[Federal Register Volume 67, Number 20 (Wednesday, January 30, 2002)]
[Notices]
[Pages 4432-4453]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-2130]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families

[Program Announcement No. OCS-2002-04]


Request for Applications Under the Office of Community Services' 
Fiscal Year 2002 National Youth Sports Program (NYSP Program)

AGENCY: Office of Community Services (OCS), Administration for Children 
and Families, Department of Health and Human Services.

ACTION: Announcement of availability of funds and request for 
competitive applications under the Office of Community Services' 
National Youth Sports Program.

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SUMMARY: The Administration for Children and Families (ACF), Office of 
Community Services (OCS) announces that competing applications will be 
accepted for new grants pursuant to the Secretary's discretionary 
authority under Section 682 of the Community Services Block Grant Act, 
as amended, 42 U.S.C 9923.
    This announcement is inviting applications for project periods up 
to 5 years. Awards, on a competitive basis, will be for a one-year 
budget period, although project periods may be for 5 years. 
Applications for continuation grants funded under these awards beyond 
the one-year budget period but within the 5 year project period will be 
entertained in subsequent years on a noncompetitive basis, subject to 
availability of funds, satisfactory progress of the grantee and a 
determination that continued funding would be in the best interest of 
the Government.

CLOSING DATE: The closing date and time for receipt of applications is 
4:30 p.m., (Eastern Time Zone), on April 1, 2002. Mailed or hand 
carried applications received after 4:30 p.m. on the closing date will 
be classified as late.

FOR FURTHER INFORMATION CONTACT: Veronica Terrell (202) 401-5295, 
[email protected] or Richard Saul, [email protected], Department 
of Health and Human Services, Administration for Children and Families, 
Office of Community Services, 5th Floor West, 370 L'Enfant Promenade, 
SW., Washington, DC 20447. In addition, this Announcement is accessible 
on the OCS WEBSITE for reading and downloading at: http://www.acf.dhhs.gov/programs/ocs--

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Double click on Funding Opportunities. The Catalog of Federal Domestic 
Assistance (CFDA) number for this program is 93.570. The title is 
National Youth Sports Program (NYSP Program).

Paperwork Reduction Act of 1995

    All information collections within this program announcement are 
approved under the following currently valid OMB control number 0970-
0139 which expires 12/31/2003.
    Public reporting burden for this collection of information is 
estimated to average 10 hours per response, including the time for 
reviewing instructions, gathering and maintaining the data needed and 
reviewing the collection information. 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.

SUPPLEMENTARY INFORMATION: This program announcement consists of seven 
parts plus Attachments:

Part I: Introduction

    Legislative authority, definition of terms, and purpose.

Part II: Background Information

    Eligible applicants, program priority area, project and budget 
period, availability of funds and grant amounts, matching funds 
requirements, program participants and beneficiaries.

Part III: The Project Description, Program Proposal Elements and 
Review Criteria

    Purpose, project summary/abstract, objectives and need for 
assistance, results or benefits expected, organizational profiles, 
budget justification, administrative costs and indirect costs, non-
federal resources, and evaluation/review criteria.

Part IV: Applicaiton Procedures

    Availability of forms, application submission, application 
consideration, and application screening.

Part V: Instructions for Completing Applications Forms: SF 424, SF 
424A, and SF 424B

Part VI: Contents of Application and Receipt Process

    Content and order of application and acknowledgment of receipt.

Part VII: Post Award Information and Reporting Requirements

    Notification of grant award, reporting requirements, audit 
requirements, prohibitions and requirements with regard to lobbying.

Part I. Introduction

A. Legislative Authority

    Section 682 of the Community Services Block Grant Act, as amended, 
42 U.S.C. 9923 authorizes the Secretary of Health and Human Services to 
make a grant to an eligible service provider to administer national or 
regional programs designed to provide instructional activities for low-
income youth.

B. Definitions of Terms

    For purposes of this Program Announcement the following definitions 
apply:

--Low-income youth: a youth between the ages of 10 through 16 whose 
family income does not exceed the DHHS Poverty Income Guidelines (see 
Attachment A).
--Budget period: The interval of time into which a grant period of 
assistance is divided for budgetary and funding purposes.
--Project period: The total time for which a project is approved for 
support, including any approved extensions.
--Secretary: Means the Secretary of Health and Human Services, acting 
through the Director of the Office of Community Services.

C. Program Purpose

    The Department of Health and Human Services is committed to 
improving the health and physical fitness of young people, particularly 
those that are members of low-income families and residents of 
economically disadvantaged areas of the United States.

Part II--Background Information

A. Eligible Applicants

    A service provider that is a national private, non-profit 
organization, a coalition of such organizations, or a private, non-
profit organization applying jointly with a business concern and faith-
based organizations shall be eligible to apply for a grant under this 
section if:
    1. the applicant has demonstrated experience in operating a program 
providing instruction to low-income youth;
    2. the applicant agrees to contribute an amount (in cash or in-
kind, fairly evaluated) of not less than 25 per cent of the amount 
requested, for the program funded through the grant;
    3. the applicant agrees to use no funds from a grant authorized 
under this section for administrative expenses; and
    4. the applicant agrees to comply with the regulations or program 
guidelines promulgated by the Secretary for use of funds made available 
through the grant.

B. Program Priority Area

    There is one Program Priority Area under this announcement.

C. Project and Budget Period (See Definition of Terms)

    The project period will be 60 months (5 years), with budget periods 
not to exceed 12 months. A significant amount of the program activities 
must be undertaken in the period covering June, July and August of each 
fiscal year.

D. Availability of Funds and Grants Amounts

    In Fiscal Year 2002, OCS expects approximately $17,000,000 to be 
available for funding commitments to approximately one new project 
under this program. For Fiscal Years 2003-2006, OCS anticipates, 
subject to the availability of funds, that one non-competing 
continuation grant will be made under this program.

E. Matching Funds Requirements

    The grant requires a match of either cash or third party in-kind, 
fairly evaluated and not less than 25% of the Federal funds requested.

F. Program Participants/Beneficiaries

    Projects proposed for funding under this announcement must result 
in direct benefits targeted toward youth between the ages of 10-16 from 
low-income families.
    Attachment A of the appendices to this announcement is an excerpt 
from the HHS Poverty Income Guidelines currently in effect. Annual 
revisions of these Guidelines are normally published in the Federal 
Register in February or early March of each year and are applicable to 
projects being implemented during the year subsequent to publication. 
Grantees will be required to apply the most recent Guidelines 
throughout the project period. No other government agency or privately 
defined poverty guidelines are applicable to the determination of low-
income eligibility for this OCS funded program.

G. Multiple Submittals and Multiple Grants

    An applicant organization should not submit more than one 
application under this Program Announcement.

H. Maintenance of Effort

    The activities funded under this program announcement must be in 
addition to, and not in substitution for, activities previously carried 
on without

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Federal assistance. A Certificate of Maintenance of Effort must be 
included with the application (See Attachment J).

Part III. The Project Description, Program Proposal Elements and 
Review Criteria

A. Purpose

    The project description provides the major means by which an 
application is evaluated and ranked to compete with other applications 
for available assistance. The project description should be concise and 
complete and should address the activity for which Federal funds are 
being requested. Supporting documents should be included where they can 
present information clearly and succinctly. Applicants should provide 
information on their organizational structure, staff, related 
experience, and other information considered to be relevant. Awarding 
offices use this and other information to determine whether the 
applicant has the capability and resources necessary to carry out the 
proposed project. It is important, therefore, that this information be 
included in the application. However, in the narrative the applicant 
must distinguish between resources directly related to the proposed 
project and those resources that will not be used in support of the 
specific project for which funds are requested.

B. Project Summary/Abstract

    Provide a summary of the project description (a page or less) with 
reference to the funding request.

C. Objectives and Need for Assistance

    Clearly identify the physical, economic, social, financial, 
instructional, and/or other problem(s) requiring solution. The need for 
assistance must be demonstrated and the principal and subordinate 
objectives of the proposal must be clearly stated; supporting 
documentation, such as letters of support and testimonials from 
concerned interests other than the applicant, may be included. Any 
relevant data based on planning studies should be included or referred 
to in the endnotes/footnotes. Incorporate demographic data and 
participant/beneficiary information, as needed. In developing the 
project description, the applicant may volunteer or be requested to 
provide information on the total range of projects currently being 
conducted and supported (or to be initiated), some of which may be 
outside the scope of the program announcement.

D. Results or Benefits Expected

    Identify the results and benefits to be derived.

E. Approach

    Outline a plan of action which describes the scope and detail of 
how the proposed work will be accomplished. Account for all functions 
or activities identified in the application. Cite factors which might 
accelerate or decelerate the work and state your reason for taking the 
proposed approach rather than others. Describe any unusual features of 
the project such as design or technological innovations, reductions in 
cost of time, or extraordinary social and community involvement.
    Provide quantitative monthly or quarterly projections of the 
accomplishments to be achieved for each function or activity in such 
terms as the number of people to be served. When accomplishments cannot 
be quantified by activity or function, list them in chronological order 
to show the schedule or accomplishments and their target dates.
    If any data is to be collected, maintained, and/or disseminated, 
clearance may be required from the U.S. Office of Management and Budget 
(OMB). This clearance pertains to any ``collection of information that 
is conducted or sponsored by ACF.''
    List organizations, cooperating entities, consultants, or other key 
individuals who will work on the project along with a short description 
of the nature of their effort or contribution.

F. Organizational Profiles

    Provide information on the applicant organization(s) and 
cooperating partners such as organizational charts, financial 
statements, audit reports or statements from CPAs/Licensed Public 
Accountants, Employer Identification Numbers, names of bond carriers, 
contact persons and telephone numbers, child care licenses and other 
documentation of professional accreditation, information on compliance 
with Federal/State/local government standards, documentation of 
experience in the program area, and other pertinent information. Any 
non-profit organization submitting an application must submit proof of 
its non-profit status in its application at the time of submission. The 
non-profit agency can accomplish this by providing a copy of the 
applicant's listing in the Internal Revenue Service's (IRS) most recent 
list of tax-exempt organizations described in Section 501(c)(3) of the 
IRS code, or, by providing a copy of the currently valid IRS tax 
exemption certificate, or, by providing a copy of the articles of 
incorporation bearing the seal of the State in which the corporation or 
association is domiciled.

G. Budget and Budget Justification

    Provide a 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 details 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 that describes how 
categorical costs are derived. Discuss the necessity, reasonableness, 
and allocability of the proposed costs.
    The following guidelines are for preparing the budget and budget 
justification. Both Federal and non-Federal resources must be detailed 
and justified in the budget and narrative justification. For purposes 
of preparing the budget and budget justification, ``Federal resources'' 
refers only to the ACF grant for which you are applying. Non-Federal 
resources are all other Federal and non-Federal resources. It is 
suggested that budget amounts and computations be presented in a 
columnar format: first column, object class categories; second column, 
Federal budget; next column(s), non-Federal budget(s), and last column, 
total budget. The budget justification should be a narrative.
Personnel
    Description: Costs of employee salaries and wages.
    Justification: Identify the project director or principal 
investigator, if known. For each staff person, provide the title, time 
commitment to the project (in months), time commitment to the project 
(as a percentage or full-time equivalent), annual salary, grant salary, 
wage rates, etc. Do not include the costs of consultants or personnel 
costs of delegate agencies or of specific project(s) or businesses to 
be financed by the applicant. Administrative costs may not be charged 
to the Federal grant.
Fringe Benefits
    Description: Costs of employee fringe benefits unless treated as 
part of an approved indirect cost rate.
    Justification: Provide a breakdown of the amounts and percentages 
that comprise fringe benefit costs such as

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health insurance, FICA, retirement insurance, taxes, etc.
Travel
    Description: Costs of project-related travel by employees of the 
applicant organization (does not include costs of consultant travel).
    Justification: For each trip, show the total number of traveler(s), 
travel destination, duration of trip, per diem, mileage allowances, if 
privately owned vehicles will be used, and other transportation costs 
and subsistence allowances.
Equipment
    Description: ``Equipment'' means an article of nonexpendable, 
tangible personal property having a useful life of more than one year 
and an acquisition cost which equals or exceeds the lesser of (a) the 
capitalization level established by the organization for the financial 
statement purposes, or (b) $5,000. (Note: Acquisition cost means the 
net invoice unit price of an item of equipment, including the cost of 
any modifications, attachments, accessories, or auxiliary apparatus 
necessary to make it usable for the purpose for which it is acquired. 
Ancillary charges, such as taxes, duty, protective in-transit 
insurance, freight, and installation shall be included in or excluded 
from acquisition cost in accordance with the organization's regular 
written accounting practices.)
    Justification: For each type of equipment requested, provide a 
description of the equipment, the cost per unit, the number of units, 
the total cost, and a plan for use on the project, as well as use or 
disposal of the equipment after the project ends. An applicant 
organization that uses its own definition for equipment should provide 
a copy of its policy or section of its policy which includes the 
equipment definition.
Supplies
    Description: Costs of all tangible personal property other than 
that included under the Equipment category.
    Justification: Specify general categories of supplies and their 
costs. Show computations and provide other information which supports 
the amount requested.
Contractual
    Description: Costs of all contracts for services and goods except 
for those which belong under other categories such as equipment, 
supplies, construction, etc. Third-party evaluation contracts (if 
applicable) and contracts with secondary recipient organizations, 
including delegate agencies and specific project(s) or businesses to be 
financed by the applicant, should be included under this category.
    Justification: All procurement transactions shall be conducted in a 
manner to provide, to the maximum extent practical, open and free 
competition. Recipients and subrecipients, other than States that are 
required to use procedures in 45 CFR part 92, must justify any 
anticipated procurement action that is expected to be awarded without 
competition and exceed the simplified acquisition threshold fixed at 41 
U.S.C. 403(11) (currently set at $100,000). Recipients might be 
required to make available to ACF pre-award review and procurement 
documents, such as request for proposals or invitations for bids, 
independent cost estimates, etc.

    Note: Whenever the applicant intends to delegate part of the 
project to another agency, the applicant must provide a detailed 
budget and budget narrative for each delegate agency, by agency 
title, along with the required supporting information referred to in 
these instructions.

Other
    Indicate the totals for all other costs. Such costs, where 
applicable and appropriate, may include but are not limited to 
insurance, food, medical and dental costs (noncontractual), 
professional services costs, space and equipment rentals, printing and 
publication, computer use, training costs, such as tuition and 
stipends, staff development costs, and administrative costs.
    Justification: Provide computations, a narrative description and a 
justification for each cost under this category.

H. Administrative Costs

    No federal funds from a grant made under this program may be used 
for administrative expenses.

I. Indirect Costs

    Total amount of indirect costs. This category should be used only 
when the applicant currently has an indirect cost rate approved by the 
Department of Health and Human Services (HHS) or another cognizant 
Federal agency.
    Justification: An applicant that will charge indirect costs to the 
grant must enclose a copy of the current rate agreement. If the 
application organization is in the process of initially developing or 
renegotiating a rate, it should immediately upon notification that an 
award will be made, develop a tentative indirect cost rate proposal 
based on its most recently completed fiscal year in accordance with the 
principles set forth in the cognizant agency's guidelines for 
establishing indirect cost rates, and submit it to the cognizant 
agency. Applicants awaiting approval of their indirect cost proposals 
may also request indirect costs. It should be noted that when an 
indirect cost rate is requested, those costs included in the indirect 
cost pool should not also be charged as direct costs to the grant. 
Also, if the applicant is requesting a rate which is less than what is 
allowed under the program, the authorized representative of the 
applicant organization must submit a signed acknowledgment that the 
applicant is accepting a lower rate than allowed.

J. Program Income

    The estimated amount of income, if any, expected to be generated 
from this project.
    Justification: Describe the nature, source and anticipated use of 
program income in the budget or refer to the pages in the application 
which contain this information.

K. Non-Federal Resources

    Amounts of non-Federal resources that will be used to support the 
project as identified in Block 15 of the SF-424.
    Justification: The firm commitment of these resources must be 
documented and submitted with the application in order to be given 
credit in the review process. A detailed budget must be prepared for 
each funding source.

L. Evaluation Criteria

    Each application which passes the initial screening will be 
addressed and scored by three independent 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. Scoring will be based on a 
total of 100 points, and for each application will be the average of 
the scores of the three reviewers.
    The competitive review of proposals will be based on the degree to 
which applicants adhere to the program requirements and incorporate 
each of the Elements and Sub-Elements below into their proposals.
Review Criteria--Proposal Elements and Review Criteria for Applications

Purpose

    Any instructional activity carried out by an eligible service 
provider receiving a grant under this program announcement shall be 
carried out on the campus of an institution of higher

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education (as defined in section 1201(a) of the Higher Education Act) 
and shall include--
    a. Access to the facilities and resources of such institution;
    b. An initial medical examination and follow-up referral or 
treatment, without charge, for youth during their participation in such 
activity;
    c. At least one nutritious meal daily, without charge, for 
participating youth during each day of participation;
    d. High quality instruction in a variety of sports (that shall 
include swimming and that may include dance and any other high quality 
recreational activity) provided by coaches and teachers from 
institutions of higher education and from elementary and secondary 
schools (as defined in section 14101 of the Elementary and Secondary 
Education Act of 1965); and
    e. Enrichment instruction and information on matters relating to 
the well-being of youth, to include educational opportunities and study 
practices, education for the prevention of drug and alcohol abuse, 
health and nutrition, career opportunities, and family and job 
responsibilities.
    The eligible service provider shall, in each community in which a 
program is funded shall ensure that:
    a. A community-based advisory committee is established, with 
representatives from local youth, family, and social service 
organizations, schools, entities providing park and recreation 
services, and other community-based organizations serving high-risk 
youth;
    b. An existing community-based advisory board, commission, or 
committee with similar membership is utilized to serve the committee 
described above; and
    c. Enter into formal partnerships with youth serving organizations 
or other appropriate social service entities in order to link program 
participants with year-round services in their home communities that 
support and continue the objectives of this subtitle.
Review Criteria--Objectives and Need for Assistance (Maximum: 5 points)
    The applicant should clearly define the specific needs that the 
project will address and state its underlying assumptions about how 
these specific needs can be addressed by the proposed project. As 
previously noted, any relevant data based on planning studies should be 
included or referred to in the endnotes/footnotes and demographic data 
and participant/beneficiary information should be incorporated, as 
needed. In developing the project description, the applicant may also 
volunteer or be requested to provide information on the total range of 
projects currently being conducted and supported (or to be initiated), 
some of which may be outside the scope of the program announcement.
Review Criteria--Organizational Profile (Maximum: 25 Points)

Organizational Experience in Program Area and Staff Responsibilities

    a. Organizational experience in program area (0-10 points). 
Documentation provided indicates that projects previously undertaken 
have been relevant and effective and have provided significant benefits 
to low-income youth. Information provided should also address the 
achievements and competence of any participating institutions.
    b. Management history (0-5 points). Applicants must fully detail 
their ability to implement sound and effective management practices. If 
they have been recipients of other Federal or other governmental 
grants, they must also detail that they have consistently complied with 
financial and program progress reporting and audit requirements. 
Applicants should submit any available documentation on their 
management practices and progress reporting procedures. Applicant 
should also submit a statement by a Certified or Licensed Public 
Accountant as to the sufficiency of the applicant's financial 
management system to protect any Federal funds which may be awarded 
under this program.
    c. Staffing skills, resources and responsibilities (0-10 points). 
Applicant must briefly describe the experience and skills of the 
proposed project director showing that the individual is not only well 
qualified but that his/her professional capabilities are relevant to 
the successful implementation of the project. If the key staff person 
has not been identified, the application should contain a comprehensive 
position description which indicates that the responsibilities assigned 
to the project director are relevant to the successful implementation 
of the project.
    The application must indicate that the applicant and the 
subgrantees or delegate institutions have adequate facilities and 
resources (i.e. space and equipment) to successfully carry out the 
proposed work plan. The application must clearly show that sufficient 
time of the Project Director and other senior staff will be budgeted to 
assure timely implementation and oversight of the project and that the 
assigned responsibilities of the staff are appropriate to the tasks 
identified for the project.
Review Criteria--Approach--Project Design and Implementation (Maximum: 
40 Points)
    Approach I: Location and Number of Institutions of Higher Education 
(Maximum: 20 points).
    a. Applicant must describe and document the number and location of 
Institutions of Higher Education committed to participation in this 
program, with special attention to documenting the accessibility of the 
schools to economically disadvantaged communities. (0-12 points).
    b. Applicant must describe in the aggregate the facilities which 
will be available on the campuses of the institutions to be used in the 
program (swimming pools, medical facilities, food preparation 
facilities, etc). (0-8 points).
    Approach II: Adequacy of Work Program (Maximum: 20 Points).
    a. Applicant must set forth realistic weekly time targets for the 
summer program. The time targets should specify the tasks to be 
accomplished in the given time frames. (0-8 points).
    b. Applicant must address the legislatively-mandated activities 
found in Part I(A), to include: (1) Project priorities and rationale 
for selecting them; (2) project goals and objectives; and (3) project 
activities. (0-12 points)
Review Criteria--Adequacy of Budget (Maximum: 10 Points)
    Budget is adequate and funds requested are commensurate with the 
level of effort necessary to accomplish the goals and objectives of the 
program. The estimated cost of the project to the government is 
reasonable in relation to the anticipated results.
Evaluation Criteria--Results or Benefits Expected (Maximum: 20 Points)
    Element I: Significant and Beneficial Impact.
    a. Applicant proposes to improve nutritional services to the 
participating youths (0-5 points).
    b. Project incorporates medical examinations along with follow-up 
referral or treatment without charge (0-5 points).
     c. Project includes counseling related to drug and alcohol abuse 
by couselors with experience in those areas as a major element (0-5 
points).
    d. Project makes use of an existing outreach activity of a 
community action agency or some other community-based organization (0-5 
points).

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Part IV--Application Procedures

A. Availability of Forms

    Attachments B through J contain all of the standard forms under 
this OCS program. These attachments and PARTS V, and VI of this Notice 
contain all the instructions required for submittal of applications.

B. Application Submission

    Mailing Address: NYSP applications should be mailed to the U.S. 
Department of Health and Human Services, Administration for Children 
and Families, Office of Grants Management, Office of Child Support 
Enforcement, Attn: NYSP Program, 370 L'Enfant Promenade, SW., 4th Floor 
West, Washington, DC 20447.
    Number of Copies Required. One signed original application and two 
copies must be submitted at the time of initial submission. (OMB 0970-
0139). Two additional optional copies would be appreciated to 
facilitate the processing of applications.
    Deadline: Mailed applications shall be considered as meeting an 
announced deadline if they are received on or before the deadline time 
and date at the U.S. Department of Health and Human Services, 
Administration for Children and Families, Office of Grants Management, 
Office of Child Support Enforcement, Attn: NYSP Program, 370 L'Enfant 
Promenade, SW., 4th Floor West, Washington, DC 20447. Applicants are 
responsible for mailing applications well in advance, when using all 
mail services, to ensure that the applications are received on or 
before the deadline time and date.
    Applications hand carried by applicants, applicant couriers, or by 
other representatives or 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 at the U.S. 
Department of Health and Human Services, Administration for Children 
and Families, Office of Grants Management, Office of Child Support 
Enforcement, ACF Mailroom, 2nd Floor (near loading dock), Aerospace 
Center, 901 ``D'' Street, SW., Washington, DC 20024, between Monday and 
Friday (excluding Federal holidays). (Applicants are cautioned that 
express/overnight mail services do not always deliver as agreed). The 
address must appear on the envelope/package containing the application 
with the note ``Attention: NYSP Program.''
    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 deadline: ACF may extend application deadlines when 
circumstances such as acts of God such as floods, hurricanes, etc. 
occur, when there are widespread disruptions of mail service, or in 
other rare cases. A determination to extend or waive deadline 
requirements rest with ACF's Chief Grants Management Officer.
    Intergovernmental Review: This program is covered under Executive 
Order 12372, Intergovernmental Review of Federal Programs, and 45 CFR 
Part 100, Program and Activities. Under the order States may design 
their own processes for reviewing and commenting on proposed Federal 
assistance under covered programs.
    All States and Territories except Alabama, Alaska, Arizona, 
Colorado, Connecticut, Kansas, Hawaii, Idaho, Indiana, Louisiana, 
Massachusetts, Minnesota, Montana, Nebraska, New Jersey, New York, 
Ohio, Oklahoma, Oregon, Palau, Pennsylvania, South Dakota, Tennessee, 
Vermont, Virginia, Washington and Wyoming have elected to participate 
in the Executive Order process and have established Single Points of 
Contacts (SPOCs). Applicants from these twenty-seven jurisdictions need 
take no action regarding E.O. 12372. Applicants for projects to be 
administered by Federally-recognized Indian Tribes are also exempt from 
the requirements of E.O. 12372. Otherwise, applicants should contact 
their SPOCs as soon as possible to alert them of the prospective 
applications and receive any necessary instructions. Applicants must 
submit any required material to the SPOCs as soon as possible so that 
the program office can obtain and review SPOC comments as part of the 
award process. It is imperative that the applicant submit all required 
materials, if any, to the SPOC and indicate the date of this submittal 
(or the date of contact if no submittal is required) on the Standard 
Form 424, item 16a.
    Under 45 CFR 100.8(a)(2), a SPOC has 60 days from the application 
deadline to comment on proposed new or competing continuation awards.
    When comments are submitted directly to ACF, they should be 
addressed to: Department of Health and Human Services, Administration 
for Children and Families, OCSE Office of Grants Management, 4th Floor 
West, 370 L'Enfant Promenade, SW., Washington, DC 20447.
    A list of the Single Points of Contact for each State and Territory 
is included as Attachment K to this Announcement.

C. Application Consideration

    Applications which meet the screening requirements in Section D 
below will be reviewed competitively. Such applications will be 
referred to reviewers for a numerical score and explanatory comments 
based solely on responsiveness to program guidelines and evaluation 
criteria published in this announcement. The applications will be 
reviewed by qualified reviewers. 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 will 
generally be considered in order of the average scores assigned by 
reviewers. However, highly ranked applications are not guaranteed 
funding since the Director may also consider other factors deemed 
relevant 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; previous program performance of applicants; 
compliance with grant terms under previous DHHS grants; audit reports; 
investigative reports; and applicant's progress in resolving any final 
audit disallowances on OCS or other Federal agency grants. OCS reserves 
the right to discuss applications with other Federal or non-Federal 
funding sources to ascertain the applicant's performance record.

D. Criteria for Reviewing Applications

    All applications that meet the published deadline for submission 
will be screened to determine completeness and conformity to the 
requirements of this Announcement. Only those applications meeting the 
following requirements will be reviewed and evaluated competitively. 
Others will be returned to the applicants with a notation that they 
were unacceptable.
Initial Screening
    (1) The application must contain a completed Standard Form 424 
``Application for Federal Assistance'' (SF-424), signed by an official 
of the organization applying for the grant who has authority to 
obligate the organization legally;
    (2) One budget form (SF-424A) covering the entire NYSP project; and

[[Page 4438]]

    (3) Signed ``Assurances'' (SF-424B) by the appropriate official.
Pre-Rating Review
    Applications which pass the initial screening will be forwarded to 
reviewers for analytical comment and scoring based on the criteria 
detailed in the Section III.L above and the specific requirements 
contained in Part IV of this Announcement. Prior to the programmatic 
review, these reviewers and/or OCS staff will verify that the 
applications comply with this Program Announcement in the following 
areas:
    (1) Eligibility: Applicant meets the eligibility requirements found 
in Part II.
    (2) Target Populations: The application clearly targets the 
specific outcomes and benefits of the project to low-income 
participants as defined in the DHHS Poverty Income Guidelines 
(Attachment A).
    (3) Grant Amount: The amount of funds requested does not exceed the 
estimated amount of $17 million.
    Applications which pass the initial screening and 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 from 
describing major strengths and major weaknesses under each applicable 
criterion published in this Announcement.

Part V. Instructions for Completing Application Forms

    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(Attachment B and C) 
as modified by the OCS specific instructions set forth below:
    Provide line item 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 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

    (One SF-424 to be completed by applicant).
Top of Page
    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 (third line from the top).
    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 for non-profit organization.
    Item 9. Name of Federal Agency--Enter DHHS-ACF/OCS.
    Item 10. The Catalog of Federal Domestic Assistance number for OCS 
programs covered under this announcement is 93.570.
    Item 11. Enter a brief descriptive title of the project.
    Item 13. Proposed Project--The project start must begin on or 
before June 1, 2002; the ending date should be calculated on the basis 
of a 60 month Project Period.
    Item 15a. The amount should be no greater than $17 million.
    Item 15e. These items should reflect both cash and third party, in-
kind contributions for the Project Period.

B. SF-424A--Budget Information--Non-Construction Programs

    (One SF-424A completed for applicant, covering the entire NYSP 
Project).
    In completing these sections, the Federal Funds budget entries will 
relate to the requested OCS funds only, and Non-Federal will included 
mobilized funds from all other sources--applicant, state, local, other. 
Federal funds other requested OCS funding should be included in Non-
Federal entries.
Section A--Budget Summary
You need only fill in lines 1 and 5 (with the same amounts)
Col. (a): Enter ``NYSP Program''
Col. (b): Catalog of Federal Domestic Assistance 93.570. Col. (c) and 
(d) not relevant to this program
Column (e)-(g): enter the appropriate grant request amount
Section B--Budget Categories
    For applicants, a single SF-424A covering the entire NYSP project: 
complete a one-year budget in accordance with the instructions 
provided.

    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. Costs of supplies should 
be included under Category e. ``Supplies'' is tangible personal 
property other than ``equipment.'' ``Equipment'' means an article of 
nonexpendable, tangible personal property having a useful life of 
more than one year and acquisition cost which equals or exceeds the 
lesser of (a) the capitalization level establishing by the 
organization for financial statement purposes, or (b) $5,000. 
Articles costing less should be included in ``Supplies.''

    Section C--Non-Federal Resources should be completed in accordance 
with the instructions provided, remembering that ``all non-OCS funds'' 
fall into this category.
    Section D, E and F may be left blank.
    As previously noted in this Part, a supporting Budget Justification 
must be submitted providing details of expenditures under each budget 
category, with justification of dollar amounts which relate to the 
proposed expenditures to the work program and goals of the project.

C. SF-424B Assurances: Non-Construction Programs

    (One SF-424B to be submitted by applicant).
    Applicants requesting financial assistance for a non-construction 
project must file Standard Form 424B, ``Non-Construction Programs.'' 
(Attachment D). Applicants must sign and return the Standard Form 424B 
with their applications.
    Applicants must provide a certification concerning Lobbying prior 
to receiving an award in excess of $100,000. Applicants shall furnish 
an executed copy of the lobbying certification (See Attachments G and 
H). Applicants must sign and return the certifications with their 
applications. Applicants should note that the Lobbying Disclosure Act 
of 1995 has simplified the lobbying information required to be 
disclosed under 31 U.S.C. 1352.
    Applicants must make the appropriate certification on their 
compliance with the Drug-Free Workplace Act of 1998 and the Pro-
Children Act of 1994 (Certification Regarding Smoke Free Environment). 
(See Attachments E and I). By signing and submitting the applications, 
applicants are attesting to their intent to comply with these 
requirements 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

[[Page 4439]]

ineligible for award. (See Attachment F). 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 assurances are located at the end of this 
announcement.

Part VI. Contents of Application and Receipt Process

    Application pages should be numbered sequentially throughout the 
application package, beginning with a Summary/Abstract of the proposed 
project as page number one; and each application must include all of 
the following, in the order listed below:

A. Content and Order of Application

1. Table of Contents
    2. Project Summary--provide a summary of the project description, 
(a page or less), that would be suitable for use in an announcement 
application has been selected for a grant award; which the type of 
project, identifies the target population and number of participants to 
be served, number of institutions of higher education committed to the 
project and the major elements of the work program.
    3. A completed Standard Form 424 which has been signed by an 
official of the organization applying for the grant who has authority 
to obligate the organization legally; [Note: The original SF-424 must 
bear the original signature of the authorizing representative of the 
applicant];
    4. A single Budget Information-Non-Construction Programs (SF-424A) 
for the applicant, covering the entire NYSP Project.
    5. Narrative Budget Justification for each object class category 
included under Section B.
    6. Project Narrative is limited to the number of pages specified 
below.
    7. Appendices, which should include the following:
    a. Filled out, signed and dated Assurances--Non-Construction (SF 
424-B), Attachment C;
    b. Instructions for Completion of SP-LLL, Disclosure of Lobbying 
Activities: fill out, sign and date form found at Attachment G;
    c. Disclosure of Lobbying Activities SF-LLL: fill out, sign and 
date form found at Attachment H, if appropriate (omit Items 11-15 on 
the SF-LLL and ignore references to Attachment G, page, SF-LLL-A);
    d. Maintenance of Effort Certification (See Attachment J);
    e. Resumes and/or position descriptions (should be included in the 
appendices);
    f. Single Points of Contact comments, if available.
    g. and other information such: organization by-laws, articles of 
incorporation, proof of non-profit status, statement by a Certified or 
Licensed Public Accountant as to the sufficiency of the applicant's 
financial management system to protect Federal funds.

    Note: The total number of pages for the entire application 
package should not exceed 50 pages, including appendices. 
Applications should be two holed punched at the top and fastened 
separately with a compressor slide paper fastener or a binder clip. 
The submission of bound applications, or applications enclosed in 
binder, is especially discouraged. Pages should be numbered 
sequentially throughout the application package, excluding 
Appendices, beginning with the Summary/Abstract as Page #1.

    Applications must be uniform in composition since OCS may find it 
necessary to duplicate them for review purposes. Therefore, 
applications must be submitted on white 8\1/2\  x  11 inch paper only. 
They should not include colored, oversized or folded materials. Do not 
include organizational brochures or other promotional materials, 
slides, films, clips, etc. in the proposal. They may be discarded, if 
included.

B. Acknowledgment of Receipt

    Acknowledgment of Receipt--All applicants will receive an 
acknowledgment with an assigned identification number. Applicants are 
requested to supply a self-addressed mailing label with their 
application which can be attached to this acknowledgment. All 
applicants are requested to provide a FAX number and/or e-mail address 
as part of their application. The assigned identification number, along 
with any other identifying codes, must be referenced in all subsequent 
communications concerning the application. If an acknowledgment and/or 
notice is not received within three weeks after the deadline date, 
please notify ACF by telephone at (202) 401-5307 or 5295.

Part VII. 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 for use in 
the project period, the budget period for which support is provided, 
and the terms and conditions of the award, the total project period for 
which support is contemplated, and the total required grantee financial 
participation, if any.
    For Fiscal Years 2003-2006 the grantee will be notified of the 
requirements for submission of the continuation application by February 
of the pertinent fiscal year.

B. Reporting Requirements

    Grantee will be required to submit semi-annual progress and 
financial reports (SF-269) throughout the project period, as well as a 
final program and financial report 90 after the end of the project 
period.

C. Audit Requirements

    Grantee is subject to the audit requirements in 45 CFR Part 74 and 
OMB Circular A-133.
    In addition to the General Conditions and Special Conditions (where 
the latter are warranted) which will be applicable to grant, the 
grantee will be subject to the provisions of 45 CFR Part 74 along with 
OMB Circulars A-122, A-133, and, for institutions of higher education, 
A-21.

D. Prohibitions and Requirements with regard to Lobbying

    Section 1352 of Public Law 101-121, signed into law on October 23, 
1989, imposes prohibitions and requirements for disclosure and 
certification related to lobbying on recipients of Federal contracts, 
grants, cooperative agreements, and loans. It provides exemptions for 
Indian Tribes and tribal organizations. Current and prospective 
recipients (and their subtier contractors and/or grantees) are 
prohibited from using Federal funds, other than profits from a Federal 
contract, for lobbying Congress or any Federal agency in connection 
with the award of a contract, grant, cooperative agreement or loan. In 
addition, for each award action in excess of $100,000 (or $150,000 for 
loans) the law requires recipients and their subtier contractors and/or 
subgrantees (1) to certify that they have neither used nor will use any 
appropriated funds for payment to lobbyists; (2) to disclose the name, 
address, payment details, and purpose of any agreements with lobbyists 
whom recipients or their subtier contractor, or subgrantees will pay 
with profits or nonappropriated funds on or after December 22, 1989; 
and (3) to file quarterly up-dates about the use of lobbyists if 
material changes occur in their use. The law establishes civil 
penalties for noncompliance. See Attachments G and H for certification 
and disclosure forms to be submitted with the applications for this 
program.


[[Page 4440]]


    Dated: January 17, 2002.
Clarence H. Carter,
Director, Office of Community Services.

List of Attachments

A. Income Poverty Guidelines
B. Application for Federal Assistance (SF-424)
C. Budget Information--Non-Construction Programs (SF-424A)
D. Assurances--Non-Construction Programs (SF-424B)
E. Certification Regarding Drug-Free Workplace Requirements
F. Certification Regarding Debarment, Suspension, and other 
Responsibility Matters
G. Instructions for Completion of SF-LLL, Disclosure of Lobbying 
Activities
H. Disclosure of Lobbying Activities
I. Certification Regarding Environmental Tobacco Smoke
J. Certification Regarding Maintenance of Effort
K. Single Points of Contact Listing

BILLING CODE 4184-01-P

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[[Page 4442]]


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BILLING CODE 4184-01-C

[[Page 4443]]

Attachment B--Instructions for the SF-424

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

Item and Entry:

    1. Self-explanatory.
    2. Date application submitted to Federal agency (or State if 
applicable) & applicant's control number (if applicable).
    3. State use only (if applicable).
    4. If this application is to continue or revise an existing 
award, enter present Federal identifier number. If for a new 
project, leave blank.
    5. Legal name of applicant, name of primary organizational unit 
which will undertake the assistance activity, complete address of 
the applicant, and name and telephone number of the person to 
contact on matters related to this application.
    6. Enter Employer Identification Number (EIN) as assigned by 
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 Governments 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 District(s) 
affected by the program or project.
    15. Amount requested or to be contributed during the first 
funding/budget period by each contributor. Value of in-kind 
contributions should be included on appropriate lines as applicable. 
If the action will result in a dollar change to an existing award, 
indicate only the amount of the change. For decreases, enclose the 
amounts in parentheses. If both basic and supplemental amounts are 
included, show breakdown on an attached sheet. For multiple program 
funding, use totals and show breakdown using same categories as item 
15.
    16. Applicants should contact the State Single Point of Contact 
(SPOC) for Federal Executive Order 12372 to determine whether the 
application is subject to the State intergovernmental review 
process.
    17. This question applies to the applicant organization, not the 
person who signs as the authorized representative. Categories of 
debt include delinquent audit disallowances, loans and taxes.
    18. To be signed by the authorized representative of the 
applicant. A copy of the governing body's authorization for you to 
sign this application as official representative must be on file in 
the applicant's office. (Certain Federal agencies may require that 
this authorization be submitted as part of the application.)
BILLING CODE 4184-01-P

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[[Page 4445]]


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BILLING CODE 4184-01-C

[[Page 4446]]

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

Section B. Budget Categories

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

    Line 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 Line 13 and 14.

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

    Line 16-19--Enter in Column (a) the same grant program titles 
shown in column (a), Section A. A breakdown by function or activity 
is not necessary. For new applications and continuation grant 
applications, enter in the proper columns amounts of Federal funds 
which will be needed to complete the program or project over the 
succeeding funding periods (usually in years). This section need not 
be completed for revisions (amendments, changes, or supplements) to 
funds for the current year of existing grants.
    If more than four lines are needed to list the program titles, 
submit additional schedules as necessary.
    Line 20--Enter the total for each of the Columns (b)-(e). When 
additional schedules are prepared for this Section, annotate 
accordingly and show the overall totals on this line.

Section F. Other Budget Information

    Line 21--Use this space to explain amounts for individual direct 
object-class cost categories that may appear to be out of the 
ordinary or to explain the details as required by the Federal 
grantor agency.
    Line 22--Enter the type of indirect rate (provisional, 
predetermined, final or fixed) that will be in effect during the 
funding period, the estimated amount of the base to which the rate 
is applied, and the total indirect expense.
    Line 23--Provide any other explanations or comments deemed 
necessary.

Attacment D--Assurances--Non-Construction Programs

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

[[Page 4447]]

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 apply the non-Federal share of project costs) to 
ensure proper planning, management and completion of the project 
described in this application.
    2. Will give the awarding agency, the Comptroller General of the 
United States, and if appropriate, the State, through any authorized 
representative, access to and the right to examine all records, 
books, papers, or documents related to the award; and will establish 
a proper accounting system in accordance with generally accepted 
accounting standard or agency directives.
    3. Will establish safeguards to prohibit employees from using 
their positions for a purpose that constitutes or presents the 
appearance of personal or organizational conflict of interest, or 
personal gain.
    4. Will initiate and complete the work within the applicable 
time frame after receipt of approval of the awarding agency.
    5. Will comply with the Intergovernmental Personnel Act of 1970 
(42 U.S.C. Secs. 4728-4763) relating to prescribed standards for 
merit systems for programs funded under one of the nineteen statutes 
or regulations specified in Appendix A of OPM's Standard for a Merit 
System of Personnel Administration (5 C.F.R. 900, Subpart F).
    6. Will comply with all Federal statues 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. Secs. 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 non-
discrimination in the sale, rental or financing of housing; (i) any 
other nondiscrimination provisions in the specific statue(s) under 
which application for Federal assistance is being made; and (j) the 
requirements of any other nondiscrimination statue(s) which may 
apply to the application.
    7. Will comply, or has already complied, with the requirements 
of the 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 person displaced or 
whose property is acquired as a result of Federal or federally 
assisted programs. These requirements apply to all interests in real 
property acquired for project purposes regardless of Federal 
participation in purchases.
    8. Will comply with the provisions of the Hatch Act (5 U.S.C. 
Secs. 1501-1508 and 7324-7328) which limit the political activities 
of employees whose principal employment activities are funded in 
whole or in part with Federal funds.
    9. Will comply, as applicable with the provisions of the Davis-
Bacon Act (40 U.S.C. Secs. 276a to 276a-7), the Copeland Act (40 
U.S.C. Sec. 276c and 18 U.S.C. 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 wetland pursuant to EO 11990; (d) 
evaluation of flood hazards in floodplains in accordance with EO 
11988; (e) assurance of project consistency with the approved State 
management program developed under the Coastal Zone Management Act 
of 1972 (16 U.S.C. Secs. 1451 et seq.); (f) conformity of Federal 
actions to State (Clear Air) Implementation Plans under Section 
176(c) of the 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 River 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 of 1984.
    18. Will comply with all applicable requirements of all other 
Federal laws, executive orders, regulations and policies governing 
this program.
----------------------------------------------------------------------
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL

----------------------------------------------------------------------
TITLE

----------------------------------------------------------------------
APPLICANT ORGANIZATION

----------------------------------------------------------------------
DATE SUBMITTED

Attachment E--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 point is: Division of Grants Management and 
Oversight, Office of Management and Acquisition, Department of 
Health and Human Services, Room 517-D, 200 Independence Avenue, SW., 
Washington, DC 20201.

Certification Regarding Drug-Free Workplace Requirements (Instructions 
for Certification)

    1. By signing and/or submitting this application or grant 
agreement, the grantee is providing the certification set out below.
    2. The certification set out below is a material representation 
of fact upon which reliance is placed when the agency awards the 
grant. If it is later determined that the grantee knowingly rendered 
a false 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

[[Page 4448]]

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 followingdefinitions from these rules:
    Controlled substance means a controlled substance in Schedules I 
through V of the Controlled Substances Act (21 U.S.C. 812) and as 
further defined by regulation (21 CFR 1308.11 through 1308.15);
    Conviction means a finding of guilt (including a plea of nolo 
contendere) or imposition of sentence, or both, by any judicial body 
charged with the responsibility to determine violations of the 
Federal or State criminal drug statutes;
    Criminal drug statute means a Federal or non-Federal criminal 
statute involving the manufacture, distribution, dispensing, use, or 
possession of any controlled substance;
    Employee means the employee of a grantee directly engaged in the 
performance of work under a grant, including: (i) All direct charge 
employees; (ii) All indirect charge employees unless their impact or 
involvement is insignificant to the performance of the grant; and, 
(iii) Temporary personnel and consultants who are directly engaged 
in the performance of work under the grant and who are on the 
grantee's payroll. This definition does not include workers not on 
the payroll of the grantee (e.g., volunteers, even if used to meet a 
matching requirement; consultants or independent contractors not on 
the grantee's payroll; or employees of recipients 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;
    (23) Any available drug counseling, rehabilitation, and employee 
assistance programs;
    (4) The penalties that may be imposed upon employees for drug 
abuse violations occurring in the workplace;
    (c) Making it a requirement that each employee to be engaged in 
the performance of the grant be given a copy of the statement 
required by paragraph (a);
    (d) Notifying the employee in the statement required by 
paragraph (a) that, as a condition of employment under the grant, 
the employee will--(1) Abide 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 
other 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 on 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 employee, 
up to and including termination, consistent with the requirements of 
the Rehabilitation Act of 1973, as amended; or
    (2) Requiring such employee to participate satisfactorily in a 
drug abuse assistance or rehabilitation program approved for such 
purposes by a Federal, State, or local health law enforcement, or 
other appropriate agency;
    (g) Making a good faith effort to continue to maintain a drug-
free workplace through implementation of paragraphs (a), (b), (c), 
(d), (e) and (f).
    (B) The grantee may insert in the space provided below the 
site(s) for the performance of work done in connection with the 
specific grant:
    Place of Performance (Street address, city, county, state, zip 
code).
    Check 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 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.

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 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 department or agency to which this proposal is 
submitted if at any time the prospective primary participant learns 
that its certification was erroneous when submitted or has become 
erroneous by reason of changed circumstances.
    5. The terms covered transaction, debarred, suspended, 
ineligible, lower tier covered transaction, participant, person, 
primary covered transaction, principal, proposal, and voluntarily 
excluded, as used in this clause, have the meanings set out in the 
Definitions and Coverage sections of the rules implementing 
Executive Order 12549. You may contact the department or agency to 
which this proposal is being submitted for assistance in obtaining a 
copy of those regulations.
    6. The prospective primary participant agrees by submitting this 
proposal that, should the proposed covered transaction be entered 
into, it shall not knowingly enter into any lower tier covered 
transaction with a person who is proposed for debarment under 48 CFR 
part 9, subpart 9.4, debarred, suspended, declared ineligible, or 
voluntarily excluded from participation in this covered transaction, 
unless authorized by the department or agency entering into this 
transaction.
    7. The prospective primary participant further agrees by 
submitting this proposal that it will include the clause titled

[[Page 4449]]

``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 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.
    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 principals:
    (a) Are not presently debarred, suspended, proposed for 
debarment, declared ineligible, or voluntarily excluded by any 
Federal department or agency;
    (b) Have not within a three-year period preceding this proposal 
been convicted of or had a civil judgment rendered against them for 
commission of fraud or a criminal offense in connection with 
obtaining, attempting to obtain, or performing a public (Federal, 
State or local) transaction or contract under a public transaction; 
violation of Federal or State antitrust statutes or commission of 
embezzlement, theft, forgery, bribery, falsification or destruction 
of records, making false statements, or receiving stolen property;
    (c) Are not presently indicted for or otherwise criminally or 
civilly charged by a governmental entity (Federal, State or local) 
with commission of any of the offenses enumerated in paragraph 
(1)(b) of this certification; and
    (d) Have not within a three-year period preceding this 
application/proposal has 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 Covered 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 Transactions,'' 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 and 
Voluntary Exclusion--Lower Tier Covered Transactions

    (1) The prospective lower tier participant certifies, by 
submission of this proposal, that neither it nor its principals is 
presently debarred, suspended, proposed for debarment, declared 
ineligible, or voluntarily excluded from participation in this 
transaction by any Federal department or agency.
    (2) Where the prospective lower tier participant is unable to 
certify to any of the statements in this certification, such 
prospective participant shall attach an explanation to this 
proposal.

Attachment G-Instructions for Completion of SF-LLL, Disclosure of 
Lobbying Activities

    This decision 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 an 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. Use the SF-
LLL-A Continuation Sheet for additional information if the space on 
the form is inadequate. 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.

[[Page 4450]]

    3. Identify the appropriate classification of this report. If 
this is a follow-up 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 for the covered 
Federal action (item 1). If known, enter the full Catalog of Federal 
Domestic Assistance (CFDA) number for 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 or 
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 entity engaged by the reporting entity identified in 
item 4 to 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. Enter the amount of compensation paid or reasonably expected 
to be paid by the reporting entity (item 4) to the lobbying entity 
(item 10). Indicate whether the payment has been made (actual) or 
will be made (planned). Check all boxes that apply. If this is a 
material change report, enter the cumulative amount of payment made 
or planned to be made.

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. 0343-0046. 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 Budget, Paperwork Reduction Project (0348-0046), 
Washington, DC 20503.

Disclosure of Lobbying Activities Continuation Sheet

Reporting Entity: ______
 ______---------------------------------------------------------------
Page ______ of ______
BILLING CODE 4184-01-C

[[Page 4451]]

[GRAPHIC] [TIFF OMITTED] TN30JA02.004

BILLING CODE 4184-01-C

[[Page 4452]]

Attachment I--Certification Regarding Environmental Tobacco Smoke

    Public Law 103-227, 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 J--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 K--Intergovernment Review (SPOC List)

    It is estimated that in 2001 the Federal Government will outlay 
$305.6 billion in grants to State and local governments. Executive 
Order 12372, ``Intergovernmental Review of Federal Programs,'' was 
issued with the desire to foster the intergovernmental partnership 
and strengthen federalism by relying on State and local processes 
for the coordination and review of proposed Federal financial 
assistance and direct Federal development. The Order allows each 
State to designate an entity to perform this function. Below is the 
official list of those entities. For those States that have a home 
page for their designated entity, a direct link has been provided 
below.
    States that are not listed on this page have chosen not to 
participate in the intergovernmental review process, and therefore 
do not have a SPOC. If you are located within one of these States, 
you may still send application materials directly to a Federal 
awarding agency.
    Contact information for Federal agencies that award grants can 
be found in Appendix IV of the Catalog of Federal Domestic 
Assistance.

ARKANSAS

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

CALIFORNIA

Grants Coordination
State Clearinghouse
Office of Planning and Research
P.O. Box 3044, Room 222
Sacramento, California 95812-3044
Telephone: (916) 445-0613
Fax: (916) 323-3018
[email protected]

DELAWARE

Charles H. Hopkins
Executive Department
Office of the Budget
540 S. Dupont Highway, 3rd Floor
Dover, Delaware 19901
Telephone: (302) 739-3323
Fax: (302) 739-5661
[email protected]

DISTRICT OF COLUMBIA

Luisa Montero-Diaz
Office of Partnerships and Grants
Development
Executive Office of the Mayor
District of Columbia Government
441 4th Street, NW, Suite 530 South
Washington, DC 20001
Telephone: (202) 727-8900
Fax: (202) 727-1652
[email protected]

FLORIDA

Jasmin Raffington
Florida State Clearinghouse
Department of Community Affairs
2555 Shumard Oak Blvd.
Tallahassee, Florida 32399-2100
Telephone: (850) 922-5438
Fax: (850) 414-0479
[email protected]

GEORGIA

Georgia State Clearinghouse
270 Washington Street, SW
Atlanta, Georgia 30334
Telephone: (404) 656-3855
Fax: (404) 656-7901
[email protected]

ILLINOIS

Virginia Bova
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) 814-8485
[email protected]

IOWA

Steven R. McCann
Division of Community and Rural
Development
Iowa Department of Economic Development
200 East Grand Avenue
Des Moines, Iowa 50309
Telephone: (515) 242-4719
Fax: (515) 242-4809
[email protected]

KENTUCKY

Ron Cook
Department for Local Government
1024 Capital Center Drive, Suite 340
Frankfort, Kentucky 40601
Telephone: (502) 573-2382
Fax: (502) 573-2512
[email protected]

MAINE

Joyce Benson
State Planning Office
184 State Street
38 State House Station
Augusta, Maine 04333
Telephone: (207) 287-3261
(207) 287-1461 (direct)
Fax: (207) 287-6489
[email protected]

MARYLAND

Linda Janey
Manager, Clearinghouse and Plan Review Unit
Maryland Office of Planning
301 West Preston Street--Room 1104
Baltimore, Maryland 21201-2305
Telephone: (410) 767-4490
Fax: (410) 767-4480
[email protected]

MICHIGAN

Richard Pfaff
Southeast Michigan Council of Governments
535 Griswold, Suite 300
Detroit, Michigan 48226
Telephone: (313) 961-4266
Fax: (313) 961-4869
[email protected]

MISSISSIPPI

Cathy Mallette
Clearinghouse Officer
Department of Finance and Administration
1301 Woolfolk Building, Suite E
501 North West Street
Jackson, Mississippi 39201
Telephone: (601) 359-6762
Fax: (601) 359-6758

MISSOURI

Angela Boessen
Federal Assistance Clearinghouse
Office of Administration
P.O. Box 809
Truman Building, Room 840
Jefferson city, Missouri 65102
telephone: (573) 751-4834
Fax: (573) 522-4395
[email protected]

NEVADA

Heather Elliott
Department of Administration
State Clearinghouse
209 E. Musser Street, Room 200
Carson City, Nevada 89701

[[Page 4453]]

Telephone: (775) 684-0209
Fax: (775) 684-0260
[email protected]

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
[email protected]

NEW MEXICO

Ken Hughes
Local Government Division
Room 201 Bataan Memorial Building
Santa Fe, New Mexico 87503
Telephone: (505) 827-4370
Fax: (505) 827-4948
[email protected]

NORTH CAROLINA

Jeanette Furney
Department of Administration
1302 Mail Service Center
Raleigh, North Carolina 27699-1302
Telephone: (919) 807-2323
Fax: (919) 733-9571
[email protected]

NORTH DAKOTA

Jim Boyd
Division of Community Services
600 East Boulevard Ave., Dept 105
Bismarck, North Dakota 58505-0170
Telephone: (701) 328-2094
Fax: (701) 328-2308
[email protected]

RHODE ISLAND

Kevin Nelson
Department of Administration
Statewide Planning Program
One Capitol Hill
Providence, Rhode Island 02908-5870
Telephone: (401) 222-2093
Fax: (401) 222-2083
[email protected]

SOUTH CAROLINA

Omeagia Burgess
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
[email protected]

TEXAS

Denise S. Francis
Director, State Grants Team
Governor's Office of Budget and Planning
P.O. Box 12428
Austin, Texas 78711
Telephone: (512) 305-9415
Fax: (512) 936-2681
[email protected]

UTAH

Carolyn Wright
Utah State Clearinghouse
Governor's Office of Planning and Budget
State Capitol, Room 114
Salt Lake City, Utah 84114
Telephone: (801) 538-1535
Fax: (801) 538-1547
[email protected]

WEST VIRGINIA

Fred Cutlip, Director
Community Development Division
West Virginia Development Office
Building #6, Room 553
Charleston, West Virginia 25305
Telephone: (304) 558-4010
Fax: (304) 558-3248
[email protected]

AMERICAN SAMOA

Pat M. Galea'i
Federal Grants/Programs Coordinator
Office of Federal Programs
Office of the Governor/Department of Commerce
American Samoa Government
Pago Pago, American Samoa 96799
Telephone: (684) 633-5155
Fax: (684) 633-4195
[email protected]

GUAM

Director
Bureau of Budget and Management
Research
Office of the Governor
P.O. Box 2950
Agana, Guam 96910
Telephone: 011-671-472-2285
Fax: 011-472-2825
[email protected]

NORTH MARIANA ISLANDS

Ms. Jacoba T. Seman
Federal Programs Coordinator
Office of Management and Budget
Office of the Governor
Saipan, MP 96950
Telephone: (670) 664-2289
Fax: (670) 664-2272
[email protected]

PUERTO RICO

Jose Caballero/Mayra Silva
Puerto Rico Planning Board
Federal/Proposals Review Office
Minillas Government Center
P.O. Box 41119
San Juan, Puerto Rico 00940-1119
Telephone: (787) 723-6190
Fax: (787) 722-6783

VIRGIN ISLANDS

Ira Mills
Director, Office of Management and Budget
#41 Norre Gade Emancipation Garden Station, Second Floor
Saint Thomas, Virgin Islands 00802
Telephone: (340) 774-0750
Fax: (340) 776-0069
[email protected]

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
[email protected]

    Changes to this list can be made only after OMB is notified by a 
State's officially designated representative. E-mail messages can be 
sent to [email protected]. If you prefer, you may send 
correspondence to the following postal address:

Attn: Grants Management
Office of Management and Budget
New Executive Office Building, Suite 6025
725 17th Street, NW
Washington, DC 20503

    Please note: Inquiries about obtaining a Federal grant should 
not be sent to the OMB e-mail or postal address shown above. The 
best source for this information is the CFDA.

[FR Doc. 02-2130 Filed 1-29-02; 8:45 am]
BILLING CODE 4184-01-P