[Federal Register Volume 62, Number 42 (Tuesday, March 4, 1997)]
[Notices]
[Pages 9773-9793]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-5300]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
[Program Announcement No. OCS-97-02]
Request for Applications Under the Office of Community Services'
Fiscal Year 1997 National Youth Sports Program
AGENCY: Office of Community Services, ACF, DHHS.
ACTION: Request for applications under the Office of Community
Services' National Youth Sports Program.
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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
[[Page 9774]]
amended. This Program Announcement contains forms and instructions for
submitting an application.
For Fiscal Years 1998-2001 the National Youth Sport Program would
become a non-competing continuation grant. This means that once the
Fiscal Year 1997 grantee has been selected the continuation grant
funded under this award beyond the first one year budget period, will
be entertained in subsequent years on a non-competitive basis, subject
to availability of funds, satisfactory progress of the grantee, and a
determination that continued funding would be in the best interest of
the Government. The National Youth Sports Program will be announced
again in Fiscal Year 2002.
CLOSING DATE: The closing date and time for receipt of applications is
4:30 p.m., eastern time zone, on May 5, 1997. Applications received
after 4:30 p.m. will be classified as late. Postmarks and other similar
documents do not establish receipt of an application. Detailed
application submission instructions including the addresses where
applications must be received are found in Part G.1. of this
announcement.
CONTACT: Joseph R. Carroll, Acting 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) 401-9354.
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. Catalog of Federal Domestic Assistance
The Catalog of Federal Domestic Assistance number for OCS programs
covered under this announcement is 93.570. The title is ``CSBG
Discretionary Awards.''
3. 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 Applicant: 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 3. 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 currently valid IRS tax exemption
certification, or 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
In Fiscal Year 1997, OCS anticipates that one grant will be made
under this program. For Fiscal Years 1998-2001, OCS anticipates,
subject to the availability of funds, that one grant will be made under
this program.
b. Grant Amounts
Estimated twelve million dollars ($12,000,000) is available for
Fiscal Year 1997. For Fiscal Years 1998-2001, the estimated amounts of
($12,000,000) are subject to final appropriation.
c. Matching Requirements
The grants require a match of either cash or third party in-kind of
one dollar for each dollar awarded up to $9,400,000 and a cash match of
25% of the Federal funds requested in excess of $9,400,000.
3. Project Period and Budget Period
The project period must not exceed 60 months (5 years), with a
budget period not to exceed 12 months. A significant amount of the
program activities must be undertaken in the period covering June, July
and August of each fiscal year.
4. Administrative Costs/Indirect Costs
No federal 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. No
other government agency or privately defined poverty guidelines are
applicable to the determination of low-income eligibility for this OCS
program.
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.
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 drug and alcohol abuse.
2. Project Requirements
Any instructional activity carried out by an eligible service
provider receiving
[[Page 9775]]
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 D.
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. 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 drug and 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
See Application Forms in Attachment B.
1. Contents of Application
Each application package should include one original and two
additional copies of the following:
a. A signed Federal Assistance Application (SF-424)
b. A signed Budget Information Non-construction Program (SF-424A)
c. A signed Assurances--Non-construction Programs (SF-424B)
d. A signed Disclosure of Lobbying Activities
e. 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 (Part B).
(ii) Number and location of Institutions of Higher Education
committed to the program and their accessibility to youth from
economically disadvantaged areas (Part C).
[[Page 9776]]
(iii) Organization experience and staff responsibilities (Part D).
(iv) Executive Summary--one page or less (Part D).
(v) Work Program (Part D).
(vi) 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 and
Environmental Tobacco Smoke.
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
If an acknowledgement and/or notice is not received within three
weeks after the deadline date, please notify ACF by telephone (202)
401-9365.
Part F--Instructions for Completing Application Package
See Application Forms in Attachment B.
Section A--Indirect Cost Rates
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.
Section B--Non-Federal Resources
Mobilized funds from other non-Federal resources should be listed
on a separate sheet and describe whether it is a grantee-incurred cost
or a third-party in-kind contribution.
Part G--Application Procedures
Section A--See Application Forms in Attachment B
1. Application Submission
The date by which applications must be received is indicated under
``Closing Date'' at the beginning of this announcement.
Deadline: Mailed applications shall be considered as meeting an
announced deadline if they are received on or before the deadline time
and date at the U.S. Department of Health and Human Services,
Administration for Children and Families, Division of Discretionary
Grants, 370 L'Enfant Promenade, S.W., Mail Stop 6C-462, Washington,
D.C. 20447, Attention: Application for National Youth Sports Program.
Applicants are responsible for mailing applications well in advance,
when using all mail services, to ensure that the applications are
received on or before the deadline time and date.
Applications handcarried by applicants, applicant couriers, or by
overnight/express mail couriers shall be considered as meeting an
announced deadline if they are received on or before the deadline date,
between the hours of 8:00 a.m. and 4:30 p.m., at the U.S. Department of
Health and Human Services, Administration for Children and Families,
Division of Discretionary Grant, 901 ``D'' Street, S.W., ACF Mailroom,
Second Floor, Washington, D.C. 20024, between Monday and Friday
(excluding Federal holidays). (Applicants are cautioned that express/
overnight mail services do not always deliver as agreed.)
ACF cannot accommodate transmission of applications by fax or
through other electronic media. Therefore, applications transmitted to
ACF electronically will not be accepted regardless of Date or Time of
submission and time of receipt.
2. Late Application and Extension of Deadlines
Applications which do not meet the criteria above are considered
late applications. ACF shall notify each late applicant that its
application will not be considered in the current competition.
ACF may extend the deadline for all applicants because of acts of
God such as floods, hurricanes, etc., widespread disruption of the
mails, or when it is anticipated that many of the applications will
come from rural or remote areas. However, if ACF does not extend the
deadline for all applicants, it may not waive or extend the deadline
for any applicants.
3. Paperwork Reduction Act of 1995
The Paperwork Reduction Act of 1995, Public Law 104-13, the
Department is required to submit to OMB for review and approval any
reporting and recordkeeping requirements in regulations, including
program announcements. This program announcement does not contain
information collection requirements beyond those approved for ACF grant
applications under OMB Control Number 0970-0139.
4. Project Development (Intergovernmental Review)
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, American Samoa,
Colorado, Connecticut, Kansas, Hawaii, Idaho, Louisiana, Massachusetts,
Minnesota, Montana, Nebraska, New Jersey, Oklahoma, Oregon, Palau,
Pennsylvania, South Dakota, Tennessee, Vermont, Virginia, and
Washington have elected to participate in the Executive Order process
and have established Single Points of Contacts (SPOCs). Applicants from
these twenty-three 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
[[Page 9777]]
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.
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 Attachment C of this announcement.
Section B--Information Not Available
1. Availability of Forms
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
For Fiscal Years 1998-2001 the grantee will be notified of the
requirements for submission of the continuation application by March of
the current fiscal year.
3. 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.
4. Criteria for Reviewing 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 A 2.
(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 the
estimated amount of $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 prerating 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 for use in
the project period, 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 A-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.
Dated: February 26, 1997.
Donald Sykes,
Director, Office of Community Services.
[[Page 9778]]
Attachment A
------------------------------------------------------------------------
Poverty
Size of family unit guidelines
------------------------------------------------------------------------
1996 Poverty Income Guidelines for the 48 Contiguous States and District
of Columbia
1 $7,740
2........................................................... 10,360
3........................................................... 12,980
4........................................................... 15,600
5........................................................... 18,220
6........................................................... 20,840
7........................................................... 23,460
8........................................................... 26,080
For family units with more than 8 members, add $2,226 for each
additional member. (The same increment applies to smaller family sizes
also, as can be seen in the figures above.)
------------------------------------------------------------------------
1996 Poverty Income Guidelines for Alaska
------------------------------------------------------------------------
1........................................................... $9,660
2........................................................... 12,940
3........................................................... 16,220
4........................................................... 19,500
5........................................................... 22,780
6........................................................... 26,060
7........................................................... 29,340
8........................................................... 32,620
For family units with more than 8 members, add $3,280 for each
additional member. (The same increment applies to smaller family sizes
also, as can be seen in the figures above.)
1........................................................... $9,660
2........................................................... 12,940
3........................................................... 16,220
4........................................................... 19,500
5........................................................... 22,780
6........................................................... 26,060
7........................................................... 29,340
8........................................................... 32,620
For family units with more than 8 members, add $3,280 for each
additional member. (The same increment applies to smaller family sizes
also, as can be seen in the figures above.)
------------------------------------------------------------------------
BILLING CODE 4184-04-P
[[Page 9779]]
Attachment B
[GRAPHIC] [TIFF OMITTED] TN04MR97.003
BILLING CODE 4184-01-C
[[Page 9780]]
Instructions for the SF 424
This 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.
Item and Entry
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 this 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).
13. 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
[[Page 9781]]
[GRAPHIC] [TIFF OMITTED] TN04MR97.004
[[Page 9782]]
[GRAPHIC] [TIFF OMITTED] TN04MR97.005
BILLING CODE 4184-01-C
[[Page 9783]]
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.
Lines 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 to 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.
Lines 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), Link 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.
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,
[[Page 9784]]
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 C.F.R. 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. 372-333), 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. 92-190) 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
Program Narrative
This program narrative section was designed for use by many and
varied programs. Consequently, it is not possible to provide
specific guidance for developing a program narrative statement that
would be appropriate in all cases. Applicants must refer the
relevant program announcement for information on specific program
requirements and any additional guidelines for preparing the program
narrative statement. The following are general guidelines for
preparing a program narrative statement.
The program narrative provides a major means by which the
application is evaluated and ranked to compete with other
applications for available assistance. It should be concise and
complete and should address the activity for which Federal funds are
requested. Supporting documents should be included where they can
present information clearly and succinctly. Applicants are
encouraged to provide information on their organizational structure,
staff, related experience, and other information considered to be
relevant. Awarding offices use this and other information to
determine whether the applicant has the capability and resources
necessary to carry out the proposed project. It is important,
therefore, that this information be included in the application.
However, in the narrative the applicant must distinguish between
resources directly related to the proposed project from those which
will not be used in support of the specific project for which funds
are requested.
Cross-referencing should be used rather than repetition. ACF is
particularly interested in specific factual information and
statements of measurable goals in quantitative terms. Narratives are
evaluated on the basis of substance, not length. Extensive exhibits
are not required. (Supporting information concerning activities
which will not be directly funded by the grant or information which
does not directly pertain to an integral part of the grant funded
activity should be placed in an appendix.) Pages should be numbered
for easy reference.
Prepare the program narrative statement in accordance with the
following instructions:
Applicants submitting new applications or competing
continuation applications should respond to Items A and D.
Applicants submitting noncompeting continuation
applications should respond to Item B.
Applicants requesting supplemental assistance should
respond to Item C.
[[Page 9785]]
A. Project Description--Components
1. Project Summary/Abstract
A summary of the project description (usually a page or less)
with reference to the funding request should be placed directly
behind the table of contents or SF-424.
2. Objectives and Need for Assistance
Applicants must clearly identify the physical, economic, social,
financial, institutional, or other problem(s) requiring a solution.
The need for assistance must be demonstrated and the principal and
subordinate objectives of the project must be clearly stated;
supporting documentation such as letters of support and testimonials
from concerned interests other than the applicant may be included.
Any relevant data based on planning studies should be included or
referenced in the endnotes/footnotes. Incorporate demographic data
and participant/beneficiary information, as needed. In developing
the narrative, the applicant may volunteer or be requested to
provide information on the total range of projects currently
conducted and supported (or to be initiated), some of which may be
outside the scope of the program announcement.
3. Results or Benefits Expected
Identify results and benefits to be derived. For example, when
applying for a grant to establish a neighborhood child care center,
describe who will occupy the facility, who will use the facility,
how the facility will be used, and how the facility will benefit the
community which it will serve.
4. Approach
Outline a plan of action which describes the scope and detail of
how the proposed work will be accomplished. Account for all
functions or activities identified in the application. Cite factors
which might accelerate or decelerate the work and state your reason
for taking this approach rather than others. Describe any unusual
features of the project such as design or technological innovations,
reductions in cost or time, or extraordinary social and community
involvement.
Provide quantitative monthly or quarterly projections of the
accomplishments to be achieved for each function or activity in such
terms as the number of people to be served and the number of
microloans made. When accomplishments cannot be quantified by
activity or function, list them in chronological order to show the
schedule of accomplishments and their target dates.
Identify the kinds of data to be collected, maintained, and/or
disseminated. (Note that clearance from the U.S. Office of
Management and Budget might be needed prior to an information
collection.) List organizations, cooperating entities, consultants,
or other key individuals who will work on the project along with a
short description of the nature of their effort or contribution.
5. Evaluation
Provide a narrative addressing how you will evaluate 1) the
results of your project and 2) the conduct of your program. In
addressing the evaluation of results, state how you will determine
the extent to which the program has achieved its stated objectives
and the extent to which the accomplishment of objectives can be
attributed to the program. Discuss the criteria to be used to
evaluate results; explain the methodology that will be used to
determine if the needs identified and discussed are being met and if
the project results and benefits are being achieved. With respect to
the conduct of your program, define the procedures you will employ
to determine whether the program is being conducted in a manner
consistent with the work plan you presented and discuss the impact
of the program's various activities upon the program's
effectiveness.
6. Geographic Location
Give the precise location of the project and boundaries of the
area to be served by the proposed project. Maps or other graphic
aids may be attached.
7. Additional Information (Include if applicable)
Additional information may be provided in the body of the
program narrative or in the appendix. Refer to the program
announcement and ``General Information and Instructions'' for
guidance on placement of application materials.
Staff and Position Data--Provide a biographical sketch for key
personnel appointed and a job description for each vacant key
position. Some programs require both for all positions. Refer to the
program announcement for guidance on presenting this information.
Generally, a biographical sketch is required for original staff and
new members as appointed.
Plan for Project Continuance Beyond Grant Support--A plan for
securing resources and continuing project activities after Federal
assistance has ceased.
Business Plan--When federal grant funds will be used to make an
equity investment, provide a business plan. Refer to the program
announcement for guidance on presenting this information.
Organization Profiles--Information on applicant organizations
and their cooperating partners such as organization charts,
financial statements, audit reports or statements from CPA/Licensed
Public Accountant, Employer Identification Numbers, names of bond
carriers, contact persons and telephone numbers, child care licenses
and other documentation of professional accreditation, information
on compliance with federal/state/local government standards,
documentation of experience in program area, and other pertinent
information. Any non-profit organization submitting an application
must submit proof of its non-profit status in its application at the
time of submission. 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, or by
providing a copy of the articles of incorporation bearing the seal
of the State in which the corporation or association is domiciled.
Dessemination Plan--A plan for distributing reports and other
project outputs to colleagues and the public. Applicants must
provide a description of the kind, volume and timing of
distribution.
Third-Party Agreements--Written agreements between grantees and
subgrantees or subcontractors or other cooperating entities. These
agreements may detail scope of work, work schedules, remuneration,
and other terms and conditions that structure or define the
relationship.
Waiver Request--A statement of program requirements for which
waivers will be needed to permit the proposed project to be
conducted.
Letters of Support--Statements from community, public and
commercial leaders which support the project proposed for funding.
B. Noncompeting Continuation Applications
A program narrative usually will not be required for
noncompeting continuation applications for nonconstruction programs.
Noncompeting continuation applications shall be abbreviated unless
the ACF Program Office administering this program has issued a
notice to the grantee that a full application will be required.
An abbreviated application consists of:
1. The Standard Form 424 series (SF 424, SF 424A, SF-424B)
2. The estimated or actual unobligated balance remaining from
the previous budget period should be identified on an accurate SF-
269 as well as in Section A, Columns (c) and (d) of the SF-424A.
3. The grant budget, broken down into the object class
categories on the 424A, and if category ``other'' is used, the
specific items supported must be identified.
4. Required certifications.
A full application consists of all elements required for an
abbreviated application plus:
1. Program narrative information explaining significant changes
to the original program narrative statement, a description of
accomplishments from the prior budget period, a projection of
accomplishments throughout the entire remaining project period, and
any other supplemental information that ACF informs the grantee is
necessary.
2. A full budget proposal for the budget period under
consideration with a full cost analysis of all budget categories.
3. A corrective action plan, if requested by ACF, to address
organizational performance weaknesses.
C. Supplemental Requests
For supplemental assistance requests, explain the reason for the
request and justify the need for additional funding. Provide a
budget and budget justification only for those items for which
additional funds are requested. (See Item D for guidelines on
preparing a budget and budget justification.)
D. Budget and Budget Justification
Provide line item detail and detailed calculations for each
budget object class identified on the Budget Information form.
Detailed calculations must include estimation methods, quantities,
unit costs, and other similar quantitative detail
[[Page 9786]]
sufficient for the calculation to be duplicated. The detailed budget
must also include a breakout by the funding sources identified in
Block 15 of the SF-424.
Provide a narrative budget justification which describes how the
categorical costs are derived. Discuss the necessity,
reasonableness, and allocability of the proposed costs
The following guidelines are for preparing the budget and budget
justification. Both federal and non-federal resources should be
detailed and justified in the budget and narrative justification.
For purposes of preparing the program narrative, ``federal
resources'' refers only to the ACF grant for which you are applying.
Non-Federal resources are all other federal and non-federal
resources. It is suggested that for the budget, applicants use a
column format: Column 1, object class categories; Column 2, federal
budget amounts; Column 3, non-federal budget amounts, and Column 4,
total amounts. The budget justification should be a narrative.
Personnel. Costs of employee salaries and wages.
Justification: Identify the project director or principal
investigator, if known. For each staff person, show name/title, time
commitment to the project (in months), time commitment to the
project (as a percentage or full-time equivalent), annual salary,
grant salary, wage rates, etc. 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. Costs of employee fringe benefits unless
treated as part of an approved indirect cost rate.
Justification: Provide a breakdown of amounts and percentages
that comprise fringe benefit costs, such as health insurance, FICA,
retirement insurance, taxes, etc.
Travel. Costs of project related travel by employees of the
applicant organization (does not include costs of consultant
travel).
Justification: For each trip, show the total number of
traveler(s), travel destination, duration of trip, per diem, mileage
allowances, if privately owned vehicles will be used, and other
transportation costs and subsistence allowances. Travel costs for
key staff to attend ACF sponsored workshops as specified in this
program announcement should be detailed in the budget.
Equipment. Costs of all non-expendable, tangible personal
property to be acquired by the project where each article has a
useful life of more than one year and an acquisition cost which
equals the lesser of (a) the capitalization level established by the
applicant organization for financial statement purposes, or (b)
$5000.
Justification: For each type of equipment requested, provide a
description of the equipment, cost per unit, number of units, total
cost, and a plan for use on the project, as well as use or disposal
of the equipment after the project ends.
Supplies. Costs of all tangible personal property (supplies)
other than that included under the Equipment category.
Justification: Specify general categories of supplies and their
costs. Show computations and provide other information which
supports the amount requested.
Contractual. Costs of all contracts for services and goods
except for those which belong under other categories such as
equipment, supplies, construction, etc. Third-party evaluation
contracts (if applicable) and contracts with secondary recipient
organizations including delegate agencies and specific project(s) or
businesses to be financed by the applicant should be included under
this category.
Justification: All procurement transactions shall be conducted
in a manner to provide, to the maximum extent practical, open and
free competition. If procurement competitions were held or if a sole
source procurement is being proposed, attach a list of proposed
contractors, indicating the names of the organizations, the purposes
of the contracts, the estimated dollar amounts, and the award
selection process. Also provide back-up documentation where
necessary to support selection process.
Note: Whenever the applicant/grantee intends to delegate part of
the program to another agency, the applicant/grantee must provide a
detailed budget and budget narrative for each delegate agency by
agency title, along with the required supporting information
referenced in these instructions.
Applicants must identify and justify any anticipated procurement
that is expected to exceed the simplified purchase threshold
(currently set at $100,000) and to be awarded without competition.
Recipients are required to make available to ACF pre-award review
and procurement documents, such as request for proposals or
invitations for bids, independent cost estimates, etc. under the
conditions identified at 45 CFR Part 74.44(e).
Construction. Costs of construction by applicant or contractor.
Justication: Provide detailed budget and narrative in accordance
with instructions for other object class categories. Identity which
construction activity/costs will be contractual and which will
assumed by the applicant.
Other. Enter the total of all other costs. Such costs, where
applicable and appropriate, may include but are not limited to
insurance, food, medical and dental costs (noncontractual), fees and
travel paid directly to individual consultants, space and equipment
rentals, printing and publication, computer use, training costs,
including tuition and stipends, training service costs including
wage payments to individuals and supportive service payments, and
staff development costs.
Indirect Charges. Total amount of indirect costs. This category
should be used only when the applicant currently has an indirect
cost rate approved by the Department of Health and Human Services or
another cognizant Federal agency.
Justification: With the exception of most local government
agencies, an applicant which will charge indirect costs to the grant
must enclose a copy of the current rate agreement if the agreement
was negotiated with a cognizant Federal agency other than the
Department of Health and Human Services (DHHS). If the rate
agreement was negotiated with the Department of Health and Human
Services, the applicant should state this in the budget
justification. 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. Applicants
awaiting approval of their indirect cost proposals may also request
indirect costs. It should be noted that when an indirect cost rate
is requested, those costs included in the indirect costs pool should
not be also charged as direct costs to the grant. Also, if the
applicant is requesting a rate which is less than what is allowed
under this program announcement, the authorized representative of
your organization needs to submit a signed acknowledgement that the
applicant is accepting a lower rate than allowed.
Program Income. The estimated amount of income, if any, expected
to be generated from this project. Separately show expected program
income generated from program support and income generated from
other mobilized funds. Do not add or subtract this amount from the
budget total. Show the nature and source of income in the program
narrative statement.
Justification: Describe the nature, source and anticipated use
of program income in the budget or reference pages in the program
narrative statement which contain this information.
Non-Federal Resources. Amounts of non-Federal resources that
will be used to support the project as identified in Block 15 of the
SF-424.
Justificaiton: The firm commitment of these resources must be
documented and submitted with the application in order to be given
credit in the review process.
Total Direct Charges, Total Indirect Charges, Total Project
Costs. (self explanatory)
BILLING CODE 4184-01-P
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[GRAPHIC] [TIFF OMITTED] TN04MR97.007
BILLING CODE 4184-01-C
[[Page 9789]]
.....................................................................
Certification Regarding Debarment, Suspension, and Other Responsibility
Matters--Primary Covered Transactions
Instructions for Certification
1. By signing and submitting this proposal, the prospective
primary participant is providing the certification set out below.
2. The inability of a person to provide the certification
required below will not necessarily result in denial of
participation in this covered transaction. The prospective
participant shall submit an explanation of why it cannot provide the
certification set out below. The certification or explanation will
be considered in connection with the department or agency's
determination whether to enter into this transaction. However,
failure of the prospective primary participant to furnish a
certification or an explanation shall disqualify such person from
participation in this transaction.
3. The certification in this clause is a material representation
of fact upon which reliance was placed when the department or agency
determined to enter into this transaction. If it is later determined
that the prospective primary participant knowingly rendered an
erroneous certification, in addition to other remedies available to
the Federal Government, the department or agency may terminate this
transaction for cause or default.
4. The prospective primary participant shall provide immediate
written notice to the department or agency to which this proposal is
submitted if at any time the prospective primary participant learns
that its certification was erroneous when submitted or has become
erroneous by reason of changed circumstances.
5. The terms covered transaction, debarred, suspended,
ineligible, lower tier covered transaction, participant, person,
primary covered transaction, principal, proposal, and voluntarily
excluded, as used in this clause, have the meanings set out in the
Definitions and Coverage sections of the rules implementing
Executive Order 12549. You may contact the department or agency to
which this proposal is being submitted for assistance in obtaining a
copy of those regulations.
6. The prospective primary participant agrees by submitting this
proposal that, should the proposed covered transaction be entered
into, it shall not knowingly enter into any lower tier covered
transaction with a person who is proposed for debarment under 48 CFR
part 9, subpart 9.4, debarred, suspended, declared ineligible, or
voluntarily excluded from participation in this covered transaction,
unless authorized by the department or agency entering into this
transaction.
7. The prospective primary participant further agrees by
submitting this proposal that it will include the clause titled
``Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion--Lower Tier Covered Transaction,'' providing by
the department or agency entering into this covered transaction,
without modification, in all lower tier covered transactions and in
all solicitations for lower tier covered transactions.
8. A participant in a covered transaction may rely upon a
certification of a prospective participant in a lower tier covered
transaction that it is not proposed for debarment under 48 CFR part
9, subpart 9.4, debarred, suspended, ineligible, or voluntarily
excluded from the covered transaction, unless it knows that the
certification is erroneous. A participant may decide the method and
frequency by which is determines the eligibility of its principals.
Each participant may, but is not required to, check the List of
Parties Excluded from Federal Procurement and Nonprocurement
Programs.
9. Nothing contained in the foregoing shall be construed to
require establishment of a system of records in order to render in
good faith the certification required by this clause. The knowledge
and information of a participant is not required to exceed that
which is normally processed by a prudent person in the ordinary
course of business dealings.
10. Except for transactions authorized under paragraph 6 of
these instructions, if a participant in a covered transaction
knowingly enters into a lower tier covered transaction with a person
who is proposed for debarment under 48 CFR part 9, subpart 9.4,
suspended, debarred, ineligible, or voluntarily excluded from
participation in this transaction, in addition to other remedies
available to the Federal Government, the department or agency may
terminate this transaction for cause or default.
* * * * *
Certification Regarding Debarment, Suspension, and Other Responsibility
Matters--Primary Covered Transactions
(1) The prospective primary participant certifies to the best of
its knowledge and belief, that it and its principals:
(a) Are not presently debarred, suspended, proposed for
debarment, declared ineligible, or voluntarily excluded by any
Federal department or agency;
(b) Have not within a three-year period preceding this proposal
been convicted of or had a civil judgment rendered against them for
commission of fraud or a criminal offense in connection with
obtaining, attempting to obtain, or performing a public (Federal,
State or local) transaction or contract under a public transaction;
violation of Federal or State antitrust statutes or commission of
embezzlement, theft, forgery, bribery, falsification or destruction
of 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 participant is unable to
certify to any of the statements in this certification, such
prospective participant shall attach an explanation to this
proposal.
Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion--Lower Tier Covered Transactions
Instructions for Certification
1. By signing and submitting this proposal, the prospective
lower tier participant is providing the certification set out below.
2. The certification in this clause is a material representation
of fact upon which reliance was placed when this transaction was
entered into. If it is later determined that the prospective lower
tier participant knowingly rendered an erroneous certification, in
addition to other remedies available to the Federal Government the
department or agency with which this transaction originated may
pursue available remedies, including suspension and/or debarment.
3. The prospective lower tier participant shall provide
immediate written notice to the person to which this proposal is
submitted if at any time the prospective lower tier participant
learns that its certification was erroneous when submitted or had
become erroneous by reason of changed circumstances.
4. The terms covered transaction, debarred, suspended,
ineligible, lower tier covered transaction, participant, person,
primary covered transaction, principal, proposal, and voluntarily
excluded, as used in this clause, have the meaning set out in the
Definitions and Coverage sections of rules implementing Executive
Order 12549. You may contact the person to which 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 this clause titled
``Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion--Lower Tier Covered Transaction,'' without
modification, in all lower tier covered transactions and in all
solicitations for lower tier covered transactions.
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 covered transactions, unless it knows that the
certification is erroneous. A participant may decide the method and
frequency by which it determines the eligibility of its principals.
Each participant may, but is not required to,
[[Page 9790]]
check the List of Parties Excluded from Federal Procurement and
Nonprocurement Programs.
8. Nothing contained in the foregoing shall be construed to
require establishment of a system of records in order to render in
good faith the certification required by this clause. The knowledge
and information of a participant is not required to exceed that
which is normally possessed by a prudent person in the ordinary
course of business dealings.
9. Except for transactions authorized under paragraph 5 of these
instructions, if a participant in a covered transaction knowingly
enters into a lower tier covered transaction with a person who is
proposed for debarment under 48 CFR part 9, subpart 9.4, suspended,
debarred, ineligible, or voluntarily excluded from participation in
this transaction, in addition to other remedies available to the
Federal Government, the department or agency with which this
transaction originated may pursue available remedies, including
suspension and/or debarment.
* * * * *
Certification Regarding Debarment, Suspension, Ineligibility an
Voluntary Exclusion--Lower Tier Covered Transactions
(1) The prospective lower tier participant certifies, by
submission of this proposal, that neither it nor its principals is
presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from participation in this
transaction by any Federal department or agency.
(2) Where the prospective lower tier participant is unable to
certify to any of the statements in this certification, such
prospective participant shall attach an explanation to this
proposal.
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 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 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 of 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 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
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 require statement shall
be subject to a civil penalty of not less than $10,000 and not more
than $100,000 for each such failure.
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Signature
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Title
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Organization
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Date
BILLING CODE 4184-01-P
[[Page 9791]]
[GRAPHIC] [TIFF OMITTED] TN04MR97.008
BILLING CODE 4184-01-C
[[Page 9792]]
Certification Regarding Environmental Tobacco Smoke
Public Law 103-227, Part C--Environmental Tobacco Smoke, also
known as the Pro-Children Act of 1994 (Act), requires that smoking
not be permitted in any portion of any indoor routinely owned or
leased or contracted for by an entity and used routinely or
regularly for provision of health, day care, education, or library
services to children under the age of 18, if the services are funded
by Federal programs either directly or through State or local
governments, by Federal grant, contract, loan, or loan guarantee.
The law does not apply to children's services provided in private
residences, facilities funded solely by Medicare or Medicaid funds,
and portions of facilities used for inpatient drug or alcohol
treatment. Failure to comply with the provisions of the law may
result in the imposition of a civil monetary penalty of up to $1000
per day and/or the imposition of an administrative compliance order
on the responsible entity.
By signing and submitting this application the applicant/grantee
certifies that it will comply with the requirements of the Act. The
applicant/grantee further agrees that it will require the language
of this certification be included in any subawards which contain
provisions for the children's services and that all subgrantees
shall certify accordingly.
Attachment C--OMB State Single Point of Contact Listing
Arizona
Joni Saad, Arizona State Clearinghouse, 3800 N. Central Avenue,
Fourteenth Floor, Phoenix, Arizona 85012, Telephone (602) 280-1315,
Fax: (602) 280-8144
Arkansas
Mr. Tracy L. Copeland, Manager, State Clearinghouse, Office of
Intergovernmental Services, Department of Finance and
Administration, 1515 W. 7th St., Room 412, Little Rock, Arkansas
72203, Telephone: (501) 682-1074, Fax: (501) 682-5206
California
Grants Coordinator, Office of Planning & Research, 1400 Tenth
Street, Room 121, Sacramento, California 95814, Telephone: (916)
323-7480, Fax: (916) 323-3018
Delaware
Francine Booth, State Single Point of Contact Executive Department,
Thomas Collins Building, P.O. Box 1401, Dover, Delaware 19903,
Telephone: (302) 739-3326, Fax: (302) 739-5661
District of Columbia
Charles Nichols, State Single Point of Contact, Office of Grants
Mgmt. & Dev., 717 14th Street, N.W.--Suite 500, Washington, D.C.
20005, Telephone: (202) 727-6554, Fax: (202) 727-1617
Florida
Florida State Clearinghouse, Department of Community Affairs, 2740
Centerview Drive, Tallahassee, Florida 32399-2100, Telephone: (904)
922-5438, Fax: (904) 487-2899
Georgia
Tom L. Reid, III, Administrator, Georgia State Clearinghouse, 254
Washington Street, S.W.--Room 401J, Atlanta, Georgia 30334,
Telephone: (404) 656-3855 or (404) 656-3829, Fax: (404) 656-7938
Illinois
Virginia Bova, State Single Point of Contact, Department of Commerce
and Community Affairs, James R. Thompson Center, 100 West Randolph,
Suite 3-400, Chicago, Illinois 60601, Telephone: (312) 814-6028,
Fax: (312) 814-1800
Indiana
Amy Brewer, State Budget Agency, 212 State House, Indianapolis,
Indiana 46204, Telephone: (317) 232-5619, Fax: (317) 233-3323
Iowa
Steven R. McCann, Division for Community Assistance, Iowa Department
of Economic Development, 200 East Grand Avenue, Des Moines, Iowa
50309, Telephone: (515) 242-4719, Fax: (515) 242-4859
Kentucky
Ronald W. Cook, Office of the Governor, Department of Local
Government, 1024 Capitol Center Drive, Frankfort, Kentucky 40601-
8204, Telephone: (502) 573-2382, Fax: (502) 573-2512
Maine
Joyce Benson, State Planning office, State House Station #38,
Augusta, Maine 0433, Telephone: (207) 287-3261, Fax: (207) 287-6489
Maryland
William G. Carroll, Manager, State Clearinghouse for
Intergovernmental Assistance, Maryland Office of Planning, 301 W.
Preston Street--Room 1104, Baltimore, Maryland 21201-2365, Staff
Contact: Linda Janey, Telephone: (410) 225-4490, Fax: (410) 225-4480
Michigan
Richard Pfaff, Southeast Michigan Council of Governments, 1900
Edison Plaza, 660 Plaza Drive, Detroit, Michigan 48226, Telephone:
(313) 961-4266, Fax: (313) 961-4869
Mississippi
Cathy Malette, Clearinghouse Officer, Department of Finance and
Administration, 455 North Lamar Street, Jackson, Mississippi 39202-
3087, Telephone: (601) 359-6762, Fax: (601) 359-6764
Missouri
Lois Pohl, Federal Assistance Clearinghouse, Office of
Administration, P.O. Box 809, Room 760, Truman Building, Jefferson
City, Missouri 65102, Telephone: (314) 751-4834, Fax: (314) 751-7819
Nevada
Department of Administration, State Clearinghouse, Capitol Complex,
Carson City, Nevada 89710, Telephone: (702) 687-4065, Fax: (702)
687-3983
New Hampshire
Jeffrey H. Taylor, Director, New Hampshire Office of State Planning,
Attn: Intergovernmental Review Process, Mike Blake, 2\1/2\ Beacon
Street, Concord, New Hampshire 03301, Telephone: (603) 271-2155,
Fax: (603) 271-1728
New Mexico
Robert Peters, State Budget Division, Room 190, Bataan Memorial
Building, Santa Fe, New Mexico 87503, Telephone: (505) 827-3640
New York
New York State Clearinghouse, Division of the Budget, State Capitol,
Albany, New York 12224, Telephone: (518) 474-1605
North Carolina
Chrys Baggett, Director, N.C. State Clearinghouse, Office of the
Secretary of Admin., 116 West Jones Street, Raleigh, North Carolina
27603-8003, Telephone: (919) 733-7232, Fax: (919) 733-9571
North Dakota
North Dakota Single Point of Contact, Office of Intergovernmental
Assistance, 600 East Boulevard Avenue, Bismarck, North Dakota 58505-
0170, Telephone: (701) 224-2094, Fax: (701) 224-2308
Ohio
Larry Weaver, State Single Point of Contact, State Clearinghouse,
Office of Budget and Management, 30 East Broad Street, 34th Floor,
Columbus, Ohio 43266-0411
Please direct correspondence and questions about
intergovernmental review to: Linda Wise, Telephone: (614) 466-0698,
Fax: (614) 466-5400.
Rhode Island
Daniel W. Varin, Associate Director, Department of Administration/
Division of Planning, One Capitol Hill, 4th Floor, Providence, Rhode
Island 02908-5870, Telephone: (401) 277-2656, Fax: (401) 277-2083
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, Fax: (803) 734-0385
Texas
Tom Adams, Governors Office, Director, Intergovernmental
Coordination, P.O. Box 12428, Austin, Texas 78711, Telephone: (512)
463-1771, Fax: (512) 463-1888
Utah
Carolyn Wright, Utah State Clearinghouse, Office of Planning and
Budget, Room 116, State Capitol, Salt Lake City, Utah 84114,
Telephone: (801) 538-1535, Fax: (801) 538-1547
West Virginia
Fred Cutlip, Director, Community Development Division, W. Virginia
Development Office, Building #6, Room 553, Charleston, West Virginia
25305, Telephone: (304) 558-4010, Fax: (304) 558-3248
[[Page 9793]]
Wisconsin
Martha Kerner, Section Chief, State/Federal Relations, Wisconsin
Department of Administration, 101 East Wilson Street--6th Floor,
P.O. Box 7868, Madison, Wisconsin 53707, Telephone: (608) 266-2125,
Fax: (608) 267-6931
Wyoming
Sheryl Jeffries, State Single Point of Contact, Office of the
Governor, State Capital, Room 124, Cheyenne, Wyoming 82002,
Telephone: (307) 777-5930, Fax: (307) 632-3909
Territories
Guam
Mr. Giovanni T. Sgambellluri, Director, Bureau of Budget and
Management Research, Office of the Governor, P.O. Box 2950, Agana,
Guam 96910, Telephone: 011-671-472-2285, Fax: 011-671-472-2825
Puerto Rico
Norma Burgos/Jose E. Caro, Chairwoman/Director, Puerto Rico Planning
Board, Federal Proposals Review Office, Minillas Government Center,
P.O. Box 41119, San Juan, Puerto Rico 00940-1119, Telephone: (809)
727-4444, (809) 723-6190, Fax: (809) 724-3270, (809) 724-3103
North Mariana Islands
Mr. Alvaro A. Santos, Executive Officer, State Single Point of
Contact, Office of Management and Budget, Office of the Governor,
Saipan, MP, Telephone: (670) 664-2256, Fax: (670) 664-2272
Contact Person: Ms. Jacoba T. Seman, Federal Programs Coordinator,
Telephone: (670) 644-2289, Fax: (670) 644-2272
Virgin Islands
Jose George, Director, Office of Management and Budget, #41
Norregade Emancipation Garden Station, Second Floor, Saint Thomas,
Virgin Islands 00802
Please direct all questions and correspondence about
intergovernmental review to: Linda Clarke, Telephone: (809) 774-
0750, Fax: (809) 776-0069.
[FR Doc. 97-5300 Filed 3-3-97; 8:45 am]
BILLING CODE 4184-01-P