[Federal Register Volume 59, Number 116 (Friday, June 17, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-14752]


[[Page Unknown]]

[Federal Register: June 17, 1994]



TN17JN94.049

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 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-P

TN17JN94.051


TN17JN94.047

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 budgeted amounts plus 
or minus, as appropriate, the amounts shown in Columns (e) and (f). 
The amount(s) in Column (g) should not equal the sum of amounts in 
Columns (e) and (f).
    Line 5--Show the totals for all columns used.

Section B. Budget Categories

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

Section C. Non-Federal-Resources

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

Assurances-Non-Construction Programs

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

    As the duly authorized representative of the applicant I certify 
that the applicant:
    1. Has the legal authority to apply for Federal assistance, and 
the institutional, managerial and financial capability (including 
funds sufficient to pay the non-Federal share of project costs) to 
ensure proper planning, management and completion of the project 
described in this application.
    2. Will give the awarding agency, the Comptroller General of the 
United States, and if appropriate, the State, through any authorized 
representative, access to and the right to examine all records, 
books, papers, or documents related to the award; and will establish 
a proper accounting system in accordance with generally accepted 
accounting standards or agency directives.
    3. Will establish safeguards to prohibit employees from using 
their positions for a purpose that constitutes or presents the 
appearance of personal or organizational conflict of interest, or 
personal gain.
    4. Will initiate and complete the work within the applicable 
time frame after receipt of approval of the awarding agency.
    5. Will comply with the Intergovernmental Personnel Act of 1970 
(42 U.S.C. Secs. 4728-4763) relating to prescribed standards for 
merit systems for programs funded under one of the nineteen statutes 
or regulations specified in Appendix A of OPM's Standards for a 
Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
    6. Will comply with all Federal statutes relating to 
nondiscrimination. These include but are not limited to: (a) title 
VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits 
discrimination on the basis of race, color or national origin; (b) 
Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 
Secs. 1681-1683, and 1685-1686), which prohibits discrimination on 
the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, 
as amended (29 U.S.C. Sec. 794), which prohibits discrimination on 
the basis of handicaps; (d) the Age Discrimination Act of 1975, as 
amended (42 U.S.C. Secs. 6101-6107), which prohibits discrimination 
on the basis of age; (e) the Drug Abuse Office and Treatment Act of 
1972 (P.L. 92-255), as amended, relating to nondiscrimination on the 
basis of drug abuse; (f) the Comprehensive Alcohol Abuse and 
Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 
(P.L. 91-616), as amended, relating to nondiscrimination on the 
basis of alcohol abuse or alcoholism; (g) Secs. 523 and 527 of the 
Public Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee-3), 
as amended, relating to confidentiality of alcohol and drug abuse 
patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 
U.S.C. Sec. 3601 et seq.), as amended, relating to non-
discrimination in the sale, rental or financing of housing; (i) any 
other nondiscrimination provisions in the specific statute(s) under 
which application for Federal assistance is being made; and (j) the 
requirements of any other nondiscrimination statute(s) which may 
apply to the application.
    7. Will comply, or has already complied, with the requirements 
of Titles II and III of the Uniform Relocation Assistance and Real 
Property Acquisition Policies Act of 1970 (P.L. 91-646) which 
provide for fair and equitable treatment of persons displaced or 
whose property is acquired as a result of Federal or federally 
assisted programs. These requirements apply to all interests in real 
property acquired for project purposes regardless of Federal 
participation in purchases.
    8. Will comply with the provisions of the Hatch Act (5 U.S.C. 
Secs. 1501-1508 and 7324-7328) which limit the political activities 
of employees whose principal employment activities are funded in 
whole or in part with Federal funds.
    9. Will comply, as applicable, with the provisions of the Davis-
Bacon Act (40 U.S.C. Secs. 276a to 276a-7), the Copeland Act (40 
U.S.C. Sec. 276c and 18 U.S.C. Secs. 874), and the Contract Work 
Hours and Safety Standards Act (40 U.S.C. Secs. 327-333), regarding 
labor standards for federally assisted construction subagreements.
    10. Will comply, if applicable, with flood insurance purchase 
requirements of Section 102(a) of the Flood Disaster Protection Act 
of 1973 (P.L. 93-234) which requires recipients in a special flood 
hazard area to participate in the program and to purchase flood 
insurance if the total cost of insurable construction and 
acquisition is $10,000 or more.
    11. Will comply with environmental standards which may be 
prescribed pursuant to the following: (a) institution of 
environmental quality control measures under the National 
Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order 
(EO) 11514; (b) notification of violating facilities pursuant to EO 
11738; (c) protection of wetlands pursuant to EO 11990; (d) 
evaluation of flood hazards in floodplains in accordance with EO 
11988; (e) assurance of project consistency with the approved State 
management program developed under the Coastal Zone Management Act 
of 1972 (16 U.S.C. Secs. 1451 et seq.); (f) conformity of Federal 
actions to State (Clear Air) Implementation Plans under Section 
176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. Sec. 7401 
et seq.); (g) protection of underground sources of drinking water 
under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-
523); and (h) protection of endangered species under the Endangered 
Species Act of 1973, as amended, (P.L. 93-205).
    12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 
U.S.C. Secs. 1271 et seq.) related to protecting components or 
potential components of the national wild and scenic rivers system.
    13. Will assist the awarding agency in assuring compliance with 
Section 106 of the National Historic Preservation Act of 1966, as 
amended (16 U.S.C. 470), EO 11593 (identification and protection of 
historic properties), and the Archaeological and Historic 
Preservation Act of 1974 (16 U.S.C. 469a-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. Secs. 4801 et seq.) which prohibits the use of lead 
based paint in construction or rehabilitation of residence 
structures.
    17. Will cause to be performed the required financial and 
compliance audits in accordance with the Single Audit Act of 1984.
    18. Will comply with all applicable requirements of all other 
Federal laws, executive orders, regulations and policies governing 
this program.

----------------------------------------------------------------------
Signature of Authorized Certifying Official

----------------------------------------------------------------------
Title

----------------------------------------------------------------------
Applicant Organization

----------------------------------------------------------------------
Date Submitted

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, N.W., Suite 500, 
Washington, D.C. 20005, Telephone (202) 727-6551

Florida

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

Georgia

Charles H. Badger, Administrator, Georgia State Clearinghouse, 254 
Washington Street, S.W., Atlanta, Georgia 30334, Telephone (404) 
656-3855

Illinois

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

Indiana

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

Iowa

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 Fee, New Mexico 87503, Telephone 
(505) 827-3640, FAX (505) 827-3006

New York

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

North Carolina

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

North Dakota

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

Ohio

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

Rhode Island

Mr. Daniel W. Varin, Associate Director, Statewide Planning Program, 
Department of Administration, Division of Planning, 265 Melrose 
Street, Providence, Rhode Island 02907, Telephone (401) 277-2656

    Please direct correspondence and questions to: Review 
Coordinator, Office of Strategic Planning

South Carolina

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

Tennessee

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

Texas

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

Utah

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

Vermont

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

West Virginia

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

Wisconsin

Mr. William C. Carey, Federal/State Relations, Wisconsin Department 
of Administration, 101 South Webster Street, P.O. Box 7864, Madison, 
Wisconsin 53707, Telephone (608) 226-0267

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

BILLING CODE 4184-01-P

TN17JN94.052


TN17JN94.053

BILLING CODE 4184-01-C

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.

Certification Regarding Lobbying

Certification for Contracts, Grants, Loans, and Cooperative Agreements

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

State for Loan Guarantee and Loan Insurance

    The undersigned states, to the best of his or her knowledge and 
belief, that:
    If any funds have been paid or will be paid to any person for 
influencing or attempting to influence an officer or employee of any 
agency, a Member of Congress, an officer or employee of Congress, or an 
employee of a Member of Congress in connection with this commitment 
providing for the United States to insure or guarantee a loan, the 
undersigned shall complete and submit Standard Form-LLL ``Disclosure 
Form to Report Lobbying,'' in accordance with its instructions.
    Submission of this statement is a prerequisite for making or 
entering into this transaction imposed by section 1352, title 31, U.S. 
Code. Any person who fails to file the required statement shall be 
subject to a civil penalty of not less then $10,000 and not more than 
$100,000 for each such failure.

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Signature

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Title

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Organization

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Date


BILLING CODE 4184-01-P

TN17JN94.054

[FR Doc. 94-14759 Filed 6-16-94; 8:45 am]
BILLING CODE 4184-01-C
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Part VII





Department of the Interior





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Bureau of Indian Affairs



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St. Regis Mohawk Tribal Alcohol Beverages Control Act; Notice
DEPARTMENT OF THE INTERIOR

Bureau of Indian Affairs

 
St. Regis Mohawk Tribal Alcohol Beverages Control Act

AGENCY: Bureau of Indian Affairs, Interior.

Action: Notice.

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SUMMARY: This Notice is published in accordance with authority 
delegated by the Secretary of the Interior to the Assistant Secretary--
Indian Affairs by 209 DM8, and in accordance with the Act of August 15, 
1953, 67 Stat. 586, 18 U.S.C. Sec. 1161. I certify that the St. Regis 
Mohawk Tribal Alcohol Beverages Control Act was duly adopted by the St. 
Regis Mohawk Tribe on November 19, 1993. The Ordinance provides for the 
regulation, manufacture, distribution, possession, sale, and 
consumption of liquor on the St. Regis Mohawk Indian Reservation of the 
State of New York.

DATES: This Ordinance is effective as of June 17, 1994.

.FOR FURTHER INFORMATION CONTACT: Chief, Branch of Judicial Services, 
Division of Tribal Government Services, 1849 C Street NW., MS 2611-MIB, 
Washington, DC 20240-4001; telephone (202) 208-4400.

SUPPLEMENTARY INFORMATION: The St. Regis Mohawk Tribal Alcohol 
Beverages Control Act is to read as follows:

St. Regis Mohawk Tribal Alcohol Beverages Control Act

    This Ordinance shall be cited as the ``St. Regis Mohawk Tribal 
Alcoholic Beverages Control Act'' and, pursuant to the inherent 
sovereignty of the St. Regis Mohawk Indian Tribe of the State of New 
York, shall be deemed an exercise of the Tribe's powers for the purpose 
of protecting the welfare, health, peace, morals and safety of all 
people residing on the St. Regis Mohawk Indian Reservation of the State 
of New York.
    All of the provisions of this Ordinance shall be liberally 
construed to accomplish the above declared purpose. It is the St. Regis 
Mohawk Tribe's declared intent in enacting this Ordinance to regulate 
and control all traffic in liquor on the St. Regis Mohawk Indian 
Reservation of the State of New York except to the extent allowed and 
permitted under the express terms of this Ordinance.
Section 1. Definitions
    As used in this Ordinance, the following definitions shall apply 
unless the context clearly indicates otherwise:
    1.1 Alcohol shall mean neutral spirits distilled at or above 190 
proof, whether or not such product is subsequently reduced for non-
industrial use.
    1.2  Alcoholic beverage shall mean any liquid suitable for human 
consumption, which contains one-half of one percent or more of alcohol 
by volume.
    1.3  Barter or bartering shall mean the trading for any commodity, 
act or consideration whether or not there is intrinsic value in the 
item traded.
    1.4  Beer shall mean any malt beverage containing more than one-
half of one percent of alcohol by volume.
    1.5  Distilled spirits shall mean any alcoholic beverage that is 
not beer, wine, sparkling wine or alcohol.
    1.6  Enterprise of the Tribe shall mean the St. Regis Mohawk Tribe, 
a member of the St. Regis Mohawk Tribe or his or her spouse, or a 
business entity or association owned and controlled by any of the 
foregoing, that is licensed by the Tribal Council and pays the 
appropriate fee set by the Tribal Council by Resolution at not less 
than Two Hundred ($200.00) Dollars and no more than Five Thousand 
($5,000.00) Dollars annually.
    1.7  Liquor shall mean all varieties of liquid, semisolid, or solid 
substance containing alcohol, whether brewed, fermented, formulated, or 
distilled, which is intended for human consumption.
    1.8  Minor shall mean any person under twenty-one (21) years of 
age.
    1.9  Possession or possessing shall mean having on one's person, 
vehicle or other property and includes constructive possession through 
control without regard to ownership.
    1.10  Purchase shall mean the exchange, barter, traffic, receipt 
with or without consideration in any form.
    1.11  Sale shall mean the exchange, barter, traffic, donation, with 
or without consideration, in addition to the selling, supplying or 
distribution by any means, by any person, to any person.
    1.12  Transport shall mean the introduction of alcoholic beverage 
onto the St. Regis Mohawk Indian Reservation of the State of New York 
by any means of conveyance for the purpose of sale, or distribution, to 
any licensed dealer.
    1.13  Tribal Council shall mean the duly elected governing body of 
the St. Regis Mohawk Indian Tribe of New York, a federally recognized 
Indian Tribe.
Section 2. Relation of Other Tribal Regulations
    Any and all prior ordinances, resolutions, regulations or other 
form of control of the St. Regis Mohawk Tribe of the State of New York 
whether written or unwritten, which authorize, prohibit, or deal with 
the sale of alcohol are hereby repealed and have no further force and 
effect. No Tribal Ordinance or Regulation shall be applied in a manner 
inconsistent with the provisions of this ordinance.
Section 3. Prohibition
    The introduction on the Reservation for resale, wholesale purchase, 
sale and dealing in liquor other than by the Tribe or an Enterprise of 
the Tribe is prohibited. Possession of liquor on the Reservation by any 
person not prohibited by Federal law shall be lawful so long as 
possession is in conformity with this Ordinance.
Section 4. Conformity With State Laws
    Tribal standards for liquor transactions and possessions and 
consumption of liquor shall meet or exceed those required by the State 
of New York including but not limited to:
    (a) Hours of Sale: Wine, Beer and Mixed Beverages. The Tribe or an 
Enterprise of the Tribe may sell or offer for sale wine, beer and mixed 
beverages at all times not specifically prohibited by this Section. The 
Tribe or an Enterprise of the Tribe may not sell or offer for sale wine 
and beer and mixed beverages on Sunday between the hours of 2 a.m. and 
12 noon. On any other day, the Tribe or an Enterprise of the Tribe may 
not sell or offer for sale wine, beer, or mixed beverages between the 
hours of 2 a.m. and 8 a.m.
    (b) Minor. A minor is any person who has not celebrated his or her 
twenty-first (21st) birthday.
    (c) Purchase of Alcohol by a Minor. Purchase of an alcoholic 
beverage by a minor [is] prohibited.
    (d) Sales to Minor. Sale of an alcoholic beverage to a minor by the 
Tribe or an Enterprise of the Tribe is prohibited.
    (e) Consumption of Alcohol by a Minor. Consumption of an alcoholic 
beverage by a minor is prohibited.
    (f) Possession of Alcohol by a Minor. Possession of an alcoholic 
beverage by a minor is prohibited unless such minor is in possession of 
the alcoholic beverage while in the course and scope of his employment 
and he is any employee of the Tribe or an Enterprise of the Tribe.
    (g) Purchase of Alcohol for a Minor; Furnishing Alcohol to a Minor. 
A person commits a violation of this Ordinance if he knowingly 
purchases an alcoholic beverage for or knowingly gives or makes 
available an alcoholic beverage to a minor.
    (h) Misrepresentation of Age by a Minor. A minor is in violation of 
this Ordinance if he falsely states that he or she is 21 years of age 
or older or presents any document that indicates he/she is 21 years of 
age or older to a person engaged in selling or serving alcoholic 
beverages.
    (i) Employment of Minors. The Tribe or an Enterprise of the Tribe 
shall not employ any person under 18 years of age to sell, prepare, 
serve, or otherwise handle liquor, or to assist in doing so. The Tribe 
or an Enterprise of the Tribe may, however, employ a person under 18 
years of age to work in any capacity other than the actual selling, 
preparing, serving or handling of liquor.
Section 5. Prohibition of Sales During Emergencies or Dates and Times 
Established by the Tribal Council
    The Tribal Council Head Chief, by authority of Tribal Council 
Resolution, may on an emergency basis and for a period of time not to 
exceed five (5) business days, by written order, act, directive or 
notice, prohibit the sale of liquor until such emergency order can be 
considered by the Tribal Council which may in its discretion, terminate 
or extend such order for any length of time it deems necessary, or may 
issue emergency rules, regulations directions or orders concerning the 
sale of liquor which will be valid during the stated emergency period. 
The Tribal Council may likewise issue orders prohibiting or limiting 
the sale of liquor for any period not to exceed seventy-two (72) 
consecutive hours.
Section 6. Sovereign Immunity Preserved
    Nothing in this Ordinance is intended nor shall be construed as a 
waiver of the sovereign immunity of the St. Regis Mohawk Tribe of the 
State of New York. No officer, manager or employee of an enterprise of 
the Tribe shall be authorized nor shall attempt to waive the sovereign 
immunity of the Tribe.
Section 7. Penalty
    Any person or entity purchasing, possessing, selling, bartering, or 
otherwise trafficking in liquor on the Reservation is in violation of 
this ordinance or any Rule or Regulation adopted pursuant to this 
ordinance and shall be subject to a fine or forfeiture, as applicable, 
of not more than Five Thousand Dollars ($5,000.00) and may be barred 
from admission to the Reservation through Due Process of law. In 
addition, persons or entities subject to the full jurisdiction of the 
Tribe may be subject to such other appropriate actions as the Tribal 
Council may determine. All contraband merchandise shall be confiscated 
by the Tribe and disposed of as directed by the Tribal Council.
Section 8. Severability
    If any clause, part or section of this Ordinance shall be adjudged 
invalid, such judgement shall not affect or invalidate the remainder of 
the ordinance but shall be confined in its operation to the clause, 
part or section directly involved in controversy in which such 
judgement was rendered.
Section 9. Disclaimer
    Nothing in this Ordinance shall be construed to authorize or 
require the criminal trial and punishment of non-Indians by the St. 
Regis Mohawk Tribe of the State of New York except to the extent 
allowed by an applicable present or future Act of Congress or any 
applicable laws.
Section 10. Regulations
    The Tribal Council shall have the exclusive authority to adopt and 
enforce Rules and Regulations to implement the sale, transportation or 
introduction of liquor on the Reservation and to further the purposes 
of this ordinance. Such Rules and Regulations shall have the force of 
law upon promulgation by Resolution.
Section 11. Enforcement
    This Ordinance shall be enforced by the Tribal Council, or any 
other Agency vested with such enforcement authority by resolution of 
the Tribal Council.
Section 12. Effective Date
    This ordinance shall be effective upon the date that the Secretary 
of the Interior certifies this ordinance and it is published in the 
Federal Register.
Section 13. Duration
    The duration of this Ordinance shall be perpetual.

    Dated: June 8, 1994.
Ada E. Deer,
Assistant Secretary--Indian Affairs.
[FR Doc. 94-14752 Filed 6-16-94; 8:45 am]
BILLING CODE 4310-02-M