Request for Applications for the Office of Community Services' Fiscal Year 2000 Job Opportunities for Low-Income Individuals Program

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

Community Services (OCS), announces that, based on availability of

funds, competing applications will be accepted for new grants pursuant

to the Secretary's discretionary authority under section 505 of the

Family Support Act of 1988, as amended.

Closing Date: To be considered for funding, applications must be

postmarked on or before January 14, 2000. Detailed application

submission instructions, including the addresses to which applications

must be submitted, are found in Part V-B, Application Submission.

FOR FURTHER INFORMATION CONTACT: Administration for Children and

Families, Office of Community Services, 370 L'Enfant Promenade SW.,

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

(202) 401-5324, Aleatha Slade (202) 401-5317. In addition, this Notice

is accessible on the OCS WEBSITE for reading or downloading at:

www.acf.dhhs.gov/programs/ocs/kits1.htm.

If this Program Announcement is not available at these sources, it

may be obtained by telephoning or writing the office listed under FOR

FURTHER INFORMATION CONTACT above.

The Catalog of Federal Domestic Assistance number for this program

is ``93.593''. The title is ``Job Opportunities for Low-Income

Individuals (JOLI) Program''.

Part I--Preamble

A. Legislative Authority

Section 505 of the Family Support Act of 1988, Public Law 100-485,

as amended, authorizes the Secretary of HHS to enter into agreements

with non-profit organizations (including community development

corporations) for the purpose of conducting projects designed to create

employment and business opportunities for certain low-income

individuals.

The Personal Responsibility and Work Opportunity Reconciliation Act

of 1996, Public Law 104-193, reauthorized Section 505 of the Family

Support Act of 1988. The Act also amended certain subsections of

Section 505 of the Family Support Act of 1988 to be effective July 1,

1997.

B. Definitions of Terms

For purposes of this Program Announcement, the following

definitions apply:

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

assistance (project period) is divided for budgetary and funding

purposes.

--Community-level data: Key information to be collected by each grantee

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

JOLI projects. This consists of data on the population of the target

area, including the percentage of TANF recipients and others on public

assistance, and the percentage whose incomes fall below the poverty

line; the unemployment rate; the number of new business starts and

business closings; and a description of the major employers and average

wage rates and employment opportunities with those employers.

--Community development corporation: A private, nonprofit entity,

governed by a board of directors consisting of low-income residents of

the community and business, civic leaders, that has as a principal

purpose, planning, developing, or managing community economic

development projects.

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

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

intervention and its expected result. Both the intervention and result

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

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

small business planning will be sufficient for participants to prepare

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

obtained on the number of hours of training actually received by

participants (the intervention), and the quality of loan applications

(the result), to determine the validity of the hypothesis (that eighty

hours of training is sufficient to produce the result).

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

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

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

preparation of a business plan and loan package are planned

interventions.

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

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

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

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

the expansion of existing businesses.

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

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

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

section 501(c) of such code.

--Non-traditional employment for women or minorities: Employment in an

industry or field where women or minorities currently make up less than

twenty-five percent of the work force.

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

collected data which define the net effects of the interventions

applied in the project. An outcome evaluation will produce and

interpret findings related to whether the interventions produced

desirable changes and their potential for replicability. It should

answer the question: Did this program work?

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

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

same community as the applicant and which are proposed or potential

employers of project participants.

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

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

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

recruiting participants, quality of training activities, or usefulness

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

receiving what services? and are the services being delivered as

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

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

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

identify problems that occurred and how they were dealt with and

recommend improved means of future implementation. It should answer the

question: ``How

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was the program carried out?'' In concert with the outcome evaluation,

it should also help explain, ``Why did this program work/not work?''

and ``What worked and what did not?''

--Program participant/beneficiary: An individual eligible to receive

Temporary Assistance for Needy Families under Title I of the Personal

Responsibility and Work Opportunity Reconciliation Act of 1996 (Part A

of Title IV of the Social Security Act) and any other individual whose

income level does not exceed 100 percent of the official poverty line

as found in the most recent revision of the Poverty Income Guidelines

published by the Department of Health and Human Services. (See

Attachment A.)

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

including any extensions.

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

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

assistance.

--Third party: Any individual, organization, or business entity that is

not the direct recipient of grant funds.

--Third party agreement: A written agreement entered into by the

grantee and an organization, individual or business entity (including a

wholly-owned subsidiary), by which the grantee makes an equity

investment or a loan in support of grant purposes.

--Third party in-kind contributions: The value of non-cash

contributions provided by non-federal third parties which may be in the

form of real property, equipment, supplies and other expendable

property, and the value of goods and services directly benefitting and

specifically identifiable to the project or program.

C. Purpose

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

creating new employment and business opportunities for certain low-

income individuals through the provision of technical and financial

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

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

low-income individual eligible to participate in a project conducted

under this program is any individual eligible to receive Temporary

Assistance for Needy Families (TANF) under Part A of Title IV of the

Social Security Act, as amended, or any other individual whose income

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

Attachment A.) Within these categories, emphasis should be on

individuals who are receiving TANF or its equivalent under State

auspices; those who are unemployed; those residing in public housing or

receiving housing assistance; non-custodial parents, and those who are

homeless.

Part II--Background Information and Program Requirements

A. Eligible Applicants

Organizations eligible to apply for funding under this program are

any non-profit organizations (including community development

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

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

section 501(c) of such Code.

Applicants must provide documentation of their tax exempt status.

The applicant can accomplish this by providing a copy of the

applicant's listing in the Internal Revenue Service's (IRS) most recent

list of tax-exempt organizations described in section 501(c)(3) of the

IRS code or by providing a copy of the currently valid IRS tax

exemption certificate. Failure to provide evidence of section 501(c)(3)

or (4) tax exempt status will result in rejection of the application.

Applicants that have applied to IRS for certification as a 501(c)

(3) or (4) tax exempt organization must provide documentation that

their application is currently pending IRS determination. However,

applicant must have status at time of award.

B. Project and Budget Periods

The Personal Responsibility and Work Opportunity Reconciliation Act

of 1996, Public Law 104-193, reauthorized and modified Section 505 of

the Family Support Act of 1988, the JOLI authorizing legislation. Among

the modifications effected was the deletion of sub-section (e), which

had legislatively mandated project duration. Applicants are therefore

free to apply for projects of from one to three years' duration,

depending on the proposed work program and the applicant's assessment

of the time required to achieve the proposed project goals. OCS has

made the programmatic determination that the nature of job creation and

career development projects which meet the funding criteria set forth

in this Announcement is such that it is not feasible to divide funding

into 12-month increments, and that completion of the entire project is

in each case necessary to achieve the purposes of the JOLI program.

Consequently, budget periods for grants under this Announcement may be

up to three years.

Given the limited funds available for the JOLI program, applicants

should make a realistic assessment of the time and funds needed to

achieve the goals set forth in their proposal, and design a work

program and budget accordingly. The grant request should be for an

amount, up to a maximum of $500,000, needed to implement that part of

the project plan supported by OCS funds, taking into consideration

other cash and in-kind resources mobilized by the applicant in support

of the proposed project. (See Paragraph D, below, Mobilization of

Resources, and Part IV, Element VI, Budget Appropriateness and

Reasonableness.)

C. Availability of Funds and Grant Amounts

All grant awards are subject to the availability of appropriated

funds. It is anticipated that approximately $5,500,000 will be

available in FY 2000 for JOLI. OCS estimates that approximately

$5,000,000 will be available for new grants and the remaining $500,000

will be set aside for the national JOLI contract. The 1996 amendments

to the JOLI authorizing legislation also deleted the limitation on the

number of grants to be made in any one fiscal year. Thus, the Office of

Community Services expects to award up to 10 new grants by September

30, 2000, based on the amounts requested and contingent on the

availability of funds. Grants of up to $500,000 in OCS funds for

project periods and budget periods of up to three years will be awarded

to selected organizations under this program in FY 2000.

D. Mobilization of Resources

OCS will give favorable consideration in the review process to

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

for direct use in the project. The firm commitment of these resources

must be documented and submitted with the application in order to be

given credit in the review process under the Public-Private

Partnerships program element. Except in unusual situations, this

documentation must be in the form of letters of commitment from the

organization(s)/individual(s) from which resources will be received.

Even though there is no matching requirement for the JOLI Program,

grantees will be held accountable for any match, cash or in-kind

contribution proposed or pledged as part of an approved application.

(See Part IV, Element V, and Part VI, B., Instructions for Completing

the SF-424A, Section C, Non-Federal Resources)

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E. Program Participants/beneficiaries

Projects proposed for funding under this Announcement must result

in direct benefits to low-income people or persons at or below the

poverty line, as defined in the most recently published Poverty Income

Guidelines and individuals eligible to receive TANF under Part A of

Title IV of the Social Security Act, as amended.

Attachment A to this Announcement is an excerpt from the guidelines

currently in effect. Annual revisions of these guidelines are normally

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

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

throughout the project period. These revised guidelines also may be

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

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

Washington, D.C. 20402.

No other government agency or privately-defined poverty guidelines

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

program.

F. Prohibition and Restrictions on the Use of Funds

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

property is prohibited. Costs incurred for the rearrangement and

alteration of facilities required specifically for the grant program

are allowable when specifically approved in advance by ACF in writing.

If the applicant is proposing a project which will affect a

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

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

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

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

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

inclusion in the National Register of Historic Places, the applicant

should consult with the State Historic Preservation Officer. (See

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

applicant should contact OCS early in the development of its

application for instructions regarding compliance with the Act and data

required to be submitted to the Department of Health and Human

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

application being ineligible for funding consideration.

G. Multiple Submittals

Due to the limited amount of funds available under this program,

only a single proposal from any one eligible applicant will be funded

by OCS from FY 2000 JOLI funds pursuant to this Announcement.

H. Re-funding

OCS will not re-fund a previously funded grantee to carry out the

same work plan in the same target area.

I. Sub-contracting or Delegating Projects

An applicant will not be funded where the proposal indicates that

the applicant if funded will serve as a straw-party, that is, act as a

mere conduit of funds to a third party without performing a substantive

role itself. This prohibition does not bar sub-contracting or sub-

awarding for specific services or activities needed to conduct the

project.

J. Maintenance of Effort

The application must include an assurance that activities funded

under this Program Announcement are in addition to, and not in

substitution for, activities previously carried out without Federal

assistance. (See Part VII-A. 9 and Attachment M.)

Part III--Application Requirements and Priority Areas

A. Program Focus

The Congressional Conference Report on the 1992 appropriations for

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

related agencies directed the ACF to require economic development

strategies as part of the application process to ensure that highly

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

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

Priority will be given to applications proposing to serve those

areas containing the highest percentage of individuals receiving

Temporary Assistance to Needy Families (TANF) under Title IV-A of the

Social Security Act, as amended.

While projected employment in future years may be included in the

application, it is essential that the focus of the project concentrate

on the creation of new full-time, permanent jobs and/or new business

development opportunities for TANF recipients and other low-income

individuals during the duration of the grant project period. OCS is

particularly interested in receiving innovative proposals that grow out

of the experience and creativity of applicants and the needs of their

clientele and communities.

Applicants should include strategies which seek to integrate

projects financed and jobs created under this program into a larger

effort of broad community revitalization which will promote job and

business opportunities for eligible program participants and impact the

overall economic environment.

OCS will only fund projects that create new employment and/or

business opportunities for eligible program participants. That is, new

full-time permanent jobs through the expansion of a pre-identified

business or new business development, or by providing opportunities for

self-employment. In addition, projects should enhance the participants'

capacities, abilities and skills and thus contribute to their progress

toward self-sufficiency.

With national welfare reform a reality, and many States already

implementing ``welfare-to-work'' programs, the need for well-paying

jobs with career potential for TANF recipients becomes ever more

pressing. In this context, the role of JOLI as a vehicle for exploring

new and promising areas of employment opportunity for the poor is more

important than ever.

Within the JOLI Program framework of job creation through new or

expanding businesses or self-employment, OCS would welcome proposals

offering business or career opportunities to eligible participants in a

variety of fields. For instance, these might include day care and

transportation, which are not only opportunities for employment, but

when not available can be serious barriers to employment for TANF

recipients; environmental justice initiatives involving activities such

as toxic waste clean-up, water quality management, or Brownfields

remediation; health-related jobs such as home health aides or medical

support services; and non-traditional jobs for women and minorities.

B. Creation of Jobs and Employment Opportunities

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

opportunities (jobs) applies to all applications. OCS has determined

that the creation of non-traditional job opportunities for women or

minorities in industries or activities where they currently make up

less than twenty-five percent of the work force meets the requirements

of the JOLI legislation for the creation of new employment

opportunities. OCS continues to solicit other JOLI applications to

propose the creation of jobs through the expansion of existing

businesses, the development of new businesses, or the creation of

employment opportunities through self-employment/ microenterprise

development.

[[Page 55345]]

Proposed projects must show that the jobs and/or business/self

employment opportunities to be created under this program will

contribute to achieving self-sufficiency among the target population.

The employment opportunities should provide hourly wages that exceed

the minimum wage and also provide benefits such as health insurance,

child care, and career development opportunities.

C. Cooperative Partnership Agreement With the Designated Agency

Responsible for the Temporary Assistance for Needy Families (TANF)

Program

A formal, cooperative relationship between the applicant and the

designated State agency responsible for administering the Temporary

Assistance for Needy Families (TANF) program (as provided for under

Title IV-A of the Social Security Act, as amended,) in the area served

by the project is a requirement for funding. The application must

include a signed, written agreement between the applicant and the

designated State agency responsible for administering the TANF program,

or a letter of commitment to such an agreement within 6 months of a

grant award (contingent only on receipt of OCS funds). The agreement

must describe the cooperative relationship, including specific

activities and/or actions each of these entities propose to carry out

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

The agreement, at a minimum, must cover the specific services and

activities that will be provided to the target population. (See

Attachment I for a list of the State IV-A agencies administering TANF.)

D. Third-Party Project Evaluation

Proposals must include provision for an independent,

methodologically sound evaluation of the effectiveness of the

activities carried out with the grant and their efficacy in creating

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

process evaluation, and an outcome evaluation whose design will permit

tracking of project participants throughout the proposed project

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

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

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

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

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

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

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

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

be collected and available.

E. Economic Development Strategy

As noted in A. above, the Congress, in the Conference Report on the

FY 1992 appropriation, directed ACF to require economic development

strategies as part of the application process for JOLI to ensure that

highly qualified organizations participate in the demonstration.

Accordingly, applicants must include in their proposal an explanation

of how the proposed project is integrated with and supports a larger

economic development strategy within the target community. Where

appropriate, applicants should document how they were involved in the

preparation and planned implementation of a comprehensive community-

based strategic plan, such as that required for applying for

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

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

proposed project supports the goals of that plan. (See Part IV, Sub-

Element III (b).)

F. Training and Support for Micro-Business Development

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

business opportunities for eligible participants, the applicant must

detail how it will provide training and support services to potential

entrepreneurs. The assistance to be provided to potential entrepreneurs

must include, at a minimum: (1) Technical assistance in basic business

planning and management concepts; (2) assistance in preparing a

business plan and loan application; and (3) access to business loans.

G. Support for Noncustodial Parents

The Office of Community Services and the Office of Child Support

Enforcement, both in the Administration for Children and Families,

signed a Memorandum of Understanding (MOU) to foster and enhance

partnerships between OCS grantees and local Child Support Enforcement

(CSE) agencies. (See Attachment N for the list of CSE State Offices

that can identify local CSE agencies). In the words of the MOU:

``The purpose of these partnerships will be to develop and

implement innovative strategies in States and local communities to

increase the capability of low-income parents and families to fulfill

their parental responsibilities. Too many low-income parents are

without jobs or resources needed to support their children. A

particular focus of these partnerships will be to assist low-income,

non-custodial parents of children receiving Temporary Assistance for

Needy Families to achieve a degree of self-sufficiency that will enable

them to provide support that will free their families of the need for

such assistance.''

Accordingly, a rating factor and a review criterion have been

included in this Program Announcement which will award two points to

applicants who have entered into partnership agreements with their

local CSE agency to provide for referrals to their project in

accordance with provisions of the OCS-OCSE MOU. (See Part IV, Sub-

Element III (c))

H. Technical Assistance to Employers

Technical assistance should be specifically addressed to the needs

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

individuals and/or to the individuals themselves in areas such as job-

readiness, literacy and other basic skills training, job preparation,

self-esteem building, etc. Financial assistance may be provided to the

private employer as well as to the individual.

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

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

commitments from the businesses to create the planned jobs must be

included with the application.

I. Applicant Experience and Cost-Per-Job

In the review process, favorable consideration will be given to

applicants with a demonstrated record of achievement in promoting job

and enterprise opportunities for low-income people. Favorable

consideration also will be given to those applicants who show the

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

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

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

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

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

counted in the cost-per-job formula. (See Part IV, Sub-Element III (d))

J. Loan Funds

The creation of a revolving loan fund with funds received under

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

of funds from other

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sources for this purpose. Loans made to eligible beneficiaries for

business development activities must be at or below market rate.

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

continue or expand the activities of the approved project.

K. Business Plans

Where applicant is proposing the development and start-up of a new

business or the expansion of an existing business, a Business Plan that

follows the outline in Attachment L to this Announcement must be

submitted as an appendix to the proposal.

L. Dissemination of Project Results

Applications should include a plan for disseminating the results of

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

up to $2,000 for dissemination purposes. Final Project Reports should

include a description of dissemination activities with copies of any

materials produced.

M. General Projects 1.0 and Community Development Corporations Set-

Aside 2.0

All grant awards are subject to the availability of appropriated

funds. The Office of Community Services expects to award approximately

$5 million by no later than September 30, 2000 for new grants under

this announcement: approximately $4 million for General Projects 1.0,

and up to $1 million for CDC Set-Aside Projects 2.0. (For definition of

Community Development Corporation, See Part I, Section B)

The same purposes, requirements and prohibitions are applicable to

proposals submitted under both General Projects 1.0 and Community

Development Corporations Set-Aside 2.0. Applications for the set-aside

funds that are not funded due to the limited amount of funds available

will also be considered competitively within the larger pool of

eligible applicants.

N. Third Party Agreements

Any applicant submitting a proposal for funding who proposes to use

some or all of the requested OCS funds to enter into a third party

agreement in order to make an equity investment (such as the purchase

of stock) or a loan to an organization, or business entity (including a

wholly-owned subsidiary), must include in the application, along with

the business plan, a copy of the signed third party agreement for

approval by OCS.

A third party agreement covering an equity investment must contain,

at a minimum, the following:

1. The type of equity transaction (e.g. stock purchase);

2. Purpose(s) for which the equity investment is being made;

3. Cost per share;

4. Number of shares being purchased;

5. Percentage of ownership of the business; and

6. Number of seats on the board, if applicable.

A third party agreement covering a loan transaction must contain,

at a minimum, the following information:

1. Purpose(s) for which the loan is being made;

2. Rates of interest and other fees;

3. Terms of loan;

4. Repayment schedules;

5. Collateral security; and

6. Default and collection procedures.

All third party agreements must include written commitments as

follows:

From the third party (as appropriate):

1. A minimum of 75% of the jobs to be created as a result of the

injection of grant funds will be filled by low-income individuals;

2. The grantee will have the right to screen applicants for jobs to

be filled by low-income individuals and to verify their eligibility;

3. If the grantee's equity investment equals 25% or more of the

business's assets, the grantee will have representation on the board of

directors;

4. Reports will be made to the grantee regarding the use of grant

funds no less than on a quarterly basis;

5. A procedure will be developed to assure that there are no

duplicate counts of jobs created; and

6. Detailed information will be provided on how the grant funds

will be used by the third party by submitting a Source and Use of Funds

Statement. In addition, the agreement must provide details on how the

grantee will provide support and technical assistance to the third

party in areas of recruitment and retention of low-income individuals.

From the grantee:

Detailed information on how the grantee will provide support and

technical assistance to the third party in areas of recruitment and

retention of low-income individuals.

All third party agreements should be accompanied by:

1. A signed statement from a Certified or Licensed Public

Accountant as to the sufficiency of the third party's financial

management system in accordance with 45 CFR part 74, to protect

adequately any federal funds awarded under the application;

2. Financial statements for the third party organization for the

prior three years (If not available because the organization is a

newly-formed entity, include a statement to this effect.); and

3. The third party agreement will specify how the grantee will

provide oversight of the third party for the life of the agreement.

Also, the agreement will specify that the third party will maintain

documentation related to the expenditure of grant funds loaned to or

invested in the third party and grant objectives as specified in the

agreement and will provide the grantee and HHS access to that

documentation.

If a signed third party agreement is not available when the

application is submitted, the applicant must submit as part of the

narrative as much of the above-mentioned information as possible in

order to enable reviewers to evaluate the proposal. It should be noted

that that portion of a grant which will be used to fund a third party

agreement will not be released until the agreement has been approved by

OCS.

Part IV--Application Elements and Review Criteria

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

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

application reviewed. These numerical scores will be supported by

explanatory statements on a formal rating form describing major

strengths and weaknesses under each applicable criterion published in

the Announcement.

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

criteria coupled with the specific requirements described in Part III.

Scoring will be based on a total of 100 points.

The ultimate goals of the project to be funded under the JOLI

Program are: (1) To achieve, through project activities and

interventions, the creation of employment opportunities for TANF

recipients and other low-income individuals which can lead to economic

self-sufficiency of members of the communities served; (2) to evaluate

the effectiveness of these interventions and of the project design

through which they were implemented; and (3) thus to make possible the

replication of successful programs. OCS intends to make the awards of

all the above grants on the basis of brief, concise applications. The

elements and format of these applications, along with the review

criteria that will be used to evaluate them, will be outlined in this

Part.

In order to simplify the application preparation and review

process, OCS seeks to keep grant proposals cogent and brief.

Applications with project narratives (excluding appendices) of more

than 30 letter-sized pages of 12 characters per inch (c.p.i.) type or

[[Page 55347]]

equivalent on a single side will not be reviewed for funding.

Applicants should prepare and assemble their project description using

the following outline of required project elements. They should,

furthermore, build their project concept, plans, and application

description upon the guidelines set forth for each of the project

elements.

For each of the Project Elements or Sub-Elements below, there is,

at the end of the discussion, a suggested number of pages to be devoted

to the particular element or sub-element. These are suggestions only;

but the applicant must remember that the overall Project Narrative

cannot be longer than 30 pages.

The competitive review of proposals will be based on the degree to

which applicants incorporate each of the Elements and Sub-Elements

below into their proposals, so as to:

1. Describe convincingly a project that will develop new employment

or business opportunities for TANF recipients and other low income

individuals that can lead to a transition from dependency to economic

self-sufficiency;

2. Propose a realistic budget and time frame for the project that

will support the successful implementation of the work plan to achieve

the project's goals in a timely and cost effective manner; and

3. Provide for the testing and evaluation of the project design,

implementation, and outcomes so as to make possible replication of a

successful program.

Element I--Organizational Experience in Program Area and Staff Skills,

Resources and Responsibilities

Sub-Element I (a)--Agency's Experience and Commitment in Program Area

(Weight of 0-10 points in proposal review)

Applicants should cite their organization's capability and relevant

experience in developing and operating programs which deal with poverty

problems similar to those to be addressed by the proposed project. They

should also cite the organization's experience in collaborative

programming and operations which involve evaluations and data

collection. Applicants should identify agency executive leadership in

this section and briefly describe their involvement in the proposed

project and provide assurance of their commitment to its successful

implementation.

The application should include documentation that briefly

summarizes two similar projects undertaken by the applicant agency and

the extent to which the stated and achieved performance targets,

including permanent benefits to low-income populations, have been

achieved. The application should note and justify the priority that

this project will have within the agency, including the facilities and

resources that it has available to carry it out.

It is suggested that applicants use no more than 2 pages for this

Sub-Element.

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

organizations with a demonstrated record of achievement in promoting

job creation and enterprise opportunities for low-income people.

Sub-Element I (b)--Staff Skills, Resources and Responsibilities

(Weight of 0-10 points in proposal review)

The application must identify the two or three individuals who will

have the key responsibility for managing the project, coordinating

services and activities for participants and partners, and for

achieving performance targets. The focus should be on the

qualifications, experience, capacity and commitment to the program of

the executive officials of the organization and the key staff persons

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

project director should have supervisory experience, experience in

finance and business, and experience with the target population.

Because this is a demonstration project within an already-established

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

if not hired.

The application must also include a resume of the third party

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

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

person with recognized evaluation skills who is organizationally

distinct from, and not under the control of, the applicant. (See

Element IV, Project Evaluation, below, for fuller discussion of

evaluator qualifications.)

Actual resumes of key staff and position descriptions should be

included in an Appendix to the proposal.

It is suggested that applicants use no more than 3 pages for this

Sub-Element.

Element II: Project Theory, Design, and Plan

OCS seeks to learn from the application why and how the project as

proposed is expected to lead to the creation of new employment

opportunities for low-income individuals, which can lead to significant

improvements in individual and family self-sufficiency.

Applicants are urged to design and present their project in terms

of a conceptual cause-effect framework. In the following paragraphs, a

framework is described that suggests a way to present a project so as

to show the logic of the cause-effect relations between project

activities and project results. Applicants don't have to use the exact

language described; but it is important to present the project in a way

that makes clear the cause-effect relationship between what the project

plans to do and the results it expects to achieve.

Sub-Element II (a)--Description of Target Population, Analysis of Need,

and Project Assumptions

(Weight of 0-10 points in application review)

The project design or plan should begin with identifying the

underlying assumptions about the program. These are the beliefs on

which the proposed program is built. These assumptions include: The

needs of the population to be served; the current services available to

that population, and where and how they fail to meet their needs; why

the proposed services or interventions are appropriate and will meet

those needs; and the impact the proposed interventions will have on the

project participants.

In other words, the underlying assumptions of the program are the

applicant's analysis of the needs and problems to be addressed by the

project, and the applicant's theory of how its proposed interventions

will address those needs and problems to achieve the desired result.

Thus a strong application is based upon a clear description of the

needs and problems to be addressed and a persuasive understanding of

the causes of those problems.

In this sub-element of the proposal, the applicant must precisely

identify the target population to be served. The geographic area to be

impacted should then be briefly described, citing the percentage of

residents who are low-income individuals and TANF recipients, as well

as the unemployment rate and other data that are relevant to the

project design.

The application should include an analysis of the identified

personal barriers to employment, job retention and greater self-

sufficiency faced by the population to be targeted by the project.

(These might include such problems as illiteracy, substance abuse,

family violence, lack of skills training, health or medical problems,

need for childcare, lack of suitable clothing or equipment, or poor

self-image.) The application

[[Page 55348]]

should also include an analysis of the identified community systemic

barriers which the project will seek to overcome. These might include

lack of jobs (high unemployment rate); lack of public transportation;

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

inadequate social service (employment service, child care, job

training); high incidence of crime; inadequate health care; or

environmental hazards (such as toxic dumpsites or leaking underground

tanks). Applicants should be sure not to overlook the personal and

family services and support that might be needed by project

participants after they are on the job which will enhance job retention

and advancement. If the jobs to be created by the proposed project are

themselves designed to fill one or more of the needs, or remove one or

more of the barriers so identified, this fact should be highlighted in

the discussion, e.g., jobs in childcare, health care, or

transportation.

It is suggested that applicants use no more than 4 pages for this

Sub-Element.

Sub-Element II (b)--Project Strategy and Design: Interventions,

Outcomes, and Goals

(Weight of 0-10 points in proposal review)

The work plan must describe the proposed project activities, or

interventions, and explain how they are expected to result in outcomes

which will meet the needs of the program participants and assist them

to overcome the identified personal and systemic barriers to

employment, job retention, and self-sufficiency. In other words, what

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

and how will what they do (interventions) assist in creating and

sustaining employment and business opportunities for program

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

identified.

The underlying assumptions concerning client needs and the theory

of how they can be effectively addressed, which are discussed above,

lead in the project design to the conduct of a variety of project

activities or interventions, each of which is assumed to result in

immediate changes, or outcomes.

The immediate changes lead to intermediate outcomes; and the

intermediate outcomes lead to the attainment of the final project

goals.

The applicant should describe the major activities, or

interventions, which are to be carried out to address the needs and

problems identified in Sub-Element II (a); and should discuss the

immediate changes, or outcomes, which are expected to result. These are

the results expected from each service or intervention immediately

after it is provided. For example, a job readiness training program

might be expected to result in clients having increased knowledge of

how to apply for a job, improved grooming for job interviews, and

improved job interview skills; or business training and training in

bookkeeping and accounting might be expected to result in project

participants making an informed decision about whether they were suited

for entrepreneurship.

At the next level are the intermediate outcomes, which result from

these immediate changes. Often an intermediate project outcome is the

result of several immediate changes resulting from a number of related

interventions such as training and counseling. Intermediate outcomes

should be expressed in measurable changes in knowledge, attitudes,

behavior, or status/condition. In the above examples, the immediate

changes achieved by the job readiness program, coupled with technical

assistance to an employer in the expansion of a business, could be

expected to lead to intermediate outcomes of creation of new job

openings and the participant applying for a job with the company. The

acquisition of business skills, coupled with the establishment of a

loan fund, could be expected to result in the actual decision to go

into a particular business venture or seek the alternative track of

pursuing job readiness and training.

Finally, the application should describe how the achievement of

these intermediate outcomes will be expected to lead to the attainment

of the project goals: employment in newly created jobs, new careers in

non-traditional jobs, successful business ventures, or employment in an

expanded business, depending on the project design. Applicants must

remember that if the major focus of the project is to be the

development and start-up of a new business or the expansion of an

existing business, then a Business Plan which follows the outline in

Attachment L to this announcement must be submitted as an Appendix to

the Proposal. (See Part III K)

Applicants do not have to use the exact terminology described

above, but it is important to describe the project in a way that makes

clear the expected cause-and-effect relationship between what the

project plans to do--the activities or interventions, the changes that

are expected to result, and how those changes will lead to attainment

of the project goals of new employment opportunities and greater self-

sufficiency. The competitive review of this Sub-Element will be based

on the extent to which the application makes a convincing case that the

activities to be undertaken will lead to the projected results.

It is suggested that applicants use no more than 4 pages for this

Sub-Element.

Sub-Element II (c)--Work Plan

(Weight of 0-10 points in proposal review)

Once the project strategy and design framework is established, the

applicant should present the highlights of a work plan for the project.

The plan should explicitly tie into the project design framework and

should be feasible, i.e., capable of being accomplished with the

resources, staff, and partners available. The plan should briefly

describe the key project tasks and show the timelines and major

milestones for their implementation. Critical issues or potential

problems that might affect the achievement of project objectives should

be explicitly addressed, with an explanation of how they would be

overcome, and how the objectives will be achieved notwithstanding any

such problems. The plan should be presented in such a way that it can

be correlated with the budget narrative included earlier in the

application.

Applicants may be able to use a simple Gantt or time line chart to

convey the work plan in minimal space.

The application contains a full and accurate description of the

proposed use of the requested financial assistance.

If the applicant proposes to make an equity investment or a loan to

an individual, organization, or business entity (including a wholly-

owned subsidiary), the applicant must include: A signed third party

agreement; a signed statement by a Certified or Licensed Public

Accountant as to the sufficiency of the third party's financial

management system; and financial statements for the third party's prior

three years of operation. (If newly formed and unable to provide the

information regarding the prior three years of operation, a statement

to that effect should be included.) If the applicant states that an

agreement is not currently in place, the application must contain in

the narrative as much information required for third party agreement as

is available.

Also, if the project proposes the development of a new or expanding

business, service, physical or commercial activity, the application

must address applicable elements of a

[[Page 55349]]

business plan. Guidelines for a Business Plan are included in

Attachment L.

Special attention should be given to assure that the financial plan

element, which indicates the project's potential and timetable for

financial self-sufficiency, is included. It must include for the

applicant and the third party, if appropriate, the following exhibits

for the first three years (on a quarterly basis) of the business'

operations: Profit and Loss Forecasts, Cash Flow Projections, and

Proforma Balance Sheets. Based on these documents, the application must

also contain an analysis of the financial feasibility of the project.

Also, a Source and use of Funds statement for all project funding must

be included.

It is suggested that applicants use no more than 3 pages for this

Sub-Element.

Element III--Significant and Beneficial Impact

Sub-Element III (a)--Quality of Jobs/Business Opportunities

(Weight of 0-10 points in proposal review)

The proposed project is expected to produce permanent and

measurable results that will reduce the incidence of poverty in the

community and lead welfare recipients from welfare dependency toward

economic self-sufficiency. Results are expected to be quantifiable in

terms of the creation of permanent, full-time jobs; the development of

business opportunities; the expansion of existing businesses; or the

creation of non-traditional employment opportunities. In developing

business opportunities and self employment for TANF recipients and low-

income individuals, the applicant proposes, at a minimum, to provide

basic business planning and management concepts, and assistance in

preparing a business plan and loan package.

The application should document that:

The business opportunities to be developed for eligible

participants will contribute significantly to their progress toward

self-sufficiency; and/or jobs to be created for eligible participants

will contribute significantly to their progress toward self-

sufficiency. For example, they should provide salaries that exceed the

minimum wage, plus benefits such as health insurance, child care and

career development opportunities.

It is suggested that applicants use no more than 2 pages for this

Sub-Element.

Sub-Element III (b)--Community Empowerment Consideration

(Weight of 0-3 points in proposal review)

Special consideration will be given to applicants that are located

in areas that are characterized by conditions of extreme poverty and

other indicators of socio-economic distress such as a poverty rate of

at least 20%, designation as an Empowerment Zone or Enterprise

Community, high levels of violence, gang activity or drug use; and who

document that in response to these conditions they have been involved

in the preparation and planned implementation of a comprehensive

community-based strategic plan to achieve both economic and human

development in an integrated manner; and how the proposed project will

support the goals of that plan.

It is suggested that applicants use no more than 2 pages for this

Sub-Element.

Sub-Element III(c)--Support for Noncustodial Parents

(Weight of 0-2 points in proposal review)

Applicants that have entered into partnership agreements with local

Child Support Enforcement Agencies to develop and implement innovative

strategies to increase the capability of low-income parents and

families to fulfill their parental responsibilities, and specifically,

to this end, to provide for referrals to the funded projects of

identified income eligible families and non-custodial parents

economically unable to provide child support, will also receive special

consideration.

To receive the full credit of two points, applicants should include

as an appendix to the application, a signed letter of agreement with

the local CSE Agency for referral of eligible non-custodial parents to

the proposed project.

It is suggested that applicants use no more than 1 page for this

Sub-Element.

Sub-Element III (d)--Cost-Per-Job

(Weight of 0-5 points in proposal review)

The applicant should document that during the project period the

proposed project will create new, permanent jobs through business

opportunities or non-traditional employment opportunities for low-

income residents at a cost-per-job below $15,000 in OCS funds. The cost

per job should be calculated by dividing the total amount of grant

funds requested (e.g. $420,000) by the number of jobs to be created

(e.g., 60) which would equal the cost-per-job ($7,000)). If any other

calculations are used, include the methodology and rationale in this

section. In making calculations of cost-per-job, only jobs filled by

low-income project participants may be counted. (See Part III, Section

I)

Note: Except in those instances where independent reviewers

identify extenuating circumstances related to business development

activities, or high wage levels and living costs such as in Hawaii

or Alaska, the maximum number of points will be given only to those

applicants proposing cost-per-job created estimates of $5,000 or

less of OCS requested funds. Higher cost-per-job estimates will

receive correspondingly fewer points.

It is suggested that applicants use no more than 1 page for this

Sub-Element.

Element IV--Project Evaluation

(Weight of 0-15 points in the proposal review)

Sound evaluations are essential to the JOLI Program. OCS requires

applicants to include in their applications a well thought through

outline of an evaluation plan for their project. The outline should

explain how the applicant proposes to answer the key questions about

how effectively the project is being/was implemented; whether the

project activities, or interventions, achieved the expected immediate

outcomes, and why or why not (the process evaluation); and whether and

to what extent the project achieved its stated goals, and why or why

not (the outcome evaluation). Together, the process and outcome

evaluations should answer the question: ``What did this program

accomplish and why did it work/not work?''

Applicants are not being asked to submit a complete and final

evaluation plan as part of their proposal; but they must include:

1. A well thought through outline of an evaluation plan that

identifies the principal cause-and-effect relationships to be tested,

and that demonstrates the applicant's understanding of the role and

purpose of both process and outcome evaluations. (See previous

paragraph);

2. A reporting format based on the grantee's documentation of its

activities (interventions) and their effectiveness, to be included in

the grantee's semi-annual program progress report, which will provide

OCS with insights and lessons learned, as they become evident,

concerning the various aspects of the work plan, such as recruitment,

training, support, public-private partnerships, and coordination with

other community resources, as they may be relevant to the proposed

project;

3. The identity and qualifications of the proposed third-party

evaluator, or if

[[Page 55350]]

not selected, the qualifications which will be sought in choosing an

evaluator, which must include successful experience in evaluating

social service delivery programs, and the planning and/or evaluation of

programs designed to foster self-sufficiency in low income populations;

and

4. A commitment to the selection of a third-party evaluator

approved by OCS, and to completion of a final evaluation design and

plan, in collaboration with the approved evaluator and the OCS

Evaluation Technical Assistance Contractor during the six-month start-

up period of the project, if funded.

Applicants should ensure, above all, that the evaluation outline

presented is consistent with their project design. A clear project

framework of the type recommended earlier identifies the key project

assumptions about the target populations and their needs, as well as

the hypotheses, or expected cause-effect relationships to be tested in

the project; and the proposed project activities, or interventions,

that will address those needs in ways that will lead to the achievement

of the project goals of self-sufficiency. It also identifies in advance

the most important process and outcome measures that will be used to

identify performance success and expected changes in individual

participants, the grantee organization, and the community.

Finally, as noted above, the outline should provide for prompt

reporting, concurrently with the semi-annual program progress reports,

of lessons learned during the course of the project, so that they may

be shared without waiting for the final evaluation report.

For all these reasons, it is important that each successful

applicant have a third-party evaluator selected and performing at the

very latest by the time the work program of the project is begun, and

if possible before that time so that he or she can participate in the

final design of the program, and in order to assure that data necessary

for the evaluation will be collected and available. Plans for selecting

an evaluator should be included in the application narrative. A third-

party evaluator must have knowledge about and have experience in

conducting process and outcome evaluations in the job creation field,

and have a thorough understanding of the range and complexity of the

problems faced by the target population.

The competitive procurement regulations (45 CFR part 74,

Secs. 74.40-74.48, esp. 74.43) apply to service contracts such as those

for evaluators.

It is suggested that applicants use no more than 3 pages for this

Element, plus the resume or position description for the evaluator,

which should be in an appendix.

Element V--Public/Private Partnerships

(Weight of 0-10 points in the proposal review)

The proposal should briefly describe any public/private

partnerships, which will contribute to the implementation of the

project. Where partners' contributions to the project are a vital part

of the project design and work program, the narrative should describe

undertakings of the partners, and a partnership agreement specifying

the roles of the partners and making a clear commitment to the

fulfilling of the partnership role, must be included in an appendix to

the proposal. The firm commitment of mobilized resources must be

documented and submitted with the application in order to be given

credit under this element. The application should meet the following

criteria:

(a) Where other resources are mobilized, the application must

provide documentation that public and/or private sources of cash and/or

third-party-in-kind contributions will be available, in the form of

letters of commitment from the organization(s)/individual(s) from which

resources will be received. Applications that can document dollar for

dollar contributions equal to the OCS funds and demonstrate that the

partnership agreement clearly relates to the objectives of the proposed

project will receive the maximum number of points for this criterion.

Lesser contributions will be given consideration based upon the value

documented.

Note: Even though there is no matching requirement for the JOLI

Program, grantees will be held accountable for any match, cash or

in-kind contribution proposed or pledged as part of an approved

application. (See Part II, D--Mobilization of Resources)

(b) Partners involved in the proposed project should be responsible

for substantive project activities and services. Applicants should note

that partnership relationships are not created via service delivery

contracts.

It is suggested that applicants use no more than 4 pages for this

Element.

Element VI--Budget Appropriateness and Reasonableness

(Weight of 0-5 points in proposal review)

Applicants are required to submit Federal budget forms with their

proposals to provide basic applicant and project information (SF 424)

and information about how Federal and other project funds will be used

(424A). (See Part VI.) Immediately following the completed Federal

budget forms, (Attachments B and C), applicants must submit a Budget

Narrative, or explanatory budget information which includes a detailed

budget breakdown for each of the budget categories in the SF-424A. This

Budget Narrative is not considered a part of the Project Narrative, and

does not count as part of the thirty pages; but rather should be

included in the application following the budget forms.

The duration of the proposed project and the funds requested in the

budget must be commensurate with the level of effort necessary to

accomplish the goals and objectives of the project. The budget

narrative should briefly explain how grant funds will be expended and

show the appropriateness of the Federal funds and any mobilized

resources to accomplish project purposes within the proposed timeframe.

The estimated cost to the government of the project should be

reasonable in relation to the project's duration and to the anticipated

results, and include reasonable administrative costs, if an indirect

cost rate has not been negotiated with a cognizant Federal agency.

Applicants are encouraged to use job titles and not specific names

in developing the applicant budget. However, the specific salary rates

or amounts for staff positions identified must be included in the

application budget.

Resources in addition to OCS grant funds are encouraged both to

augment project resources and strengthen the basis for continuing

partnerships to benefit the target community. The amounts of such

resources, their appropriateness to the project design, and the

likelihood that they will continue beyond the project timeframe will be

taken into account in judging the application. As noted in Element V,

above, even though there is no matching requirement for the JOLI

program, grantees will be held accountable for any match, cash or in-

kind contribution proposed or pledged as part of an approved

application.

Applicants should include funds in the project budget for travel by

Project Directors and Chief Evaluators to attend two national

evaluation workshops in Washington, DC (See Part VIII, Evaluation

Workshops.) The score for this element will be based on the budget form

(SF-424A) and the associated detailed budget narrative.

[[Page 55351]]

Part V--Application Procedures

A. Availability of Forms

Attachments B through N contain all of the standard forms necessary

for the application for awards under this OCS program. These

attachments and Parts V and VI of this Announcement contain all the

instructions required for submittal of applications.

Additional copies may be obtained by writing or telephoning the

office listed under the section entitled FOR FURTHER INFORMATION

CONTACT: at the beginning of this announcement. In addition, this

Announcement is accessible on the Internet through the OCS website for

reading or downloading at the following address: www.acf.dhhs.gov/

programs/ocs/kits1.htm

The applicant must be aware that in signing and submitting the

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

the Federal requirements concerning the Drug-Free workplace, Debarment

regulations and the Certification Regarding Environmental Tobacco

Smoke, set forth in Attachments E, F and J.

Part IV contains instructions for the substance and development of

the project narrative. Part VII, Section A describes the contents and

format of the application as a whole.

B. Application Submission

Mailing Address: JOLI 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, DC 20447;

Attention: Application for JOLI 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 October 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 hand carried by applicants, applicant 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 a.m. and 4:30 p.m., EST, and 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, DC 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 JOLI 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.

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 (flood, 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.

C. Paperwork Reduction Act of 1995

Under the Paperwork Reduction Act of 1995, Public Law 104-13, the

Department is required to submit to OMB for review and approval any

reporting and record keeping requirements in regulations, including

Program Announcements. An agency may not conduct or sponsor, and a

person is not required to respond to, a collection of information

unless it displays a currently valid OMB control number. This Program

Announcement does not contain information collection requirements

beyond those approved for ACF grant announcements/applications under

OMB Control Number OMB-0970-0062, expiration date October 31, 2001.

D. 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.

Note: State/territory participation in the intergovernmental

review process does not signify applicant eligibility for financial

assistance under a program. A potential applicant must meet the

eligibility requirements of the program for which it is applying

prior to submitting an application to its single point of contact

(SPOC), if applicable, or to ACF.

As of March 5, 1999, the following jurisdictions have elected NOT

to participate in the Executive Order process:

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.

Applicants from these 24 jurisdictions need take no action

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

Federally recognized Indian Tribes are also exempt from the

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

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

and receive any necessary instructions. Applicants must submit any

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

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

process. It is imperative that the applicant submit all required

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

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

Form 424, item 16a. Under 45 CFR 100.8(a)(2), a SPOC has sixty (60)

days from the application deadline to comment on proposed new or

competing continuation awards.

SPOCs are encouraged to eliminate the submission routine

endorsements as official recommendations. Additionally, SPOCs are

requested to differentiate clearly between mere advisory comments and

those official State process recommendations which may

[[Page 55352]]

trigger the ``accommodate or explain'' rule.

When comments are submitted directly to ACF, they should be

addressed to: Department of Health and Human Services, Administration

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

West, Aerospace Center, 370 L'Enfant Promenade, S.W., Washington, D.C.

20447.

A list of the SPOCs for each State and Territory is included as

Attachment G to this Announcement.

E. Application Consideration

Applications that meet the screening requirements below will be

reviewed competitively. Such applications will be referred to reviewers

for numerical scoring and explanatory comments based solely on

responsiveness to the guidelines and evaluation criteria published in

this Announcement.

Applications will be reviewed by persons outside of the OCS unit.

The results of these reviews will assist the Director and OCS program

staff in considering competing applications. Reviewers' scores will

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

considered.

Applications generally will be considered in order of the average

scores assigned by reviewers. However, highly ranked applications are

not guaranteed funding since other factors are taken into

consideration, including, but not limited to: The timely and proper

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

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

evaluation and input; the amount and duration of the grant requested

and the proposed project's consistency and harmony with OCS goals and

policy; geographic distribution of applications; previous program

performance of applicants; the limitations on project continuation or

refunding (see Part II, Section H); the number of previous JOLI grants

made to applicants; compliance with grant terms under previous HHS

grants, including the actual dedication to program of mobilized

resources as set forth in project applications; audit reports;

investigative reports; and applicant's progress in resolving any final

audit disallowance's on previous OCS or other Federal agency grants.

OCS reserves the right to discuss applications with other Federal

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

record and the documents submitted.

F. Criteria for Screening Applications

All applications that meet the published deadline requirements as

provided in this Program Announcement will be screened for completeness

and conformity with the requirements. Only complete applications that

meet the requirements listed below will be reviewed and evaluated

competitively. Other applications will be returned to the applicant

with a notation that they were unacceptable and will not be reviewed.

The following requirements must be met by all applicants:

1. The application must contain a Standard Form 424 ``Application

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

``Assurances'' (SF-424B) completed according to instructions published

in Part VI and Attachments C and D, of this Program Announcement.

2. All JOLI applications must include a signed cooperative

partnership agreement within the designated State Agency responsible

for administering the TANF Program, or a letter of commitment to such

an agreement within six months of a grant award, contingent only on

receipt of OCS funds. This cooperative partnership agreement must fully

describe the role and/or responsibilities of each partner for specific

activities and/or services to be provided which must clearly relate to

the objectives of the proposed project.

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

requires that the narrative portion of the application be limited to 30

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

and type face no smaller than 12 characters per inch (c.p.i.) or

equivalent. The Budget Narrative Charts, exhibits, resumes, position

descriptions, letters of support, cooperative agreements, and business

plans (where required) are not counted against this page limit. It is

strongly recommended that applicants follow the format and content for

the narrative set out in Part IV.

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

organization applying for the grant who has authority to obligate the

organization legally. Applicants must also be aware that the

applicant's legal name as required on the SF-424 (Item 5) must match

that listed as corresponding to the Employer Identification Number

(Item 6).

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

exempt status as required under Part II, Section A.

6. Written Agreement When Applicant Proposes to Make Equity

Investment or Loan: The application must contain a written third party

agreement, or a discussion of a proposed agreement, signed by the

applicant and the third party that includes all of the elements

required in Part III, Section N.

Part VI--Instructions for Completing the SF-424

(Approved by the Office of Management and Budget under Control

Number 0970-0062, expiration date October 31, 2001.)

The standard forms attached to this Announcement shall be used to

apply for funds under this Program Announcement.

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

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

your application in accordance with instructions provided on the forms

(Attachments B and C) as modified by the OCS specific instructions set

forth below:

Provide line item detail and detailed calculations for each budget

object class identified on the Budget Information form. Detailed

calculations must include estimation methods, quantities, unit costs,

and other similar quantitative detail sufficient for the calculation to

be duplicated. The detailed budget must also include a breakout by the

funding sources identified in Block 15 of the SF-424.

Provide a narrative budget justification, which describes how the

categorical costs are derived. Discuss the necessity, reasonableness,

and allocability of the proposed costs.

A. SF-424--Application for Federal Assistance

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

which the application is being submitted (1.0 or 2.0). An application

should be submitted under only one priority area.

Where the applicant is a previous Department of Health and Human

Services grantee, enter the Central Registry System Employee

Identification Number (CRS/EIN) and the Payment Identifying Number, if

one has been assigned, in the Block entitled Federal Identifier located

at the top right hand corner of the form.

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

considered Applications; there are no Pre-Applications.

Item 7. Enter N in the box and specify non-profit corporation on

the line marked Other.

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

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

[[Page 55353]]

programs covered under this Announcement is 93.593. The title is ``Job

Opportunities for Low-Income Individuals Program''.

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

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

following letter designations:

JO--General Project

JS--Community Development Corporation Set-Aside

Item 13. ``Proposed Project''--The ending date should be based on

the requested project period, not to exceed three years (36 months).

Item 15a. This amount should be no greater than $500,000.

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

in-kind contributions for the three year budget period requested.

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

In completing these sections, the Federal Funds budget entries will

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

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

other. Federal funds other than requested OCS funding should be

included in ``Non-Federal'' entries.

Section A, B, and C of SF-424A should reflect budget estimates for

each year of the budget period for which funding is being requested.

Section A--Budget Summary

You need only fill in lines 1 and 5 (with the same amounts) Column

(a): Enter Job Opportunities for Low-Income Individuals Program. Column

(b): Catalog of Federal Domestic Assistance number is 93.593.

--Columns (c) and (d): not relevant to this program.

--Columns (e)-(g): enter the appropriate amounts (column e should not

be more than $500,000).

Section B--Budget Categories

(Note that the following information supersedes the instructions

provided with the Form SF-424A in Attachment C)

Columns (1)-(5): For each of the relevant Object Class Categories:

--Column 1: Enter the OCS grant funds for the first year;

--Column 2: Enter the OCS grant funds for the second year (where

appropriate);

--Column 3: Enter the OCS grant funds for the third year (where

appropriate);

--Column 4: Leave Blank.

--Column 5: Enter the total Federal OCS grant funds for the total

budget period by Class Categories, showing a total budget of not more

than $500,000.

Note: With regard to Class Categories, only out-of-town travel

should be entered under Category c. Travel. Local travel costs

should be entered under Category h. Other. Equipment costing less

than $5000 should be included in Category e. Supplies.

Section C--Non-Federal Resources

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

that will be used to support the project. For the purposes of this

application, ``non-Federal'' resources means other than the OCS funds

for which the applicant is applying. Therefore, mobilized funds from

other Federal programs, such as the Job Training Partnership Act

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

these ``non-Federal'' resources on a separate sheet and describe

whether it is a grantee-incurred cost or a third-party cash or in-kind

contribution. The firm commitment of these resources must be documented

and submitted with the application in order to be given credit in the

review process under the Public-Private Partnerships program element.

Except in unusual situations, this documentation must be in the

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

from which resources will be received.

Note: Even though there is no matching requirement for the JOLI

Program, grantees will be held accountable for any match, cash or

in-kind contribution proposed or pledged as part of an approved

application. (See Part IV, Element V.)

This Section should be completed in accordance with the

instructions provided.

Section D, E, and F may be left blank.

A supporting Budget Narrative must be submitted providing details

of expenditures under each budget category, and justification of dollar

amounts which relate the proposed expenditures to the work program and

goals of the project. (See Part IV, Element VI)

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

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

``Assurances'' with the application. (See Attachment D)

Part VII--Contents of Application and Receipt Process

A. Contents of Application

Each JOLI Application must include all of the following, in the

order listed below:

1. Table of Contents;

2. An Abstract of the Proposed Project--very brief, not to exceed

250 words, that would be suitable for use in an announcement that the

application has been selected for a grant award; which identifies the

type of project(s), the target population, and the major elements of

the work plan;

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

of the organization applying for the grant who has authority to

obligate the organization legally;

Note: The original SF-424 must bear the original signature of

the authorizing representative of the applicant organization.)

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

5. A narrative budget justification for each object class category

required under Section B, SF-424A;

6. Certifications and Assurance Required for Non-Construction

Programs, as follows:

Applicants requesting financial assistance for a non-construction

project must file the Standard Form 424B, ``Assurances: Non-

Construction Programs''. Applicants must sign and return the Standard

Form 424B with their applications.

Applicants must provide a Certification Regarding 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 application.

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.

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. Copies of the certifications and assurance are located at

the end of this Announcement.

Applicants must make the appropriate certification of their

compliance with all Federal statutes relating to nondiscrimination. By

signing and submitting the applications, applicants are providing the

certification and need not mail back a certification form.

7. Certification Regarding Environmental Tobacco Smoke--Signature

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

requirements of the Pro-Children Act of 1994 (no signature required on

form).

8. A Project Narrative of no more than 30 pages, consisting of the

Elements

[[Page 55354]]

described in Part IV of this Announcement set forth in the order there

presented; preceded by a consecutively numbered Table of Contents (not

to be counted as part of the 30 pages).

9. Appendices--proof of non-profit tax-exempt status as outlined in

Part II, Section A; proof that the organization is a community

development corporation, if applying under the CDC Set-aside;

commitments from officials of businesses that will be expanded or

franchised, where applicable; partnership agreement with the designated

State TANF agency and CSE agency; Single Point of Contact comments, if

applicable; resumes and position descriptions; a Business Plan, where

required; and the Maintenance of Effort Certification (See Part II-J

and Attachment M).

The total number of pages for the narrative portion of the

application package must not exceed 30 pages, excluding Appendices and

Narrative Table of Contents. See Part V(f) (c) for pages that do not

count against the 30-page limit.

Pages should be numbered sequentially throughout, including

Appendices, beginning with the Abstract as Page 1. The application may

also contain letters that show collaboration or substantive commitments

to the project by organizations other than the designated TANF agency.

Such letters are not part of the narrative and should be included in

the Appendices. These letters are, therefore, not counted against the

30 page limit.

B. Application Format

Applications must be uniform in composition since OCS may find it

necessary to duplicate them for review purposes. Therefore,

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

Applications must not include colored, oversized or folded materials.

Applications should not include organizational brochures or other

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

Such material will not be reviewed and will be discarded if included.

Applications must be bound or enclosed in loose-leaf binder

notebooks. Preferably, applications should be two-holed punched at the

top center and fastened separately with a compressor slide paper

fastener, or a binder clip.

C Acknowledgment of Receipt

Applicants who meet the initial screening criteria outlined in Part

V, Section E, will receive within ten days after the deadline date for

submission of applications, an acknowledgment with an assigned

identification number. To facilitate receipt of this acknowledgment

from ACF, applicant is asked to include a cover letter with the

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

these items are available to applicant.

Applicants are requested to supply a self-addressed mailing label

with their application which can be attached to this acknowledgment

notice. This mailing label should reflect the mailing address of the

authorizing official who is applying on behalf of the organization.

This number and the program letter code, i.e., JO or JS, must be

referred to in all subsequent communications with OCS concerning the

application. If an acknowledgment is not received within three weeks

after the deadline date, please notify ACF by telephone (202) 401-5103.

Part VIII--Post Award Information and Reporting Requirements

A. Notification of Grant Award

Following approval of the application selected for funding, notice

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

made in writing. The official award document is the Financial

Assistance Award, which provides the amount of Federal funds approved

for use in the project, the project and budget periods for which

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

total project period for which support is contemplated.

B. Attendance at Evaluation Workshops

The Project Directors and third-party evaluators will be required

to attend two national evaluation workshops in Washington, DC. A three-

day program development and evaluation workshop will be scheduled

shortly after the effective date of the grant. They also will be

required to attend, as presenters, the final evaluation workshop on

utilization and dissemination to be held at the end of the project

period. Project budgets must include funds for travel to and attendance

at these workshops. (See Part IV, Element VI, Budget Appropriateness

and Reasonableness.)

C. Reporting Requirements

Grantees will be required to submit semi-annual program progress

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

financial report within 90 days of the expiration of the grant. An

annual evaluation report will be due 30 days after each twelve months.

A written draft policies and procedures manual based on the finding of

the process evaluation should be submitted along with the first annual

evaluation report. A final evaluation report will be due 90 days after

the expiration of the grant.

D. Audit Requirements

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

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

E. Prohibitions and Requirements With Regard to Lobbying

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

1989, imposes prohibitions and requirements for disclosure and

certification related to lobbying on recipients of Federal contracts,

grants, cooperative agreements, and loans. It provides limited

exemptions for Indian tribes and tribal organizations. Current and

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

are prohibited from using appropriated funds for lobbying Congress or

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

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

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

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

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

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

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

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

any agreements with such lobbyists whom recipients or their subtier

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

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

occurs that materially affects the accuracy of the information

submitted by way of declaration and certification.

The law establishes civil penalties for noncompliance and is

effective with respect to contracts, grants, cooperative agreements and

loans entered into or made on or after December 23, 1989. See

Attachment H for certification and disclosure forms to be submitted

with the applications for this program.

F. Applicable Federal Regulations

Attachment K indicates the regulations that apply to all

applicants/grantees under the Job Opportunities for Low-Income

Individuals Program.

[[Page 55355]]

Dated: October 4, 1999.

Donald Sykes,

Director, Office of Community Services.

Job Opportunities for Low-Income Individuals; Attachments

A Poverty Income Guidelines for the 48 Contiguous States and the

District of Columbia

B Standard Form 424

C Standard Form 424A

D Standard Form 424B

E Certification Regarding Drug-Free Workplace Requirements

F Certification Regarding Debarment, Suspension and Other

Responsibility Matters

G State Single Point of Contact Listing Maintained by OMB

H Certification Regarding Lobbying Activities and Disclosure of

Lobbying Activities, SF-LLL

I State Human Services Administrators

J Certification Regarding Environmental Tobacco Smoke

K DHHS Regulations Applying to All Applicants/Grantees Under the

Job Opportunities for Low-Income Individuals (JOLI) Program

L Business Plan

M Certification Regarding Maintenance of Effort

N OCSE IV-D Report

O Applicant's Checklist

Attachment A

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

Poverty

Size of family unit guideline

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

1999 POVERTY GUIDELINES FOR THE 48 CONTIGUOUS STATES AND THE DISTRICT OF

COLUMBIA

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

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

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

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

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

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 55356]]

[GRAPHIC] [TIFF OMITTED] TN12OC99.000

BILLING CODE 4184-01-C

[[Page 55357]]

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 an additional funding/

budget period for a project with a projected completion date.

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

financial obligation or contingent liability from an existing

obligation.

9. Name of Federal agency from which assistance is being

requested with this application.

10. Use the Catalog of Federal Domestic Assistance number and

title of the program under which assistance is requested.

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

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

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

projects), attach a map showing project location. For

preapplications, use a separate sheet to provide a summary

description of this project.

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

State, counties, cities).

13. Self-explanatory.

14. List the applicant's Congressional District and any

District(s) affected by the program or project.

15. Amount requested or to be contributed during the first

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

contributions should be included on appropriate lines as applicable.

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

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

amounts in parentheses. If both basic and supplemental amounts are

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

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

15.

16. Applicants should contact the State Single Point of Contact

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

application is subject to the State intergovernmental review

process.

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

person who signs as the authorized representative. Categories of

debt include delinquent audit disallowances, loans and taxes.

18. To be signed by the authorized representative of the

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

sign this application as official representative must be on file in

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

this authorization be submitted as part of the application.)

BILLING CODE 4184-01-M

[[Page 55358]]

[GRAPHIC] [TIFF OMITTED] TN12OC99.001

[[Page 55359]]

[GRAPHIC] [TIFF OMITTED] TN12OC99.002

BILLING CODE 4184-01-C

[[Page 55360]]

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 Column

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

which includes the total previous authorized budgeted amounts plus

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

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

Columns (e) and (f).

Line 5--Show the Totals for All Columns Used

Section B. Budget Categories

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

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

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

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

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

Federal and non-Federal) by object class categories.

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.

Seciton E. Budget Estimates of Federal Funds Needed for Balance of

the Project

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

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

is not necessary. For new applications and continuation grant

applications, enter in the proper columns amounts of Federal funds

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

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

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

funds for the current year of existing grants.

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

submit additional schedules as necessary.

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

additional schedules are prepared for this Section, annotate

accordingly and show the overall totals on this line.

Section F. Other Budget Information

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

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

ordinary or to explain the details as required by the Federal

grantor agency.

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

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

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

is applied, and the total indirect expense.

Line 23--Provide any other explanations or comments deemed

necessary.

Attachment D

Assurancs--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

[[Page 55361]]

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 (0348-0040), 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. Secs. 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 OPMs's Standards for a Merit

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

6. Will comply with all Federal statutes relating to

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

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

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

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

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

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

as amended (29 U.S.C. Sec. 794), which prohibits discrimination on

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

amended (42 U.S.C. Secs. 6101-6107), which prohibits discrimination

on the basis of age; (e) the Drug Abuse Office and Treatment Act of

1972 (P.L. 92-255), as amended, relating to nondiscrimination on the

basis of drug abuse; (f) the Comprehensive Alcohol Abuse and

Alcoholism Prevention, Treatment and Rehabilitation Act of 1970

(P.L. 91-616), as amended, relating to nondiscrimination on the

basis of alcohol abuse or alcoholism; (g) Secs. 523 and 527 of the

Public Health Service Act of 1912 (42 U.S.C. Secs. 290 dd-3 and 290

ee-3), as amended, relating to confidentiality of alcohol and drug

abuse patient records; (h) Title VIII of the Civil Rights Act of

1968 (42 U.S.C. Secs. 3601 et seq.), as amended, relating to

nondiscrimination in the sale, rental or financing of housing; (i)

any other nondiscrimination provisions in the specific statute(s)

under which application for Federal assistance is being made; and,

(j) the requirements of any other nondiscrimination statute(s) which

may apply to the application.

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

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

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

provide for fair and equitable treatment of persons displaced or

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

assisted programs. These requirements apply to all interests in real

property acquired for project purposes regardless of Federal

participation in purchases.

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

(5 U.S.C. Secs. 1501-1508 and 7324-7328) which limit the political

activities of employees whose principal employment activities are

funded in whole or in part with Federal funds.

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

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

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

Hours and Safety Standards Act (40 U.S.C. Secs. 327-333), regarding

labor standards for federally-assisted construction subagreements.

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

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

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

hazard area to participate in the program and to purchase flood

insurance if the total cost of insurable construction and

acquisition is $10,000 or more.

11. Will comply with environmental standards which may be

prescribed pursuant to the following: (a) Institution of

environmental quality control measures under the National

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

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

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

evaluation of flood hazards in floodplains in accordance with EO

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

management program developed under the Coastal Zone Management Act

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

actions to State (Clean Air) Implementation Plans under Section

176(c) of the Clean Air Act of 1955, as amended (42 U.S.C.

Secs. 7401 et seq.); (g) protection of underground sources of

drinking water under the Safe Drinking Water Act of 1974, as amended

(P.L. 93-523); and, (h) protection of endangered species under the

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

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

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

potential components of the national wild and scenic rivers system.

13. Will assist the awarding agency in assuring compliance with

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

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

protection of historic properties), and the Archaeological and

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

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

human subjects involved in research, development, and related

activities supported by this award of assistance.

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

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

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

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

assistance.

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

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

based paint in construction or rehabilitation of residence

structures.

17. Will cause to be performed the required financial and

compliance audits in accordance with the Single Audit Act 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

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

TITLE

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

APPLICANT ORGANIZATOIN

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

DATE SUBMITTED

Certification 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 pint 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.

[[Page 55362]]

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 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

this 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 pea 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 statutes;

Criminal drug statute means a Federal or non-Federal criminal

statute involving the manufacture, distribution, 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 a

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 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 prohibition;

(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 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 statute 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 good 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, country, 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.

[55 FR 21690, 21702, May 25, 1990]

Attachment F

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

[[Page 55363]]

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 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 perspective 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 entering 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 principles:

(a) 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 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 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 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.

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 an

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

[[Page 55364]]

prospective participant shall attach an explanation to this

proposal.

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 at the States to review and coordinate proposed Federal

financial assistance and direct Federal development.'' This attached

listing 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: (302) 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 Monies, 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 Officer 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

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 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) 687-4065

FAX: (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) 225-2308

Rhode Island

Kevin Nelson

Review Coordinator

Department of Administration

[[Page 55365]]

Division of Planning

One Capitol Hill, 4th Floor

Providence, Rhode Island 02908-5870

Telephone: (401) 277-2656

FAX: (401) 277-2083

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

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 list 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

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 the 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 connection with this

commitment providing for the United States to insure or guarantee a

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

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

instructions. Submission of this statement is a prerequisite for

making or entering into this transaction imposed by section 1352,

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

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

$10,000 and not more than $100,000 for each such failure.

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

Signature

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

Title

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

Organization

BILLING CODE 4184-01-M

[[Page 55366]]

[GRAPHIC] [TIFF OMITTED] TN12OC99.003

BILLING CODE 4184-01-C

[[Page 55367]]

Instructions 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 of 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. It

this is a followup 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 of 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 of the covered

Federal action (item 1). If known, enter the full Catalog of Federal

Domestic Assistance (CFDA) number of 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 Federal action where there has been an award of

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 of 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 it

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, 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. to the Office of Management and Budget,

Paperwork Reduction Project (0348-0046), Washington, DC 20503.

Attachment I

State Human Services Administrators

A

Mr. Tony Petelos

Commissioner

Alabama State Department of Human Resources

50 Ripley Street

Montgomery, AL 36130-4000

Phone: (334) 242-1160

FAX: (334) 242-0198

Ms. Karen Perdue

Commissioner

Alaska Department of Health and Social Services

P.O. Box 110601

Juneau, AK 99811-0601

Phone: (907) 465-3030

FAX: (907) 465-3068

Ms. Marie Ma'o

Director

American Samoa Department of Social Services

Pago Pago, AS 96799

Phone: 011 (684) 633-2969

FAX: 011 (684) 633-7449

Mr. John L. Clayton

Director

Arizona Department of Economic Security

P.O. Box 6123, Site Code 010A

Phoenix, AZ 85005

Phone: (602) 542-5678

FAX: (602) 542-5339

Mr. Kurt Knickrehm

Director

Arkansas Department of Human Services

P.O. Box 1437--Suite 329

Little Rock, AR 72203-1437

Phone: (501) 682-8650

FAX: (501) 682-6836

C

Mr. Grantland Johnson

Secretary

California Health and Welfare Agency

1600 Ninth Street, Room 460

Sacramento, CA 95814

Phone: (916) 654-3345

FAX: (916) 654-3343

Mrs. Marva Livingston Hammons

Executive Director

Colorado Department of Human Services

1575 Sherman Street, 8th Floor

Denver, CO 80203-1714

Phone: (303) 866-5096

FAX: (303) 866-4740

Ms. Patricia A. Wilson-Coker

Commissioner

Connecticut Department of Social Services

25 Sigourney Street

Hartford, CT 06106

Phone: (860) 424-5008

FAX: (860) 424-4960

D

Dr. Gregg C. Sylvester

Secretary

Delaware Department of Health & Social Services

Herman M. Holloway Campus

Administration Building, 1st floor

1901 N. DuPont Highway

New Castle, DE 19720

Phone: (302) 577-4500

FAX: (302) 577-4510

Mrs. Jearline Williams

Director

D.C. Department of Human Services

801 East Building

2700 Martin Luther King, Jr. Avenue

Washington, DC 20032

Phone: (202) 279-6002

FAX: (202) 279-6014

F

Judge Kathleen Kearney

Secdretary

Florida Department of Children and Families

Building 1, Room 202

1317 Winewood Boulevard

Tallahassee, FL 32399-0700

Phone: (850) 487-1111

FAX: (850) 922-2993

Mr. Robert G. Brooks

Secretary

Florida Department of Health

2020 Capital Circle, S.E., BIN 800

Tallahassee, FL 32399-0701

Phone: (850) 487-2945

FAX: (850) 487-3729

G

Ms. Audrey Horne

Commissioner

Georgia Department of Human Resources

2 Peach Tree Street, N.W., Suite 29-250

Atlanta, GA 30303

Phone: (404) 656-5680

FAX: (404) 651-8669

Mr. Dennis G. Rodriguez

Director

Guam Department of Public Health and Social Services

[[Page 55368]]

P.O. Box 2816

Agana, GU 96932

Phone: 011 (671) 734-7102

FAX: 011 (671) 734-5910

H

Ms. Susan Chandler

Director

Hawaii Department of Human Services

P.O. Box 339

Honolulu, HI 96809-0339

Phone: (808) 586-4997

FAX: (808) 586-4890

I

Mr. Karl Kurtz

Director

Idaho Department of Health and Welfare

P.O. Box 83720

Boise, ID 83720-0036

Phone: (208) 334-5500

FAX: (208) 334-6558

Mr. Howard Peters

Secretary

Illinois Department of Human Services

Harris Building, 3rd floor

100 South Grand Avenue, East

Springfiled, IL 62762

Phone: (217) 557-1602

FAX: (217) 557-1647

Mr. Peter Sybinsky

Secretary

Indiana Family and Social Services Administration

402 West Washington Street, Room W-461

Indianapolis, IN 46207-7083

Phone: (317) 233-4452

FAX: (317) 233-4693

Ms. Jessie Rasmussen

Director

Iowa Department of Human Services

5th floor, Hoover State Office Building

Des Moines, IA 50319

Phone: (515) 281-5452

FAX: (515) 281-4597

K

Ms. Rochelle B. Cronister

Secretary

Kansas Department of Social and Rehabilitation Services

Docking State Office Building, 6th floor

915 Harrison Street

Topeka, KS 66612-1570

Phone: (785) 296-3271

FAX: (785) 296-4685

Ms. Viola P. Miller

Secretary

Kentucky Cabinet for Families and Children

275 East Main Street, 4th floor West

Frankfort, KY 40621

Phone: (502) 564-7130

FAX: (502) 564-3866

L

Ms. Gwendolyn P. Hamilton

Secretary

Louisiana Department of Social Services

P.O. Box 3776

Baton Rouge, LA 70821

Phone: (504) 342-0286

FAX: (504) 342-8636

M

Mr. Kevin W. Concannon

Commissioner

Maine Department of Human Services

11 Statehouse Station

221 State Street

Augusta, ME 04333

Phone: (207) 287-3106

FAX: (207) 287-3005

Ms. Lynda G. Fox

Secretary

Maryland Department of Human Resources

Saratoga State Center

311 West Saratoga Street

Baltimore, MD 21201

Phone: (410) 767-71109

FAX: (410) 333-0099

Mr. William O'Leary

Commissioner

Massachusetts Department of Social Services

24 Farnsworth Street

Boston, MA 02210

Phone: (617) 727-0900

FAX: (617) 439-4482

Ms. Claire McIntire

Commissioner

Massachusetts Department of Transitional

Assistance

600 Washington Street

Boston, MA 02111

Phone: (617) 348-8400

FAX: (617) 348-8575

Mr. Douglas Howard

Director

Michigan Family Independence Agency

235 South Grand Avenue

Lansing, MI 48909

Phone: (517) 373-2000

FAX: (617) 335-6101

Mr. Michael O'Keefe

Commissioner

Minnesota Department of Human Services

444 Lafayette Road

St. Paul, MN 55155-3815

Phone: (651) 296-2701

FAX: (651) 296-5868

Mr. Donald Taylor

Executive Director

Missippi Department of Human Services

750 North State Street

Jackson, MS 39202

Phone: (601) 359-4480

FAX: (601) 359-4477

Mr. Gary J. Stangler

Director

Missouri Department of Social Services

Broadway State Office Building

221 W. High Street

Jefferson City, MO 65102

Phone: (573) 751-4815

FAX: (573) 751-3203

Ms. Laurie Ekanger

Director

Montana Department of Public Health and Human Services

P.O. Box 4210

Helena, MT 59604-4210

Phone: (406) 444-5622

FAX: (406) 444-1970

N

Mr. Ron Ross

Director

Nebraska Department of Health and Human Services

P.O. Box 95044

Lincoln, NE 68509-5044

Phone: (402) 471-9106

FAX: (402) 471-0820

Ms. Charlotte Crawford

Director

Nevada Department of Human Resources

505 East King Street, Suite 600

Carson City, NV 89710

Phone: (775) 684-4000

FAX: (775) 684-4010

Mr. Donald L. Shumway

Commissioner

New Hampshire Department of Health and

Human Services

129 Pleasant Street

Concord, NH 03301

Phone: (603) 271-4334

FAX: (603) 271-4912

Ms. Michelle Guhl

Commissioner

New Jersey Department of Human Services

222 South Warren Street

Trenton, NJ 08625-0700

Phone: (609) 292-3717

FAX: (609) 292-3824

Mr. Alex Valdez

Secretary

New Mexico Human Services Department

P.O. Box 2348

Santa Fe, NM 87504-2348

Phone: (505) 827-7750

FAX: (505) 827-6286

Mr. Brian Wing

Commissioner

New York State Office of Temporary and

Disability Assistance

40 North Pearl Street

Albany, NY 12243

Phone: (518) 473-9772 and 474-9475

FAX: (518-6255

Mr. John A. Johnson

Commissioner

New York State Office of Children

and Family Services

52 Washington Street

Rensselaer, NY 12144

Phone: (518) 473-8437

FAX: (518) 473-9131

Mr. James McGowan

Commissioner

New York State Department of Labor

State Campus, Building 12

Albany, NY 12240

Phone: (518) 457-2741

FAX: (518) 457-6908

Dr. H. David Bruton

Secretary

North Carolina Department of Health and

Human Services

101 Blair Drive

Raleigh, NC 27603

Phone: (919) 733-4534

FAX: (919) 715-4645

Ms. Carol K. Olson

Executive Director

North Dakota Department of Human Services

State Capitol--Judicial Wing--Dept. 325

600 East Boulevard

Bismarck, ND 58505

Phone: (701) 328-2310

FAX: (701) 328-1545

O

Ms. Jacqueline Romer-Sensky

Director

Ohio Department of Human Services

[[Page 55369]]

30 East

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