[Federal Register Volume 62, Number 103 (Thursday, May 29, 1997)]
[Notices]
[Pages 29244-29269]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-14074]
[[Page 29243]]
_______________________________________________________________________
Part IV
Department of Health and Human Services
_______________________________________________________________________
Administration for Children and Families
_______________________________________________________________________
Fiscal Year 1997 Family Violence Prevention and Services Discretionary
Funds Program; Availability of Funds and Request for Applications;
Notice
Federal Register / Vol. 62, No. 103 / Thursday, May 29, 1997 /
Notices
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
[Program Announcement No. OCS 97-07]
Fiscal Year 1997 Family Violence Prevention and Services
Discretionary Funds Program; Availability of Funds and Request for
Applications
AGENCY: Office of Community Services, ACF, DHHS.
ACTION: Announcement of the availability of funds and request for
applications under the Office of Community Services Family Violence
Prevention and Services Discretionary Funds Program.
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SUMMARY: The Office of Community Services (OCS) announces its Family
Violence Prevention and Services discretionary funds program for fiscal
year (FY) 1997. Funding for grants under this announcement is
authorized by the Family Violence Prevention and Services Act, Public
Law 102-295, as amended, governing discretionary programs for family
violence prevention and services. Applicants should note that the award
of grants and cooperative agreements under this program announcement is
subject to the availability of funds. This announcement contains all
forms and instructions for submitting an application.
CLOSING DATE: The closing date for submission of applications is July
28, 1997. Applications postmarked after the closing date will be
classified as late. Applicants are cautioned to request a legibly dated
U.S. Postal Service postmark or to obtain a legibly dated receipt from
a commercial carrier or U.S. Postal Service. Private metered postmarks
shall not be accepted as proof of timely mailing. Detailed application
submission instructions, including the addresses where applications
must be received, are found in Part IV of this announcement.
ADDRESSES: Applications may be mailed to Department of Health and Human
Services, Administration for Children and Families/Division of
Discretionary Grants, (OCS-97-07), 370 L'Enfant Promenade, S.W., Mail
Stop 6C-462, Washington, D.C. 20447.
Hand delivered applications are accepted during the normal working
hours of 8:00 a.m. to 4:30 p.m., at the U.S. Department of Health and
Human Services, Administration for Children and Families, Division of
Discretionary Grants, ACF Mailroom, 2nd Floor Loading Dock, Aerospace
Center 901 D Street, S.W., Washington, DC 20447, between Monday and
Friday (excluding Federal holidays). (Applicants are cautioned that
express/overnight mail services do not always deliver as agreed.)
FOR FURTHER INFORMATION CONTACT: Administration for Children and
Families, Office of Community Services, Division of State Assistance,
370 L'Enfant Promenade, S.W., Washington, D.C. 20447. Telephone Trudy
Hairston, (202) 401-5319, James Gray, (202) 401-5705, or William Riley
(202) 401-5529.
SUPPLEMENTARY INFORMATION:
The Office of Community Services, Administration for Children and
Families, announces that applications are being accepted for funding
for FY 1997 projects on:
FV-01-97, Developing and Enhancing Services for Immigrant
and Migrant Battered Women;
FV-02-97, Domestic Violence/Temporary Assistance for Needy
Families (Welfare Reform);
FV-03-97, A Special Issue Resource Center to Aid Indian
Tribes and Tribal Organizations in Preventing Domestic Violence; and
FV-04-97, Training Grant Stipends in Domestic Violence for
Historically Black, Hispanic-serving and Tribal Colleges and
Universities.
This program announcement consists of four parts.
Part I provides information on the family violence prevention and
services program and the statutory funding authority applicable to this
announcement.
Part II describes the priority areas under which applications for
FY 1997 family violence funding are being requested.
Part III describes the review process.
Part IV provides information and instructions for the development
and submission of applications.
The forms to be used for submitting an application follow Part IV.
Please copy and use these forms in submitting an application under this
announcement. No additional application materials are available or
needed to submit an application.
Part I. Introduction
Title III of the Child Abuse Amendments of 1984, (Pub. L. 98-457,
42 U.S.C. 10401, et seq.) is entitled the Family Violence Prevention
and Services Act (the Act). The Act was first implemented in FY 1986,
was reauthorized and amended in 1992 by Pub. L. 102-295, and was
amended and reauthorized for fiscal years 1996 through 2000 by Pub. L.
103-322, the Violent Crime Control and Law Enforcement Act of 1994 (the
Crime Bill), signed into law on September 13, 1994. The Act was most
recently amended by Pub. L. 104-235, the ``Child Abuse Prevention and
Treatment Act Amendment of 1996.''
The purpose of this legislation is to assist States in supporting
the establishment, maintenance, and expansion of programs and projects
to prevent incidents of family violence and provide immediate shelter
and related assistance for victims of family violence and their
dependents.
We expect to fund four priority areas in FY 1997. (These include
three new areas in which OCS will seek interested applicants for this
fiscal year.)
1. To develop and enhance the services and supports available to
immigrant and migrant battered victims of domestic violence by
supporting collaborations between domestic violence, immigration, and
migrant-serving organizations by providing organizations an opportunity
to jointly design, develop, and implement collaborative projects
addressing key issues or areas of concern facing immigrant and/or
migrant battered women and their families.
2. The implementation of the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996, also known as ``welfare
reform,'' has provided an opportunity for creative and challenging
collaborations regarding the work requirements and penalties under the
law and the policy and operational implications for domestic violence
victims. The OCS will invite interested agencies and advocacy
organizations to identify and initiate collaborations in these areas;
3. The establishment of a special issue resource center for Indian
Tribes and Tribal organizations. The proposed resource center is
predicated on the unique government-to-government relationship between
the U.S. Federal government and the Federally recognized Indian Tribes
as well as the need for increased support for the work that is being
initiated by Indian advocates in their communities; and
4. The provision of training grant stipends to Historically Black,
Hispanic-Serving and Tribal Colleges and Universities will assist in
generating skill-building and training opportunities particularly
responsive to issues of cultural content and the extent to which some
minority groups participate in the domestic violence system.
[[Page 29245]]
Part II. Fiscal Year 1997 Family Violence Projects
1. Priority Area Number FV-01-97: Developing and Enhancing Services for
Immigrant and Migrant Battered Women
Background
Today the numbers of battered immigrant and migrant women who
receive services from domestic violence programs is extremely small.
Immigrant and migrant women may feel alienated by mainstream shelters
and domestic violence programs where food and customs are completely
foreign and where staff and other program participants do not speak
their language. Traditional public education efforts conducted by
domestic violence programs often fail to adequately reach immigrant and
migrant communities due to language and other barriers.
Immigrant battered women have great difficulty accessing services
to assist them in escaping domestic violence. They encounter numerous
barriers in the legal system that makes accessing services even more
difficult than for other abuse victims. Few police officers are
bilingual; few court systems have multi-lingual staff or interpreters;
and few culturally sensitive programs provide services to immigrant
domestic violence victims. Battered immigrant women often need creative
legal remedies that redress the effects of their abusers' control over
their immigration status or that prevent international child snatching.
In other cases, battered women will have to fight the abuser's attempts
to wrongly introduce immigration concerns into their family law cases
in an attempt to shift the focus of the case away from his violent
behavior.
A number of unique issues face migrant families dealing with
domestic violence: continuity of critical social services, enforcement
of protection orders, securing shelter and support services for
battered women and their children, and intervention services for
batterers. Systems that link migrant health services with the domestic
violence program network are almost non-existent.
Purpose
To develop and enhance the services and supports available to
immigrant and migrant victims of domestic violence by supporting
collaborations between domestic violence, immigration, and migrant-
serving organizations. To offer the applicant organizations an
opportunity to jointly design, develop, and implement collaborative
projects addressing key issues or areas of concern facing immigrant
and/or migrant battered women and their families.
Efforts are to be focused on the joint development of model
protocols and programs, training curricula and materials, models of
cross-training, and the conduct of training for staff at agencies
working in immigrant and migrant communities and with domestic violence
victims. Training would focus on ensuring that those coming into
contact with immigrant or migrant victims of domestic violence
understand how both domestic violence and immigrant or migrant status
affect an individual's need for services. Of particular importance,
also, is cultural sensitivity, which may make it more difficult for an
individual to access or respond to particular services.
The development of model protocols and programs and the training of
immigrant and migrant-serving agency representatives and domestic
violence advocates will enable the most efficient and effective
response to the often complex concerns arising when an immigrant or
migrant worker is facing domestic violence. These activities may
include outreach to and the identification, assessment, and referral of
potential victims of domestic violence to appropriate culturally-
sensitive crisis intervention, legal representation, support and other
related services and programs. Moreover, to be effective, these
activities should demonstrate culturally-sensitive case coordination by
all the agencies and advocates involved that respond to the safety,
confidentiality, and services needs of immigrant and migrant domestic
violence victims.
The design, development and implementation of protocols for
effective strategies are needed to:
(1) Ensure confidentiality of client information at every stage of
the process;
(2) Enlighten domestic violence advocates and agencies regarding
the impact of immigrant or migrant status on the victim's needs,
access, and response to services;
(3) Advise immigration and migrant advocates and agencies of the
impact of domestic violence on their immigrant or migrant clients'
needs, access, and response to services;
(4) Ensure the safety of domestic violence victims who are involved
in immigration proceedings, family law proceedings, or interstate or
intrastate migrant farmworker networks; and
(5) Promote collaborations that bring together the expertise and
services of domestic violence programs and agencies working with
immigrant and migrant communities to enhance and coordinate services
delivery.
Applicants may propose to do one or more of the following:
(a) Plan and implement the training of domestic violence advocates,
immigration rights organizations, migrant health and social services
agencies, and/or social services providers on the relationship of
domestic violence and immigration and migrant status, including the
development of reproducible training curricula and materials;
(b) Develop and implement a system of recruiting, training, and
providing backup expert support to pro bono immigration attorneys and
shelter advocates, as well as peer advocates, to work with immigrant
battered women to secure culturally sensitive and responsive services
and enhance safety;
(c) Develop effective outreach strategies for domestic violence
programs to recruit and train culturally sensitive staff, develop
culturally sensitive and responsive materials, and more effectively
reach immigrant and migrant communities, including the design and pilot
testing of radio and television PSAs targeted to reach isolated
domestic violence victims;
(d) Develop a model of intrastate and interstate networks of
domestic violence services to meet the unique needs of migrant
farmworker families dealing with domestic violence, including links
with migrant health centers and legal services; and
(e) Gather and submit data on the types of interventions and the
effects of those interventions on helping immigrant and migrant
battered women receive adequate services.
Products should include reproducible materials, and replicable
models of programs, curricula, policies, and protocols.
Eligible Applicants
State and local public agencies, erritories, Federally recognized
American Indian Tribes and Tribal Organizations, and Native American
communities; public and private nonprofit agencies providing services
to immigrant or migrant communities; domestic violence advocacy
organizations; and State and local domestic violence coalitions.
The applicant organization must submit a Memorandum of
Understanding (MOU) between and among the collaborating organizations.
The MOU must identify the projected role and responsibilities of each
proposed participant organization in the implementation of the project
and the level of commitment in providing
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training, assistance, and or services to victims of domestic violence
and migrant advocacy organizations working in their behalf.
Project Period
The length of the project will not exceed 17 months.
Federal Share of the Project
The maximum Federal share of the project is not to exceed $50,000
for the 17 month project period. Applications for lesser amounts also
will be considered for this project.
Matching Requirement
Successful grantees must provide at least 25 percent of the total
cost of the project. The total cost of the project is the sum of the
ACF share and the non-Federal share. The non-Federal share may be met
by cash or in-kind contributions, although applicants are encouraged to
meet their match requirements through cash contributions. Therefore, a
project requesting $50,000 in Federal funds (based on an award of
$50,000 per budget period) must include a match of at least $16,666
(25% of total project cost) for a total budget of $66,666.
Anticipated Number of Projects to be Funded
It is anticipated that four projects may be funded at the maximum
level; more than four projects may be funded depending on the number of
acceptable applications for lesser amounts which are received.
CFDA: 93.592 Family Violence Prevention and Services: Family
Violence Prevention and Services Act, as amended.
2. Priority Area Number FV-02-97: Domestic Violence/Temporary
Assistance for Needy Families (TANF) Program (welfare reform)
Background
On August 22, 1997, Pub. L. 104-193, the Personal Responsibility
and Work Opportunities Reconciliation Act of 1996 (PRWORA) was enacted.
Also known as ``welfare reform,'' it abolishes the Aid to Families with
Dependent Children (AFDC) and the Job Opportunities and Basic Skills
(JOBS) Training programs and replaces them with the Temporary
Assistance for Needy Families (TANF) State block grant program. The
TANF program includes specific work participation requirements and
penalizes States if these standards are not met.
The Family Violence Amendment, section 402(a)(7) of the Social
Security Act, also known as the Wellstone/Murray Amendment, is an
optional certification for States to develop a three-pronged strategy
for helping victims of domestic violence applying for, or receiving
welfare move successfully into the work force. The strategy includes:
(1) Identifying a victim of domestic violence as that person enters the
assistance system; (2) waiving certain program requirements if
compliance would put the victim at risk of further violence, make it
more difficult for the victim to escape violence, or unfairly penalize
the victim; and (3) providing referrals for supportive services. The
goal of this grant is to promote services to victims of domestic
violence who are TANF applicants or recipients regardless of whether a
State has chosen to implement the Family Violence Amendment.
Purpose
To develop effective strategies for integrating domestic violence
services into State/local or Tribal welfare service systems to promote
services, including crisis intervention and other domestic violence
services, to victims of domestic violence, while assisting victims
towards employment and self-sufficiency.
Moreover, to offer the applicant organizations an opportunity to
jointly design, develop, and implement collaborative projects
addressing several issues or areas of concern among State and local
TANF and Tribal TANF programs and the domestic violence community and
other community-based organizations providing services to victims of
domestic violence.
Minimum Requirements for Project Design
Efforts are to be focused on the joint development of model
protocols and programs, training curricula and materials, models of
cross-training, training of front-line staff in welfare offices and the
training of domestic violence advocates and service providers. The
public agency staff trained would include anyone in the local welfare
office or related offices (such as child support enforcement or job
training programs) who has direct contact with TANF applicants/
recipients.
Domestic violence advocates would be trained in State/local and
Tribal TANF office procedures, child support enforcement, paternity
establishment, and job training and work activity issues to the extent
that the procedures and programs impact upon victims of domestic
violence.
Protocols for effective strategies of intervention should be
considered to:
(1) Ensure confidentiality of client information at every stage of
the process;
(2) Enlighten TANF eligibility workers and case workers, job
training and employment personnel, and child support enforcement staff
about the possible effects of domestic violence on a victim's ability
to work; and
(3) Allow job training and employment staff as well as child
support enforcement workers to ensure the safety of domestic violence
victims who are involved in their system.
The services and activities affected by these strategies would
include the identification, screening, assessment and referral of
victims or potential victims of domestic violence during the course of
eligibility transactions (including Food Stamps and Medicaid) to
appropriate crisis intervention and support services. The intervention
and support services may be job training and other related services and
programs, case management by TANF, child support enforcement,
employment service and agencies that respond to the safety,
confidentiality, and service needs of domestic violence victims.
Applicants may propose to do one or more of the following:
(a) Develop a plan for and implement the training of TANF
eligibility and case workers, child support enforcement workers and
supervisors, on the relationship of domestic violence, poverty and work
activity as it relates to TANF recipients, and related cross-training
of domestic violence programs staff;
(b) Design, pilot test and implement domestic violence-appropriate
model approaches to screening, notification, safety planning,
employability planning and referral systems to be adopted by the State
or Tribal TANF program including eligibility, case maintenance, and
child support enforcement;
(c) Develop and implement through the TANF structure, a domestic
violence-specific curriculum which will become part of a mandatory
training program; and
(d) Gather and submit data on the types of interventions and the
effects of those interventions on helping recipients, identified as
domestic violence victims or potential victims, achieve self-
sufficiency.
Eligible Applicants
State and local public agencies, Territories, and Federally
recognized American Indian Tribes and Tribal Organizations; State and
local welfare agencies; child support enforcement
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agencies; private nonprofit agencies providing services to TANF
recipients; domestic violence advocacy organizations; and State and
local domestic violence coalitions.
The applicants must submit a Memorandum of Understanding between
and among the TANF systems, the domestic violence state/local systems
and community-based service providers, specifically identifying the
role each participant organization has in the implementation of the
proposed project and the level of commitment to providing training to
staff, and services to victims of domestic abuse. The Memorandum of
Understanding is necessary because the successful implementation of a
proposed project would have implications for systemic/procedural change
in the TANF and/or the domestic violence community.
In addition to the Memorandum of Understanding, applicants must
submit signed Letters of Support from the State or Tribal TANF agency
or from the appropriate public agency that is the collaborative partner
and from the state domestic violence coalition or the specific domestic
violence advocacy organization. These letters should identify the
specific commitment that each collaborative partner will bring to the
implementation of the project. If the Memorandum of Agreement and
Letters of Support are not included as part of the application, then
the application will be considered as non-responsive, declared
ineligible, and will be excluded from competition.
Project Period
The length of the project will not exceed 17 months.
Federal Share of the Project
The maximum Federal share of the project is not to exceed $75,000
for the 17 month project period. Applications for lesser amounts also
will be considered for this project.
Matching Requirement
Successful grantees must provide at least 25 percent of the total
cost of the project. The total cost of the project is the sum of the
ACF share and the non-federal share. The non-Federal share may be met
by cash or in-kind contributions, although applicants are encouraged to
meet their match requirements through cash contributions. Therefore, a
project requesting $75,000 in Federal funds (based on an award of
$75,000 per budget period) must include a match of at least $25,000
(25% of total project cost). Therefore, a total project cost of
$100,000 would be comprised of $75,000 Federal funds and $25,000 non-
Federal funds. If approved for funding, grantees will be held
accountable for commitments of non-Federal resources and failure to
provide the required amount will result in a disallowance of unmatched
Federal funds.
Anticipated Number of Projects To Be Funded
It is anticipated that four projects may be funded at the maximum
level; more than four projects may be funded depending on the number of
acceptable applications for lesser amounts which are received.
CFDA: 93.592 Family Violence Prevention and Services: Family
Violence Prevention and Services Act, as amended.
3. Priority Area Number FV-03-97: The Establishment and Implementation
of a Special Issue Resource Center (SIRC) To Aid Indian Tribes and
Tribal Organizations
Purpose
The purpose of the SIRC To Aid Indian Tribes and Tribal
Organizations is to provide specific leadership in the prevention of
domestic violence, resource information and materials, technical
assistance and professional consultation to Tribes, Tribal
organizations, individuals, and other persons and entities seeking to
assist Tribes and Tribal organizations.
Background
The Office of Community Services seeks to support a nationwide
effort that is staffed by an expert and multi-disciplinary team that
responds to requests for resource information, policy analysis,
technical assistance and training. These requests would be from
individuals, agencies, and organizations at the Tribal, Federal, State
and local levels.
The current Domestic Violence Resource Network--a network of four
domestic violence resource centers and the national hotline: (1)
National Resource Center on Domestic Violence; (2) Resource Center on
Civil and Criminal Law, aka the Battered Women's Justice Project; (3)
Health Resource Center on Domestic Violence; (4) Resource Center on
Child Protection and Custody; and (5) the National Domestic Violence
Hotline--serves to strengthen the existing support systems servicing
battered women, their dependents and other victims of domestic
violence. The Resource Network provides nationally recognized
comprehensive program information and information on resources, policy
development, and technical assistance designed to enhance community
resources for the prevention of domestic violence. The Office of
Community Services will consider applications for an additional
resource center to work as part of this network in partnership with
Indian Tribes and Tribal organizations, community-based domestic
violence programs, State domestic violence coalitions, Federal, State
and local governmental agencies, policy makers and individuals involved
in assisting programs for victims of domestic violence. In addition to
providing information and technical assistance, the SIRC to Aid Indian
Tribes and Tribal organizations must provide in relation to Indian
Tribes, issues, and population:
Comprehensive statistics, fact sheets, and specialized
information packets addressing a range of domestic violence issues;
Materials to support the development and replication of
model programs, legislation and exemplary practices;
Technical assistance and training to assist organizations,
programs and communities to adapt available resources to meet local
needs;
A toll-free information line which allows the public to
access the latest developments in research, policy, and practice; and
A customized service reachable by fax or mail whereby
programs, agencies, and professionals may receive packets, newsletters,
bibliographies, policy papers and fact sheets.
The proposed SIRC must have the ability to deliver highly
individualized technical assistance which enables an Indian Tribe or
Tribal organization to solve a specific problem. In addition to
facilitating on-site assistance, the SIRC shall:
Identify, develop, and disseminate research and evaluation
findings pertinent to Indian Tribes and Tribal organizations;
Prepare and distribute technical assistance packages to
aid in the replication of effective services, prevention efforts and
training programs that have been found effective and are culturally
relevant to the Indian Tribes and Tribal organizations;
And identify new areas for demonstration activities that
address domestic violence issues.
Eligible Applicants
Private nonprofit organizations that have focused primarily on
domestic violence prevention and intervention activities and have
extensive experience in the field with Indian Tribes and Tribal
organizations in training
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activities, direct technical assistance, program and services design,
implementation and administration.
Form of Award
The Office of Community Services (OCS) intends to support the SIRC
to Aid Indian Tribes and Tribal organizations with a Cooperative
Agreement. A Cooperative Agreement is Federal financial aid in which
substantial Federal involvement is anticipated. The respective
responsibilities of OCS and of the successful applicant will be
identified and incorporated into the cooperative agreement during pre-
award negotiations. The grantee will outline a plan of interaction with
OCS for implementation under a cooperative agreement including, as
appropriate, activities involving Federal staff. The plan under the
cooperative agreement will describe the general and specific
responsibilities of the grantee and the grantor as well as foreseeable
joint responsibilities. A schedule of tasks will be developed and
agreed upon in addition to any special conditions relating to the
implementation of the project.
Minimum Requirements for Project Design
In order to successfully compete under this announcement, the
applicant must:
(a) Describe the immediacy of the need(s) to be addressed and
provide information on the specific services your organization
currently provides to Tribes or Tribal Organizations and what
information, specific training, and technical assistance would be
provided as an SIRC;
(b) Demonstrate an in-depth understanding of the program/service
and access/response issues of the Indian Tribes and Tribal
organizations and the problems associated with them;
(c) Present the technical approach and the specific workplans for
the provision of training and technical assistance to Tribes and Tribal
Organizations that is nationwide in scope and utilizes the support and
facilitating efforts of the National Resource Center (NRC) and the
Resource Center Network; describe a plan for continuous contact with
the field, an 800 telephone number and direct mailings; and a plan for
the development and use of a network of experts for the provision of
direct training and consultation, including fees for service, if
necessary;
(d) Describe the efforts that you currently make or would
implement, and the relationships that you currently have or will form,
to coordinate activities with other appropriate resource centers,
domestic violence advocacy organizations, State domestic violence
coalitions, public agencies, the NRC, and affiliated SIRCs in a
national domestic violence network to enhance the Center's activities
and to avoid duplication;
(e) Provide a plan to determine the need to implement special
projects related to training curricula, service delivery models or
other aspects of the proposed SIRC to Aid Indian Tribes and Tribal
organizations;
(f) Provide a plan to evaluate the effectiveness of the proposed
project activities within one year of the effective date of the grant;
(g) Describe the proposed SIRC staff with appropriate expertise;
and
(h) Describe the administrative and organizational structure, the
management plan, the cost structure within which the project would
operate; and describe the operational and programmatic relationships to
be formed with the affiliated SIRCs and the NRC. Charts depicting the
organizational structures and the ensuing relationships must be
included.
Project Period
The length of the project for the SIRC will not exceed 48 months.
The award, on a competitive basis, will be for an initial 12-month
budget period, although the project period may be for 4 years.
Applications for continuation grants funded under this award beyond the
12-month budget period but within the 4-year project period will be
considered in subsequent years on a non-competitive basis, subject to
the availability of funds, satisfactory progress of the grantee and a
determination that continued funding would be in the best interest of
the government.
Budget Period and Federal Share
The fiscal year 1997 Federal share for the SIRC to Aid Indian
Tribes and Tribal organizations is $600,000 for the first 12-month
budget period subject to the availability of funds. Applications for
lesser amounts also will be considered for this project. The estimated
Federal share for the second, third, and fourth budget period is
$600,000 per 12-month period.
Matching Requirement
SUCCESSFUL GRANTEES MUST PROVIDE AT LEAST 25 PERCENT OF THE TOTAL
COST OF THE PROJECT. THE TOTAL COST OF THE PROJECT IS THE SUM OF THE
ACF SHARE AND THE NON-FEDERAL SHARE. The non-Federal share may be met
by cash or in-kind contributions, although applicants are encouraged to
meet their match requirements through cash contributions. Therefore, a
project requesting $600,000 in Federal funds (based on an award of
$600,000 per budget period) must include a match of at least $200,000
(25% of total project cost). Therefore, a total project cost of
$800,000 would be comprised of $600,000 in Federal funds and $200,000
in non-Federal funds. If approved for funding, grantees will be held
accountable for commitments of non-Federal resources and failure to
provide the required amount will result in a disallowance of unmatched
Federal funds.
Anticipated Number of Projects To Be Funded
It is anticipated that one (1) project may be funded.
CFDA: 93.592 Family Violence Prevention and Services: Family
Violence Prevention and Services Act, as amended.
4. Priority Area Number FV-04-97: Training Grant Stipends in Domestic
Violence for Historically Black, Hispanic-Serving and Tribal Colleges
and Universities
Background
Media coverage, court records, and crime statistics suggest that a
substantial proportion of the domestic violence which occurs in the
general population involves underserved populations, including
populations that are underserved because of ethnic, racial, cultural,
language diversity or geographic isolation (Brachman & Saltzman, 1995).
Official statistics on child abuse and spouse abuse indicate that
women, minorities, and the poor are over-represented among victims of
domestic violence (Straus, Gelles & Steinmetz, 1980). The scholars and
practitioners who are responding to violence in underserved communities
are currently few in number and work in isolation. The purpose of this
effort and priority area is to increase the capacity for advocates and
allies to do the work that is needed to prevent domestic violence.
There are three Executive Orders that support the provision of
training grants to the educational institutions targeted in this
priority area:
--Executive Order 13021 of October 19, 1969, Tribal Colleges and
Universities;
--Executive Order 12900 of December 5, 1994, Educational Excellence for
Hispanic Americans; and
[[Page 29249]]
--Executive Order 12876 of November 1, 1993, Historically Black
Colleges and Universities.
Executive Order 13021 reaffirms the special relationship of the
Federal Government to the American Indians and identifies several
purposes that support access to opportunities, resources, and that
support educational opportunities for economically disadvantaged
students; Executive Order 12900 requires the provision of quality
education and increased educational opportunities for Hispanic
Americans; and Executive Order 12876 requires strengthening the
capacity of Historical Black Colleges and Universities to provide
quality education and increased opportunities to participate in and
benefit from Federal programs.
Purpose
(a) To provide support for graduate and undergraduate students who
show promise and demonstrate serious interest and commitment to issues
of domestic violence in underserved populations. Historically Black,
Hispanic and American Indian colleges and universities will be given
special consideration in order to generate skill building and training
opportunities particularly responsive to issues of cultural content.
(b) To support the growth of college and university-based practice
knowledge about domestic violence and encourage social work students
and faculty to pursue careers which address the issue of domestic
violence experiences and underscore the need to draw new social
workers.
(c) To identify best practices regarding critical issues in
domestic violence prevention, identification, and treatment efforts in
under-served domestic violence populations. These grants will include
an institutional payment, to cover the individual student's tuition and
fees, and a stipend for the student.
Minimum Requirements for Project Design
Field Placement: The grant will provide stipends for qualified
individuals pursuing degrees in social work with a special interest in
domestic violence. It will provide one year graduate and undergraduate
stipends to support skill building and training of students interested
in domestic violence treatment and intervention services to underserved
racial and ethnic minority populations.
Placements must provide a structured learning environment that
enables students to compare their field placement experiences,
integrate knowledge from the classroom, and expand knowledge beyond the
scope of the practicum setting (Council on Social Work Education
[CSWE], {1994}. Baccalaureate and Master's Program Evaluative
Standards, Interpretive Guidelines, Curriculum Policy Statement, and
Self-Study Guide. The Accreditation Standards and Self-Study Guides).
Proposals must include content about differences and similarities
in the experiences, needs, and beliefs of the people being served. The
proposals must also include content about differential assessment and
intervention skills that will enable practitioners to serve diverse
populations. The field placements must focus on the general and
specific topic areas as indicated in this announcement. The applicant
student must indicate the area of interest, objectives, and goals of
the placement/study. Field placements will be at a minimum of 900 hours
per semester.
Faculty Involvement: Faculty must indicate the use of professional
supervision to enhance the learning of students and must coordinate and
monitor practicum placements of student selected for stipends.
Proposals must define the social work setting and practice, field
instructor assignments and activities, and student learning
expectations and responsibilities.
Individual faculty may organize their practicum-placements in
different ways but must ensure educationally directed, coordinated, and
monitored practicum experiences are maintained for students and related
to domestic violence.
Faculty must articulate clear practice and evaluation goals for the
field practicum and for each student and faculty proposals must provide
an orientation plan for the student to the practicum placement and the
agency's policy.
Final Products/Results and Benefits Expected:
Practicum proposal/contract between the student, the
organization (agency), and the college or university indicating defined
objectives, goals, students performance, benefits to student, lessons
learned, and recommendations for future placement at agency;
A report focusing on agency population served,
difficulties encountered, outcomes, implications and recommendations
for future placements. The report should be prepared and submitted to
the Office of Community Services; and
One mid-semester student performance evaluation.
Eligible Applicants
Historically Black Colleges and Universities; Hispanic-serving
Colleges and Universities; and Tribal Colleges and Universities.
Hispanic-serving Colleges and Universities are defined as those whose
student population is more than 25% Hispanic. Tribal Colleges and
Universities are those institutions cited in section 532 of the Equity
in Educational Land-Grant Status Act of 1994 (7 U.S.C. 301 note), any
other institution that qualifies for funding under the Tribally
Controlled Community College Assistance Act of 1978 (25 U.S.C. 1801 et
seq.) and Navajo Community College, authorized in the Navajo Community
College Assistance Act of 1978, Pub. L. 95-471, title II (25 U.S.C.
640a note.)
Applicant institutions must be fully accredited by one of the
regional institutional accrediting commissions recognized by the U.S.
Secretary of Education and the Council on Social Work Education.
Participants would include: qualified undergraduate or graduate
social work students. All individuals seeking student stipends must be
enrolled in the institution.
Recipients of student stipends must maintain satisfactory
academic records and be full-time students.
Awards will be made only to eligible institutions on
behalf of their qualified candidates.
Project Period
Stipends are awarded for one year, not to exceed 12
months.
Federal Share of the Project Cost
This competitive program provides stipends for a maximum amount not
to exceed $75,000 (includes direct and indirect costs) per college or
university. The Federal share will fund up to four student candidates
at a maximum of $11,250 each and will fund one faculty coordinator of
the project at $30,000.
Anticipated Number of Projects to be Funded
It is anticipated that 4 projects will be funded at $75,000 each.
Applications for lesser amounts will also be considered for this
priority area. CDFA: 93.592 Family Violence Prevention and Services:
Family Violence Prevention and Services Act as amended.
Part III. The Review Process
A. Eligible Applicants
Before applications are reviewed, each application will be screened
to determine that the applicant organization is an eligible applicant
as
[[Page 29250]]
specified under the selected priority area. Applications from
organizations which do not meet the eligibility requirements for the
priority area will not be considered or reviewed in the competition,
and the applicant will be so informed.
Each priority area description contains information about the types
of agencies and organizations which are eligible to apply under that
priority area. Since eligibility varies among priority areas, it is
critical that the ``Eligible Applicants'' section under each specific
priority area be read carefully.
Only agencies and organizations, not individuals, are eligible to
apply under any of the priority areas. On all applications developed
jointly by more than one agency or organization, the applications must
identify only one organization as the lead organization and official
applicant. The other participating agencies and organizations can be
included as co-participants, subgrantees or subcontractors.
Any non-profit agency submitting an application must submit proof
of non-profit status with its grant application. The non-profit agency
can accomplish this by providing a copy of the applicant's listing in
the Internal Revenue Service's (IRS) most recent list of tax-exempt
organizations described in section 501 (c)(3) of the IRS Code or by
providing a copy of the currently valid IRS tax exemption certificate,
or by providing a copy of the articles of incorporation bearing the
seal of the State in which the corporation or association is domiciled.
ACF cannot fund a non-profit applicant without acceptable proof of its
non-profit status.
B. Review Process and Funding Decisions
Experts in the field, generally persons from outside of the Federal
government, will use the appropriate evaluation criteria listed later
in this Part to review and score the applications. The results of this
review are a primary factor in making funding decisions.
ACF reserves the option of discussing applications with, or
referring them to, other Federal or non-Federal funding sources when
this is determined to be in the best interest of the Federal government
or the applicant. It may also solicit comments from ACF Regional Office
staff, other Federal agencies, interested foundations, national
organizations, specialists, experts, States and the general public.
These comments, along with those of the expert reviewers, will be
considered by OCS in making funding decisions.
In making decisions on awards, OCS may give preference to
applications which focus on or feature: a substantially innovative
strategy with the potential to improve theory or practice in the field
of human services; a model practice or set of procedures that holds the
potential for replication by organizations involved in the
administration or delivery of human services; substantial involvement
of volunteers; substantial involvement (either financial or
programmatic) of the private sector; a favorable balance between
Federal and non-Federal funds available for the proposed project; the
potential for high benefit for low Federal investment; a programmatic
focus on those most in need; and/or substantial involvement in the
proposed project by national or community foundations.
To encourage increased collaboration and coordination among
existing programs and related initiatives, OCS will give additional
consideration to applications from organizations and/ or agencies that
are documented participants in Empowerment Zone and/or Enterprise
Community plans and applications. Applicants citing participation with
Empowerment Zones and/or Enterprise Communities should document that
they were involved in the preparation and proposed implementation of
the plan and how their proposed family violence project supports the
goal of the Empowerment or Enterprise plans (0-5 points).
C. Evaluation Criteria
Using the appropriate evaluation criteria below, a panel of at
least three reviewers (primarily experts from outside the Federal
government) will review each application. Applicants should ensure that
they address each minimum requirement in the priority area description
under the appropriate section of the Program Narrative Statement.
Reviewers will determine the strengths and weaknesses of each
application in terms of the appropriate evaluation criteria listed
below, provide comments and assign numerical scores. The point value
following each criterion heading indicates the maximum numerical weight
that each section may be given in the review process.
Evaluation Criteria for Priority Areas
Applications submitted under priority areas:
FV-01-97, Developing and Enhancing Services for Immigrant
and Migrant Battered Women;
FV-02-97, Domestic Violence/Temporary Assistance for Needy
Families (TANF) Program; and
FV-04-97, Minority Training Grant Stipends in Domestic
Violence,
will be evaluated against the following criteria.
1. Need for the Project (10 Points)
The extent to which the need for the project and the problems it
will address have national and local significance; the applicability of
the project to coordination efforts by national, Tribal, State and
local governmental and non-profit agencies, and its ultimate impact on
domestic violence prevention services and intervention efforts,
policies and practice; the relevance of other documentation as it
relates to the applicant's knowledge of the need for the project; and
the identification of the specific topic or program area to be served
by the project. Maps and other graphic aids may be attached.
2. Goals and Objectives (10 Points)
The extent to which the specific goals and objectives have national
or local significance, the clarity of the goals and objectives as they
relate to the identified need for and the overall purpose of the
project, and their applicability to policy and practice. The provision
of a detailed discussion of the objectives and the extent to which the
objectives are realistic, specific, and achievable.
3. Approach (30 Points)
The extent to which the application outlines a sound and workable
plan of action pertaining to the scope of the project, and details how
the proposed work will be accomplished; relates each task to the
objectives and identifies the key staff member who will be the lead
person; provides a chart indicating the timetable for completing each
task, the lead person, and the time committed; cites factors which
might accelerate or decelerate the work, giving acceptable reasons for
taking this approach as opposed to others; describes and supports any
unusual features of the project, such as design or technological
innovations, reductions in cost or time, or extraordinary social and
community involvements; and provides for projections of the
accomplishments to be achieved.
The extent to which, when applicable, the application describes the
evaluation methodology that will be used to determine if the needs
identified and discussed are being met and if the results and benefits
identified are being achieved.
[[Page 29251]]
4. Results and Benefits (20 Points)
The extent to which the application identifies the results and
benefits to be derived, the extent to which they are consistent with
the objectives of the application, the extent to which the application
indicates the anticipated contributions to policy, practice, and
theory, and the extent to which the proposed project costs are
reasonable in view of the expected results. Identify, in specific
terms, the results and benefits, for target groups and human service
providers, to be derived from implementing the proposed project.
Describe how the expected results and benefits will relate to previous
demonstration efforts.
5. Level of Effort: (30 Points)
Staffing pattern--Describe the staffing pattern for the proposed
project, clearly linking responsibilities to project tasks and
specifying the contributions to be made by key staff.
Competence of staff--Describe the qualifications of the project
team including any experiences working on similar projects. Also,
describe the variety of skills to be used, relevant educational
background and the demonstrated ability to produce final results that
are comprehensible and usable. One or two pertinent paragraphs on each
key member are preferred to resumes. However, resumes may be included
in the ten pages allowed for attachments/appendices.
Adequacy of resources--Specify the adequacy of the available
facilities, resources and organizational experience with regard to the
tasks of the proposed project. List the financial, physical and other
resources to be provided by other profit and nonprofit organizations.
Explain how these organizations will participate in the day to day
operations of the project.
Budget--Relate the proposed budget to the level of effort required
to obtain project objectives and provide a cost/benefit analysis.
Demonstrate that the project's costs are reasonable in view of the
anticipated results.
Collaborative efforts--Discuss in detail and provide documentation
for any collaborative or coordinated efforts with other agencies or
organizations. Identify these agencies or organizations and explain how
their participation will enhance the project. Letters from these
agencies and organizations discussing the specifics of their commitment
must be included in the application.
Authorship--The authors of the application must be clearly
identified together with their current relationship to the applicant
organization and any future project role they may have if the project
is funded.
Applications submitted under priority area:
FV-03-97, The Establishment and Implementation of a
Special Issue Resource Center to Aid Indian Tribes and Tribal
Organizations;
will be evaluated against the following criteria.
1. Need for the Project (10 Points)
The extent to which the need for the project and the problems it
will address have national and local significance; the applicability of
the project to coordination efforts by national, Tribal, State and
local governmental and non-profit agencies, and its ultimate impact on
domestic violence prevention services and intervention efforts,
policies and practice on Tribal Trust lands and reservations; the
relevance of other documentation as it relates to the applicants
knowledge of the need for the project; and the identification,
understanding and knowledge of the specific topic or program area to be
served by the project. Maps and other graphic aids may be attached.
2. Goals and Objectives (10 Points)
The extent to which the specific goals and objectives have national
or local significance, the clarity of the goals and objectives as they
relate to the identified need for and the overall purpose of the
project, and their applicability to policy and practice. The provision
of a detailed discussion of the objectives and the extent to which the
objectives are realistic, specific, and achievable.
3. Approach (30 Points)
The extent to which the application outlines a sound and workable
plan of action pertaining to the scope of the project, and details how
the proposed work will be accomplished; relates each task to the
objectives and identifies the key staff member who will be the lead
person; provides a chart indicating the timetable for completing each
task, the lead person, and the time committed; cites factors which
might accelerate or decelerate the work, giving acceptable reasons for
taking this approach as opposed to others; describes and supports any
unusual features of the project, such as design or technological
innovations, reductions in cost or time, or extraordinary social and
community involvements; and provides for projections of the
accomplishments to be achieved.
The extent to which the application describes the evaluation
methodology that will be used to determine if the needs identified and
discussed are being met and if the results and benefits identified are
being achieved.
4. Results and Benefits (20 Points)
The extent to which the application identifies the results and
benefits to be derived, the extent to which they are consistent with
the objectives of the application, the extent to which the application
indicates the anticipated contributions to policy, practice, and
theory, and the extent to which the proposed project costs are
reasonable in view of the expected results.
The applicant should identify, in specific terms, the results and
benefits, for target groups and human service providers, to be derived
from implementing the proposed project. Applicant should also describe
how the expected results and benefits will relate to previous
demonstration efforts.
5. Level of Effort: (30 Points)
Expertise, Commitment, and Support
(a) Applicants must have documented individual and organizational
experience in the area of domestic violence prevention and services
with Indian Tribes and Tribal organizations. Each applicant
organization must have an advisory board.
(b) The extent to which the applicant has nationally recognized
expertise in the area of domestic violence and a record of high quality
service to victims of domestic violence, including a demonstration of
support from advocacy groups, such as State Domestic Violence
Coalitions or recognized national domestic violence advocacy groups;
the extent of the applicant's commitment to diversity, and to the
provision of services to Indian Tribes and Tribal organizations.
Staff Background, Organizational Experience, and Competence of Staff
(c) The adequacy of the staffing pattern for the proposed project,
how the individual responsibilities are linked to project tasks, and
the contributions to be made by key staff. Each collaborating or
cooperative organization, individual consultant, or other key
individuals who will work on the project should be listed along with a
description of the nature of their effort or contribution.
The background and experience of the project director and key
project staff and the history and accomplishments of the organization;
the qualifications of the project team including any experience with
similar projects; the variety of skills, relevant educational
background, and the ability to effectively manage the project and to
coordinate with other agencies. One or two pertinent
[[Page 29252]]
paragraphs on each key member are preferred to vitae/resumes. However,
resumes may be included.
Adequacy of Resources and the Budget
(d) The adequacy of the available resources and organizational
experience with regard to the scope of the tasks of the proposed
project. A list of the financial, physical, and other resources already
committed by other private and public institutions and agencies, if
any, and the explanation of how these organizations will participate in
the day-to-day operations of the project. Letters from these agencies
and organizations identifying and discussing the specifics of their
commitment and participation must be included in the application. The
extent to which the proposed budget is related to the level of effort
required to obtain the project's objectives; demonstration that the
project's costs are reasonable in view of the anticipated results.
Collaborative Effort
(e) The extent of the additional private sector resources that may
be available to support or enhance the overall program. A discussion in
detail and the provision of documentation for any proposed
collaborative or coordinated efforts with other public or private
agencies or organizations. Letters from these agencies and
organizations must be included discussing their interest and/or
commitment in supporting the proposed project, stating at what juncture
they would become involved and the expected level of resource
commitment.
Applicants should note that non-responsiveness to the section
designated as ``Minimum Requirements for Project Design,'' in the
applicable priority areas, will result in a low evaluation score by the
panel of expert reviewers.
Applicants must clearly identify the specific priority area under
which they wish to have their applications considered, and tailor their
applications accordingly. Previous experience has shown that an
application which is broad and more general in concept than outlined in
the priority area description is less likely to score as well as one
which is more clearly focused and directly responsive to the concerns
of that specific priority area.
D. Available Funds
ACF intends to award grants resulting from this announcement during
the fourth quarter of FY 1997. The size of the actual awards will vary.
Each priority area description includes information on the maximum
Federal share of the project costs and the anticipated number of
projects to be funded.
The term ``budget period'' refers to the interval of time (usually
12 or 17 months) into which a multi-year period of assistance (project
period) is divided for budgetary and funding purposes. The term
``project period'' refers to the total time a project is approved for
support, including any extensions.
Where appropriate, applicants may propose project periods which are
shorter than the maximums specified in the various priority areas. Non-
Federal share contributions may exceed the minimums specified in the
various priority areas when the applicant is able to do so.
E. Grantee Share of Project Costs
Federal funds will be provided to cover up to 75% of the total
allowable project costs. Therefore, the non-Federal share must amount
to at least 25% of the total (Federal plus non-Federal) project cost.
This means that, for every $3 in Federal funds received, up to the
maximum amount allowable under each priority area, applicants must
contribute at least $1.
For example, the cost breakout for a project with a total cost of
$66,666 to implement would be:
------------------------------------------------------------------------
Non-Federal
Federal request share Total cost
------------------------------------------------------------------------
$50,000....................................... $16,666 $66,666
75%........................................... 25% 100%
------------------------------------------------------------------------
Part IV--Instructions for the Development and Submission of
Applications
This Part contains information and instructions for submitting
applications in response to this announcement. Application forms are
provided as part of this publication along with a checklist for
assembling an application package. Please copy and use these forms in
submitting an application.
Potential applicants should read this section carefully in
conjunction with the information contained within the specific priority
area under which the application is to be submitted. The priority area
descriptions are in Part II.
A. Required Notification of the State Single Point of Contact
This program is covered under Executive Order 12372, (E.O.)
``Intergovernmental Review of Federal Programs,'' and 45 CFR Part 100,
``Intergovernmental Review of Department of Health and Human Services
Program and Activities.'' Under the E.O., States may design their own
processes for reviewing and commenting on proposed Federal assistance
under covered programs.
All States and territories, except Alabama, Alaska, Colorado,
Connecticut, Hawaii, Idaho, Kansas, Louisiana, Massachusetts,
Minnesota, Montana, Nebraska, New Jersey, Oklahoma, Oregon,
Pennsylvania, South Dakota, Tennessee, Vermont, Virginia, Washington,
American Samoa and Palau, have elected to participate in the E.O.
process and have established a Single Point of Contact (SPOCs).
Applicants from these twenty-three jurisdictions need take no action
regarding E.O. 12372. Applicants for projects to be administered by
Federally-recognized Indian Tribes are also exempt from the
requirements of E.O. 12372. Otherwise, applicants should contact their
SPOCs as soon as possible to alert them of the prospective applications
and receive any necessary instructions. Applicants must submit any
required material to the SPOCs as soon as possible so that OCS 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 application
deadline to comment on proposed new or competing continuation awards.
SPOCs are encouraged to eliminate the submission of routine
endorsements as official recommendations. Additionally, SPOCs are
requested to differentiate clearly 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, (OCS-97-
07) 370 L'Enfant Promenade, SW., 6th Floor East, Washington, DC 20447.
A list of the Single Point of Contact for each State and Territory
is included at the end of this announcement.
B. Paperwork Reduction Act of 1995
Under the Paperwork Reduction Act of 1995, Public Law 104-13, the
Department is required to submit to the Office of Management and Budget
(OMB) for review and approval any reporting and recordkeeping
requirements in regulations, including program announcements. This
program announcement does not contain
[[Page 29253]]
information requirements beyond those approved for ACF grant
applications under OMB Control Number 0970-0062 which will expire 09/
30/98. An agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays
a currently valid OMB control number.
C. Deadline for Submittal of Applications
The closing date and time for submittal of applications under this
program announcement is found at the beginning of this program
announcement under CLOSING DATE.
Mailed applications shall be considered as meeting an announced
deadline if they are either received on or before the deadline date or
sent on or before the deadline date and received by ACF in time for the
independent review to: U.S. Department of Health and Human Services,
Administration for Children and Families, Division of Discretionary
Grants, 370 L'Enfant Promenade, SW., Mail Stop 6C-462, Washington, DC
20447, Attention: Application for Family Violence Prevention and
Services Program.
Applications handcarried by applicants, applicant couriers, or
overnight/express mail couriers shall be considered as meeting an
announced deadline if they are received on or before the deadline date,
between the hours of 8:00 a.m. and 4:30 p.m., at the U.S. Department of
Health and Human Services, Administration for Children and Families,
Division of Discretionary Grants, ACF Mailroom, 2nd Floor Loading Dock,
Aerospace Center, 901 D Street, SW., Washington, DC 20024, between
Monday and Friday, (excluding Federal holidays). (Applicants are
cautioned that express/overnight mail services do not always deliver as
agreed.)
ACF cannot accommodate transmission of applications by fax or
through other electronic media. Therefore, applications transmitted to
ACF electronically will not be accepted regardless of the date or time
of submission and time of receipt.
Late applications
Applications which do not meet the criteria above are considered
late applications. The ACF shall notify each late applicant that its
application will not be considered in the current competition.
Extension of Deadlines
ACF may extend the deadline for all applicants due to acts of God,
such as floods, hurricanes or earthquakes; widespread disruption of the
mails; or if ACF determines a deadline extension to be in the best
interest of the Government. However, if ACF does not extend the
deadline for all applicants, it may not waive or extend the deadline
for any applicant.
D. Instructions for Preparing the Application and Completing
Application Forms
The SF 424, Page 2; and certifications have been reprinted for your
convenience in preparing the application. You should reproduce single-
sided copies of these forms from the reprinted forms in the
announcement, typing your information onto the copies. Please do not
use forms directly from the Federal Register announcement, as they are
printed on both sides of the page.
In order to assist applicants in correctly completing the SF 424
and SF 424A, instructions for these forms have been included at the end
of Part IV of this announcement.
Where specific information is not required under this program, NA
(not applicable) has been preprinted on the form.
Please prepare your application in accordance with the following
instructions:
1. SF 424 Page 1, Application Cover Sheet
Please read the following instructions before completing the
application cover sheet. An explanation of each item is included.
Complete only the items specified.
Top of Page. Enter the single priority area number under which the
application is being submitted. An application should be submitted
under only one priority area.
Item 1. ``Type of Submission''--Preprinted on the form.
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''--State use only (if applicable).
Item 4. ``Date Received by Federal Agency''--Leave blank.
Item 5. ``Applicant Information.''
``Legal Name''--Enter the legal name of applicant organization. For
applications developed jointly, enter the name of the lead organization
only. There must be a single applicant for each application.
``Organizational Unit''--Enter the name of the primary unit within
the applicant organization which will actually carry out the project
activity. Do not use the name of an individual as the applicant. If
this is the same as the applicant organization, leave the
organizational unit blank.
``Address''--Enter the complete address that the organization
actually uses to receive mail, since this is the address to which all
correspondence will be sent. Do not include both street address and
P.O. box number unless both must be used in mailing.
``Name and telephone number of the person to be contacted on
matters involving this application (give area code)''--Enter the full
name (including academic degree, if applicable) and telephone number of
a person who can respond to questions about the application. This
person should be accessible at the address given here and will receive
all correspondence regarding the application.
Item 6. ``Employer Identification Number (EIN)''--Enter the
employer identification number of the applicant organization, as
assigned by the Internal Revenue Service, including, if known, the
Central Registry System suffix.
Item 7. ``Type of Applicant''--Self-explanatory.
Item 8. ``Type of Application''--Preprinted on the form.
Item 9. ``Name of Federal Agency''--Preprinted on the form.
Item 10. ``Catalog of Federal Domestic Assistance Number and
Title''--Enter the Catalog of Federal Domestic Assistance (CFDA) number
assigned to the program under which assistance is requested and its
title, as indicated in the relevant priority area description.
Item 11. ``Descriptive Title of Applicant's Project''--Enter the
project title. The title is generally short and is descriptive of the
project, not the priority area title.
Item 12. ``Areas Affected by Project''--Enter the governmental unit
where significant and meaningful impact could be observed. List only
the largest unit or units affected, such as State, county, or city. If
an entire unit is affected, list it rather than subunits.
Item 13. ``Proposed Project''--Enter the desired start date for the
project and projected completion date.
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. If statewide, a multi-State effort, or
nationwide, enter ``00.''
Items 15. ``Estimated Funding Levels''--In completing 15a through
15f, the dollar amounts entered should reflect, for a 17 month or less
project period, the total amount requested.
[[Page 29254]]
Item 15a. Enter the amount of Federal funds requested in accordance
with the preceding paragraph. This amount should be no greater than the
maximum amount specified in the priority area description.
Items 15 b-e Enter the amount(s) of funds from non-Federal sources
that will be contributed to the proposed project. Items b-e are
considered cost-sharing or ``matching funds.'' The value of third party
in-kind contributions should be included on appropriate lines as
applicable. For more information regarding funding as well as
exceptions to these rules, see Part III, Sections E and F, and the
specific priority area description.
Item 15f. Enter the estimated amount of income, if any, expected to
be generated from the proposed project. Do not add to or subtract this
amount from the total project amount entered under item 15g. Describe
the nature, source and anticipated use of this income in the Project
Narrative Statement.
Item 15g. Enter the sum of items 15a-15e.
Item 16a. ``Is Application Subject to Review By State Executive
Order 12372 Process? Yes.''--Enter the date the applicant contacted the
SPOC regarding this application. Select the appropriate SPOC from the
listing provided at the end of Part IV. The review of the application
is at the discretion of the SPOC. The SPOC will verify the date noted
on the application. If there is a discrepancy in dates, the SPOC may
request that the Federal agency delay any proposed funding until
September 30, 1997.
Item 16b. ``Is Application Subject to Review By State Executive
Order 12372 Process? No.''--Check the appropriate box if the
application is not covered by E.O. 12372 or if the program has not been
selected by the State for review.
Item 17. ``Is the Applicant Delinquent on any Federal Debt?''--
Check the appropriate box. This question applies to the applicant
organization, not the person who signs as the authorized
representative. Categories of debt include audit disallowances, loans
and taxes.
Item 18. ``To the best of my knowledge and belief, all data in this
application/preapplication are true and correct. The document has been
duly authorized by the governing body of the applicant and the
applicant will comply with the attached assurances if the assistance is
awarded.''--To be signed by the authorized representative of the
applicant. A copy of the governing body's authorization for signature
of this application by this individual as the official representative
must be on file in the applicant's office, and may be requested from
the applicant.
Item 18 a-c. ``Typed Name of Authorized Representative, Title,
Telephone Number''--Enter the name, title and telephone number of the
authorized representative of the applicant organization.
Item 18d. ``Signature of Authorized Representative''--Signature of
the authorized representative named in Item 18a. At least one copy of
the application must have an original signature. Use colored ink (not
black) so that the original signature is easily identified.
Item 18e. ``Date Signed''--Enter the date the application was
signed by the authorized representative.
2. SF 424A--Budget Information--Non-Construction Programs
This is a form used by many Federal agencies. For this application,
Sections A, B, C, E and F are to be completed. Section D does not need
to be completed.
Sections A and B should include the Federal as well as the non-
Federal funding for the proposed project covering (1) the total project
period of 17 months or less or (2) the first year budget period, if the
proposed project period exceeds 17 months.
Section A--Budget Summary. This section includes a summary of the
budget. On line 5, enter total Federal costs in column (e) and total
non-Federal costs, including third party in-kind contributions, but not
program income, in column (f). Enter the total of (e) and (f) in column
(g).
Section B--Budget Categories. This budget, which includes the
Federal as well as non-Federal funding for the proposed project, covers
the total project period of 17 months or less. It should relate to item
15g, total funding, on the SF 424. Under column (5), enter the total
requirements for funds (Federal and non-Federal) by object class
category.
A separate budget justification should be included to explain fully
and justify major items, as indicated below. The types of information
to be included in the justification are indicated under each category.
For multiple year projects, it is desirable to provide this information
for each year of the project. The budget justification should
immediately follow the second page of the SF 424A.
Personnel--Line 6a. Enter the total costs of salaries and wages of
applicant/grantee staff. Do not include the costs of consultants, which
should be included on line 6h, ``Other.''
Justification: Identify the project director, if known. 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.
Fringe Benefits--Line 6b. Enter the total costs of fringe benefits,
unless treated as part of an approved indirect cost rate.
Justification: Provide a break-down of amounts and percentages that
comprise fringe benefit costs, such as health insurance, FICA,
retirement insurance, etc.
Travel--6c. Enter total costs of out-of-town travel (travel
requiring per diem) for staff of the project. Do not enter costs for
consultant's travel or local transportation, which should be included
on Line 6h, ``Other.''
Justification: Include the name(s) of traveler(s), total number of
trips, destinations, length of stay, transportation costs and
subsistence allowances.
Equipment--Line 6d. Enter the total costs of all equipment to be
acquired by the project. Equipment is defined as non-expendable
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
justified. The equipment must be required to conduct the project, and
the applicant organization or its subgrantees must not have the
equipment or a reasonable facsimile available to the project. The
justification also must contain plans for future use or disposal of the
equipment after the project ends.
Supplies--Line 6e. Enter the total costs of all tangible expendable
personal property (supplies) other than those included on Line 6d.
Justification: Specify general categories of supplies and their
costs.
Contractual--Line 6f. Enter the total costs of all contracts,
including procurement contracts (except those which belong on other
lines such as equipment, supplies, etc.) and contracts with secondary
recipient organizations. Also include any contracts with organizations
for the provision of technical assistance. Do not include payments to
individuals on this line.
Justification: Attach a list of contractors, indicating the names
of the organizations, the purposes of the contracts, and the estimated
dollar amounts of the awards as part of the budget justification.
Whenever the applicant/grantee intends to delegate part or all of the
program to another agency, the applicant/grantee must complete this
section (Section B, Budget
[[Page 29255]]
Categories) for each delegate agency by agency title, along with the
supporting information. The total cost of all such agencies will be
part of the amount shown on Line 6f. Provide backup documentation
identifying the name of contractor, purpose of contract, and major cost
elements.
Construction--Line 6g. Not applicable. New construction is not
allowable.
Other--Line 6h. Enter the total of all other costs. Where
applicable, such costs may include, but are not limited to: insurance;
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. Note that costs identified as ``miscellaneous'' and
``honoraria'' are not allowable.
Justification: Specify the costs included.
Total Direct Charges--Line 6i. Enter the total of Lines 6a through
6h.
Indirect Charges--6j. Enter the total amount of indirect charges
(costs). If no indirect costs are requested, enter ``none.'' Generally,
this line should be used when the applicant (except State and local
governments) has a current indirect cost rate agreement approved by the
Department of Health and Human Services or another Federal agency. Note
percentage for indirect cost rate and include a copy of the indirect
cost rate with the application.
Local and State governments should enter the amount of indirect
costs determined in accordance with HHS requirements. When an indirect
cost rate is requested, these costs are included in the indirect cost
pool and should not be charged again as direct costs to the grant. In
the case of training grants to other than State or local governments
(as defined in title 45, Code of Federal Regulations, part 74), the
Federal reimbursement of indirect costs will be limited to the lesser
of the negotiated (or actual) indirect cost rate or 8 percent of the
amount allowed for direct costs, exclusive of any equipment charges,
rental of space, tuition and fees, post-doctoral training allowances,
contractual items, and alterations and renovations.
For training grant applications, the entry under line 6j should be
the total indirect costs being charged to the project. The Federal
share of indirect costs is calculated as shown above. The applicant's
share is calculated as follows:
(a) Calculate total project indirect costs (a*) by applying the
applicant's approved indirect cost rate to the total project (Federal
and non-Federal) direct costs.
(b) Calculate the Federal share of indirect costs (b*) at 8 percent
of the amount allowed for total project (Federal and non-Federal)
direct costs exclusive of any equipment charges, rental of space,
tuition and fees, post-doctoral training allowances, contractual items,
and alterations and renovations.
(c) Subtract (b*) from (a*). The remainder is what the applicant
can claim as part of its matching cost contribution.
Justification: Enclose a copy of the indirect cost rate agreement
if it was negotiated with a Federal agency other than DHHS. Applicants
subject to the limitation on the Federal reimbursement of indirect
costs for training grants should specify this.
Total--Line 6k. Enter the total amounts of lines 6i and 6j.
Program Income--Line 7. Enter the estimated amount of income, if
any, expected to be generated from this project. Do not add or subtract
this amount from the total project amount.
Justification: Describe the nature, source, and anticipated use of
program income in the Program Narrative Statement.
Section C--Non-Federal Resources. This section summarizes the
amounts of non-Federal resources that will be applied to the grant.
Enter this information on line 12 entitled ``Totals.'' In-kind
contributions are defined in title 45 of the Code of Federal
Regulations, Part 74.2, as the value of non-cash contributions provided
by non-Federal third parties. Third party in-kind contributions may be
in the form of real property, equipment, supplies, and other expendable
property, and the value of goods and services directly benefiting and
specifically identifiable to the project or program.
Justification: Describe third party in-kind contributions, if
included.
Section D--Forecasted Cash Needs. Not applicable.
Section E--Budget Estimate of Federal Funds Needed For Balance of
the Project. Not applicable.
Totals--Line 20. For projects that will have more than one budget
period, enter the estimated required Federal funds for the second
budget period (months 13 through 24) under column ``(b) First.'' If a
third budget period will be necessary, enter the Federal funds needed
for months 25 through 36 under ``(c) Second.'' Columns (d) and (e) are
not applicable in most instances, since ACF funding is almost always
limited to a three-year maximum project period. They should remain
blank.
Section F--Other Budget Information.
Direct Charges--Line 21. Not applicable.
Indirect Charges--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.
Remarks--Line 23. If the total project period exceeds 17 months,
you must enter your proposed non-Federal share of the project budget
for each of the remaining years of the project.
3. Project Summary Description
Clearly mark this separate page with the applicant name as shown in
item 5 of the SF 424, and the title of the project as shown in item 11
of the SF 424. The summary description should not exceed 300 words.
These 300 words become part of the computer database on each project.
Care should be taken to produce a summary description which
accurately and concisely reflects the application. It should describe
the objectives of the project, the approaches to be used and the
outcomes expected. The description should also include a list of major
products that will result from the proposed project, such as software
packages, materials, management procedures, data collection
instruments, training packages, or videos (please note that
audiovisuals should be closed captioned). The project summary
description, together with the information on the SF 424, will
constitute the project ``abstract.'' It is the major source of
information about the proposed project and is usually the first part of
the application that the reviewers read in evaluating the application.
4. Program Narrative Statement
The Program Narrative Statement is a very important part of an
application. It should be clear, concise, and address the specific
requirements mentioned under the priority area description in Part II.
The narrative should also provide information concerning how the
application meets the evaluation criteria using the following headings:
(a) Need for the Project;
(b) Goals and Objectives;
(c) Approach;
(d) Results and Benefits; and
(e) Level of Effort.
The specific information to be included under each of these
headings
[[Page 29256]]
is described in Section C of Part III, Evaluation Criteria.
The narrative should be typed double-spaced on a single-side of an
8\1/2\'' x 11'' plain white paper, with 1'' margins on all sides. All
pages of the narrative (including charts, references/footnotes, tables,
maps, exhibits, etc.) must be sequentially numbered, beginning with
``Objectives and Need for the Project'' as page number one. Applicants
should not submit reproductions of larger size paper, reduced to meet
the size requirement.
The length of the application, including the application forms and
all attachments, should not exceed 60 pages. A page is a single side of
an 8\1/2\ x 11'' sheet of paper. Applicants are requested not to send
pamphlets, maps, brochures or other printed material along with their
application as these pose photocopy difficulties. These materials, if
submitted, will not be included in the review process if they exceed
the 60-page limit. Each page of the application will be counted to
determine the total length.
5. Organizational Capability Statement
The Organizational Capability Statement should consist of a brief
(two to three pages) background description of how the applicant
organization (or the unit within the organization that will have
responsibility for the project) is organized, the types and quantity of
services it provides, and/or the research and management capabilities
it possesses. This description should cover capabilities not included
in the Program Narrative Statement. It may include descriptions of any
current or previous relevant experience, or describe the competence of
the project team and its demonstrated ability to produce a final
product that is readily comprehensible and usable. An organization
chart showing the relationship of the project to the current
organization should be included.
6. Assurances/Certifications
Applicants are required to file an SF 424B, Assurances--
Non-Construction Programs, and the Certification Regarding
Lobbying. Both must be signed and returned with the application. In
addition, applicants must certify their compliance with: (1) Drug-Free
Workplace Requirements; and (2) Debarment and Other Responsibilities;
and (3) Certification Regarding Environmental Tobacco Smoke. These
certifications are self-explanatory. Copies of these assurances/
certifications are reprinted at the end of this announcement and should
be reproduced, as necessary. A duly authorized representative of the
applicant organization must certify that the applicant is in compliance
with these assurances/certifications. A signature on the SF 424
indicates compliance with the Drug Free Workplace Requirements, and
Debarment and Other Responsibilities, and Environmental Tobacco Smoke
certifications.
E. Checklist for a Complete Application
The checklist below is for your use to ensure that your application
package has been properly prepared.
____One original, signed and dated application, plus two copies.
Applications for different priority areas are packaged separately;
____Application is from an organization which is eligible under the
eligibility requirements defined in the priority area description
(screening requirement);
____Application length does not exceed 60 pages, unless otherwise
specified in the priority area description.
____A complete application consists of the following items in this
order:
____Application for Federal Assistance (SF 424A, REV 4-92);
____A completed SPOC certification with the date of SPOC contact
entered in line 16, page 1 of the SF 424A if applicable.
____Budget Information--Non-Construction Programs (SF 424A, REV 4-
92);
____Budget justification for Section B--Budget Categories;
____Cable of Contents;
____Letter from the Internal Revenue Service to prove non-profit
status, if necessary;
____Copy of the applicant's approved indirect cost rate agreement,
if appropriate;
____Project summary description and listing of key words;
____Program Narrative Statement (See Part III, Section C);
____Organizational capability statement, including an organization
chart;
____Any appendices/attachments;
____Assurances--Non-Construction Programs (Standard Form 424B, REV
4-92);
____Certification Regarding Lobbying;
____Certification Regarding Drug-Free Workplace Requirements; and
____Certification Regarding Environmental Tobacco Smoke.
F. The Application Package
Each application package must include an original and two copies of
the complete application. Each copy should be stapled securely (front
and back if necessary) in the upper left-hand corner. All pages of the
narrative (including charts, tables, maps, exhibits, etc.) must be
sequentially numbered, beginning with page one. In order to facilitate
handling, please do not use covers, binders or tabs. Do not include
extraneous materials as attachments, such as agency promotion
brochures, slides, tapes, film clips, minutes of meetings, survey
instruments or articles of incorporation.
Applicant should include a self-addressed, stamped acknowledgment
card. All applicants will be notified automatically about the receipt
of their application. If acknowledgment of receipt of your application
is not received within eight weeks after the deadline date, please
notify ACF by telephone at (202) 401-5529.
G. Post-Award Information and Reporting Requirements
Following approval of the applications selected for funding, notice
of project approval and authority to draw down project funds will be
made in writing. The official award document is the Financial
Assistance Award which provides the amount of Federal funds approved
for use in the project, the project and budget periods for which
support is provided, the terms and conditions of the award, the total
project period for which support is contemplated, and the total
required financial grantee participation.
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 part 74 or 92.
Grantees will be required to submit quarterly progress and semi-
annual financial reports (SF 269) throughout the project period, as
well as a final progress and financial report within 90 days of the
termination of the project.
Grantees are subject to the audit requirements in 45 CFR Parts 74
(non-governmental), 92 (governmental), OMB Circular A-133 and OMB
Circular A-128. If an applicant does not request indirect costs, it
should anticipate in its budget request the cost of having an audit
performed at the end of the grant period.
Section 319 of Public Law 101-121, signed into law on October 23,
1989, imposes prohibitions and requirements for disclosure and
certification related to lobbying on recipients of Federal contracts,
grants, cooperative agreements, and loans. It provides exemptions for
Indian Tribes and Tribal organizations. Current and prospective
recipients (and their subtier contractors
[[Page 29257]]
and/or grantees) are prohibited from using Federal funds, other than
profits from a Federal contract, 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 disclose the name, address, payment details, and
purpose of any agreements with lobbyists whom recipients or their
subtier contractors or subgrantees will pay with profits or
nonappropriated funds on or after December 22, 1989 and (3) to file
quarterly up-dates about the use of lobbyists if material changes occur
in their use. The law establishes civil penalties for noncompliance.
(Catalog of Federal Domestic Assistance number 93.592, Family
Violence Prevention and Services)
Dated: May 14, 1997.
Donald Sykes,
Director, Office of Community Services.
BILLING CODE 4184-01-P
[[Page 29258]]
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BILLING CODE 4184-01-C
[[Page 29259]]
Instructions for the SF 424
Public reporting burden for this collection of information is
estimated to average 45 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding the burden
estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of
Management and Budget. Paperwork Reduction Project (0348-0043),
Washington, DC 20503.
Please do not return your completed form to the Office of
Management and Budget, send it to the address provided by the
sponsoring agency.
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 which assistance is being requested
with this application.
10. Use the Catalog of Federal Domestic Assistance number and
title of the program under which assistance is requested.
11. Enter a brief descriptive title of the project. If more than
one program is involved, you should append an explanation on a
separate sheet. If appropriate (e.g., construction or real property
projects), attach a map showing project location. For
preapplications, use a separate sheet to provide a summary
description of this project.
12. List only the largest political entities affected (e.g.,
State, counties, cities.)
13. Self-explanatory.
14. List the applicant's Congressional District and any
District(s) affected by the program or project.
15. Amount requested or to be contributed during the first
funding/budget period by each contributor. Value of inkind
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 allowances, loans and taxes.
18. To be signed by the authorized representative of the
applicant. A copy of the governing body's authorization for you to
sign this application as official representative must be on file in
the applicant's office. (Certain Federal agencies may require that
this authorization be submitted as part of the application.)
BILLING CODE 4184-01-P
[[Page 29260]]
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[[Page 29261]]
[GRAPHIC] [TIFF OMITTED] TN29MY97.009
BILLING CODE 4184-01-C
[[Page 29262]]
Instructions for the SF 424F
Public reporting burden for this collection of information is
estimated to average 180 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding the burden
estimate or any other aspect of this collection of information,
including suggestion for reducing this burden, to the Office of
Management and Budget, Paperwork Reduction Project (0348-0043),
Washington, DC 20530.
Please do not return your completed form to the Office of
Paperwork and Budget, send it to the address provided by the
sponsoring agency.
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. Section A, B, C,
and D should include budget estimates for the whole project except
when applying for assistance which required 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 function 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 of 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 programs, leave Columns (c) and (d) blank. For each line
in Columns (a) and (b), enter in Columns (e), (f), and (g) the
appropriate amounts of funds needed to support the project for the
first funding period (usually a year).
For continuing grant program applications, submit these forms
before the end of each funding period as required by the grantor
agency. Enter in Columns (c) and (d) the estimated amounts of funds
which will remain unobligated at the end of the grant funding period
only if the Federal grantor agency instructions provide for this.
Otherwise, leave these columns blank. Enter in Columns (e) and (f)
the amounts of funds needed for the upcoming period. The amount(s)
in Column (g) should be the sum of amounts in Columns (e) and (f).
For supplemental grants and changes to existing grants, do not
use Columns (c) and (d). Enter in Column (e) the amount of the
increase or decrease of Federal funds and enter in Column (f) the
amount of the increase or decrease or 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 in Columns (e)
and (f).
Line 5--Shown the total 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), Lines 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 in
determining the total amount of the grant.
Section. 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 in 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 total 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 who the overall totals on this line.
Section F. Other Budget Information
Line 21--Use this space to explain amounts for individual direct
object-class cost categories that may appear to be out of the
ordinary or to explain the details as required by the Federal
grantor agency.
Line 22--Enter the type of indirect rate (provisional,
predetermined, final or fixed) that will be in effect during the
funding period, the estimated amount of the base to which the rate
is applied, and the total indirect expense.
Line 23--Provide any other explanations or comments deemed
necessary.
Assurances--Non-Construction Programs
Public reporting burden for this collection of information is
estimated to average 15 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the
collection of information. Send
[[Page 29263]]
comments regarding the burden estimate or any other aspect of this
collection of information, including suggestions for reducing this
burden, to the Office of Management and Budget, Paperwork Reduction
Project (0348-0043), Washington, DC 20503.
Please do not return your completed form to the Office of
Management and Budget, send it to the address provided by the
Sponsoring agency.
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
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. Sec. 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 290ee-3),
as amended, relating to confidentiality of alcohol and drug abuse
patient records; (h) Title VIII of the Civil Rights Act of 1968 (42
U.S.C. Sec. 3601 et seq.), as amended, relating to non-
discrimination in the sale, rental or financing of housing; (i) any
other nondiscrimination provisions in the specific statute(s) under
which application for Federal assistance is being made; and (j) the
requirements of any other nondiscrimination statute(s) which may
apply to the application.
7. Will comply, or has already complied, with the requirements
of Title 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, as applicable, with the provisions of the Health
Act (5 U.S.C. Secs. 1501-1508 and 7324-7328) which limit the
political activities of employees whose principal employment
activities are funded in whole or in part with Federal funds.
9. Will comply, as applicable, with the provisions of the Davis-
Bacon Act (40 U.S.C. Secs. 276a to 276a-7), the Copeland Act (40
U.S.C. Secs. 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.
Secs. 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 or
OMB Circular No. A-133, Audits of Institutions of Higher Learning
and other Non-profit Institutions.
18. Will comply with all applicable requirements of all other
Federal laws, executive orders, regulations and policies governing
this program.
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Signature of Authorized Certifying Official
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Title
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Applicant Organization
----------------------------------------------------------------------
Date Submitted
Certification Regarding Lobbying
Certification for Contracts, Grants, Loans, and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge
and belief, that:
(1) No Federal appropriated funds have been paid or will be
paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of an
agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with the awarding
of any Federal contract, the making of any Federal grant, the making
of any Federal loan, the entering into of any cooperative agreement,
and the extension, continuation, renewal, amendment, or modification
of any Federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been
paid or will be paid to any person for influencing or attempting to
influence an officer or employee of any agency, a Member of
Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with this Federal contract, grant,
[[Page 29264]]
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.
Statement for Loan Guarantees and Loan Insurance
The undersigned states, to the best of his or her knowledge and
belief, that:
If any funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with this
commitment providing for the United States to insure or guarantee a
loan, the undersigned shall complete and submit Standard Form-LLL,
``Disclosure Form to Report Lobbying,'' in accordance with its
instructions. Submission of this statement is a prerequisite for
making or entering into this transaction imposed by section 1352,
title 31, U.S. Code. Any person who fails to file the 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.
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Signature
----------------------------------------------------------------------
Title
----------------------------------------------------------------------
Organziation
----------------------------------------------------------------------
Date
BILLING CODE 4184-01-P
[[Page 29265]]
[GRAPHIC] [TIFF OMITTED] TN29MY97.010
BILLING CODE 4184-01-C
[[Page 29266]]
This certification is required by the regulations implementing
the Drug-Free Workplace Act of 1988: 45 CFR Part 76, Subpart, F.
Sections 76.630 (c) and (d)(2) and 76.645 (a)(1) and (b) provide
that a Federal agency may designate a central receipt point for
STATE-WIDE AND STATE AGENCY-WIDE certifications, and for
notification of criminal drug convictions. For the Department of
Health and Human Services, the central pint is: Division of Grants
Management and Oversight, Office of Management and Acquisition,
Department of Health and Human Services, Room 517-D, 200
Independence Avenue, SW, Washington, DC 20201.
Certification Regarding Drug-Free Workplace Requirements
(Instructions for Certification)
1. By signing and/or submitting this application or grant
agreement, the grantee is providing the certification set out below.
2. The certification set out below is a material representation
of fact upon which reliance is placed when the agency awards the
grant. If it is later determined that the grantee knowingly rendered
a false certification, or otherwise violates the requirements of the
Drug-Free Workplace Act, the agency, in addition to any other
remedies available to the Federal Government, may take action
authorized under the Drug-Free Workplace Act.
3. For grantees other than individuals, Alternate I applies.
4. For grantees who are individuals, Alternate II applies.
5. Workplaces under grants, for grantees other than individuals,
need not be identified on the certification. If known, they may be
identified in the grant application. If the grantee does not
identify the workplaces at the time of application, or upon award,
if there is no application, the grantee must keep the identity of
the workplace(s) on file in its office and make the information
available for Federal inspection. Failure to identify all known
workplaces constitutes a violation of the grantee's drug-free
workplace requirements.
6. Workplace identifications must include the actual address of
buildings (or parts of buildings) or other sites where work under
the grant takes place. Categorical descriptions may be used (e.g.,
all vehicles of a mass transit authority or State highway department
while in operation, State employees in each local unemployment
office, performers in concert halls or radio studios).
7. If the workplace identified to the agency changes during the
performance of the grant, the grantee shall inform the agency of the
change(s), if it previously identified the workplaces in question
(see paragraph five).
8. Definitions of terms in the Nonprocurement Suspension and
Debarment common rule and Drug-Free Workplace common rule apply to
this certification. Grantees' attention is called, in particular, to
the following definitions from these rules:
Controlled substances means a controlled substance in Schedules
I through V of the Controlled Substances Act (21 U.S.C. 812) and as
further defined by regulation (21 CFR 1308.11 through 1308.15);
Conviction means a finding of guilt (including a plea of nolo
contendere) or imposition of sentence, or both, by any judicial body
charged with the responsibility to determine violations of the
Federal or State criminal drug statutes;
Criminal drug statute means a Federal or non-Federal criminal
statute involving the manufacture, distribution, dispensing, use, or
possession of any controlled substance;
Employee means the employee of a grantee directly engaged in the
performance of work under a grant, including: (i) All direct charge
employees; (ii) All indirect charge employees unless their impact or
involvement is insignificant to the performance of the grant; and,
(iii) Temporary personnel and consultants who are directly engaged
in the performance of work under the grant and who are on the
grantee's payroll. This definition does not include workers not on
the payroll of the grantee (e.g., volunteers, even if used to meet a
matching requirement; consultants or independent contractors not on
the grantee's payroll; or employees of subrecipients or
subcontractors in covered workplaces).
Certification Regarding Drug-Free Workplace Requirements
Alternate I. (Grantees Other Than Individuals)
The grantee certifies that it will or will continue to provide a
drug-free workplace by:
(a) Publishing a statement notifying employees that the unlawful
manufacture, distribution, dispensing, possession, or use of a
controlled substance is prohibited in the grantee's workplace and
specifying the actions that will be taken against employees for
violation of such prohibition;
(b) Establishing an ongoing drug-free awareness program to
inform employees about--
(1) The dangers of drug abuse in the workplace;
(2) The grantee's policy of maintaining a drug-free workplace;
(3) Any available drug counseling, rehabilitation, and employee
assistance programs; and
(4) The penalties that may be imposed upon employees for drug
abuse violations occurring in the workplace;
(c) Making it a requirement that each employee to be engaged in
the performance of the grant be given a copy of the statement
required by paragraph (a);
(d) Notifying the employee in the statement required by
paragraph (a) that, as a condition of employment under the grant,
the employee will--
(1) Abide by the terms of the statement; and
(2) Notify the employer in writing of his or her conviction for
a violation of a criminal drug statute occurring in the workplace no
later than five calendar days after such conviction;
(e) Notifying the agency in writing, within ten calendar days
after receiving notice under paragraph (d)(2) from an employee or
otherwise receiving actual notice of such conviction. Employers of
convicted employees must provide notice, including position title,
to every grant officer or other designee on whose grant activity the
convicted employee was working, unless the Federal agency has
designated a central point for the receipt of such notices. Notice
shall include the identification number(s) of each affected grant;
(f) Taking one of the following actions, within 30 calendar days
of receiving notice under paragraph (d)(2), with respect to any
employee who is so convicted--
(1) Taking appropriate personnel action against such an
employee, up to and including termination, consistent with the
requirements of the Rehabilitation Act of 1973, as amended; or
(2) Requiring such employee to participate satisfactorily in a
drug abuse assistance or rehabilitation program approved for such
purposes by a Federal, State, or local health, law enforcement, or
other appropriate agency;
(g) Making a good faith effort to continue to maintain a drug-
free workplace through implementation of paragraphs (a), (b), (c),
(d), (e) and (f).
(B) The grantee may insert in the space provided below the
site(s) for the performance of work done in connection with the
specific grant:
Place of Performance (Street address, city, county, state, zip
code)
----------------------------------------------------------------------
----------------------------------------------------------------------
Check {time} if there are workplaces on file that are not
identified here.
Alternate II. (Grantees Who Are Individuals)
(a) The grantee certifies that, as a condition of the grant, he
or she will not engage in the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance in
conducting any activity with the grant;
(b) If convicted of a criminal drug offense resulting from a
violation occurring during the conduct of any grant activity, he or
she will report the conviction, in writing, within 10 calendar days
of the conviction, to every grant officer or other designee, unless
the Federal agency designates a central point for the receipt of
such notices. When notice is made to such a central point, it shall
include the identification number(s) of each affected grant.
[55 FR 21690, 21702, May 25, 1990]
Certification Regarding Debarment, Suspension, and Other Responsibility
Matters--Primary Covered Transactions
Instructions for Certification
1. By signing and submitting this proposal, the prospective
primary participant is providing the certification set out below.
2. The inability of a person to provide the certification
required below will not necessarily result in denial of
participation in this covered transaction. The prospective
participant shall submit an explanation of why it cannot provide the
certification set out below. The certification or explanation will
be considered in connection with the department or agency's
determination whether to enter into this transaction. However,
failure of the prospective primary participant to furnish a
certification or an
[[Page 29267]]
explanation shall disqualify such person from participation in this
transaction.
3. The certification in this clause is a material representation
of fact upon which reliance was placed when the department or agency
determined to enter into this transaction. If it is later determined
that the prospective primary participant knowingly rendered an
erroneous certification, in addition to other remedies available to
the Federal Government, the department or agency may terminate this
transaction for cause or default.
4. The prospective primary participant shall provide immediate
written notice to the department or agency to which this proposal is
submitted if at any time the prospective primary participant learns
that its certification was erroneous when submitted or has become
erroneous by reason of changed circumstances.
5. The terms covered transaction, debarred, suspended,
ineligible, lower tier covered transaction, participant, person,
primary covered transaction, principal, proposal, and voluntarily
excluded, as used in this clause, have the meanings set out in the
Definitions and Coverage sections of the rules implementing
Executive Order 12549. You may contact the department or agency to
which this proposal is being submitted for assistance in obtaining a
copy of those regulations.
6. The prospective primary participant agrees by submitting this
proposal that, should the proposed covered transaction by entered
into, it shall not knowingly enter into any lower tier covered
transaction with a person who is proposed for debarment under 48 CFR
part 9, subpart 9.4, debarred, suspended, declared ineligible, or
voluntarily excluded from participation in this covered transaction,
unless authorized by the department or agency entering into this
transaction.
7. The prospective primary participant further agrees by
submitting this proposal that it will include the clause titled
``Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion-Lower Tier Covered Transaction,'' provided by
the department or agency entering into this covered transaction,
without modification, in all lower tier covered transactions and in
all solicitations for lower tier covered transactions.
8. A participant in a covered transaction may rely upon a
certification of a prospective participant in a lower tier covered
transaction that it is not proposed for debarment under 48 CFR part
9, subpart 9.4, debarred, suspended, ineligible, or voluntarily
excluded from the covered transaction, unless it knows that the
certification is erroneous. A participant may decide the method and
frequency by which it determines the eligibility of its principals.
Each participant may, but is not required to, check the List of
Parties Excluded from Federal Procurement and Nonprocurement
Programs.
9. Nothing contained in the foregoing shall be construed to
require establishment of a system of records in order to render in
good faith the certification required by this clause. The knowledge
and information of a participant is not required to exceed that
which is normally possessed by a prudent person in the ordinary
course of business dealings.
10. Except for transactions authorized under paragraph 6 of
these instructions, if a participant in a covered transaction
knowingly enters into a lower tier covered transaction with a person
who is proposed for debarment under 48 CFR part 9, subpart 9.4,
suspended, debarred, ineligible, or voluntarily excluded from
participation in this transaction, in addition to other remedies
available to the Federal Government, the department or agency may
terminate this transaction for cause or default.
* * * * *
Certification Regarding Debarment, Suspension, and Other Responsibility
Matters--Primary Covered Transactions
(1) The prospective primary participant certifies to the best of
its knowledge and belief, that it and its principals:
(a) Are not presently debarred, suspended, proposed for
debarment, declared ineligible, or voluntarily excluded by any
Federal department or agency;
(b) Have not within a three-year period preceding this proposal
been convicted of or had a civil judgment rendered against them for
commission of fraud or a criminal offense in connection with
obtaining, attempting to obtain, or performing a public (Federal,
State or local) transaction or contract under a public transaction;
violation of Federal or State antitrust statutes or commission of
embezzlement, theft, forgery, bribery, falsification or destruction
of records, making false statements, or receiving stolen property;
(c) Are not presently indicted for or otherwise criminally or
civilly charged by a governmental entity (Federal, State or local)
with commission of any of the offenses enumerated in paragraph
(1)(b) of this certification; and
(d) Have not within a three-year period preceding this
application/proposal had one or more public transactions (Federal,
State or local) terminated for cause or default.
(2) Where the prospective primary participant is unable to
certify to any of the statements in this certification, such
prospective participant shall attach an explanation to this
proposal.
Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion--Lower Tier Covered Transactions
Instructions for Certification
1. By signing and submitting this proposal, the prospective
lower tier participant is providing the certification set out below.
2. The certification in this clause is a material representation
of fact upon which reliance was placed when this transaction was
entered into. If it is later determined that the prospective lower
tier participant knowingly rendered an erroneous certification, in
addition to other remedies available to the Federal Government the
department or agency with which this transaction originated may
pursue available remedies, including suspension and/or debarment.
3. The prospective lower tier participant shall provide
immediate written notice to the person to which this proposal is
submitted if at any time the prospective lower tier participant
learns that its certification was erroneous when submitted or had
become erroneous by reason of changed circumstances.
4. The terms covered transaction, debarred, suspended,
ineligible, lower tier covered transaction, participant, person,
primary covered transaction, principal, proposal, and voluntarily
excluded, as used in this clause, have the meaning set out in the
Definitions and Coverage sections of rules implementing Executive
Order 12549. You may contact the person to which this proposal is
submitted for assistance in obtaining a copy of those regulations.
5. The prospective lower tier participant agrees by submitting
this proposal that, [[Page 33043]] should the proposed covered
transaction be entered into, it shall not knowingly enter into any
lower tier transaction with a person who is proposed for debarment
under 48 CFR part 9, subpart 9.4, debarred, suspended, declared
ineligible, or voluntarily excluded from participation in this
covered transaction, unless authorized by the department or agency
with which this transaction originated.
6. The prospective lower tier participant further agrees by
submitting this proposal that it will include this clause titled
``Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion-Lower Tier Covered Transaction,'' without
modification, in all lower tier covered transactions and in all
solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a
certification of a prospective participant in a lower tier covered
transaction that it is not proposed for debarment under 48 CFR part
9, subpart 9.4, debarred, suspended, ineligible, or voluntarily
excluded from covered transactions, unless it knows that the
certification is erroneous. A participant may decide the method and
frequency by which it determines the eligibility of its principals.
Each participant may, but is not required to, check the List of
Parties Excluded from Federal Procurement and Nonprocurement
Programs.
8. Nothing contained in the foregoing shall be construed to
require establishment of a system of records in order to render in
good faith the certification required by this clause. The knowledge
and information of a participant is not required to exceed that
which is normally possessed by a prudent person in the ordinary
course of business dealings.
9. Except for transactions authorized under paragraph 5 of these
instructions, if a participant in a covered transaction knowingly
enters into a lower tier covered transaction with a person who is
proposed for debarment under 48 CFR part 9, subpart 9.4, debarred,
suspended, ineligible, or voluntarily excluded from participation in
this transaction, in addition to other remedies available to the
Federal
[[Page 29268]]
Government, the department or agency with which this transaction
originated may pursue available remedies, including suspension and/
or debarment.
* * * * *
Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion--Lower Tier Covered Transactions
(1) The prospective lower tier participant certifies, by
submission of this proposal, that neither it nor its principals is
presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from participation in this
transaction by any Federal department or agency.
(2) Where the prospective lower tier participant is unable to
certify to any of the statements in this certification, such
prospective participant shall attach an explanation to this
proposal.
Certification Regarding Environmental Tobacco Smoke
Public Law 103-227, Part C--Environmental Tobacco Smoke, also
known as the Pro-Children Act of 1994 (Act), requires that smoking
not be permitted in any portion of any indoor routinely owned or
leased or contracted for by an entity and used routinely or
regularly for provision of health, day care, education, or library
services to children under the age of 18, if the services are funded
by Federal programs either directly or through State or local
governments, by Federal grant, contract, loan, or loan guarantee.
The law does not apply to children's services provided in private
residences, facilities funded solely by Medicare or Medicaid funds,
and portions of facilities used for inpatient drug or alcohol
treatment. Failure to comply with the provisions of the law may
result in the imposition of a civil monetary penalty of up to $1000
per day and/or the imposition of an administrative compliance order
on the responsible entity.
By signing and submitting this application the applicant/grantee
certifies that it will comply with the requirements of the Act. The
applicant/grantee further agrees that it will require the language
of this certification be included in any subawards which contain
provisions for the children's services and that all subgrantees
shall certify accordingly.
OMB State Single Point of Contact Listing
Arizona
Joni Saad, Arizona State Clearinghouse, 3800 N. Central Avenue,
Fourteenth Floor, Phoenix, Arizona 85012, Telephone (602) 280-1315,
FAX: (602) 280-8144
Arkansas
Mr. Tracy L. Copeland, Manager, State Clearinghouse, Office of
Intergovernmental Services, Department of Finance and
Administration, 1515 W. 7th St., Room 412, Little Rock, Arkansas
72203, Telephone: (501) 682-1074, FAX: (501) 682-5206
California
Grants Coordinator, Office of Planning & Research, 1400 Tenth
Street, Room 121, Sacramento, California 95814, Telephone (916) 323-
7480, FAX (916) 323-3018
Delaware
Francine Booth, State Single Point of Contact Executive Department,
Thomas Collins Building, P.O. Box 1401, Dover, Delaware 19903,
Telephone: (302) 739-3326, FAX: (302) 739-5661
District of Columbia
Charles Nichols, State Single Point of Contact, Office of Grants
Mgmt. & Dev. 717 14th Street, N.W.,--Suite 500, Washington, D.C.
20005, Telephone: (202) 727-6554, FAX: (202) 727-1617
Florida
Florida State Clearinghouse, Department of Community Affairs, 2740
Centerview Drive, Tallahassee, Florida 32399-2100, Telephone: (904)
922-5438, FAX: (904) 487-2899
Georgia
Tom L. Reid, III, Administrator, Georgia State Clearinghouse, 254
Washington Street, S.W.--Room 401J, Atlanta, Georgia 30334,
Telephone: (404) 656-3855 or (404) 656-3829, FAX: (404) 656-7938
Illinois
Virginia Bova, State Single Point of Contact, Department of Commerce
and Community Affairs, James R. Thompson Center, 100 West Randolph,
Suite 3-400, Chicago, Illinois 60601, Telephone: (312) 814-6028,
FAX: (312) 814-1800
Indiana
Frances Williams, State Budget Agency, 212 State House,
Indianapolis, Indiana 46204-2796, Telephone: (317) 232-5619, FAX:
(317) 233-3323
Iowa
Steven R. McCann, Division for Community Assistance, Iowa Department
of Economic Development, 200 East Grand Avenue, Des Moines, Iowa
50309, Telephone: (515) 242-4719, FAX: (515) 242-4859
Kentucky
Ronald W. Cook, Office of the Governor, Department of Local
Government, 1024 Capitol Center Drive, Frankfort, Kentucky 40601-
8204, Telephone: (502) 573-2382, FAX: (502) 573-2512
Maine
Joyce Benson, State Planning Office, State House Station #38,
Augusta, Maine 04333, Telephone: (207) 287-3261, FAX: (207) 287-6489
Maryland
William G. Carroll, Manager, State Clearinghouse for
Intergovernmental Assistance, Maryland Office of Planning, 301 W.
Preston Street--Room 1104, Baltimore, Maryland 21201-2365, Staff
Contact: Linda Janey, Telephone: (410) 225-4490, FAX: (410) 225-4480
Michigan
Richard Pfaff, Southeast Michigan Council of Governments, 1900
Edison Plaza, 660 Plaza Drive, Detroit, Michigan 48226, Telephone:
(313) 961-4266, FAX: (313) 961-4869
Mississippi
Cathy Malette, Clearinghouse Officer, Department of Finance and
Administration, 455 North Lamar Street, Jackson, Mississippi 39202-
3087, Telephone: (601) 359-6762, FAX: (601) 359-6764
Missouri
Lois Pohl, Federal Assistance Clearinghouse, Office of
Administration, P.O. Box 809, Room 760, Truman Building, Jefferson
City, Missouri 65102, Telephone: (314) 751-4834, FAX: (314) 751-7819
Nevada
Department of Administration, State Clearinghouse, Capitol Complex,
Carson City, Nevada 89710, Telephone: (702) 687-4065, FAX: (702)
687-3983
New Hampshire
Jeffrey H. Taylor, Director, New Hampshire Office of State Planning,
Attn: Intergovernmental Review Process, Mike Blake, 2\1/2\ Beacon
Street, Concord, New Hampshire 03301, Telephone: (603) 271-2155,
FAX: (603) 271-1728
New Mexico
Robert Peters, State Budget Division, Room 190 Bataan Memorial
Building, Santa Fe, New Mexico 87503, Telephone: (505) 827-3640
New York
New York State Clearinghouse, Division of the Budget, State Capitol,
Albany, New York 12224, Telephone: (518) 474-1605, FAX: (518) 486-
5617
North Carolina
Chrys Baggett, Director, N.C. State Clearinghouse, Office of the
Secretary of Admin., 116 West Jones Street, Raleigh, North Carolina
27603-8003, Telephone: (919) 733-7232, FAX: (919) 733-9571
North Dakota
North Dakota Single Point of Contact, Office of Intergovernmental
Assistance, 600 East Boulevard Avenue, Bismark, North Dakota 58505-
0170, Telephone: (701) 224-2094, FAX: (701) 224-2308
Ohio
Larry Weaver, State Single Point of Contact, State Clearinghouse,
Office of Budget and Management, 30 East Broad Street, 34th Floor,
Columbus, Ohio 43266-0411
Please direct correspondence and questions about intergovernmental
review to: Linda Wise, Telephone: (614) 466-0698, FAX: (614) 466-
5400
Rhode Island
Kevin Nelson, Review Coordinator, Department of Administration,
Division of Planning, One Capitol Hill, 4th Floor, Providence, Rhode
Island 02908-5870,
[[Page 29269]]
Telephone: (401) 277-2656, FAX: (401) 277-2083
Please direct correspondence and questions to: Review Coordinator,
Office of Strategic Planning
South Carolina
Rodney Grizzle, State Single Point of Contact, Grant Services,
Office of the Governor, 1205 Pendleton Street, Room 331, Columbia,
South Carolina 29201, Telephone: (803) 734-0494, FAX: (803) 734-0356
Texas
Tom Adams, Governors Office, Director, Intergovernmental
Coordination, P.O. Box 12428, Austin, Texas 78711, Telephone: (512)
463-1771, FAX: (512) 463-1888
Utah
Carolyn Wright, Utah State Clearinghouse, Office of Planning and
Budget, Room 116, State Capitol, Salt Lake City, Utah 84114,
Telephone: (801) 538-1535, FAX: (801) 538-1547
West Virginia
Fred Cutlip, Director, Community Development Division, W. Virginia
Development Office, Building #6, Room 553, Charleston, West Virginia
25305, Telephone: (304) 558-4010, FAX: (304) 558-3248
Wisconsin
Jeff Smith, Section Chief, State/Federal Relations, Wisconsin
Department of Administration, 101 East Wilson Street, 6th Floor,
P.O. Box 7868, Madison, Wisconsin 53707, Telephone: (608) 266-0267,
FAX: (608) 267-6931
Wyoming
Matthew Jones, State Single Point of Contact, Office of the
Governor, 200 West 24th Street, State Capital, Room 124, Cheyenne,
Wyoming 82002, Telephone: (307) 777-7446, FAX: (307) 632-3909
TERRITORIES
Guam
Mr. Giovanni T. Sgambelluri, Director, Bureau of Budget and
Management Research, Office of the Governor, P.O. Box 2950, Agana,
Guam 96910, Telephone: 011-671-472-2285, FAX: 011-671-472-2825
Puerto Rico
Normal Burgos/Jose E. Caro, Chairwoman/Director, Puerto Rico
Planning Board, Federal Proposals Review Office, Minillas Government
Center, P.O. Box 41119, San Juan, Puerto Rico 00940-1119, Telephone:
(809) 727-4444, (809) 723-6190, FAX: (809) 724-3270, (809) 724-3103
North Mariana Islands
Mr. Alvaro A. Santos, Executive Officer, State Single Point of
Contact, Office of Management and Budget, Office of the Governor,
Saipan, MP, Telephone: (670) 664-2256, FAX: (670) 664-2272
Contact Person: Ms. Jacoba T. Seman, Federal Programs Coordinator,
Telephone: (670) 644-2289, FAX: (670) 644-2272
Virgin Islands
Nelson Bowry, Director, Office of Management and Budget, #41
Norregade Emancipation Garden Station, Second Floor, Saint Thomas,
Virgin Islands 00802
Please direct all questions and correspondence about
intergovernmental review to: Linda Clarke, Telephone: (809) 774-
0750, FAX: (809) 776-0069.
[FR Doc. 97-14074 Filed 5-28-97; 8:45 am]
BILLING CODE 4184-01-P-M
