Responsible Fatherhood Projects

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families

Responsible Fatherhood Projects

AGENCY: Administration for Children and Families, (ACF), Department of

Health and Human Services, (HHS).

[[Page 17067]] ACTION: Announcement of the availability of funds and

request for applications to demonstrate promising program interventions

to encourage and increase responsible fatherhood.

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SUMMARY: The Administration for Children and Families (ACF) announces

the availability of Federal funding to demonstrate promising program

interventions to encourage and increase responsible fatherhood. Funding

under this announcement is authorized by section 1110 of the Social

Security Act governing Social Services Research and Demonstration

activities (Catalog of Federal Domestic Assistance 93.647).

DATES: The closing date for submission of applications is June 5, 1995.

MAILING ADDRESSES: William J. McCarron, Administration for Children and

Families, Division of Discretionary Grants--Room 6C-462, 370 L'Enfant

Promenade SW., Washington, DC 20447. For hand delivered applications,

use: William J. McCarron, Administration for Children and Families,

Division of Discretionary Grants, 6th Floor, ACF Guard Station, 901 D

Street SW., Washington, DC 20447.

FOR FURTHER INFORMATION CONTACT: Mark Fucello, Administration for

Children and Families, Office of Policy and Evaluation, 370 L'Enfant

Promenade SW., Washington, DC 20447. Telephone (202) 401-4538.

SUPPLEMENTARY INFORMATION: The Administration for Children and Families

announces that competing applications are being accepted for Federal

financial assistance to demonstrate promising program interventions to

encourage and increase responsible fatherhood. Up to five awards will

be made under this announcement for project periods of 24 months. Each

successful recipient will receive a financial award for an initial

budget period of 17 months. The second budget period, consisting of

months 18 through 24, will be unfunded with Federal funds; applicants

are encouraged to secure other sources of funding to cover these latter

months of the project period. Each recipient will be expected to enter

into a cooperative agreement with ACF which will outline the terms of

ACF's interest and involvement in the project and the responsibilities

of the recipient.

This program announcement consists of three parts. Part I describes

the activities supported by this announcement and application

requirements. Part II describes the application review process. Part

III provides information and instructions for the development and

submission of applications. The forms to be used for submitting an

application follow Part III.

Part I.--Project Design

Purpose

The purpose of the announcement is to inform the public of the

availability of Federal funding to demonstrate promising program

interventions to encourage and increase responsible fatherhood. There

is a growing body of evidence suggesting that the impact of fathers'

participation on children's behavior is significant. Although research

does not suggest a straightforward relationship between paternal

participation in child rearing and child well-being, it can be

reasonably assumed that children benefit emotionally and

developmentally when fathers play a larger role in children's lives.

According to this program announcement, ACF will provide funding to

community programs designed to strengthen the role and parenting

abilities of fathers and to enable fathers to relate positively to

their children and their children's mothers. The target populations for

these programs should encompass a wide range of fathers including

disadvantaged, never-married non-custodial fathers; separated or

divorced non-custodial fathers, as well as fathers living with their

children.

The recipients will operate projects designed to create an

environment where fathers are encouraged and supported in conduct that

allows them to improve the quality of life for their families. Projects

should provide comprehensive services designed to assist men and their

families for the purpose of attempting to reverse the negative trends

among adults and youth related to at-risk behaviors such as substance

abuse, gang involvement, school failure, and unemployment. Beyond

encouraging and increasing basic responsible acts such as establishing

paternity and encouraging contact between father and children, programs

should teach fathers:

How to understand their children's development,

How to understand and positively affect their children's

behavior,

How to be positive role models for their children, and

How to work constructively with the children's mother for

the benefit of the children regardless of whether both parents live in

the same household as the children.

Eligible Applicants

Organizations eligible to apply for financial assistance under this

announcement include States, local governments, and public or private

nonprofit organizations. Any nonprofit organization submitting an

application must submit proof of its nonprofit status in its

application at the time of submission. The nonprofit agency can

accomplish this by providing a copy of the applicant's listing in the

Internal Revenue Service's (IRS) most recent list of tax-exempt

organizations described in section 501(c)(3) of the IRS code or by

providing a copy of the currently valid IRS tax exemption certificate,

or by providing a copy of the articles of incorporation bearing the

seal of the State in which the corporation or association is domiciled.

ACF is interested in providing financial support to organizations:

With experience in working with fathers and which are knowledgeable

about the issues concerning fathers; with developed plans and methods

to teach fathers how to act responsibly and to understand their

children's development and positively affect their children's behavior;

and which have significant, long-term financial support ensuring

uninterrupted project operation beyond the projected period of federal

assistance.

Minimum Requirements for Project Design

In order to compete successfully in response to this announcement,

the applicant should develop an application which:

Describes the applicant's experience in working with

fathers. The description should highlight the applicant's experience in

coordinating services from different providers or levels of government

aimed at encouraging men to be responsible fathers and should describe

the men whom the project has served. The types of services provided or

to which clients are referred may include health and nutrition

instruction, employment and career counseling, parenting education,

peer support, and formal and informal mediation and dispute resolution

with the children's mother, etc.

Explains the applicant's methods to teach fathers how to

act responsibly and to adopt behaviors which exemplify the following

principles: Raising children requires an active commitment from both

parents--financially and emotionally; employment is important to being

a responsible father not only to provide financial support but also to

be a good role model; and successful child-rearing depends on

understanding how children develop. The application must explain in

detail how the proposed project aims to enable fathers at risk of

[[Page 17068]] destructive behaviors to develop an achievement

orientation from which they will be better able to act responsibly and

to interact constructively with the children and the children's mother

regardless of whether both parents live in the same household as the

children.

Identifies the typical settings or points in fathers'

lives that the applicant first engages and enrolls individuals for

program services, e.g., in-hospital recruitment of new fathers,

community centers where neighborhood men gather, half-way houses, etc.

ACF is interested in funding a group of programs which together engage

men at various points in their lives and in various settings to help

develop for the public a better understanding about how to structure

programs and services for fathers.

Includes assurance that the recipient will produce two

major reports (in addition to regular quarterly progress reports) to be

issued during the project. The initial major report, due mid-way into

the project, should discuss program implementation and participation

and activities of fathers, including a discussion of program approaches

and activities, paternity establishment, level of employment among

participating fathers, and level of contact of fathers with their

children as well as with the children's mother. The final report, due

at the end of the project (90 days after the end of the 24-month

project period), should cover the topics discussed above with longer

follow-up and more detailed discussion of the project's staffing

structure; procedures for referrals to services and coordination with

other public and private agencies; type and duration of services

actually provided; procedures and criteria used in recruitment and

training of staff; and recommendations for others seeking to establish

similar projects. Recommendations should include a discussion of the

project's contextual factors, such as the social, economic, and

political forces that may have a bearing on the implementation of this

type of project. These reports are intended to further the general

knowledge of the public, community-based organizations, and social

service departments regarding program interventions to increase

responsible fatherhood. In addition regular quarterly progress reports

must be submitted within 60 days of the end of each quarter of the 24-

month project period.

Includes assurance of the recipient's willingness and

intention to participate in and cooperate with evaluability assessment

activities to be funded by the Department of Health and Human Services,

possibly leading to a full-scale program evaluation if determined to be

feasible.

Includes financial support for project activities in

addition to Federal funding to ensure uninterrupted project operation

over the project period. ACF will give preference to applicants who

provide evidence of significant, long-term financial support ensuring

uninterrupted project operation beyond the period of federal

assistance. Applicants should provide evidence of funding commitments

from organizations such as private foundations.

Also, the recipient must be prepared to enter into a cooperative

agreement with ACF which will outline the terms of ACF's interest and

involvement in the project and the responsibilities of the recipient.

The cooperative agreement:

(a) Will provide that ACF retain authority for review of

significant program design changes from the model proposed in the

original application; (b) will provide that ACF maintain involvement in

any evaluability assessment activities to be funded by the Department

of Health and Human Services, and (c) will provide for ACF review of

reports (other than quarterly progress reports) before publication.

Project Duration

This announcement is soliciting applications for project periods of

24 months. Awards, on a competitive basis, will be for an initial 17-

month budget period, although project periods will be for 24 months,

subject to availability of funds. Each recipient will receive an

initial financial award for 17 months. The second budget period,

consisting of months 18 through 24, will be unfunded with Federal

funds; applicants are encouraged to secure other sources of funding to

cover these latter months of the project period.

Federal Share of the Project

The maximum Federal share of each project is not to exceed $85,000

for the initial 17-month budget period, subject to the availability of

funds.

Matching Requirement

Recipients must provide at least 20 percent of the total approved

cost of the project. The total approved cost of the project is the sum

of the ACF share and the non-Federal share. The non-Federal share may

be met by in-kind contributions from a third party or cash, although

applicants are encouraged to meet their match requirements through cash

contributions. Therefore, a project requesting $85,000 in Federal funds

must include a match of at least $21,250 (20 percent of total project

cost).

If approved for funding, recipients will be held accountable for

commitments of non-Federal resources; and failure to provide the

required amount will result in a disallowance of unmatched Federal

funds.

Anticipated number of Projects to be Funded

Five projects will be funded under this announcement. A single

organization may apply on behalf of separate project sites operated by

the same organization. If operated by the same organization, each

project site which applies must submit a separate application.

Part II--The Review Process

A. Review Process and Funding Decisions

Timely applications from eligible applicants will be reviewed and

scored competitively. Reviewers will use the evaluation criteria listed

below to review and score the application.

In addition ACF may refer applications for review to other Federal

or non-Federal entities when it is determined to be in the best

interest of the Federal Government or the applicant. It may also

solicit comments from ACF Regional Office staff, other Federal

agencies, interested foundations and national organizations. These

comments along with those of the reviewers will be considered by ACF in

making the funding decision.

In making a funding decision, ACF may give preference to

applications which reflect experience in working with fathers since

such experience on the part of an applicant has the potential to

substantially improve the theory and practice of increasing responsible

behavior among fathers and improving the well-being of their children.

ACF may also give preference to applicants who make a greater

financial commitment to the demonstration since a greater total

financial investment than the minimum required in this announcement has

the potential of producing a high benefit in furthering knowledge about

policies and practice of working with fathers for a low Federal

investment.

B. Evaluation Criteria

Using the evaluation criteria below, reviewers will review and

score each application. Applicants should insure that they address each

minimum requirement listed above.

Reviewers will determine the strengths and weaknesses of each

[[Page 17069]] application in terms of the appropriate evaluation

criteria listed below, provide comments, and assign numerical scores.

The point value following each criterion heading indicates the maximum

numerical weight that each criterion may be given in the review

process.

Review Criteria

(1) Organizational experience (15 points) The application should

provide evidence of organizational experience in working with fathers

including disadvantaged, never-married non-custodial fathers; separated

or divorced non-custodial fathers, as well as fathers living with their

children. Evidence of this experience should include a complete

description of past or current projects which serve fathers and are

aimed at improving their understanding of their responsibilities to

their children, their roles as fathers, and their children's

development.

(2) Staff skills and responsibilities (15 points) The application

should list each consultant or other key individuals who will work on

the project along with a short description of the nature of their

contribution. Summarize the background and experience of the project

director and key project staff. Applicants are encouraged to discuss

staff experience in working with fathers.

(3) Knowledge of issues concerning fathers (15 points) The

application should provide evidence of the applicant's understanding of

the demographics and experiences of fathers, including disadvantaged,

never-married non-custodial fathers; separated or divorced non-

custodial fathers, as well as fathers living with their children.

Evidence of this understanding should include (a) knowledge of key

issues concerning fathers, any obstacles to effecting healthy levels of

paternal involvement in their children's lives, and strengths and

deficits of fathers in meeting their responsibilities to their

children; and (b) if appropriate to the target population of fathers

considered, familiarity with how men interact with child support

enforcement systems, courts, employment and training programs, and

social service agencies.

(4) Approach and project design (50 points) The application should

describe how the organization will operate projects designed to create

an environment where fathers are encouraged and supported in conduct

that allows them to improve the quality of life for their families. The

application should explain the applicant's methods to teach fathers how

to act responsibly and to adopt behaviors which exemplify the following

principles: Raising children requires an active commitment from both

parents--financially and emotionally; employment is important to being

a responsible father not only to provide financial support but also to

be a good role model; and successful child-rearing depends on

understanding how children develop. The application must explain in

detail the typical settings or points in fathers' lives that the

applicant first plans to engage and enroll individuals for program

services, e.g., in-hospital, community centers, employment agency, etc.

The application should explain how the project plans to increase basic

responsible acts among fathers, such as establishing paternity and

encouraging contact between father and children, but also, and more

important, how programs will teach fathers to understand their

children's development, to understand and positively affect their

children's behavior, to be positive role models for their children, and

to work constructively with the children and the children's mother

regardless of whether both parents live in the same household as the

children. The application should also describe the types of services to

be provided or to which clients will be referred, e.g., health and

nutrition instruction, employment and career counseling, parenting

education, peer support, formal and informal mediation and dispute

resolution with the children's mother, etc.

(5) Budget Appropriateness (5 points) The application should

demonstrate that the project's costs are reasonable in view of the

anticipated results and benefits. Applicants may refer to the budget

information presented in the Standard Forms 424 and 424A.

Part III. Instructions for the Development and Submission of

Applications

This part contains information and instructions for submitting

applications in response to this announcement. Application forms are

provided as part of this announcement along with a checklist for

assembling an application package.

A. Required Notification of the State Single Point of Contact

This program announcement 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, Virginia, Pennsylvania, South Dakota,

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

Executive Order process and have established Single Points of Contact

(SPOCs), listed at the end of this announcement. 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 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, Washington, DC. 20447.

B. Deadline for Submittal of Applications

Applications shall be considered as meeting an announced deadline

if they are either:

1. Received on or before the deadline date at the receipt point

specified in this program announcement, or

2. Sent on or before the deadline date and received by ACF in time

for the independent review. Applicants are cautioned to request a

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

receipt from a commercial carrier or U.S. Postal Service. Private

[[Page 17070]] Metered postmarks shall not be acceptable as proof of

timely mailing.

Late applications: Applications which do not meet the criteria in 1

and 2 above are considered late applications. ACF shall notify each

late applicant that its application will not be considered in the

current competition.

Extension of deadlines: ACF may extend the deadline for all

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

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

does not extend the deadline for all applicants, it will not extend the

deadline for any applicants.

C. Instructions for Preparing the Application

In order to assist applicants in completing the application, the

Standard Forms 424 and 424A, required certifications, and a list of

SPOCs have been included at the end of Part III of this announcement.

Please reproduce single-sided copies of these forms from the reprinted

forms and type your information onto the copies. Do not use forms

directly from the Federal Register announcement, as they are printed on

both sides of the page.

Please prepare your application in accordance with the following

instructions:

1. SF 424 Page 1, Application Cover Sheet

Please read the following instructions before completing the

application cover sheet. An explanation of each item is included.

Complete only the items specified.

Item 1. ``Type of Submission''--Non-Construction.

Item 2. ``Date Submitted'' and ``Applicant Identifier''--Date

application is submitted to ACF and applicant's own internal control

number, if applicable.

Item 3. ``Date Received By State''--State use only (if applicable).

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

Item 5. ``Applicant Information'' ``Legal Name''--Enter the legal

name of applicant organization. For applications developed jointly,

enter the name of the lead organization only. There must be a single

applicant for each application.

``Organizational Unit''--Enter the name of the primary unit within

the applicant organization which will actually carry out the project

activity. If this is the same as the applicant organization, leave the

organizational unit blank.

``Address''--Enter the complete address that the organization

actually uses to receive mail, since this is the address to which all

correspondence will be sent. Do not include both street address and

P.O. box number unless both must be used in mailing.

``Name and telephone number of the person to be contacted on

matters involving this application (give area code)''--Enter the full

name and telephone number of a person who can respond to questions

about the application. This person should be accessible at the address

given.

Item 6. ``Employer Identification Number (EIN)''--Enter the

employer identification number of the applicant organization, as

assigned by the Internal Revenue Service, including, if known, the

Central Registry System suffix.

Item 7. ``Type of Applicant''--Self-explanatory.

Item 8. ``Type of Application''--New.

Item 9. ``Name of Federal Agency''--DHHS/ACF.

Item 10. ``Catalog of Federal Domestic Assistance Number''--93.647.

Item 11. ``Descriptive Title of Applicant's Project''--Responsible

Fatherhood Project.

Item 12. ``Areas Affected by Project''--Self-explanatory.

Item 13. ``Proposed Project''--Enter the desired start date for the

project and projected completion date.

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

number of the Congressional district where the applicant's principal

office is located.

Items 15 ``Estimated Funding Levels''--In completing 15a through

15f, the dollar amounts entered should reflect the total amount

requested for the initial 17-month budget period.

Item 15a. Enter the amount of Federal funds requested in accordance

with the preceding paragraph. This amount should be no greater than the

maximum amount available under this announcement for the initial 17-

month budget period.

Items 15b-e Enter the amount(s) of funds from non-Federal sources

that will be contributed to the proposed project. Items b-e are

considered cost-sharing or ``matching funds.''

Item 15f. Enter the estimated amount of income, if any, expected to

be generated from the proposed project. Do not add or subtract this

amount from the total project amount entered under item 15g. Describe

the nature, source and anticipated use of this income in the Project

Narrative Statement.

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

Item 16a. ``Is Application Subject to Review By State Executive

Order 12372 Process?--Check ``Yes'' if your State participates in the

E.O. 12372 process. Enter the date the application was made available

to the State for review. Select the appropriate SPOC from the listing

provided at the end of Part IV. The review of the application is at the

discretion of the SPOC.

Item 16b. ``Is Application Subject to Review By State Executive

Order 12372 Process?--Check ``No'' if the program has not been selected

by State for review.

Item 17. ``Is the Applicant Delinquent on any Federal Debt?''--

Check the appropriate box. This question applies to the applicant

organization, not the person who signs as the authorized

representative. Categories of debt include audit disallowances, loans

and taxes.

Item 18. ``To the best of my knowledge and belief, all data in this

application/preapplication are true and correct. The document has been

duly authorized by the governing body of the applicant and the

applicant will comply with the attached assurances if the assistance is

awarded.''--To be signed by the authorized representative of the

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

of this application by this individual as the official representative

must be on file in the applicant's office, and may be requested from

the applicant.

Item 18a-c. ``Typed Name of Authorized Representative, Title,

Telephone Number''--Enter the name, title and telephone number of the

authorized representative of the applicant organization.

Item 18d. ``Signature of Authorized Representative''--Signature of

the authorized representative named in Item 18a. At least one copy of

the application must have an original signature. Use colored ink (not

black) so that the original signature is easily identified.

Item 18e. ``Date Signed''--Enter the date the application was

signed by the authorized representative.

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

This is a form used by many Federal agencies. For this application,

Sections A, B, and C are to be completed. Sections D, E and F do not

need to be completed.

Section A--Budget Summary. Line 1:

Column (a): Enter ``Responsible Fatherhood'';

Column (b): Enter 93.647.

Columns (c) and (d): Leave blank.

Columns (e), (f) and (g): Enter the appropriate amounts needed to

support the project for the budget period.

Section B--Budget Categories. This budget should include the

Federal as well as non-Federal funding for the proposed project for the

budget period. [[Page 17071]] The budget should relate to item 15g,

total funding, on the SF 424. Under column (5), enter the total

requirements for funds (Federal and non-Federal) by object class

category.

A separate budget justification should be included to explain fully

and justify major items, as indicated below. The types of information

to be included in the justification are indicated under each category.

The budget justification should immediately follow the second page of

the SF 424A.

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

applicant/grantee staff. Do not include the costs of consultants, which

should be included on line 6h, ``Other.''

Justification: Identify the project director, if known. Specify by

title or name the percentage of time allocated to the project, the

individual annual salaries, and the cost to the project (both Federal

and non-Federal) of the organization's staff who will be working on the

project.

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

Justification: Provide a break-down of amounts and percentages that

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

retirement insurance, etc.

Travel--6c. Enter total costs of out-of-town travel (travel

requiring per diem) for staff of the project. Do not enter costs for

consultant's travel or local transportation, which should be included

on Line 6h, ``Other.''

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

trips, destinations, length of stay, transportation costs and

subsistence allowances.

Equipment--Line 6d. Enter the total costs of all equipment to be

acquired by the project. For grants governed by the administrative

requirements of either 45 CFR Part 92 or 45 CFR Part 74, equipment is

defined as tangible, non-expendable personal property having a useful

life of more than one year and an acquisition cost of $5,000 or more

per unit.

Justification: Equipment to be purchased with Federal funds must be

justified. The equipment must be required to conduct the project, and

the applicant organization or its subgrantees must not have the

equipment or a reasonable facsimile available to the project. The

justification also must contain plans for future use or disposal of the

equipment after the project ends.

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

personal property (supplies) other than those included on Line 6d.

Justification: Specify general categories of supplies and their

costs.

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

including procurement contracts (except those which belong on other

lines such as equipment, supplies, etc.) and contracts with secondary

recipient organizations. Also include any contracts with organizations

for the provision of technical assistance. Do not include payments to

individuals on this line.

Justification: Attach a list of contractors, indicating the names

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

dollar amounts of the awards as part of the budget justification.

Whenever the applicant/grantee intends to delegate part or all of the

program to another agency, the applicant/grantee must complete this

section (Section B, Budget Categories) for each delegate agency by

agency title, along with the supporting information. The total cost of

all such agencies will be part of the amount shown on Line 6f. Provide

backup documentation identifying the name of contractor, purpose of

contract, and major cost elements.

Construction--Line 6g. Not applicable. New construction is not

allowable.

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

applicable, such costs may include, but are not limited to: Insurance;

medical and dental costs; noncontractual fees and travel paid directly

to individual consultants; local transportation (all travel which does

not require per diem is considered local travel); space and equipment

rentals; printing and publication; computer use; training costs,

including tuition and stipends; training service costs, including wage

payments to individuals and supportive service payments; and staff

development costs. Note that costs identified as ``miscellaneous'' and

``honoraria'' are not allowable.

Justification: Specify the costs included.

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

6h.

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

(costs). If no indirect costs are requested, enter ``none.'' This line

should be used when the applicant (except local governments) has a

current indirect cost rate agreement approved by the Department of

Health and Human Services or another Federal agency.

Local and State governments should enter the amount of indirect

costs determined in accordance with HHS requirements. When an indirect

cost rate is requested, these costs are included in the indirect cost

pool and should not be charged again as direct costs to the grant. In

the case of training grants to other than State or local governments

(as defined in title 45, Code of Federal Regulations, part 74), the

Federal reimbursement of indirect costs will be limited to the lesser

of the negotiated (or actual) indirect cost rate or 8 percent of the

amount allowed for direct costs, exclusive of any equipment charges,

rental of space, tuition and fees, post-doctoral training allowances,

contractual items, and alterations and renovations.

Justification: Enclose a copy of the indirect cost rate agreement,

if applicable.

Total--Line 6k. Enter the total amounts of lines 6i and 6j.

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

any, expected to be generated from this project. Do not add or subtract

this amount from the total project amount.

Justification: Describe the nature, source, and anticipated use of

program income in the Program Narrative Statement.

Section C--Non-Federal Resources. This section summarizes the

amounts of non-Federal resources that will be applied to the grant. On

lines 8-11, list estimates for each projected budget period within the

total project period (if an additional line is needed, use line 23 and

label it appropriately). Enter total amounts on line 12.

In-kind contributions are defined in title 45 of the Code of

Federal Regulations, Sec. 74.2, as the value of non-cash contributions

provided by non-Federal third parties. Third party in-kind

contributions may be in the form of real property, equipment, supplies

and other expendable property, and the value of goods and services

directly benefiting and specifically identifiable to the project or

program.

Justification: Describe third party in-kind contributions, if

included.

Section D--Forecasted Cash Needs. Not applicable.

Section E--Budget Estimate of Federal Funds Needed For Balance of

the Project. Not applicable

Section F--Other Budget Information. Not applicable.

3. Program Narrative Statement

The Program Narrative Statement should be clear, concise, and

address the specific requirements mentioned under Part I. The narrative

should also provide information concerning how the application meets

the evaluation criteria using the following headings:

(a) Organizational Experience;

(b) Staff Skills and Responsibilities; [[Page 17072]]

(c) Knowledge of Issues Concerning Fathers;

(d) Approach and Project Design;

(e) Budget Appropriateness.

The specific information to be included under each of these

headings is described in section B of Part II--Evaluation Criteria.

The narrative should be typed double-spaced. All pages of the

narrative (including charts, references, footnotes, tables, maps,

exhibits, etc.) must be sequentially numbered, beginning with

``Organizational Experience.'' The length of the application, including

the application forms and all attachments, should not exceed 50 pages.

4. Assurances/Certifications

Applicants are required to file an SF 424B, Assurances--Non-

Construction Programs, and the Certification Regarding Lobbying. Both

must be signed and returned with the application. In addition,

applicants must certify their compliance with: (1) Drug-Free Workplace

Requirements; (2) Debarment and Other Responsibilities; and (3)

Certification Regarding Environmental Tobacco Smoke. These

certifications are self-explanatory. Copies of these assurances and

certifications are reprinted at the end of this announcement and should

be reproduced, as necessary. A duly authorized representative of the

applicant organization must certify that the applicant is in compliance

with these assurances and certifications. A signature on the SF 424

indicates compliance with Drug-Free Workplace Requirements, Debarment

and Other Responsibilities, and Environmental Tobacco Smoke

certifications.

D. Checklist for a Complete Application

The checklist below is for your use to ensure that your application

package has been properly prepared.

--One original application, signed and dated, plus two copies.

--Complete application length should not exceed 60 pages.

--A complete application consists of the following items in this order:

Application for Federal Assistance (SF 424);

A completed SPOC certification with the date of SPOC

contact entered in line 16, page 1 of the SF 424 if applicable;

Budget Information--Non-construction programs (SF 424A);

Budget Justification for SF 424A Section B--Budget

Categories;

Letter from the Internal Revenue Service to prove

nonprofit status, if necessary;

Copy of the applicant's approved indirect cost rate

agreement, if appropriate;

Program Narrative Statement (See Part II, Section C);

Assurances--Non-construction programs (SF 424B); and

Certification Regarding Lobbying.

E. Submitting the Application

Each application package must include an original and two copies of

the complete application. Each copy should be stapled securely. All

pages of the narrative (including charts, tables, maps, exhibits, etc.)

must be sequentially numbered. In order to facilitate handling, please

do not use covers, binders, or tabs.

Applicant should include a self-addressed, stamped acknowledgment

card. All applicants will be notified automatically about the receipt

of their application.

Dated: March 28, 1995.

Howard Rolston,

Director, Office of Policy and Evaluation.

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BILLING CODE 4184-01-C

[[Page 17074]]

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 is response to Executive Order 12372 and have

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

given an opportunity to review the applicant's submission.

Item and Entry:

1. Self-explanatory.

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

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

3. State use only (if applicable).

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

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

project, leave blank.

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

which will undertake the assistance activity, complete address of

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

contact on matters related to this application.

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

Internal Revenue Service.

7. Enter the appropriate letter in the space provided.

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

space(s) provided:

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

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

budget period for a project with a projected completion date.

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

financial obligation or contingent liability from an existing

obligation.

9. Name of Federal agency from which assistance is being

requested with this application.

10. Use the Catalog of Federal Domestic Assistance number and

title of the program under which assistance is requested.

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

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

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

projects), attach a map showing project location. For

preapplications, use a separate sheet to provide a summary

description of this project.

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

State, counties, cities).

13. Self-explanatory.

14. List the applicant's Congressional District and any

District(s) affected by the program or project.

15. Amount request 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.)

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BILLING CODE 4184-01-C

[[Page 17077]]

Instructions for the SF-424A

General Instructions

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

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

any existing Federal grantor agency guidelines which prescribe how

and whether budgeted amounts should be separately shown for

different functions or activities within the program. For some

programs, grantor agencies may require budgets to be separately

shown by function or activity. For other programs, grantor agencies

may require a breakdown by function or activity. Sections A, B, C,

and D should include budget estimates for the whole project except

when applying for assistance which requires Federal authorization in

annual or other funding period increments. In the latter case,

Sections A, B, C, and D should provide the budget for the first

budget period (usually a year) and Section E should present the need

for Federal assistance in the subsequent budget periods. All

applications should contain a breakdown by the object class

categories shown in Lines a-k of Section B.

Section A. Budget Summary

Lines 1-4, Columns (a) and (b)--For applications pertaining to a

single Federal grant program (Federal Domestic Assistance Catalog

number) and not requiring a functional or activity breakdown, enter

on Line 1 under Column (a) the catalog program title and the catalog

number in Column (b).

For applications pertaining to a single program requiring budget

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

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

catalog number in Column (b). For applications pertaining to

multiple programs where none of the programs require a breakdown by

function or activity, enter the catalog program title on each line

in Column (a) and the respective catalog number on each line in

Column (b).

For applications pertaining to multiple programs where one or

more programs require a breakdown by function or activity, prepare a

separate sheet for each program requiring the breakdown. Additional

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

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

sheet is used, the first page should provide the summary totals by

programs.

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

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

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

(g) the appropriate amounts of funds needed to support the project

for the first funding period (usually a year).

For continuing grant program applications, submit these forms

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

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

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

only if the Federal grantor agency instructions provide for this.

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

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

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

For supplemental grants and changes to existing grants, do not

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

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

amount of the increase or decrease of non-Federal funds. In Column

(g) enter the new total budgeted amount (Federal and non-Federal)

which includes the total previous authorized budgeted amounts plus

or minus, as appropriate, the amounts shown in Columns (e) and (f).

The amount(s) in Column (g) should not equal the sum of amounts in

Columns (e) and (f).

Line 5--Show the totals for all columns used.

Section B. Budget Categories

In the column headings (1) through (4), enter the titles of the

same programs, functions, and activities shown on Lines 1-4, Column

(a), Section A. When additional sheets are prepared for Section A,

provide similar column headings on each sheet. For each program,

function or activity, fill in the total requirements for funds (both

Federal and non-Federal) by object class categories.

Lines 6 a-i--Show the totals of Lines 6a to 6h in each column.

Line 6j--Show the amount of indirect cost.

Line 6k--Enter the total of amounts on Lines 6i and 6j. For all

applications for new grants and continuation grants the total amount

in column (5), Line 6k, should be the same as the total amount shown

in Section A, Column (g), Line 5. For supplemental grants and

changes to grants, the total amount of the increase or decrease as

shown in Columns (1)-(4), Line 6k should be the same as the sum of

the amounts in Section A, Columns (e) and (f) on Line 5.

Line 7--Enter the estimated amount of income, if any, expected

to be generated from this project. Do not add or subtract this

amount from the total project amount. Show under the program

narrative statement the nature and source of income. The estimated

amount of program income may be considered by the federal grantor

agency in determining the total amount of the grant.

Section C. Non-Federal Resources

Lines 8-11--Enter amounts of non-Federal resources that will be

used on the grant. If in-kind contributions are included, provide a

brief explanation on a separate sheet.

Column (a)--Enter the program titles identical to Column (a),

Section A. A breakdown by function or activity is not necessary.

Column (b)--Enter the contribution to be made by the applicant.

Column (c)--Enter the amount of the State's cash and in-kind

contribution if the applicant is not a State or State agency.

Applicants which are a State or State agencies should leave this

column blank.

Column (d)--Enter the amount of cash and in-kind contributions

to be made from all other sources.

Column (e)--Enter totals of Columns (b), (c), and (d).

Line 12--Enter the total for each of Columns (b)-(e). The amount

in Column (e) should be equal to the amount on Line 5, Column (f),

Section A.

Section D. Forecasted Cash Needs

Line 13--Enter the amount of cash needed by quarter from the

grantor agency during the first year.

Line 14--Enter the amount of cash from all other sources needed

by quarter during the first year.

Line 15--Enter the totals of amounts on Lines 13 and 14.

Section E. Budget Estimates of Federal Funds Needed for Balance of the

Project

Lines 16-19--Enter in Column (a) the same grant program titles

shown in Column (a), Section A. A breakdown by function or activity

is not necessary. For new applications and continuation grant

applications, enter in the proper columns amounts of Federal funds

which will be needed to complete the program or project over the

succeeding funding periods (usually in years). This section needs

not be completed for revisions (amendments, changes, or supplements)

to funds for the current year of existing grants.

If more than four lines are needed to list the program titles,

submit additional schedules as necessary.

Line 20--Enter the total for each of the Columns (b)-(e). When

additional schedules are prepared for this Section, annotate

accordingly and show the overall totals on this line.

Section F. Other Budget Information

Line 21--Use this space to explain amounts for individual direct

object-class cost categories that may appear to be out of the

ordinary or to explain the details as required by the Federal

grantor agency.

Line 22--Enter the type of indirect rate (provisional,

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

funding period, the estimated amount of the base to which the rate

is applied, and the total indirect expense.

Line 23--Provide any other explanations or comments deemed

necessary.

Assurances--Non-Construction Programs

Note: Certain of these assurances may not be applicable to your

project or program. If you have questions, please contact the

awarding agency. Further, certain Federal awarding agencies may

require applicants to certify to additional assurances. If such is

the case, you will be notified.

As the duly authorized representative of the applicant I certify

that the applicant:

1. Has the legal authority to apply for Federal assistance, and

the institutional, managerial and financial capability (including

funds sufficient to pay the non-Federal share of project costs) to

ensure proper planning, management and completion of the project

described in this application.

2. Will give the awarding agency, the Comptroller General of the

United States, and if appropriate, the State, through any authorized

representative, access to and the right to examine all records,

books, papers, or documents related to the award; and will 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 [[Page 17078]] 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 nondiscrimination in the

sale, rental or financing of housing; (i) any other

nondiscrimination provisions in the specific statute(s) under which

application for Federal assistance is being made; and (j) the

requirements of any other nondiscrimination statute(s) which may

apply to the application.

7. Will comply, or has already complied, with the requirements

of Titles II and III of the uniform Relocation Assistance and Real

Property Acquisition Policies Act of 1970 (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 under ground sources of drinking water

under the Safe Drinking Water Act of 1974; as amended, (P.L. 93-

523); and (h) protection of endangered species under the Endangered

Species Act of 1973, as amended, (P.L. 93-205).

12. Will comply with the Wild and Scenic Rivers Act of 1968 (16

U.S.C Secs. 1271 et seq.) related to protecting components or

potential components of the national wild and scenic rivers system.

13. Will assist the awarding agency in assuring compliance with

Section 106 of the National Historic Preservation Act of 1966, as

amended (16 U.S.C. 470), EO 11593 (identification and protection of

historic properties), and the Archaeological and Historic

Preservation Act of 1974 (16 U.S.C. 469a-1 et seq.).

14. Will comply with P.L. 93-348 regarding the protection of

human subjects involved in research, development, and related

activities supported by this award of assistance.

15. will comply with the Laboratory Animal Welfare Act of 1996

(P.L. 89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the

care, handling, and treatment of warm blooded animals held for

research, teaching, or other activities supported by this award of

assistance.

16. Will comply with the Lead-Based Paint Poisoning Prevention

Act (42 U.S.C. Secs. 4801 et seq.) which prohibits the use of lead

based paint in construction or rehabilitation of residence

structures.

17. Will cause to be performed the required financial and

compliance audits in accordance with the Single Audit Act of 1984.

18. Will comply with all applicable requirements of all other

Federal laws, executive orders, regulations and policies governing

this program.

Signature of Authorized Certifying Official

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Title

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Applicant Organization

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Date Submitted

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BILLING CODE 4184-01-C

[[Page 17081]]

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 antitrust statutes or commission of

embezzlement, theft, forgery, bribery, falsification or destruction

of records, making false statements, or receiving stolen property;

(c) are not presently indicted or otherwise criminally or

civilly charged by a governmental entity (Federal, State or local)

with commission of any of the offenses enumerated in paragraph

(1)(b) of this certification; and

(d) have not within a 3-year period preceding this application/

proposal had one or more public transactions (Federal, State, or

local) terminated for cause or default.

The inability of a person to provide the certification required

above will not necessarily result in denial of participation in this

covered transaction. If necessary, the prospective participant shall

submit an explanation of why it cannot provide the certification.

The certification or explanation will be considered in connection

with the Department of Health and Human Services (HHS) determination

whether to enter into this transaction. However, failure of the

prospective primary participant to furnish a certification or an

explanation shall disqualify such person from participation in this

transaction.

The prospective primary participant agrees that by submitting

this proposal, it will include the clause entitled ``Certification

Regarding Debarment, Suspension, Ineligibility, and Voluntary

Exclusion--Lower Tier Covered Transaction.'' Provided below without

modification in all lower tier covered transactions and in all

solicitations for lower tier covered transactions.

Certification Regarding Debarment, Suspension, Ineligibility and

Voluntary Exclusion--Lower Tier Covered Transactions

(To Be Supplied to Lower Tier Participants)

By signing and submitting this lower tier proposal, the

prospective lower tier participant, as defined in 45 CFR Part 76,

certifies to the best of its knowledge and belief that it and its

principals:

(a) are not presently debarred, suspended, proposed for

debarment, declared ineligible, or voluntarily excluded from

participation in this transaction by any federal department or

agency.

(b) where the prospective lower tier participant is unable to

certify to any of the above, such prospective participant shall

attach an explanation to this proposal.

The prospective lower tier participant further agrees by

submitting this proposal that it will include this clause entitled

``Certification Regarding Debarment, Suspension, Ineligibility, and

Voluntary Exclusion--Lower Tier Covered Transactions'' without

modification in all lower tier covered transactions and in all

solicitations for lower tier covered transactions.

Certification Regarding Lobbying

Certification for Contracts, Grants, Loans, and Cooperative

Agreements

The undersigned certifies, to the best of his or her knowledge

and belief, that:

(1) No Federal appropriated funds have been paid or will be

paid, by or on behalf of the undersigned, to any person for

influencing or attempting to influence an officer or employee of any

agency, a Member of Congress, an officer or employee of Congress, or

an employee of a Member of Congress in connection with the awarding

of any Federal contract, the making of any Federal grant, the making

of any Federal loan, the entering into of any cooperative agreement,

and the extension, continuation, renewal, amendment, or modification

of any Federal contract, grant, loan, or cooperative agreement.

(2) If any funds other than Federal appropriated funds have been

paid or will be paid to any person for influencing or attempting to

influence an officer or employee of any agency, a Member of

Congress, an officer or employee of Congress, or an employee of a

Member of Congress in connection with this Federal contract, grant,

loan or cooperative agreement, the undersigned shall complete and

submit Standard Form-LLL, ``Disclosure Form to Report Lobbying,'' in

accordance with its instructions.

(3) The undersigned shall require that the language of this

certification be included in the award documents for all subawards

at all tiers (including subcontracts, subgrants, and contracts under

grants, loans, and cooperative agreements) and that all

subrecipients shall certify and disclose accordingly.

This certification is a material representation of fact upon

which reliance was placed when this transaction was made or entered

into. Submission of this certification is a prerequisite for making

or entering into this transaction imposed by section 1352, title 31,

U.S. Code. Any person who fails to file the required certification

shall be subject to a civil penalty of not less than $10,000 and not

more than $100,000 for each such failure.

State for Loan Guarantee and Loan Insurance

The undersigned states, to the best of his or her knowledge and

belief, that:

If any funds have been paid or will be paid to any person for

influencing or attempting to influence an officer or employee of any

agency, a Member of Congress, an officer or employee of Congress, or

an employee of a Member of Congress in connection with this

commitment providing for the United States to insure or guarantee a

loan, the undersigned shall complete and submit Standard Form-LLL

``Disclosure Form to Report Lobbying,'' in accordance with its

instructions.

Submission of this statement is a prerequisite for making or

entering into this transaction imposed by section 1352, title 31,

U.S. Code. Any person who fails to file the 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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Signature

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Title

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Organization

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Date

BILLING CODE 4184-01-P

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BILLING CODE 4184-01-C

[[Page 17083]]

Certification Regarding Environmental Tobacco Smoke

Public Law 103-227, Part C--Environmental Tobacco Smoke, also

known as the Pro-Children Act of 1994 (Act), requires that smoking

not be permitted in any portion of any indoor facility owned or

leased or contracted for by an entity and used routinely or

regularly for the provision of health, day care, education, or

library services to children under the age of 18, if the services

are funded by Federal programs either directly or through State or

local governments, by Federal grant, contract, loan, or loan

guarantee. The law does not apply to children's services provided in

private residences, facilities funded solely by Medicare or Medicaid

funds, and portions of facilities used for inpatient drug or alcohol

treatment. Failure to comply with the provisions of the law may

result in the imposition of a civil monetary penalty of up to $1000

per day and/or the imposition of an administrative compliance order

on the responsible entity.

By signing and submitting this application the applicant/grantee

certifies that it will comply with the requirements of the Act. The

applicant/grantee further agrees that it will require the language

of this certification be included in any subawards which contain

provisions for children's services and that all subgrantees shall

certify accordingly.

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

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, Action 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 Capital,

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, 1204 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 [[Page 17084]]

Texas

Mr. Thomas Adams, Governor's Office of Budget and Planning, PO Box

12428, Austin, Texas 78711, Telephone (512) 463-1778

Utah

Utah State Clearinghouse, Office of Planning and Budget, ATTN:

Carolyn Wright, Room 116 State Capitol, Salt Lake City, Utah 84114,

Telephone (801) 538-1535

Vermont

Mr. Bernard D. Johnson, Assistant Director, Office of Policy

Research & Coordination, Pavilion Office Building, 109 State Street,

Montpelier, Vermont 05602, Telephone (802) 828-3326

West Virginia

Mr. Fred Cutlip, Director, Community Development Division, West

Virginia Development Office, Building #6, Room 553, Charleston, West

Virginia 25305 Telephone (304) 348-4010

Wisconsin

Mr. William C. Carey, Federal/State Relations, Wisconsin Department

of Administration, 101 South Webster Street, PO Box 7864, Madison,

Wisconsin 53707 Telephone (608) 266-0267

Wyoming

Sheryl Jeffries, State Single Point of Contact, Herschler Building,

4th Floor, East Wing, Cheyenne, Wyoming 82002, Telephone (307) 777-

7574

Guam

Mr. Michael J. Reidy, Director, Bureau of Budget and Management

Research, Office of the Governor, PO Box 2950, Agana, Guam 96910,

Telephone (617) 472-2285

Northern Mariana Islands

State Single Point of Contact, Planning and Budget Office, Office of

the Governor, Saipan, CM, Northern Mariana Islands 96950

Puerto Rico

Norma Burgos/Jose H. Caro, Chairman/Director, Puerto Rico Planning

Board, Minillas Government Center, PO Box 41119, San Juan, Puerto

Rico 00940-9985, Telephone (809) 727-4444

Virgin Islands

Jose L. George, Director, Office of Management and Budget, #41

Norregade Emancipation Garden Station, Second Floor, Saint Thomas,

Virgin Islands 00802

Please direct correspondence to: Linda Clarke, Telephone (809) 774-

0750

[FR Doc. 95-8131 Filed 4-3-95; 8:45 am]

BILLING CODE 4184-01-P