[Federal Register Volume 60, Number 45 (Wednesday, March 8, 1995)]
[Notices]
[Pages 12828-12858]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-5512]
[[Page 12827]]
_______________________________________________________________________
Part II
Department of Health and Human Services
_______________________________________________________________________
Administration for Children and Families
_______________________________________________________________________
Office of Community Services Fiscal Year 1995 Job Opportunities for
Low-Income Individuals Program (Demonstration Projects); Request for
Applications; Notice
Federal Register / Vol. 60, No. 45 / Wednesday, March 8, 1995 /
Notices
[[Page 12828]]
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
[Program Announcement No. OCS-95-08]
Request for Applications Under the Office of Community Services
Fiscal Year 1995 Job Opportunities for Low-Income Individuals Program
(Demonstration Projects)
AGENCY: Administration for Children and Families (ACF), DHHS.
ACTION: Announcement of availability of funds and request for
applications under the Office of Community Services' FY 1995 Job
Opportunities for Low-Income Individual Program (Demonstration
Projects).
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SUMMARY: The Administration for Children and Families (ACF), Office of
Community Services (OCS), announces that competing applications will be
accepted for new grants pursuant to the Secretary's discretionary
authority under section 505 of the Family Support Act of 1988, as
amended.
CLOSING DATES: The closing date for submission of applications is April
24, 1995.
FOR FURTHER INFORMATION CONTACT: Office of Community Services,
Administration for Children and Families, 370 L'Enfant Promenade SW.,
Washington, DC 20447, Telephone (202) 401-5282, Contact: Nolan Lewis.
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 I--Preamble
A. Legislative Authority
B. Eligible Applicants
C. Definition of Terms
D. Purpose
Part II--Program Priority Area
A. General Projects 1.0
B. Community Development Corporations Set-aside 2.0
Part III--Application Requirements
A. Background Information
1. Project and Budget Periods
2. Availability of Funds and Grant Amounts
3. Mobilization of Resources
4. Program Participants/Beneficiaries
5. Cooperative Partnership Agreement with State IV-A Agency
(JOBS Program)
6. Prohibition and Restrictions on the Use of Funds
7. Multiple Submittals
8. Continuation and Refunding
9. Third-Party Project Evaluation
10. Economic Development Strategy
11. Maintenance of Effort
Part IV--Application Review Process
A. Criteria for Review and Assessment of Applications in Priority
Areas 1.0 and 2.0
Part V--Application Procedures and Selection Process
A. Availability of Forms
B. Application Submission
C. Intergovernmental Review
D. Application Consideration
E. Criteria for Screening Applications
Part VI--Instructions for Completing the SF-424
A. SF-424--Application for Federal Assistance
B. SF-424A--Budget Information--Non-Construction Programs
C. SF-424B--Assurances--Non-Construction
Part VII--Contents of Application and Receipt Process
A. Contents and Order of Application
B. Acknowledgement of Receipt
Part VIII--Post Award Information and Reporting Requirements
Part I--Preamble
A. Legislative Authority
The Senate Committee on Appropriations, in its recommendations,
provides $5,500,000 for job creation demonstration activities
authorized under section 505 of the Family Support Act of 1988, Pub. L.
100-485, as amended. Senate Report No. 103-318, 103d Cong., 2nd Session
(1994), to accompany H.R. 4606. Section 505 of the Family Support Act
of 1988 authorizes the Secretary to enter into agreements with not less
than 5 nor more than 10 non-profit organizations (including community
development corporations) for the purpose of conducting demonstration
projects to create employment and business opportunities for certain
low-income individuals. The Social Security Act Amendments of 1994,
Public Law 103-432, reauthorize Section 505 of the Family Support Act
of 1988 through Fiscal Year 1996, and amends subsection (e) and changes
the project period from three to six years. The six year project period
applies only to grant awards beginning in Fiscal Year 1995.
B. Eligible Applicants
Organizations eligible to apply for funding under this program are
any non-profit organizations (including community development
corporations) that are exempt from taxation under Section 501(a) of the
Internal Revenue Code of 1986 by reason of paragraph (3) or (4) of
section 501(c) of such Code. Applicants must provide documentation of
their tax exempt status. The applicant 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 its Articles
of Incorporation bearing the seal of the State in which the corporation
or association is domiciled. Failure to provide evidence of non-profit
status will result in rejection of the application.
C. Definition of Terms
For purposes of this Program Announcement the following definitions
apply:
--Budget Period: The interval of time into which a multi-year period of
assistance (project period) is divided for budgetary and funding
purposes.
--Community-Level Data: Key information to be collected by each grantee
that will allow for a national-level analysis of common features of
JOLI projects. This includes data on the population of the target area,
including the percentage on AFDC and other public assistance, and the
percentage whose incomes fall below the poverty line; the unemployment
rate; the number of new business starts and business closings; and a
description of the major employers and average wage rates and
employment opportunities with those employers.
--Community Development Corporation: A private, locally initiated,
nonprofit entity, governed by a board consisting of residents of the
community and business, civic leaders, and/or public officials which
has a record of implementing economic development projects or whose
Articles of Incorporation and/or By-Laws indicate that it has a focus
in the area of economic development.
--Hypothesis: An assumption made in order to test its validity. It
should assert a cause-and-effect relationship between a program
intervention and its expected result. Both the intervention and result
must be measured in order to confirm the hypothesis. For example, the
following is a hypothesis: ``Eighty hours of classroom training in
small business planning will be sufficient for participants to prepare
a successful loan application.'' In this example, data would be
obtained on the number of hours of training actually received by
participants (the [[Page 12829]] intervention), and the quality of loan
applications (the result), to determine the validity of the hypothesis
(are eighty hours of training sufficient to produce the result?).
--Intervention: Any planned activity within a project that is intended
to produce changes in the target population and/or the environment and
that can be formally evaluated. For example, assistance in the
preparation of a business plan and loan package are planned
interventions.
--Job Creation: To bring about, by activities and services funded under
this program, new jobs, that is, jobs that were not in existence before
the start of the project. These activities can include self-employment/
micro-enterprise training, the development of new business ventures or
the expansion of existing businesses.
--Non-profit Organization: Any organization (including a community
development corporation) exempt from taxation under section 501(a) of
the Internal Revenue Code of 1986 by reason of paragraph (3) or (4) of
section 501(c) of such code.
--Outcome Evaluation: An assessment of project results as measured by
collected data which define the net effects of the interventions
applied in the project. An outcome evaluation will produce and
interpret findings related to whether the interventions produced
desirable changes and their potential for replicability. It should
answer the question, Did this program work?
--Private employers: Third-party private non-profit organizations or
third-party for-profit businesses operating or proposing to operate in
the same community as the applicant and which are proposed or potential
employers of project participants.
--Process Evaluation: The ongoing examination of the implementation of
a program. It focuses on the effectiveness and efficiency of the
program's activities and interventions (for example, methods of
recruiting participants, quality of training activities, or usefulness
of follow-up procedures). It should answer questions such as: Who is
receiving what services?, and are the services being delivered as
planned? It is also known as formative evaluation because it gathers
information that can be used as a management tool to improve the way a
program operates while the program is in progress. It should also
identify problems that occurred and how they were dealt with and
recommend improved means of future implementation. It should answer the
question: ``How was the program carried out?'' In concert with the
outcome evaluation, it should also help explain, ``Why did this program
work/not work?''
--Program Participant/Beneficiary: Any individual eligible to receive
Aid to Families with Dependent Children under Part A of Title IV of the
Social Security Act and any other individual whose income level does
not exceed 100 percent of the official poverty line as found in the
most recent Annual Revision of Poverty Income Guidelines published by
the Department of Health and Human Services. (See Attachment A.)
--Project Period: The total time a project is approved for support,
including any extensions.
--Self-Sufficiency: A condition where an individual or family, by
reason of employment, does not need and is not eligible for public
assistance.
D. Purpose
The purpose of this program is to demonstrate and evaluate ways of
creating new employment and business opportunities for certain low-
income individuals through the provision of technical and financial
assistance to private employers in the community, self-employment/
micro-enterprise programs and/or new business development programs. A
low-income individual eligible to participate in a project conducted
under this program is any individual eligible to receive Aid to
Families with Dependent Children (AFDC) under Part A of Title IV of the
Social Security Act and any other individual whose income level does
not exceed 100 percent of the official poverty line. (See Attachment
A.) Within these categories, emphasis should be on individuals who are
unemployed, those residing in public housing or receiving housing
assistance, and those who are homeless.
Part II--Program Priority Areas
A. General Projects 1.0
The Congressional Conference Report on the FY 1992 appropriations
for the Department of Labor, Health and Human Services, and Education
and related agencies directed the ACF to require economic development
strategies as part of the application process to ensure that highly
qualified organizations participate in the demonstration [H.R. Conf.
Rep. No. 282, 102d Cong., 1st Sess. 39 (1991)]. These strategies should
include descriptions of how projects financed and jobs created under
this program will be integrated into a larger effort to promote job and
business opportunities for eligible program participants. Applicants
should demonstrate how their proposed projects will impact the overall
community/communities served by the applicant. OCS will only fund
projects that create new employment and/or business opportunities for
eligible program participants. Projects funded under this program must
demonstrate how the proposed project will enhance the participants'
abilities and skills in their progress toward self-sufficiency.
Therefore, proposed projects must show promise toward progress of
achieving self-sufficiency among the target population. OCS expects
that the jobs and/or business/self employment opportunities to be
created under this program will contribute to the goal of self-
sufficiency. The employment opportunities should provide hourly wages
that exceed the minimum wage and also provide benefits such as health
insurance, transportation, child care, and career development
opportunities.
Applicants must show that the proposed project will create a
significant number of new full-time permanent jobs through the
expansion of a pre-identified business or new business development, by
providing opportunities for self-employment to eligible participants,
or by creating new non-traditional employment opportunities for women
and minorities in highway construction and maintenance or in the
machine tool industry as described below.
While projected employment in future years may be included in the
application, it is essential that the focus of employment opportunities
concentrate on new full-time, permanent jobs to be created during the
duration of the grant project period and/or on the creation of new
business development opportunities for low-income individuals. OCS is
particularly interested in receiving proposals in three areas:
1. Local Initiative. In the spirit of ``local initiative'' OCS
looks forward to innovative proposals that grow out of the experience
of applicants and the needs of their clientele and communities, and
will make the fruits of local creativity available broadly to others
seeking solutions to similar problems.
2. Highway Construction and Maintenance. At the same time, OCS is
particularly interested in receiving a number of applications which
seek to create non-traditional employment opportunities for women and
minorities in highway construction and maintenance.
[[Page 12830]]
Approximately $20 billion a year goes to States for highway
construction and repair, creating over 270,000 jobs with State Highway
Agencies and 500,000+ jobs with contractors. The Federal Highway
Administration (FHWA), in conjunction with the Department of Labor and
the Women's Bureau, has been seeking ways to increase minority and
women participation. State Highway Agencies now have the option to use
up to \1/2\ per cent of their Federal highway funds for On-the Job
Training (OJT) and supportive services to expand employment
opportunities for minorities and women, similar to programs such as
Youth Build. In addition, the FHWA has developed and presented a
training course, Women in Highway Construction, nationally to over 700
Federal and State Highway Agency personnel and highway contractors on
strategies to increase participation of women on highway construction
projects.
Because of the aging worker population, there is a serious shortage
of qualified workers in highway construction and maintenance in many
parts of the country. The shortages will become more critical as the
population ages further. Consequently, unions are now taking advantage
of opportunities to recruit women and minorities into non-traditional
highway construction and maintenance jobs.
Applicants seeking further information about the efforts being
undertaken by the FHWA, such as its training efforts and the OJT
supportive services program, should contact the appropriate FHWA
Regional Civil Rights Director. (See Attachment K.)
3. Machine Tool Industry. Another area from which OCS would welcome
applications for creation of non-traditional employment opportunities
is the machine tool industry. This industry is one into which it has
traditionally been difficult for minority, women and low-income workers
to gain entry. One possibility might be a strategy of small, high
quality ``micro-enterprise'' machine shops organized in cooperative
sub-contracting arrangements with existing industries or businesses.
The requirement for creation of new, full-time permanent jobs
applies to all applications. OCS has determined that creation of non-
traditional job opportunities for women and minorities in highway
construction and maintenance and in the machine tool industry, which
previously have been closed to these populations, meets the employment
opportunity creation requirements of the JOLI legislation. OCS
continues to require JOLI applications to propose the creation of jobs
through the expansion of existing businesses, the development of new
businesses, or the creation of employment opportunities through self-
employment/microenterprise development. All applications for JOLI
grantees must submit a signed written agreement with the State IV-A
agency which administers the JOBS program and the appropriate local
partners participating in the project. (See Part IV, Criterion VI).
The agreements should describe the cooperative partnerships and
include the specific activities to be performed by each partner over
the course of the grant period. For example, the agreement should
include a description of the training to be provided the eligible
participants and local hiring practices, apprenticeships arrangements,
and relationship with local unions where applicable.
In the case of proposals for creating self-employment micro-
business opportunities for eligible participants, the applicant must
detail how it will provide training and support services to potential
entrepreneurs. The assistance to be provided to potential entrepreneurs
must include, at a minimum, technical assistance in basic business
planning and management concepts, and assistance in preparing a
business plan (See Part IV, Criterion III for requirements) and loan
application.
Any funds that are used for training participants who are AFDC
recipients and therefore eligible for JOBS support must be limited to
providing specific job-related training to such eligible participants
who have been selected for employment (expansion of an existing
business, new business venture or non-traditional employment) and/or
self-employment business opportunities. Where participants are not
receiving AFDC and are therefore not eligible for JOBS support, project
funds may be used to provide basic skills training and other support
services.
In the review process, favorable consideration will be given to
applicants with a demonstrated record of achievement in promoting job
and enterprise opportunities for low-income people. Favorable
consideration also will be given to those applicants who show the
lowest cost-per-job created for low-income individuals. For this
program, OCS views $15,000 in OCS funds as the maximum amount for the
creation of a job and, unless there are extenuating circumstances, will
not fund projects where the cost-per-job in OCS funds exceeds this
amount. Only those jobs created and filled by low-income people will be
counted in the cost-per-job formula. (See Part IV, Criterion IV.)
Technical assistance should be specifically addressed to the needs
of the private employer in creating new jobs to be filled by eligible
individuals and/or to the individuals themselves such as skills
training, job preparation, self-esteem building, etc. Financial
assistance may be provided to the private employer as well as the
individual.
If the technical and/or financial assistance is to be provided to
pre-identified businesses that will be expanded or franchised, written
commitments from the businesses to create the planned jobs must be
included with the application.
The creation of a revolving loan fund with funds received under
this program is an allowable activity. However, OCS encourages the use
of funds from other sources for this purpose. Points will be awarded in
the review process to those applicants who leverage funds from other
sources. (See Part IV, Criterion VI.) Loans made to eligible
beneficiaries for business development activities must be at or below
market rate.
Note: Interest accrued on revolving loan funds may be used to
continue or expand the activities of the approved project.
Grant funds received under this program may not be used for
construction.
A formal, cooperative relationship between the applicant and the
agency responsible for administering the Job Opportunities and Basic
Skills Training (JOBS) program (as provided for under title IV-A of the
Social Security Act) in the area served by the project is a requirement
for funding. The application must include a signed, written agreement
between the applicant and the local State IV-A (public welfare) agency
administering the JOBS program, or a letter of commitment to such an
agreement within 6 months of a grant award (contingent only on receipt
of OCS funds). The agreement must describe the cooperative
relationship, including specific activities and/or actions each of
these entities propose to carry out over the course of the grant period
in support of the project.
The agreement, at a minimum, must cover activities that will be
provided to the target population and which are related to one or more
of the mandatory or optional components offered by the appropriate
State's JOBS program. The mandatory activities offered by the States'
JOBS programs consist of the following components and services: Basic
educational activities (below [[Page 12831]] secondary level i.e. H.S.,
GED, ESL; job skills training; job readiness activities; job
development and job placement; childcare; and other supportive services
(45 CFR 250.44 and 255.0). The optional services offered by the States'
JOBS programs must include two (2) of the following components of group
and individual job search assistance: on-the-job-training experience;
work supplementation; or community work experience (45 CFR 250.45).
(See Attachment I for a list of the State IV-A agencies.)
Projects also must include an independent, methodologically sound
evaluation of the effectiveness of the activities carried out with the
grant funds in creating new jobs and/or business opportunities. (See
Part I, C Definition of Terms, and Part IV, Criterion V).
Applications should include a plan for disseminating the results of
the project after expiration of the grant period. Applicants may budget
up to $2,000 for dissemination purposes.
Priority will be given to applications proposing to serve those
areas containing the highest percentage of individuals receiving Aid to
Families with Dependent Children (AFDC) under Title IV-A of the Social
Security Act. (See Part IV, Criterion II.)
B. Community Development Corporations Set-Aside 2.0
For Fiscal Year 1995, a set-aside fund of $1 million will be
included for Community Development Corporations. (For definition of
Community Development Corporation, see Part I, C.)
Such projects must conform to the purposes, requirements, and
prohibitions applicable to those submitted under Part II, General
Projects 1.0.
Applications for these set-aside funds which are not funded due to
the limited amount of funds available will also be considered
competitively within the larger pool of eligible applicants.
Part III--Application Requirements
A. Background Information
1. Project and Budget Periods
The Social Security Act Amendment of 1994 which reauthorized the
JOLI program also lengthened the project duration from a 3-year period
to a 6-year period. In our effort to implement this change, OCS will
approve FY 1995 grants for a project period of six years and an initial
budget period of 36 months, or three years. This initial 36-month
budget period will be considered the Operational Phase of the project,
during which the Work Plan described in this announcement is to be
carried out. The second 36 months, or three years, of the Project
Period is to be considered a period of tracking workers in the newly
created jobs, of providing them, as needed, with modest support and
assistance, and of continuing Project Evaluation. Applications for
continuation grants funded under these awards beyond the 36-month
budget period but within the six (6) year project period will be
entertained in subsequent years on a non-competitive basis, in a modest
amount commensurate with the reduced level of effort, and subject to
the availability of funds, satisfactory progress of the grantee, and
determination that this would be in the best interest of the
government.
2. Availability of Funds and Grant Amounts
The Office of Community Services expects to award approximately
$5,000,000 by September 30, 1995 for new grants under this program ($1
million of which will be awarded pursuant to the Joint OCS/EPA
Announcement/NOFA described above).
A maximum of $500,000 for the first 36-month budget period will be
awarded to selected organizations under this program in FY 1995. OCS
will award no less than 5 and no more than 10 grants under this
program.
For Fiscal Year 1995 up to $1 million in JOLI funds is being made
available, along with up to $500,000 of Community Services Block Grant
(CSBG) Discretionary Economic Development grant funds, as part of a
Joint Program Announcement/Notice of Funds Availability (NOFA) issued
by the Office of Community Services (OCS) and the U.S. Environmental
Protection Agency (EPA) to fund up to three projects addressing
Community-Based Lead Abatement Training and Career Development and Lead
Poisoning Prevention Education. EPA will be providing up to $1.5
million to public agencies, which together with the OCS funding to
private non-profit agencies, will make possible the funding of three $1
million projects with the public and non-profit grantee agencies in
partnership, each Federal agency contributing $500,000 to each of the
three projects. These will be projects of job creation in community
based lead abatement within the requirements of JOLI and CSBG
Discretionary Programs; and the EPA funds will be available for worker
and community training and education. Prospective applicants for these
projects should obtain copies of the Joint OCS-EPA Announcement/NOFA
which will contain all necessary information, instructions and forms.
Copies of the Joint Announcement will be published in the Federal
Register and will be available for downloading from the OCS Electronic
Bulletin Board 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.
3. Mobilization of Resources
OCS will give favorable consideration in the review process to
applicants who mobilize cash and/or third-party in-kind contributions
for direct use in the project. (See Part IV, Criterion VI.)
4. Program Participants/Beneficiaries
Projects proposed for funding under this announcement must result
in direct benefits to low-income people as defined in the most recent
Annual Revision of Poverty Income Guidelines published by DHHS and
individuals eligible to receive AFDC under Part A of Title IV of the
Social Security Act.
Attachment A to this announcement is an excerpt from the guidelines
currently in effect. Annual revisions of these guidelines are normally
published in the Federal Register in February or early March of each
year. Grantees will be required to apply the most recent guidelines
throughout the project period. These revised guidelines also may be
obtained at public libraries, Congressional offices, or by writing the
Superintendent of Documents, U.S. Government Printing Office,
Washington, DC 20402. They also are accessible on the OCS Electronic
Bulletin Board for reading and/or downloading. (See For Further
Information at beginning of this announcement.)
No other government agency or privately-defined poverty guidelines
are applicable for the determination of low-income eligibility for this
program.
5. Cooperative Partnership Agreement With State IV-A Agency (JOBS
Program)
A signed written agreement, or letter of commitment to sign such an
agreement within six months of a grant award, between the applicant and
the local State IV-A agency must be submitted with the application in
order to be reviewed and evaluated competitively. The agreement/letter
must describe the cooperative relationship and include specific
activities and/or actions that each of the entities proposes to carry
out over the course of the grant period in support of the project.
(Please review PART II, General Projects 1.0 for additional specific
information related to this agreement.) [[Page 12832]]
6. Prohibition and Restrictions on the Use of Funds
The use of funds for new construction or the purchase of real
property is prohibited. Costs incurred for rearrangement and alteration
of facilities required specifically for the grant program are allowable
when specifically approved by ACF in writing.
If the applicant is proposing a project which will affect a
property listed in, or eligible for inclusion in the National Register
of Historic Places, it must identify this property in the narrative and
explain how it has complied with the provisions of section 106 of the
National Historic Preservation Act of 1966 as amended. If there is any
question as to whether the property is listed in or eligible for
inclusion in the National Register of Historic Places, the applicant
should consult with the State Historic Preservation Officer. (See
Attachment D: SF-424B, Item 13 for additional guidelines.) The
applicant should contact OCS early in the development of its
application for instructions regarding compliance with the Act and data
required to be submitted to the Department of Health and Human
Services. Failure to comply with the cited Act will result in the
application being ineligible for funding consideration.
7. Multiple Submittals
Due to the limited number of grants that will be made under this
program, only one proposal from an eligible applicant will be funded by
OCS from FY 1995 JOLI funds, be it pursuant to this announcement
(Program areas 1.0 and 2.0) or the aforementioned Joint Announcement/
NOFA with EPA.
8. Continuation and Refunding
OCS will not provide continuation funding or refunding to a
previously funded grantee to conduct the same demonstration in the same
target area.
9. Third-Party Project Evaluation
Proposals must include provision for an independent,
methodologically sound evaluation of the effectiveness of the
activities carried out with the grant and their efficacy in creating
new jobs and business opportunities. There must be a well defined
Process Evaluation, and an Outcome Evaluation whose design will permit
tracking of project participants throughout the second 36 months of the
project. The evaluation must be conducted by an independent evaluator,
i.e., a person with recognized evaluation skills who is
organizationally distinct from, and not under the control of, the
applicant. It is important that each successful applicant have a third-
party evaluator selected, and performing at the very latest by the time
the work program of the project is begun, and if possible before that
time so that he or she can participate in the final design of the
program, in order to assure that data necessary for the evaluation will
be collected and available.
10. Economic Development Strategy
In accordance with the legislative reference cited in Part II,
Section A, applicants must include in their proposal an explanation of
how the proposed project is integrated with and supports a larger
economic development strategy within the target community. Where
appropriate, applicants should document how they were involved in the
preparation and planned implementation of a comprehensive community-
based strategic plan, such as that required for applying for
Empowerment Zones/Enterprise Community (EZ/EC) status, to achieve both
economic and human development in an integrated manner, and how the
proposed project supports the goals of that plan. (See Review Criterion
II (ii) in Part IV A below.)
11. Maintenance of Effort
The application must include an assurance that activities funded
under this program announcement are in addition to, and not in
substitution for, activities previously carried out without Federal
assistance.
Part IV--Application Review Process
Applications which pass the 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 weaknesses under each applicable criterion published in
the announcement.
The in-depth assessment and review process will use the following
criteria coupled with the specific requirements described in Part III.
Scoring will be based on a total of 100 points.
Note: The following review criteria reiterate the collection of
information requirements contained in Part VI of this announcement.
These requirements are approved under OMB Control Number 0970-0062,
expiration 09-30-95.
A. Criteria for Review and Assessment of Applications in Priority Areas
1.0 and 2.0
Criterion I: Organizational Experience in Program Area and Staff
Responsibilities (Maximum: 20 points)
(i) Agency's commitment and experience in program area. The
application includes documentation which briefly summarizes two similar
projects undertaken by the applicant agency and the extent to which the
stated and achieved performance targets, including permanent benefits
to low-income populations, have been achieved. Application notes and
justifies the priority that this project will have within the agency
including the facilities and resources that it has available to carry
out the project. (0-10 points)
Note: The maximum number of points will be given only to those
organizations with a demonstrated record of achievement in promoting
job creation and enterprise opportunities for low-income people.
(ii) Staff skills, resources and responsibilities. The application
must profile the two or three individuals who will have the most
responsibility for shaping the project, connecting it to customers, and
achieving performance targets. The focus should be on the
qualifications, experience, capacity and commitment to the program of
the Executive Officials of the organization and the key staff persons
who will administer and implement the project. The person identified as
Project Director should have supervisory experience, experience in
finance and business, and experience with the target population.
Because this is a demonstration project within an already-established
agency, OCS expects that the key staff person(s) would be identified,
if not hired.
The application must also include a resume of the third party
evaluator, if identified or hired; or the minimum qualifications and a
position description for the third-party evaluator, who must be a
person with recognized evaluation skills who is organizationally
distinct from, and not under the control of, the applicant. It is
important that each successful applicant have a third-party evaluator
selected and performing at the very latest by the time the work program
of the project is begun, and if possible before that time so that he or
she can participate in the final design of the program, in order to
assure that data necessary for the evaluation will be collected and
available. Plans for selecting an evaluator should be included in the
application narrative. A third-party evaluator must have
[[Page 12833]] knowledge about and have experience in conducting
process and outcome evaluations, evaluating issues in the job creation
field, expansion of businesses and the creation of self-employment and
small business opportunities for low-income neighborhoods and a
thorough understanding of the range and complexity of the problems
faced by the target population. The competitive procurement regulations
(45 CFR Part 74, Appendix H) apply to service contracts such as those
for evaluators when the costs of such service will exceed $25,000. (0-
10 points)
Criterion II: Analysis of Need (Maximum: 15 points)
(i) Target area and population description. The application
includes a brief description of the geographic area and population to
be served, indicating what the unemployment rates are and (to the
extent practicable) how the proposed businesses and subsequent jobs
will impact on the nature and extent of the problem. It should also
include (with an identification of the source of the information) the
number and percentage of individuals receiving AFDC and the total
number of individuals which make up the population in the area where
the project will operate. (0-5 points)
(ii) Nature and extent of problems to be addressed. Application
includes an analysis of the identified personal barriers to employment
and greater self-sufficiency faced by the population to be targeted by
the project. (These might include such problems as illiteracy,
substance abuse, family violence, lack of skills training, health or
medical problems, need for childcare, or poor self-image.) Application
also includes an analysis of the identified community systemic barriers
which the project will seek to overcome. These might include lack of
jobs; lack of transportation; lack of suitable clothing or equipment;
lack of markets; unavailability of financing, insurance or bonding;
inadequate municipal services (water, sewage treatment, street
lighting, trash collection, electricity, traffic control); high
incidence of crime; inadequate health care; or environmental hazards
(such as toxic dumpsites or leaking underground tanks). If the jobs to
be created by the proposed project are themselves designed to fill one
or more of the needs so identified, this fact should be included in the
discussion. (0-5 points)
(iii) Community empowerment consideration. Special consideration
will be given to applicants who are located in areas which are
characterized by poverty and other indicators of socio-economic
distress such as a poverty rate of at least 20%, designation as an EZ/
EC, high levels of unemployment, and high levels of incidences of
violence, gang activity, crime, or drug use. Applicants should document
that they were involved in the preparation and planned implementation
of a comprehensive community-based strategic plan to achieve both
economic and human development in an integrated manner and how the
proposed project supports the goal(s) of that plan. (0-5 points)
Criterion III: Work Program (Maximum: 20 points)
The work plan and business plan(s), where appropriate, must be both
sound and feasible. If the applicant is proposing to use project funds
to provide technical and/or financial assistance for the establishment
of an identified business, or to a third-party private employer to
develop or expand a pre-identified business, the application must
include a complete business plan (see ii, below). An application that
does not include a business plan where one is appropriate may be
disqualified and returned to the applicant.
The project must be responsive to the needs and problems identified
in the Analysis of Need and Problems to be Addressed.
(i) Work plan. The work plan must describe the proposed project
activities, or interventions, and explain how they are expected to
result in outcomes which will meet the needs of the program
participants and assist them to overcome the identified personal and
systemic barriers to employment and self-sufficiency. In other words,
what will the project staff do with the resources provided to the
project and how will what they do (interventions) assist in the
creation of employment and business opportunities for program
participants in the face of the needs and problems that have been
identified. The application should include a hypothesis or hypotheses
that is (are) significant and include(s) the key interventions, and
which permit(s) measurement of the extent to which the target
population can achieve greater self-sufficiency as a result of its
involvement in the project. The key interventions should include the
types and sources of technical and financial assistance to be provided
the participants, as well as any education, training, and support
services and the problems or barriers they are designed to overcome. If
the technical and/or financial assistance is to be provided to pre-
identified businesses that will be expanded or franchised, written
commitments from the businesses specifying their undertakings and
levels of participation must be included with the application. The work
program must set forth realistic quarterly time targets by which the
various work tasks will be completed.
The application identifies and defines critical issues or potential
problems that might impact negatively on the project and explains how
they can be overcome and the project objectives reasonably attained
despite such potential problems.
(ii) Business plan (where required). As noted above, a business
plan is required whenever the applicant is proposing to establish a
new, specific and identified business, or will be providing assistance
to a private third-party private employer for the development or
expansion of a pre-identified business. In these cases the business
plan is one of the major components that will be evaluated by OCS to
determine the feasibility of a jobs creation project.
Because the following guidelines were written to cover a variety of
possibilities, rigid adherence to them is not possible nor even
desirable for all projects. For example, a plan for a service business
would not require a discussion of manufacturing nor product design.
With this understanding, the business plan should be prepared in
accordance with the following guidelines:
1. The business and its industry. This section should describe the
nature and history of the business and provide some background on its
industry.
a. The Business: as a legal entity; the general business category;
b. Description and Discussion of Industry: Current status and
prospects for the industry;
2. Products and Services: This section deals with the following:
a. Description: Describe in detail the products or services to be
sold;
b. Proprietary Position: Describe proprietary features, if any, of
the product, e.g. patents, trade secrets;
c. Potential: Features of the product or service that may give it
an advantage over the competition;
3. Market Research and Evaluation: This section should present
sufficient information to show that the product or service has a
substantial market and can achieve sales in the face of competition;
a. Customers: Describe the actual and potential purchasers for the
product or service by market segment.
b. Market Size and Trends: State the size of the current total
market for the product or service offered; [[Page 12834]]
c. Competition: An assessment of the strengths and weaknesses of
competitive products and services;
d. Estimated Market Share and Sales: Describe the characteristics
of the product or service that will make it competitive in the current
market;
4. Marketing Plan: The marketing plan should detail the product,
pricing, distribution, and promotion strategies that will be used to
achieve the estimated market share and sales projections. The marketing
plan must describe what is to be done, how it will be done and who will
do it. The plan should address the following topics--Overall Marketing
Strategy, Packaging, Service and Warranty, Pricing, Distribution and
Promotion.
5. Design and Development Plans: If the product, process or service
of the proposed venture requires any design and development before it
is ready to be placed on the market, the nature and extent and cost of
this work should be fully discussed. The section should cover items
such as Development Status and Tasks, Difficulties and Risks, Product
Improvement and New Products, and Costs.
6. Manufacturing and Operations Plan: A manufacturing and
operations plan should describe the kind of facilities, plant location,
space, capital equipment and labor force (part and/or full time and
wage structure) that are required to provide the company's product or
service.
7. Management Team: The management team is the key in starting and
operating a successful business. The management team should be
committed with a proper balance of technical, managerial and business
skills, and experience in doing what is proposed. This section must
include a description of: the key management personnel and their
primary duties; compensation and/or ownership; the organizational
structure; Board of Directors; management assistance and training
needs; and supporting professional services.
8. Overall Schedule: A schedule that shows the timing and
interrelationships of the major events necessary to launch the venture
and realize its objectives. Prepare, as part of this section, a month-
by-month schedule that shows the timing of such activities as product
development, market planning, sales programs, and production and
operations. Sufficient detail should be included to show the timing of
the primary tasks required to accomplish each activity.
9. Critical Risks and Assumptions: The development of a business
has risks and problems and the Business Plan should contain some
explicit assumptions about them. Accordingly, identify and discuss the
critical assumptions in the Business Plan and the major problems that
will have to be solved to develop the venture. This should include a
description of the risks and critical assumptions relating to the
industry, the venture, its personnel, the product's market appeal, and
the timing and financing of the venture.
10. Community Benefits: The proposed project must contribute to
economic, community and human development within the project's target
area.
11. The Financial Plan: The Financial Plan is basic to the
development of a Business Plan. Its purpose is to indicate the
project's potential and the timetable for financial self-sufficiency.
In developing the Financial Plan, the following exhibits must be
prepared for the first three years of the business' operation:
a. Profit and Loss Forecasts-quarterly for each year;
b. Cash Flow Projections-quarterly for each year;
c. Pro forma balance sheets-quarterly for each year;
d. Initial sources of project funds;
e. Initial uses of project funds; and
f. Any future capital requirements and sources.
(iii) Facilities. If the rearrangement or alteration of facilities
will be required in implementing the project, the applicant has
described and justified such changes.
Criterion IV: Significant and Beneficial Impact (Maximum: 20 points)
(i) Quality of JOBS/business opportunities. The proposed project is
expected to produce permanent and measurable results that will reduce
the incidence of poverty in the community. Expected results are
quantifiable in terms of the creation of permanent, full-time jobs or
business opportunities developed (or the creation of non-traditional
employment opportunities in highway construction and maintenance or the
machine tool industry). In developing business opportunities and self-
employment for AFDC recipients and low-income individuals the applicant
proposes, at a minimum, to provide basic business planning and
management concepts, and assistance in preparing a business plan and
loan package.
The application documents that:
--The business opportunities to be developed for eligible participants
will contribute significantly to their progress toward self-
sufficiency; and/or
--Jobs to be created for eligible participants will contribute
significantly to their progress toward self-sufficiency; they provide,
for example, wages that exceed the minimum wage, plus benefits such as
health insurance, transportation, child care and career development
opportunities. (0-15 points)
(ii) Cost-per-job. During the project period the proposed project
will create new, permanent jobs through business opportunities or non-
traditional employment opportunities for low-income residents at a
cost-per-job below $15,000 in OCS funds, (e.g. cost per job is
calculated by dividing the total amount of grant funds requested
($420,000) by the number of jobs to be created (60) which equals the
cost-per-job ($7,000)). If any other calculations are used, please
include your methodology in this section. [Note: Except in those
instances where independent reviewers identify extenuating
circumstances related to business development activities, the maximum
number of points will be given only to those applicants proposing cost-
per-job created estimates of $5,000 or less of OCS requested funds.
Higher cost-per-job estimates will receive correspondingly fewer
points.] (0-5 points)
Criterion V: Third-Party Evaluation (Maximum: 10 points)
A plan for a methodologically sound third-party (i.e. independent)
evaluation of the demonstration project must be included in the
application. Application indicates how the applicant will verify the
extent to which the performance targets are achieved in this project.
The Evaluation Plan
--Includes a specific working definition of ``self-sufficiency''
(consistent with the broad definition contained in Part I) that permits
the measurement of incremental progress of eligible individuals and
their families from dependency toward self-sufficiency;
--Clearly defines the changes or benefits (outcomes) to be produced,
the activities (interventions) that will produce the changes, and the
measures of client progress toward self-sufficiency for which
information will be collected (for example: increases in income,
decreases in public assistance payments);
--Provides for the annual compilation of community-level data on the
characteristics of the population in the project area, including
percentage on public assistance, percentage below the poverty line,
[[Page 12835]] unemployment rate, business starts and failures, and
major employers;
--Provides for the conduct of a continuing process evaluation. This
should include the periodic assessment of the following: client
characteristics, pertinent policies and procedures; staffing;
cooperative partnerships with state and local agencies; use of other
community resources; client outreach and recruitment; client service
delivery; cost of services; and, level of technical and financial
assistance to employers. The types of data and information, measures
and indicators to be used for the process evaluation, as well as the
methods and timeframe for collecting and analyzing the required data
should be indicated;
--Provides for the completion of two interim evaluation reports and a
final report comprising both process and outcome evaluation. The final
evaluation report will describe the program design and any changes from
the original workplan, outreach and recruitment results, interventions,
and accomplishments. The measurement instruments, data collection
procedures, and analysis techniques should be discussed, and the report
should yield conclusions as to how well the program works and why. It
should also discuss the program's potential for replication in other
communities; and
--Includes a realistic plan for disseminating the project findings to
other interested organizations and public agencies.
Criterion VI: Public-Private Partnerships (Maximum: 10 points)
--The cooperative partnership arrangements are fully described and
clearly relate to the objectives of the proposed project, and the
activities include one or more of the mandatory or optional components
of the State's JOBS program as described in Part II, Section A.
--In the case of projects involved in the creation of non-traditional
employment opportunities in highway construction and maintenance or the
machine tool industry, agreements with the appropriate partners (for
example: highway departments, contractors, unions or businesses) should
clearly identify the undertakings of each partner in terms of training,
support, apprenticeships, career opportunities, and the like.
--The application documents that the applicant will mobilize from
public and/or private sources cash and/or third-party in-kind
contributions. Applications that document that the value of such
contributions will be at least equal to the OCS funds requested, and
demonstrate that the cooperative partnership arrangements clearly
relate to the objectives of the proposed project, will receive the
maximum number of points for this criterion. Lesser contributions will
be given consideration based upon the value documented.
--Applicants should note that partnership relationships are not created
via service delivery contracts; partners should be responsible for
substantive project components or elements.
--The above requirements are also applicable to applications submitted
in the area of non-traditional employment opportunities. (See Part II,
A for minimum requirement to be included in the cooperative partnership
agreement.)
Criterion VII: Budget Appropriateness and Reasonableness (Maximum: 5
points)
Funds requested are commensurate with the level of effort necessary
to accomplish the goals and objectives of the project.
The application includes a detailed budget break-down for each of
the budget categories in the SF-424A. The applicant presents a
reasonable administrative cost if an indirect cost rate has not been
negotiated with the cognizant Federal agency (See Part VI, Section B,
Line 6j).
The estimated cost to the government of the project also is
reasonable in relation to the anticipated results.
Part V--Application Procedures and Selection Process
A. Availability of Forms
Attachment B contains all of the standard forms necessary for the
application for awards under this OCS program. This attachment and
Parts VI and VII of this announcement contain all of the instructions
required for submittal of applications. These forms may be photocopied
for the application.
Copies of the Federal Register containing this announcement are
available at most local libraries and Congressional District Offices
for reproduction or accessible on the OCS Electronic Bulletin Board for
downloading through your computer modem by calling 1-800-627-8886. If
copies are not available at these sources, they may be obtained by
writing or telephoning the office listed under the section entitled FOR
FURTHER INFORMATION at the beginning of this announcement.
The applicant must be aware that in signing and submitting the
application for this award, it is certifying that it will comply with
the Federal requirements concerning the drug-free workplace and
debarment regulations set forth in Attachments C and D.
Part VII, Section A contains instructions for the project
narrative.
B. Application Submission
The closing date for submission of applications is noted under
``CLOSING DATE'' at the beginning of this Announcement.
1. Deadlines. Applications shall be considered as meeting the
deadline if they are either:
a. Received on or before the deadline date at the Department of
Health and Human Services, Administration for Children and Families,
Division of Discretionary Grants, 370 L'Enfant Promenade, SW., 6th
Floor, (OCS-95-08) Washington, DC 20447, Attention: Maiso Bryant, or
b. Sent on or before the deadline date and received by the granting
agency in time for them to be considered during the competitive review
and evaluation process under Chapter 1-62 of the Health and Human
Services Grants Administration Manual. (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 the U.S. Postal
Service. Private metered postmarks are not acceptable as proof of
timely mailing.)
2. Applications submitted by other means. Applications which are
not submitted in accordance with the above criteria shall be considered
as meeting the deadline only if they are physically received before the
close of business on or before the deadline date. Hand delivered
applications will be accepted at the Department of Health and Human
Services, Administration for Children and Families, Division of
Discretionary Grants, 901 D Street SW., 6th Floor, ACF Guard Station,
Washington, DC 20447 during the normal working hours of 8 a.m. to 4:30
p.m., Monday through Friday.
3. Late Applications. Applications which do not meet one of these
criteria are considered late applications. The ACF Division of
Discretionary Grants will notify each late applicant that its
application will not be considered in this competition.
4. Extension of Deadline. The ACF may extend the deadline for all
applicants because of acts of God such as floods, hurricanes, etc. or
when there is a disruption of the mails. However, if the granting
agency does not extend the deadline for all applicants, it may not
[[Page 12836]] waive or extend the deadline for any applicant.
Applications once submitted are considered final and no additional
materials will be accepted. One signed original application and four
copies should be submitted.
C. 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
Program 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 Contact
(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(a)(2), a SPOC has sixty (60) days from the
application deadline 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, 370
L'Enfant Promenade, SW., 6th Floor, Washington, DC 20447.
A list of the Single Points of Contact for each State and Territory
is included as Attachment E of this announcement.
D. Application Consideration
Applications which meet the screening requirements in Part V, item
E below will be reviewed competitively. Such applications will be
referred to reviewers for a numerical score and explanatory comments
based solely on responsiveness to the guidelines and evaluation
criteria published in this announcement.
Applications will be reviewed by persons outside of the OCS unit
which will 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 generally will be considered in order
of the average scores assigned by reviewers. However, highly ranked
applications are not guaranteed funding since other factors are taken
into consideration, 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 previous 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.
E. Criteria for Screening Applicants
1. Initial Screening
The receipt of applications that meet the published deadline for
submission will be acknowledged in writing with an assigned
identification number. This number, must be referenced in all
subsequent communications concerning the application. If an
acknowledgement is not received within three weeks after the deadline
date, please notify ACF by telephone at (202) 401-9365.
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. The application must contain a Standard Form 424 Application for
Federal Assistance (SF-424), a budget (SF-424A), and signed Assurances
(SF-424B) completed according to instructions published in Part VI and
Attachment B of this Program Announcement.
b. A project narrative must also accompany the standard forms. OCS
requires that the narrative portion of the application be limited to 50
pages, typewritten on one side of the paper only with one-inch margins
and type face no smaller than 10 characters per inch (cpi) or
equivalent. Charts, exhibits, letters of support and cooperative
agreements are not counted against this page limit. It is strongly
recommended that you follow the format for the narrative in Part VII,
A, 10.
c. The SF-424 and the SF-424B must be signed by an official of the
organization applying for the grant who has authority to obligate the
organization legally.
d. Application must contain documentation of the applicant's tax
exempt status as required under Part I, Section B.
2. Pre-Rating Review
Applications which pass the initial screening will be forwarded to
reviewers and/or OCS staff prior to the programmatic review to verify
that the applications comply with this Program Announcement in the
following areas:
a. Eligibility: Applicant meets the eligibility requirements
described in Part I, Section B. Proof of non-profit status must be
included in the Appendices to the Project Narrative (See Part VII,
Section A, 11).
Applicants must also be aware that the applicant's legal name as
required on the SF-424 (Item 5) must match that listed as corresponding
to the Employer Identification Number (Item 6).
b. Target Populations: The application clearly targets the specific
outcomes and benefits of the project to those types of low-income
participants and beneficiaries described in Part III, Section A,
Program Participants/Beneficiaries.
c. Grant Amount: The amount of funds requested does not exceed the
limits indicated in Part III, Section A, item 2.
d. Cooperative Partnership Agreement. The application contains a
written agreement or letter of [[Page 12837]] commitment that includes,
at a minimum, the activities cited in Part II, Section A. The agreement
must be signed by an official of the State IV-A agency responsible for
administering the JOBS program in the area to be served.
e. Third-Party Project Evaluation. A third-party project evaluation
plan is included.
f. Business Plan. If a third-party private employer is part of the
proposed project, a complete business plan is included in the
application.
An application will be disqualified from the competition and
returned if it does not conform to all of the above requirements.
Part VI--Instructions for Completing the SF-424
(Approved by the Office of Management and Budget under Control Number
0970-0062.)
The standard forms attached to this announcement shall be used to
apply for funds under this program announcement.
It is suggested that you reproduce single-sided copies of the SF-
424 and SF-424A, and type your application on the copies. Please
prepare your application in accordance with instructions provided on
the forms as well as with the OCS specific instructions set forth
below:
A. SF-424--Application for Federal Assistance
Top of Page. Please enter the single priority area number under
which the application is being submitted. An application should be
submitted under only one priority area.
Item 1. For the purposes of this announcement, all projects are
considered Applications; there are no Pre-Applications.
Prepare your application in accordance with the standard
instructions given in Attachments B and C corresponding to the forms,
as well as the OCS specific instructions set forth below:
Item 2. Date Submitted and Applicant Identifier--Date application
is submitted to ACF and applicant's own internal control number, if
applicable.
Item 3. Date Received by State--N/A
Item 4. Date Received by Federal Agency--Leave blank.
Items 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 (CRS/EIN) and the Payment Identifying Number, if one has been
assigned, in the Block entitled Federal Identifier located at the top
right hand corner of the form.
Item 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, such as IRS determination, Articles of
Incorporation, or By-laws, must be included as an appendix to the
project narrative.
Item 8. Type of Application--Please indicate the type of
application.
Item 9. Name of Federal Agency--Enter DHHS-ACF/OCS.
Item 10. The Catalog of Federal Domestic Assistance number for OCS
programs covered under this announcement is 93.647. The title is Social
Services Research Demonstration.
Item 11. In addition to a brief descriptive title of the project,
indicate the priority area for which funds are being requested. Use the
following letter designations:
JO--General Project
JS--Community Development Corporation Set-Aside
Item 12. Areas Affected by Project--List only the largest unit or
units affected, such as State, county or city.
Item 13. Proposed Project--The ending date should be calculated
based on a 72-month project period.
Item 14. Congressional District of Applicant/Project--Enter the
number of the Congressional District where the applicant's principal
office is located and the number of the Congressional district(s) where
the project will be located.
Item 15a. This amount should be no greater than the amount
specified under Part III, Availability of Funds and Grant Amounts.
Item 15b-e. These items should reflect both cash and third-party,
in-kind contributions for the budget period requested.
Item 15f. N/A.
Item 15g. Enter the sum of Items 15a-15e.
B. 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 funds only, and Non-Federal will include
mobilized funds from all other sources--applicant, state, local, and
other. Federal funds other than requested OCS funding should be
included in Non-Federal entries.
Sections A, B, C and D of SF-424A should reflect budget estimates
for the first budget period of the project.
Section A--Budget Summary
Lines 1-4
Col. (a):
Line 1--Enter Social Services Research and Demonstration.
Col. (b):
Line 1--Catalog of Federal Domestic Assistance number is 93.647
Col. (c) and (d):
Columns (c) and (d) are not relevant to this program and should not
be completed.
Column (e)-(g):
For line 1, enter in columns (e), (f) and (g) the appropriate
amounts needed to support the project. (Maximum $500,000)
Line 5--Enter the figures from Line 1 for all columns completed
(e), (f), and (g).
Section B--Budget Categories
Please Note: This information supersedes the instructions provided
following SF-424A.
Columns (1)-(5):
Column 1: Enter the first budget period of 12 months.
Column 2: Enter the second budget period of 12 months.
Column 3: Enter the third budget period of 12 months.
Column 4: Leave blank.
Column 5: Enter the total requirements for Federal funds by the
Object Class Categories of this section.
Allocability of costs are governed by the cost principles set forth
in OMB Circular A-122 and 45 CFR Part 74.
Budget estimates for national administrative costs must be
supported by adequate detail for the grants officer to perform a cost
analysis and review. Adequately detailed calculations for each budget
object class are those which reflect estimation methods, quantities,
unit costs, salaries, and other similar quantitative detail sufficient
for the calculation to be duplicated. For any additional object class
categories included under the object class other identify the
additional object class(es) and provide supporting calculations.
Supporting narratives and justifications are required for each
budget category, with emphasis on unique/special initiatives, large
dollar amounts; local, regional, or other travels, new positions, major
equipment purchases and training programs.
A detailed itemized budget with a separate budget justification for
each major item should be included as indicated below: [[Page 12838]]
Personnel-Line 6a. Enter the total costs of salaries and wages.
Justification: Identify the principal investigator or project
director, if known. Specify by title or name the percentage of time
allocated the project, the individual annual salaries, and the cost to
the project of the organization's staff who will be working on the
project. 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.
Justification: Provide a breakdown of amounts and percentages that
comprise fringe benefit costs, such as health insurance, FICA,
retirement insurance, taxes, etc.
Travel--Line 6c. Enter total costs of all travel by employees of
the project. Do not enter costs for consultant's travel.
Justification: Include the total number of traveler(s), total
number of trips, destinations, number of days, transportation costs and
subsistence allowances. Travel costs to attend two national workshops
in Washington, D.C. by the project director and the third-party
evaluator should be included.
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 personal property having a unit cost
of $5000 or more and having a useful life of one year.
Justification: Only equipment required to conduct the project may
be purchased with Federal funds. The applicant organization or its
subgrantees must not have such equipment, or a reasonable facsimile,
available for use in the project. The justification also must contain
plans for future use or disposal of the equipment after the project
ends. 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 above. (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.
Justification: Specify general categories of supplies and their
costs.
Contractual--Line 6f. Enter the total costs of all contracts,
including (1) the estimated cost of the third-party evaluation
contract; travel costs for the chief evaluator to attend two national
workshops in Washington, D.C. should be included; (2) procurement
contracts (except those which belong on other lines such as equipment,
supplies, etc.) and (3) contracts with secondary recipient
organizations including delegate agencies and specific project(s) or
businesses to be financed by the applicant.
Justification: Attach a list of contractors, indicating the names
of the organizations, the purposes of the contracts, the estimated
dollar amounts, and selection process of the awards as part of the
budget justification. Also provide back-up documentation identifying
the name of contractor, purpose of contract, and major cost elements.
Note: Whenever the applicant/grantee intends to delegate part of
the program to another agency, the applicant/grantee must submit
Sections A and B of this Form SF-424A, completed for each delegate
agency by agency title, along with the required supporting
information referenced in the applicable instructions.
The total costs of all such agencies will be part of the amount
shown on Line 6f. Provide draft Request for Proposal in accordance with
45 CFR Part 74, Appendix H. Free and open competition is encouraged for
any procurement activities planned using ACF grant funds. Prior
approval is required when applicants anticipate evaluation procurements
that will exceed $25,000 and are requesting an award without
competition.
The applicant's procurement procedures should outline the type of
advertisement appropriate to the nature and anticipated value of the
contract to be awarded. Advertisements are typically made in city,
regional, and local newspapers; trade journals; and/or through
announcements by professional associations.
Construction--Line 6g. Not applicable.
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 (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.
Total Direct Charges--Line 6i. Show the total of Lines 6a through
6h.
Indirect Charges--Line 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 cognizant Federal agency. With the exception of
local governments, applicants should enclose a copy of the current rate
agreement if it was negotiated with a cognizant Federal agency other
than the Department of Health and Human Services. 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 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.
Program Income--Line 7. Enter the estimated amount of income, if
any, expected to be generated from this project. Separately show
expected program income generated from OCS 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 Program Narrative Statement.
Column 5: 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 those
other than OCS funds. Therefore, mobilized funds from other Federal
programs 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. The
firm commitment of these resources must be documented and submitted
with the application in order to be given credit in the Public-Private
Partnerships criterion.
Except in unusual situations, this documentation must be in the
form of letters of commitment from the organization(s)/individuals from
which funds will be received. [[Page 12839]]
Justification: Describe third-party, in-kind contributions, if
included.
Grant Program--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 (c): Enter the State contribution. If the applicant is a
State agency, enter the non-Federal funds to be contributed by the
State other than the applicant.
Column (d): Enter the amount of cash and third-party in-kind
contributions to be made from all other sources.
Column (e): Enter the total of columns (b), (c), and (d).
Grant Program--Lines 9, 10, and 11 should be left blank.
Grant Program--Line 12.
Carry the total of each column of Line 8, (b) through (e). The
amount in Column (e) should be equal to the amount on Section A, Line
5, column (f).
Section D--Forecasted Cash Needs
Federal--Line 13. Enter the amount of Federal (OCS) cash needed for
this grant, by quarter, during the first 12 month budget period.
Non Federal--Line 14. Enter the amount of cash from all other
sources needed by quarter during the first 12-month budget period.
Totals--Line 15. Enter the total of Lines 13 and 14.
Section E--Budget Estimates of Federal Funds Needed for Balance of
Project(s)
For new 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).
Section F--Other Budget Information
Direct Charges--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:
A. Salary amounts and percentage of time worked for those key
individuals who are identified in the project narrative;
B. Any foreign travel;
C. A list of all equipment and estimated cost of each item to be
purchased wholly or in part with grant funds which meet the definition
of nonexpendable personal property provided on Line 6d, Section B. Need
for equipment must be supported in program narrative;
D. Contractual: major items or groups of smaller items; and
E. 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.
Indirect Charges--Line 22. Enter the type of HHS or other cognizant
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 and attach
a copy of the rate agreement.
Remarks--Line 23. Provide any other explanations and continuation
sheets required or deemed necessary to justify or explain the budget
information.
C. SF-424B Assurances--Non-Construction
All applicants must fill out, sign, date and return the Assurances
with the application.
Part VII--Contents of Application and Receipt Process
A. Contents and Order of Application
Each application submission should include a signed original and
four additional copies of the application. Each application should
include the following in the order presented:
1. Table of Contents;
2. Completed Standard Form 424 which has been signed by an Official
of the organization applying for the grant who has authority to
obligate the organization legally. (Note: The original SF-424 must bear
the original signature of the authorizing representative of the
applicant organization.)
3. Budget Information--Non-Construction Programs (SF-424A);
4. A narrative budget justification for each object class category
required under Section B, SF-424A;
5. Filled out, signed, and dated Assurances--Non-Construction
Programs (SF-424B);
6. By signing and submitting this application, the applicant is
certifying that it will comply with the Federal requirements concerning
debarment regulations set forth in attachments E and F.
7. Restrictions on Lobbying, Certification for Contracts, Grants,
Loans, and Cooperative Agreements: fill out, sign and date form found
at Attachment H.
8. Disclosure of Lobbying Activities, SF-LLL: Filled out, signed,
and dated form found at Attachment H, if appropriate.
9. Certification Regarding Environmental Tobacco Smoke--Signature
on the application attests to the applicants intent to comply with the
requirements of the Pro-Children Act of 1994. A signed form does not
have to be returned with application.
10. An Executive Summary--not to exceed 300 words;
11. A Project Narrative consisting of the following elements
preceded by a consecutively numbered Table of Contents that will
describe the project in the following order:
(i) Eligibility Confirmation
(ii) Organizational Experience and Staff Responsibilities
(iii) Analysis of Need
(iv) Project Design/Work Program
(v) Business Plan (If appropriate)
(vi) Third-Party Evaluation
(vii) Cooperative Partnership Agreement
(viii) Budget Appropriateness and Reasonableness
12. Appendices--proof of non-profit status as outlined in Part I,
Section B; proof that the organization is a community development
corporation, if applying under the CDC Set-aside; commitments from
officials of businesses that will be expanded or from franchises, where
applicable; partnership agreement with State IV-A (JOBS Program)
agency; Single Point of Contact comments, if applicable; Maintenance of
Effort Certification and resumes.
The total number of pages for the narrative portion of the
application package must not exceed 50 pages, excluding Appendices.
Pages should be numbered sequentially throughout, excluding Appendices,
beginning with the SF-424 as Page 1. The application may also contain
letters that show collaboration or substantive commitments to the
project by organizations other than the JOBS agency. Such letters are
not part of the narrative and should be included in the Appendices.
These letters are, therefore, not counted against the fifty page limit.
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 must not include colored, oversized or folded materials.
[[Page 12840]] Do not include organizational brochures or other
promotional materials, slides, films, clips, etc. in the proposal. They
will be discarded if included. The applications should be two-hole
punched at the top center and fastened separately with a compressor
slide paper fastener, or a binder clip. The submission of bound
applications, or applications enclosed in binders, is specifically
discouraged.
Attachment J provides a checklist to applicants in preparing a
complete application package.
B. Acknowledgement of Receipt
Applicants who meet the initial screening criteria outlined in Part
V, Section E, 1, 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. This number and the program
letter code, i.e., JO or JS, must be referred to in all subsequent
communications with OCS concerning the application. If an
acknowledgement is not received within three weeks after the deadline
date, please notify ACF by telephone (202) 401-9234.
Part VIII--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 project and budget period for which support
is provided, the terms and conditions of the award, and the total
project period for which support is contemplated.
Project directors and chief evaluators will be required to attend
two national evaluation workshops in Washington, D.C. A program
development and evaluation workshop will be scheduled shortly after the
effective date of the grant. They also will be required to attend, as
presenters, the final evaluation workshop on utilization and
dissemination to be held at the end of the project period.
Grantees will be required to submit semi-annual progress and
financial reports (SF-269) as well as a final progress and financial
report within 90 days of the expiration of the grant. Interim
evaluation reports, along with a written policies and procedures manual
based on the findings of the process evaluation, will be due 30 days
after the first twelve months, and the second interim evaluation 30
days after the second twelve months, and a final evaluation report will
be due 90 days after the expiration of the grant. This final report
will cover 36 months of activities related to project participants.
Reporting requirements for the remaining 36 months of the project
period will be provided during the solicitation of applications.
Grantees are subject to the audit requirements in 45 CFR Parts 74
(non-profit organization) and OMB Circular A-133.
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 on recipients of Federal contracts,
grants, cooperative agreements, and loans. 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 non-appropriated
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 non-appropriated 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 F for certification
and disclosure forms to be submitted with the applications for this
program.
Attachment G indicates the regulations which apply to all
applicants/grantees under the Job Opportunities for Low-Income
Individuals Program.
Dated: February 24, 1995.
Donald Sykes,
Director, Office of Community Services.
Attachment A.--1995 Poverty Income Guidelines for all States (Except
Alaska and Hawaii) and the District of Columbia
------------------------------------------------------------------------
Poverty
Size of family unit guideline
------------------------------------------------------------------------
1....................................................... $7,470
2....................................................... 10,030
3....................................................... 12,590
4....................................................... 15,150
5....................................................... 17,710
6....................................................... 20,270
7....................................................... 22,830
8....................................................... 25,390
------------------------------------------------------------------------
For family units with more than 8 members, add $2,560 for each
additional member. (The same increment applies to smaller family sizes
also, as can be seen in the figures above.)
[[Page 12841]]
Poverty Income Guidelines for Alaska
------------------------------------------------------------------------
Poverty
Size of family unit guideline
------------------------------------------------------------------------
1....................................................... $9,340
2....................................................... 12,540
3....................................................... 15,740
4....................................................... 18,940
5....................................................... 22,140
6....................................................... 25,340
7....................................................... 28,540
8....................................................... 31,740
------------------------------------------------------------------------
For family units with more than 8 members, add $3,200 for each
additional member. (The same increment applies to smaller family sizes
also, as can be seen in the figures above.)
Poverty Guidelines for Hawaii
------------------------------------------------------------------------
Poverty
Size of family unit guideline
------------------------------------------------------------------------
1....................................................... $8,610
2....................................................... 11,550
3....................................................... 14,490
4....................................................... 17,430
5....................................................... 20,370
6....................................................... 23,310
7....................................................... 26,250
8....................................................... 29,190
------------------------------------------------------------------------
For family units with more than 8 members, add $2,940 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
[[Page 12842]]
[GRAPHIC][TIFF OMITTED]TN08MR95.007
BILLING CODE 4184-01-C [[Page 12843]]
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.
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 required.
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-M
[[Page 12844]]
[GRAPHIC][TIFF OMITTED]TN08MR95.008
[[Page 12845]]
[GRAPHIC][TIFF OMITTED]TN08MR95.009
BILLING CODE 4184-01-C
[[Page 12846]]
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 Column (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 provided 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.
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), 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 Column (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 compete 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. [[Page 12847]]
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, 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 non-discrimination 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. Secs. 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-l et seq.).
14. Will comply with P.L. 93-348 regarding the protection of human
subjects involved in research, [[Page 12848]] 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.
BILLING CODE 4184-01-M
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[[Page 12850]]
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BILLING CODE 4184-01-C
[[Page 12851]]
Attachment D--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 of 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 Service (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 E--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, NW., Suite 500,
Washington, DC 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 SW., Atlanta, Georgia 30334, Telephone (404) 656-3855
Illinois
Steve Klokkenga, State Single Point of Contact, Office of the 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 [[Page 12852]]
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
(801) 538-1535
Vermont
Mr. Bernard D. Johnson, Assistant Director, Office of Policy Research &
Coordination, Pavilion Office Building, 109 State Street, Montpelier,
Vermont 05602, Telephone (802) 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 F--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 [[Page 12853]] 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 persons 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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BILLING CODE 4184-01-M
[[Page 12854]]
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BILLING CODE 4184-01-C
[[Page 12855]]
Attachment G--DHHS Regulations Applying to All Applicants/Grantees
Under the Job Opportunities for Low-Income Individuals Program
Title 45 of the Code of Federal Regulations:
Part 16--Department of Grant Appeals Process
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 from 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 83--Non-discrimination on the basis of sex in the admission of
individuals to training programs
Part 84--Non-discrimination on the Basis of Handicap in 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
Attachment H--Certification Regarding Maintenance of Effort
The undersigned certifies that:
(1) activities funded under this program announcement are in
addition to, and not in substitution for, activities previously carried
on without Federal assistance.
(2) funds or other resources currently devoted to activities
designed to meet the needs of the poor within a community, area, or
State have not been reduced in order to provide the required matching
contributions.
When legislation for a particular block grant permits the use of
its funds as match, the applicant must show that it has received a real
increase in its block grant allotment and must certify that other anti-
poverty programs will not be scaled back to provide the match required
for this project.
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Organization
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Authorized Signature
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Title
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Date
Attachment I--Department of Health & Human Services Administration for
Children and Families, Office of Family Assistance, Washington, DC
20447
February 1994
Jobs Program Directory
Alabama
Claire Ealy, Director, Office of Work and Training Services, Public
Assistance Division, S. Gordon Persons Building, 50 Ripley Street,
Montgomery, Alabama 36130, (205) 242-1950
Alaska
Charles Knittel, Work Programs Coordinator, Division of Public
Assistance, Department of Health and Social Service, P.O. Box 110640,
Juneau, Alaska 99811-0640, (907) 465-3347
Arizona
Gretchen Evans, JOBS Program Director, Dept. of Economic Security, P.O.
Box 6123, Site Code 8011, Phoenix, Arizona 85005, (602) 542-6310
Arkansas
Ken Whitlock, Deputy Director, Project SUCCESS, Department of Human
Services, P.O. Box 1437, Little Rock, Arkansas 72203, (501) 682-8375
California
Bruce Wagstaff, Chief, Employment & Immigrations Programs Branch,
Department of Social Services, 744 P Street M/S 6-700, Sacramento,
California 95814, (916) 657-2367
Colorado
Bob Henson, Director, Work Programs, Department of Social Services,
1575 Sherman Street, Denver, Colorado 80203, (303) 866-2643
Connecticut
Dawn Homer-Bouthiette, Planning Supervisor, Job Connection, Department
of Social Services, 110 Bartholomew Avenue, Hartford, Connecticut
06106, (203) 566-7125
Delaware
Rebecca Varella, Chief Administrator, Employment and Training, Division
of Social Services, P.O. Box 906, New Castle, Delaware 19720, (302)
577-4451
District of Columbia
Shari Curtis, Chief, Bureau of Training and Employment, Department of
Human Services, 33 N Street NE., Washington, DC 20001, (202) 727-1293
Florida
Reggis Smith, Chief, Benefit Recovery and Special Programs, Department
of Health and Rehabilitative Services, 1317 Winewood Boulevard, Bldg.
6, Tallahassee, Florida 32399-0700, (904) 487-2966
Georgia
Sylvia Elam, Chief, Employment Services Unit, Division of Family and
Children Services, Department of Human Resources, 2 Peachtree St., 14th
Floor, Room 402, Atlanta, Georgia 30303, (404) 657-3737
Guam
Diana Calvo, Social Services Supervisor, Department of Public Health
and Social Services, P.O. Box 2816, Agana, Guam 96910, (011-671) 734-
7286
Hawaii
Garry Kemp, Special Assistant to the Director, Department of Human
Services, P.O. Box 339, Honolulu, Hawaii, 96809, (808) 586-7054
Idaho
Kathy James, Acting Bureau Chief, Bureau of Family Self Support,
Department of Health and Welfare, 450 West State Street, Boise, Idaho
83720, (208) 334-5704
Illinois
Karan Maxson, Administrator, Division of Planning and Community
Services, Department of Public Aid, 100 S. Grand, 2nd Floor,
Springfield, Illinois 62762, (217) 785-3300
Indiana
Thomas Reel, Program Manager, IMPACT, Department of Public Welfare, 402
W. Washington, W. 363, Indianapolis, Indiana 46204, (317) 232-2002
Iowa
Doug Howard, Coordinator, Employment and Training Programs,
[[Page 12856]] Department of Human Services, Fifth Floor, Hoover State
Office Building, Des Moines, Iowa 50319, (515) 281-8629
Kansas
Phyllis Lewin, Director, Employment Preparation Services, Department of
Social and Rehabilitation Services, 300 SW Oakley, West Hall, Topeka,
Kansas 66606, (913) 296-4276
Kentucky
Sharon Perry, Assistant Director, Center for Program Development,
Department of Social Insurance, Cabinet for Human Resources, 275 E.
Main Street, Frankfurt, Kentucky 40621, (502) 564-3703
Louisiana
Howard Prejean, Assistant Secretary, Department of Social Services,
Office of Eligibility Determination, P.O. Box 3776, Baton Rouge,
Louisiana 70821, (504) 342-4953
Maine
Barbara Van Burgel, ASPIRE Coordinator, Bureau of Income Maintenance,
Department of Human Services, Statehouse Station #11, 32 Winthrop St.,
Augusta, Maine 04333, (207) 289-3106
Maryland
Carlene Gallion, Acting Executive Director, Office of Project
Independence Management, Department of Human Resources, Room 745, 311
W. Saratoga Street, Baltimore, Maryland 21201, (410) 333-0837
Massachusetts
John Buonomo, Director, Massachusetts JOBS Program, Department of
Public Welfare, 600 Washington St., Boston, Massachusetts 02111, (617)
348-5931
Michigan
Alex D. Hawkins, Director, Job Skills Development Group, Michigan Jobs
Commission, 201 North Washington Square, Third floor, Victor Centre,
Lansing, Michigan 48913, (517) 373-7382
Minnesota
Bonnie Baker, Supervisor, Program Development, Department of Human
Services, 444 Lafayette Road, St. Paul, Minnesota 55155, (612) 296-2499
Mississippi
Jean Temple, Director, JOBS Branch, Office of Children & Youth,
Department of Human Services, 421 W. Pascagoula, Jackson, Mississippi
29302, (601) 359-4855
Missouri
Richard Koon, FUTURES Program Director, Income Maintenance, Division of
Family Services, 72728 Plaza Drive, P.O. Box 88, Jefferson City,
Missouri 65103, (314) 751-3124
Montana
Marylis Filipovich, Bureau Chief, Program & Policy, Department of
Social and Rehabilitation Services, P.O. Box 4210, Helena, Montana
59604, (406) 444-4540
Nebraska
Margaret Hall, Public Assistance Administrator, Public Assistance
Division, Department of Social Services, 301 Centennial Mall South,
P.O. Box 95026, Lincoln, Nebraska 68509, (402) 471-3121
Nevada
John Alexander, Employment & Training Coordinator, Nevada State Welfare
Division, Capitol Complex, 2527 North Carson Street, Carson City,
Nevada 89710, (702) 687-4143
New Hampshire
Arthur Chicaderis, JOBS Administrator, Employment Support Services,
Office of Economic Services, Division of Human Services, Department of
Health and Human Services, 6 Hazen Drive, Concord, New Hampshire 03301-
6521, (603) 271-4249
New Jersey
Marion E. Reitz, Director, Division of Family Development, Department
of Human Services, CN 716, Trenton, New Jersey 08625, (609) 588-2401
New Mexico
Bill Dunbar, Acting Director, Income Support Division, Department of
Human Services, P.O. Box 2348, Santa Fe, New Mexico 87500, (505) 827-
7252
New York
Jack Ryan, Director, Bureau of Employment Programs, Department of
Social Services, 40 North Pearl Street, Albany, New York 12243, (518)
473-8744
North Carolina
Lucy Burgess, Chief, Employment Programs Section, Department of Human
Resources, 325 North Salisbury Street, Raleigh, North Carolina 27611,
(919) 733-2873
North Dakota
Gloria House, JOBS Coordinator, Director of Public Assistance,
Department of Human Services, State Capitol, New Wing 3rd Floor,
Bismark, North Dakota 58505, (701) 224-4001
Ohio
Mary L. Harris, Deputy Director, Family Support and JOBS, Department of
Human Services, State Office Tower, 31st Floor, 30 East Broad Street,
Columbus, Ohio 43266-0423, (614) 466-3196
Oklahoma
Raymond Haddock, Division Administrator, Family Services Division,
Department of Human Services, P.O. Box 25352, Oklahoma City, Oklahoma
73125, (405) 521-3076
Oregon
Debbi White, JOBS Program Manager, Adult and Family Services Division,
Human Resource Bldg, 2nd Floor, Salem, Oregon 97310-1013, (503) 945-
6127
Pennsylvania
David Florey, Director, Bureau of Employment and Training Program,
Department of Public Welfare, P.O. Box 2675, Harrisburg, Pennsylvania
17105, (717) 787-8613
Puerto Rico
Migdalia Marrero, Special Asst. to Secretary, SOSEDF, Isla Grande,
Building #10, P.O. Box 11398, Santurce, Puerto Rico 00910, (809) 722-
2863
Rhode Island
Sherry Campanelli, Associate Director, Community Services, Department
of Human Services, 600 New London Avenue, Cranston, Rhode Island 02920,
(401) 464-2423
South Carolina
Hiram Spain, Executive Assistant for Self-Sufficiency, Department of
Social Services, P.O. Box 1520, Columbia, South Carolina 29202, (803)
737-5937
South Dakota
Julie Osnes, Administrator, Office of Family Independence, Department
of Social Services, Richard F. Kneip Building, Pierre, South Dakota
57501, (605) 773-3493
Tennessee
Wanda Moore, Director of Program Services, Department of Human
Services, 12th Floor, 400 Deadericks, Nashville, Tennessee 37219, (615)
741-6953 [[Page 12857]]
Texas
Irma Bermea, Deputy Commissioner, Department of Human Services, Mail
Code 521E, P.O. Box 2960, Austin, Texas 78769, (512) 450-3011
Utah
Helen Thatcher, Assistant Director, Office of Family Support,
Department of Human Services, 120 North 200 West, Salt Lake City, Utah
84145-0500, (801) 538-8231
Vermont
Steve Gold, Director, REACH-UP Program, Department of Social Welfare,
State Office Building, 103 South Main Street, Waterbury, Vermont 05676,
(802) 241-2800
Virgin Islands
Ermin Boshulte, Director, Public Assistance Programs, Department of
Human Services, Financial Programs Division, Knud Hansen Complex--
Building A, 1303 Hospital Ground, Charlotte Amalie, V.I. 00802, (809)
774-4673
Virginia
David Olds, Program Manager, Employment Services, Department of Social
Services, 730 E. Broad St, 2nd Floor, Richmond, Virginia 23219-1849,
(804) 692-1229
Washington
Lee Todorovich, Acting Assistant Director, Division of Income
Assistance, Department of Social and Health Services, P.O. Box 45400,
Olympia, Washington 98504-5400, (206) 438-8350
West Virginia
Sharon Paterno, Director, Division of Work and Training, Department of
Health and Human Services, Building 6, State Office Complex,
Charleston, West Virginia 25305, (304) 558-3186
Wisconsin
Jean Rogers, Administrator, Division of Economic Support, Department of
Health and Social Services, P.O. Box 7935, 1 West Wilson Street,
Madison, Wisconsin 53707-7935, (608) 266-3035
Wyoming
Kirk McKinney, JOBS Coordinator, Self-Sufficiency Division, Department
of Family Services, Hathaway Building, Rm 347, 2300 Capitol Avenue,
Cheyenne, Wyoming 82002-0710, (307) 777-6849
Attachment J: Checklist for Use in Submitting OCS Grant Applications
Job Opportunities for Low-Income Individuals (Optional)
The application should contain:
1. Table of Contents
2. A completed, signed SF-424, Application for Federal Assistance.
The letter code for the priority area (JO) should be in the lower
right-hand corner of the page.
3. A completed SF-424A, Budget Information--Non-Construction.
4. A narrative budget justification for each object class category
required under Section B, SF-424A;
5. Filled out signed, and dated Assurances--Non-Construction
Programs (SF-424B);
6. The applicant should sign Attachments E and F. In so doing, the
applicant is certifying that it will comply with the Federal
requirements concerning the drug-free workplace and debarment
regulations set forth in Attachments E.
7. A signed copy of Certification Regarding Anti-Lobbying
Activities.
8. A completed Disclosure of Lobbying Activities, if applicable.
9. An Executive Summary--not to exceed 300 words;
10. A Project Narrative beginning with a Table of Contents that
describes the project in the following order:
(1) Eligibility Confirmation
(ii) Organizational Experience and Staff Responsibilities
(iii) Analysis of Need
(iv) Project Design/Work Program
(v) Business Plan (If appropriate)
(vi) Third-Party Evaluation
(vii) Cooperative Partnership Agreement
(viii) Budget Appropriateness and Reasonableness
11. Appendices, including proof of non-profit status; proof that
the organization is a community development corporation, if applying
under the CDC Set-aside; a signed copy of the Cooperative Partnership
Agreement or letter of commitment with State IV-A agency (JOBS
Program); commitments from officials of businesses that will be
expanded or from franchises, where applicable; Single Point of Contact
comments, if applicable; Maintenance of Effort Certification and
resumes.
12. A self-addressed mailing label which can be affixed to a
postcard to acknowledge receipt of application.
Attachment K
Federal Highway Administration, Regional Civil Rights Directors
Region One--Includes CT, ME, MA, NH, NJ, NY, RI, VT, Puerto Rico, and
the Virgin Islands
Mr. Dennis Perrott
Albany, NY
(518) 431-4224, ext. 247
Region Three--Includes DE, DC, MD, PA, VA, WV
Ms. Jo Blackstone
Baltimore, MD
(410) 962-4030
Region Four--Includes AL, FL, GA, KY, MS, NC, SC, TN
Mr. Charles Stinson
Atlanta, GA
(404) 347-4791
Region Five--Includes IL, IN, MI, MN, OH, WI
Mr. Joe Forst
Olympia Fields, IL
(708) 283-3924
Region Six--Includes AR, LA, NM, OK, TX
Mr. Humberto Martinez
Fort Worth, TX
(817) 334-3671
Region Seven--Includes IA, KS, MO, NE
Mr. Glen Smith
Kansas City, MO
(816) 276-2747
Region Eight--Includes CO, MT, ND, SD, UT, WY
Ms. Teresa Banks
Lakewood, CO
Region Nine--Includes AZ, CA, HI, NV, Guam, and American Samoa
Mr. Harold Dorell
San Francisco, CA
(415) 744-3114
Region Ten--Includes AK, ID, OR, WA
Mr. Willie Harris
Portland, OR
(503) 326-2067
Attachment L--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 residence, facilities
funded solely by Medicare or Medicaid funds, and portions of facilities
used for inpatient drug or alcohol treatment. [[Page 12858]] 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.
[FR Doc. 95-5512 Filed 3-7-95; 8:45 am]
BILLING CODE 4184-01-P
