94-8178. Request for Applications Under the Office of Community Services' Fiscal Year 1994 Community Food and Nutrition Program  

  • [Federal Register Volume 59, Number 66 (Wednesday, April 6, 1994)]
    [Unknown Section]
    [Page 0]
    From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
    [FR Doc No: 94-8178]
    
    
    [[Page Unknown]]
    
    [Federal Register: April 6, 1994]
    
    
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    DEPARTMENT OF HEALTH AND HUMAN SERVICES
    Office of Community Services
    [Program Announcement No. OCS 94-02]
    
     
    
    Request for Applications Under the Office of Community Services' 
    Fiscal Year 1994 Community Food and Nutrition Program
    
    AGENCY: Office of Community Services, Administration for Children and 
    Families, Department of Health and Human Services.
    
    ACTION: Request for applications under the Office of Community 
    Services' Community Food and Nutrition Program.
    
    -----------------------------------------------------------------------
    
    SUMMARY: The Office of Community Services (OCS) announces that 
    competing applications will be accepted for new grants pursuant to the 
    Secretary's discretionary authority under section 681A of the Community 
    Services Block Grant Act of 1981 as amended. This Program Announcement 
    contains forms and instructions for submitting an application. Grants 
    made under this Program Announcement are subject to the availability of 
    funds for support of these activities.
    
    CLOSING DATES: The closing date for submission of applications is June 
    6, 1994.
    
    FOR FURTHER INFORMATION CONTACT: Office of Community Services, 370 
    L'Enfant Promenade SW., Washington, DC 20447 (202) 401-9233, Contact: 
    Joseph Reid.
    
    Table of Contents
    
    Part A--Preamble
    
    1. Legislative Authority
    2. Definitions of Terms
    3. Purpose of Community Food and Nutrition Program
        (a) Project Requirements
        (b) Project Elements
    
    Part B--Application Requirements
    
    1. Eligible applicants
    2. Availability of Funds and Grant Amounts
    3. Project Periods and Budget Periods
    4. Administrative Costs/Indirect Costs
    5. Program Beneficiaries
    6. Number of Projects in Application
    7. Multiple Submittals
    8. Sub-Contracting or Delegating Projects
    
    Part C--Program Priority Area
    
    1. General Projects
    2. Set-Asides
    3. Nationwide Programs
    
    Part D--Review Criteria
    
    Criteria for Review and Evaluation of Application Submitted Under 
    This Program Announcement
    
    Part E--Instructions for Completing Application Package
    
    1. SF-424--``Application for Federal Assistance''
    2. SF-424A and SF-424B
    3. Project Narrative
    
    Part F--Application Procedures
    
    l. Availability of Forms
    2. Application Submission
    3. Intergovernmental Review
    4. Application Consideration
    5. Criteria for Screening Applications
        a. Initial Screening
        b. Pre-Rating Review
        c. Evaluation Criteria
    
    Part G--Contents of Application Package and Receipt Process
    
    Part H--Post Award Information and Reporting Requirements
    
    Part A--Preamble
    
    1. Legislative Authority
    
        The Community Services Block Grant Act as amended authorizes the 
    Secretary of Health and Human Services to make funds available under 
    several programs to support program activities which will result in 
    direct benefits targeted to low-income people. This Program 
    Announcement covers the grant authority found at Section 681A, 
    Community Food and Nutrition, which authorizes the Secretary to make 
    funds available for grants to be awarded on a competitive basis to 
    eligible entities for local and statewide programs (1) to coordinate 
    existing private and public food assistance resources, whenever such 
    coordination is determined to be inadequate, to better serve low-income 
    communities; (2) to assist low-income communities to identify potential 
    sponsors of child nutrition programs and to initiate new programs in 
    underserved or unserved areas; and (3) to develop innovative approaches 
    at the State and local levels to meet the nutrition needs of low-income 
    people. The Act also requires that 20 percent of appropriated funds in 
    excess of $6 million be awarded on a competitive basis to eligible 
    agencies for nationwide programs, including programs benefitting Native 
    Americans and Migrant Farmworkers.
    
    2. Definitions of Terms
    
        For purposes of this Program Announcement the following definitions 
    apply:
    
    --Displaced worker: An individual who is in the labor market but has 
    been unemployed for six months or longer.
    --Indian tribe: A tribe, band, or other organized group of Native 
    American Indians recognized in the State or States in which it resides 
    or considered by the Secretary of the Interior to be an Indian tribe or 
    an Indian organization for any purpose.
    --Innovative project: One that departs from or significantly modifies 
    past program practices and tests a new approach.
    --Migrant Farmworker: An individual who works in agricultural 
    employment of a seasonal or other temporary nature who is required to 
    be absent from his/her place of permanent residence in order to secure 
    such employment.
    --Seasonal farmworker: Any individual employed in agricultural work of 
    a seasonal or other temporary nature who is able to remain at his/her 
    place of permanent residence while employed.
    --Underserved area (as it pertains to child nutrition programs): A 
    locality in which less than one-half of the low-income children 
    eligible for assistance participate in any child nutrition program.
    --Budget Period: The term ``budget period'' refers to the interval of 
    time into which a grant period of assistance (project period) is 
    divided for budgetary and funding purposes.
    --Eligible Entity: States and other public and private non-profit 
    agencies/organizations including agencies which administer nationwide 
    programs.
    --Project Period: The term ``project period'' refers to the total time 
    a project is approved for support, including any approved extensions.
    --Self-Sufficiency: A condition where an individual or family does not 
    need and is not eligible for public assistance.
    
    3. Purpose of Community Food and Nutrition Program
    
        The Department of Health and Human Services is committed to 
    improving the health and well-being of individuals through improved 
    preventive health care and promotion of personal responsibility. The 
    Department seeks to unify the approach to health promotion and disease 
    prevention activities with personal messages aimed at families and 
    communities, in various settings and environments in which individuals 
    and groups can most effectively be reached. The Department is 
    specifically interested in improving the health status of minority and 
    low-income persons. HHS encourages community efforts to improve the 
    coordination and integration of health services for all low-income 
    families, and to identify opportunities for integrating other programs 
    and services for this population.
    a. Project Requirements
        Projects funded under this program should:
        (1) Be designed and intended to provide nutrition benefits, 
    including those which incorporate the benefits of disease prevention, 
    to a targeted low-income group of people;
        (2) Provide outreach or public education to inform low-income 
    individuals and displaced workers of the services available to them 
    under the various Federally-assisted nutrition programs;
        (3) Focus on one or more legislatively mandated program activities:
        (a) Coordination of existing private and public food assistance 
    resources, whenever such coordination is determined to be inadequate, 
    to better serve low-income populations;
        (b) Assistance to low-income communities in identifying potential 
    sponsors of child nutrition programs and initiating new programs in 
    underserved or unserved areas; and
        (c) Development of innovative approaches at the national, state or 
    local levels to meet the nutrition needs of low-income people.
    b. Project Elements
        Projects must:
        Focus on one or more of the legislatively mandated program 
    activities in the above--Part A.3.1. OCS views this program as a 
    capacity building program, rather than as a service delivery program.
    
    Part B--Application Requirements
    
    1. Eligible Applicants
    
        Eligible applicants are States, public and private non-profit 
    agencies/organizations with a demonstrated ability to successfully 
    develop and implement programs and activities similar to those 
    enumerated above. OCS encourages Historically Black Colleges and 
    Universities to submit applications. In addition, applicants for the 
    set-aside must be either: (1) Indian tribes, (2) private non-profit 
    groups whose governing board is comprised of a majority of Indians and 
    whose primary purpose is serving Indian populations, or (3) groups 
    whose sole purpose is serving migrant and seasonal farmworker 
    populations. Proof of non-profit status must be included in the 
    Appendices of the Project Narrative where applicable. Any of the 
    following is acceptable evidence of non-profit status: (1) A copy of 
    the applicant organization's list in the Internal Revenue Service's 
    most recent list of tax-exempt organizations described in section 
    501(c)(3) of the IRS code; or (2) A copy of the currently valid IRS tax 
    exemption certificate. Failure to provide evidence of non-profit status 
    will result in rejection of the application.
    
    2. Availability of Funds and Grant Amounts
    
    a. FY 94 Funding
        The funds available for grant awards under the CFN Program in FY 94 
    are:
    
    General Projects
    $2,777,600
    Set-Asides
    400,000
    Nationwide Programs
    388,800
    b. Grant Amounts
        No individual grant application will be considered for an amount 
    which is in excess of $50,000 for applications submitted under General 
    Projects and Set-Asides. No eligible organization may receive more than 
    $300,000 in the aggregate for a nationwide program.
    c. Mobilization of Resources
        OCS would like to mobilize as many resources as possible to enhance 
    projects funded under this program. OCS supports and encourages 
    proposals submitted by applicants whose programs will leverage other 
    resources, either cash or third-party in-kind.
    
    3. Project Periods and Budget Periods
    
        For most projects OCS will grant funds for one year. However, in 
    rare instances, depending on the characteristics of any individual 
    project and on the justification presented by the applicant in its 
    proposal, a grant may be made for a period of up to 17 months.
    
    4. Administrative Costs/Indirect Costs
    
        There is no administrative cost limitation for projects funded 
    under this program. Indirect costs consistent with approved Indirect 
    Cost Rate Agreements are allowable. Applicants should enclose a copy of 
    the current approved rate agreement. However, it should be understood 
    that indirect costs are part of, and not in addition to, the amount of 
    funds awarded in the subject grant.
    
    5. Program Beneficiaries
    
        Projects proposed for funding under this Announcement must result 
    in direct benefits targeted toward low-income people as defined in the 
    most recent Annual Update of Poverty Income Guidelines published by 
    DHHS. Attachment A to this Announcement is an excerpt from the most 
    recently published guidelines. Annual revisions of these guidelines are 
    normally published in the Federal Register in February or early March 
    of each year and are applicable to projects being implemented at the 
    time of publication. Grantees will be required to apply the most recent 
    guidelines throughout the project period. The Federal Register may be 
    obtained from public libraries, Congressional offices, or by writing 
    the Superintendent of Documents, U.S. Government Printing Office, 
    Washington, DC 20402. No other government agency or privately defined 
    poverty guidelines are applicable to the determination of low-income 
    eligibility for this OCS program.
    
    6. Number of Projects in Application
    
        An application may contain only one project and this project must 
    address the basic criteria found in Part C. Applications which are not 
    in compliance with these requirements will be ineligible for funding.
    
    7. Multiple Submittals
    
        There is no limit to the number of applications that can be 
    submitted as long as each application contains a proposal for a 
    different project. However, no applicant can receive more than one 
    grant.
    
    8. Sub-Contracting or Delegating Projects
    
        OCS will not fund any project where the role of the eligible 
    applicant is primarily to serve as a conduit for funds to other 
    organizations.
    
    Part C--Program Priority Areas
    
    1. General Projects--FN
    
        The application should include a description of the target area and 
    population to be served as well as a discussion of the nature and 
    extent of the problem to be solved. The application must contain a 
    detailed and specific work program that is both sound and feasible. 
    Projects funded under this Announcement must produce permanent and 
    measurable results that fulfill the purposes of this program as 
    described in the above. The OCS grant funds, in combination with 
    private and/or other public resources, must be targeted to low-income 
    individuals and communities.
        Applicants will certify in their submission that projects will only 
    serve the low-income population as stipulated in the DHHS Poverty 
    Income Guidelines (Attachment A).
        Failure to comply with the cited Act may result in the application 
    being ineligible for consideration for funding. If an 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, applicant should consult with the 
    State Historic Preservation Officer. 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. In the case of projects 
    proposed for funding which mobilize or improve the coordination of 
    existing public and private food assistance resources, the guidelines 
    governing those resources apply. However, in the case of projects 
    providing direct assistance to beneficiaries through grants funded 
    under this program, beneficiaries must fall within the official DHHS 
    Poverty Income Guidelines as set forth in Attachment A.
        Applications which propose the use of grant funds for the 
    development of any printed or visual materials must contain convincing 
    evidence that these materials are not available from other sources. OCS 
    will not provide funding for such items if justification is not 
    sufficient. Approval of any films or visual presentations proposed by 
    applicants approved for funding will be made part of the grant award. 
    In cases where material outlays for equipment (audio and visual) are 
    requested, specific evidence must be presented that there is a definite 
    programmatic connection between the equipment (audio and visual) usage 
    and the outreach requirements described in Part A.1.b of this 
    Announcement.
        OCS also is interested in projects that address the needs of 
    homeless families, welfare families, low-income and minority health 
    initiatives.
        OCS welcomes project proposals which seek to develop innovative 
    approaches to promote health, particularly among low-income and 
    minority populations. These proposals should have as their goals the 
    reduction of incidences of premature death and chronic disease among 
    the targeted populations.
    
    2. Set-Asides--SA
    
        In recognition of the special needs of Indians and Migrant and 
    Seasonal Farmworkers, a set-aside will be established to afford 
    priority consideration to proposals submitted by agencies serving these 
    populations. Applications which are not funded within this set-aside 
    will also be considered competitively within the larger pool of 
    eligible applicants. See Part D, Section 1-6, (Criterion II) for 
    special instructions on developing a work program.
    
    3. Nationwide Programs--NA
    
        Projects funded must be nationwide in scope and must meet the 
    requirements of Part C.1 (General Projects). No eligible organization 
    may receive more than $300,000 in the aggregate for a nationwide 
    program.
    
    Part D--Review Criteria
    
        Applications which pass the initial screening and pre-rating review 
    (See Part F, Section 5) 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 evaluation and review process will use the following 
    criteria coupled with the specific requirements as described in Part F.
        Applicants should write their project narrative to the review 
    criteria using the same sequential order.
    
        (Note: The following review criteria reiterate collection of 
    information requirements contained in Part D of this Announcement. 
    These requirements are approved under OMB Control Number 0970-0062.)
    
    Criteria for Review and Evaluation of Applications Submitted Under 
    This Program Announcement
    
    Criterion I: Analysis of Needs/Priorities (Maximum: 13 points)
    
        (a) Target area and population to be served are adequately 
    described (0-5 points).
        In addressing the above criterion, the applicant should include the 
    following:
        The applicant should include a description of the target area and 
    population to be served including specific details on any minority 
    population(s) to be served.
        (b) Nature and extent of problem are adequately described and 
    documented (0-8 points).
        In addressing the above criterion, the applicant should include the 
    following:
        Applicant should discuss the nature and extent of the problem 
    including specific information on minority population(s).
    
    Criterion II: Adequacy of Work Program (Maximum: 15 points)
    
        (a) Set forth realistic quarterly time targets by which the various 
    work tasks will be completed (0-7 points).
        (b) Activities are adequately described and appropriately related 
    to goals (0-8 points).
        In addressing the above criterion, the applicant should include the 
    following:
        The applicant should address the basic criteria and legislatively-
    mandated activities found in Part A.3.a and should include:
        (a) Project priorities and rationale for selecting them;
        (b) Goals and objectives; and
        (c) Project activities.
    
    Criterion III: Significant and Beneficial Impact (Maximum 38 points)
    
        (a) Applicant proposes to significantly improve or increase 
    nutrition services to low-income people and such improvements or 
    increases are quantified. (0-12 points).
        (b) Project incorporates low-income health promotion activities, 
    including minority low-income health promotion activities as 
    appropriate, along with nutritional services (0-8 points).
        (c) Project will significantly leverage or mobilize other community 
    resources and such resources are detailed and quantified (0-6 points).
        (d) Project builds on an existing outreach activity (0-5 points).
        (e) Proposal addresses a problem which can be resolved by one-time 
    OCS funding or demonstrates that non-Federal funding is available to 
    continue the project without Federal support (0-7 points).
        In addressing the above criterion, the applicant must include:
        Quantitative data for items (a),(b),(c), and (d) and discuss how 
    the beneficial impact relates to the relevant legislatively- mandated 
    program activities identified in Part A.3.a.
    
    Criterion IV: Coordination/Services Integration (Maximum 15 points)
    
        Proposal addresses applicant's understanding of the importance of 
    improving the integration, coordination, and continuity of various HHS-
    funded services potentially available to families with children living 
    in poverty, and the difficulty of undertaking collaborative efforts 
    between organizations.
        In addressing the above criterion, the applicant should include the 
    following:
        Strategies should be identified which support coordinated 
    community-based planning, maximize the efficient and effective use of 
    scarce resources, reduce duplicative overhead, improve accountability, 
    and result in measurable outcomes.
        If the applicant is receiving funds from the State for community 
    food and nutrition activities, the applicant should address how the 
    funds are being utilized. If State funds are being used in the project 
    for which OCS funds are being requested, their usage should be 
    specifically described.
    
    Criterion V: Organization Experience in Program Area and Staff 
    Responsibilities (Maximum 12 points)
    
        (a) Organizational experiences in program area (0-4 points).
        Documentation provided indicates that projects previously 
    undertaken have been relevant and effective and have provided permanent 
    benefits to the low-income population. Organizations which propose 
    providing training and technical assistance have detailed competence in 
    the specific program priority area and as a deliverer with expertise in 
    the fields of training and technical assistance. If applicable, 
    information provided by these applicants also addresses related 
    achievements and competence of each cooperating or sponsoring 
    organization
        (b) Management History (0-4 points).
        Applicants must fully detail their ability to implement sound and 
    effective management practices and if they have been recipients of 
    other Federal or other governmental grants, they must also detail that 
    they have consistently complied with financial and program progress 
    reporting and audit requirements. Applicants should submit any 
    available documentation on their management practices and progress 
    reporting procedures along with a statement by a Certified or Licensed 
    Public Accountant as to the sufficiency of the applicant's financial 
    management system to protect adequately any Federal funds awarded under 
    the application submitted.
        (c) Staffing skills, Resources and Responsibilities (0-4 points).
        The application briefly describes the experience and skills of the 
    proposed project director showing that the individual is not only well 
    qualified, but that his/her professional capabilities are relevant to 
    the successful implementation of the project. If the key staff person 
    has not yet been identified, the application contains a comprehensive 
    position description which indicates that the responsibilities to be 
    assigned to the project director are relevant to the successful 
    implementation of the project. The application must indicate that the 
    applicant has adequate facilities and resources (i.e. space and 
    equipment) to successfully carry out the work plan.
        In addressing the above criterion, the applicant should include the 
    following:
        The applicant must clearly show that sufficient time of the Project 
    Director and other senior staff will be budgeted to assure timely 
    implementation and oversight of the project and that the assigned 
    responsibilities of the staff are appropriate to the tasks identified 
    for the project.
    
    Criterion VI: Adequacy of Budget (Maximum: 7 points)
    
        (a) Budget is adequate and administrative costs are appropriate in 
    relation to the services proposed (0-7 points).
    
    Part E--Instructions for Completing Application Package
    
    (Approved by the OMB under Control Number 0970-0062)
    
        The standard forms attached to this Announcement shall be used when 
    submitting applications for all funds under this Announcement.
        It is recommended that you reproduce single-sided copies of the SF-
    424, SF-424A and SF-424B, 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:
    
    1. SF-424--Application for Federal Assistance
    
        Top of Page. Please enter the single priority area designation 
    under which the application is being submitted. An application should 
    be submitted under only one priority area. (See Item 11)
        Item 1. For the purposes of this announcement, all projects are 
    considered Applications; there are no Pre-Applications.
        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 certification, 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. Enter DHHS-ACF/OCS.
        Item 10. The Catalog of Federal Domestic Assistance number for the 
    OCS program covered under this announcement is 93.571. The title is 
    Community Services Block Grant Discretionary Awards--Community Food and 
    Nutrition Program.
        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:
    
    FN--General Projects
    SA--Projects where Migrant and Seasonal Farmworker organizations and 
    Indian Tribes or Indian organizations are applying specifically for 
    set-aside funds described in Part B.
    NP--Grants to organizations with nationwide programs
    
        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 12-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. For purposes of this Announcement, this amount should 
    reflect the amount requested for the entire project period.
        Item 15b-e. These items should reflect both cash and third-party 
    in-kind contributions for the total project period.
        Item 15f. N/A.
        Item 15g. Enter the sum of Items 15a-15e.
    
    2. SF-424A--``Budget Information-Non-Construction Programs''
    
        See Instructions accompanying this page as well as the instructions 
    set forth below:
        In completing these sections, the Federal Funds budget entries will 
    relate to the requested OCS Community Food and Nutrition Program funds 
    only, and Non-Federal will include mobilized funds from all other 
    sources--applicants, State, and other. Federal funds other than those 
    requested from the Community Food and Nutrition Program should be 
    included in Non-Federal entries.
        Sections A and D of SF-424A must contain entries for both Federal 
    (OCS) and non-Federal (mobilized funds).
    Section A--Budget Summary
        Line 1-4
        Col. (a):
        Line 1--Enter OCS Community Food and Nutrition Program;
        Col. (b):
        Line 1--Enter 93.571.
        Col. (c) and (d): Not Applicable
        Col. (e)--(g):
        For each line 1-4, enter in columns (e), (f) and (g) the 
    appropriate amounts needed to support the project for the entire 
    project period.
        Line 5--Enter the figures from Line 1 for all columns completed, 
    (e), (f), and (g).
    Section B--Budget Categories
        This section should contain entries for OCS funds only. For all 
    projects, the first budget period of 12 months will be entered in 
    Column #1.
        Allocability of costs is governed by applicable cost principles set 
    forth in 45 CFR parts 74 and 92.
        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:
        Line 6a--Personnel: Enter the total costs of salaries and wages.
    
    Justification
    
        Identify the project director. Specify by title or name the 
    percentage of time allocated to the project, the individual annual 
    salaries and the cost to the project (both Federal and non-Federal) of 
    the organization's staff who will be working on the project.
        Line 6b--Fringe Benefits: Enter the total costs of fringe benefits 
    unless treated as part of an approved indirect cost rate which is 
    entered on line 6j.
    
    Justification
    
        Enter the total costs of fringe benefits, unless treated as part of 
    an approved indirect cost rate.
        Line 6c--Travel: Enter total cost of all travel by employees of the 
    project. Do not enter costs for consultant's travel.
    
    Justification
    
        Include the name(s) of traveler(s), total number of trips, 
    destinations, length of stay, mileage rate, transportation costs and 
    subsistence allowances.
        Line 6d--Equipment: Enter the total costs of all non-expendable 
    personal property to be acquired by the project. Non-expendable 
    personal property'', for purposes of governmental entities, means 
    tangible personal property having a useful life of more than one year 
    and an acquisition cost of $5,000 or more per unit.
    
    Justification
    
        Equipment to be purchased with Federal funds must be required to 
    conduct the project, and the applicant organization or its subgrantees 
    must not already have the equipment or a reasonable facsimile available 
    to the project.
        Line 6e--Supplies: Enter the total costs of all tangible personal 
    property (surplus) other than that included on line 6d.
        Line 6f--Contractual. Enter the total costs of all contracts, 
    including (1) procurement contracts (except those which belong on other 
    lines such as equipment, supplies, etc.) and (2) contracts with 
    secondary recipient organizations including delegate agencies and 
    specific project(s) 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. Applicants 
    who anticipate evaluation procurements that will exceed $25,000 and are 
    requesting an award without competition should call (202) 401-9234 for 
    clarification on the process.
        Line 6g--Construction: Not applicable.
        Line 6h--Other: 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, local transportation (all travel 
    which does not require per diem is considered local travel), 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.
        Line 6j--Indirect Charges: 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 other Federal agencies.
        If the applicant organization is in the process of initially 
    developing or renegotiating a rate, it should immediately upon 
    notification that an award will be made, develop a tentative indirect 
    cost rate proposal based on its most recently completed fiscal year in 
    accordance with the principles set forth in the pertinent DHHS Guide 
    for Establishing Indirect Cost Rates, and submit it to the appropriate 
    DHHS Regional Office. It should be noted that when an indirect cost 
    rate is requested, those costs included in the indirect cost pool 
    cannot be also budgeted or charged as direct costs to the grant. 
    Indirect costs consistent with approved Indirect Cost Rate Agreements 
    are allowable.
        Line 6k--Totals. Enter the total amounts of Lines 6i and 6j.
        Line 7--Program Income: 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.
    Section C--Non-Federal Resources
        This section is to record the amounts of Non-Federal resources that 
    will be used to support the project. Non-Federal resources mean other 
    than OCS funds for which the applicant has received a commitment. 
    Provide a brief explanation, on a separate sheet, showing the type of 
    contribution, broken out by Object Class Category, (See Section B.6) 
    and whether it is cash or third-party in-kind. The firm commitment of 
    these required funds must be documented and submitted with the 
    application in order to be given credit in the criterion.
        Except in unusual situations, this documentation must be in the 
    form of letters of commitment or letters of intent from the 
    organization(s)/individuals from which funds will be received.
    Line 8--Grant Program
        Col. (a): Enter the project title.
        Col. (b): Enter the amount of cash or donations to be made by the 
    applicant.
        Col. (c): Enter the State contribution.
        Col. (d): Enter the amount of cash and third party in-kind 
    contributions to be made from all other sources.
        Col. (e): Enter the total of columns (b), (c), and (d).
        Lines 9, 10, and 11 should be left blank.
        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).
    
    Justification
    
        Describe third party in-kind contributions, if included.
    Section D--Forecasted Cash Needs
        Line 13--Federal: Enter the amount of Federal (OCS) cash needed for 
    this grant, by quarter, during the 12 month budget period.
        Line 14--Non-Federal: Enter the amount of cash from all other 
    sources needed by quarter during the first year.
        Line 15--Totals: Enter the total of Lines 13 and 14.
    Section F--Other Budget Information
        Line 21--Direct Charges: Include narrative justification required 
    under Section B for each object class category for the total project 
    period.
        Line 22--Indirect Charges: Enter the type of HHS or other Federal 
    agency approved indirect cost rate (provisional, predetermined, final 
    or fixed) that will be in effect during the funding period, the 
    estimated amount of the base to which the rate is applied and the total 
    indirect expense. Also, enter the date the rate was approved, where 
    applicable. Attach a copy of the approved rate agreement.
        Line 23--Provide any other explanations and continuation sheets 
    required or deemed necessary to justify or explain the budget 
    information.
    
    3. SF-424B ``Assurances Non-Construction''
    
        All applicants must sign and return the ``Assurances'' with the 
    application.
    
    4. Project Narrative
    
        Each narrative should include the following major Sections:
    
    a. Analysis of Need
    b. Project Design (Work Programs)
    c. Organizational Experience in Program Areas
    d. Management History
    e. Staffing and Resources
    f. Staff Responsibilities
    
        The project narrative must address the specific purposes mentioned 
    in Part A of this Program Announcement. The narrative should provide 
    information on how the application meets the evaluation criteria in 
    part D of this Program Announcement.
    
    Part F--Application Procedures
    
    1. Availability of Forms
    
        Applications for awards under this OCS program must be submitted on 
    Standard Forms (SF) 424, 424A, and 424B. Part E and attachment B to 
    this Program Announcement contain all the instructions and forms 
    required for submittal of applications. The forms may be reproduced for 
    use in submitting applications. Copies of the Federal Register issue 
    containing this Announcement are available at most local libraries and 
    Congressional District Offices for reproduction. If copies are not 
    available at these sources they may be obtained by writing or 
    telephoning the office listed in the section entitled FOR FURTHER 
    INFORMATION at the beginning of this Announcement.
    
    2. Application Submission
    
        The closing date for submission of applications is June 6, 1994.
        a. Deadlines. Applications shall be considered as meeting the 
    deadline if they are either:
        (1) 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, Washington, DC 20447, or
        (2) 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.)
        b. 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, Washington, DC 
    during the normal working hours of 8:30 a.m. to 5 p.m., Monday through 
    Friday.
        c. 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.
        d. Extension of Deadline. The ACF Office of Community Services 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 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.
    
        Note: Applicants should note that the U.S. Postal Service does 
    not uniformly provide a dated postmark. Before relying on this 
    method, applicants should check with their local post office. In 
    some instances packages presented for mailing after a pre-determined 
    time are postmarked with the next day's date. In other cases, 
    postmarks are not routinely placed on packages. Applicants are 
    cautioned to verify that there is a date on the package, and that it 
    list the correct date of mailing, before accepting a receipt.
    
        Applications which have a postmark later than the closing date, or 
    which are hand-delivered after the closing date, will be returned to 
    the sender without consideration in the competition.
        One signed original application and four copies is required.
    
    3. Intergovernmental Review
    
        This program is covered under Executive Order 12372, 
    Intergovernmental Review of Federal Programs, and 45 CFR Part 100, 
    Intergovernmental Review of Department of Health and Human Services 
    Programs and Activities. Under the Order, States may design their own 
    processes for reviewing and commenting on proposed Federal assistance 
    under covered programs.
        All States and Territories except Alabama, Alaska, Connecticut, 
    Hawaii, Idaho, Kansas, Louisiana, Minnesota, Montana, Nebraska, 
    Oklahoma, Oregon, Pennsylvania, 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 seventeen 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. 
    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 60 days from the application 
    deadline date to comment on proposed new or competing continuation 
    awards. Applicants should contact their SPOCs as soon as possible to 
    alert them of the prospective applications and receive any necessary 
    instructions. SPOCs are encouraged to eliminate the submission of 
    routine endorsements as official recommendations. Additionally, SPOCs 
    are requested to clearly differentiate between mere advisory comments 
    and those official State process recommendations which may trigger the 
    ``accommodate or explain'' rule.
        When comments are submitted directly to ACF, they should be 
    addressed to: Department of Health and Human Services Administration 
    for Children and Families Division of Discretionary Grants, 6th Floor 
    370 L'Enfant Promenade, SW. Washington, DC 20447.
        A list of the Single Points of Contact for each State and Territory 
    is included as Attachment E of this Announcement.
    
    4. Application Consideration
    
        Applications which meet the screening requirements in Section 5 
    below will be reviewed competitively. Such applications will be 
    referred to reviewers for a numerical score and explanatory comments 
    based solely on responsiveness to program guidelines and evaluation 
    criteria published in this Announcement. Applications will be reviewed 
    by persons outside of the OCS unit which would be directly responsible 
    for programmatic management of the grant. The results of these reviews 
    will assist the Director and OCS program staff in considering competing 
    applications. Reviewers' scores will weigh heavily in funding decisions 
    but will not be the only factors considered. Applications will 
    generally be considered in order of the average scores assigned by 
    reviewers. However, highly ranked applications are not guaranteed 
    funding since the Director may also consider other factors deemed 
    relevant including, but not limited to, the timely and proper 
    completion of projects funded with OCS funds granted in the last five 
    (5) years: Comments of reviewers and government officials; staff 
    evaluation and input; geographic distribution; previous program 
    performance of applicants; compliance with grant terms under previous 
    DHHS grants; audit reports; investigative reports; and applicant's 
    progress in resolving any final audit disallowances on OCS or other 
    Federal agency grants. OCS reserves the right to discuss applications 
    with other Federal or non-Federal funding sources to ascertain the 
    applicant's performance record.
    
    5. Criteria for Screening Applications
    
    a. Initial Screening
        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.
        (1) The application must contain a completed and signed Standard 
    Form SF-424.
        (2) The SF-424 must be signed by an official of the organization 
    applying for the grant who has authority to obligate the organization 
    legally.
    b. Pre-rating Review
        Applications which pass the initial screening will be forwarded to 
    reviewers for analytical comment and scoring based on the criteria 
    detailed in the Section below and the specific requirements contained 
    in Part A of this Announcement. Prior to the programmatic review, these 
    reviewers and/or OCS staff will verify that the applications comply 
    with this program announcement in the following areas:
        (1) Eligibility: Applicant meets the eligibility requirements found 
    in Part B.
        (2) Number of Projects: The application contains only one project.
        (3) Target Populations: The application clearly targets the 
    specific outcomes and benefits of the project to low-income 
    participants and beneficiaries as defined in the DHHS Poverty Income 
    Guidelines (Attachment A).
        (4) Grant Amount: The amount of funds requested does not exceed 
    $50,000 (except for nationwide programs).
        (5) Program Focus: The application addresses the purposes described 
    in Part A of this Announcement.
    c. Evaluation Criteria
        Applications which pass the initial screening and pre-rating review 
    will be assessed and scored by reviewers. Each reviewer will give a 
    numerical score for each application reviewed. These numerical scores 
    will be supported by explanatory statements on a formal rating form 
    describing major strengths and major weaknesses under each applicable 
    criterion published in this Announcement.
    
    Part G--Contents of Application and Receipt Process
    
    (Approved by the OMB under Control Number 0970-0062)
    
    1. Contents of Application
    
        Each application submission must include:
        A signed original and four additional copies of the application.
        Each copy of the application must contain in the order listed each 
    of the following:
        a. Table of Contents with page numbers noted for each major section 
    and subsection of the proposal and each section of the appendices. Each 
    page in the application, including those in all appendices, must be 
    numbered consecutively.
        b. Standard Form 424. Application for Federal Assistance. The SF-
    424 should be completed in accordance with instructions provided with 
    the form, as well as OCS specific instructions set forth in Part E of 
    this Announcement. The SF-424 must contain an original signature of the 
    certifying representative of the applicant organization.
        Applicants must also be aware that the applicant's legal name as 
    required in SF-424 (Item 5) must match that listed as corresponding to 
    the Employer Identification Number (Item 6).
        c. Standard Form 424A, Budget Information. Pages 1 and 2 should be 
    completed.
        d. Standard Form 424B, Assurances--Non-Construction Programs. This 
    form must be signed and submitted with the Application.
        e. Restriction on Lobbying Activities--Fill out, sign and date form 
    found at Attachment F. Certification for Contracts, Grants, Loans, and 
    Cooperative Agreements.
        f. Disclosure of Lobbying Activities--SF-ILL: Fill out, sign and 
    date form found at Attachment F, (required only if lobbying has 
    actually taken place or is expected to take place in trying to obtain 
    the grant for which the applicant is applying.)
        g. Project Narrative--(See Part E, Section 3.)
        h. By signing and submitting this application, the applicant is 
    certifying that it will comply with the Federal requirements concerning 
    debarment and drug-free regulations set forth in Attachments C and D.
        The total number of pages for the narrative portion of the 
    application package must not exceed 30 pages in their entirety. 
    Applications must be uniform in composition since OCS may find it 
    necessary to duplicate them for review purposes. Therefore, 
    applications must be submitted on 8\1/2\ x 11 inch paper only. They 
    must not include colored, oversized or folded materials, organizational 
    brochures, or other promotional materials, slides, films, clips, etc., 
    in the proposal. Such materials will be discarded if included.
        Applications should be two-holed punched at the top center and 
    fastened separately with a compressor slide paper fastener, such as an 
    ACCO clip, or a binder clip.
        While applications must be comprehensive, OCS encourages 
    conciseness and brevity in the presentation of materials and cautions 
    the applicant to avoid unnecessary duplication of information.
    
    2. Acknowledgment of Receipt
    
        An acknowledgment postcard will be mailed to all applicants with an 
    identification number which will be noted on the acknowledgment. This 
    number must be referred to in all subsequent communications with OCS 
    concerning the application. If an acknowledgment is not received within 
    three weeks after the deadline date, applicants must notify ACF by 
    telephone (202) 401-9234. Applicant should also submit a mailing label 
    for the acknowledgment card.
    
    Part H--Post Award Information and Reporting Requirements
    
        Following approval of the applications selected for funding, notice 
    of project approval and authority to draw down project funds will be 
    made in writing. The official award document is the Financial 
    Assistance Award which provides the amount of Federal funds approved 
    for use in the project, the budget period for which support is 
    provided, and the terms and conditions of the award.
        In addition to the General Conditions and Special Conditions (where 
    the latter are warranted) which will be applicable to grants, grantees 
    will be subject to the provisions of 45 CFR parts 74 (non-governmental) 
    and 92 (governmental) along with OMB Circulars 122 and 87.
        Grantees will be required to submit semi-annual progress and 
    financial reports (SF-269) as well as a final progress and financial 
    report.
        Grantees are subject to the audit requirements in 45 CFR Parts 74 
    and 92.
        Section 319 of Public Law 101-121, signed into law on October 23, 
    1989, imposes [new] prohibitions and requirements for disclosure and 
    certification related to lobbying when applicant has engaged in 
    lobbying activities or is expected to lobby in trying to obtain the 
    grant. It provides limited exemptions for Indian tribes and tribal 
    organizations. Current and prospective recipients (and their subtier 
    contractors and/or grantees) are prohibited from using appropriated 
    funds for lobbying Congress or any Federal agency in connection with 
    the award of a contract, grant, cooperative agreement or loan. In 
    addition, for each award action in excess of $100,000 (or $150,000 for 
    loans) the law requires recipients and their subtier contractors and/or 
    subgrantees (1) to certify that they have neither used nor will use any 
    appropriated funds for payment to lobbyists, (2) to submit a 
    declaration setting forth whether payments to lobbyists have been or 
    will be made out of 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 nonappropriated funds and (3) to file quarterly up-
    dates about the use of lobbyists if any 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 Discretionary Grants Program.
    
        Dated March 22, 1994.
    Donald Sykes,
    Director, Office of Community Services.
        BILLING CODE 4184-01-P
    
    TN06AP94.076
    
    
    TN06AP94.077
    
    
        BILLING CODE 4184-01-C
    
    Instructions for the SF 424
    
        This is a standard form used by applicants as a required 
    facesheet for preapplications and applications submitted for Federal 
    assistance. It will be used by Federal agencies to obtain applicant 
    certification that States which have established a review and 
    comment procedure in response to Executive Order 12372 and have 
    selected the program to be included in their process, have been 
    given an opportunity to review the applicant's submission.
    
    Item and Entry
    
        1. Self-explanatory.
        2. Date application submitted to Federal agency (or State if 
    applicable) & applicant's control number (if applicable).
        3. State use only (if applicable).
        4. If this application is to continue or revise an existing 
    award, enter present Federal identifier number. If for a new 
    project, leave blank.
        5. Legal name of applicant, name of primary organizational unit 
    which will undertake the assistance activity, complete address of 
    the applicant, and name and telephone number of the person to 
    contact on matters related to this application.
        6. Enter Employer Identification Number (EIN) as assigned by the 
    Internal Revenue Service.
        7. Enter the appropriate letter in the space provided.
        8. Check appropriate box and enter appropriate letter(s) in the 
    space(s) provided:
    
    --``New'' means a new assistance award.
    --``Continuation'' means an extension for an additional funding/
    budget period for a project with a projected completion date.
    --``Revision'' means any change in the Federal Government's 
    financial obligation or contingent liability from an existing 
    obligation.
        9. Name of Federal agency from which assistance is being 
    requested with this application.
        10. Use the Catalog of Federal Domestic Assistance number and 
    title of the program under which assistance is requested.
        11. Enter a brief descriptive title of the project. If more than 
    one program is involved, you should append an explanation on a 
    separate sheet. If appropriate (e.g., construction or real property 
    projects), attach a map showing project location. For 
    preapplications, use a separate sheet to provide a summary 
    description of this project.
        12. List only the largest political entities affected (e.g., 
    State, counties).
        13. Self-explanatory.
        14. List the applicant's Congressional District and any 
    District(s) affected by the program or project.
        15. Amount requested or to be contributed during the first 
    funding/budget period by each contributor. Value of in-kind 
    contributions should be included on appropriate lines as applicable. 
    If the action will result in a dollar change to an existing award, 
    indicate only the amount of the change. For decreases, enclose the 
    amounts in parentheses. If both basic and supplemental amounts are 
    included, show breakdown on an attached sheet. For multiple program 
    funding, use totals and show breakdown using same categories as item 
    15.
        16. Applicants should contact the State Single Point of Contact 
    (SPOC) for Federal Executive Order 12372 to determine whether the 
    application is subject to the State intergovernmental review 
    process.
        17. This question applies to the applicant organization, not the 
    person who signs as the authorized representative. Categories of 
    debt include delinquent audit disallowances, loans and taxes.
        18. To be signed by the authorized representative of the 
    applicant. A copy of the governing body's authorization for you to 
    sign this application as official representative must be on file in 
    the applicant's office. (Certain Federal agencies may require that 
    this authorization be submitted as part of the application.)
    
        BILLING CODE 4184-01-P
    
    TN06AP94.078
    
    
    TN06AP94.079
    
        BILLING CODE 4184-01-C
    
    Instructions for the SF-424A
    
    General Instructions
    
        This form is designed so that application can be made for funds 
    from one or more grant programs. In preparing the budget, adhere to 
    any existing Federal grantor agency guidelines which prescribe how 
    and whether budgeted amounts should be separately shown for 
    different functions or activities within the program. For some 
    programs, grantor agencies may require budgets to be separately 
    shown by function or activity. For other programs, grantor agencies 
    may require a breakdown by function or activity. Sections A, B, C, 
    and D should include budget estimates for the whole project except 
    when applying for assistance which requires Federal authorization in 
    annual or other funding period increments. In the latter case, 
    Sections A, B, C, and D should provide the budget for the first 
    budget period (usually a year) and Section E should present the need 
    for Federal assistance in the subsequent budget periods. All 
    applications should contain a breakdown by the object class 
    categories shown in Lines a-k of Section B.
    
    Section A. Budget Summary
    
    Lines 1-4, Columns (a) and (b)
    
        For applications pertaining to a single Federal grant program 
    (Federal Domestic Assistance Catalog number and not requiring a 
    functional or activity breakdown, enter on Line 1 under Column (a) 
    the catalog program title and the catalog number in Column (b).
        For applications pertaining to a single program requiring budget 
    amounts by multiple functions or activities, enter the name of each 
    activity or function on each line in Column (a), and enter the 
    catalog number in Column (b). For applications pertaining to 
    multiple programs where none of the programs require a breakdown by 
    function or activity, enter the catalog program title on each line 
    in Column (a) and the respective catalog number on each line in 
    Column (b).
        For applications pertaining to multiple programs where one or 
    more programs require a breakdown by function or activity, prepare a 
    separate sheet for each program requiring the breakdown. Additional 
    sheets should be used when one form does not provide adequate space 
    for all breakdown of data required. However, when more than one 
    sheet is used, the first page should provide the summary totals by 
    programs.
    
    Lines 1-4, Columns (c) through (g)
    
        For new applications, leave Columns (c) and (d) blank. For each 
    line entry in Columns (a) and (b), enter in Columns (e), (f), and 
    (g) the appropriate amounts of funds needed to support the project 
    for the first funding period (usually a year).
        For continuing grant program applications, submit these forms 
    before the end of each funding period as required by the grantor 
    agency. Enter in Columns (c) and (d) the estimated amounts of funds 
    which will remain unboligated at the end of the grant funding period 
    only if the Federal grantor agency instructions provide for this. 
    Otherwise, leave these columns blank. Enter in Columns (e) and (f) 
    the amounts of funds needed for the upcoming period. The amount(s) 
    in Column (g) should be the sum of amounts in Columns (e) and (f).
        For supplemental grants and changes to existing grants, do not 
    use Columns (c) and (d). Enter in Column (e) the amount of the 
    increase or decrease of Federal funds and enter in Column (f) the 
    amount of the increase or decrease of non-Federal funds. In Column 
    (g) enter the new total budgeted amount (Federal and non-Federal) 
    which includes the total previous authorized budgeted amounts plus 
    or minus, as appropriate, the amounts shown in Columns (e) and (f). 
    The amount(s) in Column (g) should not equal the sum of amounts in 
    Columns (e) and (f).
        Line 5--Show the totals for all columns used.
    
    Section B Budget Categories
    
        In the column headings (1) through (4), enter the titles of the 
    same programs, functions, and activities shown on Lines 1-4, Column 
    (a), Section A. When additional sheets are prepared for Section A, 
    provide similar column headings on each sheet. For each program, 
    function or activity, fill in the total requirements for funds (both 
    Federal and non-Federal) by object class categories.
        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 Columns (b), (c), and (d).
        Line 12--Enter the total for each of Columns (b)-(e). The amount 
    in Column (e) should be equal to the amount on line 5, Column (f), 
    Section A.
    
    Section D. Forecasted Cash Needs
    
        Line 13--Enter the amount of cash needed by quarter from the 
    grantor agency during the first year.
        Line 14--Enter the amount of cash from all other sources needed 
    by quarter during the first year.
        Line 15--Enter the totals of amounts on Lines 13 and 14.
    
    Section E. Budget Estimates of Federal Funds Needed for Balance of the 
    Project
    
        Lines 16-19--Enter in Column (a) the same grant program titles 
    shown in Column (a), Section A. A breakdown by function or activity 
    is not necessary. For new applications and continuation grant 
    applications, enter in the proper columns amounts of Federal funds 
    which will be needed to complete the program or project over the 
    succeeding funding periods (usually in years.) This section need not 
    be completed for revisions (amendments, changes, or supplements) to 
    funds for the current year of existing grants.
        If more than four lines are needed to list the program titles, 
    submit additional schedules as necessary.
        Line 20--Enter the total for each of the Columns (b)-(e). When 
    additional schedules are prepared for this Section, annotate 
    accordingly and show the overall totals on this line.
    
    Section F. Other Budget Information
    
        Line 21--Use this space to explain amounts for individual direct 
    object-class costs 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 statutes(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 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-1 et seq.).
        14. Will comply with P.L. 93-348 regarding the protection of 
    human subjects involved in research, development, and related 
    activities supported by this award of assistance.
        15. Will comply with the laboratory Animal Welfare Act of 1966 
    (P.L. 89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the 
    care, handling, and treatment of warm blooded animals held for 
    research, teaching, or other activities supported by this award of 
    assistance.
        16. Will comply with the Lead-Based Paint Poisoning Prevention 
    Act (42 U.S.C. Secs. 4801 et seq.) which prohibits the use of lead 
    based paint in construction or rehabilitation of residence 
    structures.
        17. Will cause to be performed the required financial and 
    compliance audits in accordance with the Single Audit Act of 1984.
        18. Will comply with all applicable requirements of all other 
    Federal laws, executive orders, regulations and policies governing 
    this program.
    
    Signature of Authorized Certifying
    Official---------------------------------------------------------------
    Title------------------------------------------------------------------
    Applicant Organization-------------------------------------------------
    Date submitted---------------------------------------------------------
    
        BILLING CODE 4184-01-P
    
    TN06AP94.080
    
    
    TN06AP94.081
    
    
        BILLING CODE 4184-01-C
    
    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 belief that it and its 
    principals:
        (a) Are not presently debarred, suspended, proposed for 
    debarment, declared ineligible, or voluntarily excluded from covered 
    transactions by any Federal Department or agency;
        (b) Have not within a 3-year period preceding this proposal been 
    convicted of or had a civil judgment rendered against them for 
    commission of fraud or a criminal offense in connection with 
    obtaining, attempting to obtain, or performing a public (Federal, 
    State, or local) transaction or contract under a public transaction; 
    violation of Federal or State antitrust statutes or commission of 
    embezzlement, theft, forgery, bribery, falsification or destruction 
    of records, making false statements, or receiving stolen property;
        (c) Are not presently indicted or otherwise criminally or 
    civilly charged by a governmental entity (Federal, State or local) 
    with commission of any of the offenses enumerated in paragraph 
    (1)(b) of this certification; and
        (d) Have not within a 3-year period preceding this application/
    proposal had one or more public transactions (Federal, State, or 
    local) terminated for cause or default.
        The inability of a person to provide the certification required 
    above will not necessarily result in denial of participation in this 
    covered transaction. If necessary, the prospective participant shall 
    submit an explanation of why it cannot provide the certification. 
    The certification or explanation will be considered in connection 
    with the Department of Health and Human Services (HHS) determination 
    whether to enter into this transaction. However, failure of the 
    prospective primary participant to furnish a certification or an 
    explanation shall disqualify such person from participation in this 
    transaction.
        The prospective primary participant agrees that by submitting 
    this proposal, it will include the clause entitled ``Certification 
    Regarding Debarment, Suspension, Ineligibility, and Voluntary 
    Exclusion--Lower Tier Covered Transaction'' provided below without 
    modification in all lower tier covered transactions and in all 
    solicitations for lower tier covered transactions.
    
    Certification Regarding Debarment, Suspension, Ineligibility and 
    Voluntary Exclusion--Lower Tier Covered Transactions
    
    (To Be Supplied to Lower Tier Participants)
    
        By signing and submitting this lower tier proposal, the 
    prospective lower tier participant, as defined in 45 CFR Part 76, 
    certifies to the best of its knowledge and belief that it and its 
    principals:
        (a) Are not presently debarred, suspended, proposed for 
    debarment, declared ineligible, or voluntarily excluded from 
    participation in this transaction by any federal department or 
    agency.
        (b) Where the prospective lower tier participant is unable to 
    certify to any of the above, such prospective participant shall 
    attach an explanation to this proposal.
        The prospective lower tier participant further agrees by 
    submitting this proposal that it will include this clause entitled 
    ``Certification Regarding Debarment, Suspension, Ineligibility, and 
    Voluntary Exclusion--Lower Tier Covered Transactions'' without 
    modification in all lower tier covered transactions and in all 
    solicitations for lower tier covered transactions.
    
    Attachment 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
    
    Colorado
    
    State Single Point of Contact, State Clearinghouse, Division of 
    Local Government, 1313 Sherman Street, room 520, Denver, Colorado 
    80203, Telephone (303) 866-2156
    
    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
    
    Florda State Clearinghouse, Intergovernmental Affairs Policy Unit, 
    Executive Office of the Governor, Office of Planning and Budgeting, 
    The Capitol, Tallahassee, Florida 32399-0001, Telephone (904) 448-
    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 No. 38, 
    Augusta, Maine 04333, Telephone (207) 289-3261
    
    Maryland
    
    Ms. Mary Abrams, Chief, Maryland State Clearinghouse, Department of 
    State Planning, 301 West Preston Street, Baltimore, Maryland 21201-
    2365, Telephone (301) 225-4490
    
    Massachusetts
    
    Karen Arone, State Clearinghouse, Executive Office of Communities 
    and Development, 100 Cambridge Street, room 1803, Boston, 
    Massachusetts 02202, Telephone (617) 727-7001
    
    Michigan
    
    Richard S. Pastula, Director, Michigan Department of Commerce, 
    Lansing, Michigan 48909, Telephone (517) 373-7356
    
    Mississippi
    
    Ms. Cathy Mallette, Clearinghouse Officer, Office of Federal Grant 
    Management and Reporting, 301 West Pearl Street, Jackson, 
    Mississippi 39203, Telephone (601) 960-2174
    
    Missouri
    
    Ms. Lois Pohl, Federal Assistance Clearinghouse, Office of 
    Administration, P.O. Box 809, room 430, Truman Building, Jefferson 
    City, Missouri 65102, Telephone (314) 751-4834
    
    Nevada
    
    Department of Administration, State Clearinghouse, Capitol Complex, 
    Carson City, Nevada 89710, Telephone (702) 687-4065, Attention: Ron 
    Sparks, Clearinghouse Coordinator
    
    New Hampshire
    
    Mr. Jeffrey H. Taylor, Director, New Hampshire Office of State 
    Planning, Attn: Intergovernmental Review, Process/James E. Bieber, 
    2\1/2\ Beacon Street, Concord, New Hampshire 03301, Telephone (603) 
    271-2155
    
    New Jersey
    
    Gregory W. Adkins, Acting Director, Division of Community Resources, 
    N.J. Department of Community Affairs, Trenton, New Jersey 08625-
    0803, Telephone (609) 292-6613
    Please direct correspondence and questions to: Andrew J. Jaskolka, 
    State Review Process, Division of Community Resources, CN 814, room 
    609, Trenton, New Jersey 08625-0803, Telephone (609) 292-9025
    
    New Mexico
    
    George Elliott, Deputy Director, State Budget Division, room 190, 
    Bataan Memorial Building, Santa Fe, New Mexico 87503, Telephone 
    (505) 827-3640, FAX (505) 827-3006
    
    New York
    
    New York State Clearinghouse, Division of the Budget, State Capitol, 
    Albany, New York 12224, Telephone (518) 474-1605
    
    North Carolina
    
    Mrs. Chrys Baggett, Director, Office of the Secretary of Admin., 
    N.C. State Clearinghouse, 116 W. Jones Street, Raleigh, North 
    Carolina 27603-8003, Telephone (919) 733-7232
    
    North Dakota
    
    N.D. Single Point of Contact, Office of Intergovernmental 
    Assistance, Office of Management and Budget, 600 East Boulevard 
    Avenue, Bismarck, North Dakota 58505-0170, Telephone (701) 224-2094
    
    Ohio
    
    Larry Weaver, State Single Point of Contact, State/Federal Funds 
    Coordinator, State Clearinghouse, Office of Budget and Management, 
    30 East Broad Street, 34th Floor, Columbus, Ohio 43266-0411, 
    Telephone (614) 466-0698
    
    Rhode Island
    
    Mr. Daniel W. Varin, Associate Director, Statewide Planning Program, 
    Department of Administration, Division of Planning, 265 Melrose 
    Street, Providence, Rhode Island 02907, Telephone (401) 277-2656
    Please direct correspondence and questions to: Review Coordinator, 
    Office of Strategic Planning
    
    South Carolina
    
    Omeagia Burgess, State Single Point of Contact, Grant Services, 
    Office of the Governor, 1205 Pendleton Street, room 477, Columbia, 
    South Carolina 29201, Telephone (803) 734-0494
    
    South Dakota
    
    Ms. Susan Comer, State Clearinghouse Coordinator, Office of the 
    Governor, 500 East Capitol, Pierre, South Dakota 57501, Telephone 
    (605) 773-3212
    
    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:
        No Federal appropriated funds have been paid or will be paid, by 
    or on behalf of the undersigned, to any person for influencing or 
    attempting to influence an officer or employee of any agency, a 
    Member of Congress, an officer or employee of Congress, or an 
    employee of a Member of Congress in connection with the awarding of 
    any Federal contract, the making of any Federal grant, the making of 
    any Federal loan, the entering into of any cooperative agreement, 
    and the extension, continuation, renewal, amendment, or modification 
    of any Federal contract, grant, loan, or cooperative agreement.
        (2) If any funds other then Federal appropriated funds have been 
    paid or will be paid to any person for influencing or attempting to 
    influence an officer or employee of any agency, a Member of 
    Congress, an officer or employee of Congress, or an employee of a 
    Member of Congress in connection with this Federal contract, grant, 
    loan or cooperative agreement, the undersigned shall complete and 
    submit Standard Form-LLL, ``Disclosure Form to Report Lobbying,'' in 
    accordance with its instructions.
        (3) The undersigned shall require that the language of this 
    certification be included in the award documents for all subawards 
    at all tiers (including subcontracts, subgrants, and contracts under 
    grants, loans, and cooperative agreements) and that all 
    subrecipients shall certify and disclose accordingly.
        This certification is a material representation of fact upon 
    which reliance was placed when this transaction was made or entered 
    into. Submission of this certification is a prerequisite for making 
    or entering into this transaction imposed by section 1352, title 31, 
    U.S. Code. Any person who fails to file the required certification 
    shall be subject to a civil penalty of not less than $10,000 and not 
    more than $100,000 for each such failure.
    
    State for Loan Guarantee and Loan Insurance
    
        The undersigned states, to the best of his or her knowledge and 
    belief, that:
        If any funds have been paid or will be paid to any person for 
    influencing or attempting to influence an officer or employee of any 
    agency, a Member of Congress, an officer or employee of Congress, or 
    any employee of a Member of Congress in connection with this 
    commitment providing for the United States to insure or guarantee a 
    loan, the undersigned shall complete and submit Standard Form-LLL 
    ``Disclosure Form to Report Lobbying,'' in accordance with its 
    instructions.
        Submission of this statement is a prerequisite for making or 
    entering into this transaction imposed by section 1352, title 31, 
    U.S. Code. Any person who fails to file the required statement shall 
    be subject to a civil penalty of not less than $10,000 and not more 
    than $100,000 for each such failure.
    
    Signature--------------------------------------------------------------
    Title------------------------------------------------------------------
    Organization-----------------------------------------------------------
    Date-------------------------------------------------------------------
        BILLING CODE 4184-01-P
    
    TN06AP94.082
    
    
        BILLING CODE 4181-01-C
    
    Attachment G
    
        The following DHHS regulations apply to all applicants/grantees 
    under the Community Food and Nutrition Program:
        Title 45 of the Code of Federal Regulations:
    
    Part 16--Procedures of the Departmental Grant Appeals Board
    Part 74--Administration of Grants (non-governmental)
        Part 74--Administration of Grants (state and local governments 
    and Indian Tribal affiliates):
    Sec.
    74.62(a)  Non-Federal Audits
    74.173  Hospitals
    74.174(b)  Other Nonprofit Organizations
    74.304  Final Decisions in Disputes
    74.710  Real Property, Equipment and Supplies
    74.715  General Program Income
    Part 75--Informal Grant Appeal Procedures
    Part 76--Debarment and Suspension form Eligibility for Financial 
    Assistance
        Subpart F--Drug Free Workplace Requirements
    Part 80--Non-discrimination under Programs Receiving Federal 
    Assistance through the Department of Health and Human Services 
    Effectuation of Title VI of the Civil Rights Act of 1964
    Part 81--Practice and Procedures for Hearings Under Part 80 of this 
    Title
    Part 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
    
      Optional Checklist (for Use of Applicant Only) To Verify Contents of  
                                   Application                              
                                                                            
                                                                     Check  
                                                                            
    A. Application contains:                                                
      1. Table of Contents.......................................         []
      2. Completed SF 424, Application for Federal Assistance....         []
      3. Completed SF 424, Budget Information--Non-Construction             
       Programs..................................................         []
      4. Signed SF 424B, Assurances--Non-Construction Programs...         []
      5. A project narrative with the following components:                 
        a. Analysis of need......................................         []
        b. Project design........................................         []
        c. Organizational experience in program..................         []
        d. Management history....................................           
        e. Staffing and resources (re.1sume.1 or job description)           
        f. Staff responsibilities................................           
      6. Relevant portions of the organization's by-laws and                
       articles of incorporation confirming eligibility..........         []
      7. A signed copy of Certification Regarding the Anti-                 
       Lobbying Provision;.......................................         []
      8. A completed Disclosure of Lobbying Activities form, if             
       appropriate...............................................         []
      9. A self-addressed mailing label which can be affixed to a           
       postcard to acknowledge receipt of application............         []
    B. Application does not exceed a total of 30 pages...........         []
    C. Application includes one original and four copies, printed           
     on white 8\1/2\ by 11 inch paper............................         []
    D. Applicant is aware that in signing and submitting the                
     application for funds under the CFN Program, it is                     
     certifying that it has read and understood the Federal                 
     Guidelines concerning a drug-free workplace and the                    
     debarment regulations set forth in attachments E and F                 
     respectively................................................         []
                                                                            
    
    [FR Doc. 94-8178 Filed 4-5-94; 8:45 am]
    BILLING CODE 4184-01-P
    
    
    

Document Information

Published:
04/06/1994
Department:
Health and Human Services Department
Entry Type:
Uncategorized Document
Action:
Request for applications under the Office of Community Services' Community Food and Nutrition Program.
Document Number:
94-8178
Dates:
The closing date for submission of applications is June 6, 1994.
Pages:
0-0 (1 pages)
Docket Numbers:
Federal Register: April 6, 1994, Program Announcement No. OCS 94-02
CFR: (6)
45 CFR 74.62(a)
45 CFR 74.174(b)
45 CFR 74.173
45 CFR 74.304
45 CFR 74.710
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