[Federal Register Volume 59, Number 58 (Friday, March 25, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-7140]


[[Page Unknown]]

[Federal Register: March 25, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of Community Services
[Program Announcement No. OCS 94-04]

 

Request for Applications Under the Office of Community Services' 
Fiscal Year 1994 Training and Technical Assistance Program

AGENCY: Office of Community Services, ACF, DHHS.

ACTION: Request for applications under the Office of Community 
Services' Training and Technical Assistance Program.

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SUMMARY: The Office of Community Services (OCS) announces that 
competing applications will be accepted for new grants pursuant to the 
Secretary's discretionary authority under Section 681(a)(3) of the 
Community Services Block Grant Act of 1981 (Title VI of Public Law 97-
35, the Omnibus Budget Reconciliation Act of 1981, 42 U.S.C. 
9910(a)(3)). This Program Announcement consists of seven parts. Part A 
covers information on the legislative authority and defines terms used 
in the Program Announcement. Part B describes the types of activities 
that will be considered for funding. Part C provides details on who is 
eligible to apply and application prerequisites. Part D provides 
information on application procedures including the availability of 
forms, where to submit an application, criteria for initial screening 
of applications, and project evaluation criteria. Part E provides 
guidance on the content of an application package and the application 
itself. Part F provides instructions for completing an application. 
Part G details post-award requirements.

CLOSING DATE: The closing date for submission of applications is May 
24, 1994.

FOR FURTHER INFORMATION CONTACT: Mae Brooks, Division of Block Grants, 
Office of Community Services, Administration for Children and Families, 
370 L'Enfant Promenade SW., Washington, DC 20447. You may also call 
(202) 401-9343.

Part A--Preamble

1. Legislative Authority

    Section 681(a)(3) of the Community Services Block Grant (CSBG) Act 
authorizes the Secretary of Health and Human Services to make funds 
available to States and public and private nonprofit organizations to 
provide for training and technical assistance to aid States in carrying 
out their responsibilities under the CSBG Act.

2. Definitions of Terms

    For purposes of this Program Announcement the following definitions 
apply:
    ``Training'' is an educational activity or event which is designed 
to impart knowledge, understanding, or increase the development of 
skills. Such training activities may be in the form of assembled events 
such as workshops, seminars, or programs of self-instructional 
activities.
    ``Technical assistance'' is a problem-solving event generally 
utilizing the services of an expert. Such services may be provided on-
site, by telephone, or other communications. These services address 
specific problems and are intended to assist with the immediate 
resolution of a given problem or set of problems.
    ``State'' means all of the States and the District of Columbia. 
Except where specifically noted, for purposes of this Program 
Announcement it also means ``Territory.''
    ``Territory'' refers to the Commonwealth of Puerto Rico, the 
American Virgin Islands, Guam, American Samoa, the Commonwealth of the 
Northern Mariana Islands, and the Republic of Palau.
    ``Local service providers'' are the approximately 1,000 local 
public or private nonprofit agencies that receive Community Services 
Block Grant funds from States to provide services to, or undertake 
activities on behalf of, low-income people.
    ``Nationwide'' refers to the scope of the technical assistance 
training on data collection projects to be undertaken with grant funds. 
Proposed projects must provide for the implementation of technical 
assistance, training or data collection for a significant number of 
States, and the local service providers who administer CSBG funds.

Part B--Purpose

    Section 681(a)(3) of the CSBG Act authorizes the Secretary of the 
Department of Health and Human Services to make grants to States and 
public agencies and private nonprofit organizations, or to enter into 
contracts or jointly financed cooperative arrangements with States and 
public agencies and private nonprofit organizations, to provide for 
training and technical assistance to aid States in carrying out their 
responsibilities for conducting and administering the CSBG Program.
    OCS is soliciting applications which implement these legislative 
mandates on a national basis and in a comprehensive manner. OCS 
believes that training and technical assistance needs are best 
identified at the State and local levels, not at the Federal level. 
Therefore, funds will be provided in the form of grants. Proposed 
projects under this Program Announcement must focus on one of the 
following program priorities:
    Priority 1--Training and Technical Assistance: The development and 
implementation of a comprehensive, nationwide training and/or technical 
assistance program to assist State staff and/or staff of local service 
providers which receive funding under the CSBG Act, to acquire the 
skills and knowledge needed to administer and implement programs 
designed to ameliorate the causes of poverty in the communities. 
Programs must include the provision of training and/or technical 
assistance to State staff and/or staff of local service providers 
nationwide, i.e., in each of the Federal Regions, in the most cost 
effective manner possible. Collaboration with State CSBG coordinators 
and local service providers will be required in identifying the 
training and technical assistance needs of staff of local service 
providers.
    Priority 2--Data Collection: The design of a survey instrument, and 
the collection, analysis, and dissemination of information on FY 1993 
CSBG Programs on a nationwide basis through a process that relies on 
voluntary State cooperation. The information must be comprehensive 
enough and disseminated in such formats as to enable States and local 
service providers to improve their planning, management, and delivery 
of services and to assure that the general public has a clear 
understanding of those programs and their outcomes.
    Submissions which propose the use of grant funds for the 
development of any printed or visual materials must contain convincing 
evidence that these materials are not available from other sources. OCS 
will not provide funding for such items if justification is not 
sufficient. Approval of the development of films or visual 
presentations proposed by applicants approved for funding will made 
part of the grant ward.
    See Part F, Section 4, for special instructions on developing a 
work program.

Part C--Application Prerequisites

1. Eligible Applicants

    Eligible applicants for Priority 1 are States, public agencies and 
private non-profit organizations that can demonstrate familiarity and 
expertise nationwide with the training and/or technical assistance 
needs of community action agencies or State CSBG administering 
agencies; and, for Priority 2, States, public agencies and private non-
profit organizations that can demonstrate their familiarity with the 
CSBG Program and their ability to collect data from States on a 
voluntary basis. In order to be considered for funding, proof of non-
profit status must be submitted with the application. Any of the 
following is acceptable evidence: (1) Copy of the applicant 
organization'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 (2) a copy of the current valid IRS tax exemption 
certificate.

2. Available Funds

    The amount of funds available for grant awards under this 
announcement in FY 94 is $271,439; $171,439 are available for training 
and technical assistance activities and $100,000 for data collection 
activities. It is anticipated that two grants will be made for T&TA 
activities and one grant will be made for data collection activities.

3. Grant Duration

    OCS will grant funds for a maximum of 12-month project and budget 
periods. The application must clearly demonstrate that the project work 
plan will achieve measurable results and can be successfully completed 
within the stated time period.

4. Project Beneficiaries

    Projects proposed for funding under the training and technical 
assistance priority area must result in direct benefits to staffs of 
State or local service providers in carrying out their responsibilities 
under the Community Services Block Grant Act.

5. Sub-Contracting or Delegating Projects

    OCS will not fund any project where the role of the applicant is 
primarily to serve as a conduit for funds to organizations other than 
the applicant. This prohibition does not bar the making of subgrants or 
subcontracting for specific services or activities needed to conduct 
the project. However, the applicant must have a substantive role in the 
implementation of the project for which funding is requested.

Part D--Application Procedures

1. Availability of Forms

    Attachments A, B and C contain all of the standard forms necessary 
for the application for awards under these OCS programs. These forms 
may be photocopied for use in developing the application.
    Copies of the Federal Register containing this announcement are 
available at most local libraries and Congressional District Offices 
for reproduction. If copies are not available at these sources, they 
may be obtained by writing or telephoning the office listed under the 
section entitled FOR FURTHER INFORMATION at the beginning of this 
announcement.
    For purposes of this announcement, all applicants will use SF-424, 
SF-424A, and SF-424B. Instructions for completing the SF 424, SF-424A, 
and SF-424B are found in Attachments A, B, and C and Part F.
    Part F contains instructions for the project narrative. The project 
narrative will be submitted on plain bond paper along with the SF-424 
and related forms.
    Attachment I provides a checklist to aid applicants in preparing a 
complete application package for OCS.

2. Application Submission

    Refer to the section entitled ``Closing Date'' at the beginning of 
this Program Announcement for the last day on which applications should 
be submitted. Applications may be mailed to: Administration for 
Children and Families, Division of Discretionary Grants, 6th Floor OFM/
DDG, OCS-94-04, 370 L'Enfant Promenade SW., Washington, DC 20447.
    Hand-delivered applications are accepted during normal working 
hours of 8 a.m. to 4:30 p.m., Monday through Friday, except legal 
holidays, on or prior to the established closing date at: 
Administration for Children and Families, Division of Discretionary 
Grants, OCS-94-04, Sixth Floor, 901 D Street SW., Washington, DC 20447.
    An application shall be considered as meeting the announced 
deadline if it is either:
    1. Received on or before the deadline date at a place specified in 
the Program Announcement, or
    2. Sent on or before the deadline date and received by the granting 
agency in time for them to be considered during the competitive review 
and evaluation process. (Applicants are cautioned to request a legibly 
dated U.S. Postal Service postmark or to obtain a legibly dated receipt 
from a commercial carrier or the U.S. Postal Service. Private metered 
postmarks are not acceptable as proof of timely mailing.)
    Applications which do not meet one of these criteria are considered 
late applications. The ACF Division of Discretionary Grants will notify 
each late applicant that its application will not be considered in this 
competition.
    The ACF may extend the deadline for all applicants because of acts 
of God such as floods, hurricanes, etc. or when there is a disruption 
of the mails. However, if the ACF does not extend the deadline for all 
applicants, it may not waive or extend the deadline for any applicant.
    Applications once submitted are considered final and no additional 
materials will be accepted.
    One signed original application and two copies should be submitted.

3. 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 
Programs and Activities.'' Under the Order, States may design their own 
processes for reviewing and commenting on proposed Federal assistance 
under covered programs.
    All States and Territories except Alabama, Alaska, Connecticut, 
Hawaii, Idaho, Kansas, Louisiana, Minnesota, Montana, Nebraska, 
Oklahoma, Oregon, Pennsylvania, Virginia, Washington, American Samoa 
and Palau have elected to participate in the Executive Order process 
and have established Single Points of Contact (SPOCs). Applicants from 
these seventeen jurisdictions need take no action regarding E.O. 12372.
    Applicants for projects to be administered by Federally-recognized 
Indian Tribes are also exempt from the requirements of E.O. 12372. 
Otherwise, applicants should contact their SPOCs as soon as possible to 
alert them of the prospective applications and receive any necessary 
instructions, 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 424A, item 16a.
    Under 45 CFR 100.8(a)(2), a SPOC has 60 days from the application 
deadline date to comment on proposed new awards. These comments are 
reviewed as a part of the award process. Failure to notify the SPOC can 
result in a delay in grant award.
    SPOCs are encouraged to eliminate the submission of routine 
endorsements as official recommendations. Additionally, SPOCs are 
requested to clearly differentiate between mere advisory comments and 
those official State process recommendations which they intend to 
trigger the ``accommodate or explain'' rule under 45 CFR 100.10.
    When comments are submitted directly to ACF, they should be 
addressed to: Department of Health and Human Services, Administration 
for Children and Families, Division of Discretionary Grants, OCS-94-04, 
6th Floor, 370 L'Enfant Promenade SW., Washington, DC 20447. A list of 
the Single Points of Contact for each State and Territory is included 
as Appendix G of this announcement.

4. Application Consideration

    Applications which meet the screening requirements in Sections 5a 
and 5b below will be reviewed competitively. Such applications will be 
referred to reviewers for a numerical score and explanatory comments 
based solely on responsiveness to program guidelines and evaluation 
criteria published in this announcement.
    Applications will be reviewed by persons outside of the OCS unit 
which would be directly responsible for programmatic management of the 
grant. The results of these reviews will assist OCS in considering 
competing applications. Reviewers' scores will weigh heavily in funding 
decisions but will not be the only factors considered. Applications 
will be ranked and generally considered in order of the average scores 
assigned by reviewers. However, highly ranked applications are not 
guaranteed funding since the other factors deemed relevant may be 
considered including, but not limited to, the timely and proper 
completion of projects funded with OCS funds granted in the past 5 
years; comments of reviewers and government officials; staff evaluation 
and input; geographic distribution; previous program performance of 
applicants; compliance with grant terms under previous DHHS grants; 
audit reports; investigative reports; and applicant's progress in 
resolving any final audit disallowances on OCS or other Federal agency 
grants.
    OCS reserves the right to discuss applications with other Federal 
or non-Federal funding sources to ascertain the applicant's performance 
record.

5. Criteria for Screening Applications

    a. Initial screening. All applicants will receive an 
acknowledgement with an assigned identification number. This number, 
along with any other identifying codes, must be referenced in all 
subsequent communications concerning the application. If an 
acknowledgement is not received within three weeks after the deadline 
date, please notify ACF by telephone at (202) 401-9230. All 
applications that meet the published deadline for submission will be 
screened to determine completeness and conformity to the requirements 
of this announcement. Only those applications meeting the following 
requirements will be reviewed and evaluated competitively. Others will 
be returned to the applicants with a notation that they were 
unacceptable.
    (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 F and Attachments A, B, and C of this program announcement.
    (2) A project narrative must also accompany the standard forms.
    (3) 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.
    b. Pre-rating review. Applications which pass the initial screening 
will be forwarded to reviewers and/or OCS staff to verify, prior to the 
programmatic review, that the applications comply with this Program 
Announcement in the following areas:
    (1) Eligibility: Applicant meets the eligibility requirements found 
in Part C. Applicant also must 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).
    (2) Duration of Project: The application contains a project that 
can be successfully implemented in 12 months.
    (3) Target Populations: The application clearly targets the 
specific outcomes and benefits of the project to State staff recipients 
of CSBG funds and/or local providers of CSBG-funded services and 
activities.
    (4) Program Focus: The application must address development and 
implementation of a nationwide, comprehensive training and/or technical 
assistance or data collection activities as described in Part B of this 
announcement.
    An application may be disqualified from the competition and 
returned to the applicant if it does not conform to one or more of the 
above requirements.
    c. Evaluation criteria. Applications which pass the pre-rating 
review will be assessed and scored by reviewers. Each reviewer will 
give a numerical score for each application reviewed. These numerical 
scores will be supported by explanatory statements on a formal rating 
form describing major strengths and major weaknesses under each 
applicable criterion published in this announcement. The in-depth 
evaluation and review process will use the following criteria coupled 
with the specific requirements contained in Part B. (Note: The 
following review criteria reiterate collection of information 
requirements contained in Part F of this announcement. These 
requirements are approved under OMB Control Number 0970-0062.)

Criteria for Review and Evaluation of Applications Submitted Under This 
Program Announcement

    (1) Criterion I: Need for Assistance (Maximum: 20 points)
    (a) The application documents that the project addresses a vital 
nationwide need related to the purposes of this Program Announcement 
(Part B) and provides statistics and other data and information in 
support of its contention (0-10 points).
    (b) Provides current supporting documentation or other testimonies 
from State CSBG Directors and local service providers or State and 
Regional organizations of local service providers (0-10 points).
    (2) Criterion II: Work Program (Maximum: 30 points).
    (a) Goals are appropriately related to needs and are specific and 
measurable (0-10 points).
    (b) Activities are comprehensive and nationwide in scope, and 
adequately described and appropriately related to goals (0-10 points).
    (c) Time frames and chronology of key activities are realistic (0-2 
points).
    (d) The plan for conducting an assessment that will determine the 
degree to which the stated goals and objectives of the project are 
achieved is adequate and workable and, where appropriate, the plan for 
disseminating the information resulting from the project to CSBG 
grantees, local service providers, and other interested parties is 
workable and assures that all relevant parties are included in the 
dissemination (0-8 points).
    (3) Criterion III: Significant and Beneficial Impact (Maximum 25 
points)
    (a) Applicant adequately describes how the project will assure 
long-term program and management improvements for States and/or local 
providers of CSBG services and activities (0-15 points).
    (b) For T&TA applications: The project will impact on a significant 
number of State staff or local service providers (0-10 points).
    (c) For data collection applications: The applicant has the ability 
to collect data from a significant number of States (0-10 points).
    (4) Criterion IV: Ability of Applicant to Perform (Maximum: 20 
points)
    (a) The application demonstrates that the applicant has experience 
relevant to the activities that it proposes to undertake (0-10 points).
    (b) The applicant's proposed project director and primary staff are 
well qualified and their professional experiences are relevant to the 
successful implementation of the proposed project (0-10 points).
    (5) Criterion V: Adequacy of Budget (Maximum: 5 points).
    (a) The resources requested are reasonable and adequate to 
accomplish the project (0-3 points).
    (b) Total costs are reasonable and consistent with anticipated 
results (0-2 points).

Part E--Contents of Application and Receipt Process

1. Contents of Application

    Each application should include one original and two additional 
copies of the following:
    a. A 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. The applicant must be aware that 
in signing and submitting the application for this award, it is 
certifying that it will comply with the Federal requirements concerning 
the drug-free workplace and debarment regulations set forth in 
Attachments D and E.
    b. ``Budget Information-Non-Construction Programs'' (SF-424A).
    c. A filled out, signed and dated ``Assurances--Non-Construction 
Programs'' (SF-424B), Attachment C.
    d. Restrictions on Lobbying--Certification for Contracts, Grants, 
Loans, and Cooperative Agreements: fill out, sign and date form found 
at Attachment F.
    e. Disclosure of Lobbying Activities, SF-LLL: fill out, sign and 
date form found at Attachment F, as appropriate.
    f. A Project Narrative consisting of the following elements 
preceded by a consecutively numbered Table of Contents that will 
describe the project in the following order:
    (i) Need for Assistance
    (ii) Work Program
    (iii) Significant and Beneficial Impact
    (iv) Management History
    (v) Staffing and Resources
    (vi) Appendices including proof of non-profit status, such as IRS 
determination of non-profit status; By-Laws; Articles of Incorporation; 
Certification Regarding Lobbying; resumes, etc. The original must bear 
the signature of the authorizing official representing the applicant 
organization. The total number of pages for the entire application 
package should not exceed 30 pages, including appendices. Pages should 
be numbered sequentially throughout. If appendices include photocopied 
materials, they must be legible. Applications should be two-hole 
punched at the top center and fastened separately with a compressor 
slide paper fastener or a binder clip. The submission of bound 
applications or applications enclosed in a binder is specifically 
discouraged.
    Applications must be uniform in composition since OCS may find it 
necessary to duplicate them for review purposes. Therefore, 
applications must be submitted on white 8\1/2\ x 11 inch paper only. 
They must not include colored, oversized or folded materials. Do not 
include organizational brochures or other promotional materials, 
slides, films, clips, etc. in the proposal. They will be discarded if 
included.

Part F--Instructions for Completing Application Package

(Approved by the OMB Under Control Number 0970-0062)

    The standard forms attached to this Announcement shall be used when 
submitting applications for all funds under this Announcement.
    It is recommended that the applicant reproduce the SF-424 
(Attachment A), SF-424A (Attachment B), SF-424B (Attachment C) and that 
the application be typed on the copies. If an item on the SF-424 cannot 
be answered or does not appear to be related or relevant to the 
assistance requested, the applicant should write ``NA'' for ``Not 
Applicable.''
    The application should be prepared in accordance with the standard 
instructions in Attachments A and B corresponding to the forms, as well 
as the specific instructions set forth below:

1. SF-424 ``Application for Federal Assistance'' Item

    1. For the purposes of this announcement, all projects are 
considered ``Applications''; there are no ``Pre-Applications.''
    5 and 6. The legal name of the applicant must match that listed as 
corresponding to the Employer Identification Number. Where the 
applicant is a previous Department of Health and Human Services 
grantee, enter the Central Registry System Employee Identification 
Number (CRS/EIN) and the Payment Identifying Number, if one has been 
assigned, in the Block entitled ``Federal Identifier'' located at the 
top right hand corner of the form.
    7. If the applicant is a non-profit corporation, enter ``N'' in the 
box and specify ``non-profit corporation'' in the space marked 
``Other.'' Proof of non-profit status such as IRS determination, 
Articles of Incorporation, or by-laws, must be included as an appendix 
to the project narrative.
    8. For the purposes of this announcement, all applications are 
``New''.
    9. Enter ``DHHS-ACF/OCS''.
    10. The Catalog of Federal Domestic Assistance number for the OCS 
program covered under this announcement is ``93.032''.
    11. In addition to a brief descriptive title of the project, the 
following letter designations must be used: ``TA''--for training and 
technical assistance projects; ``TD''--for data collection activities.
    The title is ``Community Services Block Grant Discretionary 
Awards--Training and Technical Assistance Program.''
    15a. For purposes of this Announcement, this amount should reflect 
the amount requested for the entire project period. 15b-e. These items 
should reflect both cash and third party in-kind contributions for the 
total project period.

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

    See Instructions accompanying this page as well as the instructions 
set forth below:
    In completing these sections, the ``Federal Funds'' budget entries 
will relate to the requested OCS Training and Technical Assistance 
Program funds only, and ``Non-Federal'' will include mobilized funds 
from all other sources--applicants, State, and other. Federal funds 
other than those requested from the Training and Technical Assistance 
Program should be included in ``Non-Federal'' entries.
    Sections A and D of SF-424A must contain entries for both Federal 
(OCS) and non-Federal (mobilized funds).

Section A--Budget Summary

Line 1-4
Col. (a):
Line 1 Enter ``OCS Training and Technical Assistance Program'';
Col. (b):
Line 1 Enter ``93.032''.
Col. (c) and (d): Not Applicable
Col. (e)--(g):
    For each line 1-4, enter in columns (e), (f) and (g) the 
appropriate amounts needed to support the project for the entire 
project period.
    Line 5 Enter the figures from Line 1 for all columns completed, 
(e), (f), and (g).

Section B--Budget Categories

    This section should contain entries for OCS funds only. For all 
projects, the first budget period of 12 months will be entered in 
Column #1. Allowability of costs is governed by applicable cost 
principles set forth in 45 CFR Parts 74 and 92.
    A separate itemized budget justification should be included to 
explain fully and justify major items, as indicated below. The budget 
justification should immediately follow the Table of Contents.
    Column 5: Enter total requirements for Federal funds by the Object 
Class Categories of this section.
    Line 6a--Personnel: Enter the total costs of salaries and wages.

Justification

    Identify the project director. Specify by title or name the 
percentage of time allocated to the project, the individual annual 
salaries and the cost to the project (both Federal and non-Federal) of 
the organization's staff who will be working on the project.
    Line 6b--Fringe Benefits: Enter the total costs of fringe benefits 
unless treated as part of an approved indirect cost rate which is 
entered on line 6j.

Justification

    Enter the total costs of fringe benefits, unless treated as part of 
an approved indirect cost rate.
    Line 6c--Travel: Enter total cost of all travel by employees of the 
project. Do not enter costs for consultant's travel.

Justification

    Include the name(s) of traveler(s), total number of trips, 
destinations, length of stay, mileage rate, transportation costs and 
subsistence allowances.
    Line 6d--Equipment: Enter the total costs of all non-expendable 
personal property to be acquired by the project. Equipment means 
tangible non-expendable personal property having a useful life of more 
than one year and an acquisition cost of $5,000 or more per unit.

Justification

    Equipment to be purchased with Federal funds must be required to 
conduct the project, and the applicant organization or its subgrantees 
must not already have the equipment or a reasonable facsimile available 
to the project. The justification also must contain plans for future 
use or disposal of the equipment after the project ends.
    Line 6e--Supplies: Enter the total costs of all tangible personal 
property (surplus) other than that included on line 6d.
    Line 6h--Other: Enter the total of all other costs. Such costs, 
where applicable, may include, but are not limited to, insurance, food, 
medical and dental costs (noncontractual), fees and travel paid 
directly to individual consultants, local transportation (all travel 
which does not require per diem is considered local travel), space and 
equipment rentals, printing and publication, computer use training 
costs including tuition and stipends, training service costs including 
wage payments to individuals and supportive service payments, and staff 
development costs.
    Line 6j--Indirect Charges: Enter the total amount of indirect 
costs. This line should be used only when the applicant currently has 
an indirect cost rate approved by the Department of Health and Human 
Services or other Federal agencies. With the exception of States and 
local governments, applicants should enclose a copy of the current 
approved rate agreement if it was negotiated with a Federal agency 
other than the Department of Health and Human Services. For an 
educational institution the indirect costs on training grants will be 
allowed at the lesser of the institution's actual indirect costs or 8 
percent of the total direct costs.
    If the applicant organization is in the process of initially 
developing or renegotiating a rate, it should immediately upon 
notification that an award will be made, develop a tentative indirect 
cost rate proposal based on its most recently completed fiscal year in 
accordance with the principles set forth in the pertinent DHHS Guide 
for Establishing Indirect Cost Rates, and submit it to the appropriate 
DHHS Regional Office. It should be noted that when an indirect cost 
rate is requested, those costs included in the indirect cost pool 
cannot be also budgeted or charged as direct costs to the grant.
    The total amount shown in Section B, Column (5), Line 6k, should be 
the same as the amount shown in Section A, Line 5, Column (e).
    Line 7--Program Income: Enter the estimated amount of income, if 
any, expected to be generated from this project. Separately show 
expected program income generated from OCS support and income generated 
from other mobilized funds. Do not add or subtract this amount from the 
budget total. Show the nature and source of income in the program 
narrative statement. Column 5: Carry totals from Column 1 to Column 5 
for all line items.

Justification

    Describe the nature, source and anticipated use of program income 
in the Program Narrative Statement.

Section C--Non-Federal Resources

    This section is to record the amounts of ``Non-Federal'' resources 
that will be used to support the project. ``Non-Federal'' resources 
mean other than OCS funds for which the applicant has received a 
commitment. Provide a brief explanation, on a separate sheet, showing 
the type of contribution, broken out by Object Class Category, (See 
Section B.6) and whether it is cash or third-party in-kind. The firm 
commitment of these required funds must be documented and submitted 
with the application.
    Except in unusual situations, this documentation must be in the 
form of letters of commitment or letters of intent from the 
organization(s)/individuals from which funds will be received.

Line 8--
Col. (a): Enter the project title.
Col. (b): Enter the amount of cash or donations to be made by the 
applicant.
Col. (c): Enter the State contribution.
Col. (d): Enter the amount of cash and third party in-kind 
contributions to be made from all other sources.
Col. (e): Enter the total of columns (b), (c), and (d). Lines 9, 10, 
and 11 should be left blank.
Line 12--Carry the total of each column of Line 8, (b) through (e). The 
amount in Column (e) should be equal to the amount on Section A, Line 
5, Column (f).

Justification

    Describe third party in-kind contributions, if included.

Section D--Forecasted Cash Needs

    Line 13--Enter the amount of Federal (OCS) cash needed for this 
grant, by quarter, during the first 12 month budget period.
    Line 14--Enter the amount of cash from all other sources needed by 
quarter during the first year.
    Line 15--Enter the total of Lines 13 and 14.

Section F--Other Budget Information

    Line 21--Include narrative justification required under Section B 
for each object class category for the total project period.
    Line 22--Enter the type of HHS or other Federal agency approved 
indirect cost rate (provisional, predetermined, final or fixed) that 
will be in effect during the funding period, the estimated amount of 
the base to which the rate is applied and the total indirect expense. 
Also, enter the date the rate was approved, where applicable. Attach a 
copy of the approved rate agreement if it was negotiated with a Federal 
agency other than the Department of Health and Human Services.
    Line 23--Provide any other explanations and continuation sheets 
required or deemed necessary to justify or explain the budget 
information.

3. SF-424B ``Assurances Non-Construction''

    All applicants must sign and return the ``Assurances'' found at 
Attachment C with their application.

4. Project Narrative

    Each narrative section of the application must address one or more 
of the focus areas described in Part B and follow the format outlined 
below.
    a. Need for Assistance
    b. Work Program
    c. Significant and Beneficial Impact
    d. Ability of the Applicants to Perform
    e. Staffing and Resources
    a. Need for assistance. The application should identify the problem 
areas in which State organizations receiving CSBG funds and/or local 
service providers which receive CSBG funds as subgrantees from States 
are seeking assistance and how those needs were identified. Applicants 
also should provide current supporting documentation or other 
testimonies from State CSBG Directors and local service providers or 
State and Regional organizations of local service providers, as 
appropriate, regarding need for the proposed project.
    b. Work program. The application must contain a detailed and 
specific work program that is both sound and feasible. Applicants must 
address how the proposed project will carry out the legislative mandate 
and the program activities found in Part B. This section of the 
narrative must include the goals of the project related to the needs, 
the activities that they propose to carry out to address those goals, 
the methods by which they will carry out those activities, and the plan 
for disseminating products resulting from the project, where 
appropriate. Project activities must be described in a quantitative 
manner, e.g. number of training days, number of workshops, number of 
persons to be trained, number of local services providers to be 
impacted, materials to be developed, etc. The applicant must define the 
comprehensive nature of the proposed project and the methods which will 
be used to ensure that it is a nationwide project.
    For data collection projects, applicants should, at a minimum, 
describe the methodology to be used to identify the kind of data to be 
collected, how the data will be collected, how the applicant will 
assure that the appropriate data will be collected, a plan for data 
analysis, the methods by which the data will be disseminated and the 
audiences, and a plan for conducting an assessment of the usefulness of 
data collected.
    The application must (1) set forth realistic quarterly time targets 
by which the various work tasks will be completed; (2) include a plan 
for conducting an assessment of its activities as they relate to the 
goals and objectives; and (3) include a description of how the 
applicant will involve other appropriate organizations in the planning 
or implementation of the project in order to avoid duplication of 
effort and to leverage additional resources.
    c. Significant and beneficial impact. Each applicant must indicate 
how the project will have a significant and beneficial impact. At a 
minimum the applicant must provide (1) A description of how the project 
will result in long-term improvements for the State organization 
receiving CSBG funds and/or local providers who receive CSBG as a 
subgrantee of the State and (2) the types and amounts of public and/or 
private resources it will mobilize and how those resources will 
directly benefit the project. An applicant proposing a project with a 
training and technical assistance focus also must indicate the number 
of local service providers and/or staff it will impact. An applicant 
proposing a project with a data collection focus also must provide a 
description of the mechanism the applicant will use to collect data, 
how it can assure collections from a significant number of states, and 
how many states will be willing to submit data to the applicant.
    d. Ability of applicants to perform. Organizations must detail 
their competence in the specific program area. Documentation must be 
provided which addresses (1) accomplishments relevant to the proposed 
project, and (2) experience relevant to the CSBG program.
    Organizations which propose providing training and technical 
assistance must detail their competence in the specific program 
priority area and as a deliverer with expertise in the fields of 
training and technical assistance on a nationwide basis. If applicable, 
information provided by these applicants must also address related 
achievements and competence of each cooperating or sponsoring 
organization.
    e. Staffing and resources. The application must fully describe 
(e.g. a resume) the experience and skills of the proposed project 
director and primary staff showing that the individuals are not only 
well qualified but that their professional capabilities are relevant to 
the successful implementation of the proposed project.

Part G--Post Award Information and Reporting Requirements

    Following approval of the applications selected for funding, notice 
of project approval and authority to draw down project funds will be 
made in writing. The official award document is the Notice of Grant 
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.
    In addition to the standard terms and conditions which will be 
applicable to grants, grantee will be subject to the provisions of 45 
CFR parts 74 (non-governmental) and 92 (governmental) and OMB Circulars 
A-128 and A-133.
    Grantees will be required to submit quarterly progress and 
financial reports (SF-269) as well as a final progress and financial 
report.
    Grantees are subject to the audit requirements in 45 CFR parts 74 
(non-governmental) and 92 (governmental) and OMB Circulars A-128 and A-
133.
    Section 1352 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 exemptions for 
Indian tribes and tribal organizations. Current and prospective 
recipients (and their subtier contractors and/or grantees) are 
prohibited from using Federal funds, other than profits from a Federal 
contract, 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 disclose the name, 
address, payment details, and purpose of any agreements with lobbyists 
whom recipients or their subtier contractors or subgrantee will pay 
with profits or nonappropriated funds on or after December 22, 1989, 
and (3) to file quarterly up-dates about the use of lobbyists if 
material changes occur in their use. The law establishes civil 
penalties for noncompliance. See Attachment F for certification and 
disclosure forms to be submitted with the applications for this 
program.
    Attachment H indicates the regulations which apply to all 
applicants/grantees under this program.

    Dated: March 17, 1994.
Donald Sykes,
Director, Office of Community Services.

BILLING CODE 4184-01-P

TN25MR94.000


BILLING CODE 4184-01-C

Instructions for the SF 424

    This is a standard form used by applicants as a required 
facesheet for preapplications and applications submitted for Federal 
assistance. It will be used by Federal agencies to obtain applicant 
certification that States which have established a review and 
comment procedure in response to Executive Order 12372 and have 
selected the program to be included in their process, have been 
given an opportunity to review the applicant's submission.

Item and Entry:

    1. Self-explanatory.
    2. Date application submitted to Federal agency (or State if 
applicable) & applicant's control number (if applicable).
    3. State use only (if applicable).
    4. If this application is to continue or revise an existing 
award, enter present Federal identifier number. If for a new 
project, leave blank.
    5. Legal name of applicant, name of primary organizational unit 
which will undertake the assistance activity, complete address of 
the applicant, and name and telephone number of the person to 
contact on matters related to his 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-P

TN25MR94.001


TN25MR94.002


BILLING CODE 4184-01-C

Instructions for the SF-424A

General Instructions

    This form is designed so that application can be made for funds 
from one or more grant programs. In preparing the budget, adhere to 
any existing Federal grantor agency guidelines which prescribe how 
and whether budgeted amounts should be separately shown for 
different functions or activities within the program. For some 
programs, grantor agencies may require budgets to be separately 
shown by function or activity. For other programs, grantor agencies 
may require a breakdown by function or activity. Sections A, B, C, 
and D should include budget estimates for the whole project except 
when applying for assistance which requires Federal authorization in 
annual or other funding period increments. In the latter case, 
Sections A, B, C, and D should provide the budget for the first 
budget period (usually a year) and Section E should present the need 
for Federal assistance in the subsequent budget periods. All 
applications should contain a breakdown by the object class 
categories shown in Lines a-k of Section B.

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

    For applications pertaining to a single Federal grant program 
(Federal Domestic Assistance Catalog number) and not requiring a 
functional or activity breakdown, enter on Line 1 under Column (a) 
the catalog program title and the catalog number in Column (b).
    For applications pertaining to a single program requiring budget 
amounts by multiple functions or activities, enter the name of each 
activity or function on each line in Column (a), and enter the 
catalog number in Column (b). For applications pertaining to 
multiple programs where none of the programs require a breakdown by 
function or activity, enter the catalog program title on each line 
in Column (a) and the respective catalog number on each line in 
Column (b).
    For applications pertaining to multiple programs where one or 
more programs require a breakdown by function or activity, prepare a 
separate sheet for each program requiring the breakdown. Additional 
sheets should be used when one form does not provide adequate space 
for all breakdown of data required. However, when more than one 
sheet is used, the first page should provide the summary totals by 
programs.

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

    For new applications, leave Columns (c) and (d) blank. For each 
line entry in Columns (a) and (b), enter in Columns (e), (f), and 
(g) the appropriate amounts of funds needed to support the project 
for the first funding period (usually a year).
    For continuing grant program applications, submit these forms 
before the end of each funding period as required by the grantor 
agency. Enter in Columns (c) and (d) the estimated amounts of funds 
which will remain unobligated at the end of the grant funding period 
only if the Federal grantor agency instructions provide for this. 
Otherwise, leave these columns blank. Enter in columns (e) and (f) 
the amounts of funds needed for the upcoming period. The amount(s) 
in Column (g) should be the sum of amounts in Columns (e) and (f).
    For supplemental grants and changes to existing grants, do not 
use Columns (c) and (d). Enter in Column (e) the amount of the 
increase or decrease of Federal funds and enter in Column (f) the 
amount of the increase or decrease of non-Federal funds. In Column 
(g) enter the new total budgeted amount (Federal and non-Federal) 
which includes the total previous authorized budget amounts plus or 
minus, as appropriate, the amounts shown in Columns (e) and (f). The 
amount(s) in Column (g) should not equal the sum of amounts in 
Columns (e) and (f).
    Line 5--Show the totals for all columns used.

Section B. Budget Categories

    In the column headings (1) through (4), enter the titles of the 
same programs, functions, and activities shown on Lines 1-4, Column 
(a), Section A. When additional sheets are prepared for Section A, 
provide similar column headings on each sheet. For each program, 
function or activity, fill in the total requirements for funds (both 
Federal and non-Federal) by object class categories.
    Lines 6a-i--Show the totals of Lines 6a to 6h in each column.
    Line 6j--Show the amount of indirect cost.
    Line 6k--Enter the total of amounts on Lines 6i and 6j. For all 
applications for new grants and continuation grants the total amount 
in column (5), Line 6k, should be the same as the total amount shown 
in Section A, Column (g), Line 5. For supplemental grants and 
changes to grants, the total amount of the increase or decrease as 
shown in Columns (1)-(4), Line 6k should be the same as the sum of 
the amounts in Section A, Columns (e) and (f) on Line 5.
    Line 7--Enter the estimated amount of income, if any, expected 
to be generated from this project. Do not add or subtract this 
amount from the total project amount. Show under the program 
narrative statement the nature and source of income. The estimated 
amount of program income may be considered by the federal grantor 
agency in determining the total amount of the grant.

Section C. Non-Federal Resources

    Lines 8-11--Enter amounts of non-Federal resources that will be 
used on the grant. If in-kind contributions are included, provide a 
brief explanation on a separate sheet.
    Column (a)--Enter the program titles identical to Column (a), 
Section A. A breakdown by function or activity is not necessary.
    Column (b)--Enter the contribution to be made by the applicant.
    Column (c)--Enter the amount of the State's cash and in-kind 
contribution if the applicant is not a State or State agency. 
Applicants which are a State or State agencies should leave this 
column blank.
    Column (d)--Enter the amount of cash and inkind contributions to 
be made from all other sources.
    Column (e)--Enter totals of Columns (b), (c), and (d).
    Line 12--Enter the total for each of Columns (b)-(e). The amount 
in Column (e) should be equal to the amount on Line 5, Column (f), 
Section A.

Section D. Forecasted Cash Needs

    Line 13--Enter the amount of cash needed by quarter from the 
grantor agency during the first year.
    Line 14--Enter the amount of cash from all other sources needed 
by quarter during the first year.
    Line 15--Enter the totals of amounts on Lines 13 and 14.

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

    Line 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 C--Assurances--Non-Construction Programs

    Note: Certain of these assurances may not be applicable to your 
project or program. If you have questions, please contact the 
awarding agency. Further, certain Federal awarding agencies may 
require applicants to certify to additional assurances. If such is 
the case, you will be notified.

    As the duly authorized representative of the applicant I certify 
that the applicant:
    1. Has the legal authority to apply for Federal assistance, and 
the institutional, managerial and financial capability (including 
funds sufficient to pay the non-Federal share of project costs) to 
ensure proper planning, management and completion of the project 
described in this application.
    2. Will give the awarding agency, the Comptroller General of the 
United States, and if appropriate, the State, through any authorized 
representative, access to and the right to examine all records, 
books, papers, or documents related to the award; and will establish 
a proper accounting system in accordance with generally accepted 
accounting standards or agency directives.
    3. Will establish safeguards to prohibit employees from using 
their positions for a purpose that constitutes or presents the 
appearance of personal or organizational conflict of interest, or 
personal gain.
    4. Will initiate and complete the work within the applicable 
time frame after receipt of approval of the awarding agency.
    5. Will comply with the Intergovernmental Personnel Act of 1970 
(42 U.S.C. 4728-4763) relating to prescribed standards for merit 
systems for programs funded under one of the nineteen statutes or 
regulations specified in Appendix A of OPM's Standards for a Merit 
System of Personnel Administration (5 CFR 900, Subpart F).
    6. Will comply with all Federal statutes relating to 
nondiscrimination. These include but are not limited to: (a) Title 
VI of the Civil Rights Act of 1964 (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. 
1681-1683, and 1685-1686), which prohibits discrimination on the 
basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as 
amended (29 U.S.C. 794), which prohibits discrimination on the basis 
of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 
U.S.C. 6101-6107), which prohibits discrimination on the basis of 
age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-
255), as amended, relating to nondiscrimination on the basis of drug 
abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism 
Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), 
as amended, relating to nondiscrimination on the basis of alcohol 
abuse or alcoholism; (g) Secs. 523 and 527 of the Public Health 
Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee-3), as amended, 
relating to confidentiality of alcohol and drug abuse patient 
records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. 
3601 et seq.), as amended, relating to nondiscrimination in the 
sale, rental or financing of housing; (i) any other 
nondiscrimination provisions in the specific statute(s) under which 
application for Federal assistance is being made; and (j) the 
requirements of any other nondiscrimination statute(s) which may 
apply to the application.
    7. Will comply, or has already complied, with the requirements 
of Titles II and III of the Uniform Relocation Assistance and Real 
Property Acquisition Policies Act of 1970 (P.L. 91-646) which 
provide for fair and equitable treatment of persons displaced or 
whose property is acquired as a result of Federal or federally 
assisted programs. These requirements apply to all interests in real 
property acquired for project purposes regardless of Federal 
participation in purchases.
    8. Will comply with the provisions of the Hatch Act (5 U.S.C. 
1501-1508 and 7324-7328) which limit the political activities of 
employees whose principal employment activities are funded in whole 
or in part with Federal funds.
    9. Will comply, as applicable, with the provisions of the Davis-
Bacon Act (40 U.S.C. 276a to 276a-7), the Copeland Act (40 U.S.C. 
276c and 18 U.S.C. 874), and the Contract Work Hours and Safety 
Standards Act (40 U.S.C. 327-333), regarding labor standards for 
federally assisted construction subagreements.
    10. Will comply, if applicable, with flood insurance purchase 
requirements of Section 102(a) of the Flood Disaster Protection Act 
of (P.L. 93-234) which requires recipients in a special flood hazard 
area to participate in the program and to purchase flood insurance 
if the total cost of insurable construction and acquisition is 
$10,000 or more.
    11. Will comply with environmental standards which may be 
prescribed pursuant to the following: (a) institution of 
environmental quality control measures under the National 
Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order 
(EO) 11514; (b) notification of violating facilities pursuant to EO 
11738; (c) protection of wetlands pursuant to EO 11990; (d) 
evaluation of flood hazards in floodplains in accordance with EO 
11988; (e) assurance of project consistency with the approved State 
management program developed under the Coastal Zone Management Act 
of 1972 (16 U.S.C. Secs. 1451 et seq.); (f) conformity of Federal 
actions to State (Clear Air) Implementation Plans under Section 
176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. Sec. 7401 
et seq.); (g) protection of underground sources of drinking water 
under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-
523); and (h) protection of endangered species under the Endangered 
Species Act of 1973, as amended, (P.L. 93-205).
    12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 
U.S.C. 1271 et seq.) related to protecting components or potential 
components of the national wild and scenic rivers system.
    13. Will assist the awarding agency in assuring compliance with 
Section 106 of the National Historic Preservation Act of 1966, as 
amended (16 U.S.C. 470), EO 11593 (identification and protection of 
historic properties), and the Archaeological and Historic 
Preservation Act of 1974 (16 U.S.C. 469a-1 et seq.).
    14. Will comply with P.L. 93-348 regarding the protection of 
human subjects involved in research, development, and related 
activities supported by this award of assistance.
    15. Will comply with the Laboratory Animal Welfare Act of 1966 
(P.L. 89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the 
care, handling, and treatment of warm blooded animals held for 
research, teaching, or other activities supported by this award of 
assistance.
    16. Will comply with the Lead-Based Paint Poisoning Prevention 
Act (42 U.S.C. 4801 et seq.) which prohibits the use of lead based 
paint in construction or rehabilitation of residence structures.
    17. Will cause to be performed the required financial and 
compliance audits in accordance with the Single Audit Act of 1984.
    18. Will comply with all applicable requirements of all other 
Federal laws, executive orders, regulations and policies governing 
this program.

Signature of authorized certifying official

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


DEPARTMENT OF HEALTH AND HUMAN SERVICES
Title------------------------------------------------------------------

Applicant organization-------------------------------------------------

Date submitted---------------------------------------------------------

BILLING CODE 4184-01-P

TN25MR94.003


TN25MR94.004

BILLING CODE 4184-01-C

Attachment E--Certification Regarding Debarment, Suspension, and Other 
Responsibility Matters--Primary Covered Transactions

    By signing and submitting this proposal, the applicant, defined as 
the primary participant in accordance with 45 CFR part 76, certifies to 
the best of its knowledge and believe that it and its principals:
    (a) Are not presently debarred, suspended, proposed for debarment, 
declared ineligible, or voluntarily excluded from covered transactions 
by any Federal Department or agency;
    (b) Have not within a 3-year period preceding this proposal been 
convicted of or had a civil judgment rendered against them for 
commission of fraud or a criminal offense in connection with obtaining, 
attempting to obtain, or performing a public (Federal, State, or local) 
transaction or contract under a public transaction; violation of 
Federal or State antitrust statutes or commission of embezzlement, 
theft, forgery, bribery, falsification or destruction of records, 
making false statements, or receiving stolen property;
    (c) Are not presently indicted or otherwise criminally or civilly 
charged by a governmental entity (Federal, State, or local) with 
commission of any of the offenses enumerated in paragraph (1)(b) of 
this certification; and
    (d) Have not within a 3-year period preceding this application/
proposal had one or more public transactions (Federal, State, or local) 
terminated for cause or default.
    The inability of a person to provide the certification required 
above will not necessarily result in denial of participation in this 
covered transaction. If necessary, the prospective participant shall 
submit an explanation of why it cannot provide the certification. The 
certification or explanation will be considered in connection with the 
Department of Health and Human Services (HHS) determination whether to 
enter into this transaction. However, failure of the prospective 
primary participant to furnish a certification or an explanation shall 
disqualify such person from participation in this transaction.
    The prospective primary participant agrees that by submitting this 
proposal, it will include the clause entitled ``Certification Regarding 
Debarment, Suspension, Ineligibility, and Voluntary Exclusion--Lower 
Tier Covered Transaction,'' provided below without modification in all 
lower tier covered transactions and in all solicitations for lower tier 
covered transactions.

Certification Regarding Debarment, Suspension, Ineligibility and 
Voluntary Exclusion--Lower Tier Covered Transactions (To Be Supplied to 
Lower Tier Participants)

    By signing and submitting this lower tier proposal, the prospective 
lower tier participant, as defined in 45 CFR part 76, certifies to the 
best of its knowledge and belief that it and its principals:
    (a) Are not presently debarred, suspended, proposed for debarment, 
declared ineligible, or voluntarily excluded from participation in this 
transaction by any federal department or agency.
    (b) Where the prospective lower tier participant is unable to 
certify to any of the above, such prospective participant shall attach 
an explanation to this proposal.
    The prospective lower tier participant further agrees by submitting 
this proposal that it will include this clause entitled ``Certification 
Regarding Debarment, Suspension, Ineligibility, and Voluntary 
Exclusion--Lower Tier Covered Transactions,'' without modification in 
all lower tier covered transactions and in all solicitations for lower 
tier covered transactions.

Attachment F--Certification Regarding Anti-Lobbying Provisions

Certification for Contracts, Grants Loans, and Cooperative Agreements

    The undersigned certifies, to the best of his or her knowledge and 
belief, that:
    (1) No Federal appropriated funds have been paid or will be paid, 
by or on behalf of the undersigned, to any person for influencing or 
attempting to influence an officer or employee of any agency, a Member 
of Congress, an officer or employee of Congress, or an employee of a 
Member of Congress in connection with the awarding of any Federal 
contract, the making of any Federal grant, the making of any Federal 
loan, the entering into of any cooperative agreement, and the 
extension, continuation, renewal, amendment, or modification of any 
Federal contract, grant, loan, or cooperative agreement.
    (2) If any funds other than Federal appropriated funds have been 
paid or will be paid to any person for influencing or attempting to 
influence an officer or employee of any agency, a Member of Congress, 
an officer or employee of Congress, or an employee of a Member of 
Congress in connection with this Federal contract, grant, loan, or 
cooperative agreement, the undersigned shall complete and submit 
Standard Form-LLL, ``Disclosure Form to Report Lobbying,'' in 
accordance with its instructions.
    (3) The undersigned shall require that the language of this 
certification be included in the award documents for all subawards at 
all tiers (including subcontracts, subgrants, and contracts under 
grants, loans, and cooperative agreements) and that all subrecipients 
shall certify and disclose accordingly.
    This certification is a material representation of fact upon which 
reliance was placed when this transaction was made or entered into. 
Submission of this certification is a prerequisite for making or 
entering into this transaction imposed by section 1352, title 31, U.S. 
Code. Any person who fails to file the required certification shall be 
subject to a civil penalty of not less than $10,000 and not more than 
$100,000 for each such failure.

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.

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BILLING CODE 4184-01-P

TN25MR94.005


BILLING CODE 4184-01-C

Attachment G--Executive Order 12372--State Single Points of Contact

Arizona

Mrs. Janice Dunn, Attn: Arizona State Clearinghouse, 3800 N. Central 
Avenue, 14th Floor, Phoenix, Arizona 85012, Telephone (602) 280-1315

Arkansas

Tracie L. Copeland, Manager, State Clearinghouse, Office of 
Intergovernmental Services, Department of Finance and Administration, 
P.O. Box 3278, Little Rock, Arkansas 72203, Telephone (501) 682-1074

California

Glenn Stober, Grants Coordinator, Office of Planning and Research, 1400 
Tenth Street, Sacramento, California 95814, Telephone (916) 323-7480

Colorado

State Single Point of Contact, State Clearinghouse, Division of Local 
Government, 1313 Sherman Street, Room 520, Denver, Colorado 80203, 
Telephone (303) 866-2156

Delaware

Ms. Francine Booth, State Single Point of Contact, Executive 
Department, Thomas Collins Building, Dover, Delaware 19903, Telephone 
(302) 736-3326

District of Columbia

Rodney T. Hallman, State Single Point of Contact, Office of Grants 
Management and Development, 717 14th Street, NW., Suite 500, 
Washington, DC 20005, Telephone (202) 727-6551

Florida

Florida State Clearing House, Intergovernmental Affairs Policy Unit, 
Executive Office of the Governor, Office of Planning and Budgeting, The 
Capitol, Tallahassee, Florida 32399-0001, Telephone (904) 488-8441

Georgia

Mr. Charles H. Badger, Administrator, Georgia State Clearing House, 254 
Washington Street, SW., Atlanta, Georgia 30334, Telephone (404) 656-
3855

Illinois

Steve Klokkenga, Single Point of Contact, Office of the Governor, 107 
Stratton Building, Springfield, Illinois 62706, Telephone (217) 782-
1671

Indiana

Jean S. Blackwell, Budget Director, State Budget Agency, 212 State 
House, Indianapolis, Indiana 46204, Telephone (317) 232-5610

Iowa

Mr. Steven R. McCann, Division of Community Progress, Iowa Department 
of Economic Development, 200 East Grand Avenue, Des Moines, Iowa 50309, 
Telephone (515) 281-3725

Kentucky

Ronald W. Cook, Office of the Governor, Department of Local Government, 
1024 Capitol Center Drive, Frankfort, Kentucky 40601, Telephone (502) 
564-2382

Maine

Ms. Joyce Benson, State Planning Office, State House Station #38, 
Augusta, Maine 04333, Telephone (207) 289-3261

Maryland

Ms. Mary Abrams, Chief, Maryland State Clearinghouse, Department of 
State Planning, 301 West Preston Street, Baltimore, Maryland 21201-
2365, Telephone (301) 225-4490

Massachusetts

Karen Arone, State Clearinghouse, Executive Office of Communities and 
Development, 100 Cambridge Street, Room 1803, Boston, Massachusetts 
02202, Telephone (617) 727-7001

Michigan

Richard S. Pastula, Director, Michigan Department of Commerce, Lansing, 
Michigan 48909, Telephone (517) 373-7356

Mississippi

Ms. Cathy Mallette, Clearinghouse Officer, Office of Federal Grant 
Management and Reporting, 301 West Pearl Street, Jackson, Mississippi 
39203, Telephone (601) 960-2174

Missouri

Ms. Lois Pohl, Federal Assistance Clearinghouse, Office of 
Administration, P.O. Box 809, Room 430, Truman Building, Jefferson 
City, Missouri 65102, Telephone (314) 751-4834

Nevada

Department of Administration, State Clearinghouse, Capitol Complex, 
Carson City, Nevada 89710, Telephone (702) 687-4065, Attention: Ron 
Sparks, Clearinghouse Coordinator

New Hampshire

Mr. Jeffrey H. Taylor, Director, New Hampshire Office of State 
Planning, Attn: Intergovernmental Review, Process/James E. Bieber, 2\1/
2\ Beacon Street, Concord, New Hampshire 03301, Telephone (603) 271-
2155

New Jersey

Gregory W. Adkins, Acting Director, Division of Community Resources, 
N.J. Department of Community Affairs, Trenton, New Jersey 08625-0803, 
Telephone (609) 292-6613, Please direct correspondence and questions 
to: Andrew J. Jaskolka, State Review Process, Division of Community 
Resources, CN 814, room 609, Trenton, New Jersey 08625-0803, Telephone 
(609) 292-9025

New Mexico

George Elliott, Deputy Director, State Budget Division, room 190, 
Bataan Memorial Building, Santa Fe, New Mexico 87503, Telephone (505) 
827-3640, FAX (505) 827-3006

New York

New York State Clearinghouse, Division of the Budget, State Capitol, 
Albany, New York 12224, Telephone (518) 474-1605

North Carolina

Mrs. Chrys Baggett, Director, Office of the Secretary of Admin., N.C. 
State Clearinghouse, 116 W. Jones Street, Raleigh, North Carolina 
27603-8003, Telephone (919) 733-7232

North Dakota

N.D. Single Point of Contact, Office of Intergovernmental Assistance, 
Office of Management and Budget, 600 East Boulevard Avenue, Bismarck, 
North Dakota 58505-0170, Telephone (701) 224-2094

Ohio

Larry Weaver, State Single Point of Contact, State/Federal Funds 
Coordinator, State Clearinghouse, Office of Budget and Management, 30 
East Broad Street, 34th Floor, Columbus, Ohio 43266-0411, Telephone 
(614) 466-0698

Rhode Island

Mr. Daniel W. Varin, Associate Director, Statewide Planning Program, 
Department of Administration, Division of Planning, 265 Melrose Street, 
Providence, Rhode Island 02907, Telephone (401) 277-2656, Please direct 
correspondence and questions to: Review Coordinator, Office of 
Strategic Planning

South Carolina

Omeagia Burgess, State Single Point of Contact, Grant Services, Office 
of the Governor, 1205 Pendleton Street, Room 477, Columbia, South 
Carolina 29201, Telephone (803) 734-0494

South Dakota

Ms. Susan Comer, State Clearinghouse Coordinator, Office of the 
Governor, 500 East Capitol, Pierre, South Dakota 57501, Telephone (605) 
773-3212

Tennessee

Mr. Charles Brown, State Single Point of Contact, State Planning 
Office, 500 Charlotte Avenue, 309 John Sevier Building, Nashville, 
Tennessee 37219, Telephone (615) 741-1676

Texas

Mr. Thomas Adams, Governor's Office of Budget and Planning, P.O. Box 
12428, Austin, Texas 78711, Telephone (512) 463-1778

Utah

Utah State Clearinghouse, Office of Planning and Budget, Attn: Carolyn 
Wright, Room 116, State Capitol, Salt Lake City, Utah 84114, Telephone 
(801) 538-1535

Vermont

Mr. Bernard D. Johnson, Assistant Director, Office of Policy Research & 
Coordination, Pavilion Office Building, 109 State Street, Montpelier, 
Vermont 05602, Telephone (802) 828-3326

West Virginia

Mr. Fred Cutlip, Director, Community Development Division, West 
Virginia Development Office, Building #6, Room 553, Charleston, West 
Virginia 25305, Telephone (304) 348-4010

Wisconsin

Mr. William C. Carey, Federal/State Relations, Wisconsin Department of 
Administration, 101 South Webster Street, P.O. Box 7864, Madison, 
Wisconsin 53707, Telephone (608) 266-0267

Wyoming

Sheryl Jeffries, State Single Point of Contact, Herschler Building, 4th 
Floor, East Wing, Cheyenne, Wyoming 82002, Telephone (307) 777-7574

Guam

Mr. Michael J. Reidy, Director, Bureau of Budget and Management 
Research, Office of the Governor, P.O. Box 2950, Agana, Guam 96910, 
Telephone (671) 472-2285

Northern Mariana Islands

State Single Point of Contact, Planning and Budget Office, Office of 
the Governor, Saipan, CM, Northern Mariana Islands 96950

Puerto Rico

Norma Burgos/Jose H. Caro, Chairman/Director, Puerto Rico Planning 
Board, Minillas Government Center, P.O. Box 41119, San Juan, Puerto 
Rico 00940-9985, Telephone (809) 727-4444

Virgin Islands

Jose L. George, Director, Office of Management and Budget, #41 
Norregade Emancipation Garden Station, Second Floor, Saint Thomas, 
Virgin Islands 00802, Please direct correspondence to: Linda Clarke, 
Telephone (809) 774-0750

Attachment H

    Checklist for Use in Submitting OCS Grant Applications (Optional)
    The application should contain:
    1. A completed, signed SF-424, ``Application for Federal 
Assistance''. The letter code for the priority areas (TA) or (TD) 
should be in the lower right-hand corner of the page;
    2. A completed ``Budget Information-Non-Construction'' (SF-424A);
    3. A signed ``Assurances-Non-Construction'' (SF-424A);
    4. A Project Narrative beginning with a Table of Contents that 
describes the project in the following order:
    (a) Need for Assistance
    (b) Work Program
    (c) Significant and Beneficial Impact
    (d) Ability of Applicant to Perform
    (e) Staffing and Resources
    5. Appendices including proof of non-profit status, Single Points 
of Contact comments (where applicable), resumes;
    6. A signed copy of ``Certification Regarding Anti-Lobbying 
Activities'';
    7. A completed ``Disclosures of Lobbying Activities'', if 
appropriate; and
    8. A self-addressed mailing label which can be affixed to a 
postcard to acknowledge receipt of application.
    The application should not exceed a total of 30 pages. It should 
include one original and four identical copies, printed on white 8\1/2\ 
by 11 inch paper, two holes punched at the top center and fastened 
separately with a compressor slide paper fastener or a binder clip.
    The applicant must be aware that in signing and submitting the 
application for this award, it is certifying that it will comply with 
the Federal requirements concerning the drug-free workplace and 
debarment regulations set forth in Attachments D and E.

Attachment I

    The following DHHS regulations apply to all applicants/grantees 
under the Training and Technical Assistance Program:
    Title 45 of the Code of Federal Regulations:

Part 16--Procedures of the Departmental Grant Appeals Board
Part 74--Administration of Grants (non-governmental)
Part 74--Administration of Grants (state and local governments and 
Indian Tribal affiliates):
    Sections 74.62(a)  Non-Federal Audits
    Sections 74.173  Hospitals
    Sections 74.174(b)  Other Nonprofit Organizations
    Sections 74.304  Final Decisions in Disputes
    Sections 74.710  Real Property, Equipment and Supplies
    Sections 74.715  General Program Income
Part 75--Informal Grant Appeal Procedures
Part 76--Debarment and Suspension form Eligibility for Financial 
Assistance
Subpart F--Drug Free Workplace Requirements
Part 80--Non-discrimination
    Under Programs Receiving Federal Assistance through the Department 
of Health and Human Services
    Effectuation of Title VI of the Civil Rights Act of 1964
Part 81--Practice and Procedures for Hearings Under Part 80 of this 
Title
Part 84--Non-discrimination on the Basis of Handicap in Programs
Part 86--Nondiscrimination on the basis of sex in the admission of 
individuals to training programs
Part 91--Non-discrimination on the Basis of Age in Health and Human 
Services Programs or Activities Receiving Federal Financial Assistance
Part 92--Uniform Administrative Requirements for Grants and Cooperative 
Agreements to States and Local Governments (Federal Register, March 11, 
1988)
Part 93--New Restrictions on Lobbying
Part 100--Intergovernmental Review of Department of Health and Human 
Services Programs and Activities

[FR Doc. 94-7140 Filed 3-24-94; 8:45 am]
BILLING CODE 4184-01-P