[Federal Register Volume 64, Number 188 (Wednesday, September 29, 1999)]
[Notices]
[Pages 52600-52622]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-25331]
[[Page 52599]]
_______________________________________________________________________
Part IV
Department of Health and Human Services
_______________________________________________________________________
Administration for Children and Families
_______________________________________________________________________
Program Announcement; Request for Applications Under the Office of
Community Services' Fiscal Year 2000 Community Food and Nutrition
Program; Notice
Federal Register / Vol. 64, No. 188 / Wednesday, September 29, 1999 /
Notices
[[Page 52600]]
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
Program Announcement; Request for Applications Under the Office
of Community Services' Fiscal Year 2000 Community Food and Nutrition
Program
[Program Announcement No. OCS-2000-03]
AGENCY: Office of Community Services, Administration for Children and
Families, Department of Health and Human Services.
ACTION: Request for applications under the Office of Community
Services' Community Food and Nutrition Program (CFNP).
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SUMMARY: The Administration for Children and Families (ACF), Office of
Community Services (OCS), announces that competing applications will be
accepted for new grants pursuant to the Secretary's discretionary
authority under Section 681 of the Community Services Block Grant Act,
as amended. This Program Announcement contains forms and instructions
for submitting an application. The awarding of grants under this
Program Announcement is subject to the availability of funds for
support of these activities.
CLOSING DATE: The closing date for submission of applications is
December 6, 1999. Mailed applications postmarked after the closing date
will be classified as late.
FOR FURTHER INFORMATION CONTACT: Administration for Children and
Families, Office of Community Services, Division of Community
Discretionary Programs, 370 L'Enfant Promenade S.W., Washington DC
20447, Fax (202) 401-4687. Contact: Catherine Rivers, (202) 401-5252,
Deloris Horton, (202) 401-9363.
This Program Announcement is accessible on the OCS Website for
reading or downloading at: www.acf.dhhs.gov/programs/ocs/kits1.htm.
Application Submission
Mailing Address: CFNP Applications should be mailed to the U.S.
Department of Health and Human Services, Administration for Children
and Families, Office of Grants Management/OCSE, 4th Floor West,
Aerospace Center, 370 L'Enfant Promenade, SW, Washington, D.C. 20447;
Attention: Application for Community Food and Nutrition Program.
Number of Copies Required: One signed original application and four
copies should be submitted at the time of initial submission. (OMB-
0970-0062, expiration date 10/31/2001).
Submission Instructions: 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.
Applications mailed must bear a legibly dated U.S. Postal Service
postmark or a legibly dated, machine produced postmark of a commercial
mail service affixed to the envelope/package containing the
application(s). To be acceptable as proof of timely mailing, a postmark
from a commercial mail service must include the logo/emblem of the
commercial mail service company and must reflect the date the package
was received by the commercial mail service company from the applicant.
Private Metered postmarks shall not be acceptable as proof of timely
mailing. (Applicants are cautioned that express/overnight mail services
do not always deliver as agreed.)
Applications handcarried by applicants, applicants couriers, or by
other representatives of the applicant 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., EST, at the U.S.
Department of Health and Human Services, Administration for Children
and Families, Office of Grants Management/OCSE, ACF Mailroom, 2nd Floor
Loading Dock, Aerospace Center, 901 D Street, SW, Washington, D.C.
20024, between Monday and Friday (excluding Federal holidays). The
address must appear on the envelope/package containing the application
with the note: Attention: Application for Community Food and Nutrition
Program. (Applicants are again cautioned that express/overnight mail
services do not always deliver as agreed.)
ACF cannot accommodate transmission of applications by fax or
through other electronic media. Therefore, applications transmitted to
ACF electronically will not be accepted regardless of date or time of
submission and time of receipt.
Once submitted, applications are considered final and no additional
materials will be accepted.
Late Applications: Applications which do not meet the criteria
above are considered late applications. ACF shall notify each late
applicant that its application will not be considered in the current
competition.
Extension of Deadlines: ACF may extend application deadlines when
circumstances such as acts of God (floods, hurricanes, etc.) occur, or
when there are widespread disruptions of the mail service.
Determinations to extend or waive deadline requirements rest with ACF's
Chief Grants Management Officer.
Table of Contents
Part A--Preamble
1. Legislative Authority
2. Definitions of Terms
3. Purpose of Community Food and Nutrition Program
4. Project Requirements
Part B--Application Requirements
1. Eligible Applicants
2. Availability of Funds and Grant Amounts
3. Project Periods and Budget Periods
4. Administrative Costs/Indirect Costs
5. Program Beneficiaries
6. Number of Projects in Application
7. Multiple Submittal
8. Sub-Contracting or Delegating Projects
Part C--Program Area
General Projects
Part D--Review Criteria
Criteria for Review and Evaluation of Applications Submitted Under
this Program Announcement
Part E--Instructions for Completing Application Package
1. SF-424--Application for Federal Assistance
2. SF-424A--Budget Information--Non-Construction
3. SF-424B--Assurances--Non-Construction Programs
4. Project Narrative
Part F--Application Procedures
1. Availability of Forms
2. Intergovernmental Review
3. Application Consideration
4. Criteria for Screening Applications
Part G--Contents of Application Package and Receipt Process
Part H--Post Award Information and Reporting Requirements
Part A--Preamble
1. Legislative Authority
The Community Services Block Grant Act, as amended, authorizes the
Secretary of Health and Human Services to make funds available under
several programs to support program activities which will result in
direct benefits targeted to low-income people. This Program
Announcement covers the grant authority found at Sections 681(a) and
(b), Community Food and Nutrition, which authorizes the Secretary to
make funds available for grants to be awarded
[[Page 52601]]
on a competitive basis to eligible entities for community based, local
and statewide programs: (1) To coordinate private and public food
assistance resources, wherever the grant recipient involved determines
such coordination to be inadequate, to better serve low-income
populations; (2) to assist low-income communities to identify potential
sponsors of child nutrition programs and to initiate such programs in
underserved or unserved areas; and (3) to develop innovative approaches
at the State and local level to meet the nutrition needs of low-income
individuals.
2. Definitions of Terms
For purposes of this Program Announcement the following definitions
apply:
Budget period: The term ``budget period'' refers to the interval of
time into which a grant period of assistance (project period) is
divided for budgetary and funding purposes.
Displaced worker: An individual who is in the labor market but has
been unemployed for six months or longer.
Eligible entity: States, public agencies, and public and private
non-profit agencies/organizations including Community Action Agencies.
(See Part B-1)
Indian tribe: A tribe, band, or other organized group of Native
American Indians recognized in the State or States in which it resides
or considered by the Secretary of the Interior to be an Indian tribe or
an Indian organization for any purpose.
Innovative project: One that departs from or significantly modifies
past program practices and tests a new approach.
Migrant farmworker: An individual who works in agricultural
employment of a seasonal or other temporary nature who is required to
be absent from his/her place of permanent residence in order to secure
such employment.
Program income: Gross income earned by the grant recipient that is
directly generated by an activity supported with grant funds.
Project period: The term ``project period'' refers to the total
time for which a project is approved for support, including any
approved extensions.
Seasonal farmworker: Any individual employed in agricultural work
of a seasonal or other temporary nature who is able to remain at his/
her place of permanent residence while employed.
Self-sufficiency: A condition where an individual or family does
not need and is not eligible for public assistance.
Underserved area (as it pertains to child nutrition programs): A
locality in which less than one-half of the low-income children
eligible for assistance participate in any child nutrition program.
3. Purpose of Community Food and Nutrition Program
The Department of Health and Human Services (DHHS) is committed to
improving the overall health and nutritional well-being of individuals
through improved preventive health care and promotion of personal
responsibility. The DHHS encourages the approach to health promotion
and nutritional responsibility with personal messages aimed at families
and communities, in various settings and environments in which
individuals and groups can most effectively be reached.
The DHHS is specifically interested in improving the health and
nutrition status of low-income persons through improved access to
healthy nutritious foods or by other means. The DHHS encourages
community efforts to improve the coordination and integration of health
and social services for all low-income families, and to identify
opportunities for collaborating with other programs and services for
this population. Such collaboration can increase a community's capacity
to leverage resources and promote an integrated approach to health and
nutrition through existing programs and services.
4. Project Requirements
Projects funded under this program should:
(a) Be designed and intended to provide nutrition benefits,
including those which incorporate the benefits of disease prevention,
to a targeted low-income group of people;
(b) Provide outreach and public education to inform eligible low-
income individuals and families of other nutritional services available
to them under the various Federally-assisted programs;
(c) Carry out targeted communications/social marketing to improve
dietary behavior and increase program participation among eligible low-
income populations. Populations to be targeted can include displaced
workers, elderly people, children, and the working poor.
(d) Consult with and/or inform local offices that administer other
food programs such as W.I.C. and Food Stamps, where applicable, to
ensure effective coordination which can jointly target services to
increase their effectiveness. Such consultation may include involving
these offices in the planning of grant applications.
(e) Focus on one or more legislatively-mandated program activities:
(1) Coordination of private and public food assistance resources,
wherever the grant recipient involved determines such coordination to
be inadequate, to better serve low-income populations; (2) Assistance
to low-income communities in identifying potential sponsors of child
nutrition programs and initiating such programs in unserved or
underserved areas; and (3) Development of innovative approaches at the
state and local level to meet the nutrition needs of low-income
individuals.
The OCS views this program as a capacity building program, rather
than as a service delivery program.
Part B--Application Requirements
1. Eligible Applicants
Eligible applicants are States, public agencies, and public and
private non-profit agencies/organizations with a demonstrated ability
to successfully develop and implement programs and activities similar
to those enumerated above. The OCS encourages Historically Black
Colleges and Universities and minority institutions to submit
applications. Eligible applicants with programs benefitting Native
Americans and Migrant Farmworkers are also encouraged to submit
applications.
Any non-profit organization submitting an application must submit
proof of its non-profit status in its application at the time of
submission. The non-profit agency can accomplish this by providing a
copy of the applicant's listing in the Internal Revenue Service's (IRS)
most recent list of tax-exempt organizations described in Section
501(c)(3) of the IRS tax code or by providing a copy of the currently
valid IRS tax exemption certificate, or by providing a copy of the
applicant's Articles of Incorporation bearing the seal of the State in
which the corporation or association is domiciled.
2. Availability of Funds and Grant Amounts
a. Fiscal Year 2000 Funding
All grant awards are subject to the availability of appropriated
funds. The Office of Community Services expects to award approximately
$2,000,000 for grant awards under the CFNP in Fiscal Year 2000 for
General Projects.
b. Grant Amounts
No individual grant application will be considered for an amount
which is in excess of $50,000.
[[Page 52602]]
c. Mobilization of Resources
The OCS would like to mobilize as many resources as possible to
enhance projects funded under this program. The OCS supports and
encourages applications submitted by applicants whose programs will
leverage other resources, either cash or third party in-kind.
3. Project Periods and Budget Periods
For most projects, OCS will grant funds for one year. However, in
rare instances, depending on the characteristics of any individual
project and on the justification presented by the applicant in its
application, a grant may be made for a period of up to 17 months.
4. Administrative Costs/Indirect Costs
There is no administrative cost limitation for projects funded
under this program. Indirect costs consistent with approved indirect
cost rate agreements are allowable. Applicants should enclose a copy of
the current approved rate agreement. However, it should be understood
that indirect costs are part of, and not in addition to, the amount of
funds awarded in the subject grant.
5. Program Beneficiaries
Projects proposed for funding under this Announcement must result
in direct benefits targeted toward low-income people as defined in the
most recent annual update of the Poverty Income Guidelines published by
DHHS. Attachment A to this Announcement is an excerpt from the most
recently published guidelines. Annual revisions of these guidelines are
normally published in the Federal Register in February or early March
of each year and are applicable to projects being implemented at the
time of publication. Grantees will be required to apply the most recent
guidelines throughout the project period. The Federal Register may be
obtained from public libraries, Congressional offices, or by writing
the Superintendent of Documents, U.S. Government Printing Office,
Washington, D.C. 20402. The Federal Register is also available on the
Internet through GPO Access at the following web address: http://
www.access.gpo.gov/su__docs/aces/aces140.html
No other government agency or privately defined poverty guidelines
are applicable to the determination of low-income eligibility for this
OCS program.
6. Number of Projects in Application
An application may contain only one project and this project must
address the basic criteria found in Parts C and D. Applications which
are not in compliance with these requirements will be ineligible for
funding.
7. Multiple Submittals
There is no limit to the number of applications that can be
submitted as long as each application is for a different project.
However, no applicant can receive more than one grant.
8. Sub-Contracting or Delegating Projects
The OCS will not fund any project where the role of the eligible
applicant is primarily to serve as a conduit for funds to other
organizations.
Part C--Program Area
General Projects
The application should include a description of the target area and
population to be served as well as a discussion of the nature and
extent of the problem to be solved. The application must contain a
detailed and specific work program that is both sound and feasible.
Projects funded under this Announcement must produce permanent and
measurable results that fulfill the purposes of this program as
described above. The OCS grant funds, in combination with private and/
or other public resources, must be targeted to low-income individuals
and communities.
Applicants will certify in their submission that projects will only
serve the low-income population as stipulated in the DHHS Poverty
Income Guidelines (Attachment A). Failure to comply with the income
guidelines may result in the application being ineligible for
consideration for funding.
If an applicant is proposing a project which will affect a property
listed in or eligible for inclusion in the National Register of
Historic Places, it must identify this property in the narrative and
explain how it has complied with the provisions of Section 106 of the
National Historic Preservation Act of 1966 as amended. If there is any
question as to whether the property is listed in or eligible for
inclusion in the National Register of Historic Places, applicant should
consult with the State Historic Preservation Officer. The applicant
should contact OCS early in the development of its application for
instructions regarding compliance with the Act and data required to be
submitted to DHHS.
In the case of projects proposed for funding which mobilize or
improve the coordination of existing public and private food assistance
resources, the guidelines governing those resources apply. However, in
the case of projects providing direct assistance to beneficiaries
through grants funded under this program, beneficiaries must fall
within the official DHHS Poverty Income Guidelines as set forth in
Attachment A.
Applications that propose the use of grant funds for the
development of any printed or visual materials must contain convincing
evidence that these materials are not available from other sources. The
OCS will not provide funding for such items if justification is not
sufficient. Approval of any films or visual presentations proposed by
applicants approved for funding will be made part of the grant award.
In cases where material outlays for equipment (audio and visual) are
requested, specific evidence must be presented that there is a definite
programmatic connection between the equipment (audio and visual) usage
and the outreach requirements described in Part A-3 of this
Announcement.
The OCS is also interested in projects that address the needs of
homeless families and welcomes applications that seek to develop
innovative approaches to promote health and nutritional awareness among
low-income populations.
Part D--Review Criteria
Applications that pass the initial screening and pre-rating review
(see Part F, section 4) will be assessed and scored by reviewers. Each
reviewer will give a numerical score for each application reviewed.
These numerical scores will be supported by explanatory statements on a
formal rating form describing major strengths and weaknesses under each
applicable criterion published in the Announcement.
The in-depth evaluation and review process will use the following
criteria coupled with the specific requirements as described in Part F.
When writing their Project Narrative, applicants should respond to
the review criteria using the same sequential order.
Note: The following review criteria reiterate the information
requirements contained in Part B of this Announcement.
Criteria for Review and Evaluation of Applications Submitted Under This
Program Announcement
a. Criterion I: Analysis of Needs/Priorities (Maximum: 10 Points)
(1) Target area and population to be served are adequately
described. (0-4 Points)
In addressing the above criterion, the applicant should include a
description of the target area and population to be
[[Page 52603]]
served including specific details on any minority population(s) to be
served.
(2) Nature and extent of problem(s) and/or need(s) to be addressed
are adequately described and documented. (0-6 Points)
In addressing the above criterion, the applicant should include a
discussion of the nature and extent of the problem(s) and/or need(s),
including specific information on minority populations(s).
b. Criterion II: Adequacy of Work Program (Maximum: 25 Points)
(1) Realistic quarterly time targets are set forth by which the
various work tasks will be completed. (0-10 Points)
(2) Activities are adequately described and appear reasonably
likely to achieve results which will have a desired impact on the
identified problems and/or needs. (0-15 Points)
In addressing the above criterion, the applicant should address the
basic criteria and other mandated activities found in Part A-4 and
should include:
a. Project priorities and rationale for selecting them which relate
to the specific nutritional problem(s) and/or need(s) of the target
population which were identified under Criterion I;
b. Goals and objectives that speak to the(se) problem(s) and/or
need(s); and
c. Project activities that, if successfully carried out, can be
reasonably expected to result in the achievement of these goals and
objectives.
c. Criterion III: Significant and Beneficial Impact (Maximum: 30
Points)
(1) Applicant proposes to significantly improve or increase
nutrition services to low-income people and such improvements or
increases are quantified. (0-15 Points)
(2) Project incorporates promotional health and social services
activities for low-income people, along with nutritional services. (0-5
Points)
(3) Project will significantly leverage or mobilize other community
resources and such resources are detailed and quantified. (0-5 Points)
(4) Project addresses problem(s) that can be resolved by one-time
OCS funding or demonstrates that non-Federal funding is available to
continue the project without Federal support. (0-5 Points)
In addressing the above criterion, the applicant must include
quantitative data for items (1), (2), and (3), and discuss how the
beneficial impact relates to the relevant legislatively-mandated
program activities identified in Part A-1 and the problems and/or needs
described under Criterion I.
d. Criterion IV: Coordination/Services Integration (Maximum: 15 Points)
(1) Project shows evidence of coordinated community-based planning
in its development, including strategies in the work program to carry
on activities in collaboration with other locally-funded Federal
programs (such as DHHS health and social services and USDA Food and
Consumer Service programs) in ways that will eliminate duplication and
will, for example, (1) unite funding streams at the local level to
increase program outreach and effectiveness, (2) facilitate access to
other needed social services by coordinating and simplifying intake and
eligibility certification processes for clients, or (3) bring project
participants into direct interaction with holistic family development
resources in the community where needed. (0-10 Points)
(2) Community Empowerment Consideration--Special consideration will
be given to applicants who are located in areas which are characterized
by poverty and other indicators of socio-economic distress such as a
poverty rate of at least 20 percent, designation as an Empowerment Zone
or Enterprise Community, high levels of unemployment, and high levels
of incidences of violence, gang activity, crime, or drug use.
Applicants should document that they were involved in the preparation
and planned implementation of a comprehensive community-based strategic
plan to achieve both economic and human development in an integrated
manner. (0-5 Points)
If the applicant is receiving funds from the State for community
food and nutrition activities, the applicant should address how the
funds are being utilized, and how they will be coordinated with the
proposed project to maximize the effectiveness of both. If State funds
are being used in the project for which OCS funds are being requested,
their usage should be specifically described.
e. Criterion V: Organizational Experience in Program Area and Staff
Responsibilities (Maximum: 15 Points)
(1) Organizational Experience in Program Area (0-5 Points)
Documentation provided indicates that projects previously
undertaken have been relevant and effective and have provided permanent
benefits to the low-income population. Organizations that propose
providing training and technical assistance have detailed competence in
the program area and as a deliverer with expertise in the fields of
training and technical assistance. If applicable, information provided
by these applicants also addresses related achievements and competence
of each cooperating or sponsoring organization.
(2) Management History (0-5 Points)
Applicants must demonstrate their ability to implement sound and
effective management practices and if they have been recipients of
other Federal or other governmental grants, they must also document
that they have consistently complied with financial and program
progress reporting and audit requirements. Such documentation may be in
the form of references to any available audit or progress reports and
should be accompanied by a statement by a Certified or Licensed Public
Accountant as to the sufficiency of the applicant's financial
management system to protect adequately any Federal funds awarded under
the application submitted.
(3) Staffing Skills, Resources and Responsibilities (0-5 Points)
The application adequately describes the experience and skills of
the proposed project director showing that the individual is not only
well qualified, but that his/her professional capabilities are relevant
to the successful implementation of the project. If the key staff
person has not yet been identified, the application contains a
comprehensive position description which indicates that the
responsibilities to be assigned to the project director are relevant to
the successful implementation of the project. The application must
indicate that the applicant has adequate facilities and resources (i.e.
space and equipment) to successfully carry out the work plan.
In addressing the above criterion, the applicant must clearly show
that sufficient time of the Project Director and other senior staff
will be budgeted to assure timely implementation and oversight of the
project and that the assigned responsibilities of the staff are
appropriate to the tasks identified for the project.
f. Criterion VI: Adequacy of Budget (Maximum: 5 Points)
The budget is adequate and administrative costs are appropriate in
relation to the services proposed. (0-5 Points)
Part E--Instructions for Completing Application Package
The standard forms attached to this Announcement shall be used when
submitting applications for all funds under this Announcement. It is
recommended that you reproduce
[[Page 52604]]
single-sided copies of the SF-424, SF-424A and SF-424B, and type your
application on the copies.
Please prepare your application in accordance with the instructions
provided with the forms, as well as with the OCS specific instructions
set forth below:
1. SF-424--Application for Federal Assistance (Attachment B-1)
Item 1. Type of Submission--For the purposes of this Announcement,
all projects are considered Applications; there are no Pre-
Applications.
Item 2. Date Submitted and Applicant Identifier--Enter the date the
application is submitted to ACF and the applicant's internal control
number, if applicable.
Item 3. Date Received by State--N/A.
Item 4. Date Received by Federal Agency--Leave blank.
Items 5. and 6. Applicant Information and Employer Identification
Number--The legal name of the applicant must match that listed as
corresponding to the Employer Identification Number. Where the
applicant is a previous DHHS grantee, enter the Central Registry
System/Employee Identification Number (CRS/EIN) and the Payment
Identifying Number (PIN), if one has been assigned, in the Block
entitled Federal Identifier located at the top right hand corner of the
form.
Item 7. Type of Applicant--If the applicant is a non-profit
corporation, enter the letter ``N'' in the box and specify non-profit
corporation in the space marked ``Other''. Proof of non-profit status,
such as IRS certification, Articles of Incorporation, or By-laws must
be included as an appendix to the project narrative.
Item 8. Type of Application--Check ``New''.
Item 9. Name of Federal Agency--Enter ``DHHS-ACF/OCS.''
Item 10. The Catalog of Federal Domestic Assistance (CFDA) Number--
The CFDA number for the OCS program covered under this Announcement is
93.571. The title is ``Community Services Block Grant Discretionary
Awards--Community Food and Nutrition Program''.
Item 11. Descriptive Title of Project--Enter a brief descriptive
title of the project.
Item 12. Areas Affected by Project--List only the largest unit or
units affected, such as State, county or city.
Item 13. Proposed Project Dates--Show 12-month project period. (See
Part B-3) In addition, the project period start date must be on or
before September 30, 2000.
Item 14. Congressional District of Applicant/Project--Enter the
number(s) of the Congressional District where the applicant's principal
office is located and the number(s) of the Congressional District(s)
where the project will be located.
Item 15. Estimated Funding--15a. Show the total amount requested
for the entire project period; 15b. thru 15e. For each line item, show
both cash and third-party in-kind contributions for the total project
period; 15f. Show the estimated amount of program income for the total
project period; 15g. Enter the sum of all the lines.
2. SF-424A--Budget Information--Non-Construction Programs (Attachment
B-2)
See the instructions accompanying the Attachment as well as the
instructions set forth below.
In completing these sections, the Federal funds budget entries will
relate to the requested OCS Community Food and Nutrition Program funds
only, and Non-Federal will include mobilized funds from all other
sources--applicants, State, and other. Federal funds other than those
requested from the Community Food and Nutrition Program should be
included in Non-Federal entries.
Sections A and D of SF-424A must contain entries for both Federal
(OCS) and non-Federal (mobilized) funds.
Section A--Budget Summary
Lines 1-4
--Column (a) Line 1--Enter OCS CFNP.
--Column (b) Line 1--Enter 93.571.
--Columns (c) and (d)--Not Applicable.
--Columns (e), (f) and (g)--For lines 1 through 4, enter in appropriate
amounts needed to support the project for the entire project period.
Line 5
Enter the figures from Line 1 for all columns completed, (e), (f),
and (g).
Section B--Budget Categories
This section should contain entries for OCS funds only. For all
projects, the first budget period of 12 months will be entered in
Column (1).
Allocability of costs is governed by applicable cost principles set
forth in the Code of Federal Regulations (CFR), Title 45, Parts 74 and
92.
Budget estimates for administrative costs must be supported by
adequate detail for the grants officer to perform a cost analysis and
review. Adequately detailed calculations for each budget object class
are those which reflect estimation methods, quantities, unit costs,
salaries, and other similar quantitative detail sufficient for the
calculation to be duplicated. For any additional object class
categories included under the object class other, identify the
additional object class(es) and provide supporting calculations.
Supporting narratives and justifications are required for each
budget category, with emphasis on unique/special initiatives; large
dollar amounts; local, regional, or other travel; new positions; major
equipment purchases; and training programs.
A detailed itemized budget with a separate budget justification for
each major item should be included as indicated below:
Line 6a
Personnel--Enter the total costs of salaries and wages.
Justification--Identify the project director and staff. Specify by
title or name the percentage of time allocated to the project, the
individual annual salaries and the cost to the project (both Federal
and non-Federal) of the organization's staff who will be working on the
project.
Line 6b
Fringe Benefits--Enter the total costs of fringe benefits unless
treated as part of an approved indirect cost rate which is entered on
Line 6j.
Justification--Enter the total costs of fringe benefits, unless
treated as part of an approved indirect cost rate. Provide a breakdown
of amounts and percentages that comprise fringe benefit costs.
Line 6c
Travel--Enter total cost of all travel by employees of the project.
Do not enter costs for Consultant's travel.
Justification--Include the name(s) of traveler(s), total number of
trips, destinations, length of stay, mileage rate, transportation costs
and subsistence allowances. Traveler must be a person listed under the
personnel line or employee being paid under non-federal share.
Note: Local transportation and Consultant travel costs are
entered on Line 6h.
Line 6d
Equipment--Enter the total costs of all equipment to be acquired by
the project. Equipment means an article of nonexpendable, tangible
personal property having a useful life of more than one year and an
acquisition cost which equals or exceeds the lesser of (a) the
capitalization level established by the organization for financial
statement purposes, or (b) $5,000.
[[Page 52605]]
Note: If an applicant's current rate agreement was based on
another definition for equipment, such as ``tangible personal
property $500 or more'', the applicant shall use the definition used
by the cognizant agency in determining the rate(s). However,
consistent with the applicant's equipment policy, lower limits may
be set.
Justification--Equipment to be purchased with Federal funds must be
required to conduct the project, and the applicant organization or its
subgrantees must not already have the equipment or a reasonable
facsimile available to the project.
Line 6e
Supplies--Enter the total costs of all tangible personal property
other than that included on line 6d.
Justification--Provide a general description of what is being
purchased such as type of supplies: office, classroom, medical, etc.
Include equipment costing less than $5,000 per item.
Line 6f
Contractual--Enter the total costs of all contracts, including: (1)
Procurement contracts (except those which belong on other lines such as
equipment, supplies, etc.) and (2) contracts with secondary recipient
organizations including delegate agencies and specific project(s) or
businesses to be financed by the applicant.
Justification--Attach a list of contractors, indicating the names
of the organizations, the purposes of the contracts, the estimated
dollar amounts, and selection process of the awards as part of the
budget justification. Also provide back-up documentation identifying
the name of contractor, purpose of contract, and major cost elements.
Note 1: Whenever the applicant/grantee intends to delegate part
of the program to another agency, the applicant/grantee must submit
Sections A and B of this Form (SF-424A), completed for each delegate
agency by agency title, along with the required supporting
information referenced in the applicable instructions. The total
costs of all such agencies will be part of the amount shown on Line
6f. Provide draft Request for Proposal in accordance with 45 CFR
Part 74, Appendix A. All procurement transactions shall be conducted
in a manner to provide, to the maximum extent practical, open and
free competition.
Note 2: Contractual cannot be a person--must be an organization,
firm, etc. Enter Consultant cost on Line 6h.
Line 6g
Construction--Not applicable.
Line 6h
Other--Enter the total of all other costs. Such costs, where
applicable, may include, but are not limited to, insurance, food,
medical and dental costs (non-contractual); fees and travel paid
directly to individual consultants; local transportation (all travel
which does not require per diem is considered local travel); space and
equipment rentals; printing and publication; computer use training
costs including tuition and stipends; training service costs including
wage payments to individuals and supportive service payments; and staff
development costs.
Line 6j
Indirect Charges--Enter the total amount of indirect costs. This
line should be used only when the applicant currently has an indirect
cost rate approved by DHHS or other Federal agencies.
If the applicant organization is in the process of initially
developing or renegotiating a rate, it should, immediately upon
notification that an award will be made, develop a tentative indirect
cost rate proposal based on its most recently completed fiscal year in
accordance with the principles set forth in the pertinent DHHS Guide
for Establishing Indirect Cost Rates and submit it to the appropriate
DHHS Regional Office. It should be noted that when an indirect cost
rate is requested, those costs included in the indirect cost pool
cannot be also budgeted or charged as direct costs to the grant.
Indirect costs consistent with approved indirect cost rate agreements
are allowable.
Line 6k
Totals--Enter the total amount of Lines 6i and 6j.
Line 7
Program Income--Enter the estimated amount of income, if any,
expected to be generated from this project. Separately show expected
program income generated from OCS support and income generated from
other mobilized funds. Do not add or subtract this amount from the
budget total. Show the nature and source of income in the program
narrative statement.
Justification--Describe the nature, source and anticipated use of
program income in the Program Narrative Statement.
Section C--Non-Federal Resources
This section is to record the amounts of Non-Federal resources that
will be used to support the project. Non-Federal resources mean other
than OCS funds for which the applicant has received a commitment.
Provide a brief explanation, on a separate sheet, showing the type of
contribution, broken out by Object Class Category, (see SF-424A,
Section B.6) and whether it is cash or third party in-kind. The firm
commitment of these required funds must be documented and submitted
with the application in order to be given credit in the criterion.
Except in unusual situations, this documentation must be in the
form of letters of commitment or letters of intent from the
organization(s)/individuals from which funds will be received.
Line 8
--Column (a)--Enter the project title.
--Column (b)--Enter the amount of cash or donations to be made by the
applicant.
--Column (c)--Enter the State contribution.
--Column (d)--Enter the amount of cash and third party in-kind
contributions to be made from all other sources.
--Column (e)--Enter the total of columns (b), (c), and (d).
Lines 9, 10 and 11
Leave Blank.
Line 12
Carry the total of each column of Line 8, (b) through (e). The
amount in Column (e) should be equal to the amount on Section A, Line
5, Column (f).
Justification--Describe third party in-kind contributions, if
included.
Section D--Forecasted Cash Needs
Line 13
Federal--Enter the amount of Federal (OCS) cash needed for this
grant, by quarter, during the 12-month budget period.
Line 14
Non-Federal--Enter the amount of cash from all other sources needed
by quarter during the first year.
Line 15
Totals--Enter the total of Lines 13 and 14.
Section F--Other Budget Information
Line 21
Direct Charges--Include narrative justification required under
Section B for each object class category for the total project period.
Line 22
Indirect Charges--Enter the type of DHHS or other Federal agency
approved indirect cost rate (provisional,
[[Page 52606]]
predetermined, final or fixed) that will be in effect during the
funding period, the estimated amount of the base to which the rate is
applied and the total indirect expense. Also, enter the date the rate
was approved, where applicable. Attach a copy of the approved rate
agreement.
Line 23
Provide any other explanations and continuation sheets required or
deemed necessary to justify or explain the budget information.
3. SF-424B--Assurances Non-Construction Programs (Attachment B-3)
All applicants must sign and return the ``Assurances'' with the
application.
4. Project Narrative
Each narrative should include the following major sections:
a. Analysis of Need.
b. Project Design (Work Program).
c. Organizational Experience in the Program Area.
d. Management History.
e. Staffing and Resources.
f. Staff Responsibilities.
The project narrative must address the specific purposes mentioned
in Part A of this Program Announcement. The narrative should provide
information on how the application meets the evaluation criteria in
Part D of this Program Announcement.
Part F--Application Procedures
1. Availability of Forms
Applications for awards under this OCS program must be submitted on
Standard Forms (SF) 424, 424A, and 424B. Part E and the Attachments to
this Program Announcement contain all the instructions and forms
required for submittal of applications. The forms may be reproduced for
use in submitting applications.
A copy of this Program Announcement is available on the Internet
through the OCS Website at the following web address: www.acf.dhhs.gov/
programs/ocs/kits1.htm.
This Program Announcement also may be obtained by telephoning the
office listed in the section entitled For Further Information Contact
at the beginning of this Announcement.
The information requested under this Program Announcement is
covered under the following OMB information collection clearances: SF-
424 (No. 0348-0043), SF-424A (No. 0348-0044), SF-424B (No. 0348-0040),
and other requirements for OCS applications (No. 0970-0062, expiration
date October 31, 2001).
2. Intergovernmental Review
This program is covered under Executive Order 12372,
``Intergovernmental Review of Federal Programs,'' and 45 CFR Part 100,
``Intergovernmental Review of Department of Health and Human Services
Program and Activities.'' Under the Order, States may design their own
processes for reviewing and commenting on proposed Federal assistance
under covered programs.
As of March, 1999, the following jurisdictions have elected NOT to
participate in the Executive Order process. Applicants from these
jurisdictions or for projects administered by Federally-recognized
Indian Tribes need take no action in regard to E.O. 12372:
Alabama, Alaska, Colorado, Connecticut, Hawaii, Idaho, Kansas,
Louisiana, Massachusetts, Minnesota, Montana, Nebraska, New Jersey,
Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Vermont,
Virginia, Washington, American Samoa and Palau.
All remaining jurisdictions participate in the Executive Order
process and have established Single Points of Contact (SPOCs).
Applicants from participating jurisdictions should contact their SPOCs
as soon as possible to alert them of the prospective applications and
receive instructions. Applicants must submit any required material to
the SPOCs as soon as possible so that the program office can obtain and
review SPOC comments as part of the award process. The applicant must
submit all required materials, if any, to the SPOC and indicate the
date of this submittal (or the date of contact if no submittal is
required) on the Standard Form 424, item 16a.
Under 45 CFR 100.8(a)(2), a SPOC has 60 days from the application
deadline to comment on the proposed new award.
The SPOCs are encouraged to eliminate the submission of routine
endorsements as official recommendations.
Additionally, SPOCs are requested to clearly differentiate between
mere advisory comments and those official State process recommendations
which may trigger the ``accommodate or explain'' rule.
When comments are submitted directly to ACF, they should be
addressed to: U.S. Department of Health and Human Services,
Administration for Children and Families, Office of Grants Management/
OCSE, 4th Floor West, Aerospace Center, 370 L'Enfant Promenade, SW,
Washington, D.C. 20447.
A list of the Single Points of Contact for each State and Territory
is included as Attachment G of this Announcement.
3. Application Consideration
Applications that meet the screening requirements in Section 5
below will be reviewed competitively. Such applications will be
referred to reviewers for a numerical score and explanatory comments
based solely on responsiveness to program guidelines and evaluation
criteria published in this Announcement. Applications will be reviewed
by persons outside of the OCS unit which would be directly responsible
for programmatic management of the grant. The results of these reviews
will assist the Director and OCS program staff in considering competing
applications. Reviewers' scores will weigh heavily in funding decisions
but will not be the only factors considered. Applications will
generally be considered in order of the average scores assigned by
reviewers. However, highly ranked applications are not guaranteed
funding since the Director may also consider other factors deemed
relevant including, but not limited to, the timely and proper
completion of projects funded with OCS funds granted in the last five
(5) years; comments of reviewers and government officials; staff
evaluation and input; geographic distribution; previous program
performance of applicant; compliance with grant terms under previous
DHHS grants; audit reports; investigative reports; and applicant's
progress in resolving any final audit disallowances on OCS or other
Federal agency grants. The OCS reserves the right to discuss
applications with other Federal or non-Federal funding sources to
ascertain the applicant's performance record.
4. Criteria for Screening Applications
a. Initial Screening
All applications that meet the application deadline will be
screened to determine completeness and conformity to the requirements
of this Announcement. Only those applications meeting the below listed
requirements will be reviewed and evaluated competitively. Others will
be returned to the applicants with a notation that they were
unacceptable.
(1) The application must contain a completed and signed Standard
Form SF-424.
(2) The SF-424 must be signed by an official of the organization
applying for
[[Page 52607]]
the grant who has authority to obligate the organization legally.
b. Pre-Rating Review
Applications which pass the initial screening will be forwarded to
reviewers for analytical comment and scoring based on the criteria
detailed in the section below and the specific requirements contained
in Part A of this Announcement. Prior to the programmatic review, these
reviewers and/or OCS staff will verify that the applications comply
with this Program Announcement in the following areas:
(1) Eligibility--Applicant meets the eligibility requirements found
in Part B.
(2) Number of Projects--The application contains only one project.
(3) Target Populations--The application clearly targets the
specific outcomes and benefits of the project to low-income
participants and beneficiaries as defined in the DHHS Poverty Income
Guidelines (Attachment A).
(4) Grant Amount--The amount of funds requested does not exceed
$50,000.
(5) Program Focus--The application addresses the purposes described
in Part A of this Announcement.
c. Evaluation Criteria
Applications that pass the initial screening and pre-rating review
will be assessed and scored by reviewers. Each reviewer will give a
numerical score for each application reviewed. These numerical scores
will be supported by explanatory statements on a formal rating form
describing major strengths and major weaknesses under each applicable
criterion published in this Announcement.
Part G--Contents of Application Package and Receipt Process
1. Contents of Application
Each application submission must include a signed original and four
additional copies of the application. Each copy of the application MUST
contain, in the order listed, each of the following:
a. Table of Contents with page numbers noted for each major section
and subsection of the application, including the appendices. Each page
in the application, including those in all appendices, must be numbered
consecutively.
b. A Project Abstract which is a succinct description of the
project in 200 words or less.
c. The SF-424 (Application for Federal Assistance) (Attachment B-1)
should be completed in accordance with instructions provided with the
form, as well as OCS specific instructions set forth in Part E of this
Announcement. The SF-424 must contain an original signature of the
certifying representative of the applicant organization. Applicants
must also be aware that the applicant's legal name (Item 5) MUST match
the Employer Identification Number (Item 6).
d. SF-424A (Budget Information) (Attachment B-2) must be completed.
e. SF-424B (Assurances--Non-Construction Programs) (Attachment B-3)
must be filed by applicants requesting financial assistance for a non-
construction project. Applicants must sign and return the SF-424B with
their applications.
f. Certification Regarding Lobbying (Attachment F-1) Applicants
must provide a certification concerning lobbying. Prior to receiving an
award in excess of $100,000, applicants shall furnish an executed copy
of the lobbying certification. Applicants must sign and return the
certification with their applications.
g. Disclosure of Lobbying Activities (SF-LLL). Applicants must
fill-in, sign and date form found at Attachment F-2. (This form is
required only if lobbying has actually taken place or is expected to
take place in trying to obtain the grant for which the applicant is
applying.)
h. Project Narrative (See Part E, section 4).
i. Certification Regarding Drug-Free Workplace Requirements
(Attachment C). Applicants must make the appropriate certification of
their compliance with the Drug-Free Workplace Act of 1988. By signing
and submitting the applications, applicants are providing the
certification and need not mail back the certification with the
applications.
j. Certification Regarding Debarment, Suspension, and Other
Responsibility Matters (Attachment D). Applicants must make the
appropriate certification that they are not presently debarred,
suspended or otherwise ineligible for award. By signing and submitting
the applications, applicants are providing the certification and need
not mail back the certification with the applications.
k. Certification Regarding Environmental Tobacco Smoke (Attachment
E). Applicants must make the appropriate certification of their
compliance with the Pro-Children Act of 1944. By signing and submitting
the applications, applicants are providing the certification and need
not mail back the certification with the applications.
The total number of pages for the narrative portion of the
application package must not exceed 30 pages in its entirety.
Applications must be uniform in composition since OCS may find it
necessary to duplicate them for review purposes. Therefore,
applications must be submitted on 8\1/2\ x 11-inch paper only. They
must not include colored, oversized or folded materials, organizational
brochures, or other promotional materials, slides, films, clips, etc.
Such materials will be discarded if included.
Applications should be two-holed punched at the top center and
fastened separately with a compressor slide paper fastener or a binder
clip.
While applications must be comprehensive, OCS encourages
conciseness and brevity in the presentation of materials and cautions
the applicant to avoid unnecessary duplication of information.
2. Acknowledgment of Receipt
An acknowledgment will be mailed to all applicants with an
identification number which will be noted on the acknowledgment. This
number must be referred to in all subsequent communications with OCS
concerning the application. If an acknowledgment is not received within
three weeks after the application deadline, applicants must notify ACF
by telephone (202) 401-5103. Applicant should also submit a mailing
label for the acknowledgment.
Note: To facilitate receipt of this acknowledgment from ACF,
applicant should include a cover letter with the application
containing an E-mail address and facsimile (FAX) number if these
items are available to applicant.
Part H--Post Award Information and Reporting Requirements
Following approval of the applications selected for funding, notice
of project approval and authority to draw down project funds will be
made in writing. The official award document is the Financial
Assistance Award which provides the amount of Federal funds approved
for use in the project, the budget period for which support is
provided, and the terms and conditions of the award.
In addition to the General Conditions and Special Conditions (where
the latter are warranted) that will be applicable to grants, grantees
will be subject to the provisions of 45 CFR Parts 74 (non-governmental)
and 92 (governmental) along with Circulars 122 (non-governmental) and
87 (governmental).
Grantees will be required to submit semi-annual progress and
financial reports (SF-269) as well as a final progress and financial
report.
[[Page 52608]]
Grantees are subject to the audit requirements in 45 CFR Parts 74
and 92.
Section 319 of Public Law 101-121, signed into law on October 23,
1989, imposes new prohibitions and requirements for disclosure and
certification related to lobbying when applicant has engaged in
lobbying activities or is expected to lobby in trying to obtain the
grant. It provides limited exemptions for Indian tribes and tribal
organizations. Current and prospective recipients (and their subtier
contractors and/or grantees) are prohibited from using appropriated
funds for lobbying Congress or any Federal agency in connection with
the award of a contract, grant, cooperative agreement or loan. In
addition, for each award action in excess of $100,000 (or $150,000 for
loans) the law requires recipients and their subtier contractors and/or
subgrantees: (1) To certify that they have neither used nor will use
any appropriated funds for payment to lobbyists, (2) to submit a
declaration setting forth whether payments to lobbyists have been or
will be made out of non-appropriated funds and, if so, the name,
address, payment details, and purpose of any agreements with such
lobbyists whom recipients or their subtier contractors or subgrantees
will pay with the nonappropriated funds and (3) to file quarterly
updates about the use of lobbyists if any event occurs that materially
affects the accuracy of the information submitted by way of declaration
and certification. The law establishes civil penalties for
noncompliance and is effective with respect to contracts, grants,
cooperative agreements and loans entered into or made on or after
December 23, 1989. See Attachments F-1 and F-2 for certification and
disclosure forms to be submitted with the applications for this
program.
Attachment H indicates the regulations that apply to all
applicants/ grantees under the FY 2000 Community Food and Nutrition
Program.
Dated: September 22, 1999.
Donald Sykes,
Director, Office of Community Services.
Attachments
A--1999 Poverty Income Guidelines for the 48 Contiguous States and
the District of Columbia, Alaska, and Hawaii
B-1--Application for Federal Assistance
B-2--Budget Information--Non-Construction Programs
B-3--Assurances--Non-Construction Programs
C--Certification Regarding Drug-Free Workplace Requirements
D--Certification Regarding Debarment, Suspension, and other
Responsibility Matters (Primary and Lower Tier Covered Transactions)
E--Certification Regarding Environmental Tobacco Smoke
F-1--Certification Regarding Lobbying
F-2--Disclosure of Lobbying Activities
G--State Single Point of Contact Listing Maintained by OMB
H--DHHS Regulations applying to all Applicants/Grantees under the
Community Food and Nutrition Program
I--Applicant's Checklist
Attachment A
1999 Poverty Guidelines for the 48 Contiguous States and the District of
Columbia
------------------------------------------------------------------------
Poverty
Size of family unit guideline
------------------------------------------------------------------------
1.......................................................... $8,240
2.......................................................... 11,060
3.......................................................... 13,880
4.......................................................... 16,700
5.......................................................... 19,520
6.......................................................... 22,340
7.......................................................... 25,160
8.......................................................... 27,980
------------------------------------------------------------------------
For family units with more than 8 members, add $2,820 for each
additional member.
(The same increment applies to smaller family sizes also, as can be seen
in the figures above).
1999 Poverty Guidelines for Alaska
------------------------------------------------------------------------
Poverty
Size of family unit guideline
------------------------------------------------------------------------
1.......................................................... $10,320
2.......................................................... 13,840
3.......................................................... 17,360
4.......................................................... 20,880
5.......................................................... 24,400
6.......................................................... 27,920
7.......................................................... 31,440
8.......................................................... 34,960
------------------------------------------------------------------------
For family units with more than 8 members, add $3,520 for each
additional member.
(The same increment applies to smaller family sizes also, as can be seen
in the figures above).
1999 Poverty Guidelines for Hawaii
------------------------------------------------------------------------
Poverty
Size of family unit guidelines
------------------------------------------------------------------------
1.......................................................... $9,490
2.......................................................... 12,730
3.......................................................... 15,970
4.......................................................... 19,210
5.......................................................... 22,450
6.......................................................... 25,690
7.......................................................... 28,930
8.......................................................... 32,170
------------------------------------------------------------------------
For family units with more than 8 members, add $3,240 for each
additional member.
(The same increment applies to smaller family sizes also, as can be seen
in the figures above).
BILLING CODE 4184-01-P
[[Page 52609]]
[GRAPHIC] [TIFF OMITTED] TN29SE99.000
[[Page 52610]]
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) and 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 additional funding/budget
period for a project with a projected completion date.
--``Revision'' means any change in the Federal Government's
financial obligation or contingent liability from an existing
obligation.
9. Name of Federal agency from which assistance if 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 (i.e., construction or real property
projects), attach a map showing project location. For
preapplications, use a separate sheet to provide a summary
description of this project.
12. List only the largest political entities affected (e.g.,
State, counties, cities).
13. Self-explanatory.
14. List the applicant's Congressional District and any
District(s) affected by the program or project.
15. Amount requested or to be contributed during the first
funding/budget period by each contributor. Value of in-kind
contributions should be included on appropriate lines as applicable.
If the action will result in a dollar change to an existing award,
indicate only the amount of the change. For decreases, enclose the
amounts in parentheses. If both basic and supplemental amounts are
included, show breakdown on an attached sheet. For multiple program
funding, use totals and show breakdown using same categories as item
15.
16. Applicants should contact the State Single Point of Contact
(SPOC) for Federal Executive Order 12372 to determine whether the
application is subject to the State intergovernmental review
process.
17. This question applies to the applicant organization, not the
person who signs as the authorized representative. Categories of
debt include delinquent audit disallowances, loans and taxes.
18. To be signed by the authorized representative of the
applicant. A copy of the governing body's authorization for you to
sign this application as official representative must be on file in
the applicant's office. (Certain Federal agencies may require that
this authorization be submitted as part of the application.)
BILLING CODE 4184-01-M
[[Page 52611]]
[GRAPHIC] [TIFF OMITTED] TN29SE99.001
[[Page 52612]]
[GRAPHIC] [TIFF OMITTED] TN29SE99.002
BILLING CODE 4184-01-C
[[Page 52613]]
Instructions for the SF-424A
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 suggestions for reducing this burden, to the Office of
Management and Budget, Paperwork Reduction Project (0348-0044),
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.
General Instructions
This form is designed so that application can be made for funds
from one or more grant programs. In preparing the budget, adhere to
any existing Federal grantor agency guidelines which prescribe how
and whether budgeted amounts should be separately shown for
different functions or activities within the program. For some
programs, grantor agencies may require budgets to be separately
shown by function or activity. For other programs, grantor agencies
may require a breakdown by function or activity. Sections A, B, C,
and D should include budget estimates for the whole project except
when applying for assistance which requires Federal authorization in
annual or other funding period increments. In the latter case,
Sections A, B, C, and D should provide the budget for the first
budget period (usually a year) and Section E should present the need
for Federal assistance in the subsequent budget periods. All
applications should contain a breakdown by the object class
categories shown in Lines a-k of Section B.
Section A. Budget Summary Lines 1-4 Columns (a) and (b)
For applications pertaining to a single Federal grant program
(Federal Domestic Assistance Catalog number) and not requiring a
functional or activity breakdown, enter on Line 1 under Column (a)
the Catalog program title and the Catalog number in Column (b).
For applications pertaining to a single program requiring budget
amounts by multiple functions or activities, enter the name of each
activity or function on each line in Column (a), and enter the
Catalog number in Column (b). For applications pertaining to
multiple programs where none of the programs require a breakdown by
function or activity, enter the Catalog program title on each line
in Column (a) and the respective Catalog number on each line in
Column (b).
For applications pertaining to multiple programs where one or
more programs require a breakdown by function or activity, prepare a
separate sheet for each program requiring the breakdown. Additional
sheets should be used when one form does not provide adequate space
for all breakdown of data required. However, when more than one
sheet is used, the first page should provide the summary totals by
programs.
Lines 1-4, Columns (c) through (g):
For new applications, leave Column (c) and (d) blank. For each
line entry in Columns (a) and (b), enter in Columns (e), (f), and
(g) the appropriate amounts of funds needed to support the project
for the first funding period (usually a year).
For continuing grant program applications, submit these forms
before the end of each funding period as required by the grantor
agency. Enter in Columns (c) and (d) the estimated amounts of funds
which will remain unobligated at the end of the grant funding period
only if the Federal grantor agency instructions provide for this.
Otherwise, leave these columns blank. Enter in columns (e) and (f)
the amounts of funds needed for the upcoming period. The amount(s)
in Column (g) should be the sum of amounts in Columns (e) and (f).
For supplemental grants and changes to existing grants, do not
use Columns (c) and (d). Enter in Column (e) the amount of the
increase or decrease of Federal funds and enter in Column (f) the
amount of the increase or decrease of non-Federal funds. In Columns
(g) enter the new total budgeted amount (Federal and non-Federal)
which includes the total previous authorized budgeted amounts plus
or minus, as appropriate, the amounts shown in Columns (e) and (f).
The amount(s) in Column (g) should not equal the sum of amounts in
Columns (e) and (f).
Line 5--Show the totals for all columns used.
Section B. Budget Categories
In the column headings (1) through (4), enter the titles of the
same programs, functions, and activities shown on Lines 1-4, Column
(a), Section A. When additional sheets are prepared for Section A,
provide similar column headings on each sheet. For each program,
function or activity, fill in the total requirements for funds (both
Federal and non-Federal) by object class categories.
Line 6a-i--Show the totals of Lines 6a to 6h in each column.
Line 6j--Show the amount of indirect cost.
Line 6k--Enter the total of amounts on Lines 6i and 6j. For all
applications for new grants and continuation grants the total amount
in column (5), Line 6k, should be the same as the total amount shown
in Section A, Column (g), Line 5. For supplemental grants and
changes to grants, the total amount of the increase or decrease as
shown in Columns (1)-(4), Line 6k should be the same as the sum of
the amounts in Section A, Columns (e) and (f) on Line 5.
Line 7--Enter the estimated amount of income, if any, expected
to be generated from this project. Do not add or subtract this
amount from the total project amount. Show under the program
narrative statement the nature and source of income. The estimated
amount of program income may be considered by the Federal grantor
agency in determining the total amount of the grant.
Section C. Non-Federal Resources
Lines 8-11--Enter amounts of non-Federal resources that will be
used on the grant. If in-kind contributions are included, provide a
brief explanation on a separate sheet.
Column (a)--Enter the program titles identical to Column (a),
Section A. A breakdown by function or activity is not necessary.
Column (b)--Enter the contribution to be made by the applicant.
Column (c)--Enter the amount of the State's cash and in-kind
contribution if the applicant is not a State or State agency.
Applicants which are a State or State agencies should leave this
column blank.
Column (d)--Enter the amount of cash and in-kind contributions
to be made from all other sources.
Column (e)--Enter totals of Columns (b), (c), and (d).
Line 12--Enter the total for each of Columns (b)-(e). The amount
in Column (e) should be equal to the amount on Line 5, Column (f),
Section A.
Section D. Forecasted Cash Needs
Line 13--Enter the amount of cash needed by quarter from the
grantor agency during the first year.
Line 14--Enter the amount of cash from all other sources needed
by quarter during the first year.
Line 15--Enter the totals of amounts on Lines 13 and 14.
Section E. Budget Estimates of Federal Funds Needed for Balance of the
Project
Lines 16-19--Enter in Column (a) the same grant program titles
shown in Column (a), Section A. A breakdown by function or activity
is not necessary. For new applications and continuation grant
applications, enter in the proper columns amounts of Federal funds
which will be needed to complete the program or project over the
succeeding funding periods (usually in years). This section need not
be completed for revisors (amendments, changes, or supplements) to
funds for the current year of existing grants.
If more than four lines are needed to list the program titles,
submit additional schedules as necessary.
Line 20--Enter the total for each of the Columns (b)-(e). When
additional schedules are prepared for this Section, annotate
accordingly and show the overall totals on this line.
Section F. Other Budget Information
Line 21--Use this space to explain amounts for individual direct
object class cost categories that may appear to be out of the
ordinary or to explain the details as required by the Federal
grantor agency.
Line 22--Enter the type of indirect rate (provisional,
predetermined, final or fixed) that will be in effect during the
funding period, the estimated amount of the base to which the rate
is applied, and the total indirect expense.
Line 23--Provide any other explanations or comments deemed
necessary.
Assurances--Non-Construction Programs
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 comments regarding the burden
estimate or
[[Page 52614]]
any other aspect of this collection of information, including
suggestions for reducing this burden, to the Office of Management
and Budget, Paperwork Reduction Project (0348-0040), 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 cost) to
ensure proper planning, management and completion of the project
described in this application.
2. Will give the awarding agency, the Comptroller General of the
United States and, if appropriate, the State, through any authorized
representative, access to and the right to examine all records,
books, papers, or documents related to the award; and will establish
a proper accounting system in accordance with generally accepted
accounting standards or agency directives.
3. Will establish safeguards to prohibit employees from using
their positions for a purpose that constitutes or presents the
appearance of personal or organizational conflict of interest, or
personal gain.
4. Will initiate and complete the work within the applicable
time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970
(42 U.S.C. 4728-4763) relating to prescribed standards for merit
systems for programs funded under one of the 19 statutes or
regulations specified in Appendix A of OPM's Standards for a Merit
System of Personnel Administration (5 CFR 900, Subpart F).
6. Will comply with all Federal statutes relating to
nondiscrimination. These include but are not limited to: (a) Title
VI of the Civil Rights Act of 1964 (Pub. 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.
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. 794), which prohibits discrimination on the basis
of handicaps; (d) the Age Discrimination Act of 1975, as amended (42
U.S.C. 6101-6107), which prohibits discrimination on the basis of
age; (e) the Drug Abuse Office and Treatment Act of 1972 (Pub. 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 (Pub. L. 91-
616), as amended, relating to nondiscrimination on the basis of
alcohol abuse or alcoholism; (g) 523 and 527 of the Public Health
Service Act of 1912 (42 U.S.C. 290dd-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.
3601 et seq.,), as amended, relating to nondiscrimination in the
sale, rental or financing of housing; (i) any other
nondiscrimination provisions in the specific state(s) under which
application for Federal assistance is being made; and, (j) the
requirements of any other nondiscrimination statute(s) which may
apply to the application.
7. Will comply, or has already complied, with the requirements
of Titles II and III of the Uniform Relocation Assistance and Real
Property Acquisition Policies Act of 1970 (Pub. 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 provisions of the Hatch Act
(5 U.S.C. 1501-1508 and 7324-7326) 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. 276a to 276a-7), the Copeland Act (40 U.S.C.
276c and 18 U.S.C. 874), and the Contract Work Hours and Safety
Standards Act (40 U.S.C. 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 (Pub. 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 (Pub. 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. 1451 et seq.); (f) conformity of Federal actions
to State (Clean Air) Implementation Plans under Section 176(c) of
the Clean Air Act of 1955, as amended (42 U.S.C. 7401 et seq.); (g)
protection of underground sources of drinking water under the Safe
Drinking Water Act of 1974, as amended(Pub. L. 93-523); and, (h)
protection of endangered species under the Endangered Species Act of
1973, as amended Pub. L. 93-205).
12. Will comply with the Wild and Scenic Rivers Act of 1968 (16
U.S.C. 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 Pub. 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
Pub. 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. 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 Amendments
of 1996 and OMB Circular No. A-133, ``Audits of States, Local
Governments, and Non-Profit Organizations.''
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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Applicant Organization
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Title
----------------------------------------------------------------------
Date Submitted
Attachment C
Certificate Regarding Drug-Free Workplace Requirements
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 point 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
[[Page 52615]]
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
his certification. Grantees' attention is called, in particular, to
the following definitions from these rules:
Controlled substance 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 statues;
Criminal drug statute means a Federal or non-Federal criminal
statute involving the manufacture, distribution, or 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
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 not 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 prohibitions;
(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 statue 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 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 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.
[FR 21690, 21702, May 25, 1990]
Attachment D
Certification Regarding Debarment, Suspension and Other
Responsibility Matters
Certification Regarding Debarment, Suspension, and Other Responsibility
Matters--Primary Covered Transactions
Instructions for Certification
1. By signing and submitting this proposal, the prospective
primary participant is providing the certification set out below.
2. The inability of a person to provide the certification
required below will not necessarily result in denial of
participation in this covered transaction. The prospective
participant shall submit an explanation of why it cannot provide the
certification set out below. The certification or explanation will
be considered in connection with the department or agency's
determination whether to enter into this transaction. However,
failure of the prospective primary participant to furnish a
certification or an explanation shall disqualify such person from
participation in this transaction.
3. The certification in this clause is a material representation
of fact upon which reliance was placed when the department or agency
determined to enter into this transaction. If it is later determined
that the prospective primary participant knowingly rendered an
erroneous certification, in addition to other remedies available to
the Federal Government, the department or agency may terminate this
transaction for cause or default.
4. The prospective primary participant shall provide immediate
written notice to the department or agency to which this proposal is
submitted if at any time the prospective primary participant learns
that its certification was erroneous when submitted or has become
erroneous by reason of changed circumstances.
5. The terms covered transaction, debarred, suspended,
ineligible, lower tier covered transaction, participant, person,
primary
[[Page 52616]]
covered transaction, principal, proposal, and voluntarily excluded,
as used in this clause, have the meanings set out in the Definitions
and Coverage sections of the rules implementing Executive Order
12549. You may contact the department or agency to which this
proposal is being submitted for assistance in obtaining a copy of
those regulations.
6. The prospective primary participant agrees by submitting this
proposal that, should the proposed covered transaction be entered
into, it shall not knowingly enter into any lower tier covered
transaction with a person who is proposed for debarment under 48 CFR
part 9, subpart 9.4, debarred, suspended, declared ineligible, or
voluntarily excluded from participation in this covered transaction,
unless authorized by the department or agency entering into this
transaction.
7. The prospective primary participant further agrees by
submitting this proposal that it will include the clause titled
``Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion-Lower Tier Covered Transaction,'' provided by
the department or agency entered 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:
(1) 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 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 or a system of records in order to render in
good faith the certification required by this clause. The knowledge
and information of a participant is not required to exceed that
which is normally possessed by a prudent person in the ordinary
course of business dealings.
9. Except for transactions authorized under paragraph 5 of these
instructions, if a participant in a covered transaction knowingly
enters into a lower tier covered transaction with a person who is
proposed for debarment under 48 CFR part 9, subpart 9.4, suspended,
debarred, ineligible, or voluntarily excluded from participation in
this transaction, in addition to other remedies available to the
Federal Government, the department or agency with which this
transaction originated may pursue available remedies, including
suspension and/or debarment.
Certification Regarding Debarment, Suspension, Ineligibility 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.
Attachment E
Certification Regarding Environmental Tobacco Smoke
Public Law 103227, Part C Environmental Tobacco Smoke, also
known as the Pro Children Act of 1994, requires that smoking not be
permitted in any portion of any indoor
[[Page 52617]]
routinely owned or leased or contracted for by an entity and used
routinely or regularly for provision of health, day care, education,
or library services to children under the age of 18, if the services
are funded by Federal programs either directly or through State or
local governments, by Federal grant, contract, loan, or loan
guarantee. The law does not apply to children's services provided in
private residences, facilities funded solely by Medicare or Medicaid
funds, and portions of facilities used for inpatient drug or alcohol
treatment. Failure to comply with the provisions of the law may
result in the imposition of a civil monetary penalty of up to $1000
per day and/or the imposition of an administrative compliance order
on the responsible entity. By signing and submitting this
application the applicant/grantee certifies that it will comply with
the requirements of the Act.
The applicant/grantee further agrees that it will require the
language of this certification be included in any subawards which
contain provisions for the children's services and that all
subgrantees shall certify accordingly.
Attachment F-1
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,
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 connecting 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 $10,000 for each such failure.
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Signature
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Title
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Organization
BILLING CODE 4184-01-P
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BILLING CODE 4184-01-C
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Instruction for Completion of SF-LLL, Disclosure of Lobbying Activities
This disclosure form shall be completed by the reporting
entity,whether subawardee or prime Federal recipient, at the
initiation or receipt of a covered Federal action, or a material
change to a previous filing, pursuant to title 31 U.S.C. section
1352. The filing of a form is required for each payment or agreement
to make payment to any lobbying entity for influencing or attempting
to influence an officer or employee any agency, a Member of
Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with a covered Federal action.
Complete all items that apply for both the initial filing and
material change report. Refer to the implementing guidance published
by the Office of Management and Budget for additional information.
1. Identify the type of covered Federal action for which
lobbying activity is and/or has been secured to influence the
outcome of a covered Federal action.
2. Identify the status of the covered Federal action.
3. Identify the appropriate classification of this report. If
this is a follow up report caused by a material change to the
information previously reported, enter the year and quarter in which
the change occurred. Enter the date of the last previously submitted
report by this reporting entity for this covered Federal action.
4. Enter the full name, address, city, State and zip code of the
reporting entity. Include Congressional District, if known. Check
the appropriate classification of the reporting entity that
designates if it is, or expects to be, a prime or subaward
recipient. Identify the tier or the subawardee, e.g., the first
subawardee of the prime is the 1st tier. Subawards include but are
not limited to subcontracts, subgrants and contract awards under
grants.
5. If the organization filing the report in item 4 checks
``Subawardee,'' then enter the full name, address, city, State and
zip code of the prime Federal recipient. Include Congressional
District, if known.
6. Enter the name of the Federal agency making the award or loan
commitment. Include at least one organizational level below agency
name, if known. For example, Department of Transportation, United
States Coast Guard.
7. Enter the Federal program name or description for the covered
Federal action (item 1). If known, enter the full Catalog of Federal
Domestic Assistance (CFDA) number for grants, cooperative
agreements, loans, and loan commitments.
8. Enter the most appropriate Federal identifying number
available for the Federal action identified in item 1 (e.g., Request
for Proposal (RFP) number; Invitation for Bid (IFB) number; grant
announcement number; the contract, grant, or loan award number; the
application/proposal control number assigned by the Federal agency).
Include prefixes, e.g., ``RFP-DE-90-001.''
9. For a covered action where there has been an award or loan
commitment by the Federal agency, enter the Federal amount of the
award/loan commitment for the prime entity identified in item 4 or
5.
10. (a) Enter the full name, address, city, State and zip code
of the lobbying registrant under the Lobbying Disclosure Act of 1995
engaged by the reporting entity identified in item 4 to influence
the covered Federal action.
(b) Enter the full names of the individual(s) performing
services, and include full address if different from 10(a). Enter
Last Name, First Name, and Middle Initial (MI).
11. The certifying official shall sign and date the form, print
his/her name, title, and telephone number.
According to the Paperwork Reduction Act, as amended, no persons
are required to respond to a collection of information unless if
displays a valid OMB Control Number. The valid OMB control number
for this information collection is OMB No. 0348-0046. Public
reporting burden for this collection of information is estimated to
average 10 minutes per response, including time for reviewing
instructions, searching existing data sources's 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 (0348-0046),
Washington, DC 20503.
Attachment G
State Single Point of Contact Listing Maintained by OMB
In accordance with Executive Order #12372, ``Intergovernmental
Review of Federal Programs,'' Section 4, ``the Office of Management
and Budget (OMB) shall maintain a list of official State entities
designated by the States to review and coordinate proposed Federal
financial assistance and direct Federal development.'' This attached
list is the OFFICIAL OMB LISTING. This listing is also published in
the Catalogue of Federal Domestic Assistance biannually.
August 23, 1999
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, 515 W. 7th St., Room 412, Little Rock, Arkansas
72203, Telephone: (501) 682-1074, FAX: (501) 682-5206
California
Grants Coordination, State Clearinghouse, Office of Planning &
Research, 1400 Tenth Street, Room 121, Sacramento, California 95814,
Telephone: (916) 445-0613, FAX: (916) 323-3018
Delaware
Francine Booth, State Single Point of Contact, Executive Department,
Office of the Budget, 540 S. Dupont Highway, Suite 5, Dover,
Delaware 19901, Telephone: (301) 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 1200, Washington, D.C.
20005, Telephone: (202) 727-1700 (direct), (202) 727-6537
(secretary), FAX: (202) 727-1617
Florida
Florida State Clearinghouse, Department of Community Affairs, 2555
Shumard Oak Blvd., Tallahassee, Florida 32399-2100, Telephone: (850)
922-5438, FAX: (850) 414-0479, Contact: Cherie Trainor, (850) 414-
5495
Georgia
Deborah Stephens, Coordinator, Georgia State Clearinghouse, 270
Washington Street, S.W.--8th Floor, Atlanta, Georgia 30334,
Telephone: (404) 656-3855, FAX: (404) 656-7901
Illinois
Virginia Bova, State Single Point of Contact, Illinois 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
Renee Miller, State Budget Agency, 212 State House, Indianapolis,
Indiana 46204-2796, Telephone: (317) 232-2971 (directline), 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) 242-4809
Kentucky
Kevin J. Goldsmith, Director, Sandra Brewer, Executive Secretary,
Intergovernmental Affairs, Office of the Governor, 700 Capitol
Avenue, Frankfort, Kentucky 40601, Telephone: (502) 564-2611, FAX:
(502) 564-0437
Maine
Joyce Benson, State Planning Office, 184 State Street, 38 State
House Station, Augusta, Maine 04333, Telephone: (207) 287-3261, FAX:
(207) 287-6489
Maryland
Linda Janey, Manager, Plan & Project Review, Maryland Office of
Planning, 301 W. Preston Street--Room 1104, Baltimore, Maryland
21201-2365, Staff Contact: Linda Janey, Telephone: (410) 767-4490,
FAX: (410) 767-4480
Michigan
Richard Pfaff, Southeast Michigan Council of Governments, 660 Plaza
Drive--Suite 1900, Detroit, Michigan 48226, Telephone: (313) 961-
4266, FAX: (313) 961-4869
[[Page 52620]]
Mississippi
Cathy Mallette, Clearinghouse Officer, Department of Finance and
Administration, 550 High Street, 303 Walters Sillers Building,
Jackson, Mississippi 39201-3087, Telephone: (601) 359-6762, FAX:
(601) 359-6758
Missouri
Lois Pohl, Federal Assistance Clearinghouse, Office of
Administration, P.O. Box 809, Jefferson Building, 9th Floor,
Jefferson Building, 9th Floor, Jefferson City, Missouri 65102,
Telephone: (314) 751-4834, FAX: (314) 751-7819
Nevada
Department of Administration, State Clearinghouse, 209 E. Musser
Street, Room 220, Carson City, Nevada 89710, Telephone: (702) 687-
3983, Contact: Heather Elliot, (702) 687-6367
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
Nick Mandell, Local Government Division, Room 201 Bataan Memorial
Building, Santa Fe, New Mexico 87503, Telephone: (505) 827-3640,
Fax: (505) 827-4984
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
Jeanette Furney, North Carolina Department of Administration, 116
West Jones Street--Suite 5106, Raleigh, North Carolina 27603-8003,
Telephone: (919) 733-7232, FAX: (919) 733-9571
North Dakota
North Dakota Single Point of Contact, Office of Intergovernmental
Assistance, 600 East Boulevard Avenue, Bismarck, North Dakota 58505-
0170, Telephone: (701) 224-2094, FAX: (701) 224-2308
Rhode Island
Kevin Nelson, Review Coordinator, Department of Administration,
Division of Planning, One Capitol Hill, 4th Floor, Providence, Rhode
Island 02908-5870, Telephone: (401) 277-2656, FAX: (401) 277-2983
South Carolina
Omeagia Burgess, State Single Point of Contact, Budget and Control
Board, Office of State Budget, 1122 Ladies Street--12th Floor,
Columbia, South Carolina 29201, Telephone: (803) 734-0494, FAX:
(803) 734-0645
Texas
Tom Adams, Governors Office, Director, Intergovernmental
Coordination, P.O. Box 12428, Austin, Texas 78711, Telephone: (512)
463-1771, FAX: (512) 936-2681
Utah
Carolyn Wright, Utah State Clearinghouse, Office of Planning and
Budget, Room 116 State Capitol, Salt Lake City, Utah 84114,
Telephone: (801) 538-1027, 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, Federal/State 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
Sandy Ross, State Single Point of Contact, Department of
Administration and Information, 2001 Capitol Avenue, Room 214,
Cheyenne, WY 82002, Telephone: (307) 777-5492, FAX: (307) 777-3696
Territories
Guam
Joseph Rivera, Acting Director, Bureau of Budget and Management
Research, Office of the Governor, P.O. Box 2950, Agana, Guam 96932,
Telephone: (671) 475-9411 or 9412, FAX: (671) 472-2825
Puerto Rico
Jose Caballero-Mercado, Chairman, Puerto Rico Planning Board,
Federal Proposals Review Office, Minillas Government Center, P.O.
Box 41119, San Juan, Puerto Rico 00940-1119, Telephone: (787) 727-
4444, (787) 723-6190, FAX: (787) 724-3270
North Mariana Islands
Mr. Alvaro A. Santos, Executive Officer, Office of Management and
Budget, Office of the Governor, Saipan, MP 96950, Telephone: (670)
664-2256, FAX: (670) 664-2272, Contact person: Ms. Jacoba T. Seman,
Federal Programs Coordinator, Telephone: (670) 664-2289, FAX: (670)
664-2272
Virgin Islands
Nellon 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.
If you would like a copy of this faxed to your office, please
call our publications office at: (202) 395-9068.
* In accordance with Executive Order #12372, ``Intergovernmental
Review of Federal Programs,'' this listing represents the designated
State Single Points of Contact. The jurisdictions not listed no
longer participate in the process BUT GRANT APPLICANTS ARE STILL
ELIGIBLE TO APPLY FOR THE GRANT EVEN IF YOUR STATE, TERRITORY,
COMMONWEALTH, ETC., DOES NOT HAVE A ``STATE SINGLE POINT OF
CONTACT.'' STATES WITHOUT ``STATE SINGLE POINTS OF CONTACT''
INCLUDE: Alabama, Alaska; American Samoa; Colorado; Connecticut;
Hawaii; Idaho; Kansas; Louisiana; Massachusetts, Minnesota; Montana;
Nebraska; New Jersey; Ohio; Oklahoma; Oregon; Palau; Pennsylvania;
South Dakota; Tennessee; Vermont, Virginia; and Washington. This
list is based on the most current information provided by the
States. Information on any changes or apparent errors should be
provided to the Office of Management and Budget and the State in
question. Changes to the list will only be made upon formal
notification by the State. Also, this listing is published
biannually in the Catalogue of Federal Domestic Assistance.
Attachment H
Department of Health and Human Services (DHHS), Regulations Applying to
All Applicants/Grantees Under the Community Food and Nutrition Program
Title 45 of the Code of Federal Regulations
Part 16--DHHS Grant Appeals Process
Part 74--Administration of Grants (non-governmental)
Part 74--Administration of Grants (state and local governments and
Indian Tribal affiliates):
Sections:
74.26--Non-Federal Audits
74.27--Allowable cost for hospitals and non-profit organizations
among other things
74.32 Real Property
74.34 Equipment
74.35 Supplies
74.24 Program Income
Part 75--Informal Grant Appeal Procedures
Part 76--Debarment and Suspension from Eligibility For Financial
Assistance
Subpart F--Drug Free Workplace Requirements
Part 80--Non-discrimination Under Programs Receiving Federal
Assistance through DHHS Effectuation of Title VI of the Civil Rights
Act of 1964
Part 81--Practice and Procedures for Hearings Under Part 80 of this
Title
Part 83--Regulation for the Administration and Enforcement of
Sections 799A and 845 of the Public Health Service Act
Part 84--Non-discrimination on the Basis of Handicap in Programs and
Activities Receiving Federal Financial Assistance
Part 85--Enforcement of Non-discrimination on the Basis of Handicap
in Programs or Activities Conducted by DHHS
Part 86--Non-discrimination on the Basis of Sex in Education
Programs and Activities Receiving or Benefitting from Federal
Financial Assistance
Part 91--Non-discrimination on the Basis of Age in Health and Human
Services Programs or Activities Receiving Federal Financial
Assistance
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Part 92--Uniform Administrative Requirements for Grants and
Cooperative Agreements to States and Local Governments (Federal
Register, March 11, 1988)
Part 93--New Restrictions on Lobbying
Part 100--Intergovernmental Review of DHHS Programs and Activities
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[FR Doc. 99-25331 Filed 9-28-99; 8:45 am]
BILLING CODE 4184-01-C
