Program Announcement; Request for Applications Under the Office of Community Services' Fiscal Year 2000 Community Food and Nutrition Program

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

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

accepted for new grants pursuant to the Secretary's discretionary

authority under Section 681 of the Community Services Block Grant Act,

as amended. This Program Announcement contains forms and instructions

for submitting an application. The awarding of grants under this

Program Announcement is subject to the availability of funds for

support of these activities.

CLOSING DATE: The closing date for submission of applications is

December 6, 1999. Mailed applications postmarked after the closing date

will be classified as late.

FOR FURTHER INFORMATION CONTACT: Administration for Children and

Families, Office of Community Services, Division of Community

Discretionary Programs, 370 L'Enfant Promenade S.W., Washington DC

20447, Fax (202) 401-4687. Contact: Catherine Rivers, (202) 401-5252,

Deloris Horton, (202) 401-9363.

This Program Announcement is accessible on the OCS Website for

reading or downloading at: www.acf.dhhs.gov/programs/ocs/kits1.htm.

Application Submission

Mailing Address: CFNP Applications should be mailed to the U.S.

Department of Health and Human Services, Administration for Children

and Families, Office of Grants Management/OCSE, 4th Floor West,

Aerospace Center, 370 L'Enfant Promenade, SW, Washington, D.C. 20447;

Attention: Application for Community Food and Nutrition Program.

Number of Copies Required: One signed original application and four

copies should be submitted at the time of initial submission. (OMB-

0970-0062, expiration date 10/31/2001).

Submission Instructions: Mailed applications shall be considered as

meeting an announced deadline if they are either received on or before

the deadline date or sent on or before the deadline date and received

by ACF in time for the independent review.

Applications mailed must bear a legibly dated U.S. Postal Service

postmark or a legibly dated, machine produced postmark of a commercial

mail service affixed to the envelope/package containing the

application(s). To be acceptable as proof of timely mailing, a postmark

from a commercial mail service must include the logo/emblem of the

commercial mail service company and must reflect the date the package

was received by the commercial mail service company from the applicant.

Private Metered postmarks shall not be acceptable as proof of timely

mailing. (Applicants are cautioned that express/overnight mail services

do not always deliver as agreed.)

Applications handcarried by applicants, applicants couriers, or by

other representatives of the applicant shall be considered as meeting

an announced deadline if they are received on or before the deadline

date, between the hours of 8:00 a.m. and 4:30 p.m., EST, at the U.S.

Department of Health and Human Services, Administration for Children

and Families, Office of Grants Management/OCSE, ACF Mailroom, 2nd Floor

Loading Dock, Aerospace Center, 901 D Street, SW, Washington, D.C.

20024, between Monday and Friday (excluding Federal holidays). The

address must appear on the envelope/package containing the application

with the note: Attention: Application for Community Food and Nutrition

Program. (Applicants are again cautioned that express/overnight mail

services do not always deliver as agreed.)

ACF cannot accommodate transmission of applications by fax or

through other electronic media. Therefore, applications transmitted to

ACF electronically will not be accepted regardless of date or time of

submission and time of receipt.

Once submitted, applications are considered final and no additional

materials will be accepted.

Late Applications: Applications which do not meet the criteria

above are considered late applications. ACF shall notify each late

applicant that its application will not be considered in the current

competition.

Extension of Deadlines: ACF may extend application deadlines when

circumstances such as acts of God (floods, hurricanes, etc.) occur, or

when there are widespread disruptions of the mail service.

Determinations to extend or waive deadline requirements rest with ACF's

Chief Grants Management Officer.

Table of Contents

Part A--Preamble

1. Legislative Authority

2. Definitions of Terms

3. Purpose of Community Food and Nutrition Program

4. Project Requirements

Part B--Application Requirements

1. Eligible Applicants

2. Availability of Funds and Grant Amounts

3. Project Periods and Budget Periods

4. Administrative Costs/Indirect Costs

5. Program Beneficiaries

6. Number of Projects in Application

7. Multiple Submittal

8. Sub-Contracting or Delegating Projects

Part C--Program Area

General Projects

Part D--Review Criteria

Criteria for Review and Evaluation of Applications Submitted Under

this Program Announcement

Part E--Instructions for Completing Application Package

1. SF-424--Application for Federal Assistance

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

3. SF-424B--Assurances--Non-Construction Programs

4. Project Narrative

Part F--Application Procedures

1. Availability of Forms

2. Intergovernmental Review

3. Application Consideration

4. Criteria for Screening Applications

Part G--Contents of Application Package and Receipt Process

Part H--Post Award Information and Reporting Requirements

Part A--Preamble

1. Legislative Authority

The Community Services Block Grant Act, as amended, authorizes the

Secretary of Health and Human Services to make funds available under

several programs to support program activities which will result in

direct benefits targeted to low-income people. This Program

Announcement covers the grant authority found at Sections 681(a) and

(b), Community Food and Nutrition, which authorizes the Secretary to

make funds available for grants to be awarded

[[Page 52601]]

on a competitive basis to eligible entities for community based, local

and statewide programs: (1) To coordinate private and public food

assistance resources, wherever the grant recipient involved determines

such coordination to be inadequate, to better serve low-income

populations; (2) to assist low-income communities to identify potential

sponsors of child nutrition programs and to initiate such programs in

underserved or unserved areas; and (3) to develop innovative approaches

at the State and local level to meet the nutrition needs of low-income

individuals.

2. Definitions of Terms

For purposes of this Program Announcement the following definitions

apply:

Budget period: The term ``budget period'' refers to the interval of

time into which a grant period of assistance (project period) is

divided for budgetary and funding purposes.

Displaced worker: An individual who is in the labor market but has

been unemployed for six months or longer.

Eligible entity: States, public agencies, and public and private

non-profit agencies/organizations including Community Action Agencies.

(See Part B-1)

Indian tribe: A tribe, band, or other organized group of Native

American Indians recognized in the State or States in which it resides

or considered by the Secretary of the Interior to be an Indian tribe or

an Indian organization for any purpose.

Innovative project: One that departs from or significantly modifies

past program practices and tests a new approach.

Migrant farmworker: An individual who works in agricultural

employment of a seasonal or other temporary nature who is required to

be absent from his/her place of permanent residence in order to secure

such employment.

Program income: Gross income earned by the grant recipient that is

directly generated by an activity supported with grant funds.

Project period: The term ``project period'' refers to the total

time for which a project is approved for support, including any

approved extensions.

Seasonal farmworker: Any individual employed in agricultural work

of a seasonal or other temporary nature who is able to remain at his/

her place of permanent residence while employed.

Self-sufficiency: A condition where an individual or family does

not need and is not eligible for public assistance.

Underserved area (as it pertains to child nutrition programs): A

locality in which less than one-half of the low-income children

eligible for assistance participate in any child nutrition program.

3. Purpose of Community Food and Nutrition Program

The Department of Health and Human Services (DHHS) is committed to

improving the overall health and nutritional well-being of individuals

through improved preventive health care and promotion of personal

responsibility. The DHHS encourages the approach to health promotion

and nutritional responsibility with personal messages aimed at families

and communities, in various settings and environments in which

individuals and groups can most effectively be reached.

The DHHS is specifically interested in improving the health and

nutrition status of low-income persons through improved access to

healthy nutritious foods or by other means. The DHHS encourages

community efforts to improve the coordination and integration of health

and social services for all low-income families, and to identify

opportunities for collaborating with other programs and services for

this population. Such collaboration can increase a community's capacity

to leverage resources and promote an integrated approach to health and

nutrition through existing programs and services.

4. Project Requirements

Projects funded under this program should:

(a) Be designed and intended to provide nutrition benefits,

including those which incorporate the benefits of disease prevention,

to a targeted low-income group of people;

(b) Provide outreach and public education to inform eligible low-

income individuals and families of other nutritional services available

to them under the various Federally-assisted programs;

(c) Carry out targeted communications/social marketing to improve

dietary behavior and increase program participation among eligible low-

income populations. Populations to be targeted can include displaced

workers, elderly people, children, and the working poor.

(d) Consult with and/or inform local offices that administer other

food programs such as W.I.C. and Food Stamps, where applicable, to

ensure effective coordination which can jointly target services to

increase their effectiveness. Such consultation may include involving

these offices in the planning of grant applications.

(e) Focus on one or more legislatively-mandated program activities:

(1) Coordination of private and public food assistance resources,

wherever the grant recipient involved determines such coordination to

be inadequate, to better serve low-income populations; (2) Assistance

to low-income communities in identifying potential sponsors of child

nutrition programs and initiating such programs in unserved or

underserved areas; and (3) Development of innovative approaches at the

state and local level to meet the nutrition needs of low-income

individuals.

The OCS views this program as a capacity building program, rather

than as a service delivery program.

Part B--Application Requirements

1. Eligible Applicants

Eligible applicants are States, public agencies, and public and

private non-profit agencies/organizations with a demonstrated ability

to successfully develop and implement programs and activities similar

to those enumerated above. The OCS encourages Historically Black

Colleges and Universities and minority institutions to submit

applications. Eligible applicants with programs benefitting Native

Americans and Migrant Farmworkers are also encouraged to submit

applications.

Any non-profit organization submitting an application must submit

proof of its non-profit status in its application at the time of

submission. The non-profit agency can accomplish this by providing a

copy of the applicant's listing in the Internal Revenue Service's (IRS)

most recent list of tax-exempt organizations described in Section

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

valid IRS tax exemption certificate, or by providing a copy of the

applicant's Articles of Incorporation bearing the seal of the State in

which the corporation or association is domiciled.

2. Availability of Funds and Grant Amounts

a. Fiscal Year 2000 Funding

All grant awards are subject to the availability of appropriated

funds. The Office of Community Services expects to award approximately

$2,000,000 for grant awards under the CFNP in Fiscal Year 2000 for

General Projects.

b. Grant Amounts

No individual grant application will be considered for an amount

which is in excess of $50,000.

[[Page 52602]]

c. Mobilization of Resources

The OCS would like to mobilize as many resources as possible to

enhance projects funded under this program. The OCS supports and

encourages applications submitted by applicants whose programs will

leverage other resources, either cash or third party in-kind.

3. Project Periods and Budget Periods

For most projects, OCS will grant funds for one year. However, in

rare instances, depending on the characteristics of any individual

project and on the justification presented by the applicant in its

application, a grant may be made for a period of up to 17 months.

4. Administrative Costs/Indirect Costs

There is no administrative cost limitation for projects funded

under this program. Indirect costs consistent with approved indirect

cost rate agreements are allowable. Applicants should enclose a copy of

the current approved rate agreement. However, it should be understood

that indirect costs are part of, and not in addition to, the amount of

funds awarded in the subject grant.

5. Program Beneficiaries

Projects proposed for funding under this Announcement must result

in direct benefits targeted toward low-income people as defined in the

most recent annual update of the Poverty Income Guidelines published by

DHHS. Attachment A to this Announcement is an excerpt from the most

recently published guidelines. Annual revisions of these guidelines are

normally published in the Federal Register in February or early March

of each year and are applicable to projects being implemented at the

time of publication. Grantees will be required to apply the most recent

guidelines throughout the project period. The Federal Register may be

obtained from public libraries, Congressional offices, or by writing

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

Washington, D.C. 20402. The Federal Register is also available on the

Internet through GPO Access at the following web address: http://

www.access.gpo.gov/su__docs/aces/aces140.html

No other government agency or privately defined poverty guidelines

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

OCS program.

6. Number of Projects in Application

An application may contain only one project and this project must

address the basic criteria found in Parts C and D. Applications which

are not in compliance with these requirements will be ineligible for

funding.

7. Multiple Submittals

There is no limit to the number of applications that can be

submitted as long as each application is for a different project.

However, no applicant can receive more than one grant.

8. Sub-Contracting or Delegating Projects

The OCS will not fund any project where the role of the eligible

applicant is primarily to serve as a conduit for funds to other

organizations.

Part C--Program Area

General Projects

The application should include a description of the target area and

population to be served as well as a discussion of the nature and

extent of the problem to be solved. The application must contain a

detailed and specific work program that is both sound and feasible.

Projects funded under this Announcement must produce permanent and

measurable results that fulfill the purposes of this program as

described above. The OCS grant funds, in combination with private and/

or other public resources, must be targeted to low-income individuals

and communities.

Applicants will certify in their submission that projects will only

serve the low-income population as stipulated in the DHHS Poverty

Income Guidelines (Attachment A). Failure to comply with the income

guidelines may result in the application being ineligible for

consideration for funding.

If an applicant is proposing a project which will affect a property

listed in or eligible for inclusion in the National Register of

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

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

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

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

inclusion in the National Register of Historic Places, applicant should

consult with the State Historic Preservation Officer. The applicant

should contact OCS early in the development of its application for

instructions regarding compliance with the Act and data required to be

submitted to DHHS.

In the case of projects proposed for funding which mobilize or

improve the coordination of existing public and private food assistance

resources, the guidelines governing those resources apply. However, in

the case of projects providing direct assistance to beneficiaries

through grants funded under this program, beneficiaries must fall

within the official DHHS Poverty Income Guidelines as set forth in

Attachment A.

Applications that propose the use of grant funds for the

development of any printed or visual materials must contain convincing

evidence that these materials are not available from other sources. The

OCS will not provide funding for such items if justification is not

sufficient. Approval of any films or visual presentations proposed by

applicants approved for funding will be made part of the grant award.

In cases where material outlays for equipment (audio and visual) are

requested, specific evidence must be presented that there is a definite

programmatic connection between the equipment (audio and visual) usage

and the outreach requirements described in Part A-3 of this

Announcement.

The OCS is also interested in projects that address the needs of

homeless families and welcomes applications that seek to develop

innovative approaches to promote health and nutritional awareness among

low-income populations.

Part D--Review Criteria

Applications that pass the initial screening and pre-rating review

(see Part F, section 4) will be assessed and scored by reviewers. Each

reviewer will give a numerical score for each application reviewed.

These numerical scores will be supported by explanatory statements on a

formal rating form describing major strengths and weaknesses under each

applicable criterion published in the Announcement.

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

criteria coupled with the specific requirements as described in Part F.

When writing their Project Narrative, applicants should respond to

the review criteria using the same sequential order.

Note: The following review criteria reiterate the information

requirements contained in Part B of this Announcement.

Criteria for Review and Evaluation of Applications Submitted Under This

Program Announcement

a. Criterion I: Analysis of Needs/Priorities (Maximum: 10 Points)

(1) Target area and population to be served are adequately

described. (0-4 Points)

In addressing the above criterion, the applicant should include a

description of the target area and population to be

[[Page 52603]]

served including specific details on any minority population(s) to be

served.

(2) Nature and extent of problem(s) and/or need(s) to be addressed

are adequately described and documented. (0-6 Points)

In addressing the above criterion, the applicant should include a

discussion of the nature and extent of the problem(s) and/or need(s),

including specific information on minority populations(s).

b. Criterion II: Adequacy of Work Program (Maximum: 25 Points)

(1) Realistic quarterly time targets are set forth by which the

various work tasks will be completed. (0-10 Points)

(2) Activities are adequately described and appear reasonably

likely to achieve results which will have a desired impact on the

identified problems and/or needs. (0-15 Points)

In addressing the above criterion, the applicant should address the

basic criteria and other mandated activities found in Part A-4 and

should include:

a. Project priorities and rationale for selecting them which relate

to the specific nutritional problem(s) and/or need(s) of the target

population which were identified under Criterion I;

b. Goals and objectives that speak to the(se) problem(s) and/or

need(s); and

c. Project activities that, if successfully carried out, can be

reasonably expected to result in the achievement of these goals and

objectives.

c. Criterion III: Significant and Beneficial Impact (Maximum: 30

Points)

(1) Applicant proposes to significantly improve or increase

nutrition services to low-income people and such improvements or

increases are quantified. (0-15 Points)

(2) Project incorporates promotional health and social services

activities for low-income people, along with nutritional services. (0-5

Points)

(3) Project will significantly leverage or mobilize other community

resources and such resources are detailed and quantified. (0-5 Points)

(4) Project addresses problem(s) that can be resolved by one-time

OCS funding or demonstrates that non-Federal funding is available to

continue the project without Federal support. (0-5 Points)

In addressing the above criterion, the applicant must include

quantitative data for items (1), (2), and (3), and discuss how the

beneficial impact relates to the relevant legislatively-mandated

program activities identified in Part A-1 and the problems and/or needs

described under Criterion I.

d. Criterion IV: Coordination/Services Integration (Maximum: 15 Points)

(1) Project shows evidence of coordinated community-based planning

in its development, including strategies in the work program to carry

on activities in collaboration with other locally-funded Federal

programs (such as DHHS health and social services and USDA Food and

Consumer Service programs) in ways that will eliminate duplication and

will, for example, (1) unite funding streams at the local level to

increase program outreach and effectiveness, (2) facilitate access to

other needed social services by coordinating and simplifying intake and

eligibility certification processes for clients, or (3) bring project

participants into direct interaction with holistic family development

resources in the community where needed. (0-10 Points)

(2) Community Empowerment Consideration--Special consideration will

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

by poverty and other indicators of socio-economic distress such as a

poverty rate of at least 20 percent, designation as an Empowerment Zone

or Enterprise Community, high levels of unemployment, and high levels

of incidences of violence, gang activity, crime, or drug use.

Applicants should document that they were involved in the preparation

and planned implementation of a comprehensive community-based strategic

plan to achieve both economic and human development in an integrated

manner. (0-5 Points)

If the applicant is receiving funds from the State for community

food and nutrition activities, the applicant should address how the

funds are being utilized, and how they will be coordinated with the

proposed project to maximize the effectiveness of both. If State funds

are being used in the project for which OCS funds are being requested,

their usage should be specifically described.

e. Criterion V: Organizational Experience in Program Area and Staff

Responsibilities (Maximum: 15 Points)

(1) Organizational Experience in Program Area (0-5 Points)

Documentation provided indicates that projects previously

undertaken have been relevant and effective and have provided permanent

benefits to the low-income population. Organizations that propose

providing training and technical assistance have detailed competence in

the program area and as a deliverer with expertise in the fields of

training and technical assistance. If applicable, information provided

by these applicants also addresses related achievements and competence

of each cooperating or sponsoring organization.

(2) Management History (0-5 Points)

Applicants must demonstrate their ability to implement sound and

effective management practices and if they have been recipients of

other Federal or other governmental grants, they must also document

that they have consistently complied with financial and program

progress reporting and audit requirements. Such documentation may be in

the form of references to any available audit or progress reports and

should be accompanied by a statement by a Certified or Licensed Public

Accountant as to the sufficiency of the applicant's financial

management system to protect adequately any Federal funds awarded under

the application submitted.

(3) Staffing Skills, Resources and Responsibilities (0-5 Points)

The application adequately describes the experience and skills of

the proposed project director showing that the individual is not only

well qualified, but that his/her professional capabilities are relevant

to the successful implementation of the project. If the key staff

person has not yet been identified, the application contains a

comprehensive position description which indicates that the

responsibilities to be assigned to the project director are relevant to

the successful implementation of the project. The application must

indicate that the applicant has adequate facilities and resources (i.e.

space and equipment) to successfully carry out the work plan.

In addressing the above criterion, the applicant must clearly show

that sufficient time of the Project Director and other senior staff

will be budgeted to assure timely implementation and oversight of the

project and that the assigned responsibilities of the staff are

appropriate to the tasks identified for the project.

f. Criterion VI: Adequacy of Budget (Maximum: 5 Points)

The budget is adequate and administrative costs are appropriate in

relation to the services proposed. (0-5 Points)

Part E--Instructions for Completing Application Package

The standard forms attached to this Announcement shall be used when

submitting applications for all funds under this Announcement. It is

recommended that you reproduce

[[Page 52604]]

single-sided copies of the SF-424, SF-424A and SF-424B, and type your

application on the copies.

Please prepare your application in accordance with the instructions

provided with the forms, as well as with the OCS specific instructions

set forth below:

1. SF-424--Application for Federal Assistance (Attachment B-1)

Item 1. Type of Submission--For the purposes of this Announcement,

all projects are considered Applications; there are no Pre-

Applications.

Item 2. Date Submitted and Applicant Identifier--Enter the date the

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

number, if applicable.

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

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

Items 5. and 6. Applicant Information and Employer Identification

Number--The legal name of the applicant must match that listed as

corresponding to the Employer Identification Number. Where the

applicant is a previous DHHS grantee, enter the Central Registry

System/Employee Identification Number (CRS/EIN) and the Payment

Identifying Number (PIN), if one has been assigned, in the Block

entitled Federal Identifier located at the top right hand corner of the

form.

Item 7. Type of Applicant--If the applicant is a non-profit

corporation, enter the letter ``N'' in the box and specify non-profit

corporation in the space marked ``Other''. Proof of non-profit status,

such as IRS certification, Articles of Incorporation, or By-laws must

be included as an appendix to the project narrative.

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

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

Item 10. The Catalog of Federal Domestic Assistance (CFDA) Number--

The CFDA number for the OCS program covered under this Announcement is

93.571. The title is ``Community Services Block Grant Discretionary

Awards--Community Food and Nutrition Program''.

Item 11. Descriptive Title of Project--Enter a brief descriptive

title of the project.

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

units affected, such as State, county or city.

Item 13. Proposed Project Dates--Show 12-month project period. (See

Part B-3) In addition, the project period start date must be on or

before September 30, 2000.

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

number(s) of the Congressional District where the applicant's principal

office is located and the number(s) of the Congressional District(s)

where the project will be located.

Item 15. Estimated Funding--15a. Show the total amount requested

for the entire project period; 15b. thru 15e. For each line item, show

both cash and third-party in-kind contributions for the total project

period; 15f. Show the estimated amount of program income for the total

project period; 15g. Enter the sum of all the lines.

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

B-2)

See the instructions accompanying the Attachment as well as the

instructions set forth below.

In completing these sections, the Federal funds budget entries will

relate to the requested OCS Community Food and Nutrition Program funds

only, and Non-Federal will include mobilized funds from all other

sources--applicants, State, and other. Federal funds other than those

requested from the Community Food and Nutrition Program should be

included in Non-Federal entries.

Sections A and D of SF-424A must contain entries for both Federal

(OCS) and non-Federal (mobilized) funds.

Section A--Budget Summary

Lines 1-4

--Column (a) Line 1--Enter OCS CFNP.

--Column (b) Line 1--Enter 93.571.

--Columns (c) and (d)--Not Applicable.

--Columns (e), (f) and (g)--For lines 1 through 4, enter in appropriate

amounts needed to support the project for the entire project period.

Line 5

Enter the figures from Line 1 for all columns completed, (e), (f),

and (g).

Section B--Budget Categories

This section should contain entries for OCS funds only. For all

projects, the first budget period of 12 months will be entered in

Column (1).

Allocability of costs is governed by applicable cost principles set

forth in the Code of Federal Regulations (CFR), Title 45, Parts 74 and

92.

Budget estimates for administrative costs must be supported by

adequate detail for the grants officer to perform a cost analysis and

review. Adequately detailed calculations for each budget object class

are those which reflect estimation methods, quantities, unit costs,

salaries, and other similar quantitative detail sufficient for the

calculation to be duplicated. For any additional object class

categories included under the object class other, identify the

additional object class(es) and provide supporting calculations.

Supporting narratives and justifications are required for each

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

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

equipment purchases; and training programs.

A detailed itemized budget with a separate budget justification for

each major item should be included as indicated below:

Line 6a

Personnel--Enter the total costs of salaries and wages.

Justification--Identify the project director and staff. Specify by

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

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

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

project.

Line 6b

Fringe Benefits--Enter the total costs of fringe benefits unless

treated as part of an approved indirect cost rate which is entered on

Line 6j.

Justification--Enter the total costs of fringe benefits, unless

treated as part of an approved indirect cost rate. Provide a breakdown

of amounts and percentages that comprise fringe benefit costs.

Line 6c

Travel--Enter total cost of all travel by employees of the project.

Do not enter costs for Consultant's travel.

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

trips, destinations, length of stay, mileage rate, transportation costs

and subsistence allowances. Traveler must be a person listed under the

personnel line or employee being paid under non-federal share.

Note: Local transportation and Consultant travel costs are

entered on Line 6h.

Line 6d

Equipment--Enter the total costs of all equipment to be acquired by

the project. Equipment means an article of nonexpendable, tangible

personal property having a useful life of more than one year and an

acquisition cost which equals or exceeds the lesser of (a) the

capitalization level established by the organization for financial

statement purposes, or (b) $5,000.

[[Page 52605]]

Note: If an applicant's current rate agreement was based on

another definition for equipment, such as ``tangible personal

property $500 or more'', the applicant shall use the definition used

by the cognizant agency in determining the rate(s). However,

consistent with the applicant's equipment policy, lower limits may

be set.

Justification--Equipment to be purchased with Federal funds must be

required to conduct the project, and the applicant organization or its

subgrantees must not already have the equipment or a reasonable

facsimile available to the project.

Line 6e

Supplies--Enter the total costs of all tangible personal property

other than that included on line 6d.

Justification--Provide a general description of what is being

purchased such as type of supplies: office, classroom, medical, etc.

Include equipment costing less than $5,000 per item.

Line 6f

Contractual--Enter the total costs of all contracts, including: (1)

Procurement contracts (except those which belong on other lines such as

equipment, supplies, etc.) and (2) contracts with secondary recipient

organizations including delegate agencies and specific project(s) or

businesses to be financed by the applicant.

Justification--Attach a list of contractors, indicating the names

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

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

budget justification. Also provide back-up documentation identifying

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

Note 1: Whenever the applicant/grantee intends to delegate part

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

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

agency by agency title, along with the required supporting

information referenced in the applicable instructions. The total

costs of all such agencies will be part of the amount shown on Line

6f. Provide draft Request for Proposal in accordance with 45 CFR

Part 74, Appendix A. All procurement transactions shall be conducted

in a manner to provide, to the maximum extent practical, open and

free competition.

Note 2: Contractual cannot be a person--must be an organization,

firm, etc. Enter Consultant cost on Line 6h.

Line 6g

Construction--Not applicable.

Line 6h

Other--Enter the total of all other costs. Such costs, where

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

medical and dental costs (non-contractual); fees and travel paid

directly to individual consultants; local transportation (all travel

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

equipment rentals; printing and publication; computer use training

costs including tuition and stipends; training service costs including

wage payments to individuals and supportive service payments; and staff

development costs.

Line 6j

Indirect Charges--Enter the total amount of indirect costs. This

line should be used only when the applicant currently has an indirect

cost rate approved by DHHS or other Federal agencies.

If the applicant organization is in the process of initially

developing or renegotiating a rate, it should, immediately upon

notification that an award will be made, develop a tentative indirect

cost rate proposal based on its most recently completed fiscal year in

accordance with the principles set forth in the pertinent DHHS Guide

for Establishing Indirect Cost Rates and submit it to the appropriate

DHHS Regional Office. It should be noted that when an indirect cost

rate is requested, those costs included in the indirect cost pool

cannot be also budgeted or charged as direct costs to the grant.

Indirect costs consistent with approved indirect cost rate agreements

are allowable.

Line 6k

Totals--Enter the total amount of Lines 6i and 6j.

Line 7

Program Income--Enter the estimated amount of income, if any,

expected to be generated from this project. Separately show expected

program income generated from OCS support and income generated from

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

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

narrative statement.

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

program income in the Program Narrative Statement.

Section C--Non-Federal Resources

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

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

than OCS funds for which the applicant has received a commitment.

Provide a brief explanation, on a separate sheet, showing the type of

contribution, broken out by Object Class Category, (see SF-424A,

Section B.6) and whether it is cash or third party in-kind. The firm

commitment of these required funds must be documented and submitted

with the application in order to be given credit in the criterion.

Except in unusual situations, this documentation must be in the

form of letters of commitment or letters of intent from the

organization(s)/individuals from which funds will be received.

Line 8

--Column (a)--Enter the project title.

--Column (b)--Enter the amount of cash or donations to be made by the

applicant.

--Column (c)--Enter the State contribution.

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

contributions to be made from all other sources.

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

Lines 9, 10 and 11

Leave Blank.

Line 12

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

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

5, Column (f).

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

included.

Section D--Forecasted Cash Needs

Line 13

Federal--Enter the amount of Federal (OCS) cash needed for this

grant, by quarter, during the 12-month budget period.

Line 14

Non-Federal--Enter the amount of cash from all other sources needed

by quarter during the first year.

Line 15

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

Section F--Other Budget Information

Line 21

Direct Charges--Include narrative justification required under

Section B for each object class category for the total project period.

Line 22

Indirect Charges--Enter the type of DHHS or other Federal agency

approved indirect cost rate (provisional,

[[Page 52606]]

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

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

applied and the total indirect expense. Also, enter the date the rate

was approved, where applicable. Attach a copy of the approved rate

agreement.

Line 23

Provide any other explanations and continuation sheets required or

deemed necessary to justify or explain the budget information.

3. SF-424B--Assurances Non-Construction Programs (Attachment B-3)

All applicants must sign and return the ``Assurances'' with the

application.

4. Project Narrative

Each narrative should include the following major sections:

a. Analysis of Need.

b. Project Design (Work Program).

c. Organizational Experience in the Program Area.

d. Management History.

e. Staffing and Resources.

f. Staff Responsibilities.

The project narrative must address the specific purposes mentioned

in Part A of this Program Announcement. The narrative should provide

information on how the application meets the evaluation criteria in

Part D of this Program Announcement.

Part F--Application Procedures

1. Availability of Forms

Applications for awards under this OCS program must be submitted on

Standard Forms (SF) 424, 424A, and 424B. Part E and the Attachments to

this Program Announcement contain all the instructions and forms

required for submittal of applications. The forms may be reproduced for

use in submitting applications.

A copy of this Program Announcement is available on the Internet

through the OCS Website at the following web address: www.acf.dhhs.gov/

programs/ocs/kits1.htm.

This Program Announcement also may be obtained by telephoning the

office listed in the section entitled For Further Information Contact

at the beginning of this Announcement.

The information requested under this Program Announcement is

covered under the following OMB information collection clearances: SF-

424 (No. 0348-0043), SF-424A (No. 0348-0044), SF-424B (No. 0348-0040),

and other requirements for OCS applications (No. 0970-0062, expiration

date October 31, 2001).

2. Intergovernmental Review

This program is covered under Executive Order 12372,

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

``Intergovernmental Review of Department of Health and Human Services

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

processes for reviewing and commenting on proposed Federal assistance

under covered programs.

As of March, 1999, the following jurisdictions have elected NOT to

participate in the Executive Order process. Applicants from these

jurisdictions or for projects administered by Federally-recognized

Indian Tribes need take no action in regard to E.O. 12372:

Alabama, Alaska, Colorado, Connecticut, Hawaii, Idaho, Kansas,

Louisiana, Massachusetts, Minnesota, Montana, Nebraska, New Jersey,

Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Vermont,

Virginia, Washington, American Samoa and Palau.

All remaining jurisdictions participate in the Executive Order

process and have established Single Points of Contact (SPOCs).

Applicants from participating jurisdictions should contact their SPOCs

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

receive instructions. Applicants must submit any required material to

the SPOCs as soon as possible so that the program office can obtain and

review SPOC comments as part of the award process. The applicant must

submit all required materials, if any, to the SPOC and indicate the

date of this submittal (or the date of contact if no submittal is

required) on the Standard Form 424, item 16a.

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

deadline to comment on the proposed new award.

The SPOCs are encouraged to eliminate the submission of routine

endorsements as official recommendations.

Additionally, SPOCs are requested to clearly differentiate between

mere advisory comments and those official State process recommendations

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

When comments are submitted directly to ACF, they should be

addressed to: U.S. Department of Health and Human Services,

Administration for Children and Families, Office of Grants Management/

OCSE, 4th Floor West, Aerospace Center, 370 L'Enfant Promenade, SW,

Washington, D.C. 20447.

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

is included as Attachment G of this Announcement.

3. Application Consideration

Applications that meet the screening requirements in Section 5

below will be reviewed competitively. Such applications will be

referred to reviewers for a numerical score and explanatory comments

based solely on responsiveness to program guidelines and evaluation

criteria published in this Announcement. Applications will be reviewed

by persons outside of the OCS unit which would be directly responsible

for programmatic management of the grant. The results of these reviews

will assist the Director and OCS program staff in considering competing

applications. Reviewers' scores will weigh heavily in funding decisions

but will not be the only factors considered. Applications will

generally be considered in order of the average scores assigned by

reviewers. However, highly ranked applications are not guaranteed

funding since the Director may also consider other factors deemed

relevant including, but not limited to, the timely and proper

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

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

evaluation and input; geographic distribution; previous program

performance of applicant; compliance with grant terms under previous

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

progress in resolving any final audit disallowances on OCS or other

Federal agency grants. The OCS reserves the right to discuss

applications with other Federal or non-Federal funding sources to

ascertain the applicant's performance record.

4. Criteria for Screening Applications

a. Initial Screening

All applications that meet the application deadline will be

screened to determine completeness and conformity to the requirements

of this Announcement. Only those applications meeting the below listed

requirements will be reviewed and evaluated competitively. Others will

be returned to the applicants with a notation that they were

unacceptable.

(1) The application must contain a completed and signed Standard

Form SF-424.

(2) The SF-424 must be signed by an official of the organization

applying for

[[Page 52607]]

the grant who has authority to obligate the organization legally.

b. Pre-Rating Review

Applications which pass the initial screening will be forwarded to

reviewers for analytical comment and scoring based on the criteria

detailed in the section below and the specific requirements contained

in Part A of this Announcement. Prior to the programmatic review, these

reviewers and/or OCS staff will verify that the applications comply

with this Program Announcement in the following areas:

(1) Eligibility--Applicant meets the eligibility requirements found

in Part B.

(2) Number of Projects--The application contains only one project.

(3) Target Populations--The application clearly targets the

specific outcomes and benefits of the project to low-income

participants and beneficiaries as defined in the DHHS Poverty Income

Guidelines (Attachment A).

(4) Grant Amount--The amount of funds requested does not exceed

$50,000.

(5) Program Focus--The application addresses the purposes described

in Part A of this Announcement.

c. Evaluation Criteria

Applications that pass the initial screening and pre-rating review

will be assessed and scored by reviewers. Each reviewer will give a

numerical score for each application reviewed. These numerical scores

will be supported by explanatory statements on a formal rating form

describing major strengths and major weaknesses under each applicable

criterion published in this Announcement.

Part G--Contents of Application Package and Receipt Process

1. Contents of Application

Each application submission must include a signed original and four

additional copies of the application. Each copy of the application MUST

contain, in the order listed, each of the following:

a. Table of Contents with page numbers noted for each major section

and subsection of the application, including the appendices. Each page

in the application, including those in all appendices, must be numbered

consecutively.

b. A Project Abstract which is a succinct description of the

project in 200 words or less.

c. The SF-424 (Application for Federal Assistance) (Attachment B-1)

should be completed in accordance with instructions provided with the

form, as well as OCS specific instructions set forth in Part E of this

Announcement. The SF-424 must contain an original signature of the

certifying representative of the applicant organization. Applicants

must also be aware that the applicant's legal name (Item 5) MUST match

the Employer Identification Number (Item 6).

d. SF-424A (Budget Information) (Attachment B-2) must be completed.

e. SF-424B (Assurances--Non-Construction Programs) (Attachment B-3)

must be filed by applicants requesting financial assistance for a non-

construction project. Applicants must sign and return the SF-424B with

their applications.

f. Certification Regarding Lobbying (Attachment F-1) Applicants

must provide a certification concerning lobbying. Prior to receiving an

award in excess of $100,000, applicants shall furnish an executed copy

of the lobbying certification. Applicants must sign and return the

certification with their applications.

g. Disclosure of Lobbying Activities (SF-LLL). Applicants must

fill-in, sign and date form found at Attachment F-2. (This form is

required only if lobbying has actually taken place or is expected to

take place in trying to obtain the grant for which the applicant is

applying.)

h. Project Narrative (See Part E, section 4).

i. Certification Regarding Drug-Free Workplace Requirements

(Attachment C). Applicants must make the appropriate certification of

their compliance with the Drug-Free Workplace Act of 1988. By signing

and submitting the applications, applicants are providing the

certification and need not mail back the certification with the

applications.

j. Certification Regarding Debarment, Suspension, and Other

Responsibility Matters (Attachment D). Applicants must make the

appropriate certification that they are not presently debarred,

suspended or otherwise ineligible for award. By signing and submitting

the applications, applicants are providing the certification and need

not mail back the certification with the applications.

k. Certification Regarding Environmental Tobacco Smoke (Attachment

E). Applicants must make the appropriate certification of their

compliance with the Pro-Children Act of 1944. By signing and submitting

the applications, applicants are providing the certification and need

not mail back the certification with the applications.

The total number of pages for the narrative portion of the

application package must not exceed 30 pages in its entirety.

Applications must be uniform in composition since OCS may find it

necessary to duplicate them for review purposes. Therefore,

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

must not include colored, oversized or folded materials, organizational

brochures, or other promotional materials, slides, films, clips, etc.

Such materials will be discarded if included.

Applications should be two-holed punched at the top center and

fastened separately with a compressor slide paper fastener or a binder

clip.

While applications must be comprehensive, OCS encourages

conciseness and brevity in the presentation of materials and cautions

the applicant to avoid unnecessary duplication of information.

2. Acknowledgment of Receipt

An acknowledgment will be mailed to all applicants with an

identification number which will be noted on the acknowledgment. This

number must be referred to in all subsequent communications with OCS

concerning the application. If an acknowledgment is not received within

three weeks after the application deadline, applicants must notify ACF

by telephone (202) 401-5103. Applicant should also submit a mailing

label for the acknowledgment.

Note: To facilitate receipt of this acknowledgment from ACF,

applicant should include a cover letter with the application

containing an E-mail address and facsimile (FAX) number if these

items are available to applicant.

Part H--Post Award Information and Reporting Requirements

Following approval of the applications selected for funding, notice

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

made in writing. The official award document is the Financial

Assistance Award which provides the amount of Federal funds approved

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

provided, and the terms and conditions of the award.

In addition to the General Conditions and Special Conditions (where

the latter are warranted) that will be applicable to grants, grantees

will be subject to the provisions of 45 CFR Parts 74 (non-governmental)

and 92 (governmental) along with Circulars 122 (non-governmental) and

87 (governmental).

Grantees will be required to submit semi-annual progress and

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

report.

[[Page 52608]]

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

and 92.

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

1989, imposes new prohibitions and requirements for disclosure and

certification related to lobbying when applicant has engaged in

lobbying activities or is expected to lobby in trying to obtain the

grant. It provides limited exemptions for Indian tribes and tribal

organizations. Current and prospective recipients (and their subtier

contractors and/or grantees) are prohibited from using appropriated

funds for lobbying Congress or any Federal agency in connection with

the award of a contract, grant, cooperative agreement or loan. In

addition, for each award action in excess of $100,000 (or $150,000 for

loans) the law requires recipients and their subtier contractors and/or

subgrantees: (1) To certify that they have neither used nor will use

any appropriated funds for payment to lobbyists, (2) to submit a

declaration setting forth whether payments to lobbyists have been or

will be made out of non-appropriated funds and, if so, the name,

address, payment details, and purpose of any agreements with such

lobbyists whom recipients or their subtier contractors or subgrantees

will pay with the nonappropriated funds and (3) to file quarterly

updates about the use of lobbyists if any event occurs that materially

affects the accuracy of the information submitted by way of declaration

and certification. The law establishes civil penalties for

noncompliance and is effective with respect to contracts, grants,

cooperative agreements and loans entered into or made on or after

December 23, 1989. See Attachments F-1 and F-2 for certification and

disclosure forms to be submitted with the applications for this

program.

Attachment H indicates the regulations that apply to all

applicants/ grantees under the FY 2000 Community Food and Nutrition

Program.

Dated: September 22, 1999.

Donald Sykes,

Director, Office of Community Services.

Attachments

A--1999 Poverty Income Guidelines for the 48 Contiguous States and

the District of Columbia, Alaska, and Hawaii

B-1--Application for Federal Assistance

B-2--Budget Information--Non-Construction Programs

B-3--Assurances--Non-Construction Programs

C--Certification Regarding Drug-Free Workplace Requirements

D--Certification Regarding Debarment, Suspension, and other

Responsibility Matters (Primary and Lower Tier Covered Transactions)

E--Certification Regarding Environmental Tobacco Smoke

F-1--Certification Regarding Lobbying

F-2--Disclosure of Lobbying Activities

G--State Single Point of Contact Listing Maintained by OMB

H--DHHS Regulations applying to all Applicants/Grantees under the

Community Food and Nutrition Program

I--Applicant's Checklist

Attachment A

1999 Poverty Guidelines for the 48 Contiguous States and the District of

Columbia

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

Poverty

Size of family unit guideline

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

1.......................................................... $8,240

2.......................................................... 11,060

3.......................................................... 13,880

4.......................................................... 16,700

5.......................................................... 19,520

6.......................................................... 22,340

7.......................................................... 25,160

8.......................................................... 27,980

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

For family units with more than 8 members, add $2,820 for each

additional member.

(The same increment applies to smaller family sizes also, as can be seen

in the figures above).

1999 Poverty Guidelines for Alaska

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

Poverty

Size of family unit guideline

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

1.......................................................... $10,320

2.......................................................... 13,840

3.......................................................... 17,360

4.......................................................... 20,880

5.......................................................... 24,400

6.......................................................... 27,920

7.......................................................... 31,440

8.......................................................... 34,960

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

For family units with more than 8 members, add $3,520 for each

additional member.

(The same increment applies to smaller family sizes also, as can be seen

in the figures above).

1999 Poverty Guidelines for Hawaii

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

Poverty

Size of family unit guidelines

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

1.......................................................... $9,490

2.......................................................... 12,730

3.......................................................... 15,970

4.......................................................... 19,210

5.......................................................... 22,450

6.......................................................... 25,690

7.......................................................... 28,930

8.......................................................... 32,170

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

For family units with more than 8 members, add $3,240 for each

additional member.

(The same increment applies to smaller family sizes also, as can be seen

in the figures above).

BILLING CODE 4184-01-P

[[Page 52609]]

[GRAPHIC] [TIFF OMITTED] TN29SE99.000

[[Page 52610]]

Instructions for the SF-424

Public reporting burden for this collection of information is

estimated to average 45 minutes per response, including time for

reviewing instructions, searching existing data sources, gathering

and maintaining the data needed, and completing and reviewing the

collection of information. Send comments regarding the burden

estimate or any other aspect of this collection of information,

including suggestions for reducing this burden, to the Office of

Management and Budget, Paperwork Reduction Project (0348-0043),

Washington, DC 20503.

Please do not return your completed form to the Office of

Management and Budget. Send it to the address provided by the

sponsoring agency.

This is a standard form used by applicants as a required

facesheet for preapplications and applications submitted for Federal

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

certification that States which have established a review and

comment procedure in response to Executive Order 12372 and have

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

given an opportunity to review the applicant's submission.

Item and Entry

1. Self-explanatory.

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

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

3. State use only (if applicable).

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

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

project, leave blank.

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

which will undertake the assistance activity, complete address of

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

contact on matters related to this application.

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

Internal Revenue Service.

7. Enter the appropriate letter in the space provided.

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

space(s) provided:

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

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

period for a project with a projected completion date.

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

financial obligation or contingent liability from an existing

obligation.

9. Name of Federal agency from which assistance if being

requested with this application.

10. Use the Catalog of Federal Domestic Assistance number and

title of the program under which assistance is requested.

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

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

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

projects), attach a map showing project location. For

preapplications, use a separate sheet to provide a summary

description of this project.

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

State, counties, cities).

13. Self-explanatory.

14. List the applicant's Congressional District and any

District(s) affected by the program or project.

15. Amount requested or to be contributed during the first

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

contributions should be included on appropriate lines as applicable.

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

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

amounts in parentheses. If both basic and supplemental amounts are

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

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

15.

16. Applicants should contact the State Single Point of Contact

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

application is subject to the State intergovernmental review

process.

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

person who signs as the authorized representative. Categories of

debt include delinquent audit disallowances, loans and taxes.

18. To be signed by the authorized representative of the

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

sign this application as official representative must be on file in

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

this authorization be submitted as part of the application.)

BILLING CODE 4184-01-M

[[Page 52611]]

[GRAPHIC] [TIFF OMITTED] TN29SE99.001

[[Page 52612]]

[GRAPHIC] [TIFF OMITTED] TN29SE99.002

BILLING CODE 4184-01-C

[[Page 52613]]

Instructions for the SF-424A

Public reporting burden for this collection of information is

estimated to average 180 minutes per response, including time for

reviewing instructions, searching existing data sources, gathering

and maintaining the data needed, and completing and reviewing the

collection of information. Send comments regarding the burden

estimate or any other aspect of this collection of information,

including suggestions for reducing this burden, to the Office of

Management and Budget, Paperwork Reduction Project (0348-0044),

Washington, DC 20503.

Please do not return your completed form to the Office of

Management and Budget. Send it to the address provided by the

Sponsoring Agency.

General Instructions

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

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

any existing Federal grantor agency guidelines which prescribe how

and whether budgeted amounts should be separately shown for

different functions or activities within the program. For some

programs, grantor agencies may require budgets to be separately

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

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

and D should include budget estimates for the whole project except

when applying for assistance which requires Federal authorization in

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

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

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

for Federal assistance in the subsequent budget periods. All

applications should contain a breakdown by the object class

categories shown in Lines a-k of Section B.

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

For applications pertaining to a single Federal grant program

(Federal Domestic Assistance Catalog number) and not requiring a

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

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

For applications pertaining to a single program requiring budget

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

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

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

multiple programs where none of the programs require a breakdown by

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

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

Column (b).

For applications pertaining to multiple programs where one or

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

separate sheet for each program requiring the breakdown. Additional

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

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

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

programs.

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

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

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

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

for the first funding period (usually a year).

For continuing grant program applications, submit these forms

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

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

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

only if the Federal grantor agency instructions provide for this.

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

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

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

For supplemental grants and changes to existing grants, do not

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

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

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

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

which includes the total previous authorized budgeted amounts plus

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

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

Columns (e) and (f).

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

Section B. Budget Categories

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

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

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

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

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

Federal and non-Federal) by object class categories.

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

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

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

applications for new grants and continuation grants the total amount

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

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

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

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

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

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

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

amount from the total project amount. Show under the program

narrative statement the nature and source of income. The estimated

amount of program income may be considered by the Federal grantor

agency in determining the total amount of the grant.

Section C. Non-Federal Resources

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

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

brief explanation on a separate sheet.

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

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

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

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

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

Applicants which are a State or State agencies should leave this

column blank.

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

to be made from all other sources.

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

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

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

Section A.

Section D. Forecasted Cash Needs

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

grantor agency during the first year.

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

by quarter during the first year.

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

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

Project

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

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

is not necessary. For new applications and continuation grant

applications, enter in the proper columns amounts of Federal funds

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

succeeding funding periods (usually in years). This section need not

be completed for revisors (amendments, changes, or supplements) to

funds for the current year of existing grants.

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

submit additional schedules as necessary.

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

additional schedules are prepared for this Section, annotate

accordingly and show the overall totals on this line.

Section F. Other Budget Information

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

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

ordinary or to explain the details as required by the Federal

grantor agency.

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

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

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

is applied, and the total indirect expense.

Line 23--Provide any other explanations or comments deemed

necessary.

Assurances--Non-Construction Programs

Public reporting burden for this collection of information is

estimated to average 15 minutes per response, including time for

reviewing instructions, searching existing data sources, gathering

and maintaining the data needed, and completing and reviewing the

collection of information. Send comments regarding the burden

estimate or

[[Page 52614]]

any other aspect of this collection of information, including

suggestions for reducing this burden, to the Office of Management

and Budget, Paperwork Reduction Project (0348-0040), Washington, DC

20503.

Please do not return your completed form to the Office of

Management and Budget. Send it to the address provided by the

Sponsoring Agency.

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

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

awarding agency. Further, certain Federal awarding agencies may

require applicants to certify to additional assurances. If such is

the case, you will be notified.

As the duly authorized representative of the applicant, I

certify that the applicant:

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

the institutional, managerial and financial capability (including

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

ensure proper planning, management and completion of the project

described in this application.

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

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

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

books, papers, or documents related to the award; and will establish

a proper accounting system in accordance with generally accepted

accounting standards or agency directives.

3. Will establish safeguards to prohibit employees from using

their positions for a purpose that constitutes or presents the

appearance of personal or organizational conflict of interest, or

personal gain.

4. Will initiate and complete the work within the applicable

time frame after receipt of approval of the awarding agency.

5. Will comply with the Intergovernmental Personnel Act of 1970

(42 U.S.C. 4728-4763) relating to prescribed standards for merit

systems for programs funded under one of the 19 statutes or

regulations specified in Appendix A of OPM's Standards for a Merit

System of Personnel Administration (5 CFR 900, Subpart F).

6. Will comply with all Federal statutes relating to

nondiscrimination. These include but are not limited to: (a) Title

VI of the Civil Rights Act of 1964 (Pub. L. 88-352) which prohibits

discrimination on the basis of race, color or national origin; (b)

Title IX of the Education Amendments of 1972, as amended (20 U.S.C.

1681-1683, and 1685-1686), which prohibits discrimination on the

basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as

amended (29 U.S.C. 794), which prohibits discrimination on the basis

of handicaps; (d) the Age Discrimination Act of 1975, as amended (42

U.S.C. 6101-6107), which prohibits discrimination on the basis of

age; (e) the Drug Abuse Office and Treatment Act of 1972 (Pub. L.

92-255), as amended, relating to nondiscrimination on the basis of

drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism

Prevention, Treatment and Rehabilitation Act of 1970 (Pub. L. 91-

616), as amended, relating to nondiscrimination on the basis of

alcohol abuse or alcoholism; (g) 523 and 527 of the Public Health

Service Act of 1912 (42 U.S.C. 290dd-3 and 290ee-3), as amended,

relating to confidentiality of alcohol and drug abuse patient

records; (h) title VIII of the Civil Rights Act of 1968 (42 U.S.C.

3601 et seq.,), as amended, relating to nondiscrimination in the

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

nondiscrimination provisions in the specific state(s) under which

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

requirements of any other nondiscrimination statute(s) which may

apply to the application.

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

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

Property Acquisition Policies Act of 1970 (Pub. L. 91-646) which

provide for fair and equitable treatment of persons displaced or

whose property is acquired as a result of Federal or federally-

assisted programs. These requirements apply to all interests in real

property acquired for project purposes regardless of Federal

participation in purchases.

8. Will comply, as applicable, with provisions of the Hatch Act

(5 U.S.C. 1501-1508 and 7324-7326) which limit the political

activities of employees whose principal employment activities are

funded in whole or in part with Federal funds.

9. Will comply, as applicable, with the provisions of the Davis-

Bacon Act (40 U.S.C. 276a to 276a-7), the Copeland Act (40 U.S.C.

276c and 18 U.S.C. 874), and the Contract Work Hours and Safety

Standards Act (40 U.S.C. 327-333), regarding labor standards for

federally-assisted construction subagreements.

10. Will comply, if applicable, with flood insurance purchase

requirements of Section 102(a) of the flood Disaster Protection Act

of 1973 (Pub. L. 93-234) which requires recipients in a special

flood hazard area to participate in the program and to purchase

flood insurance if the total cost of insurable construction and

acquisition is $10,000 or more.

11. Will comply with environmental standards which may be

prescribed pursuant to the following: (a) institution of

environmental quality control measures under the National

Environmental Policy Act of 1969 (Pub. L. 91-190) and Executive

Order (EO) 11514; (b) notification of violating facilities pursuant

to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d)

evaluation of flood hazards in floodplains in accordance with EO

11988; (e) assurance of project consistency with the approved State

management program developed under the Coastal Zone Management Act

of 1972 (16 U.S.C. 1451 et seq.); (f) conformity of Federal actions

to State (Clean Air) Implementation Plans under Section 176(c) of

the Clean Air Act of 1955, as amended (42 U.S.C. 7401 et seq.); (g)

protection of underground sources of drinking water under the Safe

Drinking Water Act of 1974, as amended(Pub. L. 93-523); and, (h)

protection of endangered species under the Endangered Species Act of

1973, as amended Pub. L. 93-205).

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

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

components of the national wild and scenic rivers system.

13. Will assist the awarding agency in assuring compliance with

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

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

historic properties), and the Archaeological and Historic

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

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

human subjects involved in research, development, and related

activities supported by this award of assistance.

15. Will comply with the Laboratory Animal Welfare Act of 1966

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

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

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

assistance.

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

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

paint in construction or rehabilitation of residence structures.

17. Will cause to be performed the required financial and

compliance audits in accordance with the Single Audit Act Amendments

of 1996 and OMB Circular No. A-133, ``Audits of States, Local

Governments, and Non-Profit Organizations.''

18. Will comply with all applicable requirements of all other

Federal laws, executive orders, regulations, and policies governing

this program.

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

Signature of Authorized Certifying Official

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

Applicant Organization

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

Title

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

Date Submitted

Attachment C

Certificate Regarding Drug-Free Workplace Requirements

This certification is required by the regulations implementing

the Drug-Free Workplace Act of 1988: 45 CFR Part 76, Subpart, F.

Sections 76.630(c) and(d)(2) and 76.645(a)(1) and (b) provide that a

Federal agency may designate a central receipt point for STATE-WIDE

AND STATE AGENCY-WIDE certifications, and for notification of

criminal drug convictions. For the Department of Health and Human

Services, the central point is: Division of Grants Management and

Oversight, Office of Management and Acquisition, Department of

Health and Human Services, Room 517-D, 200 Independence Avenue, SW

Washington, DC 20201.

Certification Regarding Drug-Free Workplace Requirements (Instructions

for Certification)

1. By signing and/or submitting this application or grant

agreement, the grantee is providing the certification set out below.

2. The certification set out below is a material representation

of fact upon which reliance is placed when the agency awards the

grant. If it is later determined that the grantee knowingly rendered

a false

[[Page 52615]]

certification, or otherwise violates the requirements of the Drug-

Free Workplace Act, the agency, in addition to any other remedies

available to the Federal Government, may take action authorized

under the Drug-Free Workplace Act.

3. For grantees other than individuals, Alternate I applies.

4. For grantees who are individuals, Alternate II applies.

5. Workplaces under grants, for grantees other than individuals,

need not be identified on the certification. If known, they may be

identified in the grant application. If the grantee does not

identify the workplaces at the time of application, or upon award,

if there is no application, the grantee must keep the identity of

the workplace(s) on file in its office and make the information

available for Federal inspection. Failure to identify all known

workplaces constitutes a violation of the grantee's drug-free

workplace requirements.

6. Workplace identifications must include the actual address of

buildings (or parts of buildings) or other sites where work under

the grant takes place. Categorical descriptions may be used (e.g.,

all vehicles of a mass transit authority or State highway department

while in operation, State employees in each local unemployment

office, performers in concert halls or radio studios).

7. If the workplace identified to the agency changes during the

performance of the grant, the grantee shall inform the agency of the

change(s), if it previously identified the workplaces in question

(see paragraph five).

8. Definitions of terms in the Nonprocurement Suspension and

Debarment common rule and Drug-Free Workplace common rule apply to

his certification. Grantees' attention is called, in particular, to

the following definitions from these rules:

Controlled substance means a controlled substance in Schedules I

through V of the Controlled Substances Act (21 U.S.C. 812) and as

further defined by regulation (21 CFR 1308.11 through 1308.15);

Conviction means a finding of guilt (including a plea of nolo

contendere) or imposition of sentence, or both, by any judicial body

charged with the responsibility to determine violations of the

Federal or State criminal drug statues;

Criminal drug statute means a Federal or non-Federal criminal

statute involving the manufacture, distribution, or dispensing, use,

or possession of any controlled substance;

Employee means the employee of a grantee directly engaged in the

performance of work under a grant, including: (i) All direct charge

employees; (ii) all indirect charge employees unless their impact or

involvement is insignificant to the performance of the grant; and

(iii) temporary personnel and consultants who are directly engaged

in the performance of work under the grant and who are on the

grantee's payroll. This definition does not include workers not on

the payroll of the grantee (e.g., volunteers, even if used to meet

matching requirement; consultants or independent contractors not on

the grantee's payroll; or employees of subrecipients or

subcontractors in covered workplaces).

Certification Regarding Drug-Free Workplace Requirements

Alternate I. (Grantees Other Than Individuals)

The grantee certifies that it will or will not continue to

provide a drug-free workplace by:

(a) Publishing a statement notifying employees that the unlawful

manufacture, distribution, dispensing, possession, or use of a

controlled substance is prohibited in the grantee's workplace and

specifying the actions that will be taken against employees for

violation of such prohibitions;

(b) Establishing an ongoing drug-free awareness program to

inform employees about:

(1) The dangers of drug abuse in the workplace;

(2) The grantee's policy of maintaining a drug-free workplace;

(3) Any available drug counseling, rehabilitation, and employee

assistance programs; and

(4) The penalties that may be imposed upon employees for drug

abuse violations occurring in the workplace;

(c) Making it a requirement that each employee to be engaged in

the performance of the grant be given a copy of the statement

required by paragraph (a):

(d) Notifying the employee in the statement required by

paragraph (a) that, as a condition of employment under the grant,

the employee will--

(1) Abide by the terms of the statement; and

(2) Notify the employer in writing of his or her conviction for

a violation of a criminal drug statue occurring in the workplace no

later than five calendar days after such conviction;

(e) Notifying the agency in writing, within ten calendar days

after receiving notice under paragraph (d)(2) from an employee or

otherwise receiving actual notice of such conviction. Employers of

convicted employees must provide notice, including position title,

to every grant officer or other designee on whose grant activity the

convicted employee was working, unless the Federal agency has

designated a central point for the receipt of such notices. Notice

shall include the identification number(s) of each affected grant;

(f) Taking one of the following actions, within 30 calendar days

of receiving notice under paragraph (d)(2), with respect to any

employee who is so convicted--

(1) Taking appropriate personnel action against such an

employee, up to and including termination, consistent with the

requirements of the Rehabilitation Act of 1973, as amended; or

(2) Requiring such employee to participate satisfactorily in a

drug abuse assistance or rehabilitation program approved for such

purposes by a Federal, State, or local health, law enforcement, or

other appropriate agency;

(g) Making a faith effort to continue to maintain a drug-free

workplace through implementation of paragraphs (a), (b), (c), (d),

(e) and (f).

(B) The grantee may insert in the space provided below the

site(s) for the performance of work done in connection with the

specific grant:

Place of Performance (Street address, city, county, state, zip code)

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

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

Check if there are workplaces on file that are not identified here.

Alternate II. (Grantees Who Are Individuals)

(a) The grantee certifies that, as a condition of the grant, he

or she will not engage in the unlawful manufacture, distribution,

dispensing, possession, or use of a controlled substance in

conducting any activity with the grant;

(b) If convicted of a criminal drug offense resulting from a

violation occurring during the conduct of any grant activity, he or

she will report the conviction, in writing, within 10 calendar days

of the conviction, to every grant officer or other designee, unless

the Federal agency designates a central point for the receipt of

such notices. When notice is made to such a central point, it shall

include the identification number(s) of each affected grant.

[FR 21690, 21702, May 25, 1990]

Attachment D

Certification Regarding Debarment, Suspension and Other

Responsibility Matters

Certification Regarding Debarment, Suspension, and Other Responsibility

Matters--Primary Covered Transactions

Instructions for Certification

1. By signing and submitting this proposal, the prospective

primary participant is providing the certification set out below.

2. The inability of a person to provide the certification

required below will not necessarily result in denial of

participation in this covered transaction. The prospective

participant shall submit an explanation of why it cannot provide the

certification set out below. The certification or explanation will

be considered in connection with the department or agency's

determination whether to enter into this transaction. However,

failure of the prospective primary participant to furnish a

certification or an explanation shall disqualify such person from

participation in this transaction.

3. The certification in this clause is a material representation

of fact upon which reliance was placed when the department or agency

determined to enter into this transaction. If it is later determined

that the prospective primary participant knowingly rendered an

erroneous certification, in addition to other remedies available to

the Federal Government, the department or agency may terminate this

transaction for cause or default.

4. The prospective primary participant shall provide immediate

written notice to the department or agency to which this proposal is

submitted if at any time the prospective primary participant learns

that its certification was erroneous when submitted or has become

erroneous by reason of changed circumstances.

5. The terms covered transaction, debarred, suspended,

ineligible, lower tier covered transaction, participant, person,

primary

[[Page 52616]]

covered transaction, principal, proposal, and voluntarily excluded,

as used in this clause, have the meanings set out in the Definitions

and Coverage sections of the rules implementing Executive Order

12549. You may contact the department or agency to which this

proposal is being submitted for assistance in obtaining a copy of

those regulations.

6. The prospective primary participant agrees by submitting this

proposal that, should the proposed covered transaction be entered

into, it shall not knowingly enter into any lower tier covered

transaction with a person who is proposed for debarment under 48 CFR

part 9, subpart 9.4, debarred, suspended, declared ineligible, or

voluntarily excluded from participation in this covered transaction,

unless authorized by the department or agency entering into this

transaction.

7. The prospective primary participant further agrees by

submitting this proposal that it will include the clause titled

``Certification Regarding Debarment, Suspension, Ineligibility and

Voluntary Exclusion-Lower Tier Covered Transaction,'' provided by

the department or agency entered into this covered transaction,

without modification, in all lower tier covered transactions and in

all solicitations for lower tier covered transactions.

8. A participant in a covered transaction may rely upon a

certification of a prospective participant in a lower tier covered

transaction that it is not proposed for debarment under 48 CFR part

9, subpart 9.4, debarred, suspended, ineligible, or voluntarily

excluded from the covered transaction, unless it knows that the

certification is erroneous. A participant may decide the method and

frequency by which it determines the eligibility of its principals.

Each participant may, but is not required to, check the List of

Parties Excluded from Federal Procurement and Nonprocurement

Programs.

9. Nothing contained in the foregoing shall be construed to

require establishment of a system of records in order to render in

good faith the certification required by this clause. The knowledge

and information of a participant is not required to exceed that

which is normally possessed by a prudent person in the ordinary

course of business dealings.

10. Except for transactions authorized under paragraph 6 of

these instructions, if a participant in a covered transaction

knowingly enters into a lower tier covered transaction with a person

who is proposed for debarment under 48 CFR part 9, subpart 9.4,

suspended, debarred, ineligible, or voluntarily excluded from

participation in this transaction, in addition to other remedies

available to the Federal Government, the department or agency may

terminate this transaction for cause or default.

Certification Regarding Debarment, Suspension, and Other Responsibility

Matters--Primary Covered Transactions

(1) The prospective primary participant certifies to the best of

its knowledge and belief, that it and its principals:

(1) Are not presently debarred, suspended, proposed for

debarment, declared ineligible, or voluntarily excluded by any

Federal department or agency;

(b) Have not within a three-year period preceding this proposal

been convicted of or had a civil judgment rendered against them for

commission of fraud or a criminal offense in connection with

obtaining, attempting to obtain, or performing a public (Federal,

State or local) transaction or contract under a public transaction;

violation of Federal or State antitrust statutes or commission of

embezzlement, theft, forgery, bribery, falsification or destruction

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

(c) Are not presently indicted for or otherwise criminally or

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

with commission of any of the offenses enumerated in paragraph

(1)(b) of this certification; and

(d) Have not within a three-year period preceding this

application/proposal had one or more public transactions (Federal,

State or local) terminated for cause or default.

(2) Where the prospective primary participant is unable to

certify to any of the statements in this certification, such

prospective participant shall attach an explanation to this

proposal.

Certification Regarding Debarment, Suspension, Ineligibility and

Voluntary Exclusion--Lower Tier Covered Transactions

Instructions for Certification

1. By signing and submitting this proposal, the prospective

lower tier participant is providing the certification set out below.

2. The certification in this clause is a material representation

of fact upon which reliance was placed when this transaction was

entered into. If it is later determined that the prospective lower

tier participant knowingly rendered an erroneous certification, in

addition to other remedies available to the Federal Government the

department or agency with which this transaction originated may

pursue available remedies, including suspension and/or debarment.

3. The prospective lower tier participant shall provide

immediate written notice to the person to which this proposal is

submitted if at any time the prospective lower tier participant

learns that its certification was erroneous when submitted or had

become erroneous by reason of changed circumstances.

4. The terms covered transaction, debarred, suspended,

ineligible, lower tier covered transaction, participant, person,

primary covered transaction, principal, proposal, and voluntarily

excluded, as used in this clause, have the meaning set out in the

Definitions and Coverage sections of rules implementing Executive

Order 12549. You may contact the person to which this proposal is

submitted for assistance in obtaining a copy of those regulations.

5. The prospective lower tier participant agrees by submitting

this proposal that, (Page 33043) should the proposed covered

transaction be entered into, it shall not knowingly under 48 CFR

part 9, subpart 9.4, debarred, suspended, declared ineligible, or

voluntarily excluded from participation in this covered transaction,

unless authorized by the department or agency with which this

transaction originated.

6. The prospective lower tier participant further agrees by

submitting this proposal that it will include this clause titled

``Certification Regarding Debarment, Suspension, Ineligibility and

Voluntary Exclusion-Lower Tier Covered Transaction,'' without

modification, in all lower tier covered transactions and in all

solicitations for lower tier covered transactions.

7. A participant in a covered transaction may rely upon a

certification of a prospective participant in a lower tier covered

transaction that it is not proposed for debarment under 48 CFR part

9, subpart 9.4, debarred, suspended, ineligible, or voluntarily

excluded from covered transactions, unless it knows that the

certification is erroneous. A participant may decide the method and

frequency by which it determines the eligibility of its principals.

Each participant may, but is not required to, check the List of

Parties Excluded from Federal Procurement and Nonprocurement

Programs.

8. Nothing contained in the foregoing shall be construed to

require establishment or a system of records in order to render in

good faith the certification required by this clause. The knowledge

and information of a participant is not required to exceed that

which is normally possessed by a prudent person in the ordinary

course of business dealings.

9. Except for transactions authorized under paragraph 5 of these

instructions, if a participant in a covered transaction knowingly

enters into a lower tier covered transaction with a person who is

proposed for debarment under 48 CFR part 9, subpart 9.4, suspended,

debarred, ineligible, or voluntarily excluded from participation in

this transaction, in addition to other remedies available to the

Federal Government, the department or agency with which this

transaction originated may pursue available remedies, including

suspension and/or debarment.

Certification Regarding Debarment, Suspension, Ineligibility and

Voluntary Exclusion--Lower Tier Covered Transactions

(1) The prospective lower tier participant certifies, by

submission of this proposal, that neither it nor its principals is

presently debarred, suspended, proposed for debarment, declared

ineligible, or voluntarily excluded from participation in this

transaction by any Federal department or agency.

(2) Where the prospective lower tier participant is unable to

certify to any of the statements in this certification, such

prospective participant shall attach an explanation to this

proposal.

Attachment E

Certification Regarding Environmental Tobacco Smoke

Public Law 103227, Part C Environmental Tobacco Smoke, also

known as the Pro Children Act of 1994, requires that smoking not be

permitted in any portion of any indoor

[[Page 52617]]

routinely owned or leased or contracted for by an entity and used

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

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

are funded by Federal programs either directly or through State or

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

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

private residences, facilities funded solely by Medicare or Medicaid

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

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

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

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

on the responsible entity. By signing and submitting this

application the applicant/grantee certifies that it will comply with

the requirements of the Act.

The applicant/grantee further agrees that it will require the

language of this certification be included in any subawards which

contain provisions for the children's services and that all

subgrantees shall certify accordingly.

Attachment F-1

Certification Regarding Lobbying

Certification for Contracts, Grants, Loans, and Cooperative Agreements

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

and belief, that:

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

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

influencing or attempting to influence an officer or employee of an

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

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

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

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

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

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

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

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

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

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

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

loan, or cooperative agreement, the undersigned shall complete and

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

accordance with its instructions.

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

certification be included in the award documents for all subawards

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

grants, loans, and cooperative agreements) and that all

subrecipients shall certify and disclose accordingly. This

certification is a material representation of fact upon which

reliance was placed when this transaction was made or entered into.

Submission of this certification is a prerequisite for making or

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

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

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

more than $100,000 for each such failure.

Statement for Loan Guarantees and Loan Insurance

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

belief, that:

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

influencing or attempting to influence an officer or employee of any

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

an employee of a Member of Congress in connecting with this

commitment providing for the United States to insure or guarantee a

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

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

instructions. Submission of this statement is a prerequisite for

making or entering into this transaction imposed by section 1352,

title 31, U.S. Code. Any person who fails to file the required

statement shall be subject to a civil penalty of not less than

$10,000 and not more than $10,000 for each such failure.

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

Signature

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

Title

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

Organization

BILLING CODE 4184-01-P

[[Page 52618]]

[GRAPHIC] [TIFF OMITTED] TN29SE99.003

BILLING CODE 4184-01-C

[[Page 52619]]

Instruction for Completion of SF-LLL, Disclosure of Lobbying Activities

This disclosure form shall be completed by the reporting

entity,whether subawardee or prime Federal recipient, at the

initiation or receipt of a covered Federal action, or a material

change to a previous filing, pursuant to title 31 U.S.C. section

1352. The filing of a form is required for each payment or agreement

to make payment to any lobbying entity for influencing or attempting

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

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

Member of Congress in connection with a covered Federal action.

Complete all items that apply for both the initial filing and

material change report. Refer to the implementing guidance published

by the Office of Management and Budget for additional information.

1. Identify the type of covered Federal action for which

lobbying activity is and/or has been secured to influence the

outcome of a covered Federal action.

2. Identify the status of the covered Federal action.

3. Identify the appropriate classification of this report. If

this is a follow up report caused by a material change to the

information previously reported, enter the year and quarter in which

the change occurred. Enter the date of the last previously submitted

report by this reporting entity for this covered Federal action.

4. Enter the full name, address, city, State and zip code of the

reporting entity. Include Congressional District, if known. Check

the appropriate classification of the reporting entity that

designates if it is, or expects to be, a prime or subaward

recipient. Identify the tier or the subawardee, e.g., the first

subawardee of the prime is the 1st tier. Subawards include but are

not limited to subcontracts, subgrants and contract awards under

grants.

5. If the organization filing the report in item 4 checks

``Subawardee,'' then enter the full name, address, city, State and

zip code of the prime Federal recipient. Include Congressional

District, if known.

6. Enter the name of the Federal agency making the award or loan

commitment. Include at least one organizational level below agency

name, if known. For example, Department of Transportation, United

States Coast Guard.

7. Enter the Federal program name or description for the covered

Federal action (item 1). If known, enter the full Catalog of Federal

Domestic Assistance (CFDA) number for grants, cooperative

agreements, loans, and loan commitments.

8. Enter the most appropriate Federal identifying number

available for the Federal action identified in item 1 (e.g., Request

for Proposal (RFP) number; Invitation for Bid (IFB) number; grant

announcement number; the contract, grant, or loan award number; the

application/proposal control number assigned by the Federal agency).

Include prefixes, e.g., ``RFP-DE-90-001.''

9. For a covered action where there has been an award or loan

commitment by the Federal agency, enter the Federal amount of the

award/loan commitment for the prime entity identified in item 4 or

5.

10. (a) Enter the full name, address, city, State and zip code

of the lobbying registrant under the Lobbying Disclosure Act of 1995

engaged by the reporting entity identified in item 4 to influence

the covered Federal action.

(b) Enter the full names of the individual(s) performing

services, and include full address if different from 10(a). Enter

Last Name, First Name, and Middle Initial (MI).

11. The certifying official shall sign and date the form, print

his/her name, title, and telephone number.

According to the Paperwork Reduction Act, as amended, no persons

are required to respond to a collection of information unless if

displays a valid OMB Control Number. The valid OMB control number

for this information collection is OMB No. 0348-0046. Public

reporting burden for this collection of information is estimated to

average 10 minutes per response, including time for reviewing

instructions, searching existing data sources's gathering and

maintaining the data needed, and completing and reviewing the

collection of information. Send comments regarding the burden

estimate or any other aspect of this collection of information,

including suggestions for reducing this burden, to the Office of

Management and Budget, Paperwork Reduction Project (0348-0046),

Washington, DC 20503.

Attachment G

State Single Point of Contact Listing Maintained by OMB

In accordance with Executive Order #12372, ``Intergovernmental

Review of Federal Programs,'' Section 4, ``the Office of Management

and Budget (OMB) shall maintain a list of official State entities

designated by the States to review and coordinate proposed Federal

financial assistance and direct Federal development.'' This attached

list is the OFFICIAL OMB LISTING. This listing is also published in

the Catalogue of Federal Domestic Assistance biannually.

August 23, 1999

OMB State Single Point of Contact Listing*

Arizona

Joni Saad, Arizona State Clearinghouse, 3800 N. Central Avenue,

Fourteenth Floor, Phoenix, Arizona 85012, Telephone: (602) 280-1315,

FAX: (602) 280-8144

Arkansas

Mr. Tracy L. Copeland, Manager, State Clearinghouse, Office of

Intergovernmental Services, Department of Finance and

Administration, 515 W. 7th St., Room 412, Little Rock, Arkansas

72203, Telephone: (501) 682-1074, FAX: (501) 682-5206

California

Grants Coordination, State Clearinghouse, Office of Planning &

Research, 1400 Tenth Street, Room 121, Sacramento, California 95814,

Telephone: (916) 445-0613, FAX: (916) 323-3018

Delaware

Francine Booth, State Single Point of Contact, Executive Department,

Office of the Budget, 540 S. Dupont Highway, Suite 5, Dover,

Delaware 19901, Telephone: (301) 739-3326, FAX: (302) 739-5661

District of Columbia

Charles Nichols, State Single Point of Contact, Office of Grants

Mgmt. & Dev., 717 14th Street, N.W., Suite 1200, Washington, D.C.

20005, Telephone: (202) 727-1700 (direct), (202) 727-6537

(secretary), FAX: (202) 727-1617

Florida

Florida State Clearinghouse, Department of Community Affairs, 2555

Shumard Oak Blvd., Tallahassee, Florida 32399-2100, Telephone: (850)

922-5438, FAX: (850) 414-0479, Contact: Cherie Trainor, (850) 414-

5495

Georgia

Deborah Stephens, Coordinator, Georgia State Clearinghouse, 270

Washington Street, S.W.--8th Floor, Atlanta, Georgia 30334,

Telephone: (404) 656-3855, FAX: (404) 656-7901

Illinois

Virginia Bova, State Single Point of Contact, Illinois Department of

Commerce and Community Affairs, James R. Thompson Center, 100 West

Randolph, Suite 3-400, Chicago, Illinois 60601, Telephone: (312)

814-6028, FAX: (312) 814-1800

Indiana

Renee Miller, State Budget Agency, 212 State House, Indianapolis,

Indiana 46204-2796, Telephone: (317) 232-2971 (directline), FAX:

(317) 233-3323

Iowa

Steven R. McCann, Division for Community Assistance, Iowa Department

of Economic Development, 200 East Grand Avenue, Des Moines, Iowa

50309, Telephone: (515) 242-4719, FAX: (515) 242-4809

Kentucky

Kevin J. Goldsmith, Director, Sandra Brewer, Executive Secretary,

Intergovernmental Affairs, Office of the Governor, 700 Capitol

Avenue, Frankfort, Kentucky 40601, Telephone: (502) 564-2611, FAX:

(502) 564-0437

Maine

Joyce Benson, State Planning Office, 184 State Street, 38 State

House Station, Augusta, Maine 04333, Telephone: (207) 287-3261, FAX:

(207) 287-6489

Maryland

Linda Janey, Manager, Plan & Project Review, Maryland Office of

Planning, 301 W. Preston Street--Room 1104, Baltimore, Maryland

21201-2365, Staff Contact: Linda Janey, Telephone: (410) 767-4490,

FAX: (410) 767-4480

Michigan

Richard Pfaff, Southeast Michigan Council of Governments, 660 Plaza

Drive--Suite 1900, Detroit, Michigan 48226, Telephone: (313) 961-

4266, FAX: (313) 961-4869

[[Page 52620]]

Mississippi

Cathy Mallette, Clearinghouse Officer, Department of Finance and

Administration, 550 High Street, 303 Walters Sillers Building,

Jackson, Mississippi 39201-3087, Telephone: (601) 359-6762, FAX:

(601) 359-6758

Missouri

Lois Pohl, Federal Assistance Clearinghouse, Office of

Administration, P.O. Box 809, Jefferson Building, 9th Floor,

Jefferson Building, 9th Floor, Jefferson City, Missouri 65102,

Telephone: (314) 751-4834, FAX: (314) 751-7819

Nevada

Department of Administration, State Clearinghouse, 209 E. Musser

Street, Room 220, Carson City, Nevada 89710, Telephone: (702) 687-

3983, Contact: Heather Elliot, (702) 687-6367

New Hampshire

Jeffrey H. Taylor, Director, New Hampshire Office of State Planning,

Attn: Intergovernmental Review Process, Mike Blake, 2\1/2\ Beacon

Street, Concord, New Hampshire 03301, Telephone: (603) 271-2155,

FAX: (603) 271-1728

New Mexico

Nick Mandell, Local Government Division, Room 201 Bataan Memorial

Building, Santa Fe, New Mexico 87503, Telephone: (505) 827-3640,

Fax: (505) 827-4984

New York

New York State Clearinghouse, Division of the Budget, State Capitol,

Albany, New York 12224, Telephone: (518) 474-1605, FAX: (518) 486-

5617

North Carolina

Jeanette Furney, North Carolina Department of Administration, 116

West Jones Street--Suite 5106, Raleigh, North Carolina 27603-8003,

Telephone: (919) 733-7232, FAX: (919) 733-9571

North Dakota

North Dakota Single Point of Contact, Office of Intergovernmental

Assistance, 600 East Boulevard Avenue, Bismarck, North Dakota 58505-

0170, Telephone: (701) 224-2094, FAX: (701) 224-2308

Rhode Island

Kevin Nelson, Review Coordinator, Department of Administration,

Division of Planning, One Capitol Hill, 4th Floor, Providence, Rhode

Island 02908-5870, Telephone: (401) 277-2656, FAX: (401) 277-2983

South Carolina

Omeagia Burgess, State Single Point of Contact, Budget and Control

Board, Office of State Budget, 1122 Ladies Street--12th Floor,

Columbia, South Carolina 29201, Telephone: (803) 734-0494, FAX:

(803) 734-0645

Texas

Tom Adams, Governors Office, Director, Intergovernmental

Coordination, P.O. Box 12428, Austin, Texas 78711, Telephone: (512)

463-1771, FAX: (512) 936-2681

Utah

Carolyn Wright, Utah State Clearinghouse, Office of Planning and

Budget, Room 116 State Capitol, Salt Lake City, Utah 84114,

Telephone: (801) 538-1027, FAX: (801) 538-1547

West Virginia

Fred Cutlip, Director, Community Development Division, W. Virginia

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

25305, Telephone: (304) 558-4010, FAX: (304) 558-3248

Wisconsin

Jeff Smith, Section Chief, Federal/State Relations, Wisconsin

Department of Administration, 101 East Wilson Street--6th Floor,

P.O. Box 7868, Madison, Wisconsin 53707, Telephone: (608) 266-0267,

FAX: (608) 267-6931

Wyoming

Sandy Ross, State Single Point of Contact, Department of

Administration and Information, 2001 Capitol Avenue, Room 214,

Cheyenne, WY 82002, Telephone: (307) 777-5492, FAX: (307) 777-3696

Territories

Guam

Joseph Rivera, Acting Director, Bureau of Budget and Management

Research, Office of the Governor, P.O. Box 2950, Agana, Guam 96932,

Telephone: (671) 475-9411 or 9412, FAX: (671) 472-2825

Puerto Rico

Jose Caballero-Mercado, Chairman, Puerto Rico Planning Board,

Federal Proposals Review Office, Minillas Government Center, P.O.

Box 41119, San Juan, Puerto Rico 00940-1119, Telephone: (787) 727-

4444, (787) 723-6190, FAX: (787) 724-3270

North Mariana Islands

Mr. Alvaro A. Santos, Executive Officer, Office of Management and

Budget, Office of the Governor, Saipan, MP 96950, Telephone: (670)

664-2256, FAX: (670) 664-2272, Contact person: Ms. Jacoba T. Seman,

Federal Programs Coordinator, Telephone: (670) 664-2289, FAX: (670)

664-2272

Virgin Islands

Nellon Bowry, Director, Office of Management and Budget, #41

Norregade Emancipation Garden, Station, Second Floor, Saint Thomas,

Virgin Islands 00802

Please direct all questions and correspondence about

intergovernmental review to: Linda Clarke, Telephone: (809) 774-

0750, FAX: (809) 776-0069.

If you would like a copy of this faxed to your office, please

call our publications office at: (202) 395-9068.

* In accordance with Executive Order #12372, ``Intergovernmental

Review of Federal Programs,'' this listing represents the designated

State Single Points of Contact. The jurisdictions not listed no

longer participate in the process BUT GRANT APPLICANTS ARE STILL

ELIGIBLE TO APPLY FOR THE GRANT EVEN IF YOUR STATE, TERRITORY,

COMMONWEALTH, ETC., DOES NOT HAVE A ``STATE SINGLE POINT OF

CONTACT.'' STATES WITHOUT ``STATE SINGLE POINTS OF CONTACT''

INCLUDE: Alabama, Alaska; American Samoa; Colorado; Connecticut;

Hawaii; Idaho; Kansas; Louisiana; Massachusetts, Minnesota; Montana;

Nebraska; New Jersey; Ohio; Oklahoma; Oregon; Palau; Pennsylvania;

South Dakota; Tennessee; Vermont, Virginia; and Washington. This

list is based on the most current information provided by the

States. Information on any changes or apparent errors should be

provided to the Office of Management and Budget and the State in

question. Changes to the list will only be made upon formal

notification by the State. Also, this listing is published

biannually in the Catalogue of Federal Domestic Assistance.

Attachment H

Department of Health and Human Services (DHHS), Regulations Applying to

All Applicants/Grantees Under the Community Food and Nutrition Program

Title 45 of the Code of Federal Regulations

Part 16--DHHS Grant Appeals Process

Part 74--Administration of Grants (non-governmental)

Part 74--Administration of Grants (state and local governments and

Indian Tribal affiliates):

Sections:

74.26--Non-Federal Audits

74.27--Allowable cost for hospitals and non-profit organizations

among other things

74.32 Real Property

74.34 Equipment

74.35 Supplies

74.24 Program Income

Part 75--Informal Grant Appeal Procedures

Part 76--Debarment and Suspension from Eligibility For Financial

Assistance

Subpart F--Drug Free Workplace Requirements

Part 80--Non-discrimination Under Programs Receiving Federal

Assistance through DHHS Effectuation of Title VI of the Civil Rights

Act of 1964

Part 81--Practice and Procedures for Hearings Under Part 80 of this

Title

Part 83--Regulation for the Administration and Enforcement of

Sections 799A and 845 of the Public Health Service Act

Part 84--Non-discrimination on the Basis of Handicap in Programs and

Activities Receiving Federal Financial Assistance

Part 85--Enforcement of Non-discrimination on the Basis of Handicap

in Programs or Activities Conducted by DHHS

Part 86--Non-discrimination on the Basis of Sex in Education

Programs and Activities Receiving or Benefitting from Federal

Financial Assistance

Part 91--Non-discrimination on the Basis of Age in Health and Human

Services Programs or Activities Receiving Federal Financial

Assistance

[[Page 52621]]

Part 92--Uniform Administrative Requirements for Grants and

Cooperative Agreements to States and Local Governments (Federal

Register, March 11, 1988)

Part 93--New Restrictions on Lobbying

Part 100--Intergovernmental Review of DHHS Programs and Activities

BILLING CODE 4184-01-M

[[Page 52622]]

[GRAPHIC] [TIFF OMITTED] TN29SE99.004

[FR Doc. 99-25331 Filed 9-28-99; 8:45 am]

BILLING CODE 4184-01-C