[Federal Register Volume 60, Number 121 (Friday, June 23, 1995)]
[Notices]
[Pages 32686-32700]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-15468]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of Refugee Resettlement
Availability of Discretionary Grants to Promote Community
Development in Sites With Significant Refugee Populations in Order to
Increase Economic Independence Among Refugees and Their Families
AGENCY: Office of Refugee Resettlement (ORR), HHS.
SUMMARY: This program announcement governs the availability of funds
and award procedures for approximately $1,000,000 in FY 1995
discretionary grants for technical assistance and operating costs to
promote community development in sites with significant refugee 1
populations in order to increase economic independence among refugees
and their families. This announcement is soliciting applications for
cooperative agreement project periods up to three years. Awards, on a
competitive basis, will be for a one-year budget period, although
project periods may be for three years. Applications for continuation
grants funded under these awards beyond the one-year budget period, but
within the three-year project period will be entertained in subsequent
years on a noncompetitive basis, subject to availability of funds,
satisfactory progress by the grantee, and a determination that
continued funding would be in the best interest of the Government.
\1\ In addition to persons who meet all requirements of 45 CFR,
400.43, eligibility for refugee social services also includes: (1)
Cuban and Haitian entrants, under section 501 of the Refugee
Education Assistance Act of 1980 (Pub. L. 96-422); (2) certain
Amerasians from Vietnam who are admitted to the U.S. as immigrants
under section 584 of the Foreign Operations, Export Financing, and
Related Programs Appropriations Act, 1988, as included in the FY
1988 Continuing Resolution (Pub. L. 100-202); and (3) certain
Amerasians from Vietnam, including U.S. citizens, under title II of
the Foreign Operations, Export Financing, and Related Programs
Appropriations Act, 1989 (Pub. L. 100-461), 1990 (Pub. L. 101-167),
and 1991 (Pub. L. 101-513). For convenience, the term ``refugee'' is
used in this notice to encompass all such eligible persons unless
the specific context indicates otherwise.
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Available Funds
In FY 1995, ORR expects to make available approximately $1,000,000
for one award in this program area. The amount in subsequent years will
depend upon the availability of funding, need, and the best interests
of the Government.
The Director reserves the right to award more or less than the
funds described above depending upon the quality of the applications or
such other circumstances as may be deemed to be in the best interest of
the Government.
Authorization
Authority for this activity is contained in Section 412(c)(1)(A) of
the Immigration and Nationality Act, which authorizes the Director ``to
make grants to, and enter into contracts with, public or private
nonprofit agencies for projects specifically designed-- * * * (iii) to
provide where specific needs have been shown and recognized by the
Director, health (including mental health) services, social services,
educational, and other services.''
Application Submission
Forms and instructions for submitting an application are included
with this announcement which may be reproduced. Additional copies also
may be obtained by contacting the Office of Refugee Resettlement at the
address below. An original and two copies of all applications should be
submitted to: Department of Health and Human Services, Administration
for Children and Families, Division of Discretionary Grants, 370
L'Enfant Promenade SW, Sixth Floor, Washington, DC 20447 Or hand
delivered to: Division of Discretionary Grants, 901 D St. SW, 6th Fl.
ACF Guard Station, Washington, DC 20447.
FOR FURTHER INFORMATION CONTACT: Ms. Anna Mary Portz, Office of Refugee
Resettlement, 370 L'Enfant Promenade SW., Washington, D.C. 20447,
Telephone (202) 401-1196, email: [email protected].
Purpose and Scope
The Refugee Act of 1980 mandates two broad goals: (1) To assist
refugees in achieving self-sufficiency as early as possible after
arrival, and (2) to provide long-term effective resettlement. Since
1975, almost two million refugees have been resettled in communities
throughout the United States. While many refugees have achieved
economic and social self-sufficiency, some continue to face poverty,
joblessness, under-employment and lack of access to opportunities. ORR
recognizes that in [[Page 32687]] order for refugees to be effectively
resettled, refugees need to have continuing access to mainstream
services and resources beyond ORR funds; and refugee communities must
be strengthened so that they can provide their own members with a long-
term economic and social safety net.
The purpose of this announcement is to solicit applications for a
project to strengthen refugee community-based organizations (CBOs)
which are already engaged in community development in sites where
significant refugee populations currently reside. A strong CBO is able
to tap into a community's desire for self-help, improve services,
nurture leaders, raise money from a variety of sources within and
outside the community, expand housing and economic opportunities and,
at the same time, remain accountable to the community. Most
importantly, these organizations give refugees a sense of hope about
their community's future.
Strong refugee CBOs are critical building blocks for effective
resettlement. Such organizations can foster long-term community
development--the process by which refugee communities identify their
own needs and wants, mobilize resources, and develop and carry out
their own strategies--in order to improve their own communities.
The successful applicant to this notice will be expected to do
three things:
(1) Design and implement a comprehensive strategy which will
increase the organizational capacity of a certain number of refugee
CBOs so that these organizations can promote effective, long-term
development of their communities
(2) Provide limited core funding to this group of CBOs so that they
can devote specific staff resources to a sustained implementation of
their respective organizational and community development plans; and,
(3) Conduct a select number of activities, such as workshops or
peer-to-peer assistance, for the purpose of providing broad technical
assistance in community and organizational development to additional
refugee CBOs which are not selected for participation in items 1 and 2
described above.
ORR will enter into a cooperative agreement with the successful
applicant(s) in order to jointly develop the technical assistance
procedures and project schedules. ORR will also provide guidance on
selection of participating refugee CBOs and service and monitoring
protocols.
Eligible Applicants
Eligible applicants are public or private nonprofit organizations.
If an applicant represents a consortium (that is, the applicant
includes other types of agencies among its membership), the single
organization identified to be the grant recipient with primary
administrative and fiscal responsibilities must be a nonprofit
organization.
Application Content
All applications must be submitted on Standard Form (SF) 424 Parts
I through III. A narrative project description constitutes Part IV and
must not exceed 30 pages (typewritten, double spaced on standard,
letter-size paper) plus a maximum of 20 pages of appended material. In
the event that the project description and/or supplementary material
exceed the page limitations, only the first 30 pages of the project
description (if single-spaced, only the first 15 pages), and the first
20 pages of the supplementary material, will be considered in the
review process. The limitation should be considered as a maximum, and
not necessarily a goal to be achieved.
Part IV should contain the following sections:
A. A discussion of the specific criteria to be used in participant
selection, and the community development needs to be addressed by this
project. ORR recognizes that concentrated planning has to occur at all
stages in the design and implementation of such a project. Part of this
planning should involve detailed consideration of the priority criteria
for determination of which ethnic CBOs will be invited to participate
with the applicant technical assistance provider in proposed activities
1 and 2 referenced in the section titled Purpose and Scope.
ORR suggests the following criteria for refugee ethnic CBO
participants to be served by the grantee. Agencies served should be
viable nonprofit organizations with IRS 501(c)(3) status.
Organizational missions should provide a commitment to community
accountability and grassroots democracy.
These CBOs should have staff and an actively involved broad-based
board. Such organizations should reflect the community-responsiveness,
decision-making, and oversight role of the Board.
Applicants should discuss how they would identify organizations
with these respective characteristics, and suggest other criteria they
consider appropriate to qualify for receipt of services funded under
this grant. Applications should include examples of appropriate CBOs
for participation. (Final selection of participating CBOs will require
ORR concurrence under the terms of the Cooperative Agreement.)
B. A description of the applicant's approach to community
development and how the applicant determines the type of technical
assistance that is required. A discussion of the perceived strengths
and obstacles in promoting effective refugee community development and
how the applicant can incorporate the strengths in its approach. An
analysis of how the strategies proposed would enhance community
development for refugees, indicating specifically how these services
can be applied and how the refugee communities selected can develop
constituency support. If the proposal was developed by a consortium or
other combination of entities, the role of each must be detailed.
C. A description of the anticipated one-, two-, and three-year
outcomes. ORR expects at a minimum that during the project period a
certain number of refugee community-based organizations will exhibit
(1) significant progress toward a stabilized, multiple-source income
base appropriately related to the economic forces in the local
community; (2) outreach and accountability to multiple strata of the
local refugee community demonstrated inter alia by constituency-
contributed financial support; (3) a track record of advocacy
activities and relevant organizational collaboration; and if
appropriate, (4) a demonstrated resettlement-related service provision
or refugee representation capacity.
D. A description of the applicant's qualifications to carry out the
proposed activities, particularly descriptions of relevant previous
experience emphasizing experience with differing cultural groups.
Applications should include names and addresses of at least three
organizations for whom the applicant has previously provided similar
services, as well as a brief outline of the measurable outcomes
achieved for each. The applicant should also include resumes of key
staff proposed to work for the applicant in the implementation of this
grant, if awarded. (Applicants which cannot document experience in
technical assistance similar to that required herein will not be
considered.)
E. A description of the proposed activities based on an analysis of
refugee ethnic community-based organizational needs and available
resources, as necessary to address the development of the refugee
community. Applicants should provide a detailed workplan of
[[Page 32688]] the steps and activities proposed to carry out the
objectives of the project, if funded, including a timetable for
implementation. ORR anticipates that such activities may include, but
are not limited to:
Intensive, individually tailored technical assistance to a
certain number of refugee ethnic community-based organizations in a
limited number of sites;
General community development assistance (i.e. grassroots
democracy and organizing, leadership training, coalition building,
resource development) for a broad audience of refugee community-based
organizations;
Facilitation of peer to peer consultation among community-
based organizations; and
Development and applied testing of a refugee appropriate
model design or curricula for these activities.
F. A line-item budget with narrative justification for each line
which correlates with and/or refers to the workplan.
Application Review Criteria
Applications will be reviewed, scored, and ranked in accordance
with the following criteria:
1. Understanding of community development demonstrated by the
quality of the discussion of the criteria that would be used and how
they would be applied in selecting implementation sites and
participating refugee CBOs, including appropriate examples of each. (10
Points)
2. Adequacy of the applicant's community development strategy,
including leveraging of other resources and recruiting mainstream
service providers, and the appropriateness of this approach for refugee
community organizations. (25 Points)
3. Appropriateness of the anticipated outcomes. (15 Points)
4. Qualifications of the applicant agency, including the staffing
plan and qualifications of key personnel to carry out the proposed
activities. (25 Points)
5. Adequacy and reasonableness of implementation plan. (15 points)
6. Appropriateness, cost-effectiveness, and reasonableness of the
budget. (10 Points)
Administrative Requirement
A. Availability of Application Forms
All forms necessary for submission of an application, as described
herein are attached to this announcement and may be reproduced.
B. Assurances and Procedures
Applicants requesting financial assistance for a non-construction
project must file the Standard Form 424B, ``Assurances: Non-
Construction Programs.'' Applicants must sign and return the Standard
Form 424B with their applications.
The following certifications are attached: Drug-Free Workplace,
Debarment, Environmental Tobacco Smoke, and Anti-Lobbying. In signing
and submitting an application, the applicant should be aware that it is
certifying that it will comply with the Federal requirement concerning
the above-cited certifications for a drug-free workplace, debarment,
and environmental tobacco smoke. By signing and submitting the
applications, applicants are providing these certifications and need
not mail back the certification with the applications. However, the
applicant must submit a signed certification regarding Lobbying with
the application.
Copies of the certifications and assurance are located at the end
of this announcement.
Any non-profit organization submitting an application must submit
proof of its non-profit status in its application at the time of
submission. The non-profit agency can accomplish this by providing a
copy of the applicant's listing in the Internal Revenue Service's (IRS)
most recent list of tax-exempt organizations described in Section
501(c)(3) of the IRS code or by providing a copy of the currently valid
IRS tax exemption certificate, and by providing a copy of the articles
of incorporation bearing the seal of the State in which the corporation
or association is domiciled.
C. Closing Date
1. Applications will be considered to have met the announced
deadline if they are received at the address specified in this
announcement by 6:30 p.m. on July 24, 1995. Applicants are responsible
for mailing applications well in advance, when using all mail services,
to ensure that the applications are received on or before the deadline
date. (Applicants are cautioned that postmarks will not be considered
as a methodology for meeting the deadline.)
2. Applications which do not meet the criteria in paragraph 1 of
this section are considered late applications. The ACF shall notify
each late applicant that its application will not be considered in the
current competition.
3. The ACF may extend the deadline for all applicants because of
acts of God such as floods, hurricanes, etc., or when there is a
widespread disruption of the mails. However, if the ACF does not extend
the deadline for all applicants, it may not waive or extend the
deadline for any applicant.
4. Once an application has been submitted, it is considered as
final and no additional materials will be accepted by ORR. An
application with an original signature and two copies is required.
Applications, if mailed, should be addressed to: Department of Health
and Human Services, Administration for Children and Families, Division
of Discretionary Grants, 370 L'Enfant Promenade SW., Washington, DC
20447.
No application will be accepted by telefax. Hand delivered
applications are accepted during the normal working hours of 8 a.m. to
6:30 p.m. (Eastern Daylight Time), Monday through Friday, on or prior
to the established closing date at: Administration for Children and
Families, Division of Discretionary Grants, 6th Floor, ACF Guard
Station, 901 D Street, SW., Washington, DC 20447.
The application should reference this program announcement.
Intergovernmental Review
This program is covered by Executive Order 12372,
``Intergovernmental Review of Federal Programs,'' and 45 CFR part 100,
``Intergovernmental Review of Department of Health and Human Services
Programs and Activities.'' Under the Order, States may design their own
processes for reviewing and commenting on proposed Federal assistance
under covered programs.
All States and Territories except Alabama, Alaska, Colorado,
Connecticut, Hawaii, Idaho, Kansas, Louisiana, Massachusetts,
Minnesota, Montana, Nebraska, Oklahoma, Oregon, Pennsylvania, South
Dakota, Tennessee, Virginia, Washington, American Samoa and Palau have
elected to participate in the Executive Order process and have
established Single Points of Contact (SPOCs). Applicants from these
nineteen jurisdictions need take no action regarding Executive Order
12372. Applicants for projects to be administered by Federally-
recognized Indian Tribes are also exempt from the requirements of E.O.
12372. Otherwise, applicants should contact their SPOCs as soon as
possible to alert them of the prospective applications and receive any
necessary instructions. Applicants must submit any required material to
the SPOCs as soon as possible so that the program office can obtain and
review SPOC comments as part of the award process. It is imperative
that the applicant submit all required materials, if any, to the SPOC
and indicate the date of this submittal (or the date of contact
[[Page 32689]] if no submittal is required) on the Standard Form 424,
item 16a.
Under 45 CFR 100.8(a)(2), a SPOC has 60 days from the application
deadline date to comment on proposed new or competing continuation
awards.
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 they intend to
trigger the ``accommodate or explain'' rule.
When comments are submitted directly to ACF, they should be
addressed to: Department of Health and Human Services, Administration
for Children and Families, Division of Discretionary Grants, 6th Floor,
OFM/DDG, 370 L'Enfant Promenade SW., Washington, DC 20447.
A list of Single Points of Contact for each State and Territory is
included as Appendix A of this announcement.
Applicable Regulations
Applicable HHS regulations will be provided to grantees upon award.
Post-Award Requirements--Records and Reports
Grantees are required to file Financial Status (SF-269) on a semi-
annual basis and Program Progress Reports on a quarterly basis. Funds
shall be accounted for and reported upon separately from all other
grant activities. Successful applicants will be given specific
instructions by ACF, following the award of the grant, for reporting
grant performance.
The official recipient point for all reports and business
management correspondence is the Division of Discretionary Grants. The
original and two copies of each report and business management
correspondence shall be submitted to the Department of Health and Human
Services, Administration for Children and Families, Division of
Discretionary Grants, 370 L'Enfant Promenade SW., Washington, DC 20447.
The final Financial and Program Progress Reports shall be due 90
days after the project expiration date or termination of grant support.
ORR expects grantees to maintain adequate records to track and
report on project outcomes and expenditures by budget line item.
The Catalog of Federal Domestic Assistance (CFDA) number assigned
to this announcement is 93.576.
Dated: June 19, 1995.
Regina Lee,
Deputy Director, Office of Refugee Resettlement.
Appendix A--Executive Order 12372--State Single Points of Contact
ARIZONA
Mrs. Janice Dunn, Attn: Arizona State Clearinghouse, 3800 N.
Central Avenue, 14th Floor, Phoenix, Arizona 85012, Telephone (602)
280-1315
ARKANSAS
Tracie L. Copeland, Manager, State Clearinghouse, Office of
Intergovernmental Services, Department of Finance and
Administration, PO Box 3278, Little Rock, Arkansas 72203, Telephone
(501) 682-1074
CALIFORNIA
Glen Stober, Grants Coordinator, Office of Planning and
Research, 1400 Tenth Street, Sacramento, California 95814, Telephone
(916) 323-7480
DELAWARE
Ms. Francine Booth, State Single Point of Contact, Executive
Department, Thomas Collins Building, Dover, Delaware 19903,
Telephone (302) 736-3326
DISTRICT OF COLUMBIA
Rodney T. Hallman, State Single Point of Contact, Office of
Grants Management and Development, 717 14th Street, NW, Suite 500,
Washington, DC 20005, Telephone (202) 727-6551
FLORIDA
Florida State Clearinghouse, Intergovernmental Affairs Policy
Unit, Executive Office of the Governor, Office of Planning and
Budgeting, The Capitol, Tallahassee, Florida 32399-0001, Telephone
(904) 488-8441
GEORGIA
Mr. Charles H. Badger, Administrator, Georgia State
Clearinghouse, 254 Washington Street, SW, Atlanta, Georgia 30334,
Telephone (404) 656-3855
ILLINOIS
Steve Klokkenga, State Single Point of Contact, Office of the
Governor, 107 Stratton Building, Springfield, Illinois 62706,
Telephone (217) 782-1671
INDIANA
Jean S. Blackwell, Budget Director, State Budget Agency, 212
State House, Indianapolis, Indiana 46204, Telephone (317) 232-5610
IOWA
Mr. Steven R. McCann, Division of Community Progress, Iowa
Department of Economic Development, 200 East Grand Avenue, Des
Moines, Iowa 50309, Telephone (515) 281-3725
KENTUCKY
Ronald W. Cook, Office of the Governor, Department of Local
Government, 1024 Capitol Center Drive, Frankfort, Kentucky 40601,
Telephone (502) 564-2382
MAINE
Ms. Joyce Benson, State Planning Office, State House Station
#38, Augusta, Maine 04333, Telephone (207) 289-3261
MARYLAND
Ms. Mary Abrams, Chief, Maryland State Clearinghouse, Department
of State Planning, 301 West Preston Street, Baltimore, Maryland
21201-2365, Telephone (301) 225-4490
MASSACHUSETTS
Karen Arone, State Clearinghouse, Executive Office of
Communities and Development, 100 Cambridge Street, Room 1803,
Boston, Massachusetts 02202, Telephone (617) 727-7001
MICHIGAN
Richard S. Pastula, Director, Michigan Department of Commerce,
Lansing, Michigan 48909, Telephone (517) 373-7356
MISSISSIPPI
Ms. Cathy Mallette, Clearinghouse Officer, Office of Federal
Grant Management and Reporting, 301 West Pearl Street, Jackson,
Mississippi 39203, Telephone (601) 960-2174
MISSOURI
Ms. Lois Pohl, Federal Assistance Clearinghouse, Office of
Administration, P.O. Box 809, Room 430, Truman Building, Jefferson
City, Missouri 65102, Telephone (314) 751-4834
NEVADA
Department of Administration, State Clearinghouse, Capitol
Complex, Carson City, Nevada 89710, Telephone (702) 687-4065,
Attention: Ron Sparks, Clearinghouse Coordinator
NEW HAMPSHIRE
Mr. Jeffrey H. Taylor, Director, New Hampshire Office of State
Planning, Attn: Intergovernmental Review, Process/James E. Bieber,
2\1/2\ Beacon Street, Concord, New Hampshire 03301, Telephone (603)
271-2155
NEW JERSEY
Gregory W. Adkins, Acting Director, Division of Community
Resources, N.J. Department of Community Affairs, Trenton, New Jersey
08625-0803, Telephone (609) 292-6613
Please direct correspondence and questions to: Andrew J.
Jaskolka, State Review Process, Division of Community Resources, CN
814, Room 609, Trenton, New Jersey 08625-0803, Telephone (609) 292-
9025
NEW MEXICO
George Elliott, Deputy Director, State Budget Division, Room
190, Bataan Memorial Building, Santa Fe, New Mexico 87503, Telephone
(505) 827-3640, FAX (505) 827-3006
NEW YORK
New York State Clearinghouse, Division of the Budget, State
Capitol, Albany, New York 12224, Telephone (518) 474-1605
NORTH CAROLINA
Mrs. Chrys Baggett, Director, Office of the Secretary of Admin.,
N.C. State Clearinghouse, 116 W. Jones Street, Raleigh, North
Carolina 27603-8003, Telepone (919) 733-7232
NORTH DAKOTA
N.D. Single Point of Contact, Office of Intergovernmental
Assistance, Office of Management and Budget, 600 East Boulevard
Avenue, Bismarck, North Dakota 58505-0170, Telephone (701) 224-2094
OHIO
Larry Weaver, State Single Point of Contact, State/Federal Funds
[[Page 32690]] Coordinator, State Clearinghouse, Office of Budget
and Management, 30 East Broad Street, 34th Floor, Columbus, Ohio
43266-0411, Telephone (614) 466-0698
RHODE ISLAND
Mr. Daniel W. Varin, Associate Director, Statewide Planning
Program, Department of Administration, Division of Planning, 265
Melrose Street, Providence, Rhode Island 02907, Telephone (401) 277-
2656
Please direct correspondence and questions to: Review
Coordinator, Office of Strategic Planning
SOUTH CAROLINA
Omeagie Burgess, State Single Point of Contact, Grant Services,
Office of the Governor, 1205 Pendleton Street, Room 477, Columbia,
South Carolina 29201, Telephone (803) 734-0494
TENNESSEE
Mr. Charles Brown, State Single Point of Contact, State Planning
Office, 500 Charlotta Avenue, 309 John Sevier Building, Nashville,
Tennessee 37219, Telephone (615) 741-1676
TEXAS
Mr. Thomas Adams, Governor's Office of Budget and Planning, PO
Box 12428, Austin, Texas 78711, Telephone (512) 463-1778
UTAH
Utah State Clearinghouse, Office of Planning and Budget, Attn:
Carolyn Wright, Room 116 State Capitol, Salt Lake City, Utah 84114,
Telephone (801) 538-1535
VERMONT
Mr. Bernard D. Johnson, Assistant Director, Office of Policy
Research & Coordination, Pavilion Office Building, 109 State Street,
Montpelier, Vermont 05602, Telephone (802) 828-3326
WEST VIRGINIA
Mr. Fred Cutlip, Director, Community Development Division, West
Virginia Development Office, Building #6, Room 553, Charleston, West
Virginia 25305, Telephone (304) 348-4010
WISCONSIN
Mr. William C. Carey, Federal/State Relations, Wisconsin
Department of Administration, 101 South Webster Street, PO Box 7864,
Madison, Wisconsin 53707, Telephone (608) 266-0267
WYOMING
Sheryl Jeffries, State Single Point of Contact, Herschler
Building, 4th Floor, East Wing, Cheyenne, Wyoming 82002, Telephone
(307) 777-7574
GUAM
Mr. Michael J. Reidy, Director, Bureau of Budget and Management
Research, Office of the Governor, PO Box 2950, Agana, Guam 96910,
Telephone (671) 472-2285
NORTHERN MARIANA ISLANDS
State Single Point of Contact, Planning and Budget Office,
Office of the Governor, Saipan, CM, Northern Mariana Islands 96950
PUERTO RICO
Norma Burgos/Jose H. Caro, Chairman/Director, Puerto Rico
Planning Board, Minillas Government Center, PO Box 41119, San Juan,
Puerto Rico 00940-9985, Telephone (809) 727-4444
VIRGIN ISLANDS
Jose L. George, Director, Office of Management and Budget, #41
Norregade Emancipation Garden Station, Second Floor, Saint Thomas,
Virgin Islands 00802
Please direct correspondence to: Linda Clarke, Telephone (809)
774-0750
BILLING CODE 4184-01-P
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BILLING CODE 4184-01-C
[[Page 32692]] INSTRUCTIONS FOR THE SF 424
This is a standard form used by applicants as a required
facesheet for preapplications and applications submitted for Federal
assistance. It will be used by Federal agencies to obtain applicant
certification that States which have established a review and
comment procedure in response to Executive Order 12372 and have
selected the program to be included in their process, have been
given an opportunity to review the applicant's submission.
Item and Entry
1. Self-explanatory.
2. Date application submitted to Federal agency (or State if
applicable) & applicant's control number (if applicable).
3. State use only (if applicable).
4. If this application is to continue or revise an existing
award, enter present Federal identifier number. If for a new
project, leave blank.
5. Legal name of applicant, name of primary organizational unit
which will undertake the assistance activity, complete address of
the applicant, and name and telephone number of the person to
contact on matters related to this application.
6. Enter Employer Identification Number (EIN) as assigned by the
Internal Revenue Service.
7. Ester the appropriate letter in the space provided.
8. Check appropriate box and enter appropriate letter(s) in the
space(s) provided:
--``New'' means a new assistance award.
--``Continuation'' means an extension for an additional funding/
budget period for a project with a projected completion date.
--``Revision'' means any change in the Federal Government's
financial obligation or contingent liability from an existing
obligation.
9. Name of Federal agency from which assistance is being
requested with this application.
10. Use the Catalog of Federal Domestic Assistance number and
title of the program under which assistance is requested.
11. Enter a brief descriptive title of the project. If more than
one program is involved, you should append an explanation on a
separate sheet. If appropriate (e.g., construction or real property
projects), attach a map showing project location. For
preapplications, use a separate sheet to provide a summary
description of this project.
12. List only the largest political entities affected (e.g.,
State, counties, cities).
13. Self-explanatory.
14. List the applicant's Congressional District and any
District(s) affected by the program or project.
15. Amount requested or to be contributed during the first
funding/budget period by each contributor. Value of in-kind
contributions should be included on appropriate lines as applicable.
If the action will result in a dollar change to an existing award,
indicate only the amount of the change. For decreases, enclose the
amounts in parentheses. If both basic and supplemental amounts are
included, show breakdown on an attached sheet. For multiple program
funding, use totals and show breakdown using same categories as item
15.
16. Applicants should contact the State Single Point of Contact
(SPOC) for Federal Executive Order 12372 to determine whether the
application is subject to the State intergovernmental review
process.
17. This question applies to the applicant organization, not the
person who signs as the authorized representative. Categories of
debt include delinquent audit disallowances, loans and taxes.
18. To be signed by the authorized representative of the
applicant. A copy of the governing body's authorization for you to
sign this application as official representative must be on file in
the applicant's office. (Certain Federal agencies may require that
this authorization be submitted as part of the application.)
BILLING CODE 4184-01-P
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BILLING CODE 4184-01-C
[[Page 32695]] INSTRUCTIONS FOR THE SF-424A
General Instructions
This form is designed so that application can be made for funds
from one or more grant programs. In preparing the budget, adhere to
any existing Federal grantor agency guidelines which prescribe how
and whether budgeted amounts should be separately shown for
different functions or activities within the program. For some
programs, grantor agencies may require budgets to be separately
shown by function or activity. For other programs, grantor agencies
may require a breakdown by function or activity. Sections A, B, C,
and D should include budget estimates for the whole project except
when applying for assistance which requires Federal authorization in
annual or other funding period increments. In the latter case,
Sections A, B, C, and D should provide the budget for the first
budget period (usually a year) and Section E should present the need
for Federal assistance in the subsequent budget periods. All
applications should contain a breakdown by the object class
categories shown in Lines a-k of Section B.
Section A. Budget Summary
Lines 1-4, Columns (a) and (b).
For applications pertaining to a single Federal grant program
(Federal Domestic Assistance Catalog number) and not requiring a
functional or activity breakdown, enter on Line 1 under Column (a)
the catalog program title and the catalog number in Column (b).
For applications pertaining to a single program requiring budget
amounts by multiple functions or activities, enter the name of each
activity or function on each line in Column (a), and enter the
catalog number in Column (b). For applications pertaining to
multiple programs where none of the programs require a breakdown by
function or activity, enter the catalog program title on each line
in Column (a) and the respective catalog number on each line in
column (b).
For applications pertaining to multiple programs where one or
more programs require a breakdown by function or activity, prepare a
separate sheet for each program requiring the breakdown. Additional
sheets should be used when one form does not provide adequate space
for all breakdown of data required. However, when more than one
sheet is used, the first page should provide the summary totals by
programs.
Lines 1-4, Columns (c) through (g.)
For new applications, leave Columns (c) and (d) blank. For each
line entry in Columns (a) and (b), enter in Columns (e), (f), and
(g) the appropriate amounts of funds needed to support the project
for the first funding period (usually a year).
For continuing grant program applications, submit these forms
before the end of each funding period as required by the grantor
agency. Enter in Columns (c) and (d) the estimated amounts of funds
which will remain unobligated at the end of the grant funding period
only if the Federal grantor agency instructions provide for this.
Otherwise, leave these columns blank. Enter in Columns (e) and (f)
the amounts of funds needed for the upcoming period. The amount(s)
in Column (g) should be the sum of amounts in Columns (e) and (f).
For supplemental grants and changes to existing grants, do not
use Columns (c) and (d). Enter in Column (e) the amount of the
increase or decrease of Federal funds and enter in Column (f) the
amount of the increase or decrease of non-Federal funds. In Column
(g) enter the new total budgeted amount (Federal and non-Federal)
which includes the total previous authorized budgeted amounts plus
or minus, as appropriate, the amounts shown in Columns (e) and (f).
The amount(s) in Column (g) should not equal the sum of amounts in
Columns (e) and (f).
Line 5--Show the totals for all columns used.
Section B Budget Categories
In the column headings (1) through (4), enter the titles of the
same programs, functions, and activities shown on Lines 1-4, Column
(a), Section A. When additional sheets are prepared for Section A,
provide similar column headings on each sheet. For each program,
function or activity, fill in the total requirements for funds (both
Federal and non-Federal) by object class categories.
Lines 6a-i--Show the totals of Lines 6a to 6h in each column.
Line 6j--Show the amount of indirect cost.
Line 6k--Enter the total of amounts on Lines 6i and 6j. For all
applications for new grants and continuation grants the total amount
in column (5), Line 6k, should be the same as the total amount shown
in Section A, Column (g), Line 5. For supplemental grants and
changes to grants, the total amount of the increase or decrease as
shown in Columns (1)-(4), Line 6k should be the same as the sum of
the amounts in Section A, Columns (e) and (f) on Line 5.
Line 7--Enter the estimated amount of income, if any, expected
to be generated from this project. Do not add or subtract this
amount from the total project amount. Show under the program
narrative statement the nature and source of income. The estimated
amount of program income may be considered by the federal grantor
agency in determining the total amount of the grant.
Section C. Non-Federal-Resources
Lines 8-11--Enter amounts of non-Federal resources that will be
used on the grant. If in-kind contributions are included, provide a
brief explanation on a separate sheet.
Column (a)--Enter the program titles identical to Column (a),
Section A. A breakdown by function or activity is not necessary.
Column (b)--Enter the contribution to be made by the applicant.
Column (c)--Enter the amount of the State's cash and in-kind
contribution if the applicant is not a State or State agency.
Applicants which are a State or State agencies should leave this
column blank.
Column (d)--Enter the amount of cash and in-kind contributions
to be made from all other sources.
Column (e)--Enter totals of Columns (b), (c), and (d).
Line 12--Enter the total for each of Columns (b)-(e). The amount
in Column (e) should be equal to the amount on Line 5, Column (f),
Section A.
Section D. Forecasted Cash Needs
Line 13--Enter the amount of cash needed by quarter from the
grantor agency during the first year.
Line 14--Enter the amount of cash from all other sources needed
by quarter during the first year.
Line 15--Enter the totals of amounts on Lines 13 and 14.
Section E. Budget Estimates of Federal Funds Needed for Balance of
the Project
Lines 16-19--Enter in Column (a) the same grant program titles
shown in Column (a), Section A. A breakdown by function or activity
is not necessary. For new applications and continuation grant
applications, enter in the proper columns amounts of Federal funds
which will be needed to complete the program or project over the
succeeding funding periods (usually in years). This section need not
be completed for revisions (amendments, changes, or supplements) to
funds for the current year of existing grants.
If more than four lines are needed to list the program titles,
submit additional schedules as necessary.
Line 20--Enter the total for each of the Columns (b)-(e). When
additional schedules are prepared for this Section, annotate
accordingly and show the overall totals on this line.
Section F. Other Budget Information
Line 21--Use this space to explain amounts for individual direct
object-class cost categories that may appear to be out of the
ordinary or to explain the details as required by the Federal
grantor agency.
Line 22--Enter the type of indirect rate (provisional,
predetermined, final or fixed) that will be in effect during the
funding period, the estimated amount of the base to which the rate
is applied, and the total indirect expense.
Line 23--Provide any other explanations or comments deemed
necessary.
ASSURANCES--NON-CONSTRUCTION PROGRAMS
Note: Certain of these assurances may not be applicable to your
project or program. If you have questions, please contact the
awarding agency. Further, certain Federal awarding agencies may
require applicants to certify to additional assurances. If such is
the case, you will be notified.
As the duly authorized representative of the applicant I certify
that the applicant:
1. Has the legal authority to apply for Federal assistance, and
the institutional, managerial and financial capability (including
funds sufficient to pay the non-Federal share of project costs) to
ensure proper planning, management and completion of the project
described in this application.
2. Will give the awarding agency, the Comptroller General of the
United States, and if appropriate, the State, through any authorized
representative, access to and the right to examine all records,
books, papers, or documents related to the award; and will
[[Page 32696]] 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 nineteen 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.
1681-1583, 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) sections 523 and 527 of the Public
Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee-3), as
amended, relating to the 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 statute(s) under which
application for Federal assistance is being made; and (j) the
requirements of any other nondiscrimination statute(s) which may
apply to the application.
7. Will comply, or has already complied, with the requirements
of Titles II and III of the Uniform Relocation Assistance and Real
Property Acquisition Policies Act of 1970 (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 with the provisions of the Hatch Act (5 U.S.C.
1501-1508 and 7324-7328) which limit the political activities of
employees whose principal employment activities are funded in whole
or in part with Federal funds.
9. Will comply, as applicable, with the provisions of the Davis-
Bacon Act (40 U.S.C. 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 (Clear Air) Implementation Plans under Section 176(c) of
the Clear 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 of 1984.
18. Will comply with all applicable requirements of all other
Federal laws, executive orders, regulations and policies governing
this program.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL----------------------------
TITLE------------------------------------------------------------------
APPLICANT ORGANIZATION-------------------------------------------------
DATE SUBMITTED---------------------------------------------------------
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[[Page 32699]] Certification Regarding Debarment, Suspension, and
Other Responsibility Matters--Primary Covered Transactions
By signing and submitting this proposal, the applicant, defined
as the primary participant in accordance with 45 CFR Part 76,
certifies to the best of its knowledge and believe that it and its
principals:
(a) Are not presently debarred, suspended, proposed for
debarment, declared ineligible, or voluntarily excluded from covered
transactions by any Federal Department or agency;
(b) Have not within a 3-year period preceding this proposal been
convicted of or had a civil judgment rendered against them for
commission of fraud or a criminal offense in connection with
obtaining, attempting to obtain, or performing a public (Federal,
State, or local) transaction or contract under a public transaction;
violation of Federal or State antitrust statutes or commission of
embezzlement, theft, forgery, bribery, falsification or destruction
of records, making false statements, or receiving stolen property;
(c) Are not presently indicted or otherwise criminally or
civilly charged by a governmental entity (Federal, State, or local)
with commission of any of the offenses enumerated in paragraph
(1)(b) of this certification; and
(d) Have not within a 3-year period preceding this application/
proposal had one or more public transactions (Federal, State, or
local) terminated for cause or default.
The inability of a person to provide the certification required
above will not necessarily result in denial of participation in this
covered transaction. If necessary, the prospective participant shall
submit an explanation of why it cannot provide the certification.
The certification or explanation will be considered in connection
with the Department of Health and Human Services (HHS) determination
whether to enter into this transaction. However, failure of the
prospective primary participant to furnish a certification or an
explanation shall disqualify such person from participation in this
transaction.
The prospective primary participant agrees that by submitting
this proposal, it will include the clause entitled ``Certification
Regarding Debarment, Suspension, Ineligibility, and Voluntary
Exclusion--Lower Tier Covered Transaction.'' provided below without
modification in all lower tier covered transactions and in all
solicitations for lower tier covered transactions.
Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion--Lower Tier Covered Transactions
(To Be Supplied to Lower Tier Participants)
By signing and submitting this lower tier proposal, the
prospective lower tier participant, as defined in 45 CFR Part 76,
certifies to the best of its knowledge and belief that it and its
principals:
(a) Are not presently debarred, suspended, proposed for
debarment, declared ineligible, or voluntarily excluded from
participation in this transaction by any federal department or
agency.
(b) Where the prospective lower tier participant is unable to
certify to any of the above, such prospective participant shall
attach an explanation to this proposal.
The prospective lower tier participant further agrees by
submitting this proposal that it will include this clause entitled
``Certification Regarding Debarment, Suspension, Ineligibility, and
Voluntary Exclusion--Lower Tier Covered Transactions,'' without
modification in all lower tier covered transactions and in all
solicitations for lower tier covered transactions.
Appendix E
Certification Regarding Environmental Tobacco Smoke
Public Law 103-227, Part C--Environmental Tobacco Smoke, also
known as the Pro-Children Act of 1994 (Act), requires that smoking
not be permitted in any portion of any indoor facility owned or
leased or contracted for by an entity and used routinely or
regularly for the 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 children's services and that all subgrantees shall
certify accordingly.
Appendix F--Certification Regarding Lobbying
Certification for Contracts, Grants, Loans, and Cooperative
Agreements
The undersigned certifies, to the best of his or her knowledge
and belief, that:
(1) No Federal appropriated funds have been paid or will be
paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with the awarding
of any Federal contract, the making of any Federal grant, the making
of any Federal loan, the entering into of any cooperative agreement,
and the extension, continuation, renewal, amendment, or modification
of any Federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been
paid or will be paid to any person for influencing or attempting to
influence an officer or employee of any agency, a Member of
Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with this Federal contract, grant,
loan or cooperative agreement, the undersigned shall complete and
submit Standard Form-LLL, ``Disclosure Form to Report Lobbying,'' in
accordance with its instructions.
(3) The undersigned shall require that the language of this
certification be included in the award documents for all subawards
at all tiers (including subcontracts, subgrants, and contracts under
grants, loans, and cooperative agreements) and that all
subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon
which reliance was placed when this transaction was made or entered
into. Submission of this certification is a prerequisite for making
or entering into this transaction imposed by section 1352, title 31,
U.S. Code. Any person who fails to file the required certification
shall be subject to a civil penalty of not less than $10,000 and not
more than $100,000 for each such failure.
State for Loan Guarantee and Loan Insurance
The undersigned states, to the best of his or her knowledge and
belief, that:
If any funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with this
commitment providing for the United States to insure or guarantee a
loan, the undersigned shall complete and submit Standard Form-LLL
``Disclosure Form to Report Lobbying,'' in accordance with its
instructions.
Submission of this statement is a prerequisite for making or
entering into this transaction imposed by section 1352, title 31,
U.S. Code. Any person who fails to file the required statement shall
be subject to a civil penalty of not less than $10,000 and not more
than $100,000 for each such failure.
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Signature
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Title
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Organization
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Date
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