[Federal Register Volume 62, Number 102 (Wednesday, May 28, 1997)]
[Notices]
[Pages 28864-28884]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-13922]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families
[Program Announcement No. OPRE-97-1]


Availability of Funds and Requests for Applications for Welfare 
Reform Studies and Analyses

AGENCY: Office of Planning, Research, and Evaluation; ACF; DHHS.

ACTION: Announcement of the availability of funds and requests for 
applications for welfare reform studies and analyses (OPRE-97-1).

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SUMMARY: The Administration for Children and Families (ACF) announces 
that competing applications are being accepted for funding to stimulate 
research and support a wide range of studies and analyses of varied 
aspects of welfare program changes at the national, state and local 
levels. This research will address the effects of welfare reform 
changes on families and children; the experiences of states and 
localities involved in implementing changes; or the experiences, 
responses and impacts on other entities or programs involved in 
implementing changes. Organizations eligible to apply for this Federal 
funding include public entities; private for-profit organizations (if 
fee is waived); and public or private nonprofit organizations, 
including universities. Federal funding under this announcement is 
intended to support research analysis and evaluation exclusively, not 
program operation or service provision. Projects funded under this 
announcement are intended to complement other aspects of the ACF 
research strategy for welfare reform evaluation and study. Funding 
under this announcement is intended to stimulate research and support a 
wide range of studies or components of studies and analyses of welfare 
program changes brought about by the Personal Responsibility and Work 
Opportunity Reconciliation Act of 1996, and specifically the Temporary 
Assistance to Needy Families (TANF) program. Subject to the 
availability, funding under this announcement is authorized by section 
1110 of the Social Security Act governing Social Services Research and 
Demonstration activities (Catalog of Federal Domestic Assistance 
93.647) and is intended to support research analysis and evaluation, 
not program operation or service provision. ACF anticipates providing 
up to $1.95 million for the total group of approved projects in FY 1997 
and up to $750,000 in FY 1998, subject to the availability of funds in 
each year, and a like amount in succeeding years. We estimate that this 
level of funding will support 4 to 8 separate projects under this 
announcement in FY 1997.

CLOSING DATE: The closing date for submission of applications is July 
28, 1997. Mailed applications postmarked after the closing date will be 
classified as late.

MAILING ADDRESS: Lois B. Hodge, Administration for Children and 
Families, Division of Discretionary Grants--Room 6C-462, 370 L'Enfant 
Promenade, S.W., Washington, D.C. 20447.
    For hand delivered applications or applications sent via over-night 
mail services, use: ACF MAIL ROOM--2nd floor. Attn: Lois B. Hodge, 
Administration for Children and Families, Division of Discretionary 
Grants, 901 D Street, S.W., Washington, D.C. 20024

FOR FURTHER INFORMATION CONTACT: Administration for Children and 
Families; Office of Planning, Research and Evaluation, 370 L'Enfant 
Promenade, S.W., Washington, DC 20447.

Nancye Campbell (202) 401-5760
Mark Fucello (202) 401-4538

Overview

    The Personal Responsibility and Work Opportunity Reconciliation Act 
of 1996 brings historic changes to state control over the design of 
Federally funded public assistance under title IV-A of the Social 
Security Act as well as changes regarding how states choose to delegate 
decisions and administrative control to local agencies and authorities. 
These changes create the need to explore a broad array of issues to 
understand the effects on families and the varied institutions involved 
and to document programs and initiatives put in place to encourage and 
support self-sufficiency among welfare recipients.
    ACF's national strategy for welfare reform research and evaluation 
is multi-faceted, including initiatives such as the State Welfare 
Reform Evaluation projects, the Child Care Research Partnership 
projects, the Project on State-Level Child Outcomes, the National 
Longitudinal Study of Children and Families in the Child Welfare 
System, and Departmental collaborations on topics such as employment 
stability and immigration and public assistance. The purpose of this 
announcement is to stimulate research and augment ongoing studies that 
are consistent with ACF's multi-faceted strategy and address areas not 
adequately covered by other projects in our welfare reform research and 
evaluation agenda. While we have identified some specific areas of 
interest to ACF within this announcement, researchers are encouraged to 
submit their own ideas and rationale for potential topics. This broad 
approach will assist ACF in continuing to develop research questions 
pertinent to welfare reform programs and policies and to fund projects 
that offer the most promise to adequately address such questions.
    Currently, there is a great deal of activity in research institutes 
and firms,

[[Page 28865]]

universities, and philanthropic foundations focused on various aspects 
of the changes occurring in state and local design of welfare programs. 
ACF is interested in partnering with such entities and providing 
support to enhance or expand studies by other funders as well as to 
provide full support for a range of studies or projects that address 
some of the most critical questions about outcomes for families and 
children, program design and implementation at various levels, and 
program management in the new public assistance environment.
    With the changes brought about by enactment of the Personal 
Responsibility and Work Opportunity Reconciliation Act of 1996, and in 
particular the provisions of the Temporary Assistance to Needy Families 
(TANF) program, it will be extremely important to policy makers and 
program administrators at all levels of government to fully understand 
how programs are implemented, how the culture of welfare offices is 
changing, how children and families are progressing under new rules and 
requirements, how specific subgroups or populations are affected, and 
whether policies and services are effective. Well-executed 
implementation analyses are important to providing early feedback on 
the new flexibility accorded to States under TANF as are illustrations 
of the changing culture of local public assistance offices brought 
about by TANF. Likewise, the implementation of Tribal TANF programs 
should be assessed to provide needed feedback. ACF is interested in 
supporting studies of this type.
    We have special interest in studies that aim to understand and 
monitor family and child well-being, to complement the work being done 
as part of the Project on State-Level Child Outcomes, because such 
studies will be critical to increasing knowledge and measuring the 
success of reforms on family economic independence and child well-
being. We encourage additional projects focusing on child outcomes. 
Further, analyses that can illustrate and examine outcomes for children 
and families will be needed to answer the array of questions presented 
about TANF's effects on family self-sufficiency and child well-being.
    Understanding the complex issues surrounding the relationship 
between employment stability and child care is a necessary aspect of 
measuring the effects of reforms. To supplement the projects to be 
funded under the ACF Child Care Research Partnership program 
announcement, analyses that focus on the relationship between child 
care and employment, including quality of care and associated child 
development and well-being, are important.
    While State-level evaluations of welfare reform begun under waiver 
authority and supported through ACF's State Welfare Reform Evaluation 
initiative will provide very useful information, additional analyses 
that examine changes resulting from TANF across a spectrum of 
environments (e.g., neighborhoods, communities, political subdivisions, 
public and other institutions, service providers) are needed to 
understand the breadth and scope of welfare reform that is being 
undertaken and its effects on other entities and programs.
    As an important part of ACF's national strategy for welfare reform 
evaluation and analysis, we intend to fund projects through this 
announcement to address questions not adequately addressed elsewhere in 
other ACF research and evaluation projects, such as those noted above. 
Under this announcement we expect to fund a varied group of projects 
that complement those efforts and provide information on program 
implementation, address a range of program and policy questions of 
importance to states, the Federal government and the general public, 
and examine family and child well-being.
    This program announcement consists of three parts. Part I describes 
the activities supported by this announcement and application 
requirements. Part II describes the application review process. Part 
III provides information and instructions for the development and 
submission of applications. The forms to be used for submitting an 
application follow Part III.

Part I--Project Purpose and Design

Purpose

    The primary purpose of this announcement is to stimulate research 
to further ACF's national strategy for welfare reform evaluation and 
analysis by supporting short-term and multi-year studies and 
evaluations (or components of such projects) to document and examine 
the experience of state or local agencies in implementing welfare 
reform and to better understand the effects of welfare reform on low-
income children and families. A wide range of well-designed studies and 
evaluations will be considered under this announcement. We may provide 
principal or possibly sole funding for short-term, small-scale 
projects, such as process studies to provide rapid feedback on TANF 
implementation or the implementation of programs or services aimed at 
assisting families to obtain employment or respond to other aspects of 
welfare reform.
    Through the short-term studies, we are particularly interested in 
obtaining information about the implementation and effects of 
innovative initiatives to help welfare families become self-sufficient 
but the study of other topics will also be considered. Through the 
multi-year projects, we are primarily interested in supporting 
supplements or enhancements to existing studies funded by others in 
order to address important questions regarding agencies, communities, 
and low-income families and children affected by welfare reform which 
may not otherwise be included in an existing study. ACF will also 
consider fully funding multi-year studies subject to the availability 
of funds and agency research priorities; however, we do not expect to 
provide full funding for large-scale, multi-year impact studies.
    The studies may be descriptive in nature, collecting and reporting 
on information about the characteristics of individuals and 
organizations involved with and affected by welfare reform. They may 
examine the effects of specific welfare reform policies (e.g., work 
requirements or time limits) or address a broad range of welfare reform 
issues and outcomes. They may be focused on specific geographic areas 
or include multiple sites. They may document the effects of welfare 
reform over time at various levels (e.g, national, state, local, 
community, family and individual) or provide a quick report on the 
early stages and effects of reform initiatives.
    ACF's interests in TANF implementation (at the state, local, and 
Tribal levels); child and family outcomes and well-being; and welfare 
office culture change are not the only research topics for which 
funding will be provided under this announcement. We invite a broad 
response to this announcement for well-designed studies which can be 
expected to add significantly to the research knowledge base. We wish 
to partner with those supporting well-designed evaluations or analyses 
which are currently planned or under way in the research and evaluation 
community so that we may consider funding types of studies that expand 
the agenda we have outlined here.

Project Design

    As discussed above, funding under this announcement is expected to 
be used to support studies and evaluations which differ from one 
another in focus,

[[Page 28866]]

scope and scale. State and local welfare agencies, policy makers, and 
the general public will benefit greatly from a very broad range of 
different types of public assistance research projects. For that reason 
ACF does not prescribe here specific research or evaluation designs, 
but rather we invite varied approaches to advance understanding of 
welfare reform and child and family functioning. While the research 
methods for studies submitted may differ, they must be well designed 
and the project's methods must be adequate and appropriate to address 
the questions identified for the study. As discussed in the Review 
Criteria section below, applicants must have experience and a proven 
track record in conducting studies of the scope and scale proposed. In 
making decisions, ACF will consider an applicant organization's 
experience as well as the experience and qualifications of researchers 
and staff.
    As indicated above, we expect to support projects which address 
different and varied issue areas. Below are some general topics of 
interest to ACF which are intended to be illustrative only. We invite 
and expect proposals focused on other issue areas as well.
    We are interested in answering questions related to the public 
assistance programs put in place, the agencies operating the programs 
and changes in their organizational culture, the community environment 
and the participants and families involved.
    Important questions need to be addressed regarding time limits as 
they relate to organizational entities and to individuals and families. 
From a state/local agency perspective, a study might seek to understand 
what state/local welfare agencies are doing to assist families subject 
to time limits to gain adequate employment before losing their cash 
benefits or how the provisions are being implemented and explained at 
the worker level. It is important to understand the implications and 
effects of the time limit on other service providers and other service 
delivery systems. And it is critically important to examine the 
response of individuals to the time limits and the effects on families 
and children.
    Issues surrounding work are critically important and many important 
questions exist. These might include questions regarding the operation 
and effects of policies to move recipients into jobs and help them 
retain employment, policies to increase employment through linkages or 
subsidies to employers, and policies intended to effect behavior such 
as sanctions and disregards.
    In addition, other issues related to employment such as supportive 
services and service coordination are important topics. How are 
critical aspects of child care being addressed in different programs? 
Are child care supply and demand, accessibility, costs, and quality 
factors in supporting families' entry into the work force?
    ACF is interested in studies that address important questions about 
the progress of individuals with special needs. There is a strong need 
to develop and study models for addressing domestic violence within 
welfare families. ACF is interested in helping to provide credible 
information about promising service approaches and strategies in this 
area.
    With requirements to move TANF recipients into the unsubsidized 
labor force, many programs may exempt individuals with disabilities or 
their parents from mandatory work and training activity or other 
program requirements. The result could be that these individuals would 
lose the opportunity to become self-sufficient and the public 
assistance community would miss an opportunity to learn how to improve 
services to disabled recipients and children to better enable families 
to move toward productive work. ACF is interested in building on the 
current knowledge about how to assist and integrate families with 
disabled people into the work force and help them confront obstacles to 
self-sufficiency.
    Under TANF, many teen parents will require alternate adult-
supervised living arrangements (e.g. Second Chance Homes) and other 
services when they cannot live at home. Analysis and evaluation of 
transitioning into independent living arrangements will be necessary to 
the success of welfare reform for these young parents at risk. Analysis 
and evaluation of programs and policies focused on school attendance 
requirements and successful transition from school to work are also 
needed.
    Another issue area that should be addressed concerns innovative 
service delivery systems or methods (e.g., home visiting; neighborhood 
saturation via linkages and collaborations among multiple agencies; and 
integrated service delivery systems). In addition, questions about 
improving the material, emotional, and developmental well-being of 
children via fathers' role in children's and families' lives are also 
important.
    Further, it is important to understand how local jurisdictions, 
Tribal organizations, and welfare offices have responded to different 
state approaches to implementing TANF, including how differences in 
implementation may affect family outcomes. This may include issues 
related to changes in the culture of welfare offices in response to 
TANF, family outcomes in special jurisdictions such as reservations, 
and changes in the management of program components under TANF now 
operated by different providers, including Tribes, or sectors of the 
community (e.g., public, for-profit contractor, non-profit service 
providers).
    These topics are illustrative of some of the areas of interest to 
ACF and are consistent with its overall welfare reform research and 
evaluation agenda. This announcement seeks to stimulate sound research, 
evaluation and study of a wide range of topical areas related to 
welfare reform and a variety of study designs that aim to answer 
different sorts of questions about policy, service management and 
delivery, and outcomes for family and child well-being. ACF's purpose 
is to further its welfare reform research and evaluation agenda by 
supplementing and complementing other research projects through this 
announcement by providing sole funding in some cases and by entering 
into partnerships in other cases with local and national public and 
private funders.

Eligible Applicants

    Organizations eligible to apply for financial assistance under this 
announcement include public entities; private for-profit organizations 
(if fee is waived); and public or private nonprofit organizations, 
including universities. Any nonprofit organization submitting an 
application must submit proof of its nonprofit status in its 
application at the time of submission. The nonprofit agency can 
accomplish this by providing a copy of the applicant's listing in the 
Internal Revenue Service's (IRS) most recent list of tax-exempt 
organizations described in Section 501(c)(3) of the IRS code or by 
providing a copy of the currently valid IRS tax exemption certificate, 
or by providing a copy of the articles of incorporation bearing the 
seal of the State in which the corporation or association is domiciled.
    While a variety of organizations and entities are eligible to apply 
for funding under this announcement, potential applicants should 
carefully review the Review Criteria in Part II to determine that they 
meet the requirements for experience and expertise for conducting 
rigorous, well-designed evaluations and studies of the type and scope 
discussed herein. Applicants are reminded that funding under this 
announcement is not

[[Page 28867]]

available to support programs or service provision but rather research 
and evaluation.

Funding Instruments--Grants and Cooperative Agreements

    ACF will issue the Financial Assistance Awards under this agreement 
as either grants or cooperative agreements. Cooperative agreements will 
be the instrument used to make awards when the amount of Federal 
involvement that is anticipated by ACF for a particular project is 
greater than is required and allowed under a grant. Cooperative 
agreements will be documents which outline the terms of ACF's 
involvement as well as the responsibilities of the recipient 
organization or agency. For example, multi-year awards may begin as 
cooperative agreements in the first year and may be converted to grants 
after recipients' capabilities have been established or a grant could 
be converted to a cooperative agreement when developments in a 
particular project call for greater ACF involvement.

Funding

    ACF anticipates providing up to $1.95 million for the total group 
of approved projects in FY 1997, subject to the availability of funds. 
All grants and cooperative agreements will be awarded by September 30, 
1997. ACF anticipates providing up to $750,000 in FY 1998, subject to 
the availability of funds, and like amounts in succeeding years. We 
estimate that this level of funding will support 4 to 8 separate 
projects under this announcement in FY 1997 (some of which will be 
parts of other, larger work). Federal funding under this announcement 
is intended to support research analysis and evaluation, not program 
operation or service provision.
    As indicated, ACF anticipates funding both short-term projects and 
longer-term studies. In Federal FY 1997 recipients of multi-year awards 
may be approved for project periods of up to 60 months and will receive 
an initial Financial Assistance Award for a budget period of 12 months. 
Multi-year project recipients will be allowed to apply for additional 
funding in FY 1998 and subsequent years within the overall project 
period on a non-competitive basis.
    We also encourage short-term projects which can provide useful and 
timely information to program administrators, e.g., implementation 
analysis. For these studies, we expect to make one-time awards for 
project and budget periods of 17 months. Applicants who are seeking 
funds to support short-term studies will be expected to complete the 
work within a maximum of 17 months. Studies which cannot be completed 
within that time frame will be considered for multi-year awards as 
described above.
    We may provide sole funding for projects, provide principal 
funding, or support only individual components of projects which have 
other funders. The latter types of applications (i.e., those with other 
funding sources) should include an overview of the funding sources for 
all components of the project in addition to the Federal budget 
requirements detailed in Section III of this announcement.
    Further, to maximize the benefit of the Federal investment to 
advance knowledge about welfare reform, ACF may give preference to 
applicants who provide evidence of other sources of funding for the 
project (e.g., applicant resources or private foundation funding). The 
applicant should describe the level, sources, and duration of non-
Federal funds or resources committed to the project. Do not, however, 
list these funds on the budget forms SF 424 and SF 424A described in 
section III of this announcement. Those forms are for listing only the 
Federal funds requested under this announcement. There is no non-
Federal matching requirement for this announcement; however, recipients 
will be held accountable for any non-Federal share listed on the SF 
424A and the Financial Assistance Award. For this reason, it is 
important that applicants who provide evidence of other sources of 
funding for the project do not list these sources on the SF 424A.

Part II--The Review Process

A. Review Process and Funding Decisions

    Timely applications from eligible applicants will be reviewed and 
scored competitively. Reviewers will use the evaluation criteria listed 
below to review and score the application.
    In addition, ACF may refer applications for review to other Federal 
or non-Federal entities when it is determined to be in the best 
interest of the Federal Government or the applicant. It may also 
solicit comments from ACF Regional Office staff, other Federal 
agencies, and, if determined to be appropriate, interested foundations 
and national organizations. These comments along with those of the 
reviewers will be considered by ACF in making the funding decision.
    In making award decisions, ACF will aim to fund a group of studies 
that together address a wide range of questions of the greatest 
importance to states, the Federal government, and the general public. 
In order to ensure that a wide array of questions, topics, and policy 
issues will be addressed through projects funded under this 
announcement, in making the final selections, in addition to the review 
criteria identified below, ACF may consider additional factors 
including geographic diversity, racial/ethnic populations served, 
opportunities to analyze particular sub-groups of the public assistance 
population, and the particular TANF provisions under examination.
    Further, as noted under Funding above, to maximize the benefit of 
the Federal investment to stimulate research and advance knowledge 
about welfare reform, ACF may give preference to applicants who provide 
evidence of other sources of funding for the project (e.g., applicant 
resources or private foundation funding).
Disposition of Applications
    On the basis of the review of an application, ACF will: (a) Approve 
the application for funding; or (b) disapprove the application; or (c) 
approve the application but not fund it for such reasons as a lack of 
funds or a need for further review.

B. Evaluation Criteria

    Using the evaluation criteria below, reviewers will review and 
score each application. Reviewers will determine the strengths and 
weaknesses of each application in terms of the appropriate evaluation 
criteria listed below, provide comments, and assign numerical scores. 
The point value following each criterion heading indicates the maximum 
numerical weight that each criterion may be given in the review 
process.
(1) Organizational Experience, Skills, and Responsibilities
    (25 points) The application should provide evidence of the 
organization's experience in conducting the sort of research analysis 
proposed. This experience should include background in research on 
populations receiving public assistance, i.e., title IV-A program 
benefits, Food Stamps, Medicaid, employment and training program 
systems, child care subsidies, etc. The application should list key 
individuals who will work on the project, including all professional 
staff and (if known) any contractor staff, along with a short 
description of the nature of their contribution and relevant staff 
experience.
    If more than one agency or organization will conduct the study, the 
application should identify the

[[Page 28868]]

managing organization (i.e., the entity applying for the Financial 
Assistance Award) as well as other organizations involved. The 
application should address each organization's experience with regard 
to this criterion.
    If the research is to be conducted in specific sites or with 
specific organizations, evidence of commitment by appropriate entities 
to participate fully, as defined by the project design, to support the 
requirements of the research (e.g., provide data, participate in 
interviews) must be included in the application.
    (2) Research Questions: (25 points) The application must include 
the principal questions to be addressed by the study and the research 
hypotheses related to those questions, if appropriate. If the 
application to ACF is for funding of a particular component of a larger 
study, the applicant should describe the objective of the entire study 
and explain in detail the questions to be addressed by the activities 
for which ACF funding is requested. The application will be judged on 
the extent to which the questions identified include important 
unanswered questions regarding welfare reform or address areas in which 
additional information is most critically needed.
    (3) Project Design: (40 points) The application should describe in 
detail the project's methods for answering the research questions 
proposed. Explain why the methods proposed are adequate to address the 
research questions. Note any weaknesses in the proposed research design 
and what will be done to compensate for those weaknesses. The 
application will be judged on the extent to which the evaluation 
project design (i.e., methods) proposed is adequate and appropriate to 
measure the key outcomes identified and answer the research questions 
posed in the application.
    (4) Budget Appropriateness: (10 points) The application should 
include a narrative justification for budget items and demonstrate that 
the project's costs are reasonable and necessary to support the 
specific project design and evaluation methods proposed and in view of 
the anticipated results and benefits. Applicants should refer to the 
budget information presented in the Standard Forms 424 and 424A.

Part III--Instructions for the Development and Submission of 
Applications

    This part contains information and instructions for submitting 
applications in response to this announcement. The forms to be used for 
submitting an application follow this part. Please reproduce single-
sided copies of the forms and type your information onto the copies. Do 
not use forms directly from the Federal Register announcement, as they 
are printed on both sides of the page.
    The SF-424 and the SF-424A are available in .PDF file format at 
http://mercury.psc.dhhs.gov/forms/sforms.htm They are also available 
through FTP at ftp://aosftp.psc.dhhs.gov/pub/forms/sf/
 This part concludes with a checklist for assembling an application 
package.

A. Deadline for Submittal of Applications

    The closing date for submission of applications is July 28, 1997. 
Mailed applications postmarked after the closing date will be 
classified as late.
Deadline
    Mailed applications shall be considered as meeting an announced 
deadline if they are either received on or before the deadline date or 
sent on or before the deadline date and received by ACF in time for the 
independent review to: U.S. Department of Health and Human Services, 
Administration for Children and Families, Division of Discretionary 
Grants and Audit Resolution, Attention: Lois B. Hodge, 370 L'Enfant 
Promenade, S.W., Mail Stop 6C-462, Washington, D.C. 20447.
    Applicants must ensure that a legibly dated U.S. Postal Service 
postmark or a legibly dated, machine produced postmark of a commercial 
mail service is affixed to the envelope/package containing the 
application(s). A postmark from a commercial mail service must include 
the logo/emblem of the commercial mail service company and must reflect 
the date the package was received by the commercial mail service 
company from the applicant. Private Metered postmarks shall not be 
acceptable as proof of timely mailing. (Applicants are cautioned that 
express/overnight mail services do not always deliver as agreed.)
    Applications handcarried by applicants, applicant couriers, or by 
other representatives of the applicant shall be considered as meeting 
an announced deadline if they are received on or before the deadline 
date, between the hours of 8:00 a.m. and 4:30 p.m., EST, at the U.S. 
Department of Health and Human Services, Administration for Children 
and Families, Division of Discretionary Grants and Audit Resolution, 
ACF Mailroom, 2nd Floor Loading Dock, Aerospace Center, 901 D Street, 
S.W., Washington, D.C. 20024, between Monday and Friday (excluding 
Federal holidays). The address must appear on the envelope/package 
containing the application with the note ``Attention: Lois B. Hodge. 
(Applicants are cautioned that express/overnight mail services do not 
always deliver as agreed.)
    ACF cannot accommodate transmission of applications by fax or 
through other electronic media. Therefore, applications transmitted to 
ACF electronically will not be accepted regardless of date or time of 
submission and time of receipt.

Late Applications

    Applications which do not meet the criteria above are considered 
late applications. ACF shall notify each late applicant that its 
application will not be considered in the current competition.

Extension of Deadlines

    ACF may extend the deadline for all applicants because of acts of 
God such as floods and hurricanes, widespread disruption of the mails, 
or when it is anticipated that many of the applications will come from 
rural or remote areas. However, if ACF does not extend the deadline for 
all applicants, it may not waive or extend the deadline for any 
applicants.

B. Instructions for Preparing the Application

    In order to assist applicants in completing the application, the 
Standard Forms 424 and 424A and required certifications have been 
included at the end of Part III of this announcement. Please prepare 
your application in accordance with the following instructions:
1. SF 424 Page 1, Application Cover Sheet
    Please read the following instructions before completing the 
application cover sheet. An explanation of each item is included. 
Complete only the items specified.
    Item 1. ``Type of Submission''--Non-Construction.
    Item 2. ``Date Submitted'' and ``Applicant Identifier''--Date 
application is submitted to ACF and applicant's own internal control 
number, if applicable.
    Item 3. ``Date Received By State''--State use only (if applicable).
    Item 4. ``Date Received by Federal Agency''--Leave blank.
    Item 5. ``Applicant Information'' ``Legal Name''--Enter the legal 
name of applicant organization. For applications developed jointly, 
enter the name of the lead organization only. There must be a single 
applicant for each application. The applicant identified will be the 
entity to which an award under this

[[Page 28869]]

announcement will be issued, if the application is approved.
    ``Organizational Unit''--Enter the name of the primary unit within 
the applicant organization which will actually carry out the project 
activity. If this is the same as the applicant organization, leave the 
organizational unit blank.
    ``Address''--Enter the complete address that the organization 
actually uses to receive mail, since this is the address to which all 
correspondence will be sent. Do not include both street address and 
P.O. box number unless both must be used in mailing.
    ``Name and telephone number of the person to be contacted on 
matters involving this application (give area code)''--Enter the full 
name and telephone number of a person who can respond to questions 
about the application. This person should be accessible at the address 
given.
    Item 6. ``Employer Identification Number (EIN)''--Enter the 
employer identification number of the applicant organization, as 
assigned by the Internal Revenue Service, including, if known, the 
Central Registry System suffix.
    Item 7. ``Type of Applicant''--Self-explanatory.
    Item 8. ``Type of Application''--New
    Item 9. ``Name of Federal Agency''--DHHS/ACF
    Item 10. ``Catalog of Federal Domestic Assistance Number''--93.647
    Item 11. ``Descriptive Title of Applicant's Project''--Welfare 
Reform Studies and Analyses--OPRE 97-1
    Item 12. ``Areas Affected by Project''--Self-explanatory
    Item 13. ``Proposed Project''--Enter the proposed start date for 
the project and projected completion date. (Note: it is likely that 
most awards will not be made prior to September 1, 1997 and all project 
start dates must be within Federal fiscal year 1997 (i.e., before 
September 30, 1997).
    Item 14. ``Congressional District of Applicant/Project''--Enter the 
number of the Congressional district where the applicant's principal 
office is located.
    Items 15 ``Estimated Funding Levels''--
    In completing item 15, enter only the dollar amount of Federal 
funds requested for the first 12 months of the award in box 15a. Note: 
if applicant is applying for a one-time, short-term study, the amount 
of Federal funds requested for the full period, up to a maximum of 17 
months, should be entered in 15a. Boxes 15b, 15c, 15d, 15e and 15f 
should be left blank. Box 15g should equal the amount listed in box 
15a.
    The amount listed in 15a should be no greater than the maximum 
amount available under this announcement for the initial 12-month 
budget period or for short-term studies, for the full project period, 
up to the maximum 17 month period.
    The total Federal budget proposed, as listed in 15a and 15g, should 
be inclusive of any indirect costs.
    Item 16. ``Is Application Subject to Review By State Executive 
Order 12372 Process?''
    Check ``No.'' We have determined that this program announcement is 
not subject to Executive Order 12372, Intergovernmental Review of 
Federal Programs, because it is a program that is national in scope and 
does not directly affect State and local governments. Applicants are 
not required to seek intergovernmental review of their applications 
within the constraints of E.O. No 12372.
    Item 17. ``Is the Applicant Delinquent on any Federal Debt?''--
Check the appropriate box. This question applies to the applicant 
organization, not the person who signs as the authorized 
representative. Categories of debt include audit disallowances, loans 
and taxes.
    Item 18. ``To the best of my knowledge and belief, all data in this 
application/preapplication are true and correct. The document has been 
duly authorized by the governing body of the applicant and the 
applicant will comply with the attached assurances if the assistance is 
awarded.''--To be signed by the authorized representative of the 
applicant. A copy of the governing body's authorization for signature 
of this application by this individual as the official representative 
must be on file in the applicant's office, and may be requested from 
the applicant.
    Item 18a-c. ``Typed Name of Authorized Representative, Title, 
Telephone Number''--Enter the name, title and telephone number of the 
authorized representative of the applicant organization.
    Item 18d. ``Signature of Authorized Representative''--Signature of 
the authorized representative named in Item 18a. At least one copy of 
the application must have an original signature.
    Item 18e. ``Date Signed''--Enter the date the application was 
signed by the authorized representative.
2. SF 424A--Budget Information--Non-Construction Programs
    This is a form used by many Federal agencies. For this application, 
Sections A, B, and E are to be completed. Sections C and D do not need 
to be completed.

Section A--Budget Summary.

Line 1:
Column (a): Enter ``Welfare Reform Studies and Analyses--OPRE 97-1'';
Column (b): Enter 93.647
Columns (c) and (d): Leave blank.
Column (e): enter the appropriate amounts needed to support the project 
for the first 12-month budget period or if applying for a one-time 
award to support a short-term study, enter the amount needed to support 
the project up to the maximum 17 month period.
Column (f): leave blank
Column (g): Same amount entered into (e)
    Section B--Budget Categories. This budget should include only the 
Federal funding for the proposed project for the first 12-month budget 
period or for up to a 17-month period if applying for one-time support 
for a short-term study. The total budget should equal item 15g, total 
funding, on the SF 424 (cover sheet). Under column (5), enter the same 
amounts by object class category entered in column (1). Columns (2), 
(3), and (4) should remain blank.
    A separate budget justification should be included to explain fully 
and justify major items, as indicated below. The types of information 
to be included in the justification are indicated under each category. 
The budget justification should immediately follow the second page of 
the SF 424A.
    Personnel--Line 6a. Enter the total costs of salaries and wages of 
applicant/grantee staff. Do not include the costs of consultants, which 
should be included on line 6h, ``Other.''
    Justification: Identify the project director, if known. Specify by 
title or name the percentage of time allocated to the project, the 
individual annual salaries, and the Federal cost to the project of the 
organization's staff who will be working on the project.
    Fringe Benefits--Line 6b. Enter the total costs of fringe benefits.
    Justification: Provide a break-down of amounts and percentages that 
comprise fringe benefit costs, such as health insurance, FICA, 
retirement insurance, etc.
    Travel--6c. Enter total costs of out-of-town travel (travel 
requiring per diem) for staff of the project. Do not enter costs for 
consultant's travel or local transportation, which should be included 
on Line 6h, ``Other.''
    Justification: Include the name(s) of traveler(s), total number of 
trips, destinations, length of stay, transportation costs and 
subsistence allowances.
    Equipment--Line 6d. Enter the total costs of all equipment to be 
acquired by

[[Page 28870]]

the project. For grants governed by the administrative requirements of 
either 45 CFR part 92 or 45 CFR part 74, equipment is defined as 
tangible, non-expendable personal property having a useful life of more 
than one year and an acquisition cost of $5,000 or more per unit.
    Justification: Equipment to be purchased with Federal funds must be 
justified. The equipment must be required to conduct the project, and 
the applicant organization or its subgrantees must not have the 
equipment or a reasonable facsimile available to the project. The 
justification also must contain plans for future use or disposal of the 
equipment after the project ends.
    Supplies--Line 6e. Enter the total costs of all tangible expendable 
personal property (supplies) other than those included on Line 6d.
    Justification: Specify general categories of supplies and their 
costs.
    Contractual--Line 6f. Enter the total costs of all contracts, 
including procurement contracts (except those which belong on other 
lines such as equipment, supplies, etc.) and contracts with secondary 
recipient organizations. Also include any contracts with organizations 
for the provision of technical assistance. Do not include payments to 
individuals on this line.
    Justification: Attach a list of contractors, indicating the names 
of the organizations, the purposes of the contracts, and the estimated 
dollar amounts of the awards as part of the budget justification. 
Whenever the applicant/grantee intends to delegate part or all of the 
project to another agency, the applicant/grantee must complete this 
section (Section B, Budget Categories) for each delegate agency by 
agency title, along with the supporting information. The total cost of 
all such agencies will be part of the amount shown on Line 6f. Provide 
backup documentation identifying the name of contractor, purpose of 
contract, and major cost elements.
    Construction--Line 6g. Not applicable. New construction is not 
allowable.
    Other--Line 6h. Enter the total of all other costs. Where 
applicable, such costs may include, but are not limited to: insurance; 
medical and dental costs; noncontractual fees and travel paid directly 
to individual consultants; local transportation (all travel which does 
not require per diem is considered local travel); space and equipment 
rentals; printing and publication; computer use; training costs, 
including tuition and stipends; training service costs, including wage 
payments to individuals and supportive service payments; and staff 
development costs. Note that costs identified as ``miscellaneous'' and 
``honoraria'' are not allowable.
    Justification: Specify the costs included.
    Total Direct Charges--Line 6i. Enter the total of Lines 6a through 
6h.
    Indirect Charges--6j. Enter the total amount of indirect charges 
(costs). If no indirect costs are requested, enter ``none.'' This line 
should be used when the applicant (except local governments) has a 
current indirect cost rate agreement approved by the Department of 
Health and Human Services or another Federal agency.
    Local and State governments should enter the amount of indirect 
costs determined in accordance with HHS requirements. When an indirect 
cost rate is requested, these costs are included in the indirect cost 
pool and should not be charged again as direct costs to the grant. In 
the case of training grants to other than State or local governments 
(as defined in title 45, Code of Federal Regulations, part 74), the 
Federal reimbursement of indirect costs will be limited to the lesser 
of the negotiated (or actual) indirect cost rate or 8 percent of the 
amount allowed for direct costs, exclusive of any equipment charges, 
rental of space, tuition and fees, post-doctoral training allowances, 
contractual items, and alterations and renovations.
    Justification: Enclose a copy of the indirect cost rate agreement, 
if indirect costs are requested.
    Total--Line 6k. Enter the total amounts of lines 6i and 6j.
    Program Income--Line 7. Enter the estimated amount of income, if 
any, expected to be generated from this project. Do not add or subtract 
this amount from the total project amount. As stated under Eligible 
Applicants above, private for-profit entities must waiver any fees in 
order to compete for these funds.
    Justification: Describe the nature, source, and anticipated use of 
program income in the Project Narrative Statement.
    Section C--Non-Federal Resources. Not applicable--Leave blank. 
However, as noted in the program announcement, applicants which are 
utilizing multiple funders should include a discussion or presentation 
of such funding in the application.
    Section D--Forecasted Cash Needs. Enter the amount of cash needed 
by quarter from the award made by ACF during the first year.
    Section E--Budget Estimate of Federal Funds Needed For Balance of 
the Project. ACF expects to make funds available for approved project 
period up to 60 months. In this section, provide annual estimates of 
the Federal funds needed for the balance of the project.
    Justification: Describe the anticipated use of latter year project 
expenses in the Project Narrative Statement.
    Section F--Other Budget Information. Not applicable--Leave blank.

3. Project Narrative Statement

    The Project Narrative Statement should be clear, concise, and 
address the issues mentioned under Part I and should address how the 
application meets the evaluation criteria described in section B of 
Part II. The applicant should follow the sequence of the review 
criteria below (as outlined in section B, part II) when composing the 
project narrative.
    (a) Organizational Experience, Skills, and Responsibilities:
    (b) Research Questions
    (c) Project Design
    (d) Budget Appropriateness
    The narrative should be typed double-spaced. There is no page 
limitation, but all pages of the narrative (including charts, 
references, footnotes, tables, maps, exhibits, appendices, etc.) must 
be sequentially numbered. Please do not use covers, binders, or tabs.
4. Assurances/Certifications
    Applicants requesting financial assistance for non-construction 
projects must file the Standard Form 424B, ``Assurances: Non-
Construction Programs.'' Applicants must sign and return the Standard 
Form 424B with their applications.
    Applicants must provide a certification regarding lobbying when 
applying for an award in excess of $100,000. Applicants must sign and 
return the certification with their applications.
    Applicants must disclose lobbying activities on the Standard Form 
LLL when applying for an award in excess of $100,000. Applicants who 
have used non-Federal funds for lobbying activities in connection with 
receiving assistance under this announcement shall complete a 
disclosure form to report lobbying. Applicants must sign and return the 
disclosure form, if applicable, with their applications.
    Applicants must make the appropriate certification that they are 
not presently debarred, suspended or otherwise ineligible for an award. 
By signing and submitting the application, the applicant is providing 
the certification regarding environmental tobacco smoke and need not 
mail back the certification with the applications.
    Applicants must make the appropriate certification of their 
compliance with

[[Page 28871]]

the Drug-Free Workplace Act of 1988. By signing and submitting the 
application, the applicant is providing the certification and need not 
mail back the certification with the applications.
    Applicants must make the appropriate certification of their 
compliance with the Pro-Children Act of 1994. By signing and submitting 
the application, the applicant is providing the certification and need 
not mail back the certification with the application.
    Copies of the certifications and assurances are attached. Please 
reproduce single-sided copies of the forms. Do not use forms directly 
from the Federal Register announcement, as they are printed on both 
sides of the page. A duly authorized representative of the applicant 
organization must certify that the applicant is in compliance with 
these assurances and certifications.
    Any non-profit organization submitting an application must submit 
proof of its non-profit status in its application at the time of 
submission. The non-profit agency can accomplish this by providing a 
copy of the applicant's listing in the Internal Revenue Service's (IRS) 
most recent list of tax-exempt organizations described in Section 
501(c)(3) of the IRS code or by providing a copy of the currently valid 
IRS tax exemption certificate, or by providing a copy of the articles 
of incorporation bearing the seal of the State in which the corporation 
or association is domiciled.

D. Submitting the Application

    Each application package must include an original and two copies of 
the complete application. All pages of the narrative (including charts, 
tables, maps, exhibits, etc.) must be sequentially numbered and 
unbound. In order to facilitate handling, Please do not use covers, 
binders, or tabs.

E. Paperwork Reduction Act of 1995

    Under the Paperwork Reduction Act of 1995, Public Law 104-13, the 
Department is required to submit to OMB for review and approval any 
reporting and recordkeeping requirements in regulations, including 
Program Announcements. An agency may not conduct or sponsor, and a 
person is not required to respond to, a collection of information 
unless it displays a currently valid OMB control number. This Program 
Announcement does not contain information collection requirements 
beyond those approved for ACF grant announcements/applications under 
OMB Control Number OMB-0970-0139.

F. Intergovernmental Review

    This program is covered under Executive Order 12372, 
``Intergovernmental Review of Federal Programs,'' and 45 CFR Part 100, 
``Intergovernmental Review of Department of Health and Human Services 
Program and Activities.'' Under the Order, States may design their own 
processes for reviewing and commenting on proposed Federal assistance 
under covered programs.
    All States and Territories except Alabama, Alaska, Colorado, 
Connecticut, Hawaii, Idaho, Kansas, Louisiana, Massachusetts, 
Minnesota, Montana, Nebraska, New Jersey, Oklahoma, Oregon, 
Pennsylvania, South Dakota, Tennessee, Vermont, 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 twenty-three jurisdictions need take no action 
regarding E.E. 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. Applications must submit any 
required material to the SPOCs as soon as possible so that the program 
office can obtain and review SPOC comments as part of the award 
process. It is imperative that the applicant submit all required 
materials, if any, to the SPOC and indicate the date of this submittal 
(or the date of contact if no submittal is required) on the Standard 
Form 424, item 16a.
    Under 45 CFR 100.8(a)(2), a SPOC has sixty (60) days from the 
application deadline to comment on proposed new or competing 
continuation awards.
    SPOCs are encouraged to eliminate the submission of routine 
endorsements as official recommendations.
    Additionally, SPOCs are requested to differentiate clearly between 
mere advisory comments and those official State process recommendations 
which may trigger the ``accommodate or explain'' rule.
    When comments are submitted directly to ACF, they should be 
addressed to: Department of Health and Human Services, Administration 
for Children and Families, Division of Discretionary Grants, 370 
L'Enfant Promenade, SW., Mail Stop 6C-462, Washington, DC 20447.
    A list of the Single Points of Contact for each State and Territory 
is included as Appendix B to this Announcement.

G. Checklist for a Complete Application

    The checklist below is for your use to ensure that your application 
package has been properly prepared.

--One original application, signed and dated, plus two copies--without 
covers, binders, or tabs.
--A complete application consists of the following items in this order:
     Application for Federal Assistance (SF 424);
     Assurances--Non-construction programs (SF 424B); and
     Certification Regarding Lobbying.
     Budget Information--Non-construction programs (SF 424A);
     Budget Justification for SF 424A Section B--Budget 
Categories;
     Copy of the applicant's approved indirect cost rate 
agreement, if appropriate;
     Project Narrative that addresses and follows the sequence 
of the Evaluation Criteria in Part II section B.

    Dated: May 21, 1997.
Howard Rolston,
Director, Office of Planning, Research and Evaluation.

BILLING CODE 4184-01-P

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BILLING CODE 4184-01-C

[[Page 28873]]

Instructions for the SF 424

    Public reporting burden for this collection of information is 
estimated to average 45 minutes per response, including time for 
reviewing instructions, searching existing data sources, gathering 
and maintaining the data needed, and completing and reviewing the 
collection of information. Send comments regarding the burden 
estimate or any other aspect of this collection of information, 
including suggestions for reducing this burden, to the Office of 
Management and Budget. Paperwork Reduction Project (0348-0043), 
Washington, DC 20503.
    Please do not return your completed form to the Office of 
Management and Budget, Send it to the address provided by the 
sponsoring agency.
    This is a standard form used by applicants as a required 
facesheet for preapplications and applications submitted for Federal 
assistance. It will be used by Federal agencies to obtain applicant 
certification that States which have established a review and 
comment procedure in response to Executive Order 12372 and have 
selected the program to be included in their process, have been 
given an opportunity to review the applicant's submission.

Item and Entry

    1. Self-explanatory.
    2. Date application submitted to Federal agency (or State, if 
applicable) & 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) a 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 
tile 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 allowances, 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

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[[Page 28875]]

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BILLING CODE 4184-01-C

[[Page 28876]]

Instructions for the SF 424A

    Public reporting burden for this collection of information is 
estimated to average 180 minutes per response, including time for 
reviewing instructions, searching existing data sources, gathering 
and maintaining the data needed, and completing and reviewing the 
collection of information. Send comments regarding the burden 
estimate or any other aspect of this collection of information, 
including suggestions for reducing this burden, to the Office or 
Management and Budget, Paperwork Reduction Project (0348-0043), 
Washington, DC 20503.

    PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF 
MANAGEMENT AND BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE 
SPONSORING AGENCY.

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

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, 
Section 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 function 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 of 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 9(e) and (f).
    For supplemental grants and changes in 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 total for all columns used.

Section B. Budget Categories

    In the column headings (1) though (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-1--Show the totals of Lines 6a to 6h in each column.
    Line 6i--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 all 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 in Columns (b), (c), and (d).
    Line 12--Enter the total for each of Columns (b)-(e). The amount 
in Column (e) should be equal to the amount on Line 5, Column (f), 
Section A.

Section D. Forecasted Cash Needs

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

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

    Lines 16-19--Enter in Column (a) the same grant program titles 
shown in Column (a), Section A. A breakdown by function or activity 
is not necessary. For new applications and continuation grant 
applications, enter in the proper columns amounts of Federal funds 
which will be needed to complete the program or project over the 
succeedings 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

    Public reporting burden for this collection of information is 
estimated to average 15 minutes per response, including time for 
reviewing instructions, searching existing

[[Page 28877]]

data sources, gathering and maintaining the data needed, and 
completing and reviewing the collection of information. Send 
comments regarding the burden estimate or any other aspect of this 
collection of information, including suggestions for reducing this 
burden, to the Office of Management and Budget, Paperwork Reduction 
Project (0348-0043), Washington, DC 20503.
    Please do not return your completed form to the Office of 
Management and Budget, send it to the address provided by the 
sponsoring agency.

    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 
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. Sec. 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. 290dd-3 and 290ee-3), 
as amended, relating to confidentiality of alcohol and drug abuse 
patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 
U.S.C. 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, as applicable, 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. Secs. 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. 
Secs. 7401 et seq.); (g) protection of underground sources of 
drinking water under the Safe Drinking Water Act of 1974, as 
amended, (P.L. 93-523); and (h) protection of endangered species 
under the Endangered Species Act of 1973, as amended, (P.L. 93-205).
    12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 
U.S.C. Secs. 1271 et seq.) related to protecting components or 
potential components of the national wild and scenic rivers system.
    13. Will assist the awarding agency in assuring compliance with 
Section 106 of the National Historic Preservation Act of 1966, as 
amended (16 U.S.C. 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 or 
OMB Circular No. A-133, Audits of Institutions of Higher Learning 
and other Non-profit Institutions.
    18. Will comply with all applicable requirements of all other 
Federal laws, executive orders, regulations and policies governing 
this program.

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Signature of Authorized Certifying Official

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Title

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Applicant Organization

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

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

Instructions for Certification

    1. By signing and submitting this proposal, the prospective 
primary participant is providing the certification set out below.
    2. The inability of a person to provide the certification 
required below will not necessarily result in denial of 
participation in this covered transaction. The prospective 
participant shall submit an explanation of why it cannot provide the 
certification set out below. The certification or explanation will 
be considered in connection with the department or agency's 
determination whether to enter into this transaction. However, 
failure of the prospective primary participant to furnish a 
certification or an explanation shall disqualify such person from 
participation in this transaction.
    3. The certification in this clause is a material representation 
of fact upon which reliance was placed when the department or

[[Page 28878]]

agency determined to enter into this transaction. If it is later 
determined that the prospective primary participant knowingly 
rendered an erroneous certification, addition to other remedies 
available to the Federal Government, the department or agency may 
terminate this transaction for cause or default.
    4. The prospective primary participant shall provide immediate 
written notice to the department or agency to which this proposal is 
submitted if at any time the prospective primary participant learns 
that its certification was erroneous when submitted or has become 
erroneous by reason of changed circumstances.
    5. The terms covered transaction, debarred, suspended, 
ineligible, lower tier covered transaction, participant, person 
primary covered transaction, principal, proposal, and voluntarily 
excluded, as used in this clause, have the meanings set out in the 
Definitions and Coverage sections of the rules implementing 
Executive Order 12549. You may contact the department or agency to 
which this proposal is being submitted for assistance in obtaining a 
copy of those regulations.
    6. The prospective primary participant agrees by submitting this 
proposal that, should the proposed covered transaction be entered 
into, it shall not knowingly enter into any lower tier covered 
transaction with a person who is proposed for debarment under 48 CFR 
part 9, subpart 9.4, debarred, suspended, declared ineligible, or 
voluntarily excluded from participation in this covered transaction, 
unless authorized by the department or agency entering into this 
transaction.
    7. The prospective primary participant further agrees by 
submitting this proposal that it will include the clause titled 
``Certification Regarding Debarment, Suspension, Ineligibility and 
Voluntary Exclusion-Lower Tier Covered Transaction,'' provided by 
the department or agency entering into this covered transaction, 
without modification, in all lower tier covered transactions and in 
all solicitations for lower tier covered transactions.
    8. A participant in a covered transaction may rely upon a 
certification of a prospective participant in a lower tier covered 
transaction that it is not proposed for debarment under 48 CFR part 
9, subpart 9.4, debarred, suspended, ineligible, or voluntarily 
excluded from the covered transaction, unless it knows that the 
certification is erroneous. A participant may decide the method and 
frequency by which it determines the eligibility of its principals. 
Each participant may, but is not required to, check the List of 
Parties Excluded from Federal Procurement and Nonprocurement 
Programs.
    9. Nothing contained in the foregoing shall be construed to 
require establishment of a system or records in order to render in 
good faith the certification required by this clause. The knowledge 
and information of a participant is not required to exceed that 
which is normally possessed by a prudent person in the ordinary 
course of business dealings.
    10. Except for transactions authorized under paragraph 6 of 
these instructions, if a participant in a covered transaction 
knowingly enters into a lower tier covered transaction with a person 
who is proposed for debarment under 48 CFR part 9, subpart 9.4, 
suspended, debarred, ineligible, or voluntarily excluded from 
participation in this transaction, in addition to other remedies 
available to the Federal Government, the department or agency may 
terminate this transaction for cause or default.
* * * * *

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

    (1) The prospective primary participant certifies to the best of 
its knowledge and belief, that it and its principals:
    (a) Are not presently debarred, suspended, proposed for 
debarment, declared ineligible, or voluntarily excluded by any 
Federal department or agency;
    (b) Have not within a three-year period preceding this proposal 
been convicted of or had a civil judgment rendered against them for 
commission of fraud or a criminal offense in connection with 
obtaining, attempting to obtain, or performing a public (Federal, 
State or local) transaction or contract under a public transaction; 
violation of Federal or State antitrust statutes or commission of 
embezzlement, theft, forgery, bribery, falsification or destruction 
of records, making false statements, or receiving stolen property;
    (c) Are not presently indicted for or otherwise criminally or 
civilly charged by a governmental entity (Federal, State or local) 
with commission of any of the offenses enumerated in paragraph 
(1)(b) of this certification; and
    (d) Have not within a three-year period preceding this 
application/proposal had one or more public transactions (Federal, 
State or local) terminated for cause or default.
    (2) Where the prospective primary participant is unable to 
certify to any of the statements in this certification, such 
prospective participant shall attach an explanation to this 
proposal.

Certification Regarding Debarment, Suspension, Ineligibility and 
Voluntary Exclusion--Lower Tier Covered Transactions

Instructions for Certification

    1. By signing and submitting this proposal, the prospective 
lower tier participant is providing the certification set out below.
    2. The certification in this clause is a material representation 
of fact upon which reliance was placed when this transaction was 
entered into. If it is later determined that the prospective lower 
tier participant knowingly rendered an erroneous certification, in 
addition to other remedies available to the Federal Government the 
department or agency with which this transaction originated may 
pursue available remedies, including suspension and/or debarment.
    3. The prospective lower tier participant shall provide 
immediate written notice to the person to which this proposal is 
submitted if at any time the prospective lower tier participant 
learns that its certification was erroneous when submitted or had 
become erroneous by reason of changed circumstances.
    4. The terms covered transaction, debarred, suspended, 
ineligible, lower tier covered transaction, participant, person, 
primary covered transaction, principal, proposal, and voluntarily 
excluded, as used in this clause, have the meaning set out in the 
Definitions and Coverage sections of rules implementing Executive 
Order 12549. You may contact the person to which this proposal is 
submitted for assistance in obtaining a copy of those regulations.
    5. The prospective lower tier participant agrees by submitting 
this proposal that, [[Page 33043]] should the proposed covered 
transaction be entered into, it shall not knowingly enter into any 
lower tier covered transaction with a person who is proposed for 
debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, 
declared ineligible, or voluntarily excluded from participant in 
this covered transaction, unless authorized by the department or 
agency with which this transaction originated.
    6. The prospective lower tier participant further agrees by 
submitting this proposal that it will include this clause titled 
``Certification Regarding Debarment, Suspension, Ineligibility and 
Voluntary Exclusion-Lower Tier Covered Transaction,'' without 
modification, in all lower tier covered transactions and in all 
solicitations for lower tier covered transactions.
    7. A participant in a covered transaction may rely upon a 
certification of a prospective participant in a lower tier covered 
transaction that it is not proposed for debarment under 48 CFR part 
9, subpart 9.4, debarred, suspended, ineligible, or voluntarily 
excluded from covered transactions, unless it knows that the 
certification is erroneous. A participant may decide the method and 
frequency by which it determines the eligibility of its principals. 
Each participant may, but is not required to, check the List of 
Parties Excluded from Federal Procurement and Nonprocurement 
Programs.
    8. Nothing contained in the foregoing shall be construed to 
require establishment of a system of records in order to render in 
good faith the certification required by this clause. The knowledge 
and information of a participant is not required to exceed that 
which is normally possessed by a prudent person in the ordinary 
course of business dealings.
    9. Except for transactions authorized under paragraph 5 of these 
instructions, if a participant in a covered transaction knowingly 
enters into a lower tier covered transaction with a person who is 
proposed for debarment under 48 CFR part 9, subpart 9.4, suspended, 
debarred, ineligible, or voluntarily excluded from participation in 
this transaction, in addition to other remedies available to the 
Federal Government, the department or agency with which this 
transaction originated may pursue available remedies, including 
suspension and/or debarment.
* * * * *

[[Page 28879]]

Certification Regarding Debarment, Suspension, Ineligibility an 
Voluntary Exclusion--Lower Tier Covered Transactions

    (1) The prospective lower tier participant certifies, by 
submission of this proposal, that neither it nor its principals is 
presently debarred, suspended, proposed for debarment, declared 
ineligible, or voluntarily excluded from participation in this 
transaction by any Federal department or agency.
    (2) Where the prospective lower tier participant is unable to 
certify to any of the statements in this certification, such 
prospective participant shall attach an explanation to this 
proposal.
    This certification is required by the regulations implementing 
the Drug-Free Workplace Act of 1988: 45 CFR Part 76, Subpart F. 
Sections 76.630 (c) and (d)(2) and 76.645(a)(1) and (b) provide that 
a Federal agency may designate a central receipt point for STATE-
WIDE AND STATE AGENCY-WIDE certifications, and for notification of 
criminal drug convictions. For the Department of Health and Human 
Services, the central point is: Division of Grants Management and 
Oversight, Office of Management and Acquisition, Department of 
Health and Human Services, Room 517-D, 200 Independence Avenue, SW, 
Washington, DC 20201.

Certification Regarding Drug-Free Workplace Requirements

(Instructions for Certification)

    1. By signing and/or submitting this application or grant 
agreement, the grantee is providing the certification set out below.
    2. The certification set out below is a material representation 
of fact upon which reliance is placed when the agency awards the 
grant. If it is later determined that the grantee knowingly rendered 
a false conviction, or otherwise violates the requirements of the 
Drug-Free Workplace Act, the agency, in addition to any other 
remedies available to the Federal Government, may take action 
authorized under the Drug-Free Workplace Act.
    3. For grantees other than individuals, Alternate I applies.
    4. For grantees who are individuals, Alternate II applies.
    5. Workplaces under grants, for grantees other than individuals, 
need not be identified on the certification. If known, they may be 
identified in the grant application. If the grantees does not 
identify the workplace at the time of application, or upon award, if 
there is no application, the grantee must keep the identity of the 
workplace(s) on file in its office and make the information 
available for Federal inspection. Failure to identify all known 
workplaces constitutes a violation of the grantee's drug-free 
workplace requirements.
    6. Workplace identifications must include the actual address of 
buildings (or parts of buildings) or other sites where work under 
the grant takes place. Categorical descriptions may be used (e.g., 
all vehicles of a mass transit authority or State highway department 
while in operation, State employees in each local unemployment 
office, performers in concert halls or radio studios).
    7. If the workplace identified to the agency changes during the 
performance of the grant, the grantee shall inform the agency of the 
change(s), if it previously identified the workplaces in question 
(see paragraph five).
    8. Definitions of terms in the Nonprocurement Suspension and 
Debarment common rule and Drug-Free Workplace common rule apply to 
this certification. Grantees' attention is called, in particular, to 
the following definitions from these rules:
    Controlled substance means a controlled substance in Schedules I 
through V of the Controlled Substances Act (21 U.S.C. 812) and as 
further defined by regulation (21 CFR 1308.11 through 1308.15);
    Conviction means a finding of guilt (including a plea of nolo 
contendere) or imposition of sentence, or both, by any judicial body 
charged with the responsibility to determine violations of the 
Federal or State criminal drug statutes;
    Criminal drug statute means a Federal or non-Federal criminal 
statute involving the manufacture, distribution, dispensing, use, or 
possession of any controlled substance;
    Employee means the employee of a grantee directly engaged in the 
performance of work under a grant, including: (i) All direct charge 
employees; (ii) All indirect charge employees unless their impact or 
involvement is insignificant to the performance of the grant; and, 
(iii) Temporary personnel and consultants who are directly engaged 
in the performance of work under the grant and who are on the 
grantee's payroll. This definition does not include workers not on 
the payroll of the grantee (e.g., volunteers, even if used to meet a 
matching requirement; consultants or independent contractors not on 
the grantee's payroll; or employees of subrecipients or 
subcontractors in covered workplaces).

Certification Regarding Drug-Free Workplace Requirements

Alternate I. (Grantees Other Than Individuals)

    The grantee certifies that it will or will continue to provide a 
drug-free workplace by:
    (a) Publishing a statement notifying employees that the unlawful 
manufacture, distribution, dispensing, possession, or use of a 
controlled substance is prohibited in the grantee's workplace and 
specifying the actions that will be taken against employees for 
violation of such prohibition;
    (b) Establishing an ongoing drug-free awareness program to 
inform employees about--
    (1) The dangers of drug abuse in the workplace;
    (2) The grantee's policy of maintaining a drug-free workplace;
    (3) Any available drug counseling, rehabilitation, and employee 
assistance programs; and
    (4) The penalties that may be imposed upon employees for drug 
abuse violations occurring in the workplace;
    (c) Making it a requirement that each employee to be engaged in 
the performance of the grant be given a copy of the statement 
required by paragraph (a);
    (d) Notifying the employee in the statement required by 
paragraph (a) that, as a condition of employment under the grant, 
the employee will--
    (1) Abide by the terms of the statement; and
    (2) Notify the employer in writing of his or her conviction for 
a violation of a criminal drug statute occurring in the workplace no 
later than five calendar days after such conviction;
    (e) Notifying the agency in writing, within ten calendar days 
after receiving notice under paragraph (d)(2) from an employee or 
otherwise receiving actual notice of such conviction. Employers of 
convicted employees must provide notice, including position title, 
to every grant officer or other designee on whose grant activity the 
convicted employee was working, unless the Federal agency has 
designated a central point for the receipt of such notices. Notice 
shall include the identification number(s) of each affected grant:
    (f) Taking one of the following actions, within 30 calendar days 
of receiving notice under paragraph (d)(2), with respect to any 
employee who is so convicted--
    (1) Taking appropriate personnel action against such an 
employee, up to and including termination, consistent with the 
requirements of the Rehabilitation Act of 1973, as amended; or
    (2) Requiring such employee to participate satisfactorily in a 
drug abuse assistance or rehabilitation program approved for such 
purposes by a Federal, State, or local health, law enforcement, or 
other appropriate agency;
    (g) Making a good faith effort to continue to maintain a drug-
free workplace through implementation of paragraphs (a), (b), (c), 
(d), (e) and (f).
    (B) The grantee may insert in the space provided below the 
site(s) for the performance of work done in connection with the 
specific grant:

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

----------------------------------------------------------------------

----------------------------------------------------------------------
    Check {time}  if there are workplaces on file that are not 
identified here.

Alternate II. (Grantees Who Are Individuals)

    (a) The grantee certifies that, as a condition of the grant, he 
or she will not engage in the unlawful manufacture, distribution, 
dispensing, possession, or use of a controlled substance in 
conducting any activity with the grant;
    (b) If convicted of a criminal drug offense resulting from a 
violation occurring during the conduct of any grant activity, he or 
she will report the conviction, in writing, within 10 calendar days 
of the conviction, to every grant officer or other designee, unless 
the Federal agency designates a central point for the receipt of 
such notices. When notice is made to such a central point, it shall 
include the identification number(s) of each affected grant.

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

[[Page 28880]]

Certification Regarding Lobbying

Certification for Contracts, Grants, Loans, and Cooperative 
Agreements

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

Statement for Loan Guarantees and Loan Insurance

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

----------------------------------------------------------------------
Signature

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

----------------------------------------------------------------------
Organization

----------------------------------------------------------------------
Date

BILLING CODE 4184-01-C

[[Page 28881]]

[GRAPHIC] [TIFF OMITTED] TN28MY97.003



[[Page 28882]]

Certification Regarding Environmental Tobacco Smoke

    Public Law 103-227, Part C--Environmental Tobacco Smoke, also 
known as the Pro-Children Act of 1994 (Act), requires that smoking 
not be permitted in any portion of any indoor routinely owned or 
leased or contracted for by an entity and used routinely or 
regularly for provision of health, day care, education, or library 
services to children under the age of 18, if the services are funded 
by Federal programs either directly or through State or local 
governments, by Federal grant, contract, loan, or loan guarantee. 
The law does not apply to children's services provided in private 
residences, facilities funded solely by Medicare or Medicaid funds, 
and portions of facilities used for inpatient drug or alcohol 
treatment. Failure to comply with the provisions of the law may 
result in the imposition of a civil monetary penalty of up to $1000 
per day and/or the imposition of an administrative compliance order 
on the responsible entity.
    By signing and submitting this application the applicant/grantee 
certifies that it will comply with the requirements of the Act. The 
applicant/grantee further agrees that it will require the language 
of this certification be included in any subawards which contain 
provisions for the children's services and that all subgrantees 
shall certify accordingly.

Appendix B--OMB State Single Point of Contact Listing

Arizona

Joni Saad, Arizona State Clearinghouse, 3800 N. Central Avenue, 
Fourteenth Floor, Phoenix, Arizona 85012, Telephone (602) 280-1315, 
FAX: (602) 280-8144

Arkansas

Mr. Tracy L. Copeland, Manager, State Clearinghouse, Office of 
Intergovernmental Services, Department of Finance and 
Administration, 1515 W. 7th St., Room 412, Little Rock, Arkansas 
72203, Telephone: (501) 682-1074, FAX: (501) 682-5206

California

Grants Coordinator, Office of Planning & Research, 1400 Tenth 
Street, Room 121, Sacramento, California 95814, Telephone (916) 323-
7480, FAX (916) 323-3018

Delaware

Francine Booth, State Single Point of Contact Executive Department, 
Thomas Collins Building, P.O. Box 1401, Dover, Delaware: 19903, 
Telephone (302) 739-3326, FAX: (302) 739-5661

District of Columbia

Charles Nichols, State Single Point of Contact, Office of Grants 
Mgmt. & Dev., 717 14th Street, N.W.--Suite 500, Washington, D.C. 
20005, Telephone: (202) 727-6554, FAX (202) 727-1617

Florida

Florida State Clearinghouse, Department of Community Affairs, 2740 
Centerview Drive, Tallahassee, Florida 32399-2100, Telephone: (904) 
922-5438, FAX: (904) 487-2899

Georgia

Tom L. Reid, III, Administrator, Georgia State Clearinghouse, 254 
Washington Street, S.W.--Room 401J, Atlanta, Georgia 30334, 
Telephone: (404) 656-3855 or (404) 656-3829, FAX: (404) 656-7938

Illinois

Virginia Bova, State Single Point Of Contact, Department of Commerce 
and Community Affairs, James R. Thompson Center, 100 West Randolph, 
Suite 3-400, Chicago, Illinois 60601, Telephone: (312) 814-6028, 
FAX: (312) 814-1800

Indiana

Frances Williams, State Budget Agency, 212 State House, 
Indianapolis, Indiana 46204-2796, Telephone: (317) 232-5619, FAX: 
(317) 233-3323

Iowa

Steven R. McCann, Division for Community Assistance, Iowa Department 
of Economic Development, 200 East Grand Avenue, Des Moines, Iowa 
50309, Telephone: (515) 242-4719, FAX: (515) 242-4859

Kentucky

Ronald W. Cook, Office of the Governor, Department of Local 
Government, 1024 Capitol Center Drive, Frankfort, Kentucky 40601-
8204, Telephone: (502) 573-2382, FAX: (502) 573-2512

Maine

Joyce Benson, State Planning Office, State House Station #38, 
Augusta, Maine 04333, Telephone: (207) 287-3261, FAX: (207) 287-6489

Maryland

William G. Carroll, Manager, State Clearinghouse for 
Intergovernmental Assistance, Maryland Office of Planning, 301 W. 
Preston Street--Room 1104, Baltimore, Maryland 21201-2365, Staff 
Contact: Linda Janey, Telephone: (410) 255-4490, FAX: (410) 225-4480

Michigan

Richard Pfaff, Southeast Michigan Council of Governments, 1900 
Edison Plaza, 660 Plaza Drive, Detroit, Michigan 48226, Telephone: 
(313) 961-4266, FAX: (313) 961-4869

Mississippi

Cathy Malette, Clearinghouse Officer, Department of Finance and 
Administration, 455 North Lamar Street, Jackson, Mississippi 39202-
3087, Telephone: (601) 359-6762, FAX: (601) 359-6764

Missouri

Lois Pohl, Federal Assistance Clearinghouse, Office of 
Administration, P.O. Box 809, Room 760, Truman Building, Jefferson 
City, Missouri 65102, Telephone: (314) 751-4834, FAX: (314) 751-7819

Nevada

Department of Administration, State Clearinghouse, Capitol Complex, 
Carson City, Nevada 89710, Telephone: (702) 687-4065, FAX: (702) 
687-3983

New Hampshire

Jeffrey H. Taylor, Director, New Hampshire Office of State Planning, 
Attn: Intergovernmental Review Process, Mike Blake, 2\1/2\ Beacon 
Street, Concord, New Hampshire 03301, Telephone: (603) 271-2155, 
FAX: (603) 271-1728

New Mexico

Robert Peters, State Budget Division, Room 190 Bataan Memorial 
Building, Santa Fe, New Mexico 87503, Telephone: (505) 827-3640

New York

New York State Clearinghouse, Division of the Budget, State Capitol, 
Albany, New York 12224, Telephone: (518) 474-1605, FAX: (518) 486-
5617

North Carolina

Chrys Baggett, Director, N.C. State Clearinghouse, Office of the 
Secretary of Admin., 116 West Jones Street, Raleigh, North Carolina 
27603-8003, Telephone: (919) 733-7232, FAX: (919) 733-9571

North Dakota

North Dakota Single Point of Contact, Office of Intergovernmental 
Assistance, 600 East Boulevard Avenue, Bismarck, North Dakota 58505-
0170, Telephone: (701) 224-2094, FAX: (701) 224-2308

Ohio

Larry Weaver, State Single Point of Contact, State Clearinghouse, 
Office of Budget and Management, 30 East Broad Street, 34th Floor, 
Columbus, Ohio 43266-0411

Please direct correspondence and questions about intergovernmental 
review to: Linda Wise, Telephone: (614) 466-0698, FAX: (614) 466-
5400.

Rhode Island

Kevin Nelson, Review Coordinator, Department of Administration, 
Division of Planning, One Capitol Hill, 4th Floor, Providence, Rhode 
Island 02908-5870, Telephone: (401) 277-2656, FAX: (401) 277-2083

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

South Carolina

Rodney Grizzle, State Single Point of Contact, Grant Services, 
Office of the Governor, 1205 Pendleton Street-Room 331, Columbia, 
South Carolina 29201, Telephone: (803) 734-0494, FAX: (803) 734-0356

Texas

Tom Adams, Governors Office, Director, Intergovernmental 
Coordination, P.O. Box 12428, Austin, Texas 78711, Telephone: (512) 
463-1771, FAX: (512) 463-1888

Utah

Carolyn Wright, Utah State Clearinghouse, Office of Planning and 
Budget, Room 116, State Capitol, Salt Lake City, Utah 84114,

[[Page 28883]]

Telephone: (801) 538-1535, FAX: (801) 538-1547

West Virginia

Fred Cutlip, Director, Community Development Division, W. Virginia 
Development Office, Building #6, Room 553, Charleston, West Virginia 
25305, Telephone: (304) 558-4010, FAX: (304) 558-3248

Wisconsin

Jeff Smith, Section Chief, State/Federal Relations, Wisconsin 
Department of Administration, 101 East Wilson Street-6th Floor, P.O. 
Box 7868, Madison, Wisconsin 53707, Telephone: (608) 266-0267, FAX: 
(608) 267-6931

Wyoming

Matthew Jones, State Single Point of Contact, Office of the 
Governor, 200 West 24th Street, State Capital, Room 124, Cheyenne, 
Wyoming 82002, Telephone: (307) 777-7446, FAX: (307) 632-3909

Territories

Guam

Mr. Giovanni T. Sgambelluri, Director, Bureau of Budget and 
Management Research, Office of the Governor, P.O. Box 2950, Agana, 
Guam 96910, Telephone: 011-671-472-2285, FAX: 011-671-472-2825

Puerto Rico

Norma Burgos/Jose E. Caro, Chairwoman/Director, Puerto Rico Planning 
Board, Federal Proposals Review Office, Minillas Government Center, 
P.O. Box 41119, San Juan, Puerto Rico 00940-1119, Telephone: (809) 
727-4444, (809) 723-6190, FAX: (809) 724-3270, (809) 724-3103

North Mariana Islands

Mr. Alvaro A. Santos, Executive Officer, State Single Point of 
Contact, Office of Management and Budget, Office of the Governor, 
Saipan, MP, Telephone: (670) 664-2256, FAX: (670) 664-2272, Contact 
Person: Ms. Jacoba T. Seman, Federal Programs Coordinator, 
Telephone: (670) 644-2289, FAX: (670) 644-2272

Virgin Islands

Nelson Bowry, Director, Office of Management and Budget, #41 
Norregade Emancipation Garden Station, Second Floor, Saint Thomas, 
Virgin Islands 00802

Please direct all questions and correspondence about 
intergovernmental review to: Linda Clarke, Telephone: (809) 774-
0750, FAX: (809) 776-0069.

OMB State Single Point of Contact Listing

Arizona

Joni Saad, Arizona State Clearinghouse, 3800 N. Central Avenue, 
Fourteenth Floor, Phoenix, Arizona 85012, Telephone: (602) 280-1315, 
FAX: (602) 280-8144

Arkansas

Mr. Tracy L. Copeland, Manager, State Clearinghouse, Office of 
Intergovernmental Services, Department of Finance and 
Administration, 1515 W. 7th St., Room 412, Little Rock, Arkansas 
72203, Telephone: (501) 682-1074, FAX: (501) 682-5206

California

Grants Coordinator, Office of Planning & Research, 1400 Tenth 
Street, Room 121, Sacramento, California 95814, Telephone: (916) 
323-7480, FAX: (916) 323-3018

Delaware

Francine Booth, State Single Point of Contact Executive Department, 
Thomas Collins Building, P.O. Box 1401, Dover, Delaware 19903, 
Telephone: (302) 739-3326, FAX: (302) 739-5661

District of Columbia

Charles Nichols, State Single Point of Contact, Office of Grants 
Mgmt. & Dev., 717 14th Street, NW.--Suite 500, Washington, DC 20005, 
Telephone: (202) 727-6554, FAX: (202) 727-1617

Florida

Florida State Clearinghouse, Department of Community Affairs, 2740 
Centerview Drive, Tallahassee, Florida 32399-2100, Telephone: (904) 
922-5438, FAX: (904) 487-2899

Georgia

Tom L. Reid, III, Administrator, Georgia State Clearinghouse, 254 
Washington Street, SW.--Room 401J, Atlanta, Georgia 30334, 
Telephone: (404) 656-3855 or (404) 656-3829, FAX: (404) 656-7938

Illinois

Virginia Bova, State Single Point of Contact, Department of Commerce 
and Community Affairs, James R. Thompson Center, 100 West Randolph, 
Suite 3-400, Chicago, Illinois 60601, Telephone: (312) 814-6028, 
FAX: (312) 814-1800

Indiana

Frances Williams, State Budget Agency, 212 State House, 
Indianapolis, Indiana 46204-2796, Telephone: (317) 232-5619, FAX: 
(317) 233-3323

Iowa

Steven R. McCann, Division for Community Assistance, Iowa Department 
of Economic Development, 200 East Grand Avenue, Des Moines, Iowa 
50309, Telephone: (515) 242-4719, FAX: (515) 242-4859

Kentucky

Ronald W. Cook, Office of the Governor, Department of Local 
Government, 1024 Capitol Center Drive, Frankfort, Kentucky 40601-
8204, Telephone: (502) 573-2382, FAX: (502) 573-2512

Maine

Joyce Benson, State Planning Office, State House Station #38, 
Augusta, Maine 04333, Telephone: (207) 287-3261, FAX: (207) 287-6489

Maryland

William G. Carroll, Manager, State Clearinghouse for 
Intergovernmental Assistance, Maryland Office of Planning, 301 W. 
Preston Street--Room 1104, Baltimore, Maryland 21201-2365, Staff 
Contact: Linda Janey, Telephone: (410) 225-4490, FAX: (410) 225-4480

Michigan

Richard Pfaff, Southeast Michigan Council of Governments, 1900 
Edison Plaza, 660 Plaza Drive, Detroit, Michigan 48226, Telephone: 
(313) 961-4266, FAX: (313) 961-4869

Mississippi

Cathy Malette, Clearinghouse Officer, Department of Finance and 
Administration, 455 North Lamar Street, Jackson, Mississippi 39202-
3087, Telephone: (601) 359-6762, FAX: (601) 359-6794

Missouri

Lois Pohl, Federal Assistance Clearinghouse, Office of 
Administration, P.O. Box 809, Room 760, Truman Building, Jefferson 
City, Missouri 65102, Telephone: (314) 751-4834, FAX: (314) 751-7819

Nevada

Department of Administration, State Clearinghouse, Capitol Complex, 
Carson City, Nevada 89710, Telephone: (702) 687-4065, FAX: (702) 
687-3983

New Hampshire

Jeffrey H. Taylor, Director, New Hampshire Office of State Planning, 
Attn: Intergovernmental Review Process, Mike Blake, 2\1/2\ Beacon 
Street, Concord, New Hampshire 03301, Telephone: (603) 271-2155, 
FAX: (603) 271-1728

New Mexico

Robert Peters, State Budget Division, Room 190 Bataan Memorial 
Building, Santa Fe, New Mexico 87503, Telephone: (505) 827-3640

New York

New York State Clearinghouse, Division of the Budget, State Capitol, 
Albany, New York 12224, Telephone: (518) 474-1605, FAX: (518) 486-
5617

North Carolina

Chrys Baggett, Director, N.C. State Clearinghouse, Office of the 
Secretary of Admin. 116 West Jones Street, Raleigh, North Carolina 
27603-8003, Telephone: (919) 733-7232, FAX: (919) 733-9571

North Dakota

North Dakota Single Point of Contact, Office of Intergovernmental 
Assistance, 600 East Boulevard Avenue, Bismarck, North Dakota 58505-
0170, Telephone: (701) 224-2094, FAX: (701) 224-2308

Ohio

Larry Weaver, State Single Point of Contact, State Clearinghouse, 
Office of Budget and Management, 30 East Broad Street, 34th Floor, 
Columbus, Ohio 43266-0411

Please direct correspondence and questions about intergovernmental 
review to: Linda Wise, Telephone: (614) 466-0698, FAX: (614) 466-
5400.

Rhode Island

Kevin Nelson, Review Coordinator, Department of Administration, 
Division of

[[Page 28884]]

Planning, One Capitol Hill, 4th Floor, Providence, Rhode Island 
02908-5870, Telephone: (401) 277-2656, FAX: (401) 277-2083

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

South Carolina

Rodney Grizzle, State Single Point of Contact, Grant Services, 
Office of the Governor, 1205 Pendleton Street--Room 331, Columbia, 
South Carolina 29201, Telephone: (803) 734-0494, FAX: (803) 734-0356

Texas

Tom Adams, Governors Office, Director, Intergovernmental 
Coordination, P.O. Box 12428, Austin, Texas 78711, Telephone: (512) 
463-1771, FAX: (512) 463-1888

Utah

Carolyn Wright, Utah State Clearinghouse, Office of Planning and 
Budget, Room 116, State Capitol, Salt Lake City, Utah 84114, 
Telephone: (801) 538-1535, FAX: (801) 538-1547

West Virginia

Fred Cutlip, Director, Community Development Division, W. Virginia 
Development Office, Building #6, Room 553, Charleston, West Virginia 
25305, Telephone: (304) 558-4010, FAX: (304) 558-3248

Wisconsin

Jeff Smith, Section Chief, State/Federal Relations, Wisconsin 
Department of Administration, 101 East Wilson Street--6th Floor, 
P.O. Box 7868, Madison, Wisconsin 53707, Telephone: (608) 266-0267, 
FAX: (608) 267-6931

Wyoming

Matthew Jones, State Single Point of Contact, Office of the 
Governor, 200 West 24th Street, State Capital, Room 124, Cheyenne, 
Wyoming 82002, Telephone: (307) 777-7446, FAX: (307) 632-3909

Territories

Guam

Mr. Giovanni T. Sgambelluri, Director, Bureau of Budget and 
Management Research, Office of the Governor, P.O. Box 2950, Agana, 
Guam 96910, Telephone: 011-671-472-2285, FAX: 011-671-472-2825

Puerto Rico

Norma Burgos/Jose E. Caro, Chairwoman/Director, Puerto Rico Planning 
Board, Federal Proposals Review Office, Minillas Government Center, 
P.O. Box 41119, San Juan, Puerto Rico 00940-1119, Telephone: (809) 
727-4444, (809) 723-6190, FAX: (809) 724-3270, (809) 724-3103

North Mariana Islands

Mr. Alvaro A. Santos, Executive Officer, State Single Point of 
Contact, Office of Management and Budget, Office of the Governor, 
Saipan, MP, Telephone: (670) 664-2256, FAX: (670) 664-2272, Contact 
Person: Ms. Jacoba T. Seman, Federal Programs Coordinator, 
Telephone: (670) 644-2289, FAX: (670) 644-2272

Virgin Islands

Nelson Bowry, Director, Office of Management and Budget, #41 
Norregade Emancipation Garden Station, Second Floor, Saint Thomas, 
Virgin Islands 00802

Please direct all questions and correspondence about 
intergovernmental review to: Linda Clarke, Telephone: (809) 774-
0750, FAX: (809) 776-0069.

[FR Doc. 97-13922 Filed 5-27-97; 8:45 am]
BILLING CODE 4184-01-M