Request for Applications Under the Office of Community Services Fiscal Year 1995 Job Opportunities for Low-Income Individuals Program (Demonstration Projects)

SUMMARY: The Administration for Children and Families (ACF), Office of

Community Services (OCS), announces that competing applications will be

accepted for new grants pursuant to the Secretary's discretionary

authority under section 505 of the Family Support Act of 1988, as

amended.

CLOSING DATES: The closing date for submission of applications is April

24, 1995.

FOR FURTHER INFORMATION CONTACT: Office of Community Services,

Administration for Children and Families, 370 L'Enfant Promenade SW.,

Washington, DC 20447, Telephone (202) 401-5282, Contact: Nolan Lewis.

This Announcement is accessible on the OCS Electronic Bulletin

Board for downloading through your computer modem by calling 1-800-627-

8886. For assistance in accessing the Bulletin Board, A Guide to

Accessing and Downloading is available from Ms. Minnie Landry at (202)

401-5309.

Table of Contents

Part I--Preamble

A. Legislative Authority

B. Eligible Applicants

C. Definition of Terms

D. Purpose

Part II--Program Priority Area

A. General Projects 1.0

B. Community Development Corporations Set-aside 2.0

Part III--Application Requirements

A. Background Information

1. Project and Budget Periods

2. Availability of Funds and Grant Amounts

3. Mobilization of Resources

4. Program Participants/Beneficiaries

5. Cooperative Partnership Agreement with State IV-A Agency

(JOBS Program)

6. Prohibition and Restrictions on the Use of Funds

7. Multiple Submittals

8. Continuation and Refunding

9. Third-Party Project Evaluation

10. Economic Development Strategy

11. Maintenance of Effort

Part IV--Application Review Process

A. Criteria for Review and Assessment of Applications in Priority

Areas 1.0 and 2.0

Part V--Application Procedures and Selection Process

A. Availability of Forms

B. Application Submission

C. Intergovernmental Review

D. Application Consideration

E. Criteria for Screening Applications

Part VI--Instructions for Completing the SF-424

A. SF-424--Application for Federal Assistance

B. SF-424A--Budget Information--Non-Construction Programs

C. SF-424B--Assurances--Non-Construction

Part VII--Contents of Application and Receipt Process

A. Contents and Order of Application

B. Acknowledgement of Receipt

Part VIII--Post Award Information and Reporting Requirements

Part I--Preamble

A. Legislative Authority

The Senate Committee on Appropriations, in its recommendations,

provides $5,500,000 for job creation demonstration activities

authorized under section 505 of the Family Support Act of 1988, Pub. L.

100-485, as amended. Senate Report No. 103-318, 103d Cong., 2nd Session

(1994), to accompany H.R. 4606. Section 505 of the Family Support Act

of 1988 authorizes the Secretary to enter into agreements with not less

than 5 nor more than 10 non-profit organizations (including community

development corporations) for the purpose of conducting demonstration

projects to create employment and business opportunities for certain

low-income individuals. The Social Security Act Amendments of 1994,

Public Law 103-432, reauthorize Section 505 of the Family Support Act

of 1988 through Fiscal Year 1996, and amends subsection (e) and changes

the project period from three to six years. The six year project period

applies only to grant awards beginning in Fiscal Year 1995.

B. Eligible Applicants

Organizations eligible to apply for funding under this program are

any non-profit organizations (including community development

corporations) that are exempt from taxation under Section 501(a) of the

Internal Revenue Code of 1986 by reason of paragraph (3) or (4) of

section 501(c) of such Code. Applicants must provide documentation of

their tax exempt status. The applicant can accomplish this by providing

a copy of the applicant's listing in the Internal Revenue Service's

(IRS) most recent list of tax-exempt organizations described in section

501(c)(3) of the IRS code or by providing a copy of the currently valid

IRS tax exemption certificate, and by providing a copy of its Articles

of Incorporation bearing the seal of the State in which the corporation

or association is domiciled. Failure to provide evidence of non-profit

status will result in rejection of the application.

C. Definition of Terms

For purposes of this Program Announcement the following definitions

apply:

--Budget Period: The interval of time into which a multi-year period of

assistance (project period) is divided for budgetary and funding

purposes.

--Community-Level Data: Key information to be collected by each grantee

that will allow for a national-level analysis of common features of

JOLI projects. This includes data on the population of the target area,

including the percentage on AFDC and other public assistance, and the

percentage whose incomes fall below the poverty line; the unemployment

rate; the number of new business starts and business closings; and a

description of the major employers and average wage rates and

employment opportunities with those employers.

--Community Development Corporation: A private, locally initiated,

nonprofit entity, governed by a board consisting of residents of the

community and business, civic leaders, and/or public officials which

has a record of implementing economic development projects or whose

Articles of Incorporation and/or By-Laws indicate that it has a focus

in the area of economic development.

--Hypothesis: An assumption made in order to test its validity. It

should assert a cause-and-effect relationship between a program

intervention and its expected result. Both the intervention and result

must be measured in order to confirm the hypothesis. For example, the

following is a hypothesis: ``Eighty hours of classroom training in

small business planning will be sufficient for participants to prepare

a successful loan application.'' In this example, data would be

obtained on the number of hours of training actually received by

participants (the [[Page 12829]] intervention), and the quality of loan

applications (the result), to determine the validity of the hypothesis

(are eighty hours of training sufficient to produce the result?).

--Intervention: Any planned activity within a project that is intended

to produce changes in the target population and/or the environment and

that can be formally evaluated. For example, assistance in the

preparation of a business plan and loan package are planned

interventions.

--Job Creation: To bring about, by activities and services funded under

this program, new jobs, that is, jobs that were not in existence before

the start of the project. These activities can include self-employment/

micro-enterprise training, the development of new business ventures or

the expansion of existing businesses.

--Non-profit Organization: Any organization (including a community

development corporation) exempt from taxation under section 501(a) of

the Internal Revenue Code of 1986 by reason of paragraph (3) or (4) of

section 501(c) of such code.

--Outcome Evaluation: An assessment of project results as measured by

collected data which define the net effects of the interventions

applied in the project. An outcome evaluation will produce and

interpret findings related to whether the interventions produced

desirable changes and their potential for replicability. It should

answer the question, Did this program work?

--Private employers: Third-party private non-profit organizations or

third-party for-profit businesses operating or proposing to operate in

the same community as the applicant and which are proposed or potential

employers of project participants.

--Process Evaluation: The ongoing examination of the implementation of

a program. It focuses on the effectiveness and efficiency of the

program's activities and interventions (for example, methods of

recruiting participants, quality of training activities, or usefulness

of follow-up procedures). It should answer questions such as: Who is

receiving what services?, and are the services being delivered as

planned? It is also known as formative evaluation because it gathers

information that can be used as a management tool to improve the way a

program operates while the program is in progress. It should also

identify problems that occurred and how they were dealt with and

recommend improved means of future implementation. It should answer the

question: ``How was the program carried out?'' In concert with the

outcome evaluation, it should also help explain, ``Why did this program

work/not work?''

--Program Participant/Beneficiary: Any individual eligible to receive

Aid to Families with Dependent Children under Part A of Title IV of the

Social Security Act and any other individual whose income level does

not exceed 100 percent of the official poverty line as found in the

most recent Annual Revision of Poverty Income Guidelines published by

the Department of Health and Human Services. (See Attachment A.)

--Project Period: The total time a project is approved for support,

including any extensions.

--Self-Sufficiency: A condition where an individual or family, by

reason of employment, does not need and is not eligible for public

assistance.

D. Purpose

The purpose of this program is to demonstrate and evaluate ways of

creating new employment and business opportunities for certain low-

income individuals through the provision of technical and financial

assistance to private employers in the community, self-employment/

micro-enterprise programs and/or new business development programs. A

low-income individual eligible to participate in a project conducted

under this program is any individual eligible to receive Aid to

Families with Dependent Children (AFDC) under Part A of Title IV of the

Social Security Act and any other individual whose income level does

not exceed 100 percent of the official poverty line. (See Attachment

A.) Within these categories, emphasis should be on individuals who are

unemployed, those residing in public housing or receiving housing

assistance, and those who are homeless.

Part II--Program Priority Areas

A. General Projects 1.0

The Congressional Conference Report on the FY 1992 appropriations

for the Department of Labor, Health and Human Services, and Education

and related agencies directed the ACF to require economic development

strategies as part of the application process to ensure that highly

qualified organizations participate in the demonstration [H.R. Conf.

Rep. No. 282, 102d Cong., 1st Sess. 39 (1991)]. These strategies should

include descriptions of how projects financed and jobs created under

this program will be integrated into a larger effort to promote job and

business opportunities for eligible program participants. Applicants

should demonstrate how their proposed projects will impact the overall

community/communities served by the applicant. OCS will only fund

projects that create new employment and/or business opportunities for

eligible program participants. Projects funded under this program must

demonstrate how the proposed project will enhance the participants'

abilities and skills in their progress toward self-sufficiency.

Therefore, proposed projects must show promise toward progress of

achieving self-sufficiency among the target population. OCS expects

that the jobs and/or business/self employment opportunities to be

created under this program will contribute to the goal of self-

sufficiency. The employment opportunities should provide hourly wages

that exceed the minimum wage and also provide benefits such as health

insurance, transportation, child care, and career development

opportunities.

Applicants must show that the proposed project will create a

significant number of new full-time permanent jobs through the

expansion of a pre-identified business or new business development, by

providing opportunities for self-employment to eligible participants,

or by creating new non-traditional employment opportunities for women

and minorities in highway construction and maintenance or in the

machine tool industry as described below.

While projected employment in future years may be included in the

application, it is essential that the focus of employment opportunities

concentrate on new full-time, permanent jobs to be created during the

duration of the grant project period and/or on the creation of new

business development opportunities for low-income individuals. OCS is

particularly interested in receiving proposals in three areas:

1. Local Initiative. In the spirit of ``local initiative'' OCS

looks forward to innovative proposals that grow out of the experience

of applicants and the needs of their clientele and communities, and

will make the fruits of local creativity available broadly to others

seeking solutions to similar problems.

2. Highway Construction and Maintenance. At the same time, OCS is

particularly interested in receiving a number of applications which

seek to create non-traditional employment opportunities for women and

minorities in highway construction and maintenance.

[[Page 12830]]

Approximately $20 billion a year goes to States for highway

construction and repair, creating over 270,000 jobs with State Highway

Agencies and 500,000+ jobs with contractors. The Federal Highway

Administration (FHWA), in conjunction with the Department of Labor and

the Women's Bureau, has been seeking ways to increase minority and

women participation. State Highway Agencies now have the option to use

up to \1/2\ per cent of their Federal highway funds for On-the Job

Training (OJT) and supportive services to expand employment

opportunities for minorities and women, similar to programs such as

Youth Build. In addition, the FHWA has developed and presented a

training course, Women in Highway Construction, nationally to over 700

Federal and State Highway Agency personnel and highway contractors on

strategies to increase participation of women on highway construction

projects.

Because of the aging worker population, there is a serious shortage

of qualified workers in highway construction and maintenance in many

parts of the country. The shortages will become more critical as the

population ages further. Consequently, unions are now taking advantage

of opportunities to recruit women and minorities into non-traditional

highway construction and maintenance jobs.

Applicants seeking further information about the efforts being

undertaken by the FHWA, such as its training efforts and the OJT

supportive services program, should contact the appropriate FHWA

Regional Civil Rights Director. (See Attachment K.)

3. Machine Tool Industry. Another area from which OCS would welcome

applications for creation of non-traditional employment opportunities

is the machine tool industry. This industry is one into which it has

traditionally been difficult for minority, women and low-income workers

to gain entry. One possibility might be a strategy of small, high

quality ``micro-enterprise'' machine shops organized in cooperative

sub-contracting arrangements with existing industries or businesses.

The requirement for creation of new, full-time permanent jobs

applies to all applications. OCS has determined that creation of non-

traditional job opportunities for women and minorities in highway

construction and maintenance and in the machine tool industry, which

previously have been closed to these populations, meets the employment

opportunity creation requirements of the JOLI legislation. OCS

continues to require JOLI applications to propose the creation of jobs

through the expansion of existing businesses, the development of new

businesses, or the creation of employment opportunities through self-

employment/microenterprise development. All applications for JOLI

grantees must submit a signed written agreement with the State IV-A

agency which administers the JOBS program and the appropriate local

partners participating in the project. (See Part IV, Criterion VI).

The agreements should describe the cooperative partnerships and

include the specific activities to be performed by each partner over

the course of the grant period. For example, the agreement should

include a description of the training to be provided the eligible

participants and local hiring practices, apprenticeships arrangements,

and relationship with local unions where applicable.

In the case of proposals for creating self-employment micro-

business opportunities for eligible participants, the applicant must

detail how it will provide training and support services to potential

entrepreneurs. The assistance to be provided to potential entrepreneurs

must include, at a minimum, technical assistance in basic business

planning and management concepts, and assistance in preparing a

business plan (See Part IV, Criterion III for requirements) and loan

application.

Any funds that are used for training participants who are AFDC

recipients and therefore eligible for JOBS support must be limited to

providing specific job-related training to such eligible participants

who have been selected for employment (expansion of an existing

business, new business venture or non-traditional employment) and/or

self-employment business opportunities. Where participants are not

receiving AFDC and are therefore not eligible for JOBS support, project

funds may be used to provide basic skills training and other support

services.

In the review process, favorable consideration will be given to

applicants with a demonstrated record of achievement in promoting job

and enterprise opportunities for low-income people. Favorable

consideration also will be given to those applicants who show the

lowest cost-per-job created for low-income individuals. For this

program, OCS views $15,000 in OCS funds as the maximum amount for the

creation of a job and, unless there are extenuating circumstances, will

not fund projects where the cost-per-job in OCS funds exceeds this

amount. Only those jobs created and filled by low-income people will be

counted in the cost-per-job formula. (See Part IV, Criterion IV.)

Technical assistance should be specifically addressed to the needs

of the private employer in creating new jobs to be filled by eligible

individuals and/or to the individuals themselves such as skills

training, job preparation, self-esteem building, etc. Financial

assistance may be provided to the private employer as well as the

individual.

If the technical and/or financial assistance is to be provided to

pre-identified businesses that will be expanded or franchised, written

commitments from the businesses to create the planned jobs must be

included with the application.

The creation of a revolving loan fund with funds received under

this program is an allowable activity. However, OCS encourages the use

of funds from other sources for this purpose. Points will be awarded in

the review process to those applicants who leverage funds from other

sources. (See Part IV, Criterion VI.) Loans made to eligible

beneficiaries for business development activities must be at or below

market rate.

Note: Interest accrued on revolving loan funds may be used to

continue or expand the activities of the approved project.

Grant funds received under this program may not be used for

construction.

A formal, cooperative relationship between the applicant and the

agency responsible for administering the Job Opportunities and Basic

Skills Training (JOBS) program (as provided for under title IV-A of the

Social Security Act) in the area served by the project is a requirement

for funding. The application must include a signed, written agreement

between the applicant and the local State IV-A (public welfare) agency

administering the JOBS program, or a letter of commitment to such an

agreement within 6 months of a grant award (contingent only on receipt

of OCS funds). The agreement must describe the cooperative

relationship, including specific activities and/or actions each of

these entities propose to carry out over the course of the grant period

in support of the project.

The agreement, at a minimum, must cover activities that will be

provided to the target population and which are related to one or more

of the mandatory or optional components offered by the appropriate

State's JOBS program. The mandatory activities offered by the States'

JOBS programs consist of the following components and services: Basic

educational activities (below [[Page 12831]] secondary level i.e. H.S.,

GED, ESL; job skills training; job readiness activities; job

development and job placement; childcare; and other supportive services

(45 CFR 250.44 and 255.0). The optional services offered by the States'

JOBS programs must include two (2) of the following components of group

and individual job search assistance: on-the-job-training experience;

work supplementation; or community work experience (45 CFR 250.45).

(See Attachment I for a list of the State IV-A agencies.)

Projects also must include an independent, methodologically sound

evaluation of the effectiveness of the activities carried out with the

grant funds in creating new jobs and/or business opportunities. (See

Part I, C Definition of Terms, and Part IV, Criterion V).

Applications should include a plan for disseminating the results of

the project after expiration of the grant period. Applicants may budget

up to $2,000 for dissemination purposes.

Priority will be given to applications proposing to serve those

areas containing the highest percentage of individuals receiving Aid to

Families with Dependent Children (AFDC) under Title IV-A of the Social

Security Act. (See Part IV, Criterion II.)

B. Community Development Corporations Set-Aside 2.0

For Fiscal Year 1995, a set-aside fund of $1 million will be

included for Community Development Corporations. (For definition of

Community Development Corporation, see Part I, C.)

Such projects must conform to the purposes, requirements, and

prohibitions applicable to those submitted under Part II, General

Projects 1.0.

Applications for these set-aside funds which are not funded due to

the limited amount of funds available will also be considered

competitively within the larger pool of eligible applicants.

Part III--Application Requirements

A. Background Information

1. Project and Budget Periods

The Social Security Act Amendment of 1994 which reauthorized the

JOLI program also lengthened the project duration from a 3-year period

to a 6-year period. In our effort to implement this change, OCS will

approve FY 1995 grants for a project period of six years and an initial

budget period of 36 months, or three years. This initial 36-month

budget period will be considered the Operational Phase of the project,

during which the Work Plan described in this announcement is to be

carried out. The second 36 months, or three years, of the Project

Period is to be considered a period of tracking workers in the newly

created jobs, of providing them, as needed, with modest support and

assistance, and of continuing Project Evaluation. Applications for

continuation grants funded under these awards beyond the 36-month

budget period but within the six (6) year project period will be

entertained in subsequent years on a non-competitive basis, in a modest

amount commensurate with the reduced level of effort, and subject to

the availability of funds, satisfactory progress of the grantee, and

determination that this would be in the best interest of the

government.

2. Availability of Funds and Grant Amounts

The Office of Community Services expects to award approximately

$5,000,000 by September 30, 1995 for new grants under this program ($1

million of which will be awarded pursuant to the Joint OCS/EPA

Announcement/NOFA described above).

A maximum of $500,000 for the first 36-month budget period will be

awarded to selected organizations under this program in FY 1995. OCS

will award no less than 5 and no more than 10 grants under this

program.

For Fiscal Year 1995 up to $1 million in JOLI funds is being made

available, along with up to $500,000 of Community Services Block Grant

(CSBG) Discretionary Economic Development grant funds, as part of a

Joint Program Announcement/Notice of Funds Availability (NOFA) issued

by the Office of Community Services (OCS) and the U.S. Environmental

Protection Agency (EPA) to fund up to three projects addressing

Community-Based Lead Abatement Training and Career Development and Lead

Poisoning Prevention Education. EPA will be providing up to $1.5

million to public agencies, which together with the OCS funding to

private non-profit agencies, will make possible the funding of three $1

million projects with the public and non-profit grantee agencies in

partnership, each Federal agency contributing $500,000 to each of the

three projects. These will be projects of job creation in community

based lead abatement within the requirements of JOLI and CSBG

Discretionary Programs; and the EPA funds will be available for worker

and community training and education. Prospective applicants for these

projects should obtain copies of the Joint OCS-EPA Announcement/NOFA

which will contain all necessary information, instructions and forms.

Copies of the Joint Announcement will be published in the Federal

Register and will be available for downloading from the OCS Electronic

Bulletin Board by calling 1-800-627-8886. For assistance in accessing

the Bulletin Board, a Guide to Accessing and Downloading is available

from Ms. Minnie Landry at (202) 401-5309.

3. Mobilization of Resources

OCS will give favorable consideration in the review process to

applicants who mobilize cash and/or third-party in-kind contributions

for direct use in the project. (See Part IV, Criterion VI.)

4. Program Participants/Beneficiaries

Projects proposed for funding under this announcement must result

in direct benefits to low-income people as defined in the most recent

Annual Revision of Poverty Income Guidelines published by DHHS and

individuals eligible to receive AFDC under Part A of Title IV of the

Social Security Act.

Attachment A to this announcement is an excerpt from the guidelines

currently in effect. Annual revisions of these guidelines are normally

published in the Federal Register in February or early March of each

year. Grantees will be required to apply the most recent guidelines

throughout the project period. These revised guidelines also may be

obtained at public libraries, Congressional offices, or by writing the

Superintendent of Documents, U.S. Government Printing Office,

Washington, DC 20402. They also are accessible on the OCS Electronic

Bulletin Board for reading and/or downloading. (See For Further

Information at beginning of this announcement.)

No other government agency or privately-defined poverty guidelines

are applicable for the determination of low-income eligibility for this

program.

5. Cooperative Partnership Agreement With State IV-A Agency (JOBS

Program)

A signed written agreement, or letter of commitment to sign such an

agreement within six months of a grant award, between the applicant and

the local State IV-A agency must be submitted with the application in

order to be reviewed and evaluated competitively. The agreement/letter

must describe the cooperative relationship and include specific

activities and/or actions that each of the entities proposes to carry

out over the course of the grant period in support of the project.

(Please review PART II, General Projects 1.0 for additional specific

information related to this agreement.) [[Page 12832]]

6. Prohibition and Restrictions on the Use of Funds

The use of funds for new construction or the purchase of real

property is prohibited. Costs incurred for rearrangement and alteration

of facilities required specifically for the grant program are allowable

when specifically approved by ACF in writing.

If the applicant is proposing a project which will affect a

property listed in, or eligible for inclusion in the National Register

of Historic Places, it must identify this property in the narrative and

explain how it has complied with the provisions of section 106 of the

National Historic Preservation Act of 1966 as amended. If there is any

question as to whether the property is listed in or eligible for

inclusion in the National Register of Historic Places, the applicant

should consult with the State Historic Preservation Officer. (See

Attachment D: SF-424B, Item 13 for additional guidelines.) The

applicant should contact OCS early in the development of its

application for instructions regarding compliance with the Act and data

required to be submitted to the Department of Health and Human

Services. Failure to comply with the cited Act will result in the

application being ineligible for funding consideration.

7. Multiple Submittals

Due to the limited number of grants that will be made under this

program, only one proposal from an eligible applicant will be funded by

OCS from FY 1995 JOLI funds, be it pursuant to this announcement

(Program areas 1.0 and 2.0) or the aforementioned Joint Announcement/

NOFA with EPA.

8. Continuation and Refunding

OCS will not provide continuation funding or refunding to a

previously funded grantee to conduct the same demonstration in the same

target area.

9. Third-Party Project Evaluation

Proposals must include provision for an independent,

methodologically sound evaluation of the effectiveness of the

activities carried out with the grant and their efficacy in creating

new jobs and business opportunities. There must be a well defined

Process Evaluation, and an Outcome Evaluation whose design will permit

tracking of project participants throughout the second 36 months of the

project. The evaluation must be conducted by an independent evaluator,

i.e., a person with recognized evaluation skills who is

organizationally distinct from, and not under the control of, the

applicant. It is important that each successful applicant have a third-

party evaluator selected, and performing at the very latest by the time

the work program of the project is begun, and if possible before that

time so that he or she can participate in the final design of the

program, in order to assure that data necessary for the evaluation will

be collected and available.

10. Economic Development Strategy

In accordance with the legislative reference cited in Part II,

Section A, applicants must include in their proposal an explanation of

how the proposed project is integrated with and supports a larger

economic development strategy within the target community. Where

appropriate, applicants should document how they were involved in the

preparation and planned implementation of a comprehensive community-

based strategic plan, such as that required for applying for

Empowerment Zones/Enterprise Community (EZ/EC) status, to achieve both

economic and human development in an integrated manner, and how the

proposed project supports the goals of that plan. (See Review Criterion

II (ii) in Part IV A below.)

11. Maintenance of Effort

The application must include an assurance that activities funded

under this program announcement are in addition to, and not in

substitution for, activities previously carried out without Federal

assistance.

Part IV--Application Review Process

Applications which pass the pre-rating review will be assessed and

scored by reviewers. Each reviewer will give a numerical score for each

application reviewed. These numerical scores will be supported by

explanatory statements on a formal rating form describing major

strengths and weaknesses under each applicable criterion published in

the announcement.

The in-depth assessment and review process will use the following

criteria coupled with the specific requirements described in Part III.

Scoring will be based on a total of 100 points.

Note: The following review criteria reiterate the collection of

information requirements contained in Part VI of this announcement.

These requirements are approved under OMB Control Number 0970-0062,

expiration 09-30-95.

A. Criteria for Review and Assessment of Applications in Priority Areas

1.0 and 2.0

Criterion I: Organizational Experience in Program Area and Staff

Responsibilities (Maximum: 20 points)

(i) Agency's commitment and experience in program area. The

application includes documentation which briefly summarizes two similar

projects undertaken by the applicant agency and the extent to which the

stated and achieved performance targets, including permanent benefits

to low-income populations, have been achieved. Application notes and

justifies the priority that this project will have within the agency

including the facilities and resources that it has available to carry

out the project. (0-10 points)

Note: The maximum number of points will be given only to those

organizations with a demonstrated record of achievement in promoting

job creation and enterprise opportunities for low-income people.

(ii) Staff skills, resources and responsibilities. The application

must profile the two or three individuals who will have the most

responsibility for shaping the project, connecting it to customers, and

achieving performance targets. The focus should be on the

qualifications, experience, capacity and commitment to the program of

the Executive Officials of the organization and the key staff persons

who will administer and implement the project. The person identified as

Project Director should have supervisory experience, experience in

finance and business, and experience with the target population.

Because this is a demonstration project within an already-established

agency, OCS expects that the key staff person(s) would be identified,

if not hired.

The application must also include a resume of the third party

evaluator, if identified or hired; or the minimum qualifications and a

position description for the third-party evaluator, who must be a

person with recognized evaluation skills who is organizationally

distinct from, and not under the control of, the applicant. It is

important that each successful applicant have a third-party evaluator

selected and performing at the very latest by the time the work program

of the project is begun, and if possible before that time so that he or

she can participate in the final design of the program, in order to

assure that data necessary for the evaluation will be collected and

available. Plans for selecting an evaluator should be included in the

application narrative. A third-party evaluator must have

[[Page 12833]] knowledge about and have experience in conducting

process and outcome evaluations, evaluating issues in the job creation

field, expansion of businesses and the creation of self-employment and

small business opportunities for low-income neighborhoods and a

thorough understanding of the range and complexity of the problems

faced by the target population. The competitive procurement regulations

(45 CFR Part 74, Appendix H) apply to service contracts such as those

for evaluators when the costs of such service will exceed $25,000. (0-

10 points)

Criterion II: Analysis of Need (Maximum: 15 points)

(i) Target area and population description. The application

includes a brief description of the geographic area and population to

be served, indicating what the unemployment rates are and (to the

extent practicable) how the proposed businesses and subsequent jobs

will impact on the nature and extent of the problem. It should also

include (with an identification of the source of the information) the

number and percentage of individuals receiving AFDC and the total

number of individuals which make up the population in the area where

the project will operate. (0-5 points)

(ii) Nature and extent of problems to be addressed. Application

includes an analysis of the identified personal barriers to employment

and greater self-sufficiency faced by the population to be targeted by

the project. (These might include such problems as illiteracy,

substance abuse, family violence, lack of skills training, health or

medical problems, need for childcare, or poor self-image.) Application

also includes an analysis of the identified community systemic barriers

which the project will seek to overcome. These might include lack of

jobs; lack of transportation; lack of suitable clothing or equipment;

lack of markets; unavailability of financing, insurance or bonding;

inadequate municipal services (water, sewage treatment, street

lighting, trash collection, electricity, traffic control); high

incidence of crime; inadequate health care; or environmental hazards

(such as toxic dumpsites or leaking underground tanks). If the jobs to

be created by the proposed project are themselves designed to fill one

or more of the needs so identified, this fact should be included in the

discussion. (0-5 points)

(iii) Community empowerment consideration. Special consideration

will be given to applicants who are located in areas which are

characterized by poverty and other indicators of socio-economic

distress such as a poverty rate of at least 20%, designation as an EZ/

EC, high levels of unemployment, and high levels of incidences of

violence, gang activity, crime, or drug use. Applicants should document

that they were involved in the preparation and planned implementation

of a comprehensive community-based strategic plan to achieve both

economic and human development in an integrated manner and how the

proposed project supports the goal(s) of that plan. (0-5 points)

Criterion III: Work Program (Maximum: 20 points)

The work plan and business plan(s), where appropriate, must be both

sound and feasible. If the applicant is proposing to use project funds

to provide technical and/or financial assistance for the establishment

of an identified business, or to a third-party private employer to

develop or expand a pre-identified business, the application must

include a complete business plan (see ii, below). An application that

does not include a business plan where one is appropriate may be

disqualified and returned to the applicant.

The project must be responsive to the needs and problems identified

in the Analysis of Need and Problems to be Addressed.

(i) Work plan. The work plan must describe the proposed project

activities, or interventions, and explain how they are expected to

result in outcomes which will meet the needs of the program

participants and assist them to overcome the identified personal and

systemic barriers to employment and self-sufficiency. In other words,

what will the project staff do with the resources provided to the

project and how will what they do (interventions) assist in the

creation of employment and business opportunities for program

participants in the face of the needs and problems that have been

identified. The application should include a hypothesis or hypotheses

that is (are) significant and include(s) the key interventions, and

which permit(s) measurement of the extent to which the target

population can achieve greater self-sufficiency as a result of its

involvement in the project. The key interventions should include the

types and sources of technical and financial assistance to be provided

the participants, as well as any education, training, and support

services and the problems or barriers they are designed to overcome. If

the technical and/or financial assistance is to be provided to pre-

identified businesses that will be expanded or franchised, written

commitments from the businesses specifying their undertakings and

levels of participation must be included with the application. The work

program must set forth realistic quarterly time targets by which the

various work tasks will be completed.

The application identifies and defines critical issues or potential

problems that might impact negatively on the project and explains how

they can be overcome and the project objectives reasonably attained

despite such potential problems.

(ii) Business plan (where required). As noted above, a business

plan is required whenever the applicant is proposing to establish a

new, specific and identified business, or will be providing assistance

to a private third-party private employer for the development or

expansion of a pre-identified business. In these cases the business

plan is one of the major components that will be evaluated by OCS to

determine the feasibility of a jobs creation project.

Because the following guidelines were written to cover a variety of

possibilities, rigid adherence to them is not possible nor even

desirable for all projects. For example, a plan for a service business

would not require a discussion of manufacturing nor product design.

With this understanding, the business plan should be prepared in

accordance with the following guidelines:

1. The business and its industry. This section should describe the

nature and history of the business and provide some background on its

industry.

a. The Business: as a legal entity; the general business category;

b. Description and Discussion of Industry: Current status and

prospects for the industry;

2. Products and Services: This section deals with the following:

a. Description: Describe in detail the products or services to be

sold;

b. Proprietary Position: Describe proprietary features, if any, of

the product, e.g. patents, trade secrets;

c. Potential: Features of the product or service that may give it

an advantage over the competition;

3. Market Research and Evaluation: This section should present

sufficient information to show that the product or service has a

substantial market and can achieve sales in the face of competition;

a. Customers: Describe the actual and potential purchasers for the

product or service by market segment.

b. Market Size and Trends: State the size of the current total

market for the product or service offered; [[Page 12834]]

c. Competition: An assessment of the strengths and weaknesses of

competitive products and services;

d. Estimated Market Share and Sales: Describe the characteristics

of the product or service that will make it competitive in the current

market;

4. Marketing Plan: The marketing plan should detail the product,

pricing, distribution, and promotion strategies that will be used to

achieve the estimated market share and sales projections. The marketing

plan must describe what is to be done, how it will be done and who will

do it. The plan should address the following topics--Overall Marketing

Strategy, Packaging, Service and Warranty, Pricing, Distribution and

Promotion.

5. Design and Development Plans: If the product, process or service

of the proposed venture requires any design and development before it

is ready to be placed on the market, the nature and extent and cost of

this work should be fully discussed. The section should cover items

such as Development Status and Tasks, Difficulties and Risks, Product

Improvement and New Products, and Costs.

6. Manufacturing and Operations Plan: A manufacturing and

operations plan should describe the kind of facilities, plant location,

space, capital equipment and labor force (part and/or full time and

wage structure) that are required to provide the company's product or

service.

7. Management Team: The management team is the key in starting and

operating a successful business. The management team should be

committed with a proper balance of technical, managerial and business

skills, and experience in doing what is proposed. This section must

include a description of: the key management personnel and their

primary duties; compensation and/or ownership; the organizational

structure; Board of Directors; management assistance and training

needs; and supporting professional services.

8. Overall Schedule: A schedule that shows the timing and

interrelationships of the major events necessary to launch the venture

and realize its objectives. Prepare, as part of this section, a month-

by-month schedule that shows the timing of such activities as product

development, market planning, sales programs, and production and

operations. Sufficient detail should be included to show the timing of

the primary tasks required to accomplish each activity.

9. Critical Risks and Assumptions: The development of a business

has risks and problems and the Business Plan should contain some

explicit assumptions about them. Accordingly, identify and discuss the

critical assumptions in the Business Plan and the major problems that

will have to be solved to develop the venture. This should include a

description of the risks and critical assumptions relating to the

industry, the venture, its personnel, the product's market appeal, and

the timing and financing of the venture.

10. Community Benefits: The proposed project must contribute to

economic, community and human development within the project's target

area.

11. The Financial Plan: The Financial Plan is basic to the

development of a Business Plan. Its purpose is to indicate the

project's potential and the timetable for financial self-sufficiency.

In developing the Financial Plan, the following exhibits must be

prepared for the first three years of the business' operation:

a. Profit and Loss Forecasts-quarterly for each year;

b. Cash Flow Projections-quarterly for each year;

c. Pro forma balance sheets-quarterly for each year;

d. Initial sources of project funds;

e. Initial uses of project funds; and

f. Any future capital requirements and sources.

(iii) Facilities. If the rearrangement or alteration of facilities

will be required in implementing the project, the applicant has

described and justified such changes.

Criterion IV: Significant and Beneficial Impact (Maximum: 20 points)

(i) Quality of JOBS/business opportunities. The proposed project is

expected to produce permanent and measurable results that will reduce

the incidence of poverty in the community. Expected results are

quantifiable in terms of the creation of permanent, full-time jobs or

business opportunities developed (or the creation of non-traditional

employment opportunities in highway construction and maintenance or the

machine tool industry). In developing business opportunities and self-

employment for AFDC recipients and low-income individuals the applicant

proposes, at a minimum, to provide basic business planning and

management concepts, and assistance in preparing a business plan and

loan package.

The application documents that:

--The business opportunities to be developed for eligible participants

will contribute significantly to their progress toward self-

sufficiency; and/or

--Jobs to be created for eligible participants will contribute

significantly to their progress toward self-sufficiency; they provide,

for example, wages that exceed the minimum wage, plus benefits such as

health insurance, transportation, child care and career development

opportunities. (0-15 points)

(ii) Cost-per-job. During the project period the proposed project

will create new, permanent jobs through business opportunities or non-

traditional employment opportunities for low-income residents at a

cost-per-job below $15,000 in OCS funds, (e.g. cost per job is

calculated by dividing the total amount of grant funds requested

($420,000) by the number of jobs to be created (60) which equals the

cost-per-job ($7,000)). If any other calculations are used, please

include your methodology in this section. [Note: Except in those

instances where independent reviewers identify extenuating

circumstances related to business development activities, the maximum

number of points will be given only to those applicants proposing cost-

per-job created estimates of $5,000 or less of OCS requested funds.

Higher cost-per-job estimates will receive correspondingly fewer

points.] (0-5 points)

Criterion V: Third-Party Evaluation (Maximum: 10 points)

A plan for a methodologically sound third-party (i.e. independent)

evaluation of the demonstration project must be included in the

application. Application indicates how the applicant will verify the

extent to which the performance targets are achieved in this project.

The Evaluation Plan

--Includes a specific working definition of ``self-sufficiency''

(consistent with the broad definition contained in Part I) that permits

the measurement of incremental progress of eligible individuals and

their families from dependency toward self-sufficiency;

--Clearly defines the changes or benefits (outcomes) to be produced,

the activities (interventions) that will produce the changes, and the

measures of client progress toward self-sufficiency for which

information will be collected (for example: increases in income,

decreases in public assistance payments);

--Provides for the annual compilation of community-level data on the

characteristics of the population in the project area, including

percentage on public assistance, percentage below the poverty line,

[[Page 12835]] unemployment rate, business starts and failures, and

major employers;

--Provides for the conduct of a continuing process evaluation. This

should include the periodic assessment of the following: client

characteristics, pertinent policies and procedures; staffing;

cooperative partnerships with state and local agencies; use of other

community resources; client outreach and recruitment; client service

delivery; cost of services; and, level of technical and financial

assistance to employers. The types of data and information, measures

and indicators to be used for the process evaluation, as well as the

methods and timeframe for collecting and analyzing the required data

should be indicated;

--Provides for the completion of two interim evaluation reports and a

final report comprising both process and outcome evaluation. The final

evaluation report will describe the program design and any changes from

the original workplan, outreach and recruitment results, interventions,

and accomplishments. The measurement instruments, data collection

procedures, and analysis techniques should be discussed, and the report

should yield conclusions as to how well the program works and why. It

should also discuss the program's potential for replication in other

communities; and

--Includes a realistic plan for disseminating the project findings to

other interested organizations and public agencies.

Criterion VI: Public-Private Partnerships (Maximum: 10 points)

--The cooperative partnership arrangements are fully described and

clearly relate to the objectives of the proposed project, and the

activities include one or more of the mandatory or optional components

of the State's JOBS program as described in Part II, Section A.

--In the case of projects involved in the creation of non-traditional

employment opportunities in highway construction and maintenance or the

machine tool industry, agreements with the appropriate partners (for

example: highway departments, contractors, unions or businesses) should

clearly identify the undertakings of each partner in terms of training,

support, apprenticeships, career opportunities, and the like.

--The application documents that the applicant will mobilize from

public and/or private sources cash and/or third-party in-kind

contributions. Applications that document that the value of such

contributions will be at least equal to the OCS funds requested, and

demonstrate that the cooperative partnership arrangements clearly

relate to the objectives of the proposed project, will receive the

maximum number of points for this criterion. Lesser contributions will

be given consideration based upon the value documented.

--Applicants should note that partnership relationships are not created

via service delivery contracts; partners should be responsible for

substantive project components or elements.

--The above requirements are also applicable to applications submitted

in the area of non-traditional employment opportunities. (See Part II,

A for minimum requirement to be included in the cooperative partnership

agreement.)

Criterion VII: Budget Appropriateness and Reasonableness (Maximum: 5

points)

Funds requested are commensurate with the level of effort necessary

to accomplish the goals and objectives of the project.

The application includes a detailed budget break-down for each of

the budget categories in the SF-424A. The applicant presents a

reasonable administrative cost if an indirect cost rate has not been

negotiated with the cognizant Federal agency (See Part VI, Section B,

Line 6j).

The estimated cost to the government of the project also is

reasonable in relation to the anticipated results.

Part V--Application Procedures and Selection Process

A. Availability of Forms

Attachment B contains all of the standard forms necessary for the

application for awards under this OCS program. This attachment and

Parts VI and VII of this announcement contain all of the instructions

required for submittal of applications. These forms may be photocopied

for the application.

Copies of the Federal Register containing this announcement are

available at most local libraries and Congressional District Offices

for reproduction or accessible on the OCS Electronic Bulletin Board for

downloading through your computer modem by calling 1-800-627-8886. If

copies are not available at these sources, they may be obtained by

writing or telephoning the office listed under the section entitled FOR

FURTHER INFORMATION at the beginning of this announcement.

The applicant must be aware that in signing and submitting the

application for this award, it is certifying that it will comply with

the Federal requirements concerning the drug-free workplace and

debarment regulations set forth in Attachments C and D.

Part VII, Section A contains instructions for the project

narrative.

B. Application Submission

The closing date for submission of applications is noted under

``CLOSING DATE'' at the beginning of this Announcement.

1. Deadlines. Applications shall be considered as meeting the

deadline if they are either:

a. Received on or before the deadline date at the Department of

Health and Human Services, Administration for Children and Families,

Division of Discretionary Grants, 370 L'Enfant Promenade, SW., 6th

Floor, (OCS-95-08) Washington, DC 20447, Attention: Maiso Bryant, or

b. Sent on or before the deadline date and received by the granting

agency in time for them to be considered during the competitive review

and evaluation process under Chapter 1-62 of the Health and Human

Services Grants Administration Manual. (Applicants are cautioned to

request a legibly dated U.S. Postal Service postmark or to obtain a

legibly dated receipt from a commercial carrier or the U.S. Postal

Service. Private metered postmarks are not acceptable as proof of

timely mailing.)

2. Applications submitted by other means. Applications which are

not submitted in accordance with the above criteria shall be considered

as meeting the deadline only if they are physically received before the

close of business on or before the deadline date. Hand delivered

applications will be accepted at the Department of Health and Human

Services, Administration for Children and Families, Division of

Discretionary Grants, 901 D Street SW., 6th Floor, ACF Guard Station,

Washington, DC 20447 during the normal working hours of 8 a.m. to 4:30

p.m., Monday through Friday.

3. Late Applications. Applications which do not meet one of these

criteria are considered late applications. The ACF Division of

Discretionary Grants will notify each late applicant that its

application will not be considered in this competition.

4. Extension of Deadline. The ACF may extend the deadline for all

applicants because of acts of God such as floods, hurricanes, etc. or

when there is a disruption of the mails. However, if the granting

agency does not extend the deadline for all applicants, it may not

[[Page 12836]] waive or extend the deadline for any applicant.

Applications once submitted are considered final and no additional

materials will be accepted. One signed original application and four

copies should be submitted.

C. Intergovernmental Review

This program is covered under Executive Order 12372,

``Intergovernmental Review of Federal Programs,'' and 45 CFR part 100,

``Intergovernmental Review of Department of Health and Human Services

Program and Activities.'' Under the Order, States may design their own

processes for reviewing and commenting on proposed Federal assistance

under covered programs.

All States and Territories except Alabama, Alaska, Colorado,

Connecticut, Hawaii, Idaho, Kansas, Louisiana, Minnesota, Montana,

Nebraska, Oklahoma, Oregon, Pennsylvania, South Dakota, Virginia,

Washington, American Samoa and Palau have elected to participate in the

Executive Order process and have established Single Points of Contact

(SPOCs). Applicants from these nineteen jurisdictions need take no

action regarding E.O. 12372. Applicants for projects to be administered

by Federally-recognized Indian Tribes are also exempt from the

requirements of E.O. 12372. Otherwise, applicants should contact their

SPOCs as soon as possible to alert them of the prospective applications

and receive any necessary instructions. Applicants must submit any

required material to the SPOCs as soon as possible so that the program

office can obtain and review SPOC comments as part of the award

process. It is imperative that the applicant submit all required

materials, if any, to the SPOC and indicate the date of this submittal

(or the date of contact if no submittal is required) on the Standard

Form 424, item 16a.

Under 45 CFR 100.8(a)(2), a SPOC has sixty (60) days from the

application deadline to comment on proposed new or competing

continuation awards.

SPOCS are encouraged to eliminate the submission of routine

endorsements as official recommendations.

Additionally, SPOCs are requested to clearly differentiate between

mere advisory comments and those official State process recommendations

which may trigger the ``accommodate or explain'' rule.

When comments are submitted directly to ACF, they should be

addressed to: Department of Health and Human Services, Administration

for Children and Families, Division of Discretionary Grants, 370

L'Enfant Promenade, SW., 6th Floor, Washington, DC 20447.

A list of the Single Points of Contact for each State and Territory

is included as Attachment E of this announcement.

D. Application Consideration

Applications which meet the screening requirements in Part V, item

E below will be reviewed competitively. Such applications will be

referred to reviewers for a numerical score and explanatory comments

based solely on responsiveness to the guidelines and evaluation

criteria published in this announcement.

Applications will be reviewed by persons outside of the OCS unit

which will be directly responsible for programmatic management of the

grant. The results of these reviews will assist the Director and OCS

program staff in considering competing applications. Reviewers' scores

will weigh heavily in funding decisions but will not be the only

factors considered. Applications generally will be considered in order

of the average scores assigned by reviewers. However, highly ranked

applications are not guaranteed funding since other factors are taken

into consideration, including, but not limited to, the timely and

proper completion of projects funded with OCS funds granted in the last

five (5) years; comments of reviewers and government officials; staff

evaluation and input; geographic distribution; previous program

performance of applicants; compliance with grant terms under previous

DHHS grants; audit reports; investigative reports; and applicant's

progress in resolving any final audit disallowances on previous OCS or

other Federal agency grants.

OCS reserves the right to discuss applications with other Federal

or non-Federal funding sources to ascertain the applicant's performance

record.

E. Criteria for Screening Applicants

1. Initial Screening

The receipt of applications that meet the published deadline for

submission will be acknowledged in writing with an assigned

identification number. This number, must be referenced in all

subsequent communications concerning the application. If an

acknowledgement is not received within three weeks after the deadline

date, please notify ACF by telephone at (202) 401-9365.

All applications that meet the published deadline for submission

will be screened to determine completeness and conformity to the

requirements of this announcement. Only those applications meeting the

following requirements will be reviewed and evaluated competitively.

Others will be returned to the applicants with a notation that they

were unacceptable.

a. The application must contain a Standard Form 424 Application for

Federal Assistance (SF-424), a budget (SF-424A), and signed Assurances

(SF-424B) completed according to instructions published in Part VI and

Attachment B of this Program Announcement.

b. A project narrative must also accompany the standard forms. OCS

requires that the narrative portion of the application be limited to 50

pages, typewritten on one side of the paper only with one-inch margins

and type face no smaller than 10 characters per inch (cpi) or

equivalent. Charts, exhibits, letters of support and cooperative

agreements are not counted against this page limit. It is strongly

recommended that you follow the format for the narrative in Part VII,

A, 10.

c. The SF-424 and the SF-424B must be signed by an official of the

organization applying for the grant who has authority to obligate the

organization legally.

d. Application must contain documentation of the applicant's tax

exempt status as required under Part I, Section B.

2. Pre-Rating Review

Applications which pass the initial screening will be forwarded to

reviewers and/or OCS staff prior to the programmatic review to verify

that the applications comply with this Program Announcement in the

following areas:

a. Eligibility: Applicant meets the eligibility requirements

described in Part I, Section B. Proof of non-profit status must be

included in the Appendices to the Project Narrative (See Part VII,

Section A, 11).

Applicants must also be aware that the applicant's legal name as

required on the SF-424 (Item 5) must match that listed as corresponding

to the Employer Identification Number (Item 6).

b. Target Populations: The application clearly targets the specific

outcomes and benefits of the project to those types of low-income

participants and beneficiaries described in Part III, Section A,

Program Participants/Beneficiaries.

c. Grant Amount: The amount of funds requested does not exceed the

limits indicated in Part III, Section A, item 2.

d. Cooperative Partnership Agreement. The application contains a

written agreement or letter of [[Page 12837]] commitment that includes,

at a minimum, the activities cited in Part II, Section A. The agreement

must be signed by an official of the State IV-A agency responsible for

administering the JOBS program in the area to be served.

e. Third-Party Project Evaluation. A third-party project evaluation

plan is included.

f. Business Plan. If a third-party private employer is part of the

proposed project, a complete business plan is included in the

application.

An application will be disqualified from the competition and

returned if it does not conform to all of the above requirements.

Part VI--Instructions for Completing the SF-424

(Approved by the Office of Management and Budget under Control Number

0970-0062.)

The standard forms attached to this announcement shall be used to

apply for funds under this program announcement.

It is suggested that you reproduce single-sided copies of the SF-

424 and SF-424A, and type your application on the copies. Please

prepare your application in accordance with instructions provided on

the forms as well as with the OCS specific instructions set forth

below:

A. SF-424--Application for Federal Assistance

Top of Page. Please enter the single priority area number under

which the application is being submitted. An application should be

submitted under only one priority area.

Item 1. For the purposes of this announcement, all projects are

considered Applications; there are no Pre-Applications.

Prepare your application in accordance with the standard

instructions given in Attachments B and C corresponding to the forms,

as well as the OCS specific instructions set forth below:

Item 2. Date Submitted and Applicant Identifier--Date application

is submitted to ACF and applicant's own internal control number, if

applicable.

Item 3. Date Received by State--N/A

Item 4. Date Received by Federal Agency--Leave blank.

Items 5 and 6. The legal name of the applicant must match that

listed as corresponding to the Employer Identification Number. Where

the applicant is a previous Department of Health and Human Services

grantee, enter the Central Registry System Employee Identification

Number (CRS/EIN) and the Payment Identifying Number, if one has been

assigned, in the Block entitled Federal Identifier located at the top

right hand corner of the form.

Item 7. If the applicant is a non-profit corporation, enter N in

the box and specify non-profit corporation in the space marked Other.

Proof of non-profit status, such as IRS determination, Articles of

Incorporation, or By-laws, must be included as an appendix to the

project narrative.

Item 8. Type of Application--Please indicate the type of

application.

Item 9. Name of Federal Agency--Enter DHHS-ACF/OCS.

Item 10. The Catalog of Federal Domestic Assistance number for OCS

programs covered under this announcement is 93.647. The title is Social

Services Research Demonstration.

Item 11. In addition to a brief descriptive title of the project,

indicate the priority area for which funds are being requested. Use the

following letter designations:

JO--General Project

JS--Community Development Corporation Set-Aside

Item 12. Areas Affected by Project--List only the largest unit or

units affected, such as State, county or city.

Item 13. Proposed Project--The ending date should be calculated

based on a 72-month project period.

Item 14. Congressional District of Applicant/Project--Enter the

number of the Congressional District where the applicant's principal

office is located and the number of the Congressional district(s) where

the project will be located.

Item 15a. This amount should be no greater than the amount

specified under Part III, Availability of Funds and Grant Amounts.

Item 15b-e. These items should reflect both cash and third-party,

in-kind contributions for the budget period requested.

Item 15f. N/A.

Item 15g. Enter the sum of Items 15a-15e.

B. SF-424A--Budget Information--Non-Construction Programs

See Instructions accompanying this form as well as the instructions

set forth below:

In completing these sections, the Federal Funds budget entries will

relate to the requested OCS funds only, and Non-Federal will include

mobilized funds from all other sources--applicant, state, local, and

other. Federal funds other than requested OCS funding should be

included in Non-Federal entries.

Sections A, B, C and D of SF-424A should reflect budget estimates

for the first budget period of the project.

Section A--Budget Summary

Lines 1-4

Col. (a):

Line 1--Enter Social Services Research and Demonstration.

Col. (b):

Line 1--Catalog of Federal Domestic Assistance number is 93.647

Col. (c) and (d):

Columns (c) and (d) are not relevant to this program and should not

be completed.

Column (e)-(g):

For line 1, enter in columns (e), (f) and (g) the appropriate

amounts needed to support the project. (Maximum $500,000)

Line 5--Enter the figures from Line 1 for all columns completed

(e), (f), and (g).

Section B--Budget Categories

Please Note: This information supersedes the instructions provided

following SF-424A.

Columns (1)-(5):

Column 1: Enter the first budget period of 12 months.

Column 2: Enter the second budget period of 12 months.

Column 3: Enter the third budget period of 12 months.

Column 4: Leave blank.

Column 5: Enter the total requirements for Federal funds by the

Object Class Categories of this section.

Allocability of costs are governed by the cost principles set forth

in OMB Circular A-122 and 45 CFR Part 74.

Budget estimates for national administrative costs must be

supported by adequate detail for the grants officer to perform a cost

analysis and review. Adequately detailed calculations for each budget

object class are those which reflect estimation methods, quantities,

unit costs, salaries, and other similar quantitative detail sufficient

for the calculation to be duplicated. For any additional object class

categories included under the object class other identify the

additional object class(es) and provide supporting calculations.

Supporting narratives and justifications are required for each

budget category, with emphasis on unique/special initiatives, large

dollar amounts; local, regional, or other travels, new positions, major

equipment purchases and training programs.

A detailed itemized budget with a separate budget justification for

each major item should be included as indicated below: [[Page 12838]]

Personnel-Line 6a. Enter the total costs of salaries and wages.

Justification: Identify the principal investigator or project

director, if known. Specify by title or name the percentage of time

allocated the project, the individual annual salaries, and the cost to

the project of the organization's staff who will be working on the

project. Do not include costs of consultants or personnel costs of

delegate agencies or of specific project(s) or businesses to be

financed by the applicant.

Fringe Benefits--Line 6b. Enter the total costs of fringe benefits

unless treated as part of an approved indirect cost rate which is

entered on line 6j.

Justification: Provide a breakdown of amounts and percentages that

comprise fringe benefit costs, such as health insurance, FICA,

retirement insurance, taxes, etc.

Travel--Line 6c. Enter total costs of all travel by employees of

the project. Do not enter costs for consultant's travel.

Justification: Include the total number of traveler(s), total

number of trips, destinations, number of days, transportation costs and

subsistence allowances. Travel costs to attend two national workshops

in Washington, D.C. by the project director and the third-party

evaluator should be included.

Equipment--Line 6d. Enter the total costs of all non-expendable

personal property to be acquired by the project. Non-expendable

personal property means tangible personal property having a unit cost

of $5000 or more and having a useful life of one year.

Justification: Only equipment required to conduct the project may

be purchased with Federal funds. The applicant organization or its

subgrantees must not have such equipment, or a reasonable facsimile,

available for use in the project. The justification also must contain

plans for future use or disposal of the equipment after the project

ends. An applicant may use its own definition of non-expendable

personal property, provided that such a definition would at least

include all tangible personal property as defined above. (See Line 21

for additional requirements).

Supplies--Line 6e. Enter the total costs of all tangible personal

property (supplies) other than that included on line 6d.

Justification: Specify general categories of supplies and their

costs.

Contractual--Line 6f. Enter the total costs of all contracts,

including (1) the estimated cost of the third-party evaluation

contract; travel costs for the chief evaluator to attend two national

workshops in Washington, D.C. should be included; (2) procurement

contracts (except those which belong on other lines such as equipment,

supplies, etc.) and (3) contracts with secondary recipient

organizations including delegate agencies and specific project(s) or

businesses to be financed by the applicant.

Justification: Attach a list of contractors, indicating the names

of the organizations, the purposes of the contracts, the estimated

dollar amounts, and selection process of the awards as part of the

budget justification. Also provide back-up documentation identifying

the name of contractor, purpose of contract, and major cost elements.

Note: Whenever the applicant/grantee intends to delegate part of

the program to another agency, the applicant/grantee must submit

Sections A and B of this Form SF-424A, completed for each delegate

agency by agency title, along with the required supporting

information referenced in the applicable instructions.

The total costs of all such agencies will be part of the amount

shown on Line 6f. Provide draft Request for Proposal in accordance with

45 CFR Part 74, Appendix H. Free and open competition is encouraged for

any procurement activities planned using ACF grant funds. Prior

approval is required when applicants anticipate evaluation procurements

that will exceed $25,000 and are requesting an award without

competition.

The applicant's procurement procedures should outline the type of

advertisement appropriate to the nature and anticipated value of the

contract to be awarded. Advertisements are typically made in city,

regional, and local newspapers; trade journals; and/or through

announcements by professional associations.

Construction--Line 6g. Not applicable.

Other--Line 6h. Enter the total of all other costs. Such costs,

where applicable, may include but are not limited to insurance, food,

medical and dental costs (noncontractual), fees and travel paid

directly to individual consultants, space and equipment rentals,

printing and publication, computer use, training costs, including

tuition and stipends, training service costs including wage payments to

individuals and supportive service payments, and staff development

costs.

Total Direct Charges--Line 6i. Show the total of Lines 6a through

6h.

Indirect Charges--Line 6j. Enter the total amount of indirect

costs. This line should be used only when the applicant currently has

an indirect cost rate approved by the Department of Health and Human

Services or another cognizant Federal agency. With the exception of

local governments, applicants should enclose a copy of the current rate

agreement if it was negotiated with a cognizant Federal agency other

than the Department of Health and Human Services. If the applicant

organization is in the process of initially developing or renegotiating

a rate, it should immediately upon notification that an award will be

made, develop a tentative indirect cost rate proposal based on its most

recently completed fiscal year in accordance with the principles set

forth in the pertinent DHHS Guide for Establishing Indirect Cost Rates,

and submit it to the appropriate DHHS Regional Office. Applicants

awaiting approval of their indirect cost proposals may also request

indirect costs.

It should be noted that when an indirect cost rate is requested,

those costs included in the indirect cost pool should not be also

charged as direct costs to the grant.

Totals--Line 6k. Enter the total amounts of Lines 6i and 6j.

Program Income--Line 7. Enter the estimated amount of income, if

any, expected to be generated from this project. Separately show

expected program income generated from OCS support and income generated

from other mobilized funds. Do not add or subtract this amount from the

budget total. Show the nature and source of income in the program

narrative statement.

Justification: Describe the nature, source and anticipated use of

program income in the Program Narrative Statement.

Column 5: Carry totals from Column 1 to Column 5 for all line

items.

Section C--Non-Federal Resources

This section is to record the amounts of non-Federal resources that

will be used to support the project. Non-Federal resources mean those

other than OCS funds. Therefore, mobilized funds from other Federal

programs should be entered on these lines. Provide a brief listing of

the non-Federal resources on a separate sheet and describe whether it

is a grantee-incurred cost or a third-party in-kind contribution. The

firm commitment of these resources must be documented and submitted

with the application in order to be given credit in the Public-Private

Partnerships criterion.

Except in unusual situations, this documentation must be in the

form of letters of commitment from the organization(s)/individuals from

which funds will be received. [[Page 12839]]

Justification: Describe third-party, in-kind contributions, if

included.

Grant Program--Line 8

Column (a): Enter the project title.

Column (b): Enter the amount of contributions to be made by the

applicant to the project.

Column (c): Enter the State contribution. If the applicant is a

State agency, enter the non-Federal funds to be contributed by the

State other than the applicant.

Column (d): Enter the amount of cash and third-party in-kind

contributions to be made from all other sources.

Column (e): Enter the total of columns (b), (c), and (d).

Grant Program--Lines 9, 10, and 11 should be left blank.

Grant Program--Line 12.

Carry the total of each column of Line 8, (b) through (e). The

amount in Column (e) should be equal to the amount on Section A, Line

5, column (f).

Section D--Forecasted Cash Needs

Federal--Line 13. Enter the amount of Federal (OCS) cash needed for

this grant, by quarter, during the first 12 month budget period.

Non Federal--Line 14. Enter the amount of cash from all other

sources needed by quarter during the first 12-month budget period.

Totals--Line 15. Enter the total of Lines 13 and 14.

Section E--Budget Estimates of Federal Funds Needed for Balance of

Project(s)

For new applications, enter in the proper columns amounts of

Federal funds which will be needed to complete the program or project

over the succeeding funding periods (usually in years).

Section F--Other Budget Information

Direct Charges--Line 21. Use this space and continuation sheets as

necessary to fully explain and justify the major items included in the

budget categories shown in Section B. Include sufficient detail to

facilitate determination of allowability, relevance to the project, and

cost benefits. Particular attention must be given to the explanation of

any requested direct cost budget item which requires explicit approval

by the Federal agency. Budget items which require identification and

justification shall include, but not be limited to, the following:

A. Salary amounts and percentage of time worked for those key

individuals who are identified in the project narrative;

B. Any foreign travel;

C. A list of all equipment and estimated cost of each item to be

purchased wholly or in part with grant funds which meet the definition

of nonexpendable personal property provided on Line 6d, Section B. Need

for equipment must be supported in program narrative;

D. Contractual: major items or groups of smaller items; and

E. Other: group into major categories all costs for consultants,

local transportation, space, rental, training allowances, staff

training, computer equipment, etc. Provide a complete breakdown of all

costs that make up this category.

Indirect Charges--Line 22. Enter the type of HHS or other cognizant

Federal agency approved indirect cost rate (provisional, predetermined,

final or fixed) that will be in effect during the funding period, the

estimated amount of the base to which the rate is applied and the total

indirect expense. Also, enter the date the rate was approved and attach

a copy of the rate agreement.

Remarks--Line 23. Provide any other explanations and continuation

sheets required or deemed necessary to justify or explain the budget

information.

C. SF-424B Assurances--Non-Construction

All applicants must fill out, sign, date and return the Assurances

with the application.

Part VII--Contents of Application and Receipt Process

A. Contents and Order of Application

Each application submission should include a signed original and

four additional copies of the application. Each application should

include the following in the order presented:

1. Table of Contents;

2. Completed Standard Form 424 which has been signed by an Official

of the organization applying for the grant who has authority to

obligate the organization legally. (Note: The original SF-424 must bear

the original signature of the authorizing representative of the

applicant organization.)

3. Budget Information--Non-Construction Programs (SF-424A);

4. A narrative budget justification for each object class category

required under Section B, SF-424A;

5. Filled out, signed, and dated Assurances--Non-Construction

Programs (SF-424B);

6. By signing and submitting this application, the applicant is

certifying that it will comply with the Federal requirements concerning

debarment regulations set forth in attachments E and F.

7. Restrictions on Lobbying, Certification for Contracts, Grants,

Loans, and Cooperative Agreements: fill out, sign and date form found

at Attachment H.

8. Disclosure of Lobbying Activities, SF-LLL: Filled out, signed,

and dated form found at Attachment H, if appropriate.

9. Certification Regarding Environmental Tobacco Smoke--Signature

on the application attests to the applicants intent to comply with the

requirements of the Pro-Children Act of 1994. A signed form does not

have to be returned with application.

10. An Executive Summary--not to exceed 300 words;

11. A Project Narrative consisting of the following elements

preceded by a consecutively numbered Table of Contents that will

describe the project in the following order:

(i) Eligibility Confirmation

(ii) Organizational Experience and Staff Responsibilities

(iii) Analysis of Need

(iv) Project Design/Work Program

(v) Business Plan (If appropriate)

(vi) Third-Party Evaluation

(vii) Cooperative Partnership Agreement

(viii) Budget Appropriateness and Reasonableness

12. Appendices--proof of non-profit status as outlined in Part I,

Section B; proof that the organization is a community development

corporation, if applying under the CDC Set-aside; commitments from

officials of businesses that will be expanded or from franchises, where

applicable; partnership agreement with State IV-A (JOBS Program)

agency; Single Point of Contact comments, if applicable; Maintenance of

Effort Certification and resumes.

The total number of pages for the narrative portion of the

application package must not exceed 50 pages, excluding Appendices.

Pages should be numbered sequentially throughout, excluding Appendices,

beginning with the SF-424 as Page 1. The application may also contain

letters that show collaboration or substantive commitments to the

project by organizations other than the JOBS agency. Such letters are

not part of the narrative and should be included in the Appendices.

These letters are, therefore, not counted against the fifty page limit.

Applications must be uniform in composition since OCS may find it

necessary to duplicate them for review purposes. Therefore,

applications must be submitted on white 8\1/2\ x 11 inch paper only.

They must not include colored, oversized or folded materials.

[[Page 12840]] Do not include organizational brochures or other

promotional materials, slides, films, clips, etc. in the proposal. They

will be discarded if included. The applications should be two-hole

punched at the top center and fastened separately with a compressor

slide paper fastener, or a binder clip. The submission of bound

applications, or applications enclosed in binders, is specifically

discouraged.

Attachment J provides a checklist to applicants in preparing a

complete application package.

B. Acknowledgement of Receipt

Applicants who meet the initial screening criteria outlined in Part

V, Section E, 1, will receive an acknowledgement postcard with an

assigned identification number. Applicants are requested to supply a

self-addressed mailing label with their application which can be

attached to this acknowledgement postcard. This number and the program

letter code, i.e., JO or JS, must be referred to in all subsequent

communications with OCS concerning the application. If an

acknowledgement is not received within three weeks after the deadline

date, please notify ACF by telephone (202) 401-9234.

Part VIII--Post Award Information and Reporting Requirements

Following approval of the applications selected for funding, notice

of project approval and authority to draw down project funds will be

made in writing. The official award document is the Financial

Assistance Award which provides the amount of Federal funds approved

for use in the project, the project and budget period for which support

is provided, the terms and conditions of the award, and the total

project period for which support is contemplated.

Project directors and chief evaluators will be required to attend

two national evaluation workshops in Washington, D.C. A program

development and evaluation workshop will be scheduled shortly after the

effective date of the grant. They also will be required to attend, as

presenters, the final evaluation workshop on utilization and

dissemination to be held at the end of the project period.

Grantees will be required to submit semi-annual progress and

financial reports (SF-269) as well as a final progress and financial

report within 90 days of the expiration of the grant. Interim

evaluation reports, along with a written policies and procedures manual

based on the findings of the process evaluation, will be due 30 days

after the first twelve months, and the second interim evaluation 30

days after the second twelve months, and a final evaluation report will

be due 90 days after the expiration of the grant. This final report

will cover 36 months of activities related to project participants.

Reporting requirements for the remaining 36 months of the project

period will be provided during the solicitation of applications.

Grantees are subject to the audit requirements in 45 CFR Parts 74

(non-profit organization) and OMB Circular A-133.

Section 319 of Public Law 101-121, signed into law on October 23,

1989, imposes new prohibitions and requirements for disclosure and

certification related to lobbying on recipients of Federal contracts,

grants, cooperative agreements, and loans. It provides limited

exemptions for Indian tribes and tribal organizations. Current and

prospective recipients (and their subtier contractors and/or grantees)

are prohibited from using appropriated funds for lobbying Congress or

any Federal agency in connection with the award of a contract, grant,

cooperative agreement or loan. In addition, for each award action in

excess of $100,000 (or $150,000 for loans) the law requires recipients

and their subtier contractors and/or subgrantees (1) to certify that

they have neither used nor will use any appropriated funds for payment

to lobbyists, (2) to submit a declaration setting forth whether

payments to lobbyists have been or will be made out of non-appropriated

funds and, if so, the name, address, payment details, and purpose of

any agreements with such lobbyists whom recipients or their subtier

contractors or subgrantees will pay with the non-appropriated funds and

(3) to file quarterly up-dates about the use of lobbyists if an event

occurs that materially affects the accuracy of the information

submitted by way of declaration and certification. The law establishes

civil penalties for noncompliance and is effective with respect to

contracts, grants, cooperative agreements and loans entered into or

made on or after December 23, 1989. See Attachment F for certification

and disclosure forms to be submitted with the applications for this

program.

Attachment G indicates the regulations which apply to all

applicants/grantees under the Job Opportunities for Low-Income

Individuals Program.

Dated: February 24, 1995.

Donald Sykes,

Director, Office of Community Services.

Attachment A.--1995 Poverty Income Guidelines for all States (Except

Alaska and Hawaii) and the District of Columbia

------------------------------------------------------------------------

Poverty

Size of family unit guideline

------------------------------------------------------------------------

1....................................................... $7,470

2....................................................... 10,030

3....................................................... 12,590

4....................................................... 15,150

5....................................................... 17,710

6....................................................... 20,270

7....................................................... 22,830

8....................................................... 25,390

------------------------------------------------------------------------

For family units with more than 8 members, add $2,560 for each

additional member. (The same increment applies to smaller family sizes

also, as can be seen in the figures above.)

[[Page 12841]]

Poverty Income Guidelines for Alaska

------------------------------------------------------------------------

Poverty

Size of family unit guideline

------------------------------------------------------------------------

1....................................................... $9,340

2....................................................... 12,540

3....................................................... 15,740

4....................................................... 18,940

5....................................................... 22,140

6....................................................... 25,340

7....................................................... 28,540

8....................................................... 31,740

------------------------------------------------------------------------

For family units with more than 8 members, add $3,200 for each

additional member. (The same increment applies to smaller family sizes

also, as can be seen in the figures above.)

Poverty Guidelines for Hawaii

------------------------------------------------------------------------

Poverty

Size of family unit guideline

------------------------------------------------------------------------

1....................................................... $8,610

2....................................................... 11,550

3....................................................... 14,490

4....................................................... 17,430

5....................................................... 20,370

6....................................................... 23,310

7....................................................... 26,250

8....................................................... 29,190

------------------------------------------------------------------------

For family units with more than 8 members, add $2,940 for each

additional member. (The same increment applies to smaller family sizes

also, as can be seen in the figures above.)

BILLING CODE 4184-01-P

[[Page 12842]]

[GRAPHIC][TIFF OMITTED]TN08MR95.007

BILLING CODE 4184-01-C [[Page 12843]]

Instructions for the SF 424

This is a standard form used by applicants as a required

facesheet for preapplications and applications submitted for Federal

assistance. It will be used by Federal agencies to obtain applicant

certification that States which have established a review and

comment procedure in response to Executive Order 12372 and have

selected the program to be included in their process, have been

given an opportunity to review the applicant's submission.

Item and Entry

1. Self-explanatory.

2. Date application submitted to Federal agency (or State if

applicable) & applicant's control number (if applicable).

3. State use only (if applicable).

4. If this application is to continue or revise an existing

award, enter present Federal identifier number. If for a new

project, leave blank.

5. Legal name of applicant, name of primary organizational unit

which will undertake the assistance activity, complete address of

the applicant, and name and telephone number of the person to

contact on matters related to this application.

6. Enter Employer identification Number (EIN) as assigned by the

Internal Revenue Service.

7. Enter the appropriate letter in the space provided.

8. Check appropriate box and enter appropriate letter(s) in the

space(s) provided.

--``New'' means a new assistance award.

--``Continuation'' means an extension for an additional funding/

budget period for a project with a projected completion date.

--``Revision'' means any change in the Federal Government's

financial obligation or contingent liability from an existing

obligation.

9. Name of Federal agency from which assistance is being

requested with this application.

10. Use the Catalog of Federal Domestic Assistance number and

title of the program under which assistance is required.

11. Enter a brief descriptive title of the project. If more than

one program is involved, you should append an explanation on a

separate sheet. If appropriate (e.g., construction or real property

projects), attach a map showing project location. For

preapplications, use a separate sheet to provide a summary

description of this project.

12. List only the largest political entities affected (e.g.,

State, counties, cities).

13. Self-explanatory.

14. List the applicant's Congressional District and any

District(s) affected by the program or project.

15. Amount requested or to be contributed during the first

funding/budget period by each contributor. Value of in-kind

contributions should be included on appropriate lines as applicable.

If the action will result in a dollar change to an existing award,

indicate only the amount of the change. For decreases, enclose the

amounts in parentheses. If both basic and supplemental amounts are

included, show breakdown on an attached sheet. For multiple program

funding, use totals and show breakdown using same categories as item

15.

16. Applicants should contact the State Single Point of Contact

(SPOC) for Federal Executive Order 12372 to determine whether the

application is subject to the State intergovernmental review

process.

17. This question applies to the applicant organization, not the

person who signs as the authorized representative. Categories of

debt include delinquent audit disallowances, loans and taxes.

18. To be signed by the authorized representative of the

applicant. A copy of the governing body's authorization for you to

sign this application as official representative must be on file in

the applicant's office. (Certain Federal agencies may require that

this authorization be submitted as part of the application.)

BILLING CODE 4184-01-M

[[Page 12844]]

[GRAPHIC][TIFF OMITTED]TN08MR95.008

[[Page 12845]]

[GRAPHIC][TIFF OMITTED]TN08MR95.009

BILLING CODE 4184-01-C

[[Page 12846]]

Instructions for the SF-424A

General Instructions

This form is designed so that application can be made for funds

from one or more grant programs. In preparing the budget, adhere to any

existing Federal grantor agency guidelines which prescribe how and

whether budgeted amounts should be separately shown for different

functions or activities within the program. For some programs, grantor

agencies may require budgets to be separately shown by function or

activity. For other programs, grantor agencies may require a breakdown

by function or activity. Sections A, B, C, and D should include budget

estimates for the whole project except when applying for assistance

which requires Federal authorization in annual or other funding period

increments. In the latter case, Sections A, B, C, and D should provide

the budget for the first budget period (usually a year) and Section E

should present the need for Federal assistance in the subsequent budget

periods. All applications should contain a breakdown by the object

class categories shown in Lines a-k of Section B.

Section A. Budget Summary Lines 1-4, Columns (a) and (b)

For applications pertaining to a single Federal grant program

(Federal Domestic Assistance Catalog number) and not requiring a

functional or activity breakdown, enter on Line 1 under Column (a) the

catalog program title and the catalog number in Column (b).

For applications pertaining to a single program requiring budget

amounts by multiple functions or activities, enter the name of each

activity or function on each line in Column (a), and enter the catalog

number in Column (b). For applications pertaining to multiple programs

where none of the programs require a breakdown by function or activity,

enter the catalog program title on each line in Column (a) and the

respective catalog number on each line in Column (b).

For applications pertaining to multiple programs where one or more

programs require a breakdown by function or activity, prepare a

separate sheet for each program requiring the breakdown. Additional

sheets should be used when one form does not provide adequate space for

all breakdown of data required. However, when more than one sheet is

used, the first page should provide the summary totals by programs.

Lines 1-4, Columns (c) through (g.)

For new applications, leave Columns (c) and (d) blank. For each

line entry in Columns (a) and (b), enter in Column (e), (f), and (g)

the appropriate amounts of funds needed to support the project for the

first funding period (usually a year).

For continuing grant program applications, submit these forms

before the end of each funding period as required by the grantor

agency. Enter in Columns (c) and (d) the estimated amounts of funds

which will remain unobligated at the end of the grant funding period

only if the Federal grantor agency instructions provided for this.

Otherwise, leave these columns blank. Enter in columns (e) and (f) the

amounts of funds needed for the upcoming period. The amount(s) in

Column (g) should be the sum of amounts in Columns (e) and (f).

For supplemental grants and changes to existing grants, do not use

Columns (c) and (d). Enter in Column (e) the amount of the increase or

decrease of Federal funds and enter in Column (f) the amount of the

increase or decrease of non-Federal funds. In Column (g) enter the new

total budgeted amount (Federal and non-Federal) which includes the

total previous authorized budgeted amounts plus or minus, as

appropriate, the amounts shown in Columns (e) and (f). The amount(s) in

Column (g) should not equal the sum of amounts in Columns (e) and (f).

Line 5--Show the totals for all columns used.

Section B. Budget Categories

In the column headings (1) through (4), enter the titles of the

same programs, functions, and activities shown on Lines 1-4, Column

(a), Section A. When additional sheets are prepared for Section A,

provide similar column headings on each sheet. For each program,

function or activity, fill in the total requirements for funds (both

Federal and non-Federal) by object class categories.

Lines 6a-i--Show the totals of Lines 6a to 6h in each column.

Line 6j--Show the amount of indirect cost.

Line 6k--Enter the total of amounts on Lines 6i and 6j. For all

applications for new grants and continuation grants the total amount in

column (5), Line 6k, should be the same as the total amount shown in

Section A, Column (g), Line 5. For supplemental grants and changes to

grants, the total amount of the increase or decrease as shown in

Columns (1)-(4). Line 6k should be the same as the sum of the amounts

in Section A, Columns (e) and (f) on Line 5.

Line 7--Enter the estimated amount of income, if any, expected to

be generated from this project. Do not add or subtract this amount from

the total project amount. Show under the program narrative statement

the nature and source of income. The estimated amount of program income

may be considered by the federal grantor agency in determining the

total amount of the grant.

Section C. Non-Federal Resources

Lines 8-11--Enter amounts of non-Federal resources that will be

used on the grant. If in-kind contributions are included, provide a

brief explanation on a separate sheet.

Column (a)--Enter the program titles identical to Column (a),

Section A. A breakdown by function or activity is not necessary.

Column (b)--Enter the contribution to be made by the applicant.

Column (c)--Enter the amount of the State's cash and in-kind

contribution if the applicant is not a State or State agency.

Applicants which are a State or State agencies should leave this column

blank.

Column (d)--Enter the amount of cash and in-kind contributions to

be made from all other sources.

Column (e)--Enter totals of Column (b), (c), and (d).

Line 12--Enter the total for each of Columns (b)-(e). The amount in

Column (e) should be equal to the amount on Line 5, Column (f), Section

A.

Section D. Forecasted Cash Needs

Line 13--Enter the amount of cash needed by quarter from the

grantor agency during the first year.

Line 14--Enter the amount of cash from all other sources needed by

quarter during the first year.

Line 15--Enter the totals of amounts on Lines 13 and 14.

Section E. Budget Estimates of Federal Funds Needed for Balance of the

Project

Lines 16-19--Enter in Column (a) the same grant program titles

shown in Column (a), Section A. A breakdown by function or activity is

not necessary. For new applications and continuation grant

applications, enter in the proper columns amounts of Federal funds

which will be needed to compete the program or project over the

succeeding funding periods (usually in years). This section need not be

completed for revisions (amendments, changes, or supplements) to funds

for the current year of existing grants. [[Page 12847]]

If more than four lines are needed to list the program titles,

submit additional schedules as necessary.

Line 20--Enter the total for each of the Columns (b)-(e). When

additional schedules are prepared for this Section, annotate

accordingly and show the overall totals on this line.

Section F. Other Budget Information

Line 21--Use this space to explain amounts for individual direct

object-class cost categories that may appear to be out of the ordinary

or to explain the details as required by the Federal grantor agency.

Line 22--Enter the type of indirect rate (provisional,

predetermined, final or fixed) that will be in effect during the

funding period, the estimated amount of the base to which the rate is

applied, and the total indirect expense.

Line 23--Provide any other explanations or comments deemed

necessary.

Assurances--Non-Construction Programs

Note: Certain of these assurances may not be applicable to your

project or program. If you have questions, please contact the

awarding agency. Further, certain Federal awarding agencies may

require applicants to certify to additional assurances. If such is

the case, you will be notified.

As the duly authorized representative of the applicant I certify

that the applicant:

1. Has the legal authority to apply for Federal assistance, and the

institutional, managerial and financial capability (including funds

sufficient to pay the non-Federal share of project costs) to ensure

proper planning, management and completion of the project described in

this application.

2. Will give the awarding agency, the Comptroller General of the

United States, and if appropriate, the State, through any authorized

representative, access to and the right to examine all records, books,

papers, or documents related to the award; and will establish a proper

accounting system in accordance with generally accepted accounting

standards or agency directives.

3. Will establish safeguards to prohibit employees from using their

positions for a purpose that constitutes or presents the appearance of

personal or organizational conflict of interest, or personal gain.

4. Will initiate and complete the work within the applicable time

frame after receipt of approval of the awarding agency.

5. Will comply with the Intergovernmental Personnel Act of 1970 (42

U.S.C. Secs. 4728-4763) relating to prescribed standards for merit

systems for programs funded under one of the nineteen statutes or

regulations specified in Appendix A of OPM's Standards for a Merit

System of Personnel Administration (5 C.F.R. 900, Subpart F).

6. Will comply with all Federal statutes relating to

nondiscrimination. These include but are not limited to: (a) Title VI

of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits

discrimination on the basis of race, color or national origin; (b)

Title IX of the Education Amendments of 1972, as amended (20 U.S.C.

Secs. 1681-1683, and 1685-1686), which prohibits discrimination on the

basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as

amended (29 U.S.C. Sec. 794), which prohibits discrimination on the

basis of handicaps; (d) the Age Discrimination Act of 1975, as amended

(42 U.S.C. Secs. 6101-6107), which prohibits discrimination on the

basis of age;

(e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255),

as amended, relating to nondiscrimination on the basis of drug abuse;

(f) the Comprehensive Alcohol Abuse and Alcoholism Prevention,

Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended,

relating to nondiscrimination on the basis of alcohol abuse or

alcoholism; (g) Secs. 523 and 527 of the Public Health Service Act of

1912 (42 U.S.C. 290 dd-3 and 290 ee-3), as amended, relating to

confidentiality of alcohol and drug abuse patient records; (h) Title

VIII of the Civil Rights Act of 1968 (42 U.S.C. Sec. 3601 et seq.), as

amended, relating to non-discrimination in the sale, rental or

financing of housing; (i) any other nondiscrimination provisions in the

specific statute(s) under which application for Federal assistance is

being made; and (j) the requirements of any other nondiscrimination

statute(s) which may apply to the application.

7. Will comply, or has already complied, with the requirements of

Titles II and III of the Uniform Relocation Assistance and Real

Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide

for fair and equitable treatment of persons displaced or whose property

is acquired as a result of Federal or federally assisted programs.

These requirements apply to all interests in real property acquired for

project purposes regardless of Federal participation in purchases.

8. Will comply with the provisions of the Hatch Act (5 U.S.C.

Secs. 1501-1508 and 7324-7328) which limit the political activities of

employees whose principal employment activities are funded in whole or

in part with Federal funds.

9. Will comply, as applicable, with the provisions of the Davis-

Bacon Act (40 U.S.C. Secs. 276a to 276a-7), the Copeland Act (40 U.S.C.

Sec. 276c and 18 U.S.C. Secs. 874), and the Contract Work Hours and

Safety Standards Act (40 U.S.C. Secs. 327-333), regarding labor

standards for federally assisted construction subagreements.

10. Will comply, if applicable, with flood insurance purchase

requirements of Section 102(a) of the Flood Disaster Protection Act of

1973 (P.L. 93-234) which requires recipients in a special flood hazard

area to participate in the program and to purchase flood insurance if

the total cost of insurable construction and acquisition is $10,000 or

more.

11. Will comply with environmental standards which may be

prescribed pursuant to the following: (a) institution of environmental

quality control measures under the National Environmental Policy Act of

1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of

violating facilities pursuant to EO 11738; (c) protection of wetlands

pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in

accordance with EO 11988; (e) assurance of project consistency with the

approved State management program developed under the Coastal Zone

Management Act of 1972 (16 U.S.C. Secs. 1451 et seq.); (f) conformity

of Federal actions to State (Clear Air) Implementation Plans under

Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C.

Sec. 7401 et seq.); (g) protection of underground sources of drinking

water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-

523); and (h) protection of endangered species under the Endangered

Species Act of 1973, as amended, (P.L. 93-205).

12. Will comply with the Wild and Scenic Rivers Act of 1968 (16

U.S.C. Secs. 1271 et seq.) related to protecting components or

potential components of the national wild and scenic rivers system.

13. Will assist the awarding agency in assuring compliance with

Section 106 of the National Historic Preservation Act of 1966, as

amended (16 U.S.C. 470), EO 11593 (identification and protection of

historic properties), and the Archaeological and Historic Preservation

Act of 1974 (16 U.S.C. 469a-l et seq.).

14. Will comply with P.L. 93-348 regarding the protection of human

subjects involved in research, [[Page 12848]] development, and related

activities supported by this award of assistance.

15. Will comply with the Laboratory Animal Welfare Act of 1966

(P.L. 89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the

care, handling, and treatment of warm blooded animals held for

research, teaching, or other activities supported by this award of

assistance.

16. Will comply with the Lead-Based Paint Poisoning Prevention Act

(42 U.S.C. Secs. 4801 et seq.) which prohibits the use of lead based

paint in construction or rehabilitation of residence structures.

17. Will cause to be performed the required financial and

compliance audits in accordance with the Single Audit Act of 1984.

18. Will comply with all applicable requirements of all other

Federal laws, executive orders, regulations and policies governing this

program.

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BILLING CODE 4184-01-C

[[Page 12851]]

Attachment D--Certification Regarding Debarment, Suspension, and Other

Responsibility Matters--Primary Covered Transactions

By signing and submitting this proposal, the applicant, defined as

the primary participant in accordance with 45 CFR Part 76, certifies to

the best of its knowledge and believe that it and its principals:

(a) are not presently debarred, suspended, proposed for debarment,

declared ineligible, or voluntarily excluded from covered transactions

by any Federal Department or agency;

(b) have not within a 3-year period preceding this proposal been

convicted of or had a civil judgment rendered against them for

commission of fraud or a criminal offense in connection with obtaining,

attempting to obtain, or performing a public (Federal, State, or local)

transaction or contract under a public transaction; violation of

Federal or State antitrust statutes or commission of embezzlement,

theft, forgery, bribery, falsification or destruction of records,

making false statements, or receiving stolen property;

(c) are not presently indicted or otherwise criminally or civilly

charged by a governmental entity (Federal, State of local) with

commission of any of the offenses enumerated in paragraph (1)(b) of

this certification; and

(d) have not within a 3-year period preceding this application

proposal had one or more public transactions (Federal, State, or local)

terminated for cause or default.

The inability of a person to provide the certification required

above will not necessarily result in denial of participation in this

covered transaction. If necessary, the prospective participant shall

submit an explanation of why it cannot provide the certification. The

certification or explanation will be considered in connection with the

Department of Health and Human Service (HHS) determination whether to

enter into this transaction. However, failure of the prospective

primary participant to furnish a certification or an explanation shall

disqualify such person from participation in this transaction.

The prospective primary participant agrees that by submitting this

proposal, it will include the clause entitled ``Certification Regarding

Debarment, Suspension, Ineligibility, and Voluntary Exclusion--Lower

Tier Covered Transaction.'' provided below without modification in all

lower tier covered transactions and in all solicitations for lower tier

covered transactions.

Certification Regarding Debarment, Suspension, Ineligibility and

Voluntary Exclusion--Lower Tier Covered Transactions (To Be Supplied to

Lower Tier Participants)

By signing and submitting this lower tier proposal, the prospective

lower tier participant, as defined in 45 CFR Part 76, certifies to the

best of its knowledge and belief that it and its principals:

(a) are not presently debarred, suspended, proposed for debarment,

declared ineligible, or voluntarily excluded from participation in this

transaction by any federal department or agency.

(b) where the prospective lower tier participant is unable to

certify to any of the above, such prospective participant shall attach

an explanation to this proposal.

The prospective lower tier participant further agrees by submitting

this proposal that it will include this clause entitled ``certification

Regarding Debarment, Suspension, Ineligibility, and Voluntary

Exclusion--Lower Tier Covered Transactions.'' without modification in

all lower tier covered transactions and in all solicitations for lower

tier covered transactions.

Attachment E--Executive Order 12372--State Single Points of Contact

Arizona

Mrs. Janice Dunn, Attn: Arizona State Clearinghouse, 3800 N. Central

Avenue, 14th Floor, Phoenix, Arizona 85012, Telephone (602) 280-1315

Arkansas

Tracie L. Copeland, Manager, State Clearinghouse, Office of

Intergovernmental Services, Department of Finance and Administration,

P.O. Box 3278, Little Rock, Arkansas 72203, Telephone (501) 682-1074

California

Glenn Stober, Grants Coordinator, Office of Planning and Research, 1400

Tenth Street, Sacramento, California 95814, Telephone (916) 323-7480

Delaware

Ms. Francine Booth, State Single Point of Contact, Executive

Department, Thomas Collins Building, Dover, Delaware 19903, Telephone

(302) 736-3326

District of Columbia

Rodney T. Hallman, State Single Point of Contact, Office of Grants

Management and Development, 717 14th Street, NW., Suite 500,

Washington, DC 20005, Telephone (202) 727-6551

Florida

Florida State Clearinghouse, Intergovernmental Affairs Policy Unit,

Executive Office of the Governor, Office of Planning and Budgeting, The

Capitol, Tallahassee, Florida 32399-0001, Telephone (904) 488-8441

Georgia

Mr. Charles H. Badger, Administrator, Georgia State Clearinghouse, 254

Washington Street SW., Atlanta, Georgia 30334, Telephone (404) 656-3855

Illinois

Steve Klokkenga, State Single Point of Contact, Office of the Governor,

107 Stratton Building, Springfield, Illinois 62706, Telephone (217)

782-1671

Indiana

Jean S. Blackwell, Budget Director, State Budget Agency, 212 State

House, Indianapolis, Indiana 46204, Telephone (317) 232-5610

Iowa

Mr. Steven R. McCann, Division of Community Progress, Iowa Department

of Economic Development, 200 East Grand Avenue, Des Moines, Iowa 50309,

Telephone (515) 281-3725

Kentucky

Ronald W. Cook, Office of the Governor, Department of Local Government,

1024 Capitol Center Drive, Frankfort, Kentucky 40601, Telephone (502)

564-2382

Maine

Ms. Joyce Benson, State Planning Office, State House Station #38,

Augusta, Maine 04333, Telephone (207) 289-3261

Maryland

Ms. Mary Abrams, Chief, Maryland State Clearinghouse, Department of

State Planning, 301 West Preston Street, Baltimore, Maryland 21201-

2365, Telephone (301) 225-4490

Massachusetts

Karen Arone, State Clearinghouse, Executive Office of Communities and

Development, 100 Cambridge Street, Room 1803, Boston, Massachusetts

02202, Telephone (617) 727-7001

Michigan

Richard S. Pastula, Director, Michigan Department of Commerce, Lansing,

Michigan 48909, Telephone (517) 373-7356 [[Page 12852]]

Mississippi

Ms. Cathy Mallette, Clearinghouse Officer, Office of Federal Grant

Management and Reporting, 301 West Pearl Street, Jackson, Mississippi

39203, Telephone (601) 960-2174

Missouri

Ms. Lois Pohl, Federal Assistance Clearinghouse, Office of

Administration, P.O. Box 809, Room 430, Truman Building, Jefferson

City, Missouri 65102, Telephone (314) 751-4834

Nevada

Department of Administration, State Clearinghouse, Capitol Complex,

Carson City, Nevada 89710, Telephone (702) 687-4065, Attention: Ron

Sparks, Clearinghouse Coordinator

New Hampshire

Mr. Jeffrey H. Taylor, Director, New Hampshire Office of State

Planning, Attn: Intergovernmental Review, Process/James E. Bieber, 2\1/

2\ Beacon Street, Concord, New Hampshire 03301, Telephone (603) 271-

2155

New Jersey

Gregory W. Adkins, Acting Director, Division of Community Resources,

N.J. Department of Community Affairs, Trenton, New Jersey 08625-0803,

Telephone (609) 292-6613

Please direct correspondence and questions to: Andrew J. Jaskolka,

State Review Process, Division of Community Resources, CN 814, Room

609, Trenton, New Jersey 08625-0803, Telephone (609) 292-9025

New Mexico

George Elliott, Deputy Director, State Budget Division, Room 190,

Bataan Memorial Building, Santa Fe, New Mexico 87503, Telephone (505)

827-3640, FAX (505) 827-3006

New York

New York State Clearinghouse, Division of the Budget, State Capitol,

Albany, New York 12224, Telephone (518) 474-1605

North Carolina

Mrs. Chrys Baggett, Director, Office of the Secretary of Admin., N.C.

State Clearinghouse, 116 W. Jones Street, Raleigh, North Carolina

27603-8003, Telephone (919) 733-7232

North Dakota

N.D. Single Point of Contact, Office of Intergovernmental Assistance,

Office of Management and Budget, 600 East Boulevard Avenue, Bismarck,

North Dakota 58505-0170, Telephone (701) 224-2094

Ohio

Larry Weaver, State Single Point of Contact, State/Federal Funds

Coordinator, State Clearinghouse, Office of Budget and Management, 30

East Broad Street, 34th Floor, Columbus, Ohio 43266-0411, Telephone

(614) 466-0698

Rhode Island

Mr. Daniel W. Varin, Associate Director, Statewide Planning Program,

Department of Administration, Division of Planning, 265 Melrose Street,

Providence, Rhode Island 02907, Telephone (401) 277-2656

Please direct correspondence and questions to: Review Coordinator,

Office of Strategic Planning

South Carolina

Omeagia Burgess, State Single Point of Contact, Grant Services, Office

of the Governor, 1205 Pendleton Street, Room 477, Columbia, South

Carolina 29201, Telephone (803) 734-0494

Tennessee

Mr. Charles Brown, State Single Point of Contact, State Planning

Office, 500 Charlotte Avenue, 309 John Sevier Building, Nashville,

Tennessee 37219, Telephone (615) 741-1676

Texas

Mr. Thomas Adams, Governor's Office of Budget and Planning, P.O. Box

12428, Austin, Texas 78711, Telephone (512) 463-1778

Utah

Utah State Clearinghouse, Office of Planning and Budget, ATTN: Carolyn

Wright, Room 116 State Capitol, Salt Lake City, Utah 84114, Telephone

(801) 538-1535

Vermont

Mr. Bernard D. Johnson, Assistant Director, Office of Policy Research &

Coordination, Pavilion Office Building, 109 State Street, Montpelier,

Vermont 05602, Telephone (802) 828-3326

West Virginia

Mr. Fred Cutlip, Director, Community Development Division, West

Virginia Development Office, Building #6, Room 553, Charleston, West

Virginia 25305, Telephone (304) 348-4010

Wisconsin

Mr. William C. Carey, Federal/State Relations, Wisconsin Department of

Administration, 101 South Webster Street, P.O. Box 7864, Madison,

Wisconsin 53707, Telephone (608) 266-0267

Wyoming

Sheryl Jeffries, State Single Point of Contact, Herschler Building, 4th

Floor, East Wing, Cheyenne, Wyoming 82002, Telephone (307) 777-7574

Guam

Mr. Michael J. Reidy, Director, Bureau of Budget and Management

Research, Office of the Governor, P.O. Box 2950, Agana, Guam 96910,

Telephone (671) 472-2285

Northern Mariana Islands

State Single Point of Contact, Planning and Budget Office, Office of

the Governor, Saipan, CM, Northern Mariana Islands 96950

Puerto Rico

Norma Burgos/Jose H. Caro, Chairman/Director, Puerto Rico Planning

Board, Minillas Government Center, P.O. Box 41119, San Juan, Puerto

Rico 00940-9985, Telephone (809) 727-4444

Virgin Islands

Jose L. George, Director, Office of Management and Budget, #41

Norregade Emancipation Garden Station, Second Floor, Saint Thomas,

Virgin Islands 00802, Please direct correspondence to: Linda Clarke,

Telephone (809) 774-0750.

Attachment F--Certification Regarding Lobbying

Certification for Contracts, Grants, Loans, and Cooperative Agreements

The undersigned certifies, to the best of his or her knowledge and

belief, that:

(1) No Federal appropriated funds have been paid or will be paid,

by or on behalf of the undersigned, to any person for influencing or

attempting to influence an officer or employee of any agency, a Member

of Congress, an officer or employee of Congress, or an employee of a

Member of Congress in connection with the awarding of any Federal

contract, the making of any Federal grant, the making of any Federal

loan, the entering into of any cooperative agreement, and the

extension, continuation, renewal, amendment, or modification of any

Federal contract, grant, loan, or cooperative agreement.

(2) If any funds other than Federal appropriated funds have been

paid or will be paid to any person for influencing or attempting to

influence an officer or employee of any agency, a Member of Congress,

an officer or employee of Congress, or an employee [[Page 12853]] of a

Member of Congress in connection with this Federal contract, grant,

loan or cooperative agreement, the undersigned shall complete and

submit Standard Form-LLL, ``Disclosure Form to Report Lobbying,'' in

accordance with its instructions.

(3) The undersigned shall require that the language of this

certification be included in the award documents for all subawards at

all tiers (including subcontracts, subgrants, and contracts under

grants, loans, and cooperative agreements) and that all subrecipients

shall certify and disclose accordingly.

This certification is a material representation of fact upon which

reliance was placed when this transaction was made or entered into.

Submission of this certification is a prerequisite for making or

entering into this transaction imposed by section 1352, title 31, U.S.

Code. Any person who fails to file the required certification shall be

subject to a civil penalty of not less than $10,000 and not more than

$100,000 for each such failure.

State for Loan Guarantee and Loan Insurance

The undersigned states, to the best of his or her knowledge and

belief, that:

If any funds have been paid or will be paid to any persons for

influencing or attempting to influence an officer or employee of any

agency, a Member of Congress, an officer or employee of Congress, or an

employee of a Member of Congress in connection with this commitment

providing for the United States to insure or guarantee a loan, the

undersigned shall complete and submit Standard Form-LLL ``Disclosure

Form to Report Lobbying,'' in accordance with its instructions.

Submission of this statement is a prerequisite for making or

entering into this transaction imposed by section 1352, title 31, U.S.

Code. Any person who fails to file the require statement shall be

subject to a civil penalty of not less than $10,000 and not more than

$100,000 for each such failure.

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BILLING CODE 4184-01-M

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BILLING CODE 4184-01-C

[[Page 12855]]

Attachment G--DHHS Regulations Applying to All Applicants/Grantees

Under the Job Opportunities for Low-Income Individuals Program

Title 45 of the Code of Federal Regulations:

Part 16--Department of Grant Appeals Process

Part 74--Administration of Grants (non-governmental)

Part 74--Administration of Grants (state and local governments and

Indian Tribal affiliates):

Sections 74.62(a) Non-Federal Audits

74.173 Hospitals

74.174(b) Other Nonprofit Organizations

74.304 Final Decisions in Disputes

74.710 Real Property, Equipment and Supplies

74.715 General Program Income

Part 75--Informal Grant Appeal Procedures

Part 76--Debarment and Suspension from Eligibility for Financial

Assistance; Subpart F--Drug Free Workplace Requirements

Part 80--Non-Discrimination Under Programs Receiving Federal Assistance

through the Department of Health and Human Services Effectuation of

Title VI of the Civil Rights Act of 1964

Part 81--Practice and Procedures for Hearings Under Part 80 of this

Title

Part 83--Non-discrimination on the basis of sex in the admission of

individuals to training programs

Part 84--Non-discrimination on the Basis of Handicap in Programs

Part 91--Non-discrimination on the Basis of Age in Health and Human

Services Programs or Activities Receiving Federal Financial Assistance

Part 92--Uniform Administrative Requirements for Grants and Cooperative

Agreements to States and Local Governments (Federal Register, March 11,

1988)

Part 93--New Restrictions on Lobbying

Part 100--Intergovernmental Review of Department of Health and Human

Services Programs and Activities

Attachment H--Certification Regarding Maintenance of Effort

The undersigned certifies that:

(1) activities funded under this program announcement are in

addition to, and not in substitution for, activities previously carried

on without Federal assistance.

(2) funds or other resources currently devoted to activities

designed to meet the needs of the poor within a community, area, or

State have not been reduced in order to provide the required matching

contributions.

When legislation for a particular block grant permits the use of

its funds as match, the applicant must show that it has received a real

increase in its block grant allotment and must certify that other anti-

poverty programs will not be scaled back to provide the match required

for this project.

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Organization

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Authorized Signature

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Title

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Date

Attachment I--Department of Health & Human Services Administration for

Children and Families, Office of Family Assistance, Washington, DC

20447

February 1994

Jobs Program Directory

Alabama

Claire Ealy, Director, Office of Work and Training Services, Public

Assistance Division, S. Gordon Persons Building, 50 Ripley Street,

Montgomery, Alabama 36130, (205) 242-1950

Alaska

Charles Knittel, Work Programs Coordinator, Division of Public

Assistance, Department of Health and Social Service, P.O. Box 110640,

Juneau, Alaska 99811-0640, (907) 465-3347

Arizona

Gretchen Evans, JOBS Program Director, Dept. of Economic Security, P.O.

Box 6123, Site Code 8011, Phoenix, Arizona 85005, (602) 542-6310

Arkansas

Ken Whitlock, Deputy Director, Project SUCCESS, Department of Human

Services, P.O. Box 1437, Little Rock, Arkansas 72203, (501) 682-8375

California

Bruce Wagstaff, Chief, Employment & Immigrations Programs Branch,

Department of Social Services, 744 P Street M/S 6-700, Sacramento,

California 95814, (916) 657-2367

Colorado

Bob Henson, Director, Work Programs, Department of Social Services,

1575 Sherman Street, Denver, Colorado 80203, (303) 866-2643

Connecticut

Dawn Homer-Bouthiette, Planning Supervisor, Job Connection, Department

of Social Services, 110 Bartholomew Avenue, Hartford, Connecticut

06106, (203) 566-7125

Delaware

Rebecca Varella, Chief Administrator, Employment and Training, Division

of Social Services, P.O. Box 906, New Castle, Delaware 19720, (302)

577-4451

District of Columbia

Shari Curtis, Chief, Bureau of Training and Employment, Department of

Human Services, 33 N Street NE., Washington, DC 20001, (202) 727-1293

Florida

Reggis Smith, Chief, Benefit Recovery and Special Programs, Department

of Health and Rehabilitative Services, 1317 Winewood Boulevard, Bldg.

6, Tallahassee, Florida 32399-0700, (904) 487-2966

Georgia

Sylvia Elam, Chief, Employment Services Unit, Division of Family and

Children Services, Department of Human Resources, 2 Peachtree St., 14th

Floor, Room 402, Atlanta, Georgia 30303, (404) 657-3737

Guam

Diana Calvo, Social Services Supervisor, Department of Public Health

and Social Services, P.O. Box 2816, Agana, Guam 96910, (011-671) 734-

7286

Hawaii

Garry Kemp, Special Assistant to the Director, Department of Human

Services, P.O. Box 339, Honolulu, Hawaii, 96809, (808) 586-7054

Idaho

Kathy James, Acting Bureau Chief, Bureau of Family Self Support,

Department of Health and Welfare, 450 West State Street, Boise, Idaho

83720, (208) 334-5704

Illinois

Karan Maxson, Administrator, Division of Planning and Community

Services, Department of Public Aid, 100 S. Grand, 2nd Floor,

Springfield, Illinois 62762, (217) 785-3300

Indiana

Thomas Reel, Program Manager, IMPACT, Department of Public Welfare, 402

W. Washington, W. 363, Indianapolis, Indiana 46204, (317) 232-2002

Iowa

Doug Howard, Coordinator, Employment and Training Programs,

[[Page 12856]] Department of Human Services, Fifth Floor, Hoover State

Office Building, Des Moines, Iowa 50319, (515) 281-8629

Kansas

Phyllis Lewin, Director, Employment Preparation Services, Department of

Social and Rehabilitation Services, 300 SW Oakley, West Hall, Topeka,

Kansas 66606, (913) 296-4276

Kentucky

Sharon Perry, Assistant Director, Center for Program Development,

Department of Social Insurance, Cabinet for Human Resources, 275 E.

Main Street, Frankfurt, Kentucky 40621, (502) 564-3703

Louisiana

Howard Prejean, Assistant Secretary, Department of Social Services,

Office of Eligibility Determination, P.O. Box 3776, Baton Rouge,

Louisiana 70821, (504) 342-4953

Maine

Barbara Van Burgel, ASPIRE Coordinator, Bureau of Income Maintenance,

Department of Human Services, Statehouse Station #11, 32 Winthrop St.,

Augusta, Maine 04333, (207) 289-3106

Maryland

Carlene Gallion, Acting Executive Director, Office of Project

Independence Management, Department of Human Resources, Room 745, 311

W. Saratoga Street, Baltimore, Maryland 21201, (410) 333-0837

Massachusetts

John Buonomo, Director, Massachusetts JOBS Program, Department of

Public Welfare, 600 Washington St., Boston, Massachusetts 02111, (617)

348-5931

Michigan

Alex D. Hawkins, Director, Job Skills Development Group, Michigan Jobs

Commission, 201 North Washington Square, Third floor, Victor Centre,

Lansing, Michigan 48913, (517) 373-7382

Minnesota

Bonnie Baker, Supervisor, Program Development, Department of Human

Services, 444 Lafayette Road, St. Paul, Minnesota 55155, (612) 296-2499

Mississippi

Jean Temple, Director, JOBS Branch, Office of Children & Youth,

Department of Human Services, 421 W. Pascagoula, Jackson, Mississippi

29302, (601) 359-4855

Missouri

Richard Koon, FUTURES Program Director, Income Maintenance, Division of

Family Services, 72728 Plaza Drive, P.O. Box 88, Jefferson City,

Missouri 65103, (314) 751-3124

Montana

Marylis Filipovich, Bureau Chief, Program & Policy, Department of

Social and Rehabilitation Services, P.O. Box 4210, Helena, Montana

59604, (406) 444-4540

Nebraska

Margaret Hall, Public Assistance Administrator, Public Assistance

Division, Department of Social Services, 301 Centennial Mall South,

P.O. Box 95026, Lincoln, Nebraska 68509, (402) 471-3121

Nevada

John Alexander, Employment & Training Coordinator, Nevada State Welfare

Division, Capitol Complex, 2527 North Carson Street, Carson City,

Nevada 89710, (702) 687-4143

New Hampshire

Arthur Chicaderis, JOBS Administrator, Employment Support Services,

Office of Economic Services, Division of Human Services, Department of

Health and Human Services, 6 Hazen Drive, Concord, New Hampshire 03301-

6521, (603) 271-4249

New Jersey

Marion E. Reitz, Director, Division of Family Development, Department

of Human Services, CN 716, Trenton, New Jersey 08625, (609) 588-2401

New Mexico

Bill Dunbar, Acting Director, Income Support Division, Department of

Human Services, P.O. Box 2348, Santa Fe, New Mexico 87500, (505) 827-

7252

New York

Jack Ryan, Director, Bureau of Employment Programs, Department of

Social Services, 40 North Pearl Street, Albany, New York 12243, (518)

473-8744

North Carolina

Lucy Burgess, Chief, Employment Programs Section, Department of Human

Resources, 325 North Salisbury Street, Raleigh, North Carolina 27611,

(919) 733-2873

North Dakota

Gloria House, JOBS Coordinator, Director of Public Assistance,

Department of Human Services, State Capitol, New Wing 3rd Floor,

Bismark, North Dakota 58505, (701) 224-4001

Ohio

Mary L. Harris, Deputy Director, Family Support and JOBS, Department of

Human Services, State Office Tower, 31st Floor, 30 East Broad Street,

Columbus, Ohio 43266-0423, (614) 466-3196

Oklahoma

Raymond Haddock, Division Administrator, Family Services Division,

Department of Human Services, P.O. Box 25352, Oklahoma City, Oklahoma

73125, (405) 521-3076

Oregon

Debbi White, JOBS Program Manager, Adult and Family Services Division,

Human Resource Bldg, 2nd Floor, Salem, Oregon 97310-1013, (503) 945-

6127

Pennsylvania

David Florey, Director, Bureau of Employment and Training Program,

Department of Public Welfare, P.O. Box 2675, Harrisburg, Pennsylvania

17105, (717) 787-8613

Puerto Rico

Migdalia Marrero, Special Asst. to Secretary, SOSEDF, Isla Grande,

Building #10, P.O. Box 11398, Santurce, Puerto Rico 00910, (809) 722-

2863

Rhode Island

Sherry Campanelli, Associate Director, Community Services, Department

of Human Services, 600 New London Avenue, Cranston, Rhode Island 02920,

(401) 464-2423

South Carolina

Hiram Spain, Executive Assistant for Self-Sufficiency, Department of

Social Services, P.O. Box 1520, Columbia, South Carolina 29202, (803)

737-5937

South Dakota

Julie Osnes, Administrator, Office of Family Independence, Department

of Social Services, Richard F. Kneip Building, Pierre, South Dakota

57501, (605) 773-3493

Tennessee

Wanda Moore, Director of Program Services, Department of Human

Services, 12th Floor, 400 Deadericks, Nashville, Tennessee 37219, (615)

741-6953 [[Page 12857]]

Texas

Irma Bermea, Deputy Commissioner, Department of Human Services, Mail

Code 521E, P.O. Box 2960, Austin, Texas 78769, (512) 450-3011

Utah

Helen Thatcher, Assistant Director, Office of Family Support,

Department of Human Services, 120 North 200 West, Salt Lake City, Utah

84145-0500, (801) 538-8231

Vermont

Steve Gold, Director, REACH-UP Program, Department of Social Welfare,

State Office Building, 103 South Main Street, Waterbury, Vermont 05676,

(802) 241-2800

Virgin Islands

Ermin Boshulte, Director, Public Assistance Programs, Department of

Human Services, Financial Programs Division, Knud Hansen Complex--

Building A, 1303 Hospital Ground, Charlotte Amalie, V.I. 00802, (809)

774-4673

Virginia

David Olds, Program Manager, Employment Services, Department of Social

Services, 730 E. Broad St, 2nd Floor, Richmond, Virginia 23219-1849,

(804) 692-1229

Washington

Lee Todorovich, Acting Assistant Director, Division of Income

Assistance, Department of Social and Health Services, P.O. Box 45400,

Olympia, Washington 98504-5400, (206) 438-8350

West Virginia

Sharon Paterno, Director, Division of Work and Training, Department of

Health and Human Services, Building 6, State Office Complex,

Charleston, West Virginia 25305, (304) 558-3186

Wisconsin

Jean Rogers, Administrator, Division of Economic Support, Department of

Health and Social Services, P.O. Box 7935, 1 West Wilson Street,

Madison, Wisconsin 53707-7935, (608) 266-3035

Wyoming

Kirk McKinney, JOBS Coordinator, Self-Sufficiency Division, Department

of Family Services, Hathaway Building, Rm 347, 2300 Capitol Avenue,

Cheyenne, Wyoming 82002-0710, (307) 777-6849

Attachment J: Checklist for Use in Submitting OCS Grant Applications

Job Opportunities for Low-Income Individuals (Optional)

The application should contain:

1. Table of Contents

2. A completed, signed SF-424, Application for Federal Assistance.

The letter code for the priority area (JO) should be in the lower

right-hand corner of the page.

3. A completed SF-424A, Budget Information--Non-Construction.

4. A narrative budget justification for each object class category

required under Section B, SF-424A;

5. Filled out signed, and dated Assurances--Non-Construction

Programs (SF-424B);

6. The applicant should sign Attachments E and F. In so doing, the

applicant is certifying that it will comply with the Federal

requirements concerning the drug-free workplace and debarment

regulations set forth in Attachments E.

7. A signed copy of Certification Regarding Anti-Lobbying

Activities.

8. A completed Disclosure of Lobbying Activities, if applicable.

9. An Executive Summary--not to exceed 300 words;

10. A Project Narrative beginning with a Table of Contents that

describes the project in the following order:

(1) Eligibility Confirmation

(ii) Organizational Experience and Staff Responsibilities

(iii) Analysis of Need

(iv) Project Design/Work Program

(v) Business Plan (If appropriate)

(vi) Third-Party Evaluation

(vii) Cooperative Partnership Agreement

(viii) Budget Appropriateness and Reasonableness

11. Appendices, including proof of non-profit status; proof that

the organization is a community development corporation, if applying

under the CDC Set-aside; a signed copy of the Cooperative Partnership

Agreement or letter of commitment with State IV-A agency (JOBS

Program); commitments from officials of businesses that will be

expanded or from franchises, where applicable; Single Point of Contact

comments, if applicable; Maintenance of Effort Certification and

resumes.

12. A self-addressed mailing label which can be affixed to a

postcard to acknowledge receipt of application.

Attachment K

Federal Highway Administration, Regional Civil Rights Directors

Region One--Includes CT, ME, MA, NH, NJ, NY, RI, VT, Puerto Rico, and

the Virgin Islands

Mr. Dennis Perrott

Albany, NY

(518) 431-4224, ext. 247

Region Three--Includes DE, DC, MD, PA, VA, WV

Ms. Jo Blackstone

Baltimore, MD

(410) 962-4030

Region Four--Includes AL, FL, GA, KY, MS, NC, SC, TN

Mr. Charles Stinson

Atlanta, GA

(404) 347-4791

Region Five--Includes IL, IN, MI, MN, OH, WI

Mr. Joe Forst

Olympia Fields, IL

(708) 283-3924

Region Six--Includes AR, LA, NM, OK, TX

Mr. Humberto Martinez

Fort Worth, TX

(817) 334-3671

Region Seven--Includes IA, KS, MO, NE

Mr. Glen Smith

Kansas City, MO

(816) 276-2747

Region Eight--Includes CO, MT, ND, SD, UT, WY

Ms. Teresa Banks

Lakewood, CO

Region Nine--Includes AZ, CA, HI, NV, Guam, and American Samoa

Mr. Harold Dorell

San Francisco, CA

(415) 744-3114

Region Ten--Includes AK, ID, OR, WA

Mr. Willie Harris

Portland, OR

(503) 326-2067

Attachment L--Certification Regarding Environmental Tobacco Smoke

Public Law 103-227, Part C--Environmental Tobacco Smoke, also known

as the Pro-Children Act of 1994 (Act), requires that smoking not be

permitted in any portion of any indoor routinely owned or leased or

contracted for by an entity and used routinely or regularly for

provision of health, day care, education, or library services to

children under the age of 18, if the services are funded by Federal

programs either directly or through State or local governments, by

Federal grant, contract, loan, or loan guarantee. The law does not

apply to children's services provided in private residence, facilities

funded solely by Medicare or Medicaid funds, and portions of facilities

used for inpatient drug or alcohol treatment. [[Page 12858]] Failure to

comply with the provisions of the law may result in the imposition of a

civil monetary penalty of up to $1000 per day and/or the imposition of

an administrative compliance order on the responsible entity.

By signing and submitting this application the applicant/grantee

certifies that it will comply with the requirements of the Act. The

applicant/grantee further agrees that it will require the language of

this certification be included in any subawards which contain

provisions for the children's services and that all subgrantees shall

certify accordingly.

[FR Doc. 95-5512 Filed 3-7-95; 8:45 am]

BILLING CODE 4184-01-P