[Federal Register Volume 64, Number 196 (Tuesday, October 12, 1999)]
[Notices]
[Pages 55342-55375]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-26386]
[[Page 55341]]
_______________________________________________________________________
Part II
Department of Health and Human Services
_______________________________________________________________________
Administration for Children and Families
_______________________________________________________________________
Request for Applications for the Office of Community Services' Fiscal
Year 2000 Job Opportunities for Low-Income Individuals Program; Notice
Federal Register / Vol. 64, No. 196 / Tuesday, October 12, 1999 /
Notices
[[Page 55342]]
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
[Program Announcement No. OCS 2000-02]
Request for Applications for the Office of Community Services'
Fiscal Year 2000 Job Opportunities for Low-Income Individuals Program
AGENCY: Administration for Children and Families (ACF), DHHS.
ACTION: Announcement of availability of funds and request for
applications under the Office of Community Services' FY 2000 Job
Opportunities for Low-Income Individuals (JOLI) Program.
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SUMMARY: The Administration for Children and Families (ACF), Office of
Community Services (OCS), announces that, based on availability of
funds, competing applications will be accepted for new grants pursuant
to the Secretary's discretionary authority under section 505 of the
Family Support Act of 1988, as amended.
Closing Date: To be considered for funding, applications must be
postmarked on or before January 14, 2000. Detailed application
submission instructions, including the addresses to which applications
must be submitted, are found in Part V-B, Application Submission.
FOR FURTHER INFORMATION CONTACT: Administration for Children and
Families, Office of Community Services, 370 L'Enfant Promenade SW.,
Washington, DC 20447. Contact: Nolan Lewis (202) 401-5282, Linda Bunn
(202) 401-5324, Aleatha Slade (202) 401-5317. In addition, this Notice
is accessible on the OCS WEBSITE for reading or downloading at:
www.acf.dhhs.gov/programs/ocs/kits1.htm.
If this Program Announcement is not available at these sources, it
may be obtained by telephoning or writing the office listed under FOR
FURTHER INFORMATION CONTACT above.
The Catalog of Federal Domestic Assistance number for this program
is ``93.593''. The title is ``Job Opportunities for Low-Income
Individuals (JOLI) Program''.
Part I--Preamble
A. Legislative Authority
Section 505 of the Family Support Act of 1988, Public Law 100-485,
as amended, authorizes the Secretary of HHS to enter into agreements
with non-profit organizations (including community development
corporations) for the purpose of conducting projects designed to create
employment and business opportunities for certain low-income
individuals.
The Personal Responsibility and Work Opportunity Reconciliation Act
of 1996, Public Law 104-193, reauthorized Section 505 of the Family
Support Act of 1988. The Act also amended certain subsections of
Section 505 of the Family Support Act of 1988 to be effective July 1,
1997.
B. Definitions of Terms
For purposes of this Program Announcement, the following
definitions apply:
--Budget period: The interval of time into which a multi-year period of
assistance (project period) is divided for budgetary and funding
purposes.
--Community-level data: Key information to be collected by each grantee
that will allow for a national-level analysis of common features of
JOLI projects. This consists of data on the population of the target
area, including the percentage of TANF recipients and others on public
assistance, and the percentage whose incomes fall below the poverty
line; the unemployment rate; the number of new business starts and
business closings; and a description of the major employers and average
wage rates and employment opportunities with those employers.
--Community development corporation: A private, nonprofit entity,
governed by a board of directors consisting of low-income residents of
the community and business, civic leaders, that has as a principal
purpose, planning, developing, or managing community economic
development projects.
--Hypothesis: An assumption made in order to test its validity. It
should assert a cause-and-effect relationship between a program
intervention and its expected result. Both the intervention and result
must be measured in order to confirm the hypothesis. For example, the
following is a hypothesis: ``Eighty hours of classroom training in
small business planning will be sufficient for participants to prepare
a successful loan application.'' In this example, data would be
obtained on the number of hours of training actually received by
participants (the intervention), and the quality of loan applications
(the result), to determine the validity of the hypothesis (that eighty
hours of training is sufficient to produce the result).
--Intervention: Any planned activity within a project that is intended
to produce changes in the target population and/or the environment and
that can be formally evaluated. For example, assistance in the
preparation of a business plan and loan package are planned
interventions.
--Job creation: To bring about, by activities and services funded under
this program, new jobs, that is, jobs that were not in existence before
the start of the project. These activities can include self-employment/
micro-enterprise training, the development of new business ventures or
the expansion of existing businesses.
--Non-profit organization: Any organization (including a community
development corporation) exempt from taxation under section 501(a) of
the Internal Revenue Code of 1986 by reason of paragraph (3) or (4) of
section 501(c) of such code.
--Non-traditional employment for women or minorities: Employment in an
industry or field where women or minorities currently make up less than
twenty-five percent of the work force.
--Outcome evaluation: An assessment of project results as measured by
collected data which define the net effects of the interventions
applied in the project. An outcome evaluation will produce and
interpret findings related to whether the interventions produced
desirable changes and their potential for replicability. It should
answer the question: Did this program work?
--Private employers: Third-party non-profit organizations or third-
party for-profit businesses operating or proposing to operate in the
same community as the applicant and which are proposed or potential
employers of project participants.
--Process evaluation: The ongoing examination of the implementation of
a program. It focuses on the effectiveness and efficiency of the
program's activities and interventions (for example, methods of
recruiting participants, quality of training activities, or usefulness
of follow-up procedures). It should answer questions such as: Who is
receiving what services? and are the services being delivered as
planned? It is also known as formative evaluation because it gathers
information that can be used as a management tool to improve the way a
program operates while the program is in progress. It should also
identify problems that occurred and how they were dealt with and
recommend improved means of future implementation. It should answer the
question: ``How
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was the program carried out?'' In concert with the outcome evaluation,
it should also help explain, ``Why did this program work/not work?''
and ``What worked and what did not?''
--Program participant/beneficiary: An individual eligible to receive
Temporary Assistance for Needy Families under Title I of the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996 (Part A
of Title IV of the Social Security Act) and any other individual whose
income level does not exceed 100 percent of the official poverty line
as found in the most recent revision of the Poverty Income Guidelines
published by the Department of Health and Human Services. (See
Attachment A.)
--Project period: The total time a project is approved for support,
including any extensions.
--Self-sufficiency: A condition where an individual or family, by
reason of employment, does not need and is not eligible for public
assistance.
--Third party: Any individual, organization, or business entity that is
not the direct recipient of grant funds.
--Third party agreement: A written agreement entered into by the
grantee and an organization, individual or business entity (including a
wholly-owned subsidiary), by which the grantee makes an equity
investment or a loan in support of grant purposes.
--Third party in-kind contributions: The value of non-cash
contributions provided by non-federal third parties which may be in the
form of real property, equipment, supplies and other expendable
property, and the value of goods and services directly benefitting and
specifically identifiable to the project or program.
C. Purpose
The purpose of this program is to demonstrate and evaluate ways of
creating new employment and business opportunities for certain low-
income individuals through the provision of technical and financial
assistance to private employers in the community, self-employment/
micro-enterprise programs, and/or new business development programs. A
low-income individual eligible to participate in a project conducted
under this program is any individual eligible to receive Temporary
Assistance for Needy Families (TANF) under Part A of Title IV of the
Social Security Act, as amended, or any other individual whose income
level does not exceed 100 percent of the official poverty line. (See
Attachment A.) Within these categories, emphasis should be on
individuals who are receiving TANF or its equivalent under State
auspices; those who are unemployed; those residing in public housing or
receiving housing assistance; non-custodial parents, and those who are
homeless.
Part II--Background Information and Program Requirements
A. Eligible Applicants
Organizations eligible to apply for funding under this program are
any non-profit organizations (including community development
corporations) that are exempt from taxation under section 501(a) of the
Internal Revenue Code of 1986 by reason of paragraph (3) or (4) of
section 501(c) of such Code.
Applicants must provide documentation of their tax exempt status.
The applicant can accomplish this by providing a copy of the
applicant's listing in the Internal Revenue Service's (IRS) most recent
list of tax-exempt organizations described in section 501(c)(3) of the
IRS code or by providing a copy of the currently valid IRS tax
exemption certificate. Failure to provide evidence of section 501(c)(3)
or (4) tax exempt status will result in rejection of the application.
Applicants that have applied to IRS for certification as a 501(c)
(3) or (4) tax exempt organization must provide documentation that
their application is currently pending IRS determination. However,
applicant must have status at time of award.
B. Project and Budget Periods
The Personal Responsibility and Work Opportunity Reconciliation Act
of 1996, Public Law 104-193, reauthorized and modified Section 505 of
the Family Support Act of 1988, the JOLI authorizing legislation. Among
the modifications effected was the deletion of sub-section (e), which
had legislatively mandated project duration. Applicants are therefore
free to apply for projects of from one to three years' duration,
depending on the proposed work program and the applicant's assessment
of the time required to achieve the proposed project goals. OCS has
made the programmatic determination that the nature of job creation and
career development projects which meet the funding criteria set forth
in this Announcement is such that it is not feasible to divide funding
into 12-month increments, and that completion of the entire project is
in each case necessary to achieve the purposes of the JOLI program.
Consequently, budget periods for grants under this Announcement may be
up to three years.
Given the limited funds available for the JOLI program, applicants
should make a realistic assessment of the time and funds needed to
achieve the goals set forth in their proposal, and design a work
program and budget accordingly. The grant request should be for an
amount, up to a maximum of $500,000, needed to implement that part of
the project plan supported by OCS funds, taking into consideration
other cash and in-kind resources mobilized by the applicant in support
of the proposed project. (See Paragraph D, below, Mobilization of
Resources, and Part IV, Element VI, Budget Appropriateness and
Reasonableness.)
C. Availability of Funds and Grant Amounts
All grant awards are subject to the availability of appropriated
funds. It is anticipated that approximately $5,500,000 will be
available in FY 2000 for JOLI. OCS estimates that approximately
$5,000,000 will be available for new grants and the remaining $500,000
will be set aside for the national JOLI contract. The 1996 amendments
to the JOLI authorizing legislation also deleted the limitation on the
number of grants to be made in any one fiscal year. Thus, the Office of
Community Services expects to award up to 10 new grants by September
30, 2000, based on the amounts requested and contingent on the
availability of funds. Grants of up to $500,000 in OCS funds for
project periods and budget periods of up to three years will be awarded
to selected organizations under this program in FY 2000.
D. Mobilization of Resources
OCS will give favorable consideration in the review process to
applicants who mobilize cash and/or third-party in-kind contributions
for direct use in the project. The firm commitment of these resources
must be documented and submitted with the application in order to be
given credit in the review process under the Public-Private
Partnerships program element. Except in unusual situations, this
documentation must be in the form of letters of commitment from the
organization(s)/individual(s) from which resources will be received.
Even though there is no matching requirement for the JOLI Program,
grantees will be held accountable for any match, cash or in-kind
contribution proposed or pledged as part of an approved application.
(See Part IV, Element V, and Part VI, B., Instructions for Completing
the SF-424A, Section C, Non-Federal Resources)
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E. Program Participants/beneficiaries
Projects proposed for funding under this Announcement must result
in direct benefits to low-income people or persons at or below the
poverty line, as defined in the most recently published Poverty Income
Guidelines and individuals eligible to receive TANF under Part A of
Title IV of the Social Security Act, as amended.
Attachment A to this Announcement is an excerpt from the guidelines
currently in effect. Annual revisions of these guidelines are normally
published in the Federal Register in February or early March of each
year. Grantees will be required to apply the most recent guidelines
throughout the project period. These revised guidelines also may be
obtained at public libraries, Congressional offices, or by writing the
Superintendent of Documents, U.S. Government Printing Office,
Washington, D.C. 20402.
No other government agency or privately-defined poverty guidelines
are applicable for the determination of low-income eligibility for this
program.
F. Prohibition and Restrictions on the Use of Funds
The use of funds for new construction or the purchase of real
property is prohibited. Costs incurred for the rearrangement and
alteration of facilities required specifically for the grant program
are allowable when specifically approved in advance by ACF in writing.
If the applicant is proposing a project which will affect a
property listed in, or eligible for inclusion in the National Register
of Historic Places, it must identify this property in the narrative and
explain how it has complied with the provisions of Section 106 of the
National Historic Preservation Act of 1966 as amended. If there is any
question as to whether the property is listed in or eligible for
inclusion in the National Register of Historic Places, the applicant
should consult with the State Historic Preservation Officer. (See
Attachment D: SF-424B, Item 13 for additional guidelines.) The
applicant should contact OCS early in the development of its
application for instructions regarding compliance with the Act and data
required to be submitted to the Department of Health and Human
Services. Failure to comply with the cited Act will result in the
application being ineligible for funding consideration.
G. Multiple Submittals
Due to the limited amount of funds available under this program,
only a single proposal from any one eligible applicant will be funded
by OCS from FY 2000 JOLI funds pursuant to this Announcement.
H. Re-funding
OCS will not re-fund a previously funded grantee to carry out the
same work plan in the same target area.
I. Sub-contracting or Delegating Projects
An applicant will not be funded where the proposal indicates that
the applicant if funded will serve as a straw-party, that is, act as a
mere conduit of funds to a third party without performing a substantive
role itself. This prohibition does not bar sub-contracting or sub-
awarding for specific services or activities needed to conduct the
project.
J. Maintenance of Effort
The application must include an assurance that activities funded
under this Program Announcement are in addition to, and not in
substitution for, activities previously carried out without Federal
assistance. (See Part VII-A. 9 and Attachment M.)
Part III--Application Requirements and Priority Areas
A. Program Focus
The Congressional Conference Report on the 1992 appropriations for
the Department of Labor, Health and Human Services, and Education and
related agencies directed the ACF to require economic development
strategies as part of the application process to ensure that highly
qualified organizations participate in the demonstration [H.R. Conf.
Rep. No. 282, 102d Cong., 1st Sess. 39 (1991)].
Priority will be given to applications proposing to serve those
areas containing the highest percentage of individuals receiving
Temporary Assistance to Needy Families (TANF) under Title IV-A of the
Social Security Act, as amended.
While projected employment in future years may be included in the
application, it is essential that the focus of the project concentrate
on the creation of new full-time, permanent jobs and/or new business
development opportunities for TANF recipients and other low-income
individuals during the duration of the grant project period. OCS is
particularly interested in receiving innovative proposals that grow out
of the experience and creativity of applicants and the needs of their
clientele and communities.
Applicants should include strategies which seek to integrate
projects financed and jobs created under this program into a larger
effort of broad community revitalization which will promote job and
business opportunities for eligible program participants and impact the
overall economic environment.
OCS will only fund projects that create new employment and/or
business opportunities for eligible program participants. That is, new
full-time permanent jobs through the expansion of a pre-identified
business or new business development, or by providing opportunities for
self-employment. In addition, projects should enhance the participants'
capacities, abilities and skills and thus contribute to their progress
toward self-sufficiency.
With national welfare reform a reality, and many States already
implementing ``welfare-to-work'' programs, the need for well-paying
jobs with career potential for TANF recipients becomes ever more
pressing. In this context, the role of JOLI as a vehicle for exploring
new and promising areas of employment opportunity for the poor is more
important than ever.
Within the JOLI Program framework of job creation through new or
expanding businesses or self-employment, OCS would welcome proposals
offering business or career opportunities to eligible participants in a
variety of fields. For instance, these might include day care and
transportation, which are not only opportunities for employment, but
when not available can be serious barriers to employment for TANF
recipients; environmental justice initiatives involving activities such
as toxic waste clean-up, water quality management, or Brownfields
remediation; health-related jobs such as home health aides or medical
support services; and non-traditional jobs for women and minorities.
B. Creation of Jobs and Employment Opportunities
The requirement for creation of new, full-time permanent employment
opportunities (jobs) applies to all applications. OCS has determined
that the creation of non-traditional job opportunities for women or
minorities in industries or activities where they currently make up
less than twenty-five percent of the work force meets the requirements
of the JOLI legislation for the creation of new employment
opportunities. OCS continues to solicit other JOLI applications to
propose the creation of jobs through the expansion of existing
businesses, the development of new businesses, or the creation of
employment opportunities through self-employment/ microenterprise
development.
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Proposed projects must show that the jobs and/or business/self
employment opportunities to be created under this program will
contribute to achieving self-sufficiency among the target population.
The employment opportunities should provide hourly wages that exceed
the minimum wage and also provide benefits such as health insurance,
child care, and career development opportunities.
C. Cooperative Partnership Agreement With the Designated Agency
Responsible for the Temporary Assistance for Needy Families (TANF)
Program
A formal, cooperative relationship between the applicant and the
designated State agency responsible for administering the Temporary
Assistance for Needy Families (TANF) program (as provided for under
Title IV-A of the Social Security Act, as amended,) in the area served
by the project is a requirement for funding. The application must
include a signed, written agreement between the applicant and the
designated State agency responsible for administering the TANF program,
or a letter of commitment to such an agreement within 6 months of a
grant award (contingent only on receipt of OCS funds). The agreement
must describe the cooperative relationship, including specific
activities and/or actions each of these entities propose to carry out
over the course of the grant period in support of the project.
The agreement, at a minimum, must cover the specific services and
activities that will be provided to the target population. (See
Attachment I for a list of the State IV-A agencies administering TANF.)
D. Third-Party Project Evaluation
Proposals must include provision for an independent,
methodologically sound evaluation of the effectiveness of the
activities carried out with the grant and their efficacy in creating
new jobs and business opportunities. There must be a well-defined
process evaluation, and an outcome evaluation whose design will permit
tracking of project participants throughout the proposed project
period. The evaluation must be conducted by an independent evaluator,
i.e., a person with recognized evaluation skills who is
organizationally distinct from, and not under the control of, the
applicant. It is important that each successful applicant have a third-
party evaluator selected, and performing at the very latest by the time
the work program of the project is begun, and if possible before that
time so that he or she can participate in the final design of the
program, in order to assure that data necessary for the evaluation will
be collected and available.
E. Economic Development Strategy
As noted in A. above, the Congress, in the Conference Report on the
FY 1992 appropriation, directed ACF to require economic development
strategies as part of the application process for JOLI to ensure that
highly qualified organizations participate in the demonstration.
Accordingly, applicants must include in their proposal an explanation
of how the proposed project is integrated with and supports a larger
economic development strategy within the target community. Where
appropriate, applicants should document how they were involved in the
preparation and planned implementation of a comprehensive community-
based strategic plan, such as that required for applying for
Empowerment Zones/Enterprise Community (EZ/EC) status, to achieve both
economic and human development in an integrated manner, and how the
proposed project supports the goals of that plan. (See Part IV, Sub-
Element III (b).)
F. Training and Support for Micro-Business Development
In the case of proposals for creating self-employment micro-
business opportunities for eligible participants, the applicant must
detail how it will provide training and support services to potential
entrepreneurs. The assistance to be provided to potential entrepreneurs
must include, at a minimum: (1) Technical assistance in basic business
planning and management concepts; (2) assistance in preparing a
business plan and loan application; and (3) access to business loans.
G. Support for Noncustodial Parents
The Office of Community Services and the Office of Child Support
Enforcement, both in the Administration for Children and Families,
signed a Memorandum of Understanding (MOU) to foster and enhance
partnerships between OCS grantees and local Child Support Enforcement
(CSE) agencies. (See Attachment N for the list of CSE State Offices
that can identify local CSE agencies). In the words of the MOU:
``The purpose of these partnerships will be to develop and
implement innovative strategies in States and local communities to
increase the capability of low-income parents and families to fulfill
their parental responsibilities. Too many low-income parents are
without jobs or resources needed to support their children. A
particular focus of these partnerships will be to assist low-income,
non-custodial parents of children receiving Temporary Assistance for
Needy Families to achieve a degree of self-sufficiency that will enable
them to provide support that will free their families of the need for
such assistance.''
Accordingly, a rating factor and a review criterion have been
included in this Program Announcement which will award two points to
applicants who have entered into partnership agreements with their
local CSE agency to provide for referrals to their project in
accordance with provisions of the OCS-OCSE MOU. (See Part IV, Sub-
Element III (c))
H. Technical Assistance to Employers
Technical assistance should be specifically addressed to the needs
of the private employer in creating new jobs to be filled by eligible
individuals and/or to the individuals themselves in areas such as job-
readiness, literacy and other basic skills training, job preparation,
self-esteem building, etc. Financial assistance may be provided to the
private employer as well as to the individual.
If the technical and/or financial assistance is to be provided to
pre-identified businesses that will be expanded or franchised, written
commitments from the businesses to create the planned jobs must be
included with the application.
I. Applicant Experience and Cost-Per-Job
In the review process, favorable consideration will be given to
applicants with a demonstrated record of achievement in promoting job
and enterprise opportunities for low-income people. Favorable
consideration also will be given to those applicants who show the
lowest cost-per-job created for low-income individuals. For this
program, OCS views $15,000 in OCS funds as the maximum amount for the
creation of a job and, unless there are extenuating circumstances, will
not fund projects where the cost-per-job in OCS funds exceeds this
amount. Only those jobs created and filled by low-income people will be
counted in the cost-per-job formula. (See Part IV, Sub-Element III (d))
J. Loan Funds
The creation of a revolving loan fund with funds received under
this program is an allowable activity. However, OCS encourages the use
of funds from other
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sources for this purpose. Loans made to eligible beneficiaries for
business development activities must be at or below market rate.
Note: Interest accrued on revolving loan funds may be used to
continue or expand the activities of the approved project.
K. Business Plans
Where applicant is proposing the development and start-up of a new
business or the expansion of an existing business, a Business Plan that
follows the outline in Attachment L to this Announcement must be
submitted as an appendix to the proposal.
L. Dissemination of Project Results
Applications should include a plan for disseminating the results of
the project after expiration of the grant period. Applicants may budget
up to $2,000 for dissemination purposes. Final Project Reports should
include a description of dissemination activities with copies of any
materials produced.
M. General Projects 1.0 and Community Development Corporations Set-
Aside 2.0
All grant awards are subject to the availability of appropriated
funds. The Office of Community Services expects to award approximately
$5 million by no later than September 30, 2000 for new grants under
this announcement: approximately $4 million for General Projects 1.0,
and up to $1 million for CDC Set-Aside Projects 2.0. (For definition of
Community Development Corporation, See Part I, Section B)
The same purposes, requirements and prohibitions are applicable to
proposals submitted under both General Projects 1.0 and Community
Development Corporations Set-Aside 2.0. Applications for the set-aside
funds that are not funded due to the limited amount of funds available
will also be considered competitively within the larger pool of
eligible applicants.
N. Third Party Agreements
Any applicant submitting a proposal for funding who proposes to use
some or all of the requested OCS funds to enter into a third party
agreement in order to make an equity investment (such as the purchase
of stock) or a loan to an organization, or business entity (including a
wholly-owned subsidiary), must include in the application, along with
the business plan, a copy of the signed third party agreement for
approval by OCS.
A third party agreement covering an equity investment must contain,
at a minimum, the following:
1. The type of equity transaction (e.g. stock purchase);
2. Purpose(s) for which the equity investment is being made;
3. Cost per share;
4. Number of shares being purchased;
5. Percentage of ownership of the business; and
6. Number of seats on the board, if applicable.
A third party agreement covering a loan transaction must contain,
at a minimum, the following information:
1. Purpose(s) for which the loan is being made;
2. Rates of interest and other fees;
3. Terms of loan;
4. Repayment schedules;
5. Collateral security; and
6. Default and collection procedures.
All third party agreements must include written commitments as
follows:
From the third party (as appropriate):
1. A minimum of 75% of the jobs to be created as a result of the
injection of grant funds will be filled by low-income individuals;
2. The grantee will have the right to screen applicants for jobs to
be filled by low-income individuals and to verify their eligibility;
3. If the grantee's equity investment equals 25% or more of the
business's assets, the grantee will have representation on the board of
directors;
4. Reports will be made to the grantee regarding the use of grant
funds no less than on a quarterly basis;
5. A procedure will be developed to assure that there are no
duplicate counts of jobs created; and
6. Detailed information will be provided on how the grant funds
will be used by the third party by submitting a Source and Use of Funds
Statement. In addition, the agreement must provide details on how the
grantee will provide support and technical assistance to the third
party in areas of recruitment and retention of low-income individuals.
From the grantee:
Detailed information on how the grantee will provide support and
technical assistance to the third party in areas of recruitment and
retention of low-income individuals.
All third party agreements should be accompanied by:
1. A signed statement from a Certified or Licensed Public
Accountant as to the sufficiency of the third party's financial
management system in accordance with 45 CFR part 74, to protect
adequately any federal funds awarded under the application;
2. Financial statements for the third party organization for the
prior three years (If not available because the organization is a
newly-formed entity, include a statement to this effect.); and
3. The third party agreement will specify how the grantee will
provide oversight of the third party for the life of the agreement.
Also, the agreement will specify that the third party will maintain
documentation related to the expenditure of grant funds loaned to or
invested in the third party and grant objectives as specified in the
agreement and will provide the grantee and HHS access to that
documentation.
If a signed third party agreement is not available when the
application is submitted, the applicant must submit as part of the
narrative as much of the above-mentioned information as possible in
order to enable reviewers to evaluate the proposal. It should be noted
that that portion of a grant which will be used to fund a third party
agreement will not be released until the agreement has been approved by
OCS.
Part IV--Application Elements and Review Criteria
Applications that pass the pre-rating review will be assessed and
scored by reviewers. Each reviewer will give a numerical score for each
application reviewed. These numerical scores will be supported by
explanatory statements on a formal rating form describing major
strengths and weaknesses under each applicable criterion published in
the Announcement.
The in-depth assessment and review process will use the following
criteria coupled with the specific requirements described in Part III.
Scoring will be based on a total of 100 points.
The ultimate goals of the project to be funded under the JOLI
Program are: (1) To achieve, through project activities and
interventions, the creation of employment opportunities for TANF
recipients and other low-income individuals which can lead to economic
self-sufficiency of members of the communities served; (2) to evaluate
the effectiveness of these interventions and of the project design
through which they were implemented; and (3) thus to make possible the
replication of successful programs. OCS intends to make the awards of
all the above grants on the basis of brief, concise applications. The
elements and format of these applications, along with the review
criteria that will be used to evaluate them, will be outlined in this
Part.
In order to simplify the application preparation and review
process, OCS seeks to keep grant proposals cogent and brief.
Applications with project narratives (excluding appendices) of more
than 30 letter-sized pages of 12 characters per inch (c.p.i.) type or
[[Page 55347]]
equivalent on a single side will not be reviewed for funding.
Applicants should prepare and assemble their project description using
the following outline of required project elements. They should,
furthermore, build their project concept, plans, and application
description upon the guidelines set forth for each of the project
elements.
For each of the Project Elements or Sub-Elements below, there is,
at the end of the discussion, a suggested number of pages to be devoted
to the particular element or sub-element. These are suggestions only;
but the applicant must remember that the overall Project Narrative
cannot be longer than 30 pages.
The competitive review of proposals will be based on the degree to
which applicants incorporate each of the Elements and Sub-Elements
below into their proposals, so as to:
1. Describe convincingly a project that will develop new employment
or business opportunities for TANF recipients and other low income
individuals that can lead to a transition from dependency to economic
self-sufficiency;
2. Propose a realistic budget and time frame for the project that
will support the successful implementation of the work plan to achieve
the project's goals in a timely and cost effective manner; and
3. Provide for the testing and evaluation of the project design,
implementation, and outcomes so as to make possible replication of a
successful program.
Element I--Organizational Experience in Program Area and Staff Skills,
Resources and Responsibilities
Sub-Element I (a)--Agency's Experience and Commitment in Program Area
(Weight of 0-10 points in proposal review)
Applicants should cite their organization's capability and relevant
experience in developing and operating programs which deal with poverty
problems similar to those to be addressed by the proposed project. They
should also cite the organization's experience in collaborative
programming and operations which involve evaluations and data
collection. Applicants should identify agency executive leadership in
this section and briefly describe their involvement in the proposed
project and provide assurance of their commitment to its successful
implementation.
The application should include documentation that briefly
summarizes two similar projects undertaken by the applicant agency and
the extent to which the stated and achieved performance targets,
including permanent benefits to low-income populations, have been
achieved. The application should note and justify the priority that
this project will have within the agency, including the facilities and
resources that it has available to carry it out.
It is suggested that applicants use no more than 2 pages for this
Sub-Element.
Note: The maximum number of points will be given only to those
organizations with a demonstrated record of achievement in promoting
job creation and enterprise opportunities for low-income people.
Sub-Element I (b)--Staff Skills, Resources and Responsibilities
(Weight of 0-10 points in proposal review)
The application must identify the two or three individuals who will
have the key responsibility for managing the project, coordinating
services and activities for participants and partners, and for
achieving performance targets. The focus should be on the
qualifications, experience, capacity and commitment to the program of
the executive officials of the organization and the key staff persons
who will administer and implement the project. The person identified as
project director should have supervisory experience, experience in
finance and business, and experience with the target population.
Because this is a demonstration project within an already-established
agency, OCS expects that the key staff person(s) would be identified,
if not hired.
The application must also include a resume of the third party
evaluator, if identified or hired; or the minimum qualifications and
position description for the third-party evaluator, who must be a
person with recognized evaluation skills who is organizationally
distinct from, and not under the control of, the applicant. (See
Element IV, Project Evaluation, below, for fuller discussion of
evaluator qualifications.)
Actual resumes of key staff and position descriptions should be
included in an Appendix to the proposal.
It is suggested that applicants use no more than 3 pages for this
Sub-Element.
Element II: Project Theory, Design, and Plan
OCS seeks to learn from the application why and how the project as
proposed is expected to lead to the creation of new employment
opportunities for low-income individuals, which can lead to significant
improvements in individual and family self-sufficiency.
Applicants are urged to design and present their project in terms
of a conceptual cause-effect framework. In the following paragraphs, a
framework is described that suggests a way to present a project so as
to show the logic of the cause-effect relations between project
activities and project results. Applicants don't have to use the exact
language described; but it is important to present the project in a way
that makes clear the cause-effect relationship between what the project
plans to do and the results it expects to achieve.
Sub-Element II (a)--Description of Target Population, Analysis of Need,
and Project Assumptions
(Weight of 0-10 points in application review)
The project design or plan should begin with identifying the
underlying assumptions about the program. These are the beliefs on
which the proposed program is built. These assumptions include: The
needs of the population to be served; the current services available to
that population, and where and how they fail to meet their needs; why
the proposed services or interventions are appropriate and will meet
those needs; and the impact the proposed interventions will have on the
project participants.
In other words, the underlying assumptions of the program are the
applicant's analysis of the needs and problems to be addressed by the
project, and the applicant's theory of how its proposed interventions
will address those needs and problems to achieve the desired result.
Thus a strong application is based upon a clear description of the
needs and problems to be addressed and a persuasive understanding of
the causes of those problems.
In this sub-element of the proposal, the applicant must precisely
identify the target population to be served. The geographic area to be
impacted should then be briefly described, citing the percentage of
residents who are low-income individuals and TANF recipients, as well
as the unemployment rate and other data that are relevant to the
project design.
The application should include an analysis of the identified
personal barriers to employment, job retention and greater self-
sufficiency faced by the population to be targeted by the project.
(These might include such problems as illiteracy, substance abuse,
family violence, lack of skills training, health or medical problems,
need for childcare, lack of suitable clothing or equipment, or poor
self-image.) The application
[[Page 55348]]
should also include an analysis of the identified community systemic
barriers which the project will seek to overcome. These might include
lack of jobs (high unemployment rate); lack of public transportation;
lack of markets; unavailability of financing, insurance or bonding;
inadequate social service (employment service, child care, job
training); high incidence of crime; inadequate health care; or
environmental hazards (such as toxic dumpsites or leaking underground
tanks). Applicants should be sure not to overlook the personal and
family services and support that might be needed by project
participants after they are on the job which will enhance job retention
and advancement. If the jobs to be created by the proposed project are
themselves designed to fill one or more of the needs, or remove one or
more of the barriers so identified, this fact should be highlighted in
the discussion, e.g., jobs in childcare, health care, or
transportation.
It is suggested that applicants use no more than 4 pages for this
Sub-Element.
Sub-Element II (b)--Project Strategy and Design: Interventions,
Outcomes, and Goals
(Weight of 0-10 points in proposal review)
The work plan must describe the proposed project activities, or
interventions, and explain how they are expected to result in outcomes
which will meet the needs of the program participants and assist them
to overcome the identified personal and systemic barriers to
employment, job retention, and self-sufficiency. In other words, what
will the project staff do with the resources provided to the project
and how will what they do (interventions) assist in creating and
sustaining employment and business opportunities for program
participants in the face of the needs and problems that have been
identified.
The underlying assumptions concerning client needs and the theory
of how they can be effectively addressed, which are discussed above,
lead in the project design to the conduct of a variety of project
activities or interventions, each of which is assumed to result in
immediate changes, or outcomes.
The immediate changes lead to intermediate outcomes; and the
intermediate outcomes lead to the attainment of the final project
goals.
The applicant should describe the major activities, or
interventions, which are to be carried out to address the needs and
problems identified in Sub-Element II (a); and should discuss the
immediate changes, or outcomes, which are expected to result. These are
the results expected from each service or intervention immediately
after it is provided. For example, a job readiness training program
might be expected to result in clients having increased knowledge of
how to apply for a job, improved grooming for job interviews, and
improved job interview skills; or business training and training in
bookkeeping and accounting might be expected to result in project
participants making an informed decision about whether they were suited
for entrepreneurship.
At the next level are the intermediate outcomes, which result from
these immediate changes. Often an intermediate project outcome is the
result of several immediate changes resulting from a number of related
interventions such as training and counseling. Intermediate outcomes
should be expressed in measurable changes in knowledge, attitudes,
behavior, or status/condition. In the above examples, the immediate
changes achieved by the job readiness program, coupled with technical
assistance to an employer in the expansion of a business, could be
expected to lead to intermediate outcomes of creation of new job
openings and the participant applying for a job with the company. The
acquisition of business skills, coupled with the establishment of a
loan fund, could be expected to result in the actual decision to go
into a particular business venture or seek the alternative track of
pursuing job readiness and training.
Finally, the application should describe how the achievement of
these intermediate outcomes will be expected to lead to the attainment
of the project goals: employment in newly created jobs, new careers in
non-traditional jobs, successful business ventures, or employment in an
expanded business, depending on the project design. Applicants must
remember that if the major focus of the project is to be the
development and start-up of a new business or the expansion of an
existing business, then a Business Plan which follows the outline in
Attachment L to this announcement must be submitted as an Appendix to
the Proposal. (See Part III K)
Applicants do not have to use the exact terminology described
above, but it is important to describe the project in a way that makes
clear the expected cause-and-effect relationship between what the
project plans to do--the activities or interventions, the changes that
are expected to result, and how those changes will lead to attainment
of the project goals of new employment opportunities and greater self-
sufficiency. The competitive review of this Sub-Element will be based
on the extent to which the application makes a convincing case that the
activities to be undertaken will lead to the projected results.
It is suggested that applicants use no more than 4 pages for this
Sub-Element.
Sub-Element II (c)--Work Plan
(Weight of 0-10 points in proposal review)
Once the project strategy and design framework is established, the
applicant should present the highlights of a work plan for the project.
The plan should explicitly tie into the project design framework and
should be feasible, i.e., capable of being accomplished with the
resources, staff, and partners available. The plan should briefly
describe the key project tasks and show the timelines and major
milestones for their implementation. Critical issues or potential
problems that might affect the achievement of project objectives should
be explicitly addressed, with an explanation of how they would be
overcome, and how the objectives will be achieved notwithstanding any
such problems. The plan should be presented in such a way that it can
be correlated with the budget narrative included earlier in the
application.
Applicants may be able to use a simple Gantt or time line chart to
convey the work plan in minimal space.
The application contains a full and accurate description of the
proposed use of the requested financial assistance.
If the applicant proposes to make an equity investment or a loan to
an individual, organization, or business entity (including a wholly-
owned subsidiary), the applicant must include: A signed third party
agreement; a signed statement by a Certified or Licensed Public
Accountant as to the sufficiency of the third party's financial
management system; and financial statements for the third party's prior
three years of operation. (If newly formed and unable to provide the
information regarding the prior three years of operation, a statement
to that effect should be included.) If the applicant states that an
agreement is not currently in place, the application must contain in
the narrative as much information required for third party agreement as
is available.
Also, if the project proposes the development of a new or expanding
business, service, physical or commercial activity, the application
must address applicable elements of a
[[Page 55349]]
business plan. Guidelines for a Business Plan are included in
Attachment L.
Special attention should be given to assure that the financial plan
element, which indicates the project's potential and timetable for
financial self-sufficiency, is included. It must include for the
applicant and the third party, if appropriate, the following exhibits
for the first three years (on a quarterly basis) of the business'
operations: Profit and Loss Forecasts, Cash Flow Projections, and
Proforma Balance Sheets. Based on these documents, the application must
also contain an analysis of the financial feasibility of the project.
Also, a Source and use of Funds statement for all project funding must
be included.
It is suggested that applicants use no more than 3 pages for this
Sub-Element.
Element III--Significant and Beneficial Impact
Sub-Element III (a)--Quality of Jobs/Business Opportunities
(Weight of 0-10 points in proposal review)
The proposed project is expected to produce permanent and
measurable results that will reduce the incidence of poverty in the
community and lead welfare recipients from welfare dependency toward
economic self-sufficiency. Results are expected to be quantifiable in
terms of the creation of permanent, full-time jobs; the development of
business opportunities; the expansion of existing businesses; or the
creation of non-traditional employment opportunities. In developing
business opportunities and self employment for TANF recipients and low-
income individuals, the applicant proposes, at a minimum, to provide
basic business planning and management concepts, and assistance in
preparing a business plan and loan package.
The application should document that:
The business opportunities to be developed for eligible
participants will contribute significantly to their progress toward
self-sufficiency; and/or jobs to be created for eligible participants
will contribute significantly to their progress toward self-
sufficiency. For example, they should provide salaries that exceed the
minimum wage, plus benefits such as health insurance, child care and
career development opportunities.
It is suggested that applicants use no more than 2 pages for this
Sub-Element.
Sub-Element III (b)--Community Empowerment Consideration
(Weight of 0-3 points in proposal review)
Special consideration will be given to applicants that are located
in areas that are characterized by conditions of extreme poverty and
other indicators of socio-economic distress such as a poverty rate of
at least 20%, designation as an Empowerment Zone or Enterprise
Community, high levels of violence, gang activity or drug use; and who
document that in response to these conditions they have been involved
in the preparation and planned implementation of a comprehensive
community-based strategic plan to achieve both economic and human
development in an integrated manner; and how the proposed project will
support the goals of that plan.
It is suggested that applicants use no more than 2 pages for this
Sub-Element.
Sub-Element III(c)--Support for Noncustodial Parents
(Weight of 0-2 points in proposal review)
Applicants that have entered into partnership agreements with local
Child Support Enforcement Agencies to develop and implement innovative
strategies to increase the capability of low-income parents and
families to fulfill their parental responsibilities, and specifically,
to this end, to provide for referrals to the funded projects of
identified income eligible families and non-custodial parents
economically unable to provide child support, will also receive special
consideration.
To receive the full credit of two points, applicants should include
as an appendix to the application, a signed letter of agreement with
the local CSE Agency for referral of eligible non-custodial parents to
the proposed project.
It is suggested that applicants use no more than 1 page for this
Sub-Element.
Sub-Element III (d)--Cost-Per-Job
(Weight of 0-5 points in proposal review)
The applicant should document that during the project period the
proposed project will create new, permanent jobs through business
opportunities or non-traditional employment opportunities for low-
income residents at a cost-per-job below $15,000 in OCS funds. The cost
per job should be calculated by dividing the total amount of grant
funds requested (e.g. $420,000) by the number of jobs to be created
(e.g., 60) which would equal the cost-per-job ($7,000)). If any other
calculations are used, include the methodology and rationale in this
section. In making calculations of cost-per-job, only jobs filled by
low-income project participants may be counted. (See Part III, Section
I)
Note: Except in those instances where independent reviewers
identify extenuating circumstances related to business development
activities, or high wage levels and living costs such as in Hawaii
or Alaska, the maximum number of points will be given only to those
applicants proposing cost-per-job created estimates of $5,000 or
less of OCS requested funds. Higher cost-per-job estimates will
receive correspondingly fewer points.
It is suggested that applicants use no more than 1 page for this
Sub-Element.
Element IV--Project Evaluation
(Weight of 0-15 points in the proposal review)
Sound evaluations are essential to the JOLI Program. OCS requires
applicants to include in their applications a well thought through
outline of an evaluation plan for their project. The outline should
explain how the applicant proposes to answer the key questions about
how effectively the project is being/was implemented; whether the
project activities, or interventions, achieved the expected immediate
outcomes, and why or why not (the process evaluation); and whether and
to what extent the project achieved its stated goals, and why or why
not (the outcome evaluation). Together, the process and outcome
evaluations should answer the question: ``What did this program
accomplish and why did it work/not work?''
Applicants are not being asked to submit a complete and final
evaluation plan as part of their proposal; but they must include:
1. A well thought through outline of an evaluation plan that
identifies the principal cause-and-effect relationships to be tested,
and that demonstrates the applicant's understanding of the role and
purpose of both process and outcome evaluations. (See previous
paragraph);
2. A reporting format based on the grantee's documentation of its
activities (interventions) and their effectiveness, to be included in
the grantee's semi-annual program progress report, which will provide
OCS with insights and lessons learned, as they become evident,
concerning the various aspects of the work plan, such as recruitment,
training, support, public-private partnerships, and coordination with
other community resources, as they may be relevant to the proposed
project;
3. The identity and qualifications of the proposed third-party
evaluator, or if
[[Page 55350]]
not selected, the qualifications which will be sought in choosing an
evaluator, which must include successful experience in evaluating
social service delivery programs, and the planning and/or evaluation of
programs designed to foster self-sufficiency in low income populations;
and
4. A commitment to the selection of a third-party evaluator
approved by OCS, and to completion of a final evaluation design and
plan, in collaboration with the approved evaluator and the OCS
Evaluation Technical Assistance Contractor during the six-month start-
up period of the project, if funded.
Applicants should ensure, above all, that the evaluation outline
presented is consistent with their project design. A clear project
framework of the type recommended earlier identifies the key project
assumptions about the target populations and their needs, as well as
the hypotheses, or expected cause-effect relationships to be tested in
the project; and the proposed project activities, or interventions,
that will address those needs in ways that will lead to the achievement
of the project goals of self-sufficiency. It also identifies in advance
the most important process and outcome measures that will be used to
identify performance success and expected changes in individual
participants, the grantee organization, and the community.
Finally, as noted above, the outline should provide for prompt
reporting, concurrently with the semi-annual program progress reports,
of lessons learned during the course of the project, so that they may
be shared without waiting for the final evaluation report.
For all these reasons, it is important that each successful
applicant have a third-party evaluator selected and performing at the
very latest by the time the work program of the project is begun, and
if possible before that time so that he or she can participate in the
final design of the program, and in order to assure that data necessary
for the evaluation will be collected and available. Plans for selecting
an evaluator should be included in the application narrative. A third-
party evaluator must have knowledge about and have experience in
conducting process and outcome evaluations in the job creation field,
and have a thorough understanding of the range and complexity of the
problems faced by the target population.
The competitive procurement regulations (45 CFR part 74,
Secs. 74.40-74.48, esp. 74.43) apply to service contracts such as those
for evaluators.
It is suggested that applicants use no more than 3 pages for this
Element, plus the resume or position description for the evaluator,
which should be in an appendix.
Element V--Public/Private Partnerships
(Weight of 0-10 points in the proposal review)
The proposal should briefly describe any public/private
partnerships, which will contribute to the implementation of the
project. Where partners' contributions to the project are a vital part
of the project design and work program, the narrative should describe
undertakings of the partners, and a partnership agreement specifying
the roles of the partners and making a clear commitment to the
fulfilling of the partnership role, must be included in an appendix to
the proposal. The firm commitment of mobilized resources must be
documented and submitted with the application in order to be given
credit under this element. The application should meet the following
criteria:
(a) Where other resources are mobilized, the application must
provide documentation that public and/or private sources of cash and/or
third-party-in-kind contributions will be available, in the form of
letters of commitment from the organization(s)/individual(s) from which
resources will be received. Applications that can document dollar for
dollar contributions equal to the OCS funds and demonstrate that the
partnership agreement clearly relates to the objectives of the proposed
project will receive the maximum number of points for this criterion.
Lesser contributions will be given consideration based upon the value
documented.
Note: Even though there is no matching requirement for the JOLI
Program, grantees will be held accountable for any match, cash or
in-kind contribution proposed or pledged as part of an approved
application. (See Part II, D--Mobilization of Resources)
(b) Partners involved in the proposed project should be responsible
for substantive project activities and services. Applicants should note
that partnership relationships are not created via service delivery
contracts.
It is suggested that applicants use no more than 4 pages for this
Element.
Element VI--Budget Appropriateness and Reasonableness
(Weight of 0-5 points in proposal review)
Applicants are required to submit Federal budget forms with their
proposals to provide basic applicant and project information (SF 424)
and information about how Federal and other project funds will be used
(424A). (See Part VI.) Immediately following the completed Federal
budget forms, (Attachments B and C), applicants must submit a Budget
Narrative, or explanatory budget information which includes a detailed
budget breakdown for each of the budget categories in the SF-424A. This
Budget Narrative is not considered a part of the Project Narrative, and
does not count as part of the thirty pages; but rather should be
included in the application following the budget forms.
The duration of the proposed project and the funds requested in the
budget must be commensurate with the level of effort necessary to
accomplish the goals and objectives of the project. The budget
narrative should briefly explain how grant funds will be expended and
show the appropriateness of the Federal funds and any mobilized
resources to accomplish project purposes within the proposed timeframe.
The estimated cost to the government of the project should be
reasonable in relation to the project's duration and to the anticipated
results, and include reasonable administrative costs, if an indirect
cost rate has not been negotiated with a cognizant Federal agency.
Applicants are encouraged to use job titles and not specific names
in developing the applicant budget. However, the specific salary rates
or amounts for staff positions identified must be included in the
application budget.
Resources in addition to OCS grant funds are encouraged both to
augment project resources and strengthen the basis for continuing
partnerships to benefit the target community. The amounts of such
resources, their appropriateness to the project design, and the
likelihood that they will continue beyond the project timeframe will be
taken into account in judging the application. As noted in Element V,
above, even though there is no matching requirement for the JOLI
program, grantees will be held accountable for any match, cash or in-
kind contribution proposed or pledged as part of an approved
application.
Applicants should include funds in the project budget for travel by
Project Directors and Chief Evaluators to attend two national
evaluation workshops in Washington, DC (See Part VIII, Evaluation
Workshops.) The score for this element will be based on the budget form
(SF-424A) and the associated detailed budget narrative.
[[Page 55351]]
Part V--Application Procedures
A. Availability of Forms
Attachments B through N contain all of the standard forms necessary
for the application for awards under this OCS program. These
attachments and Parts V and VI of this Announcement contain all the
instructions required for submittal of applications.
Additional copies may be obtained by writing or telephoning the
office listed under the section entitled FOR FURTHER INFORMATION
CONTACT: at the beginning of this announcement. In addition, this
Announcement is accessible on the Internet through the OCS website for
reading or downloading at the following address: www.acf.dhhs.gov/
programs/ocs/kits1.htm
The applicant must be aware that in signing and submitting the
application for this award, it is certifying that it will comply with
the Federal requirements concerning the Drug-Free workplace, Debarment
regulations and the Certification Regarding Environmental Tobacco
Smoke, set forth in Attachments E, F and J.
Part IV contains instructions for the substance and development of
the project narrative. Part VII, Section A describes the contents and
format of the application as a whole.
B. Application Submission
Mailing Address: JOLI Applications should be mailed to the U.S.
Department of Health and Human Services, Administration for Children
and Families, Office of Grants Management/OCSE, 4th Floor West,
Aerospace Center, 370 L'Enfant Promenade, SW, Washington, DC 20447;
Attention: Application for JOLI Program.
Number of Copies Required: One signed original application and four
copies should be submitted at the time of initial submission. (OMB-
0970-0062, expiration date October 31, 2001)
Submission Instructions: Mailed applications shall be considered as
meeting an announced deadline if they are either received on or before
the deadline date or sent on or before the deadline date and received
by ACF in time for the independent review.
Applications mailed must bear a legibly dated U.S. Postal Service
postmark or a legibly dated, machine produced postmark of a commercial
mail service affixed to the envelope/package containing the
application(s). To be acceptable as proof of timely mailing, a postmark
from a commercial mail service must include the logo/emblem of the
commercial mail service company and must reflect the date the package
was received by the commercial mail service company from the applicant.
Private metered postmarks shall not be acceptable as proof of timely
mailing. (Applicants are cautioned that express/overnight mail services
do not always deliver as agreed.)
Applications hand carried by applicants, applicant couriers, or by
other representatives of the applicant shall be considered as meeting
an announced deadline if they are received on or before the deadline
date, between the hours of 8 a.m. and 4:30 p.m., EST, and at the U.S.
Department of Health and Human Services, Administration for Children
and Families, Office of Grants Management/OCSE, ACF Mailroom, 2nd Floor
Loading Dock, Aerospace Center, 901 D Street, SW, Washington, DC 20024,
between Monday and Friday (excluding Federal holidays). The address
must appear on the envelope/ package containing the application with
the note: Attention: Application for JOLI Program. (Applicants are
again cautioned that express/overnight mail services do not always
deliver as agreed.)
ACF cannot accommodate transmission of applications by fax or
through other electronic media. Therefore, applications transmitted to
ACF electronically will not be accepted regardless of date or time of
submission and time of receipt.
Late Applications: Applications which do not meet the criteria
above are considered late applications. ACF shall notify each late
applicant that its application will not be considered in the current
competition.
Extension of Deadlines: ACF may extend application deadlines when
circumstances such as acts of God (flood, hurricanes, etc.) occur, or
when there are widespread disruptions of the mail service.
Determinations to extend or waive deadline requirements rest with ACF's
Chief Grants Management Officer.
C. Paperwork Reduction Act of 1995
Under the Paperwork Reduction Act of 1995, Public Law 104-13, the
Department is required to submit to OMB for review and approval any
reporting and record keeping requirements in regulations, including
Program Announcements. An agency may not conduct or sponsor, and a
person is not required to respond to, a collection of information
unless it displays a currently valid OMB control number. This Program
Announcement does not contain information collection requirements
beyond those approved for ACF grant announcements/applications under
OMB Control Number OMB-0970-0062, expiration date October 31, 2001.
D. Intergovernmental Review
This program is covered under Executive Order 12372,
``Intergovernmental Review of Federal Programs,'' and 45 CFR part 100,
``Intergovernmental Review of Department of Health and Human Services
Program and Activities.'' Under the Order, States may design their own
processes for reviewing and commenting on proposed Federal assistance
under covered programs.
Note: State/territory participation in the intergovernmental
review process does not signify applicant eligibility for financial
assistance under a program. A potential applicant must meet the
eligibility requirements of the program for which it is applying
prior to submitting an application to its single point of contact
(SPOC), if applicable, or to ACF.
As of March 5, 1999, the following jurisdictions have elected NOT
to participate in the Executive Order process:
Alabama, Alaska, Colorado, Connecticut, Hawaii, Idaho, Kansas,
Louisiana, Massachusetts, Minnesota, Montana, Nebraska, New Jersey,
Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Vermont,
Virginia, Washington, American Samoa, and Palau.
Applicants from these 24 jurisdictions need take no action
regarding E.O. 12372. Applicants for projects to be administered by
Federally recognized Indian Tribes are also exempt from the
requirements of E.O. 12372. Otherwise, applicants should contact their
SPOC as soon as possible to alert them of the prospective applications
and receive any necessary instructions. Applicants must submit any
required material to the SPOC as soon as possible so that the program
office can obtain and review SPOC comments as part of the award
process. It is imperative that the applicant submit all required
materials, if any, to the SPOC and indicate the date of this submittal
(or the date of contact if no submittal is required) on the Standard
Form 424, item 16a. Under 45 CFR 100.8(a)(2), a SPOC has sixty (60)
days from the application deadline to comment on proposed new or
competing continuation awards.
SPOCs are encouraged to eliminate the submission routine
endorsements as official recommendations. Additionally, SPOCs are
requested to differentiate clearly between mere advisory comments and
those official State process recommendations which may
[[Page 55352]]
trigger the ``accommodate or explain'' rule.
When comments are submitted directly to ACF, they should be
addressed to: Department of Health and Human Services, Administration
for Children and Families, Office of Grants Management/OCSE, 4th Floor
West, Aerospace Center, 370 L'Enfant Promenade, S.W., Washington, D.C.
20447.
A list of the SPOCs for each State and Territory is included as
Attachment G to this Announcement.
E. Application Consideration
Applications that meet the screening requirements below will be
reviewed competitively. Such applications will be referred to reviewers
for numerical scoring and explanatory comments based solely on
responsiveness to the guidelines and evaluation criteria published in
this Announcement.
Applications will be reviewed by persons outside of the OCS unit.
The results of these reviews will assist the Director and OCS program
staff in considering competing applications. Reviewers' scores will
weigh heavily in funding decisions, but will not be the only factors
considered.
Applications generally will be considered in order of the average
scores assigned by reviewers. However, highly ranked applications are
not guaranteed funding since other factors are taken into
consideration, including, but not limited to: The timely and proper
completion of projects funded with OCS funds granted in the last five
(5) years; comments of reviewers and government officials; staff
evaluation and input; the amount and duration of the grant requested
and the proposed project's consistency and harmony with OCS goals and
policy; geographic distribution of applications; previous program
performance of applicants; the limitations on project continuation or
refunding (see Part II, Section H); the number of previous JOLI grants
made to applicants; compliance with grant terms under previous HHS
grants, including the actual dedication to program of mobilized
resources as set forth in project applications; audit reports;
investigative reports; and applicant's progress in resolving any final
audit disallowance's on previous OCS or other Federal agency grants.
OCS reserves the right to discuss applications with other Federal
or non-Federal funding sources to verify the applicant's performance
record and the documents submitted.
F. Criteria for Screening Applications
All applications that meet the published deadline requirements as
provided in this Program Announcement will be screened for completeness
and conformity with the requirements. Only complete applications that
meet the requirements listed below will be reviewed and evaluated
competitively. Other applications will be returned to the applicant
with a notation that they were unacceptable and will not be reviewed.
The following requirements must be met by all applicants:
1. The application must contain a Standard Form 424 ``Application
for Federal Assistance'' (SF-424), a budget (SF-424A), and signed
``Assurances'' (SF-424B) completed according to instructions published
in Part VI and Attachments C and D, of this Program Announcement.
2. All JOLI applications must include a signed cooperative
partnership agreement within the designated State Agency responsible
for administering the TANF Program, or a letter of commitment to such
an agreement within six months of a grant award, contingent only on
receipt of OCS funds. This cooperative partnership agreement must fully
describe the role and/or responsibilities of each partner for specific
activities and/or services to be provided which must clearly relate to
the objectives of the proposed project.
3. A project narrative must also accompany the standard forms. OCS
requires that the narrative portion of the application be limited to 30
pages, typewritten on one side of the paper only with one-inch margins
and type face no smaller than 12 characters per inch (c.p.i.) or
equivalent. The Budget Narrative Charts, exhibits, resumes, position
descriptions, letters of support, cooperative agreements, and business
plans (where required) are not counted against this page limit. It is
strongly recommended that applicants follow the format and content for
the narrative set out in Part IV.
4. The SF-424 and the SF-424B must be signed by an official of the
organization applying for the grant who has authority to obligate the
organization legally. Applicants must also be aware that the
applicant's legal name as required on the SF-424 (Item 5) must match
that listed as corresponding to the Employer Identification Number
(Item 6).
5. Application must contain documentation of the applicant's tax
exempt status as required under Part II, Section A.
6. Written Agreement When Applicant Proposes to Make Equity
Investment or Loan: The application must contain a written third party
agreement, or a discussion of a proposed agreement, signed by the
applicant and the third party that includes all of the elements
required in Part III, Section N.
Part VI--Instructions for Completing the SF-424
(Approved by the Office of Management and Budget under Control
Number 0970-0062, expiration date October 31, 2001.)
The standard forms attached to this Announcement shall be used to
apply for funds under this Program Announcement.
It is suggested that you reproduce single-sided copies of the SF-
424 and SF-424A and type your application on the copies. Please prepare
your application in accordance with instructions provided on the forms
(Attachments B and C) as modified by the OCS specific instructions set
forth below:
Provide line item detail and detailed calculations for each budget
object class identified on the Budget Information form. Detailed
calculations must include estimation methods, quantities, unit costs,
and other similar quantitative detail sufficient for the calculation to
be duplicated. The detailed budget must also include a breakout by the
funding sources identified in Block 15 of the SF-424.
Provide a narrative budget justification, which describes how the
categorical costs are derived. Discuss the necessity, reasonableness,
and allocability of the proposed costs.
A. SF-424--Application for Federal Assistance
Top of Page. Please enter the single priority area number under
which the application is being submitted (1.0 or 2.0). An application
should be submitted under only one priority area.
Where the applicant is a previous Department of Health and Human
Services grantee, enter the Central Registry System Employee
Identification Number (CRS/EIN) and the Payment Identifying Number, if
one has been assigned, in the Block entitled Federal Identifier located
at the top right hand corner of the form.
Item 1. For the purposes of this Announcement, all projects are
considered Applications; there are no Pre-Applications.
Item 7. Enter N in the box and specify non-profit corporation on
the line marked Other.
Item 9. Name of Federal Agency--Enter HHS-ACF/OCS.
Item 10. The Catalog of Federal Domestic Assistance number for OCS
[[Page 55353]]
programs covered under this Announcement is 93.593. The title is ``Job
Opportunities for Low-Income Individuals Program''.
Item 11. In addition to a brief descriptive title of the project,
indicate the priority area for which funds are being requested. Use the
following letter designations:
JO--General Project
JS--Community Development Corporation Set-Aside
Item 13. ``Proposed Project''--The ending date should be based on
the requested project period, not to exceed three years (36 months).
Item 15a. This amount should be no greater than $500,000.
Item 15b-e. These items should reflect both cash and third-party,
in-kind contributions for the three year budget period requested.
B. ``SF-424A--Budget Information-Non-Construction Programs''
In completing these sections, the Federal Funds budget entries will
relate to the requested OCS funds only, and Non-Federal will include
mobilized funds from all other sources--applicant, state, local, and
other. Federal funds other than requested OCS funding should be
included in ``Non-Federal'' entries.
Section A, B, and C of SF-424A should reflect budget estimates for
each year of the budget period for which funding is being requested.
Section A--Budget Summary
You need only fill in lines 1 and 5 (with the same amounts) Column
(a): Enter Job Opportunities for Low-Income Individuals Program. Column
(b): Catalog of Federal Domestic Assistance number is 93.593.
--Columns (c) and (d): not relevant to this program.
--Columns (e)-(g): enter the appropriate amounts (column e should not
be more than $500,000).
Section B--Budget Categories
(Note that the following information supersedes the instructions
provided with the Form SF-424A in Attachment C)
Columns (1)-(5): For each of the relevant Object Class Categories:
--Column 1: Enter the OCS grant funds for the first year;
--Column 2: Enter the OCS grant funds for the second year (where
appropriate);
--Column 3: Enter the OCS grant funds for the third year (where
appropriate);
--Column 4: Leave Blank.
--Column 5: Enter the total Federal OCS grant funds for the total
budget period by Class Categories, showing a total budget of not more
than $500,000.
Note: With regard to Class Categories, only out-of-town travel
should be entered under Category c. Travel. Local travel costs
should be entered under Category h. Other. Equipment costing less
than $5000 should be included in Category e. Supplies.
Section C--Non-Federal Resources
This section is to record the amounts of ``non-Federal'' resources
that will be used to support the project. For the purposes of this
application, ``non-Federal'' resources means other than the OCS funds
for which the applicant is applying. Therefore, mobilized funds from
other Federal programs, such as the Job Training Partnership Act
program, should be entered on these lines. Provide a brief listing of
these ``non-Federal'' resources on a separate sheet and describe
whether it is a grantee-incurred cost or a third-party cash or in-kind
contribution. The firm commitment of these resources must be documented
and submitted with the application in order to be given credit in the
review process under the Public-Private Partnerships program element.
Except in unusual situations, this documentation must be in the
form of letters of commitment from the organization(s)/individual(s)
from which resources will be received.
Note: Even though there is no matching requirement for the JOLI
Program, grantees will be held accountable for any match, cash or
in-kind contribution proposed or pledged as part of an approved
application. (See Part IV, Element V.)
This Section should be completed in accordance with the
instructions provided.
Section D, E, and F may be left blank.
A supporting Budget Narrative must be submitted providing details
of expenditures under each budget category, and justification of dollar
amounts which relate the proposed expenditures to the work program and
goals of the project. (See Part IV, Element VI)
C. SF-424B Assurances--Non-Construction
All applicants must fill out, sign, date and return the
``Assurances'' with the application. (See Attachment D)
Part VII--Contents of Application and Receipt Process
A. Contents of Application
Each JOLI Application must include all of the following, in the
order listed below:
1. Table of Contents;
2. An Abstract of the Proposed Project--very brief, not to exceed
250 words, that would be suitable for use in an announcement that the
application has been selected for a grant award; which identifies the
type of project(s), the target population, and the major elements of
the work plan;
3. Completed Standard Form 424 which has been signed by an Official
of the organization applying for the grant who has authority to
obligate the organization legally;
Note: The original SF-424 must bear the original signature of
the authorizing representative of the applicant organization.)
4. Budget Information-Non-Construction Programs--(SF-424A);
5. A narrative budget justification for each object class category
required under Section B, SF-424A;
6. Certifications and Assurance Required for Non-Construction
Programs, as follows:
Applicants requesting financial assistance for a non-construction
project must file the Standard Form 424B, ``Assurances: Non-
Construction Programs''. Applicants must sign and return the Standard
Form 424B with their applications.
Applicants must provide a Certification Regarding Lobbying. Prior
to receiving an award in excess of $100,000, applicants shall furnish
an executed copy of the lobbying certification. Applicants must sign
and return the certification with their application.
Applicants must make the appropriate certification of their
compliance with the Drug-Free Workplace Act of 1988. By signing and
submitting the applications, applicants are providing the certification
and need not mail back the certification with the applications.
Applicants must make the appropriate certification that they are
not presently debarred, suspended or otherwise ineligible for award. By
signing and submitting the applications, applicants are providing the
certification and need not mail back the certification with the
applications. Copies of the certifications and assurance are located at
the end of this Announcement.
Applicants must make the appropriate certification of their
compliance with all Federal statutes relating to nondiscrimination. By
signing and submitting the applications, applicants are providing the
certification and need not mail back a certification form.
7. Certification Regarding Environmental Tobacco Smoke--Signature
on the application attests to the applicants intent to comply with the
requirements of the Pro-Children Act of 1994 (no signature required on
form).
8. A Project Narrative of no more than 30 pages, consisting of the
Elements
[[Page 55354]]
described in Part IV of this Announcement set forth in the order there
presented; preceded by a consecutively numbered Table of Contents (not
to be counted as part of the 30 pages).
9. Appendices--proof of non-profit tax-exempt status as outlined in
Part II, Section A; proof that the organization is a community
development corporation, if applying under the CDC Set-aside;
commitments from officials of businesses that will be expanded or
franchised, where applicable; partnership agreement with the designated
State TANF agency and CSE agency; Single Point of Contact comments, if
applicable; resumes and position descriptions; a Business Plan, where
required; and the Maintenance of Effort Certification (See Part II-J
and Attachment M).
The total number of pages for the narrative portion of the
application package must not exceed 30 pages, excluding Appendices and
Narrative Table of Contents. See Part V(f) (c) for pages that do not
count against the 30-page limit.
Pages should be numbered sequentially throughout, including
Appendices, beginning with the Abstract as Page 1. The application may
also contain letters that show collaboration or substantive commitments
to the project by organizations other than the designated TANF agency.
Such letters are not part of the narrative and should be included in
the Appendices. These letters are, therefore, not counted against the
30 page limit.
B. Application Format
Applications must be uniform in composition since OCS may find it
necessary to duplicate them for review purposes. Therefore,
applications must be submitted on white 8\1/2\ x 11 inch paper only.
Applications must not include colored, oversized or folded materials.
Applications should not include organizational brochures or other
promotional materials, slides, films, clips, etc., in the proposal.
Such material will not be reviewed and will be discarded if included.
Applications must be bound or enclosed in loose-leaf binder
notebooks. Preferably, applications should be two-holed punched at the
top center and fastened separately with a compressor slide paper
fastener, or a binder clip.
C Acknowledgment of Receipt
Applicants who meet the initial screening criteria outlined in Part
V, Section E, will receive within ten days after the deadline date for
submission of applications, an acknowledgment with an assigned
identification number. To facilitate receipt of this acknowledgment
from ACF, applicant is asked to include a cover letter with the
application containing an E-mail address and facsimile (FAX) number if
these items are available to applicant.
Applicants are requested to supply a self-addressed mailing label
with their application which can be attached to this acknowledgment
notice. This mailing label should reflect the mailing address of the
authorizing official who is applying on behalf of the organization.
This number and the program letter code, i.e., JO or JS, must be
referred to in all subsequent communications with OCS concerning the
application. If an acknowledgment is not received within three weeks
after the deadline date, please notify ACF by telephone (202) 401-5103.
Part VIII--Post Award Information and Reporting Requirements
A. Notification of Grant Award
Following approval of the application selected for funding, notice
of project approval and authority to draw down project funds will be
made in writing. The official award document is the Financial
Assistance Award, which provides the amount of Federal funds approved
for use in the project, the project and budget periods for which
support is provided, the terms and conditions of the award, and the
total project period for which support is contemplated.
B. Attendance at Evaluation Workshops
The Project Directors and third-party evaluators will be required
to attend two national evaluation workshops in Washington, DC. A three-
day program development and evaluation workshop will be scheduled
shortly after the effective date of the grant. They also will be
required to attend, as presenters, the final evaluation workshop on
utilization and dissemination to be held at the end of the project
period. Project budgets must include funds for travel to and attendance
at these workshops. (See Part IV, Element VI, Budget Appropriateness
and Reasonableness.)
C. Reporting Requirements
Grantees will be required to submit semi-annual program progress
and financial reports (SF 269) as well as a final program progress and
financial report within 90 days of the expiration of the grant. An
annual evaluation report will be due 30 days after each twelve months.
A written draft policies and procedures manual based on the finding of
the process evaluation should be submitted along with the first annual
evaluation report. A final evaluation report will be due 90 days after
the expiration of the grant.
D. Audit Requirements
Grantees are subject to the audit requirements in 45 CFR Part 74
(non-profit organization) and OMB Circular A-133.
E. Prohibitions and Requirements With Regard to Lobbying
Section 319 of Public Law 101-121, signed into law on October 23,
1989, imposes prohibitions and requirements for disclosure and
certification related to lobbying on recipients of Federal contracts,
grants, cooperative agreements, and loans. It provides limited
exemptions for Indian tribes and tribal organizations. Current and
prospective recipients (and their subtier contractors and/or grantees)
are prohibited from using appropriated funds for lobbying Congress or
any Federal agency in connection with the award of a contract, grant,
cooperative agreement or loan. In addition, for each award action in
excess of $100,000 (or $150,000 for loans) the law requires recipients
and their subtier contractors and/or subgrantees (1) to certify that
they have neither used nor will use any appropriated funds for payment
to lobbyists, (2) to submit a declaration setting forth whether
payments to lobbyists have been or will be made out of non-appropriated
funds and, if so, the name, address, payment details, and purpose of
any agreements with such lobbyists whom recipients or their subtier
contractors or subgrantees will pay with the non-appropriated funds and
(3) to file quarterly up-dates about the use of lobbyists if an event
occurs that materially affects the accuracy of the information
submitted by way of declaration and certification.
The law establishes civil penalties for noncompliance and is
effective with respect to contracts, grants, cooperative agreements and
loans entered into or made on or after December 23, 1989. See
Attachment H for certification and disclosure forms to be submitted
with the applications for this program.
F. Applicable Federal Regulations
Attachment K indicates the regulations that apply to all
applicants/grantees under the Job Opportunities for Low-Income
Individuals Program.
[[Page 55355]]
Dated: October 4, 1999.
Donald Sykes,
Director, Office of Community Services.
Job Opportunities for Low-Income Individuals; Attachments
A Poverty Income Guidelines for the 48 Contiguous States and the
District of Columbia
B Standard Form 424
C Standard Form 424A
D Standard Form 424B
E Certification Regarding Drug-Free Workplace Requirements
F Certification Regarding Debarment, Suspension and Other
Responsibility Matters
G State Single Point of Contact Listing Maintained by OMB
H Certification Regarding Lobbying Activities and Disclosure of
Lobbying Activities, SF-LLL
I State Human Services Administrators
J Certification Regarding Environmental Tobacco Smoke
K DHHS Regulations Applying to All Applicants/Grantees Under the
Job Opportunities for Low-Income Individuals (JOLI) Program
L Business Plan
M Certification Regarding Maintenance of Effort
N OCSE IV-D Report
O Applicant's Checklist
Attachment A
------------------------------------------------------------------------
Poverty
Size of family unit guideline
------------------------------------------------------------------------
1999 POVERTY GUIDELINES FOR THE 48 CONTIGUOUS STATES AND THE DISTRICT OF
COLUMBIA
------------------------------------------------------------------------
1.......................................................... $8,240
2.......................................................... 11,060
3.......................................................... 13,880
4.......................................................... 16,700
5.......................................................... 19,520
6.......................................................... 22,340
7.......................................................... 25,160
8.......................................................... 27,980
------------------------------------------------------------------------
For family units with more than 8 members, add $2,820 for each
additional member. (The same increment applies to smaller family sizes
also, as can be seen in the figures above).
------------------------------------------------------------------------
1999 POVERTY GUIDELINES FOR ALASKA
------------------------------------------------------------------------
1.......................................................... 10,320
2.......................................................... 13,840
3.......................................................... 17,360
4.......................................................... 20,880
5.......................................................... 24,400
6.......................................................... 27,920
7.......................................................... 31,440
8.......................................................... 34,960
------------------------------------------------------------------------
For family units with more than 8 members, add $3,520 for each
additional member. (The same increment applies to smaller family sizes
also, as can be seen in the figures above).
------------------------------------------------------------------------
1999 POVERTY GUIDELINES FOR HAWAII
------------------------------------------------------------------------
1.......................................................... 9,490
2.......................................................... 12,730
3.......................................................... 15,970
4.......................................................... 19,210
5.......................................................... 22,450
6.......................................................... 25,690
7.......................................................... 28,930
8.......................................................... 32,170
------------------------------------------------------------------------
For family units with more than 8 members, add $3,240 for each
additional member. (The same increment applies to smaller family sizes
also, as can be seen in the figures above).
------------------------------------------------------------------------
BILLING CODE 4184-01-P
[[Page 55356]]
[GRAPHIC] [TIFF OMITTED] TN12OC99.000
BILLING CODE 4184-01-C
[[Page 55357]]
Instructions for the SF-424
Public reporting burden for this collection of information is
estimated to average 45 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding the burden
estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of
Management and Budget, Paperwork Reduction Project (0348-0043),
Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF
MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE
SPONSORING AGENCY.
This is a standard form used by applicants as a required
facesheet for preapplications and applications submitted for Federal
assistance. It will be used by Federal agencies to obtain applicant
certification that States which have established a review and
comment procedure in response to Executive Order 12372 and have
selected the program to be included in their process, have been
given an opportunity to review the applicant's submission.
Item and Entry
1. Self-explanatory.
2. Date application submitted to Federal agency (or State if
applicable) and applicant's control number (if applicable).
3. State use only (if applicable).
4. If this application is to continue or revise an existing
award, enter present Federal identifier number. If for a new
project, leave blank.
5. Legal name of applicant, name of primary organizational unit
which will undertake the assistance activity, complete address of
the applicant, and name and telephone number of the person to
contact on matters related to this application.
6. Enter Employer Identification Number (EIN) as assigned by the
Internal Revenue Service.
7. Enter the appropriate letter in the space provided.
8. Check appropriate box and enter appropriate letter(s) in the
space(s) provided.
--``New'' means a new assistance award.
--``Continuation'' means an extension for an additional funding/
budget period for a project with a projected completion date.
--``Revision'' means any change in the Federal Government's
financial obligation or contingent liability from an existing
obligation.
9. Name of Federal agency from which assistance is being
requested with this application.
10. Use the Catalog of Federal Domestic Assistance number and
title of the program under which assistance is requested.
11. Enter a brief descriptive title of the project. If more than
one program is involved, you should append an explanation on a
separate sheet. If appropriate (e.g., construction or real property
projects), attach a map showing project location. For
preapplications, use a separate sheet to provide a summary
description of this project.
12. List only the largest political entities affected (e.g.,
State, counties, cities).
13. Self-explanatory.
14. List the applicant's Congressional District and any
District(s) affected by the program or project.
15. Amount requested or to be contributed during the first
funding/budget period by each contributor. Value of in-kind
contributions should be included on appropriate lines as applicable.
If the action will result in a dollar change to an existing award,
indicate only the amount of the change. For decreases, enclose the
amounts in parentheses. If both basic and supplemental amounts are
included, show breakdown on an attached sheet. For multiple program
funding, use totals and show breakdown using same categories as item
15.
16. Applicants should contact the State Single Point of Contact
(SPOC) for Federal Executive Order 12372 to determine whether the
application is subject to the State intergovernmental review
process.
17. This question applies to the applicant organization, not the
person who signs as the authorized representative. Categories of
debt include delinquent audit disallowances, loans and taxes.
18. To be signed by the authorized representative of the
applicant. A copy of the governing body's authorization for you to
sign this application as official representative must be on file in
the applicant's office. (Certain Federal agencies may require that
this authorization be submitted as part of the application.)
BILLING CODE 4184-01-M
[[Page 55358]]
[GRAPHIC] [TIFF OMITTED] TN12OC99.001
[[Page 55359]]
[GRAPHIC] [TIFF OMITTED] TN12OC99.002
BILLING CODE 4184-01-C
[[Page 55360]]
Instructions for the SF-424A
Public reporting burden for this collection of information is
estimated to average 180 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding the burden
estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of
Management and Budget, Paperwork Reduction Project (0348-0044),
Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF
MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE
SPONSORING AGENCY.
General Instructions
This form is designed so that application can be made for funds
from one or more grant programs. In preparing the budget, adhere to
any existing Federal grantor agency guidelines which prescribe how
and whether budgeted amounts should be separately shown for
different functions or activities within the program. For some
programs, grantor agencies may require budgets to be separately
shown by function or activity. For other programs, grantor agencies
may require a breakdown by function or activity. Sections A, B, C,
and D should include budget estimates for the whole project except
when applying for assistance which requires Federal authorization in
annual or other funding period increments. In the latter case,
Sections A, B, C, and D should provide the budget for the first
budget period (usually a year) and Section E should present the need
for Federal assistance in the subsequent budget periods. All
applications should contain a breakdown by the object class
categories shown in Lines a-k of Section B.
Section A. Budget Summary Lines 1-4, Columns (a) and (b)
For applications pertaining to a single Federal grant program
(Federal Domestic Assistance Catalog number) and not requiring a
functional or activity breakdown, enter on Line 1 under Column (a)
the Catalog program title and the Catalog number in Column (b).
For applications pertaining to a single program requiring budget
amounts by multiple functions or activities, enter the name of each
activity or function on each line in Column (a), and enter the
Catalog number in Column (b). For applications pertaining to
multiple programs where none of the programs require a breakdown by
function or activity, enter the Catalog program title on each line
in Column (a) and the respective Catalog number on each line in
Column (b).
For applications pertaining to multiple programs where one or
more programs require a breakdown by function or activity, prepare a
separate sheet for each program requiring the breakdown. Additional
sheets should be used when one form does not provide adequate space
for all breakdown of data required. However, when more than one
sheet is used, the first page should provide the summary totals by
programs.
Lines 1-4, Columns (c) Through (g)
For new applications, leave Column (c) and (d) blank. For each
line entry in Columns (a) and (b), enter in Columns (e), (f), and
(g) the appropriate amounts of funds needed to support the project
for the first funding period (usually a year).
For continuing grant program applications, submit these forms
before the end of each funding period as required by the grantor
agency. Enter in Columns (c) and (d) the estimated amounts of funds
which will remain unobligated at the end of the grant funding period
only if the Federal grantor agency instructions provide for this.
Otherwise, leave these columns blank. Enter in columns (e) and (f)
the amounts of funds needed for the upcoming period. The amount(s)
in Column (g) should be the sum of amounts in Columns (e) and (f).
For supplemental grants and changes to existing grants, do not
use Columns (c) and (d). Enter in Column (e) the amount of the
increase or decrease of Federal funds and enter in Column (f) the
amount of the increase or decrease of non-Federal funds. In Column
(g) enter the new total budgeted amount (Federal and non-Federal)
which includes the total previous authorized budgeted amounts plus
or minus, as appropriate, the amounts shown in Columns (e) and (f).
The amount(s) in Column (g) should not equal the sum of amounts in
Columns (e) and (f).
Line 5--Show the Totals for All Columns Used
Section B. Budget Categories
In the column headings (1) through (4), enter the titles of the
same programs, functions, and activities shown on Lines 1-4, Column
(a), Section A. When additional sheets are prepared for Section A,
provide similar column headings on each sheet. For each program,
function or activity, fill in the total requirements for funds (both
Federal and non-Federal) by object class categories.
Line 6a-i--Show the totals of Lines 6a to 6h in each column.
Line 6j--Show the amount of indirect cost.
Line 6k--Enter the total of amounts on Lines 6i and 6j. For all
applications for new grants and continuation grants the total amount
in column (5), Line 6k, should be the same as the total amount shown
in Section A, Column (g), Line 5. For supplemental grants and
changes to grants, the total amount of the increase or decrease as
shown in Columns (1)-(4), Line 6k should be the same as the sum of
the amounts in Section A, Columns (e) and (f) on Line 5.
Line 7--Enter the estimated amount of income, if any, expected
to be generated from this project. Do not add or subtract this
amount from the total project amount. Show under the program
narrative statement the nature and source of income. The estimated
amount of program income may be considered by the Federal grantor
agency in determining the total amount of the grant.
Section C. Non-Federal Resources
Lines 8-11 Enter amounts of non-Federal resources that will be
used on the grant. If in-kind contributions are included, provide a
brief explanation on a separate sheet.
Column (a)--Enter the program titles identical to Column (a),
Section A. A breakdown by function or activity is not necessary.
Column (b)--Enter the contribution to be made by the applicant.
Column (c)--Enter the amount of the State's cash and in-kind
contribution if the applicant is not a State or State agency.
Applicants which are a State or State agencies should leave this
column blank.
Column (d)--Enter the amount of cash and in-kind contributions
to be made from all other sources.
Column (e)--Enter totals of Columns (b), (c), and (d).
Line 12--Enter the total for each of Columns (b)-(e). The amount
in Column (e) should be equal to the amount on Line 5, Column (f),
Section A.
Section D. Forecasted Cash Needs
Line 13--Enter the amount of cash needed by quarter from the
grantor agency during the first year.
Line 14--Enter the amount of cash from all other sources needed
by quarter during the first year.
Line 15--Enter the totals of amounts on Lines 13 and 14.
Seciton E. Budget Estimates of Federal Funds Needed for Balance of
the Project
Lines 16-19--Enter in Column (a) the same grant program titles
shown in Column (a), Section A. A breakdown by function or activity
is not necessary. For new applications and continuation grant
applications, enter in the proper columns amounts of Federal funds
which will be needed to complete the program or project over the
succeeding funding periods (usually in years). This section need not
be completed for revisions (amendments, changes, or supplements) to
funds for the current year of existing grants.
If more than four lines are needed to list the program titles,
submit additional schedules as necessary.
Line 20--Enter the total for each of the Columns (b)-(e). When
additional schedules are prepared for this Section, annotate
accordingly and show the overall totals on this line.
Section F. Other Budget Information
Line 21--Use this space to explain amounts for individual direct
object class cost categories that may appear to be out of the
ordinary or to explain the details as required by the Federal
grantor agency.
Line 22--Enter the type of indirect rate (provisional,
predetermined, final or fixed) that will be in effect during the
funding period, the estimated amount of the base to which the rate
is applied, and the total indirect expense.
Line 23--Provide any other explanations or comments deemed
necessary.
Attachment D
Assurancs--Non-Construction Programs
Public reporting burden for this collection of information is
estimated to average 15 minutes per response, including time for
reviewing instructions, searching existing
[[Page 55361]]
data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. Send
comments regarding the burden estimate or any other aspect of this
collection of information, including suggestions for reducing this
burden, to the Office of Management and Budget, Paperwork Reduction
Project (0348-0040), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF
MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE
SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your
project or program. If you have questions, please contact the
awarding agency. Further, certain Federal awarding agencies may
require applicants to certify to additional assurances. If such is
the case, you will be notified.
As the duly authorized representative of the applicant, I
certify that the applicant:
1. Has the legal authority to apply for Federal assistance and
the institutional, managerial and financial capability (including
funds sufficient to pay the non-Federal share of project cost) to
ensure proper planning, management and completion of the project
described in this application.
2. Will give the awarding agency, the Comptroller General of the
United States and, if appropriate, the State, through any authorized
representative, access to and the right to examine all records,
books, papers, or documents related to the award; and will establish
a proper accounting system in accordance with generally accepted
accounting standards or agency directives.
3. Will establish safeguards to prohibit employees from using
their positions for a purpose that constitutes or presents the
appearance of personal or organizational conflict of interest, or
personal gain.
4. Will initiate and complete the work within the applicable
time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970
(42 U.S.C. Secs. 4728-4763) relating to prescribed standards for
merit systems for programs funded under one of the 19 statutes or
regulations specified in Appendix A of OPMs's Standards for a Merit
System of Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all Federal statutes relating to
nondiscrimination. These include but are not limited to: (a) Title
VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits
discrimination on the basis of race, color or national origin; (b)
Title IX of the Education Amendments of 1972, as amended (20 U.S.C.
Secs. 1681-1683, and 1685-1686), which prohibits discrimination on
the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973,
as amended (29 U.S.C. Sec. 794), which prohibits discrimination on
the basis of handicaps; (d) the Age Discrimination Act of 1975, as
amended (42 U.S.C. Secs. 6101-6107), which prohibits discrimination
on the basis of age; (e) the Drug Abuse Office and Treatment Act of
1972 (P.L. 92-255), as amended, relating to nondiscrimination on the
basis of drug abuse; (f) the Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation Act of 1970
(P.L. 91-616), as amended, relating to nondiscrimination on the
basis of alcohol abuse or alcoholism; (g) Secs. 523 and 527 of the
Public Health Service Act of 1912 (42 U.S.C. Secs. 290 dd-3 and 290
ee-3), as amended, relating to confidentiality of alcohol and drug
abuse patient records; (h) Title VIII of the Civil Rights Act of
1968 (42 U.S.C. Secs. 3601 et seq.), as amended, relating to
nondiscrimination in the sale, rental or financing of housing; (i)
any other nondiscrimination provisions in the specific statute(s)
under which application for Federal assistance is being made; and,
(j) the requirements of any other nondiscrimination statute(s) which
may apply to the application.
7. Will comply, or has already complied, with the requirements
of Title II and III of the Uniform Relocation Assistance and Real
Property Acquisition Policies Act of 1970 (P.L. 91-646) which
provide for fair and equitable treatment of persons displaced or
whose property is acquired as a result of Federal or federally-
assisted programs. These requirements apply to all interests in real
property acquired for project purposes regardless of Federal
participation in purchases.
8. Will comply, as applicable, with provisions of the Hatch Act
(5 U.S.C. Secs. 1501-1508 and 7324-7328) which limit the political
activities of employees whose principal employment activities are
funded in whole or in part with Federal funds.
9. Will comply, as applicable, with the provisions of the Davis-
Bacon Act (40 U.S.C. Secs. 276a to 276a-7), the Copeland Act (40
U.S.C. Sec. 276c and 18 U.S.C. Sec. 874), and the Contract Work
Hours and Safety Standards Act (40 U.S.C. Secs. 327-333), regarding
labor standards for federally-assisted construction subagreements.
10. Will comply, if applicable, with flood insurance purchase
requirements of Section 102(a) of the Flood Disaster Protection Act
of 1973 (P.L. 93-234) which requires recipients in a special flood
hazard area to participate in the program and to purchase flood
insurance if the total cost of insurable construction and
acquisition is $10,000 or more.
11. Will comply with environmental standards which may be
prescribed pursuant to the following: (a) Institution of
environmental quality control measures under the National
Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order
(EO) 11514; (b) notification of violating facilities pursuant to EO
11738; (c) protection of wetlands pursuant to EO 11990; (d)
evaluation of flood hazards in floodplains in accordance with EO
11988; (e) assurance of project consistency with the approved State
management program developed under the Coastal Zone Management Act
of 1972 (16 U.S.C. Secs. 1451 et seq.); (f) conformity of Federal
actions to State (Clean Air) Implementation Plans under Section
176(c) of the Clean Air Act of 1955, as amended (42 U.S.C.
Secs. 7401 et seq.); (g) protection of underground sources of
drinking water under the Safe Drinking Water Act of 1974, as amended
(P.L. 93-523); and, (h) protection of endangered species under the
Endangered Species Act of 1973, as amended (P.L. 93-205).
12. Will comply with the Wild and Scenic Rivers Act of 1968 (16
U.S.C. Secs. 1271 et seq.) related to protecting components or
potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with
Section 106 of the National Historic Preservation Act of 1966, as
amended (16 U.S.C. Sec. 470), EO 11593 (identification and
protection of historic properties), and the Archaeological and
Historic Preservation Act of 1974 (16 U.S.C. Secs. 469a-1 et seq.).
14. Will comply with P.L. 93-348 regarding the protection of
human subjects involved in research, development, and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966
(P.L. 89-544, as amended, 7 U.S.C. Secs. 2131 et seq.) pertaining to
the care, handling, and treatment of warm blooded animals held for
research, teaching, or other activities supported by this award of
assistance.
16. Will comply with the Lead-Based Paint Poisoning Prevention
Act (42 U.S.C. Secs. 4801 et seq.) which prohibits the use of lead-
based paint in construction or rehabilitation of residence
structures.
17. Will cause to be performed the required financial and
compliance audits in accordance with the Single Audit Act Amendments
of 1996 and OMB Circular No. A-133, ``Audits of States, Local
Governments, and Non-Profit Organizations.''
18. Will comply with all applicable requirements of all other
Federal laws, executive orders, regulations, and policies governing
this program.
----------------------------------------------------------------------
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
----------------------------------------------------------------------
TITLE
----------------------------------------------------------------------
APPLICANT ORGANIZATOIN
----------------------------------------------------------------------
DATE SUBMITTED
Certification Regarding Drug-Free Workplace Requirements
This certification is required by the regulations implementing
the Drug-Free Workplace Act of 1988: 45 CFR Part 76, Subpart, F.
Sections 76.630(c) and (d)(2) and 76.645(a)(1) and (b) provide that
a Federal agency may designate a central receipt point for STATE-
WIDE AND STATE AGENCY-WIDE certifications, and for notification of
criminal drug convictions. For the Department of Health and Human
Services, the central pint is: Division of Grants Management and
Oversight, Office of Management and Acquisition, Department of
Health and Human Services, Room 517-D, 200 Independence Avenue, SW,
Washington, DC 20201.
[[Page 55362]]
Certification Regarding Drug-Free Workplace Requirements (Instructions
for Certification)
1. By signing and/or submitting this application or grant
agreement, the grantee is providing the certification set out below.
2. The certification set out below is a material representation
of fact upon which reliance is placed when the agency awards the
grant. If it is later determined that the grantee knowingly rendered
a false certification, or otherwise violates the requirements of the
Drug-Free Workplace Act, the agency, in addition to any other
remedies available to the Federal Government, may take action
authorized under the Drug-Free Workplace Act.
3. For grantees other than individuals, Alternate I applies.
4. For grantees who are individuals, Alternate II applies.
5. Workplaces under grants, for grantees other than individuals,
need not be identified on the certification. If known, they may be
identified in the grant application, If the grantee does not
identify the workplaces at the time of application, or upon award,
if there is no application, the grantee must keep the identity of
the workplace(s) on file in its office and make the information
available for Federal inspection. Failure to identify all known
workplaces constitutes a violation of the grantee's drug-free
workplace requirements.
6. Workplace identifications must include the actual address of
buildings (or parts of buildings) or other sites where work under
the grant takes place. Categorical descriptions may be used (e.g.,
all vehicles of a mass transit authority or State highway department
while in operation, State employees in each local unemployment
office, performers in concert halls or radio studios).
7. If the workplace identified to the agency changes during the
performance of the grant, the grantee shall inform the agency of the
change(s), if it previously identified the workplaces in question
(see paragraph five).
8. Definitions of terms in the Nonprocurement Suspension and
Debarment common rule and Drug-Free Workplace common rule apply to
this certification. Grantees' attention is called, in particular, to
the following definitions from these rules:
Controlled substance means a controlled substance in Schedules I
through V of the Controlled Substances Act (21 U.S.C. 812) and as
further defined by regulation (21 CFR 1308.11 through 1308.15);
Conviction means a finding of guilt (including a pea of nolo
contendere) or imposition of sentence, or both, by any judicial body
charged with the responsibility to determine violations of the
Federal or State criminal drug statutes;
Criminal drug statute means a Federal or non-Federal criminal
statute involving the manufacture, distribution, dispensing, use, or
possession of any controlled substance;
Employee means the employee of a grantee directly engaged in the
performance of work under a grant, including: (i) All direct charge
employees; (ii) All indirect charge employees unless their impact or
involvement is insignificant to the performance of the grant; and,
(iii) Temporary personnel and consultants who are directly engaged
in the performance of work under the grant and who are on the
grantee's payroll. This definition does not include workers not on
the payroll of the grantee (e.g., volunteers, even if used to meet a
matching requirement; consultants or independent contractors not on
the grantee's payroll; or employees of subrecipients or
subcontractors in covered workplaces).
Certification Regarding Drug-Free Workplace Requirements
Alternate I. (Grantees Other Than Individuals)
The grantee certifies that it will or will continue to provide a
drug-free workplace by:
(a) Publishing a statement notifying employees that the unlawful
manufacture, distribution, dispensing, possession, or use of a
controlled substance is prohibited in the grantee's workplace and
specifying the actions that will be taken against employees for
violation of such prohibition;
(b) Establishing an ongoing drug-free awareness program to
inform employees about:
(1) The dangers of drug abuse in the workplace;
(2) The grantee's policy of maintaining a drug-free workplace;
(3) Any available drug counseling, rehabilitation, and employee
assistance programs; and
(4) The penalties that may be imposed upon employees for drug
abuse violations occurring in the workplace;
(c) Making it a requirement that each employee to be engaged in
the performance of the grant be given a copy of the statement
required by paragraph (a);
(d) Notifying the employee in the statement required by
paragraph (a) that, as condition of employment under the grant, the
employee will--
(1) Abide by the terms of the statement; and
(2) Notify the employer in writing of his or her conviction for
a violation of a criminal drug statute occurring in the workplace no
later than five calendar days after such conviction;
(e) Notifying the agency in writing, within ten calendar days
after receiving notice under paragraph (d)(2) from an employee or
otherwise receiving actual notice of such conviction. Employers of
convicted employees must provide notice, including position title,
to every grant officer or other designee on whose grant activity the
convicted employee was working, unless the Federal agency has
designated a central point for the receipt of such notices. Notice
shall include the identification number(s) of each affected grant;
(f) Taking one of the following actions, within 30 calendar days
of receiving notice under paragraph (d)(2), with respect to any
employee who is so convicted--
(1) Taking appropriate personnel action against such an
employee, up to and including termination, consistent with the
requirements of the Rehabilitation Act of 1973, as amended; or
(2) Requiring such employee to participate satisfactorily in a
drug abuse assistance or rehabilitation program approved for such
purposes by a Federal, State, or local health, law enforcement, or
other appropriate agency;
(g) Making a good faith effort to continue to maintain a drug-
free workplace through implementation of paragraphs (a), (b), (c),
(d), (e) and (f).
(B) The grantee may insert in the space provided below the
site(s) for the performance of work done in connection with the
specific grant:
Place of Performance (Street address, city, country, state, zip
code)
----------------------------------------------------------------------
----------------------------------------------------------------------
Check if there are workplaces on file that are not identified
here.
Alternate II. (Grantees Who Are Individuals)
(a) The grantee certifies that, as a condition of the grant, he
or she will not engage in the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance in
conducting any activity with the grant;
(b) If convicted of a criminal drug offense resulting from a
violation occurring during the conduct of any grant activity, he or
she will report the conviction, in writing, within 10 calendar days
of the conviction, to every grant officer or other designee, unless
the Federal agency designates a central point for the receipt of
such notices. When notice is made to such a central point, it shall
include the identification number(s) of each affected grant.
[55 FR 21690, 21702, May 25, 1990]
Attachment F
Certification Regarding Debarment, Suspension and Other Responsibility
Matters
Certification Regarding Debarment, Suspension, and Other Responsibility
Matters--Primary Covered Transactions
Instructions for Certification
1. By signing and submitting this proposal, the prospective
primary participant is providing the certification set out below.
2. The inability of a person to provide the certification
required below will not necessarily result in denial of
participation in this covered transaction. The prospective
participant shall submit an explanation of why it cannot provide the
certification set out below. The certification or explanation will
be considered in connection with the department or agency's
determination whether to enter into this transaction. However,
failure of the prospective primary participant to furnish a
certification or an explanation shall disqualify such person from
participation in this transaction.
3. The certification in this clause is a material representation
of fact upon which reliance was placed when the department or agency
determined to enter into this transaction. If it is later determined
that the prospective primary participant knowingly rendered an
erroneous certification, in addition to other remedies available to
the Federal Government, the department or agency may terminate this
transaction for cause or default.
4. The prospective primary participant shall provide immediate
written notice to the
[[Page 55363]]
department or agency to which this proposal is submitted if at any
time the prospective primary participant learns that its
certification was erroneous when submitted or has become erroneous
by reason of changed circumstances.
5. The terms covered transaction, debarred, suspended,
ineligible, lower tier covered transaction, participant, person,
primary covered transaction, principal, proposal, and voluntarily
excluded, as used in this clause, have the meanings set out in the
Definitions and Coverage sections of the rules implementing
Executive Order 12549. You may contact the department or agency to
which this proposal is being submitted for assistance in obtaining a
copy of those regulations.
6. The perspective primary participant agrees by submitting this
proposal that, should the proposed covered transaction be entered
into, it shall not knowingly enter into any lower tier covered
transaction with a person who is proposed for debarment under 48 CFR
part 9, subpart 9.4, debarred, suspended, declared ineligible, or
voluntarily excluded from participation in this covered transaction,
unless authorized by the department or agency entering into this
transaction.
7. The prospective primary participant further agrees by
submitting this proposal that it will include the clause titled
``Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion-Lower Tier Covered Transaction,'' provided by
the department or agency entering into this covered transaction,
without modification, in all lower tier covered transactions and in
all solicitations for lower tier covered transactions.
8. A participant in a covered transaction may rely upon a
certification of a prospective participant in a lower tier covered
transaction that it is not proposed for debarment under 48 CFR part
9, subpart 9.4, debarred, suspended, ineligible, or voluntarily
excluded from the covered transaction, unless it knows that the
certification is erroneous. A participant may decide the method and
frequency by which it determines the eligibility of its principals.
Each participant may, but is not required to, check the List of
Parties Excluded from Federal Procurement and Nonprocurement
Programs.
9. Nothing contained in the foregoing shall be construed to
require establishment of a system of records in order to render in
good faith the certification required by this clause. The knowledge
and information of a participant is not required to exceed that
which is normally possessed by a prudent person in the ordinary
course of business dealings.
10. Except for transactions authorized under paragraph 6 of
these instructions, if a participant in a covered transaction
knowingly enters into a lower tier covered transaction with a person
who is proposed for debarment under 48 CFR part 9, subpart 9.4,
suspended, debarred, ineligible, or voluntarily excluded from
participation in this transaction, in addition to other remedies
available to the Federal Government, the department or agency may
terminate this transaction for cause or default.
Certification Regarding Debarment, Suspension, and Other Responsibility
Matters--Primary Covered Transactions
(1) The prospective primary participant certifies to the best of
its knowledge and belief, that it and its principles:
(a) Are not presently debarred, suspended, proposed for
debarment, declared ineligible, or voluntarily excluded by any
Federal department or agency:
(b) Have not within a three-year period preceding this proposal
been convicted of or had a civil judgment rendered against them for
commission of fraud or a criminal offense in connection with
obtaining, attempting to obtain, or performing a public (Federal,
State or local) transaction or contract under a public transaction;
violation of Federal or State antitrust statutes or commission of
embezzlement, theft, forgery, bribery, falsification or destruction
of records, making false statements, or receiving stolen property;
(c) Are not presently indicted for or otherwise criminally or
civilly charged by a governmental entity (Federal, State or local)
with commission of any of the offenses enumerated in paragraph
(1)(b) of this certification; and
(d) Have not within a three-year period preceding this
application/proposal had one or more public transactions (Federal,
State or local) terminated for cause or default.
(2) Where the prospective primary participant is unable to
certify to any of the statements in this certification, such
prospective participant shall attach an explanation to this
proposal.
Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion--Lower Tier Covered Transactions
Instructions for Certification
1. By signing and submitting this proposal, the prospective
lower tier participant is providing the certification set out below.
2. The certification in this clause is a material representation
of fact upon which reliance was placed when this transaction was
entered into. If it is later determined that the prospective lower
tier participant knowingly rendered an erroneous certification, in
addition to other remedies available to the Federal Government the
department or agency with which this transaction originated may
pursue available remedies, including suspension and/or debarment.
3. The prospective lower tier participant shall provide
immediate written notice to the person to which this proposal is
submitted if at any time the prospective lower tier participant
learns that its certification was erroneous when submitted or had
become erroneous by reason of changed circumstances.
4. The terms covered transaction, debarred, suspended,
ineligible, lower tier covered transaction, participant, person,
primary covered transaction, principal, proposal, and voluntarily
excluded, as used in this clause, have the meaning set out in the
Definitions and Coverage sections of rules implementing Executive
Order 12549. You may contact the person to which this proposal is
submitted for assistance in obtaining a copy of those regulations.
5. The prospective lower tier participant agrees by submitting
this proposal that, [[Page 33043]] should the proposed covered
transaction be entered into, it shall not knowingly enter into any
lower tier covered transaction with a person who is proposed for
debarment under 48 CFR part 9, subpart 9.4, debarred, suspended,
declared ineligible, or voluntarily excluded from participation in
this covered transaction, unless authorized by the department or
agency with which this transaction originated.
6. The prospective lower tier participant further agrees by
submitting this proposal that it will include this clause titled
``Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion-Lower Tier Covered Transaction,'' without
modification, in all lower tier covered transactions and in all
solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a
certification of a prospective participant in a lower tier covered
transaction that it is not proposed for debarment under 48 CFR part
9, subpart 9.4, debarred, suspended, ineligible, or voluntarily
excluded from covered transactions, unless it knows that the
certification is erroneous. A participant may decide the method and
frequency by which it determines the eligibility of its principals.
Each participant may, but is not required to, check the List of
Parties Excluded from Federal Procurement and Nonprocurement
Programs.
8. Nothing contained in the foregoing shall be construed to
require establishment of a system of records in order to render in
good faith the certification required by this clause. The knowledge
and information of a participant is not required to exceed that
which is normally possessed by a prudent person in the ordinary
course of business dealings.
9. Except for transactions authorized under paragraph 5 of these
instructions, if a participant in a covered transaction knowingly
enters into a lower tier covered transaction with a person who is
proposed for debarment under 48 CFR part 9, subpart 9.4, suspended,
debarred, ineligible, or voluntarily excluded from participation in
this transaction, in addition to other remedies available to the
Federal Government, the department or agency with which this
transaction originated may pursue available remedies, including
suspension and/or debarment.
Certification Regarding Debarment, Suspension, Ineligibility an
Voluntary Exclusion--Lower Tier Covered Transactions
(1) The prospective lower tier participant certifies, by
submission of this proposal, that neither it nor its principals is
presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from participation in this
transaction by any Federal department or agency.
(2) Where the prospective lower tier participant is unable to
certify to any of the statements in this certification, such
[[Page 55364]]
prospective participant shall attach an explanation to this
proposal.
Attachment G
State Single Point of Contact Listing Maintained by OMB
In accordance with Executive Order #12372, ``Intergovernmental
Review of Federal Programs,'' Section 4, ``the Office of Management
and Budget (OMB) shall maintain a list of official State entities
designated at the States to review and coordinate proposed Federal
financial assistance and direct Federal development.'' This attached
listing is the OFFICIAL OMB LISTING. This listing is also published
in the Catalogue of Federal Domestic Assistance biannually.
August 23, 1999
OMB State Single Point of Contact Listing*
Arizona
Joni Saad
Arizona State Clearinghouse
3800 N. Central Avenue
Fourteenth Floor
Phoenix, Arizona 85012
Telephone: (602) 280-1315
FAX: (602) 280-8144
Arkansas
Mr. Tracy L. Copeland
Manager, State Clearinghouse
Office of Intergovernmental Services
Department of Finance and Administration
515 W. 7th St., Room 412
Little Rock, Arkansas 72203
Telephone: (501) 682-1074
FAX: (501) 682-5206
California
Grants Coordination
State Clearinghouse
Office of Planning & Research
1400 Tenth Street, Room 121
Sacramento, California 95814
Telephone: (916) 445-0613
FAX: (916) 323-3018
Delaware
Francine Booth
State Single Point of Contact
Executive Department
Office of the Budget
540 S. Dupont Highway
Suite 5
Dover, Delaware 19901
Telephone: (302) 739-3326
FAX: (302) 739-5661
District of Columbia
Charles Nichols
State Single Point of Contact
Office of Grants Mgmt. & Dev.
717 14th Street, N.W. Suite 1200
Washington, D.C. 20005
Telephone: (202) 727-1700 (direct)
(202) 727-6537 (secretary)
FAX: (202) 727-1617
Florida
Florida State Clearinghouse
Department of Community Affairs
2555 Shumard Oak Blvd.
Tallahassee, Florida 32399-2100
Telephone: (850) 922-5438
FAX: (850) 414-0479
Contact: Cherie Trainor
(850) 414-5495
Georgia
Deborah Stephens
Coordinator
Georgia State Clearinghouse
270 Washington Street, S.W.--8th Floor
Atlanta, Georgia 30334
Telephone: (404) 656-3855
FAX: (404) 656-7901
Illinois
Virginia Bova, State Single Point of Contact
Illinois Department of Commerce and Community Affairs
James R. Thompson Center
100 West Randolph, Suite 3-400
Chicago, Illinois 60601
Telephone: (312) 814-6028
FAX (312) 814-1800
Indiana
Renee Miller
State Budget Agency
212 State House
Indianapolis, Indiana 46204-2796
Telephone: (317) 232-2971 (directline)
FAX: (317) 233-3323
Iowa
Steven R. McCann
Division for Community Assistance
Iowa Department of Economic Development
200 East Grand Avenue
Des Monies, Iowa 50309
Telephone: (515) 242-4719
FAX: (515) 242-4809
Kentucky
Kevin J. Goldsmith, Director
Sandra Brewer, Executive Secretary
Intergovernmental Affairs
Office of the Governor
700 Capitol Avenue
Frankfort, Kentucky 40601
Telephone: (502) 564-2611
FAX: (502) 564-0437
Maine
Joyce Benson
State Planning Office
184 State Street
38 State House Station
Augusta, Maine 04333
Telephone: (207) 287-3261
FAX: (207) 287-6489
Maryland
Linda Janey
Manager, Plan & Project Review
Maryland Officer of Planning
301 W. Preston Street--Room 1104
Baltimore, Maryland 21201-2365
Staff Contact: Linda Janey
Telephone: (410) 767-4490
FAX: (410) 767-4480
Michigan
Richard Pfaff
Southeast Michigan Council of Governments
660 Plaza Drive--Suite 1900
Detroit, Michigan 48226
Telephone: (313) 961-4266
FAX: (313) 961-4869
Mississippi
Cathy Mallette
Clearinghouse Officer
Department of Finance and Administration
550 High Street
303 Walters Sillers Building
Jackson, Mississippi 39201-3087
Telephone: (601) 359-6762
FAX: (601) 359-6758
Missouri
Lois Pohl
Federal Assistance Clearinghouse
Office of Administration
P.O. Box 809
Jefferson Building, 9th Floor
Jefferson City, Missouri 65102
Telephone: (314) 751-4834
FAX: (314) 751-7819
Nevada
Department of Administration
State Clearinghouse
209 E. Musser Street, Room 220
Carson City, Nevada 89710
Telephone: (702) 687-4065
FAX: (702) 687-3983
Contact: Heather Elliot
(702) 687-6367
New Hampshire
Jeffrey H. Taylor
Director, New Hampshire Office of State Planning
Attn: Intergovernmental Review Process
Mike Blake
2\1/2\ Beacon Street
Concord, New Hampshire 03301
Telephone: (603) 271-2155
FAX: (603) 271-1728
New Mexico
Nick Mandell
Local Government Division
Room 201 Bataan Memorial Building
Santa Fe, New Mexico 87503
Telephone: (505) 827-3640
Fax: (505) 827-4984
New York
New York State Clearinghouse
Division of the Budget
State Capitol
Albany, New York 12224
Telephone: (518) 474-1605
FAX: (518) 486-5617
North Carolina
Jeanette Furney
North Carolina Department of Administration
116 West Jones Street--Suite 5106
Raleigh, North Carolina 27603-8003
Telephone: (919) 733-7232
FAX: (919) 733-9571
North Dakota
North Dakota Single Point of Contact
Office of Intergovernmental Assistance
600 East Boulevard Avenue
Bismarck, North Dakota 58505-0170
Telephone: (701) 224-2094
FAX: (701) 225-2308
Rhode Island
Kevin Nelson
Review Coordinator
Department of Administration
[[Page 55365]]
Division of Planning
One Capitol Hill, 4th Floor
Providence, Rhode Island 02908-5870
Telephone: (401) 277-2656
FAX: (401) 277-2083
South Carolina
Omeagia Burgess
State Single Point of Contact
Budget and Control Board
Office of State Budget
1122 Ladies Street--12th Floor
Columbia, South Carolina 29201
Telephone: (803) 734-0494
FAX: (803) 734-0645
Texas
Tom Adams
Governors Office
Director, Intergovernmental Coordination
P.O. Box 12428
Austin, Texas 78711
Telephone: (512) 463-1771
FAX: (512) 936-2681
Utah
Carolyn Wright
Utah State Clearinghouse
Office of Planning and Budget
Room 116 State Capitol
Salt Lake City, Utah 84114
Telephone: (801) 538-1027
FAX: (801) 538-1547
West Virginia
Fred Cutlip, Director
Community Development Division
W. Virginia Development Office
Building #6, Room 553
Charleston, West Virginia 25305
Telephone: (304) 558-4010
FAX: (304) 558-3248
Wisconsin
Jeff Smith
Section Chief, Federal/State Relations
Wisconsin Department of Administration
101 East Wilson Street--6th Floor
P.O. Box 7868
Madison, Wisconsin 53707
Telephone: (608) 266-0267
FAX: (608) 267-6931
Wyoming
Sandy Ross
State Single Point of Contact
Department of Administration and Information
2001 Capitol Avenue, Room 214
Cheyenne, WY 82002
Telephone: (307) 777-5492
FAX: (307) 777-3696
TERRITORIES
Guam
Joseph Rivera
Acting Director
Bureau of Budget and Management Research
Office of the Governor
P.O. Box 2950
Agana, Guam 96932
Telephone: (671) 475-9411 or 9412
FAX: (671) 472-2825
Puerto Rico
Jose Caballero-Mercado
Chairman
Puerto Rico Planning Board
Federal Proposals Review Office
Minillas Government Center
P.O. Box 41119
San Juan, Puerto Rico 00940-1119
Telephone: (787) 727-4444
FAX: (787) 724-3270
North Mariana Islands
Mr. Alvaro A. Santos, Executive Officer
Office of Management and Budget
Office of the Governor
Saipan, MP 96950
Telephone: (670) 664-2256
FAX: (670) 664-2272
Contact person: Ms. Jacoba T. Seman
Federal Programs Coordinator
Telephone: (670) 664-2289
FAX: (670) 664-2272
Virgin Islands
Nellon Bowry
Director, Office of Management and Budget
#41 Norregade Emancipation Garden
Station, Second Floor
Saint Thomas, Virgin Islands 00802
Please direct all questions and correspondence about
intergovernmental review to: Linda Clarke, Telephone: (809) 774-
0750, FAX: (809) 776-0069.
If you would like a copy of this list faxed to your office,
please call our publications office at: (202) 395-9068.
In accordance with Executive Order # 12372, ``Intergovernmental
Review of Federal Programs,'' this listing represents the designated
State Single Points of Contact. The jurisdictions not listed no
longer participate in the process BUT GRANT APPLICANTS ARE STILL
ELIGIBLE TO APPLY FOR THE GRANT EVEN IF YOUR STATE, TERRITORY,
COMMONWEALTH, ETC DOES NOT HAVE A ``STATE SINGLE POINT OF CONTACT.''
STATES WITHOUT ``STATE SINGLE POINTS OF CONTACT'' INCLUDE: Alabama,
Alaska; American Samoa; Colorado; Connecticut; Hawaii; Idaho;
Kansas; Louisiana; Massachusetts, Minnesota; Montana; Nebraska; New
Jersey; Ohio; Oklahoma; Oregon; Palau; Pennsylvania; South Dakota;
Tennessee; Vermont, Virginia; and Washington. This list is based on
the most current information provided by the States. Information on
any changes or apparent errors should be provided to the Office of
Management and Budget and the State in question. Changes to the list
will only be made upon formal notification by the State. Also, this
listing is published biannually in the Catalogue of Federal Domestic
Assistance.
Attachment H
CERTIFICATION REGARDING LOBBYING
Certification for Contracts, Grants, Loans, and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge
and belief, that:
(1) No Federal appropriated funds have been paid or will be
paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of an
agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with the awarding
of any Federal contract, the making of any Federal grant, the making
of any Federal loan, the entering into of any cooperative agreement,
and the extension, continuation, renewal, amendment, or modification
of any Federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been
paid or will be paid to any person for influencing or attempting to
influence an officer or employee of any agency, a Member of
Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with this Federal contract, grant,
loan, or cooperative agreement, the undersigned shall complete and
submit Standard Form-LLL, ``Disclosure Form to Report Lobbying,'' in
accordance with its instructions.
(3) The undersigned shall require that the language of this
certification be included in the award documents for all subawards
at all tiers (including subcontracts, subgrants, and contracts under
grants, loans, and cooperative agreements) and that all
subrecipients shall certify and disclose accordingly. This
certification is a material representation of fact upon which
reliance was placed when the transaction was made or entered into.
Submission of this certification is a prerequisite for making or
entering into this transaction imposed by section 1352, title 31,
U.S. Code. Any person who fails to file the required certification
shall be subject to a civil penalty of not less than $10,000 and not
more than $100,000 for each such failure.
Statement for Loan Guarantees and Loan Insurance
The undersigned states, to the best of his or her knowledge and
belief, that:
If any funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with this
commitment providing for the United States to insure or guarantee a
loan, the undersigned shall complete and submit Standard Form-LLL,
``Disclosure Form to Report Lobbying,'' in accordance with its
instructions. Submission of this statement is a prerequisite for
making or entering into this transaction imposed by section 1352,
title 31, U.S. Code. Any person who fails to file the required
statement shall be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each such failure.
----------------------------------------------------------------------
Signature
----------------------------------------------------------------------
Title
----------------------------------------------------------------------
Organization
BILLING CODE 4184-01-M
[[Page 55366]]
[GRAPHIC] [TIFF OMITTED] TN12OC99.003
BILLING CODE 4184-01-C
[[Page 55367]]
Instructions for Completion of SF-LLL, Disclosure of Lobbying
Activities
This disclosure form shall be completed by the reporting entity,
whether subawardee or prime Federal recipient, at the initiation or
receipt of a covered Federal action, or a material change to a
previous filing, pursuant to title 31 U.S.C. section 1352. The
filing of a form is required for each payment or agreement to make
payment to any lobbying entity for influencing or attempting to
influence an officer or employee of any agency, a Member of
Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with a covered Federal action.
Complete all items that apply for both the initial filing and
material change report. Refer to the implementing guidance published
by the Office of Management and Budget for additional information.
1. Identify the type of covered Federal action for which
lobbying activity is and/or has been secured to influence the
outcome of a covered Federal action.
2. Identify the status of the covered Federal action.
3. Identify the appropriate classification of this report. It
this is a followup report caused by a material change to the
information previously reported, enter the year and quarter in which
the change occurred. Enter the date of the last previously submitted
report by this reporting entity for this covered Federal action.
4. Enter the full name, address, city, State and zip code of the
reporting entity. Include Congressional District, if known. Check
the appropriate classification of the reporting entity that
designates if it is, or expects to be, a prime or subaward
recipient. Identify the tier of the subawardee, e.g., the first
subawardee of the prime is the 1st tier. Subawards include but are
not limited to subcontracts, subgrants and contract awards under
grants.
5. If the organization filing the report in item 4 checks
``Subawardee,'' then enter the full name, address, city, State and
zip code of the prime Federal recipient. Include Congressional
District, if known.
6. Enter the name of the Federal agency making the award or loan
commitment. Include at least one organizational level below agency
name, if known. For example, Department of Transportation, United
States Coast Guard.
7. Enter the Federal program name or description of the covered
Federal action (item 1). If known, enter the full Catalog of Federal
Domestic Assistance (CFDA) number of grants, cooperative agreements,
loans, and loan commitments.
8. Enter the most appropriate Federal identifying number
available for the Federal action identified in item 1 (e.g., Request
for Proposal (RFP) number; Invitation for Bid (IFB) number; grant
announcement number; the contract, grant, or loan award number; the
application/proposal control number assigned by the Federal agency).
Include prefixes, e.g., ``RFP-DE-90-001.''
9. For a covered Federal action where there has been an award of
loan commitment by the Federal agency, enter the Federal amount of
the award/loan commitment for the prime entity identified in item 4
or 5.
10. (a) Enter the full name, address, city, State and zip code
of the lobbying registrant under the Lobbying Disclosure Act of 1995
engaged by the reporting entity identified in item 4 of influence
the covered Federal action.
(b) Enter the full names of the individual(s) performing
services, and include full address if different from 10(a). Enter
Last Name, First Name, and Middle Initial (MI).
11. The certifying official shall sign and date the form, print
his/her name, title, and telephone number.
According to the Paperwork Reduction Act, as amended, no persons
are required to respond to a collection of information unless it
displays a valid OMB Control Number. The valid OMB control number
for this information collection is OMB No. 0348-0046. Public
reporting burden for this collection of information is estimated to
average 10 minutes per response, including time for reviewing
instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding the burden
estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of
Management and Budget, Paperwork Reduction Project (0348-0046),
Washington, DC 20503. to the Office of Management and Budget,
Paperwork Reduction Project (0348-0046), Washington, DC 20503.
Attachment I
State Human Services Administrators
A
Mr. Tony Petelos
Commissioner
Alabama State Department of Human Resources
50 Ripley Street
Montgomery, AL 36130-4000
Phone: (334) 242-1160
FAX: (334) 242-0198
Ms. Karen Perdue
Commissioner
Alaska Department of Health and Social Services
P.O. Box 110601
Juneau, AK 99811-0601
Phone: (907) 465-3030
FAX: (907) 465-3068
Ms. Marie Ma'o
Director
American Samoa Department of Social Services
Pago Pago, AS 96799
Phone: 011 (684) 633-2969
FAX: 011 (684) 633-7449
Mr. John L. Clayton
Director
Arizona Department of Economic Security
P.O. Box 6123, Site Code 010A
Phoenix, AZ 85005
Phone: (602) 542-5678
FAX: (602) 542-5339
Mr. Kurt Knickrehm
Director
Arkansas Department of Human Services
P.O. Box 1437--Suite 329
Little Rock, AR 72203-1437
Phone: (501) 682-8650
FAX: (501) 682-6836
C
Mr. Grantland Johnson
Secretary
California Health and Welfare Agency
1600 Ninth Street, Room 460
Sacramento, CA 95814
Phone: (916) 654-3345
FAX: (916) 654-3343
Mrs. Marva Livingston Hammons
Executive Director
Colorado Department of Human Services
1575 Sherman Street, 8th Floor
Denver, CO 80203-1714
Phone: (303) 866-5096
FAX: (303) 866-4740
Ms. Patricia A. Wilson-Coker
Commissioner
Connecticut Department of Social Services
25 Sigourney Street
Hartford, CT 06106
Phone: (860) 424-5008
FAX: (860) 424-4960
D
Dr. Gregg C. Sylvester
Secretary
Delaware Department of Health & Social Services
Herman M. Holloway Campus
Administration Building, 1st floor
1901 N. DuPont Highway
New Castle, DE 19720
Phone: (302) 577-4500
FAX: (302) 577-4510
Mrs. Jearline Williams
Director
D.C. Department of Human Services
801 East Building
2700 Martin Luther King, Jr. Avenue
Washington, DC 20032
Phone: (202) 279-6002
FAX: (202) 279-6014
F
Judge Kathleen Kearney
Secdretary
Florida Department of Children and Families
Building 1, Room 202
1317 Winewood Boulevard
Tallahassee, FL 32399-0700
Phone: (850) 487-1111
FAX: (850) 922-2993
Mr. Robert G. Brooks
Secretary
Florida Department of Health
2020 Capital Circle, S.E., BIN 800
Tallahassee, FL 32399-0701
Phone: (850) 487-2945
FAX: (850) 487-3729
G
Ms. Audrey Horne
Commissioner
Georgia Department of Human Resources
2 Peach Tree Street, N.W., Suite 29-250
Atlanta, GA 30303
Phone: (404) 656-5680
FAX: (404) 651-8669
Mr. Dennis G. Rodriguez
Director
Guam Department of Public Health and Social Services
[[Page 55368]]
P.O. Box 2816
Agana, GU 96932
Phone: 011 (671) 734-7102
FAX: 011 (671) 734-5910
H
Ms. Susan Chandler
Director
Hawaii Department of Human Services
P.O. Box 339
Honolulu, HI 96809-0339
Phone: (808) 586-4997
FAX: (808) 586-4890
I
Mr. Karl Kurtz
Director
Idaho Department of Health and Welfare
P.O. Box 83720
Boise, ID 83720-0036
Phone: (208) 334-5500
FAX: (208) 334-6558
Mr. Howard Peters
Secretary
Illinois Department of Human Services
Harris Building, 3rd floor
100 South Grand Avenue, East
Springfiled, IL 62762
Phone: (217) 557-1602
FAX: (217) 557-1647
Mr. Peter Sybinsky
Secretary
Indiana Family and Social Services Administration
402 West Washington Street, Room W-461
Indianapolis, IN 46207-7083
Phone: (317) 233-4452
FAX: (317) 233-4693
Ms. Jessie Rasmussen
Director
Iowa Department of Human Services
5th floor, Hoover State Office Building
Des Moines, IA 50319
Phone: (515) 281-5452
FAX: (515) 281-4597
K
Ms. Rochelle B. Cronister
Secretary
Kansas Department of Social and Rehabilitation Services
Docking State Office Building, 6th floor
915 Harrison Street
Topeka, KS 66612-1570
Phone: (785) 296-3271
FAX: (785) 296-4685
Ms. Viola P. Miller
Secretary
Kentucky Cabinet for Families and Children
275 East Main Street, 4th floor West
Frankfort, KY 40621
Phone: (502) 564-7130
FAX: (502) 564-3866
L
Ms. Gwendolyn P. Hamilton
Secretary
Louisiana Department of Social Services
P.O. Box 3776
Baton Rouge, LA 70821
Phone: (504) 342-0286
FAX: (504) 342-8636
M
Mr. Kevin W. Concannon
Commissioner
Maine Department of Human Services
11 Statehouse Station
221 State Street
Augusta, ME 04333
Phone: (207) 287-3106
FAX: (207) 287-3005
Ms. Lynda G. Fox
Secretary
Maryland Department of Human Resources
Saratoga State Center
311 West Saratoga Street
Baltimore, MD 21201
Phone: (410) 767-71109
FAX: (410) 333-0099
Mr. William O'Leary
Commissioner
Massachusetts Department of Social Services
24 Farnsworth Street
Boston, MA 02210
Phone: (617) 727-0900
FAX: (617) 439-4482
Ms. Claire McIntire
Commissioner
Massachusetts Department of Transitional
Assistance
600 Washington Street
Boston, MA 02111
Phone: (617) 348-8400
FAX: (617) 348-8575
Mr. Douglas Howard
Director
Michigan Family Independence Agency
235 South Grand Avenue
Lansing, MI 48909
Phone: (517) 373-2000
FAX: (617) 335-6101
Mr. Michael O'Keefe
Commissioner
Minnesota Department of Human Services
444 Lafayette Road
St. Paul, MN 55155-3815
Phone: (651) 296-2701
FAX: (651) 296-5868
Mr. Donald Taylor
Executive Director
Missippi Department of Human Services
750 North State Street
Jackson, MS 39202
Phone: (601) 359-4480
FAX: (601) 359-4477
Mr. Gary J. Stangler
Director
Missouri Department of Social Services
Broadway State Office Building
221 W. High Street
Jefferson City, MO 65102
Phone: (573) 751-4815
FAX: (573) 751-3203
Ms. Laurie Ekanger
Director
Montana Department of Public Health and Human Services
P.O. Box 4210
Helena, MT 59604-4210
Phone: (406) 444-5622
FAX: (406) 444-1970
N
Mr. Ron Ross
Director
Nebraska Department of Health and Human Services
P.O. Box 95044
Lincoln, NE 68509-5044
Phone: (402) 471-9106
FAX: (402) 471-0820
Ms. Charlotte Crawford
Director
Nevada Department of Human Resources
505 East King Street, Suite 600
Carson City, NV 89710
Phone: (775) 684-4000
FAX: (775) 684-4010
Mr. Donald L. Shumway
Commissioner
New Hampshire Department of Health and
Human Services
129 Pleasant Street
Concord, NH 03301
Phone: (603) 271-4334
FAX: (603) 271-4912
Ms. Michelle Guhl
Commissioner
New Jersey Department of Human Services
222 South Warren Street
Trenton, NJ 08625-0700
Phone: (609) 292-3717
FAX: (609) 292-3824
Mr. Alex Valdez
Secretary
New Mexico Human Services Department
P.O. Box 2348
Santa Fe, NM 87504-2348
Phone: (505) 827-7750
FAX: (505) 827-6286
Mr. Brian Wing
Commissioner
New York State Office of Temporary and
Disability Assistance
40 North Pearl Street
Albany, NY 12243
Phone: (518) 473-9772 and 474-9475
FAX: (518-6255
Mr. John A. Johnson
Commissioner
New York State Office of Children
and Family Services
52 Washington Street
Rensselaer, NY 12144
Phone: (518) 473-8437
FAX: (518) 473-9131
Mr. James McGowan
Commissioner
New York State Department of Labor
State Campus, Building 12
Albany, NY 12240
Phone: (518) 457-2741
FAX: (518) 457-6908
Dr. H. David Bruton
Secretary
North Carolina Department of Health and
Human Services
101 Blair Drive
Raleigh, NC 27603
Phone: (919) 733-4534
FAX: (919) 715-4645
Ms. Carol K. Olson
Executive Director
North Dakota Department of Human Services
State Capitol--Judicial Wing--Dept. 325
600 East Boulevard
Bismarck, ND 58505
Phone: (701) 328-2310
FAX: (701) 328-1545
O
Ms. Jacqueline Romer-Sensky
Director
Ohio Department of Human Services
[[Page 55369]]
30 East Broad Street, 32nd Floor
Columbus, OH 43266-0423
Phone: (614) 466-6282
FAX: (614) 466-2815
Mr. Howard A. Hendrick
Director
Oklahoma Department of Human Services
P.O. Box 25352
Oklahoma City, OK 73125
Phone: (405) 521-3646
FAX: (405) 521-6458
Mr. Gary Weeks
Director
Oregon Department of Human Resources
500 Summer Street, N.E.
Salem, OR 97310-1012
Phone: (503) 945-5944
FAX: (503) 378-2897
P
Ms. Feather O. Houstoun
Secretary
Pennsylvania Department of Public Welfare
P.O. Box 2675
Harrisburg, PA 17105-2675
Phone: (717) 787-2600
FAX: (717) 772-2062
Ms. Angie Varela-Llavona
Secretary
Puerto Rico Department of The Family
P.O. Box 11398
San Juan, PR 00910-1398
Phone: (787) 723-8722
FAX: (787) 723-1223
R
Ms. Chistine Fereguson
Director
Rhode Island Department of Human Services
600 New London Avenue
Cranston, RI 02920
Phone: (401) 464-2121
FAX: (401) 463-3677
S
Ms. Elizabeth G. Patterson, J.D.
Director
South Carolina Department of Social Services
P.O. Box 1520
Columbia: SC 29202-1520
Phone: (803) 898-7360
FAX: (803) 898-7277
Mr. James W. Ellenbecker
Secretary
South Dakota Department of Social Services
700 Governors Drive
Pierre, SD 57501-2291
Phone: (605) 773-5990
FAX: (605) 773-5483
T
Ms. Natasha Metcalf
Commissioner
Tennessee Department of Human Services
Citizens Plaza Building, 15th Floor
400 Deaderick Street
Nashville, TN 37248-0001
Phone: (615) 313-4700
FAX: (615) 741-4165
Mr. Eric M. Bost
Commissioner
Texas Department of Human Services
701 West 51st Street
P.O. Box 149030
Austin, TX 78714-9030
Phone: (512) 438-3030
FAX: (512) 538-4220
Ms. Diane D. Rath
Chair and Commissioner Representing the Public
Texas Work Force Commission
101 East 15th Street
Austin, TX 78778
Phone: (512) 463-2222
FAX: (512) 475-2321
U
Mrs. Robin Arnold-Williams
Director
Utah Department of Human Services
P.O. Box 45599
Salt Lake City, UT 94114-0250
Phone: (801) 538-3998
FAX: (801) 538-4016
Mr. Robert C. Gross
Executive Director
Utah Department of Workforce Services
140 E. Third Street South
Salt Lake City, UT 84114
Phone: (801) 536-7400
FAX: (801) 526-9211
V
Mr. Cornelius Hogan
Secretary
Vermont Agency of Human Services
103 South Main Street
Waterbury, VT 05671-0204
Phone: (802) 241-2220
FAX: (802) 241-2979
Ms. Sedonia Halbert
Acting Commissioner
Virgin Islands Department of Human Services
Knudhansen Complex Building A
1304 Hospital Grounds
St. Thomas, VI 00802
Phone: (809) 774-1166
FAX: (809) 774-3466
Mr. Clarence H. Carter
Commissioner
Virginia Department of Social Services
730 East Broad Street, 9th floor
Richmond, VA 23219-1849
Phone: (804) 692-1900
FAX: (804) 692-1964
W
Mr. Lyle Quasim
Secretary
Washington Department of Social and Health Services
P.O. Box 45010
Olympia, WA 98504-5010
Phone: (360) 902-7800
FAX: (360) 902-7848
Ms. Joan E. Ohl
Secretary
West Virginia Department of Health and Human Resources
State Capitol Complex Building 3, Room 206
1900 Kanawha Boulevard, East
Charleston, WV 25305-0500
Phone: (304) 558-0684
FAX: (304) 558-1130
Mr. Joseph Leean
Secretary
Wisconsin Department of Health and Family Services
P.O. Box 7850
Madison, WI 53707-7850
Phone: (608) 266-9622
FAX (608) 266-7882
Ms. Shirley R. Carson
Director
Wyoming Department of Family Services
Hathaway Building, 3rd floor
2300 Capitol Avenue
Cheyenne, WY 82002-0490
Phone: (307) 777-7561
FAX: (307) 777-7747
Attachment J
Certification Regarding Environmental Tobacco Smoke
Public Law 103227, Part C Environmental Tobacco Smoke, also
known as the Pro Children Act of 1994, requires that smoking not be
permitted in any portion of any indoor routinely owned or leased or
contracted for by an entity and used routinely or regularly for
provision of health, day care, education, or library services to
children under the age of 18, if the services are funded by Federal
programs either directly or through State or local governments, by
Federal grant, contract, loan, or loan guarantee. The law does not
apply to children's services provided in private residences,
facilities funded solely by Medicare or Medicaid funds, and portions
of facilities used for inpatient drug or alcohol treatment. Failure
to comply with the provisions of the law may result in the
imposition of a civil monetary penalty of up to $1000 per day and/or
the imposition of an administrative compliance order on the
responsible entity. By signing and submitting this application the
applicant/grantee certifies that it will comply with the
requirements of the Act.
The applicant/grantee further agrees that it will require the
language of this certification be included in any subawards which
contain provisions for the children's services and that all
subgrantees shall certify accordingly.
Attachment K
DHHS Regulations Applying to All Applicants/ Grantees Under the Job
Opportunities for Low-Income Individuals (JOLI) Program
Title 45 of the Code of Federal Regulations:
Part 16--Department of Grant Appeals Process
Part 74--Administration of Grants (grants and sub-grants to
entities)
Part 75--Informal Grant Appeal Procedures
Part 76--Debarment and Suspension from Eligibility for Financial
Assistance
Subpart F--Drug Free Workplace Requirements
Part 80--Non-Discrimination Under Programs Receiving Federal
Assistance through the Department of Health and Human Services
Effectuation of Title VI of the Civil Rights Act Of 1964
Part 81--Practice and Procedures for Hearings Under Part 80 of this
Title
Part 83--Regulation for the Administration and Enforcement of
Sections 799A and 845 of the Public Health Service Act
Part 84--Non-discrimination on the Basis of Handicap in Programs and
Activities Receiving Federal Financial Assistance
[[Page 55370]]
Part 85--Enforcement of Non-Discrimination on the Basis of Handicap
in Programs or Activities Conducted by the Department of Health and
Human Services
Part 86--Nondiscrimination on the Basis of Sex in Education Programs
and Activities Receiving or Benefiting from Federal Financial
Assistance
Part 91--Non-discrimination on the Basis of Age in Health and Human
Services Programs or Activities Receiving Federal Financial
Assistance
Part 92--Uniform Administrative Requirements for Grants and
Cooperative Agreements to States and Local Governments (Federal
Register, March 11, 1988)
Part 93--New Restrictions on Lobbying
Part 100--Intergovernmental Review of Department of Health and Human
Services Programs and Activities
Attachment L
Business Plan
The business plan is one of the major components that will be
evaluated by OCS to determine the feasibility of a jobs creation
project. A business plan must be included if, the applicant is
proposing to establish a new identified business, or if the
applicant will be providing assistance to a private third party
employer for the development or expansion of a pre-identified
business.
The following guidelines were written to cover a variety of
possibilities regarding the requirements of a business plan. Rigid
adherence to them is not possible nor even desirable for all
projects. For example, a business plan for a service business would
not require discussion of manufacturing nor product designs.
Therefore, the business plans should be prepared in accordance with
the following guidelines:
1. The business and its industry. This section should describe
the nature and history of the business and include background on its
industry.
a. The Business: as a legal entity; the general business
category;
b. Description and Discussion of Industry: Current status and
prospects for the industry.
2. Products and Services: This section deals with the following:
a. Description: Describe in detail the products or services to
be sold;
b. Proprietary Position: Describe proprietary features, if any,
of the product, e.g. patents, trade secrets; and,
c. Potential: Features of the product or service that may give
it an advantage over the competition.
3. Market Research and Evaluation: This section should present
sufficient information to show that the product or service has a
substantial market and can achieve sales in the face of competition;
a. Customers: Describe the actual and potential purchasers for
the product or service by market segment;
b. Market Size and Trends: State the size of the current total
market for the product or service offered;
c. Competition: An assessment of the strengths and weaknesses of
competitive products and services; and,
d. Estimated Market Share and Sales: Describe the
characteristics of the product or service that will make it
competitive in the current market.
4. Marketing Plan: The marketing plan must describe what is to
be done, how it will be done and who will do it. The marketing plan
should detail the product, pricing, distribution, and promotion
strategies that will be used to achieve the estimated market share
and sales projections. The plan should address the following
topics--Overall Marketing Strategy, Packaging, Service and Warranty,
Pricing, Distribution and Promotion.
5. Design and Development Plans: This section of the plan should
cover items such as Development Status, Tasks, Difficulties and
Risks, Product Improvement, New Products and Costs. If the product,
process or service of the proposed venture requires any design and
development before it is ready to be placed on the market, the
nature and extent and cost of this work should be fully discussed.
6. Manufacturing and Operations Plan: A manufacturing and
operations plan should described the kind of facilities, plant
location, space, capital equipment and labor force (part and/or full
time and wage structure) that are required to provide the company's
product or service.
7. Management Team: This section must include a description of:
the key management personnel and their primary duties; compensation
and/or ownership; the organizational structure; Board of Directors;
management assistance and training needs; and, supporting
professional services. The management team is key in starting and
operating a successful business. The management team should be
committed with a proper balance of technical, managerial and
business skills, and experience in operating the proposed business.
8. Overall Schedule: This section must include a month-by-month
schedule that shows the timing of such major events, activities and
accomplishments involving product development, market planning,
sales programs, and production and operations. Sufficient detail
should be included to show the correlation between the timing of the
primary tasks required to accomplish each activity.
9. Critical Risks and Assumptions: This section should include a
description of the risks and critical assumptions/problems relating
to the industry, the venture, its personnel, the product's market
appeal, and the timing and financing of the venture. Identify and
discuss the critical assumptions/problems to overcome in the
Business Plan. Major problems must clearly identify problems to be
solved to develop the venture.
10. Community Benefits: The applicant should describe how the
proposed project will contribute to the local economy, community and
human economic development within the project's target area.
11. The Financial Plan: The Financial Plan is basic to the
development of a Business Plan. Its purpose is to indicate the
project's potential and the timetable for financial self-sufficiency
of the business. In developing the Financial Plan, the following
exhibits must be prepared for the first three years of the business'
operation:
a. Profit and Loss Forecasts--quarterly for each year;
b. Cash Flow Projections--quarterly for each year;
c. Pro forma balance sheets--quarterly for each year;
d. Initial sources of project funds;
e. Initial uses of project funds; and
f. Any future capital requirements and sources.
12. Facilities: If rearrangement or alteration of existing
facilities is required to implement the project, the applicant must
describe and justify such changes and related costs.
Attachment M
Certification Regarding Maintenance of Effort
In accordance with the applicable program statute(s) and
regulation(s), the undersigned certifies that financial assistance
provided by the Administration for Children and Families, for the
specified activities to be performed under the ________ Program by
________ (Applicant Organization), will be in addition to, and not
in substitution for, comparable activities previously carried on
without Federal assistance.
----------------------------------------------------------------------
Signature of Authorized Certifying Official
----------------------------------------------------------------------
Title
----------------------------------------------------------------------
Date
Attachment N
Alabama
Carolyn Lapsley, Director
Department of Human Resources, Division of Child Support
50 Ripley Street
Montgomery, AL 36130-1801
IVD Director's Phone: (334) 242-9300 IVD Director's Fax: (334) 242-
0606
In State Office Phone: 1-800-282-4347 (334) 242-9300
Nationwide Office Phone:
Office Fax: (334) 242-0606
E-Mail: [email protected]
Alaska
Barbara Miklos, Director
Child Support Enforcement Division
550 West 7th Avenue, Suite 312
Anchorage, AK 99501-6699
IVD Director's Phone: (907) 269-6804 IVD Director's Fax: (907) 269-
6868
In State Office Phone: (800) 478-3300 (907) 269-6813
Nationwide Office Phone:
Office Fax: (907) 269-6813
E-Mail: Barbara__M[email protected]
American Somoa
Fainuulelei L Ala'ilma-Uta, Assistant Attorney General
Office of the Attorney General
P.O. Box 7
Pago Pago, AS 96799
IVD Director's Phone: (684) 633-7161 or 633-4163 IVD Director's Fax:
(684) 633-1838
In State Office Phone:
[[Page 55371]]
Nationwide Office Phone:
Office Fax:
Arizona
Nancy Mendoza, Director
Department of Economic Security, Division of Child Support
Enforcement
P.O. Box 40458, Site Code 021A
(Street Address: 3443 N. Central Avenue, 4th Floor, Phoenix, AZ
85012)
Phoenix, AZ 85067
IVD Director's Phone: (602) 274-7646 IVD Director's Fax: (602) 274-
8250
In State Office Phone: (602) 252-4045
Nationwide Office Phone:
Office Fax:
Arkansas
Dan Mc Donald, Administrator
Office of Child Support Enforcement, Division of Revenue
P.O. Box 8133
(712 W. 3rd Street ZIP 72201)
Little Rock, AR 72203
IVD Director's Phone: (501) 682-6169 IVD Director's Fax: (501) 682-
6002
In State Office Phone: (501) 682-8398
Nationwide Office Phone: (800) 264-2445 (payments) (800) 247-4549
(program)
Office Fax: (501) 682-6002
E-Mail: [email protected]
California
Bill Walsh, Acting Chief
Office of Child Support
P.O. Box 944245
Sacramento, CA 95814
IVD Director's Phone: (916) 654-1556 IVD Director's Fax: (916) 653-
8690
In State Office Phone: (916) 654-1532 (800) 952-5253
Nationwide Office Phone:
Office Fax: (916) 657-3791
E-Mail: [email protected]
Colorado
Pauline Burton, Director
Department of Human Services, Division of Child Support Enforcement
1575 Sherman Street, 2nd floor
Denver, CO 80203-1714
IVD Director's Phone: (303) 839-1203 IVD Director's Fax: (303) 839-
1332
In State Office Phone: (303) 866-5994
Nationwide Office Phone:
Office Fax: (303) 866-2214
E-Mail: Pauline.B[email protected]
Connecticut
Diane Fray, Director
Department of Social Services, Bureau of Child Support Enforcement
25 Sigourney Street
Hartford, CT 06105-5033
IVD Director's Phone: (860) 424-5251 IVD Director's Fax: (860) 951-
2996
In State Office Phone: (860) 424-5251
Nationwide Office Phone: (800) 228-5437 (problems) (800) 647-8872
(info) (800) 698-0572 (payments)
Office Fax: (860) 951-2996
E-Mail: Diane.F[email protected]
Delaware
Karryl D. Hubbard, Director
Department of Health and Social Services, Division of Child Support
Enforcement
Herman Hallaway Campus (street addr: 1901 North Dupont Hwy)
P.O. Box 904
New Castle, DE 19720
IVD Director's Phone: (302) 577-4807 IVD Director's Fax: (302) 577-
4873
In State Office Phone: (302) 577-4863 (302) 577-4800
Nationwide Office Phone:
Office Fax: (302) 577-4873
E-Mail: K[email protected]
District of Columbia
Phil Browning, Chief
Office of Paternity and Child Support Enforcement
441 Fourth Street NW 5th Floor
Washington, DC 20024-2480
IVD Director's Phone: (202) 724-1548 IVD Director's Fax: (202)
In State Office Phone: (202) 724-1444
Nationwide Office Phone:
Office Fax:
E-Mail: DCIVD B[email protected]
Florida
Lillie Bogan, Director
Department of Revenue, Child Support Enforcement Program
P.O. Box 8030
Tallahassee, FL 32314-8030
IVD Director's Phone: (850) 488-8733 IVD Director's Fax: (850) 921-
0792
In State Office Phone: (850) 922-9590
Nationwide Office Phone:
Office Fax: (850) 414-1698
E-Mail: [email protected]
Georgia
Martin Elmore, Director
Department of Human Resources, Child Support Enforcement
P.O. Box 38450
(2 Peachtree Street, N.W., Suite 15-107, Zip 30303)
Atlanta, GA 30334-0450
IVD Director's Phone: (404) 657-3851/3856 IVD Director's Fax: (404)
657-3326
In State Office Phone: (404) 657-3851 (800) 227-7993 (for area codes
706 and 912) (for 404 and 770 dial c)
Nationwide Office Phone:
Office Fax: (404) 657-3326
E-Mail: [email protected]
Guam
Kathy Montague, Deputy Attorney General
Department of Law, Child Support Enforcement Unit
238 Archbishop F.C. Flores Street
Agana, GU 96910
IVD Director's Phone: (671) 475-3360/3363 IVD Director's Fax: (617)
477-6118
In State Office Phone: 011 (671) 475-3360
Nationwide Office Phone:
Office Fax:
E-Mail: [email protected]
Hawaii
Mike L. Meaney, Administrator
Department of Attorney General, Child Support Enforcement Agency
Kakuhihewa State Office Building
Kapolei, HI 96707
IVD Director's Phone: (808) 692-7000 IVD Director's Fax: (808) 692-
7134
In State Office Phone: (808) 587-3695
Nationwide Office Phone:
Office Fax:
E-Mail: [email protected]
Idaho
Tamara Prisock, Chief
Department of Health and Welfare, Bureau of Child Support Services
P.O. Box 83720
(450 West State Street, 6th Floor Zip 83702)
Boise, ID 83720-0036
IVD Director's Phone: (208) 334-5719 IVD Director's Fax: (208) 334-
5817
In State Office Phone: (208) 334-2479
Nationwide Office Phone: (800) 356-9868
Office Fax: (208) 334-0666
E-Mail: P[email protected]
Illinois
Robert Lyons, Administrator
Illinois Department of Public Aid, Division of Child Support
Enforcement
32 W. Randolph Street, Rm 923
Chicago, IL 60601
IVD Director's Phone: (217) 524-4602 IVD Director's Fax: (217) 524-
4608
In State Office Phone: (217) 524-4602 (800) 447-4278
Nationwide Office Phone:
Office Fax: (217) 524-4608
E-Mail: [email protected]
Indiana
Joe Mamlin, Director
Child Support Bureau
402 West Washington Street, Rm W360
Indianapolis, IN 46204
IVD Director's Phone: (317) 232-4877 IVD Director's Fax: (317) 233-
4925
In State Office Phone: (317) 233-5437
Nationwide Office Phone:
Office Fax: (317) 233-4932
E-Mail: [email protected]
Iowa
Nancy Thoma, Director
Department of Human Services, Bureau of Collections
Hoover Building--5th Floor
Des Moines, IA 50319
IVD Director's Phone: (515) 281-8886 IVD Director's Fax: (515) 281-
8854
In State Office Phone: (515) 281-5580
Nationwide Office Phone:
Office Fax: (515) 281-8854
E-Mail: [email protected]
Kansas
James A. Robertson, Administrator
Department of Social & Rehabilitation Services, Child Support
Enforcement Program
P.O. Box 497
(Street Address: 300 S.W. Oakley Street, Biddle Bldg, Topeka, KS
66606)
Topeka, KS 66601
IVD Director's Phone: (785) 296-3237 IVD Director's Fax: (785) 296-
5206
In State Office Phone: (913) 296-3237
Nationwide Office Phone: (800) 432-0152 (withholding) (800) 570-6743
(collections) (800) 432-3913 (fraud hot)
Office Fax: (913) 296-5206
E-Mail: [email protected]
Kentucky
Steven P. Veno, Director
[[Page 55372]]
Cabinet for Human Resources, Division of Child Support Enforcement
275 East Main Street
Frankfort, KY 40621
IVD Director's Phone: (502) 564-2285 ex 404 IVD Director's Fax:
(502) 564-5988
In State Office Phone: (502) 564-2285
Nationwide Office Phone:
Office Fax: (502) 564-5988
E-Mail: [email protected]
Louisiana
Gordon Hood, Director
Support Enforcement Services, Office of Family Support
P.O. Box 94065
Baton Rouge, LA 70804-4065
IVD Director's Phone: (504) 342-4780 IVD Director's Fax: (504) 342-
7397
In State Office Phone: (504) 342-4780 (800) 256-4650 (payments)
Nationwide Office Phone:
Office Fax: (504) 342-7397
E-Mail: [email protected]
Maine
Stephen L. Hussey, Director
Dept of Human Services, Bureau of Family Independence, Div of
Support Enforcement and Recovery
State House Station
Augusta, ME 04333
IVD Director's Phone: (207) 287-2886 IVD Director's Fax: (207) 287-
5096
In State Office Phone: (207) 287-2886 (800) 371-3101
Nationwide Office Phone:
Office Fax: (207) 287-2886
E-Mail: stephen.L.[email protected]
Maryland
Theresa Kaiser, Acting Executive Director
Child Support Enforcement Administration
311 West Saratoga Street
Baltimore, MD 21201
IVD Director's Phone: (410) 767-7674 or 7358 IVD Director's Fax:
(410) 333-8992
In State Office Phone: (410) 767-7619 (800) 332-6347
Nationwide Office Phone:
Office Fax: (410) 333-8992
Massachusetts
Amy Pitter, Deputy Commissioner
Department of Revenue, Child Support Enforcement Division
141 Portland Street
Cambridge, MA 02139-1937
IVD Director's Phone: (617) 577-7200 ex 30482 or 30405 IVD
Director's Fax: (617) 621-4991
In State Office Phone: (617) 577-7200
Nationwide Office Phone: (800) 332-2733
Office Fax: (617) 621-4991
E-Mail: [email protected]
Michigan
Wallace Dutkowski, Director
Family Independency Agency, Office of Child Support
P.O. Box 30478
(Street Address: 7109 W. Saginaw Hwy., Lansing, MI)
Lansing, MI 48909-7978
IVD Director's Phone: (517) 373-7570 IVD Director's Fax: (517) 373-
4980
In State Office Phone: (517) 373-7570
Nationwide Office Phone:
Office Fax: (517) 373-4980
E-Mail: [email protected]
Minnesota
Laura Kadwell, Director
Department of Human Services, Office of Child Support Enforcement
444 Lafayette Road, 4th floor
St. Paul, MN 55155-3846
IVD Director's Phone: (651) 297-8232 IVD Director's Fax: (651) 297-
4450
In State Office Phone: (651) 296-2542
Nationwide Office Phone:
Office Fax: (651) 297-4450
E-Mail: [email protected]
Mississippi
Richard Harris, Director
Department of Human Services, Division of Child Support Enforcement
P.O. Box 352
Jackson, MS 39205
IVD Director's Phone: (601) 359-4863 IVD Director's FAX: (601) 359-
4415
In State Office Phone: (601) 359-4861 (800) 354-6039 (Hins, Rankin,
and Madison counties)
Nationwide Office Phone: (800) 435-5437
Office Fax: (601) 359-4415
E-Mail: [email protected]
Missouri
Brian Kinkade, Director
Department of Social Services, Division of Child Support Enforcement
P.O. Box 2320
(227 Metro Drive)
Jefferson City, MO 65101-2320
IVD Director's Phone: (573) 751-1374 IVD Director's Fax: (573) 751-
8450
In State Office Phone: (573) 751-4301
Nationwide Office Phone; (800) 859-7999
Office Fax: (573) 751-8450
E-Mail: [email protected]
Montana
Mary Ann Wellbank, Administrator
Department of Social and Rehabilitation Services, Child Support
Enforcement Division
P.O. Box 202943
(Street Address: 3075 N. Montana Ave., Suite 112, Helena, MT 59620)
Helena, MT 59620
IVD Director's Phone: (406) 444-3338 IVD Director's Fax: 406) 444-
1370
In State Office Phone: (406) 442-7278 (800) 346-5437
Nationwide Office Phone:
Office Fax: (406) 444-1370
E-Mail:[email protected]
Nebraska
Daryl D. Wusk, CSE Administrator
Department of Health and Human Services, Child Support Enforcement
Office
P.O. Box 94728
West Campus Folsom and West Prospector Place
Lincoln, NE 68509-4728
IVD Director's Phone: (402) 479-5555 IVD Director's Fax: (402) 479-
5543
In State Office Phone: (402) 471-9160 (800) 831-4573
Nationwide Office Phone:
Office Fax: (402) 471-9455
E-Mail: Daryl.W[email protected]
Nevada
Leland Sullivan, Chief
Child Support Enforcement Program, Nevada State Welfare Division
2527 North Carson Street, Capitol complex
Carson City, NV 89716
IVD Director's Phone: (702) 687-4744 IVD Director's Fax: (702) 684-
8026
In State Office Phone: (792) 687-4744 (800) 922-0900
Nationwide Office Phone:
Office Fax; (702) 684-6026
E-Mail: [email protected]
New Hampshire
Lloyd Peterson, Acting Administrator
Office of Program Support, Office of Child Support
Health and Human Services Building
6 Hazen Drive
Concord, NH 03301
IVD Director's Phone: (603) 271-4287 IVD Director's Fax: (603) 271-
4787
In State Office Phone: (603) 271-4427 (800) 852-3345 ext 4427
Nationwide Office Phone:
Office Fax: (603) 271-4787
E-Mail: dhhs.state.nh.us
New Jersey
Alisha Griffin, Director
Department of Human Services, Bureau of Child Support and Paternity
Programs, Division of Family Dev
P.O. Box 716
Trenton, NJ 08625-0716
IVD Director's Phone: (609) 588-2402 IVD Director's Fax: (609) 588-
3369
In State Office Phone: (609) 588-2915
Nationwide Office Phone: (800) 621-5437
Office Fax: (609) 588-2354
E-Mail: [email protected]
New Mexico
Ben Silva, Director
Department: Human Services Department, Child Support Enforcement
Bureau
P.O. Box 25109
(Street Address: 2025 S. Pacheco, Santa Fe, NM 87504)
Santa Fe, NM 73512
IVD Director's Phone: (505) 827-7200 IVD Director's Fax: (505) 827-
7285
In State Office Phone: (505) 827-7200 (800) 432-6217
Nationwide Office Phone:
Office Fax: (505) 827-7285
New York
Robert Doar, Director
Department of Social Services, Office of Child Support Enforcement
P.O. Box 14
(Street Address: One Commerce Plaza, Albany, NY 12260)
Albany, NY 12260-0014
IVD Director's Phone: (518) 474-9081 IVD Director's Fax: (518) 486-
3127
In State Office Phone: (518) 474-9081
Nationwide Office Phone: (800) 343-8859
Office Fax: (518) 486-3127
E-Mail: [email protected]
North Carolina
Barry A. Miller, Chief
[[Page 55373]]
Department of Human Resources, Division of Social Services, Child
Support Enforcement Section
100 East Six Forks Road
Raleigh, NC 27609-7750
IVD Director's Phone: (919) 420-7982 IVD Director's Fax (919) 571-
4126
In State Office Phone: (919) 571-4114 (800) 992-9457
Nationwide Office Phone:
Office Fax: (919) 571-4126
E-Mail: [email protected]
North Dakota
Mike Schwindt, Director
Department of Human Services, Child Support Enforcement Agency
P.O. Box 7190
(Street Address: 1929 North Washington Street, Bismarck, ND 58507-
7190)
Bismarck, ND 58507-7190
IVD Director's Phone: (701) 328-3582 or 5493, IVD Director's Fax:
(701) 328-6575
In State Office Phone: (701) 328-3582, (800) 755-8530
Nationwide Office Phone:
Office Fax: (701) 328-5497
E-Mail: [email protected]
Ohio
Barbara Saunders, Deputy Director
Department of Human Services, Office of Child Support Enforcement
30 East Broad Street, 31st Floor
Columbus, OH 43266-0423
IVD Director's Phone: (614) 752-6561, IVD Director's Fax: (614) 752-
9760
In State Office Phone: (614) 752-6561 (800) 686-1556
Nationwide Office Phone:
Office Fax: (614) 752-9760
E-Mail: [email protected]
Oklahoma
Ray Weaver, Administrator
Department of Human Services, Child Support Enforcement Division
P.O. Box 53552
(Street Address: 2409 N. Kelley Avenue, Annex Building, Oklahoma
City, OK 73152
Oklahoma City, OK 73152
IVD Director's Phone: (405) 522-5871, IVD Director's Fax: (405) 522-
2753
In State Office Phone: (405) 522-5871
Nationwide Office Phone: (800) 522-2922
Office Fax: (405) 522-2753
E-Mail: Elaine.H[email protected]
Oregon
Kevin Aguirre, Director
Department of Human Resources, Adult and Family Services Division
Oregon Child Support Program
500 Summer St. NE
Salem, OR 97310-1013
IVD Director's Phone: (503) 945-5600, IVD Director's Fax: (503) 373-
7492
In State Office Phone: (503) 378-5567, (800) 850-0288 (800) 850-0294
(rotary)
Nationwide Office Phone:
Offixe Fax: (503) 391-5526
E-Mail: [email protected]
Pennsylvania
Daniel Richard, Director
Department of Public Welfare, Bureau of Child Support Enforcement
P.O. Box 8018
(Street Address: 1303 North Seventh St., 17102 Commerce Bldg., 12th
Floor, Harri Harrisburg, PA 17105
IVD Director's Phone: (717) 783-5441 IVD Director's FAX: (717) 772-
4936
In State Office Phone: (717) 787-3672
Nationwide Office Phone: (800) 932-0211
Office Fax: (717) 787-9706
Puerto Rico
Miguel Verdiales, Administrator
Department of Social Services, Administration for Child Support
P.O. Box 3349
San Juan, PR 00902
IVD Director's Phone: (787) 767-1886 IVD Director's FAX: (787) 282-
8324
In State Office Phone: (787) 767-1500
Nationwide Office Phone: (800) 932-0211
Office Fax: (787) 723-6187
E-Mail: [email protected]
Rhode Island
John F. Murphy, Administrator
Department of Administration, Division of Child Support Enforcement
77 Dorrance Street
Providence, RI 02903
IVD Director's Phone: (401) 222-2847 IVD Director's FAX: (401) 222-
2887
In State Office Phone: (410) 277-2847 (800) 922-0536
Nationwide Office Phone:
Office Fax: (401) 277-6674
E-Mail: [email protected]
South Carolina
Larry J. McKeown, Director
Department of Social Services, Child Support Enforcement Division
P.O. Box 1469
(Street Address: 3150 Harden Street, Columbia, SC 29202-1469)
Columbia, SC 29202-1469
IVD Director's Phone: (803) 737-5870 IVD Director's FAX: (803) 737-
6032
In State Office Phone: (803) 737-5875 (800) 768-6779 (payments)
Nationwide Office Phone: (803) 768-5858
Office Fax: (803) 737-6032
E-Mail: [email protected]
South Dakota
Terry Walter, Program Administrator
Department of Social Services, Office of Child Support Enforcement
700 Governor's Drive, Suite 84
Pierre, SD 57501-2291
IVD Director's Phone: (605) 773-3641 IVD Director's Fax: (605) 773-
5246
In State Office Phone: (605) 773-3641
Nationwide Office Phone:
Office Fax: (605) 773-5246
E-Mail: [email protected]
Tennessee
Glenda Sherron, Director
Department of Human Services, Child Support Services
Citizens Plaza Building, 12th Floor
400 Deadrick Street
Nashville, TN 37248-7400
IVD Director's Phone: (615) 313-4879 IVD Director's Fax: (615) 741-
4165
In State Office Phone: (615) 313-4880 (800) 874-0530 (payments)
Nationwide Office Phone:
Office Fax: (615) 532-2791
E-Mail: [email protected]
Texas
Howard Baldwin, Director
Office of the Attorney General, Child Support Division
P.O. Box 12017
(Street Address: 5500 E. Oltorf, Austin, TX 78741)
Austin, TX 78711-2017
IVD Director's Phone: (512) 460-6000 IVD Director's Fax: (512) 460-
6028
In State Office Phone: (512) 460-6000
Nationwide Office Phone: (800) 252-8014
Office Fax: (512) 834-9712
E-Mail: Howard.B[email protected]
Utah
James Kidder, Director
Department of Human Services, Bureau of Child Support Services
P.O. Box 45011
(515 East, 100 South, Salt Lake City, UT 84145-0011)
Salt Lake, UT 84145-0011
IVD Director's Phone: (801) 536-8911 IVD Director's Fax: (801) 536-
8509
In State Office Phone: (801) 536-8500
Nationwide Office Phone: (800) 257-9156
Office Fax: (801) 536-8509
E-Mail: [email protected]
Vermont
Jeffery Cohen, Director
Office of Child Support
103 South Main Street
Waterbury, VT 05671-1901
IVD Director's Phone: (802) 241-2319 IVD Director's Fax: (802) 244-
1483
In State Office Phone: (802) 244-1483
Nationwide Office Phone: (800) 786-3214
Office Fax: (802) 244-1483
E-Mail: [email protected]
Virgin Islands
Cisselon D Nichols, Director
Department of Justice, Paternity and Child Support Division
GERS Building, 2nd Floor
48B-50C Krondprans Gade
St. Thomas, VI 00802
IVD Director's Phone: (809) 775-3070 IVD Director's Fax: (809) 775-
3808
In State Office Phone: (809) 774-4339
Nationwide Office Phone:
Office Fax: (809) 774-9710
Virginia
Nathaniel Young, Jr., Director
Department of Social Services, Division of Child Support Enforcement
730 East Broad Street
Richmond, VA 23219
IVD Director's Phone: (804) 692-1501 IVD Director's Fax: (804) 692-
1543
In State Office Phone: (804) 692-1428 (800) 468-8894
Nationwide Office Phone:
Office Fax: (804) 692-1405
E-Mail: NLY[email protected]
Washington
Meg Sollenberger, Director
[[Page 55374]]
DSHS, Division of Child Support
P.O. Box 9162
(Street Address: 712 Pear St., SE, Olympia, WA 98507)
Olympia, WA 98507
IVD Director's Phone: (360) 664-5441 IVD Director's Fax: (360) 586-
3274
In State Office Phone: (360) 664-5005
Nationwide Office Phone: (800) 457-6202
Office Fax: (206) Seattle Area Code
E-Mail: [email protected]
West Virginia
Lena S Hill, Commissioner
Department of Health & Human Resources, Bureau of Child Support
Enforcement
Building 6, Room 817
State Capitol Complex
Charleston, WV 25305
IVD Director's Phone: (304) 558-3780 IVD Director's Fax: (304) 558-
4092
In State Office Phone: (304) 558-3780
Nationwide Office Phone: (800) 249-3778
Office Fax:
Wisconsin
Susan Pfeiffer, Director
Bureau of Child Support, Division of Economic Support
P.O. Box 7935
(Street Address: 1 West Wilson Street, Room 382, Madison, WI 53707)
Madison, WI 53707-7935
IVD Director's Phone: (608) 266-9909 IVD Director's Fax: (608) 267-
2824
In State Office Phone: (608) 266-9909
Nationwide Office Phone:
Office Fax: (608) 267-2824
E-Mail: [email protected]
Wyoming
William D Schaad, Administrator
Department of Family Services, Child Support Enforcement Program
Hathaway Building, Rm 361
2300 Capital Avenue
Cheyenne, WY 82002-0170
IVD Director's Phone: (307) 777-3695 IVD Director's Fax: (307) 777-
3693
In State Office Phone: (307) 777-7631
Nationwide Office Phone: (800) 457-3659
Office Fax: (307) 777-3693
E-Mail: [email protected]
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[FR Doc. 99-26386 Filed 10-8-99; 8:45 am]
BILLING CODE 4184-01-C