress in resolving any final audit disallowances on OCS or other
Federal agency grants. OCS reserves the right to discuss applications
with other Federal or non-Federal funding sources to ascertain the
applicant's performance record.
5. Criteria for Screening Applications
All applications that meet the published deadline for submission
will be screened to determine completeness and conformity to the
requirements of this Announcement. Only those applications meeting the
following requirements will be reviewed and evaluated competitively.
Others will be returned to the applicants with a notation that they
were unacceptable.
a. Initial Screening
(1) The application must contain a completed Standard Form SF-424
signed by an official of the entity applying for the grant who has
authority to obligate the organization legally;
(2) a budget (SF-424A); and
(3) ``Assurances'' (SF-424B) signed by the appropriate official.
b. Pre-Rating Review
Applications which pass the initial screening will be forwarded to
reviewers for analytical comment and scoring based on the criteria
detailed in the Section below and the specific requirements contained
in Part C of this Announcement. Prior to the programmatic review, these
reviewers and/or OCS staff will verify that the applications comply
with this Program Announcement in the following areas:
(1) Eligibility: Applicant meets the eligibility requirements found
in Part A2.
(2) Target Populations: The application clearly targets the
specific outcomes and benefits of the project to low-income
participants as defined in the DHHS Poverty Income Guidelines
(Attachment A).
(3) Grant Amount: The amount of funds requested does not exceed $12
million.
(4) Program Focus: The application addresses the geographic scope
and project requirements described in Part C of this announcement.
c. Evaluation Criteria
Applications which pass the initial screening and pre-rating review
will be assessed and scored by reviewers. Each reviewer will give a
numerical score for each application reviewed. These numerical scores
will be supported by explanatory statements on a formal rating form
describing major strengths and major weaknesses under each applicable
criterion published in this announcement.
Part H--Post Award Information and Reporting Requirements
Following approval of the applications selected for funding, notice
of project approval and authority to draw down project funds will be
made in writing. The official award document is the Financial
Assistance Award which provides the amount of Federal funds approved
for use in the project, the budget period for which support is
provided, and the terms and conditions of the award.
In addition to the General Conditions and Special Conditions (where
the latter are warranted) which will be applicable to grant, the
grantee will be subject to the provisions of 45 CFR part 74 along with
OMB Circulars 122, A-133, and, for institutions of higher education, A-
21.
Grantee will be required to submit progress and financial reports
(SF-269).
Grantee is subject to the audit requirements in 45 CFR part 74.
Applicants requesting financial assistance for a non-construction
project must file the Standard Form 424B, ``Assurances: Non-
Construction Programs.'' Applicants must sign and return the Standard
Form 424B with their applications.
Applicants must provide a certification concerning Lobbying. Prior
to receiving an award in excess of $100,000, applicants shall furnish
an executed copy of the lobbying certification. Applicants must sign
and return the certification with their applications.
Applicants must make the appropriate certification of their
compliance with the Drug-Free Workplace Act of 1988. By signing and
submitting the applications, applicants are providing the certification
and need not mail back the certification with the applications.
Applicants must make the appropriate certification that they are
not presently debarred, suspended or otherwise ineligible for award. By
signing and submitting the applications, applicants are providing the
certification and need not mail back the certification with the
applications.
Copies of the certifications and assurances are located at the end
of this announcement.
Section 319 of Public Law 101-121, signed into law on October 23,
1989, imposes new prohibitions and requirements for disclosure and
certification related to lobbying when an applicant has engaged in
lobbying activities or is expected to lobby in trying to obtain the
grant. It provides limited exemptions for Indian tribes and tribal
organizations. Current and prospective recipients (and their subtier
contractors and/or grantees) are prohibited from using appropriated
funds for lobbying Congress or any Federal agency in connection with
the award of a contract, grant cooperative agreement or loan. In
addition, for each award action in excess of $100,000 (or $150,000 for
loans) the law requires recipients and their subtier contractors and/or
subgrantees (1) to certify that they have neither used nor will use any
appropriated funds for payment to lobbyists, (2) to submit a
declaration setting forth whether payments to lobbyists have been or
will be made out of nonappropriated funds and, if so, the name,
address, payment details, and purpose of any agreements with such
lobbyists whom recipients or their subtier contractors or subgrantees
will pay with the nonappropriated funds and (3) to file quarterly up-
dates about the use of lobbyists if an event occurs that materially
affects the accuracy of the information submitted by way of declaration
and certification. The law establishes civil penalties for
noncompliance and is effective with respect to contracts, grants,
cooperative agreements and loans entered into or made on or after
December 23, 1989. See Attachment H for certification and disclosure
forms to be submitted with the applications for this program.
Attachment I indicates the regulations which apply to all
applicants/grantees under the Discretionary Grants Program.
Donald Sykes,
Director, Office of Community Services.
Attachment A--1994 Poverty Income Guidelines for All States Except
Alaska and Hawaii and the District of Columbia
------------------------------------------------------------------------
Poverty
Size of family unit guideline
------------------------------------------------------------------------
1............................................................ $7,360
2............................................................ 9,840
3............................................................ 12,320
4............................................................ 14,800
5............................................................ 17,280
6............................................................ 19,760
7............................................................ 22,240
8............................................................ 24,720
For family units with more than 8 members, add $2,480 for each
additional member.
Poverty Income Guidelines for Alaska
1............................................................ $9,200
2............................................................ 12,300
3............................................................ 15,400
4............................................................ 18,500
5............................................................ 21,600
6............................................................ 24,700
7............................................................ 27,800
8............................................................ 30,900
For family units with more than 8 members, add $3,100 for each
additional member.
Poverty Income Guidelines for Hawaii
1............................................................ $8,470
2............................................................ 11,320
3............................................................ 14,170
4............................................................ 17,020
5............................................................ 19,870
6............................................................ 22,720
7............................................................ 25,570
8............................................................ 28,420
For family units with more than 8 members, add $2,850 for each
additional member. (The same increment applies to smaller family sizes
also, as can be seen in the figures above.)
------------------------------------------------------------------------
BILLING CODE 4184-01-P
TN08DE94.000
BILLING CODE 4184-01-C
Instructions for the SF 424
This is a standard form used by applicants as a required
facesheet for preapplications and applications submitted for Federal
assistance. It will be used by Federal agencies to obtain applicant
certification that States which have established a review and
comment procedure in response to Executive Order 12372 and have
selected the program to be included in their process, have been
given an opportunity to review the applicant's submission.
1. Self-explanatory.
2. Date application submitted to Federal agency (or State if
applicable) & applicant's control number (if applicable).
3. State use only (if applicable).
4. If this application is to continue or revise an existing
award, enter present Federal identifier number. If for a new
project, leave blank.
5. Legal name of applicant, name of primary organizational unit
which will undertake the assistance activity, complete address of
the applicant, and name and telephone number of the person to
contact on matters related to this application.
6. Enter Employer Identification Number (EIN) as assigned by the
Internal Revenue Service.
7. Enter the appropriate letter in the space provided.
8. Check appropriate box and enter appropriate letter(s) in the
space(s) provided:
``New'' means a new assistance award.
``Continuation'' means an extension for an additional funding/
budget period for a project with a projected completion date.
``Revision'' means any change in the Federal Government's
financial obligation or contingent liability from an existing
obligation.
9. Name of Federal agency from which assistance is being
requested with the application.
10. Use the Catalog of Federal Domestic Assistance number and
title of the program under which assistance is requested.
11. Enter a brief descriptive title of the project. If more than
one program is involved, you should append an explanation on a
separate sheet. If appropriate (e.g., construction or real property
projects), attach a map showing project location. For
preapplications, use a separate sheet to provide a summary
description of this project.
12. List only the largest political entities affected (e.g.,
State, counties, cities).
Self-explanatory.
14. List the applicant's Congressional District and any
District(s) affected by the program or project.
15. Amount requested or to be contributed during the first
funding/budget period by each contributor. Value of in-kind
contributions should be included on appropriate lines as applicable.
If the action will result in a dollar change to an existing award,
indicate only the amount of the change. For decreases, enclose the
amounts in parentheses. If both basic and supplemental amounts are
included, show breakdown on an attached sheet. For multiple program
funding, use totals and show breakdown using same categories as item
15.
16. Applicants should contact the State Single Point of Contact
(SPOC) for Federal Executive Order 12372 to determine whether the
application is subject to the State intergovernmental review
process.
17. This question applies to the applicant organization, not the
person who signs as the authorized representative. Categories of
debt include delinquent audit disallowances, loans and taxes.
18. To be signed by the authorized representative of the
applicant. A copy of the governing body's authorization for you to
sign this application as official representative must be on file in
the applicant's office. (Certain Federal agencies may require that
this authorization be submitted as part of the application).
BILLING CODE 4184-01-P
Attachement C
TN08DE94.001
TN08DE94.002
BILLING CODE 4184-01-C
INSTRUCTIONS FOR THE SF-424A
General Instructions
This form is designed so that application can be made for funds
from one or more grant programs. In preparing the budget, adhere to
any existing Federal grantor agency guidelines which prescribe how
and whether budgeted amounts should be separately shown for
different functions or activities within the program. For some
programs, grantor agencies may require budgets to be separately
shown by function or activity. For other programs, grantor agencies
may require a breakdown by function or activity. Sections A, B, C,
and D should include budget estimates for the whole project except
when applying for assistance which requires Federal authorization in
annual or other funding period increments. In the latter case,
Sections A, B, C, and D should provide the budget for the first
budget period (usually a year) and Section E should present the need
for Federal assistance in the subsequent budget periods. All
applications should contain a breakdown by the object class
categories shown in Lines a-k of Section B.
Section A. Budget Summary
Lines 1-4, Columns (a) and (b)
For applications pertaining to a single Federal grant program
(Federal Domestic Assistance Catalog number) and not requiring a
functional or activity breakdown, enter on Line 1 under Column (a)
the catalog program title and the catalog number in Column (b).
For applications pertaining to a single program requiring budget
amounts by multiple functions or activities, enter the name of each
activity or function on each line in Column (a), and enter the
catalog number in Column (b). For applications pertaining to
multiple programs where none of the programs require a breakdown by
function or activity, enter the catalog program title on each line
in Column (a) and the respective catalog number on each line in
Column (b).
For applications pertaining to multiple programs where one or
more programs require a breakdown by function or activity, prepare a
separate sheet for each program requiring the breakdown. Additional
sheets should be used when one form does not provide adequate space
for all breakdown of data required. However, when more than one
sheet is used, the first page should provide the summary totals by
programs.
Line 1-4, Columns (c) through (g.)
For new applications, leave Columns (c) and (d) blank. For each
line entry in Columns (a) and (b), enter in Columns (e), (f), and
(g) the appropriate amounts of funds needed to support the project
for the first funding period (usually a year).
For continuing grant program applications, submit these forms
before the end of each funding period as required by the grantor
agency. Enter in Columns (c) and (d) the estimated amounts of funds
which will remain unobligated at the end of the grant funding period
only if the Federal grantor agency instructions provide for this.
Otherwise, leave these columns blank. Enter in columns (e) and (f)
the amounts of funds needed for the upcoming period. The amount(s)
in Column (g) should be the sum of amounts in Columns (e) and (f).
For supplemental grants and changes to existing grants do not
use Columns (c) and (d). Enter in Column (e) the amount of the
increase or decrease of Federal funds and enter in Column (f) the
amount of the increase or decrease of non-Federal funds. In Column
(g) enter the new total budgeted amount (Federal and non-Federal)
which includes the total previous authorized budgeted amounts plus
or minus, as appropriate, the amounts shown in columns (e) and (f).
The amount(s) in Column (g) should not equal the sum of amounts in
Columns (e) and (f).
Line 5
Show the totals for all columns used.
Section B Budget Categories
In the column headings (1) through (4), enter the titles of the
same programs, functions, and activities shown on Lines 1-4, Column
(a), Section A. When additional sheets are prepared for Section A,
provide similar column headings on each sheet. For each program,
function or activity, fill in the total requirements for funds (both
Federal and non-Federal) by object class categories.
Line 6a-i
Show the totals of Lines 6a to 6h in each column.
Line 6j
Show the amount of indirect cost.
Line 6k
Enter the total of amounts on Lines 6i and 6j. For all
applications for new grants and continuation grants the total amount
in column (5), Line 6k, should be the same as the total amount shown
in Section A, Column (g), Line 5. For supplemental grants and
changes to grants, the total amount of the increase or decrease as
shown in columns (1)-(4), Line 6k should be the same as the sum of
the amounts in Section A, Columns (e) and (f) on Line 5.
Line 7
Enter the estimated amount of income, if any, expected to be
generated from this project. Do not add or subtract this amount from
the total project amount. Show under the program narrative statement
the nature and source of income. The estimated amount of program
income may be considered by the federal grantor agency in
determining the total amount of the grant.
Section C. Non-Federal-Resources
Lines 8-11
Enter amounts of non-Federal resources that will be used on the
grant. If in-kind contributions are included, provide a brief
explanation on a separate sheet.
Column (a)--Enter the program titles identical to Column (a),
Section A. A breakdown by function or activity is not necessary.
Column (b)--Enter the contribution to be made by the applicant.
Column (c)--Enter the amount of the State's cash and in-kind
contribution if the applicant is not a State or State agency.
Applicants which are a State or State agencies should leave this
column blank.
Column (d)--Enter the amount of cash and in-kind contributions
to be made from all other sources.
Column (e)--Enter totals of Columns (b), (c), and (d).
Line 12
Enter the total for each of Columns (b)-(e). The amount in
Column (e) should be equal to the amount on Line 5, Column (f),
Section A.
Section D. Forecasted Cash Needs
Line 13
Enter the amount of cash needed by quarter from the grantor
agency during the first year.
Line 14
Enter the amount of cash from all other sources needed by
quarter during the first year.
Line 15
Enter the totals of amounts on Lines 13 and 14.
Section E. Budget Estimates of Federal Funds Needed for Balance of
the Project
Lines 16-19
Enter in Column (a) the same grant program titles shown in
Column (a), Section A. A breakdown by function or activity is not
necessary. For new applications and continuation grant applications,
enter in the proper columns amounts of Federal funds which will be
needed to complete the program or project over the succeeding
funding periods (usually in years). This section need not be
completed for revisions (amendments, changes, or supplements) to
funds for the current year of existing grants.
If more than four lines are needed to list the program titles,
submit additional schedules as necessary.
Line 20
Enter the total for each of the Columns (b)-(e). When additional
schedules are prepared for this Section, annotate accordingly and
show the overall totals on this line.
Section F. Other Budget Information
Line 21
Use this space to explain amounts for individual direct object-
class cost categories that may appear to be out of the ordinary or
to explain the details as required by the Federal grantor agency.
Line 22
Enter the type of indirect rate (provisional, predetermined,
final or fixed) that will be in effect during the funding period,
the estimated amount of the base to which the rate is applied, and
the total indirect expense.
Line 23
Provide any other explanations or comments deemed necessary.
Attachment D
ASSURANCES--NON-CONSTRUCTION PROGRAMS
Note: Certain of these assurances may not be applicable to your
project or program. If you have questions, please contact the
awarding agency. Further, certain Federal awarding agencies may
require applicants to certify to additional assurances. If such is
the case, you will be notified.
As the duly authorized representative of the applicant I certify
that the applicant:
1. Has the legal authority to apply for Federal assistance, and
the institutional, managerial and financial capability (including
funds sufficient to pay the non-Federal share of project costs) to
ensure proper planning, management and completion of the project
described in this application.
2. Will give the awarding agency, the Comptroller General of the
United States, and if appropriate, the State, through any authorized
representative, access to and the right to examine all records,
books, papers, or documents related to the award; and will establish
a proper accounting system in accordance with generally accepted
accounting standards or agency directives.
3. Will establish safeguards to prohibit employees from using
their positions for a purpose that constitutes or presents the
appearance of personal or organizational conflict of interest, or
personal gain.
4. Will initiate and complete the work within the applicable
time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970
(42 U.S.C. Secs. 4728-4763) relating to prescribed standards for
merit systems for programs funded under one of the nineteen statutes
or regulations specified in Appendix A of OPM's Standards for a
Merit System of Personnel Administration (5 CFR 900, Subpart F).
6. Will comply with all Federal statutes relating to
nondiscrimination. These include but are not limited to: (a) Title
VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits
discrimination on the basis of race, color or national origin; (b)
Title IX of the Education Amendments of 1972, as amended (20 U.S.C.
Secs. 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. Sec. 794), which prohibits discrimination on
the basis of handicaps; (d) the Age Discrimination Act of 1975, as
amended (42 U.S.C. Secs. 6101-6107), which prohibits discrimination
on the basis of age; (e) the Drug Abuse Office and Treatment Act of
1972 (P.L. 92-255), as amended, relating to nondiscrimination on the
basis of drug abuse; (f) the Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation Act of 1970
(P.L. 91-616), as amended, relating to nondiscrimination on the
basis of alcohol abuse or alcoholism; (g) Secs. 523 and 527 of the
Public Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee-3),
as amended, relating to confidentiality of alcohol and drug abuse
patient records; (h) Title VIII of the Civil Rights Act of 1968 (42
U.S.C. Sec. 3601 et seq.), as amended, relating to nondiscrimination
in the sale, rental or financing of housing; (i) any other
nondiscrimination provisions in the specific statute(s) under which
application for Federal assistance is being made; and (j) the
requirements of any other nondiscrimination statute(s) which may
apply to the application.
7. Will comply, or has already complied, with the requirements
of Titles II and III of the Uniform Relocation Assistance and Real
Property Acquisition Policies Act of 1970 (P.L. 91-646) which
provide for fair and equitable treatment of persons displaced or
whose property is acquired as a result of Federal or federally
assisted programs. These requirements apply to all interests in real
property acquired for project purposes regardless of Federal
participation in purchases.
8. Will comply with the provisions of the Hatch Act (5 U.S.C.
Secs. 1501-1508 and 7324-7328) which limit the political activities
of employees whose principal employment activities are funded in
whole or in part with Federal funds.
9. Will comply, as applicable, with the provisions of the Davis-
Bacon Act (40 U.S.C. Secs. 276a to 276a-7), the Copeland Act (40
U.S.C. Sec. 276c and 18 U.S.C. Sec. 874), and the Contract Work
Hours and Safety Standards Act (40 U.S.C. Secs. 327-333), regarding
labor standards for federally assisted construction subagreements.
10. Will comply, if applicable, with flood insurance purchase
requirements of Section 102(a) of the Flood Disaster Protection Act
of 1973 (P.L. 93-234) which requires recipients in a special flood
hazard area to participate in the program and to purchase flood
insurance if the total cost of insurable construction and
acquisition is $10,000 or more.
11. Will comply with environmental standards which may be
prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National
Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order
(EO) 11514; (b) notification of violating facilities pursuant to EO
11738; (c) protection of wetlands pursuant to EO 11990; (d)
evaluation of flood hazards in floodplains in accordance with EO
11988; (e) assurance of project consistency with the approved State
management program developed under the Coastal Zone Management Act
of 1972 (16 U.S.C. Secs. 1451 et seq.); (f) conformity of Federal
actions to State (Clear Air) Implementation Plans under Section
176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. Sec. 7401
et seq.); (g) protection of underground sources of drinking water
under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-
523); and (h) protection of endangered species under the Endangered
Species Act of 1973, as amended, (P.L. 93-205).
12. Will comply with the Wild and Scenic Rivers Act of 1968 (16
U.S.C. Secs. 1271 et seq.) related to protecting components or
potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with
Section 106 of the National Historic Preservation Act of 1966, as
amended (16 U.S.C. 470), EO 11593 (identification and protection of
historic properties), and the Archaeological and Historic
Preservation Act of 1974 (16 U.S.C. 469a-1 et seq.).
14. Will comply with P.L. 93-348 regarding the protection of
human subjects involved in research, development, and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966
(P.L. 89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the
care, handling, and treatment of warm blooded animals held for
research, teaching, or other activities supported by this award of
assistance.
16. Will comply with the Lead-Based Paint Poisoning Prevention
Act (42 U.S.C. Secs. 4801 et seq.) which prohibits the use of lead
based paint in construction or rehabilitation of residence
structures.
17. Will cause to be performed the required financial and
compliance audits in accordance with the Single Audit Act of 1984.
18. Will comply with all applicable requirements of all other
Federal laws, executive orders, regulations and policies governing
this program.
Signature of authorized certifying official: ________
Title: ________________
Applicant organization: __________
Date submitted: __________
BILLING CODE 4184-01-C
Attachment E
TN08DE94.003
TN08DE94.004
BILLING CODE 4184-01-C
Attachment F
Certification Regarding Debarment, Suspension, and Other Responsibility
Matters--Primary Covered Transactions
By signing and submitting this proposal, the applicant, defined as
the primary participant in accordance with 45 CFR Part 76, certifies to
the best of its knowledge and believe that it and its principals:
(a) are not presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from covered transactions
by any Federal Department or agency;
(b) have not within a 3-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 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 3-year period preceding this application/
proposal had one or more public transactions (Federal, State, or local)
terminated for cause or default.
The inability of a person to provide the certification required
above will not necessarily result in denial of participation in this
covered transaction. If necessary, the prospective participant shall
submit an explanation of why it cannot provide the certification. The
certification or explanation will be considered in connection with the
Department of Health and Human Services (HHS) 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.
The prospective primary participant agrees that by submitting this
proposal, it will include the clause entitled ``Certification Regarding
Debarment, Suspension, Ineligibility, and Voluntary Exclusion--Lower
Tier Covered Transaction.'' provided below without modification in all
lower tier covered transactions and in all solicitations for lower tier
covered transactions.
Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion--Lower Tier Covered Transactions (To Be Supplied to
Lower Tier Participants)
By signing and submitting this lower tier proposal, the prospective
lower tier participant, as defined in 45 CFR Part 76, certifies to the
best of its knowledge and belief that it and its principals:
(a) are not presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from participation in this
transaction by any federal department or agency.
(b) where the prospective lower tier participant is unable to
certify to any of the above, such prospective participant shall attach
an explanation to this proposal.
The prospective lower tier participant further agrees by submitting
this proposal that it will include this clause entitled ``certification
Regarding Debarment, Suspension, Ineligibility, and Voluntary
Exclusion--Lower Tier Covered Transactions. ``without modification in
all lower tier covered transactions and in all solicitations for lower
tier covered transactions.
Attachment G
Executive Order 12372--State Single Points of Contact
Arizona
Mrs. Janice Dunn, ATTN: Arizona State Clearinghouse, 3800 N. Central
Avenue, 14th Floor, Phoenix, Arizona 85012, Telephone (602) 280-1315
Arkansas
Tracie L. Copeland, Manager, State Clearinghouse, Office of
Intergovernmental Services, Department of Finance and Administration,
P.O. Box 3278, Little Rock, Arkansas 72203, Telephone (501) 682-1074
California
Glenn Stober, Grants Coordinator, Office of Planning and Research, 1400
Tenth Street, Sacramento, California 95814, Telephone (916) 323-7480
Delaware
Ms. Francine Booth, State Single Point of Contact, Executive
Department, Thomas Collins Building, Dover, Delaware 19903, Telephone
(302) 736-3326
District of Columbia
Rodney T. Hallman, State Single Point of Contact, Office of Grants
Management and Development, 717 14th Street, N.W., Suite 500,
Washington, D.C. 20005, Telephone (202) 727-6551
Florida
Florida State Clearinghouse, Intergovernmental Affairs Policy Unit,
Executive Office of the Governor, Office of Planning and Budgeting, The
Capitol, Tallahassee, Florida 32399-0001, Telephone (904) 488-8441
Georgia
Mr. Charles H. Badger, Administrator, Georgia State Clearinghouse, 254
Washington Street, S.W., Atlanta, Georgia 30334, Telephone (404) 656-
3855
Illinois
Steve Klokkenga, State Single Point of Contact, Office of Governor, 107
Stratton Building, Springfield, Illinois 62706, Telephone (217) 782-
1671
Indiana
Jean S. Blackwell, Budget Director, State Budget Agency, 212 State
House, Indianapolis, Indiana 46204, Telephone (317) 232-5610
Iowa
Mr. Steven R. McCann, Division of Community Progress, Iowa Department
of Economic Development, 200 East Grand Avenue, Des Moines, Iowa 50309,
Telephone (515) 281-3725
Kentucky
Ronald W. Cook, Office of the Governor, Department of Local Government,
1024 Capitol Center Drive, Frankfort, Kentucky 40601, Telephone (502)
564-2382
Maine
Ms. Joyce Benson, State Planning Office, State House Station #38,
Augusta, Maine 04333, Telephone (207) 289-3261
Maryland
Ms. Mary Abrams, Chief, Maryland State Clearinghouse, Department of
State Planning, 301 West Preston Street, Baltimore, Maryland 21201-
2365, Telephone (301) 225-4490
Massachusetts
Karen Arone, State Clearinghouse, Executive Office of Communities and
Development, 100 Cambridge Street, Room 1803, Boston, Massachusetts
02202, Telephone (617) 727-7001
Michigan
Richard S. Pastula, Director, Michigan Department of Commerce, Lansing,
Michigan 48909, Telephone (517) 373-7356
Mississippi
Ms. Cathy Mallette, Clearinghouse Officer, Office of Federal Grant
Management and Reporting, 301 West Pearl Street, Jackson, Mississippi
39203, Telephone (601) 960-2174
Missouri
Ms. Lois Pohl, Federal Assistance Clearinghouse, Office of
Administration, P.O. Box 809, Room 430, Truman Building, Jefferson
City, Missouri 65102, Telephone (314) 751-4834
Nevada
Department of Administration, State Clearinghouse, Capitol Complex,
Carson City, Nevada 89710, Telephone (702) 687-4065, Attention: Ron
Sparks, Clearinghouse Coordinator
New Hampshire
Mr. Jeffrey H. Taylor, Director, New Hampshire Office of State
Planning, Attn: Intergovernmental Review, Process/James E. Bieber, 2\1/
2\ Beacon Street, Concord, New Hampshire 03301, Telephone (603) 271-
2155
New Jersey
Gregory W. Adkins, Acting Director, Division of Community Resources,
N.J. Department of Community Affairs, Trenton, New Jersey 08625-0803,
Telephone (609) 292-6613. Please direct correspondence and questions
to: Andrew J. Jaskolka, State Review Process, Division of Community
Resources, CN 814, Room 609, Trenton, New Jersey 08625-0803, Telephone
(609) 292-9025
New Mexico
George Elliott, Deputy Director, State Budget Division, Room 190,
Bataan Memorial Building, Santa Fe, New Mexico 87503, Telephone (505)
827-3640, FAX (505) 827-3006
New York
New York State Clearinghouse, Division of the Budget, State Capitol,
Albany, New York 12224, Telephone (518) 474-1605
North Carolina
Mrs. Chrys Baggett, Director, Office of the Secretary of Admin., N.C.
State Clearinghouse, 116 W. Jones Street, Raleigh, North Carolina
27603-8003, Telephone (919) 733-7232
North Dakota
N.D. Single Point of Contact, Office of Intergovernmental Assistance,
Office of Management and Budget, 600 East Boulevard Avenue, Bismarck,
North Dakota 58505-0170, Telephone (701) 224-2094
Ohio
Larry Weaver, State Single Point of Contact, State/Federal Funds
Coordinator, State Clearinghouse, Office of Budget and Management, 30
East Broad Street, 34th Floor, Columbus, Ohio 43266-0411, Telephone
(614) 466-0698
Rhode Island
Mr. Daniel W. Varin, Associate Director, Statewide Planning Program,
Department of Administration, Division of Planning, 265 Melrose Street,
Providence, Rhode Island 02907, Telephone (401) 277-2656. Please direct
correspondence and questions to: Review Coordinator, Office of
Strategic Planning
South Carolina
Omeagia Burgess, State Single Point of Contact, Grant Services, Office
of the Governor, 1205 Pendleton Street, Room 477, Columbia, South
Carolina 29201, Telephone (803) 734-0494
Tennessee
Mr. Charles Brown, State Single Point of Contact, State Planning
Office, 500 Charlotte Avenue, 309 John Sevier Building, Nashville,
Tennessee 37219, Telephone (615) 741-1676
Texas
Mr. Thomas Adams, Governor's Office of Budget and Planning, P.O. Box
12428, Austin, Texas 78711, Telephone (512) 463-1778
Utah
Utah State Clearinghouse, Office of Planning and Budget, ATTN; Carolyn
Wright, Room 116 State Capitol, Salt Lake City, Utah 84114, Telephone
(810) 538-1535
Vermont
Mr. Bernard D. Johnson, Assistant Director, Office of Policy Research &
Coordination, Pavilion Office Building, 109 State Street, Montpelier,
Vermont 05602, Telephone (801) 828-3326
West Virginia
Mr. Fred Cutlip, Director, Community Development Division, West
Virginia Development Office, Building #6, Room 553, Charleston, West
Virginia 25305, Telephone (304) 348-4010
Wisconsin
Mr. William C. Carey, Federal/State Relations, Wisconsin Department of
Administration, 101 South Webster Street, P.O. Box 7864, Madison,
Wisconsin 53707, Telephone (608) 266-0267
Wyoming
Sheryl Jeffries, State Single Point of Contact, Herschler Building, 4th
Floor, East Wing, Cheyenne, Wyoming 82002, Telephone (307) 777-7574
Guam
Mr. Michael J. Reidy, Director, Bureau of Budget and Management
Research, Office of the Governor, P.O. Box 2950, Agana, Guam 96910,
Telephone (671) 472-2285
Northern Mariana Islands
State Single Point of Contact, Planning and Budget Office, Office of
the Governor. Saipan, CM, Northern Mariana Islands 96950
Puerto Rico
Norma Burgos/Jose H. Caro, Chairman/Director, Puerto Rico Planning
Board, Minillas Government Center, P.O. Box 41119, San Juan, Puerto
Rico 00940-9985, Telephone (809) 727-4444
Virgin Islands
Jose L. George, Director, Office of Management and Budget, #41
Norregade Emancipation Garden Station, Second Floor, Saint Thomas,
Virgin Islands, 00802, Please direct correspondence to: Linda Clarke,
Telephone (809) 774-0750
Attachment H
Certification Regarding Lobbying
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 then 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 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 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 subawards at
all tiers (including subcontracts, subgrants, and contracts under
grants, 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 or not less than $10,000 and not more than
$100,000 for each such failure.
State for Loan Guarantee and Loan Insurance
The undersigned states to the best of his or her knowledge and
belief, that:
If any funds have been 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 commitment providing for the
United States to insure or guarantee a loan, the undersigned shall
complete and submit Standard Form-LLL, ``Disclosure Form to Report
Lobbying,'' in accordance with its instructions.
Submission of this statement 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 statement shall be
subject to a civil penalty or not less than $10,000 and not more than
$100,000 for each such failure.
----------------------------------------------------------------------
Signature
----------------------------------------------------------------------
Title
----------------------------------------------------------------------
Organization
----------------------------------------------------------------------
----------------------------------------------------------------------
Date
BILLING CODE 4184-01-P
TN08DE94.005
BILLING CODE 4184-01-C
Attachment I
The following DHHS regulations apply to all applicants/grantees
under the National Youth Sports Program:
Title 45 of the Code of Federal Regulations
Part 16--Procedures of the Departmental Grant Appeals Board
Part 74--Administration of Grants (non-governmental)
Part 74--Administration of Grants (state and local governments and
Indian Tribal affiliates):
Sections 74.62(a) Non-Federal Audits
74.173 Hospitals
74.174(b) Other Nonprofit Organizations
74.304 Final Decisions in Disputes
74.710 Real Property, Equipment and Supplies
74.715 General Program Income
Part 75--Informal Grant Appeal Procedures
Part 76--Debarment and Suspension form Eligibility for Financial
Assistance
Subpart F--Drug Free Workplace Requirements
Part 80--Non-discrimination Under Programs Receiving Federal Assistance
through the Department of Health and Human Services--Effectuation of
Title VI of the Civil Rights Act of 1964
Part 81--Practice and Procedures for hearings under Part 80 of this
Title
Part 84--Non-discrimination on the Basis of Handicap in Programs
Part 86--Nondiscrimination on the basis of sex in the admission of
individuals to training programs
Part 91--Non-discrimination on the Basis of Age in Health and Human
Services Programs or Activities Receiving Federal Financial Assistance
Part 92--Uniform Administrative Requirements for Grants and Cooperative
Agreements to States and Local Governments Federal Register, March 11,
1988)
Part 93--New Restrictions on Lobbying
Part 100--Intergovernmental Review of Department of Health and Human
Services Programs and Activities
[FR Doc. 94-30139 Filed 12-7-94; 8:45 am]
BILLING CODE 4184-01-P
