[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]]

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Part II





Department of Health and Human Services





_______________________________________________________________________



Administration for Children and Families



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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

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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]]

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[[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

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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]

BILLING CODE 4184-01-M

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[FR Doc. 99-26386 Filed 10-8-99; 8:45 am]
BILLING CODE 4184-01-C