[Federal Register Volume 67, Number 35 (Thursday, February 21, 2002)]
[Notices]
[Pages 8074-8107]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-3564]
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Part II
Department of Health and Human Services
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Administration for Children and Families
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Request for Applications Under the Office of Community Services' Fiscal
Year 2002 Job Opportunities for Low-Income Individuals (JOLI) Program;
Notice
Federal Register / Vol. 67, No. 35 / Thursday, February 21, 2002 /
Notices
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
[Program Announcement No. OCS-2002-06]
Request for Applications Under The Office of Community Services'
Fiscal Year 2002 Job Opportunities for Low-income Individuals (JOLI)
Program
AGENCY: Office of Community Services, Administration for Children and
Families, Department of Health and Human Services.
ACTION: Announcement of availability of funds and request for
applications under the Office of Community Services' FY 2002 Job
Opportunities for Low-income Individuals (JOLI) Program.
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SUMMARY: The Administration for Children and Families (ACF), Office of
Community Services (OCS), announces that, based on availability of
funds, competing applications will be accepted for new grants pursuant
to the Secretary's discretionary authority under section 505 of the
Family Support Act of 1988, as amended.
DATES: To be considered for funding, applications must be postmarked on
or before April 22, 2002. Applications postmarked after that date will
not be accepted for consideration. Detailed application submission
instructions including the addresses to which applications must be
submitted are found in Part IV-B, Application Submission.
FOR FURTHER INFORMATION, CONTACT: Ros Relaford, Technical Assistance
Manager, OCS Operations Center, Call: 1-800-281-9519
or E-mail: [email protected].
For a copy of this announcement, contact: OCS Operations Center,
1815 North Fort Meyer Drive, Suite 300, Arlington, Virginia 22209, 1-
800-281-9519.
In addition, this announcement is accessible on the OCS website for
reading or downloading at: http://www.acf.dhhs.gov/programs/ocs/kits1.htm.
If this Program Announcement is not available at these sources, it
may be obtained by telephoning or writing the office listed under For
Further Information, Contact.
The Catalog of Federal Domestic Assistance number for this
program is 93.593. The title is Job Opportunities for Low-income
Individuals (JOLI) Program.
SUPPLEMENTARY INFORMATION: This program announcement consists of seven
parts plus Attachments.
Part I--Background Information
A. Legislative Authority
B. Program Purpose
C. Project Goals
D. Definitions of Terms
Part II--Program Objectives and Requirements
A. Eligible Applicants
B. Project and Budget Periods
C. Availability of Funds and Grant Amounts
D. Mobilization of Resources
E. Program Participants/Beneficiaries
F. Prohibition and Restrictions on the Use of Funds
G. Multiple Submittals
H. Re-Funding
I. Sub-Contracting or Delegating Projects
J. Maintenance of Effort
K. Program Focus
L. Creation of Jobs and Employment Opportunities
M. Cooperative Partnership Agreement with the Designated Agency
Responsible for the Temporary Assistance for Needy Families (TANF)
Program
N. Third Party Project Evaluation
O. Economic Development Strategy
P. Training and Support for Micro-Business Development
Q. Cooperative Partnership Agreement with the Designated Agency
Responsible for the Child Support Enforcement(CSE)Program Support
for Non-custodial Parents
R. Technical Assistance to Employers
S. Applicant Experience and Cost-per-Job
T. Loan Funds
U. Business Plan
V. Dissemination of Project Results
W. Third Party Agreements
Part III--The Project Description, Program Proposal Elements and Review
Criteria
A. Purpose
B. Project Summary/Abstract
C. Objectives and Need for Assistance
D. Results or Benefits Expected
E. Approach
F. Organizational Profiles
G. Budget and Budget Justification
H. Non-Federal Resources
I. Evaluation Criteria
Part IV--Application Procedures
A. Availability of Forms
B. Application Submission
C. Intergovernmental Review
D. Application Consideration
E. Criteria for Screening Applications
Part V--Instructions for Completing Forms SF-424
A. SF-424--Application for Federal Assistance
B. SF-424A--Budget Information--Non-Construction Programs
C. SF-424B--Assurances for Non-Construction
Part VI--Contents of Application and Receipt Process
A. Contents of Application
B. Application Format
C. Acknowledgement of Receipt
Part VII--Post Award Information and Reporting Requirements
A. Notification of Grant Award
B. Attendance at Evaluation Workshops
C. Reporting Requirements
D. Audit Requirements
E. Prohibitions and Requirements with Regard to Lobbying
F. Applicable Federal Regulations
Attachments
Application forms and required Attachments.
Paperwork Reduction Act of 1995
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. The project description is
approved under Office of Management and Budget (OMB) Control Number
0970-0139 which expires 12/31/2003. 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.
Part I--Background Information
A. Legislative Authority
Section 505 of the Family Support Act of 1988, Public Law 100-485,
as amended, authorizes the Secretary of HHS to enter into agreements
with nonprofit organizations (including community development
corporations) for the purpose of conducting projects designed to create
employment opportunities for certain low-income individuals (42 U.S.C.
9926).
B. Program Purpose
The purpose of the JOLI program is to test and evaluate ways of
creating employment and business opportunities for individuals
receiving Temporary Assistance for Needy Families (TANF) assistance and
other low-income individuals through self-employment, micro-enterprise,
new business ventures, expansion of existing businesses through
technical and financial assistance and non traditional initiatives.
C. Project Goals
The ultimate goals of the projects to be funded under the JOLI
Program are:
(1) To achieve through project activities and interventions, the
creation of new employment opportunities for TANF recipients and other
low-income
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individuals which can lead to economic self-sufficiency of members of
the communities served;
(2) To evaluate the effectiveness of these interventions and of the
project design through which they were implemented; and
(3) To make possible the replication of successful programs.
D. Definitions of Terms
For purposes of this Program Announcement, the following
definitions apply:
(1) Budget period: The interval of time into which a multi-year
period of assistance (project period) is divided for budgetary and
funding purposes.
(2) Community-level data: Key information to be collected by each
grantee that will allow for a national-level analysis of common
features of JOLI projects. This consists of data on the population of
the target area, including the percentage of TANF recipients and others
on public assistance, and the percentage whose incomes fall below the
poverty line; the unemployment rate; the number of new business starts
and business closings; and a description of the major employers and
average wage rates and employment opportunities with those employers.
(3) Community development corporation: A private, nonprofit entity,
governed by a board of directors consisting of residents of the
community and business and civic leaders, that has as a principal
purpose planning, developing, or managing low-income housing or
community development projects.
(4) Hypothesis: An assumption made in order to test its validity.
It should assert a cause-and-effect relationship between a program
intervention and its expected result. Both the intervention and result
must be measured in order to confirm the hypothesis. For example, the
following is a hypothesis: ``Eighty hours of classroom training in
small business planning will be sufficient for participants to prepare
a successful loan application.'' In this example, data would be
obtained on the number of hours of training actually received by
participants (the intervention), and the quality of loan applications
(the result), to determine the validity of the hypothesis (that eighty
hours of training is sufficient to produce the result).
(5) Intervention: Any planned activity within a project that is
intended to produce changes in the target population and/or the
environment and that can be formally evaluated. For example, assistance
in the preparation of a business plan and loan package are planned
interventions.
(6) Job creation: To bring about, by activities and services funded
under this program, new jobs, that is, jobs that were not in existence
before the start of the project. These activities can include self-
employment/micro-enterprise training, the development of new business
ventures or the expansion of existing businesses.
(7) Nonprofit organization: Any organization (including a community
development corporation) exempt from taxation under section 501(a) of
the Internal Revenue Code of 1986 by reason of paragraph (3) or (4) of
Section 501(c) of such Code.
(8) Non-traditional employment for women or minorities: Employment
in an industry or field where women or minorities currently make up
less than twenty-five percent of the work force.
(9) Outcome evaluation: An assessment of project results as
measured by collected data which define the net effects of the
interventions applied in the project. An outcome evaluation will
produce and interpret findings related to whether the interventions
produced desirable changes and their potential for replicability. It
should answer the question: Did this project work?
(10) Private employers: Third party nonprofit organizations or
third party for-profit businesses operating or proposing to operate in
the same community as the applicant, and which are proposed or
potential employers of project participants.
(11) Process evaluation: The ongoing examination of the
implementation of a program. It focuses on the effectiveness and
efficiency of the program's activities and interventions (for example,
methods of recruiting participants, quality of training activities, or
usefulness of follow-up procedures). It should answer questions such
as: Who is receiving what services and are the services being delivered
as planned? It is also known as formative evaluation, because it
gathers information that can be used as a management tool to improve
the way a program operates while the program is in progress. It should
also identify problems that occurred and how they were dealt with and
recommend improved means of future implementation. It should answer the
question: ``How was the program carried out?'' In concert with the
outcome evaluation, it should also help explain, ``Why did this program
work/not work?''; and, ``What worked and what did not?''
(12) Program participant/beneficiary: An individual eligible to
receive TANF assistance under Title I of the Personal Responsibility
and Work Opportunity Reconciliation Act of 1996 (Part A of Title IV of
the Social Security Act) and any other individual whose income level
does not exceed 100 percent of the official poverty line as found in
the most recent revision of the Poverty Income Guidelines published by
the Department of Health and Human Services. (See Attachment A.)
(13) Project period: The total time a project is approved for
support, including any extensions.
(14) Self-sufficiency: A condition where an individual or family,
by reason of employment, does not need and is not eligible for public
assistance.
(15) Third party: Any individual, organization, or business entity
that is not the direct recipient of grant funds.
(16) Third party agreement: A written agreement entered into by the
grantee and an organization, individual or business entity (including a
wholly-owned subsidiary), by which the grantee makes an equity
investment or a loan in support of grant purposes.
(17) Third party in-kind contributions: The value of non-cash
contributions provided by non-federal third parties which may be in the
form of real property, equipment, supplies and other expendable
property, and the value of goods and services directly benefitting and
specifically identifiable to the project or program.
Part II--Program Objectives and Requirements
The objective of the JOLI program is to conduct projects to create
new employment and business opportunities for certain low-income
individuals through the provision of technical and financial assistance
to private employers in the community, self-employment/micro-enterprise
programs, and/or new business development programs.
A. Eligible Applicants
Organizations eligible to apply for funding under this program are
nonprofit organizations (including community development corporations
and charitable organizations) that are exempt from taxation under
section 501(a) of the Internal Revenue Code of 1986 by reason of
paragraph (3) or (4) of section 501(c) of such Code. Applicants must
provide documentation of their tax exempt status. The applicant can
accomplish this by providing a copy of the applicant's listing in the
Internal Revenue Service's (IRS) most recent list of tax-exempt
organizations described in section 501(c)(3) of the IRS Code or by
providing a copy of the currently valid IRS tax exemption certificate.
Failure to
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provide evidence of Section 501(c)(3) or (4) tax exempt status will
result in rejection of the application.
B. Project and Budget Periods
The Personal Responsibility and Work Opportunity Reconciliation Act
of 1996, Public Law 104-193, reauthorized and modified Section 505 of
the Family Support Act of 1988, the JOLI authorizing legislation. Among
the modifications effected was the deletion of sub-section (e) that had
legislatively-mandated project duration. Applicants are therefore free
to apply for projects from one to three year durations, depending on
the proposed work program and the applicant's assessment of the time
required to achieve the proposed project goals.
OCS has made the programmatic determination that the nature of job
creation and career development projects which meet the funding
criteria set forth in this announcement is such that it is not feasible
to divide funding into 12-month increments, and that completion of the
entire project is in each case necessary to achieve the purposes of the
JOLI program. Consequently, budget periods for grants under this
announcement may be up to three years.
C. Availability of Funds and Grant Amounts
All grant awards are subject to the availability of appropriated
funds. It is anticipated that approximately $4,750,000 will be
available in FY 2002 for JOLI for new grants.
The 1996 amendments to the JOLI authorizing legislation also
deleted the limitation on the number of grants to be made in any one
fiscal year. Thus, OCS expects to award up to 7 new grants in FY 2002,
based on the amounts requested and contingent on the availability of
funds. Given the limited funds available for the JOLI program,
applicants should make a realistic assessment of the time and funds
needed to achieve the goals set forth in their proposal, and design a
work program and budget accordingly. The grant request should be for an
amount needed, up to a maximum of $700,000, to implement that part of
the project plan supported by OCS funds, taking into consideration
other cash and in-kind resources mobilized by the applicant in support
of the proposed project. (See Paragraph D, below, Mobilization of
Resources, and Part III, Element VI: Budget Appropriateness and
Reasonableness.)
In summary, grants of up to $700,000 in OCS funds for project
periods and budget periods of up to three years will be awarded to
selected organizations under this program in FY 2002.
D. Mobilization of Resources
OCS will give favorable consideration in the review process to
applicants who mobilize cash and/or third party in-kind contributions
for direct use in the project. The firm commitment of these resources
must be documented and submitted with the application in order to be
given credit in the review process under the Public-Private
Partnerships project element (Part III, Element V). Except in unusual
situations, this documentation must be in the form of letters of
commitment from the organization(s)/individual(s) from which resources
will be received. Even though there is no matching requirement for the
JOLI Program, grantees will be held accountable for any match, cash or
in-kind contribution proposed or pledged as part of an approved
application. (See Part III, Element V, and Part V, Instructions for
Completing the SF-424, Section C, Non-Federal Resources.)
E. Program Participants/Beneficiaries
A low-income individual eligible to participate in a project
conducted under this program is any individual eligible to receive TANF
assistance under a State program funded under Part A of Title IV of the
Social Security Act, or any other individual whose income level does
not exceed 100 percent of the official poverty line. Within these
categories, emphasis should be on individuals who are receiving TANF
assistance or its equivalent under State auspices; those who are
unemployed; those residing in public housing or receiving housing
assistance; non-custodial parents, and those who are homeless.
Attachment A to this announcement is an excerpt from the current
poverty guidelines. Annual revisions of these guidelines are normally
published in the Federal Register in February or early March. Grantees
will be required to apply the most recent guidelines throughout the
project period. These revised guidelines also may be obtained at public
libraries, Congressional offices, by writing the Superintendent of
Documents, U.S. Government Printing Office, Washington, DC 20402, or by
accessing the following website: ``http://aspe.os.dhhs.gov/poverty/
poverty.htm''.
No other government agency or privately-defined poverty guidelines
are applicable for the determination of low-income eligibility for this
program.
F. Prohibition and Restrictions on the Use of Funds
The use of funds for new construction or the purchase of real
property is prohibited. Costs incurred for the rearrangement and
alteration of facilities required specifically for the grant program
are allowable when specifically approved in advance by ACF in writing.
If the applicant is proposing a project which will affect a
property listed in, or is eligible for inclusion in, the National
Register of Historic Places, it must identify this property in the
narrative and explain how it has complied with the provisions of
section 106 of the National Historic Preservation Act of 1966 as
amended. If there is any question as to whether the property is listed
in, or is eligible for inclusion in, the National Register of Historic
Places, the applicant should consult with the State Historic
Preservation Officer. (See Attachment D: SF-424B, Item 13 for
additional guidelines.) Failure to comply with the cited Act will
result in the application being ineligible for funding consideration.
G. Multiple Submittals
Due to the limited amount of funds available under this program,
only a single proposal from any one eligible applicant will be funded
by OCS from FY 2002 JOLI funds pursuant to this announcement.
H. Re-funding
OCS will not provide funding to a previously funded grantee to
carry out the same work plan in the same target area.
I. Sub-Contracting or Delegating Projects
An applicant will not be funded where the proposal indicates that
the applicant, if funded, will serve as a straw-party, that is, act as
a mere conduit of funds to a third party without performing a
substantive role itself. This prohibition does not bar sub-contracting
or sub-awarding for specific services or activities needed to conduct
the project.
J. Maintenance of Effort
The application must include an assurance that activities funded
under this Program Announcement are in addition to, and not in
substitution for, activities previously carried out without Federal
assistance. (See Part VI, Section A.8 and Attachment M.)
K. Program Focus
The Congressional Conference Report on the 1992 appropriations for
the Departments of Labor, Health and Human Services, and Education and
related agencies directed the ACF to
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require economic development strategies as part of the application
process to ensure that highly qualified organizations participate in
the program. [H.R. Conf. Rep. No. 282, 102nd Cong., 1st Sess. 39
(1991)]
Priority will be given to applicants proposing to serve those areas
containing the highest percentage of individuals receiving TANF
assistance under a State program, which is funded under Part A of Title
IV of the Social Security Act.
While projected employment in future years may be included in the
application, it is essential that the focus of the project concentrate
on the creation of new full-time, permanent jobs and/or new business
development opportunities for TANF recipients and other low-income
individuals during the grant project period. OCS is particularly
interested in receiving innovative proposals that grow out of the
experience and creativity of applicants and the needs of their
clientele and communities.
Applicants should include strategies which seek to integrate
projects financed and jobs created under this program into a larger
effort of broad community revitalization which will promote job and
business opportunities for eligible program participants and impact the
overall economic environment.
OCS will only fund projects that create new employment and/or
business opportunities for eligible program participants. That is, new,
full-time permanent jobs through the expansion of a pre-identified
business or new business development, or by providing opportunities for
self-employment. In addition, projects should enhance the participants'
capacities, abilities and skills and thus contribute to their progress
toward self-sufficiency.
With national welfare reform a reality, and many States
implementing ``welfare-to-work'' programs, the need for well-paying
jobs with career potential for TANF recipients becomes ever more
pressing. In this context, the role of JOLI as a vehicle for exploring
new and promising areas of employment opportunity for the poor is more
important than ever.
Within the JOLI Program framework of job creation through new or
expanding businesses or self-employment, OCS would welcome proposals
offering business or career opportunities to eligible participants in a
variety of fields. For instance, these might include day care and
transportation, which are not only opportunities for employment, but
when not available can be serious barriers to employment for TANF
recipients; environmental justice initiatives involving activities such
as toxic waste clean-up, water quality management, or Brownfields
remediation; health-related jobs such as home health aides or medical
support services; and non-traditional jobs for women and minorities.
L. Creation of Jobs and Employment Opportunities
The requirement for creation of new, full-time permanent employment
opportunities (jobs) applies to all applications. OCS has determined
that the creation of non-traditional job opportunities for women or
minorities in industries or activities where they currently make up
less than twenty-five percent of the work force meets the requirements
of the JOLI legislation for the creation of new employment
opportunities. OCS continues to solicit other JOLI applications that
propose the creation of jobs through the expansion of existing
businesses, the development of new businesses, or the creation of
employment opportunities through self-employment/micro-enterprise
development.
Proposed projects must show that the jobs and/or business/self
employment opportunities to be created under this program will
contribute to achieving self-sufficiency among the target population.
The employment opportunities should provide hourly wages that exceed
the minimum wage and also provide benefits such as health insurance,
child care, and career development opportunities.
M. Cooperative Partnership Agreement With the Designated Agency
Responsible for the TANF Program
A formal, cooperative relationship between the applicant and the
designated State agency responsible for administering the TANF program
(as provided for under Part A of Title IV of the Social Security Act)
in the area served by the project is a requirement for funding. The
application should include a signed, written agreement between the
applicant and the designated State agency responsible for administering
the TANF program, or a letter of commitment to such an agreement within
6 months of a grant award (contingent only on receipt of OCS funds).
The agreement must describe the cooperative relationship, including
specific activities and/or actions each of these entities propose to
carry out over the course of the grant period in support of the
project.
The agreement, at a minimum, must cover the specific services and
activities that will be provided to the target population. (See
Attachment I for a list of the State Human Services Administrators
administering TANF.)
N. Third Party Project Evaluation
Proposals must include provision for an independent
methodologically sound evaluation of the effectiveness of the
activities carried out with the grant and their efficacy in creating
new jobs and business opportunities. There must be a well-defined
process evaluation and an outcome evaluation whose design will permit
tracking of project participants throughout the proposed project
period. The evaluation must be conducted by an independent evaluator,
i.e., a person with recognized evaluation skills who is
organizationally distinct from, and not under the control of, the
applicant. It is important that each successful applicant should have a
third party evaluator selected and performing at the very latest by the
time the work program of the project is begun, and if possible before
that time, so that he or she can participate in the final design of the
program in order to assure that data necessary for the evaluation will
be collected and available.
O. Economic Development Strategy
As noted in A. above, the Congress, in the Conference Report on the
FY 1992 appropriation, directed ACF to require economic development
strategies as part of the application process for JOLI to ensure that
highly qualified organizations participate in the program. Accordingly,
applicants must include in their proposal an explanation of how the
proposed project is integrated with and supports a larger economic
development strategy within the target community. Where appropriate,
applicants should document how they were involved in the preparation
and planned implementation of a comprehensive community-based strategic
plan, such as that required for applying for Empowerment Zone/
Enterprise Community (EZ/EC) status, to achieve both economic and human
development in an integrated manner, and how the proposed project
supports the goals of that plan. (See Part III, Sub-Element III(b).)
P. Training and Support for Micro-Business Development
In the case of proposals for creating self-employment micro-
business opportunities for eligible participants, the applicant must
detail how it will provide training and support services to potential
entrepreneurs. The assistance to be provided to potential
[[Page 8078]]
entrepreneurs must include, at a minimum: (1) Technical assistance in
basic business planning and management concepts; (2) assistance in
preparing a business plan and loan application; and, (3) access to
business loans.
Q. Support for Noncustodial Parents
OCS and the Office of Child Support Enforcement (OCSE), both part
of the ACF, signed a Memorandum of Understanding (MOU) to foster and
enhance partnerships between OCS grantees and local Child Support
Enforcement (CSE) agencies. (See Attachment N for the list of CSE State
Offices that can identify local CSE agencies.) In the words of the MOU:
``The purpose of these partnerships will be to develop and
implement innovative strategies in States and local communities to
increase the capability of low-income parents and families to
fulfill their parental responsibilities. Too many low-income parents
are without jobs or resources needed to support their children. A
particular focus of these partnerships will be to assist low-income,
non-custodial parents of children receiving TANF to achieve a degree
of self-sufficiency that will enable them to provide support that
will free their families of the need for such assistance.''
Accordingly, a rating factor and a review criterion have been
included in this Program Announcement that will award two points to
applicants who have entered into partnership agreements with their
local CSE agency to provide for referrals to their project in
accordance with provisions of the OCS-OCSE MOU. (See Part III, Sub-
Element III(c).)
R. Technical Assistance to Employers
Technical assistance should be specifically addressed to the needs
of the private employer in creating new jobs to be filled by eligible
individuals and/or to the individuals themselves in areas such as job-
readiness, literacy and other basic skills training, job preparation,
self-esteem building, etc. Financial assistance may be provided to the
private employer as well as to the individual.
If the technical and/or financial assistance is to be provided to
pre-identified businesses that will be expanded or franchised, written
commitments from the businesses to create the planned jobs must be
included with the application.
S. Applicant Experience and Cost-per-Job
In the review process, favorable consideration will be given to
applicants with a demonstrated record of achievement in promoting job
and enterprise opportunities for low-income people.
In view of inflation and other economic factors, OCS considers the
cost of creating a job under the JOLI program to be $10,000 or less.
Favorable consideration will be given to those applicants who show
the lowest cost-per-job created for low-income individuals. For this
program, OCS views $15,000 in OCS funds as the maximum amount for the
creation of a job and, unless there are extenuating circumstances, will
not fund projects where the cost-per-job in OCS funds exceeds this
amount. Only those jobs created and filled by low-income people will be
counted in the cost-per-job formula. (See Part III, Sub-Element III
(d).)
T. Loan Funds
The creation of a revolving loan fund with funds received under
this program is an allowable activity. However, OCS encourages the use
of funds from other sources for this purpose. Loans made to eligible
beneficiaries for business development activities must be at or below
market rate.
Note: Interest accrued on revolving loan funds may be used to
continue or expand the activities of the approved project.
U. Business Plan
Where the applicant is proposing the development and startup of a
new business or the expansion of an existing business, a business plan
that follows the outline in Attachment L to this announcement must be
submitted as an Appendix to the proposal.
V. Dissemination of Project Results
Applications should include a plan for disseminating the results of
the project after expiration of the grant period. Applicants may budget
up to $2,000 for dissemination purposes. Final project reports should
include a description of dissemination activities with copies of any
materials produced.
W. Third Party Agreements
Any applicant submitting a proposal for funding who proposes to use
some or all of the requested OCS funds to enter into a third party
agreement in order to make an equity investment (such as the purchase
of stock) or a loan to an organization, or business entity (including a
wholly-owned subsidiary), must include in the application, along with
the business plan, a copy of the signed third party agreement for
approval by OCS.
A third party agreement covering an equity investment must
contain, at a minimum, the following:
1. The type of equity transaction (e.g. stock purchase);
2. Purpose(s) for which the equity investment is being made;
3. Cost per share;
4. Number of shares being purchased;
5. Percentage of ownership of the business; and,
6. Number of seats on the board, if applicable.
A third party agreement covering a loan transaction must
contain, at a minimum, the following information:
1. Purpose(s) for which the loan is being made;
2. Rates of interest and other fees;
3. Terms of loan;
4. Repayment schedules;
5. Collateral security; and,
6. Default and collection procedures.
All third party agreements must include written
commitments as follows:
From the third party (as appropriate):
1. A minimum of 75% of the jobs to be created as a result of the
infusion of grant funds will be filled by low-income individuals;
2. The grantee will have the right to screen applicants for jobs to
be filled by low-income individuals and to verify their eligibility;
3. If the grantee's equity investment equals 25% or more of the
business's assets, the grantee will have representation on the board of
directors;
4. Reports will be made to the grantee regarding the use of grant
funds no less than on a quarterly basis;
5. A procedure will be developed to assure that there are no
duplicate counts of jobs created; and,
6. Detailed information should be provided on how the grant funds
will be used by the third party by submitting a narrative Source and
Use of Funds Statement. In addition, the agreement must provide details
on how the grantee will provide support and technical assistance to the
third party in areas of recruitment and retention of low-income
individuals.
From the grantee:
Detailed information on how the grantee will provide support and
technical assistance to the third party in areas of recruitment and
retention of low-income individuals.
All third party agreements should be accompanied by:
1. A signed statement from a Certified or Licensed Public
Accountant as to the sufficiency of the third party's financial
management system in accordance with 45 CFR 74, to protect adequately
any federal funds awarded under the application;
2. Financial statements for the third party organization for the
prior three
[[Page 8079]]
years. (If not available because the organization is a newly-formed
entity, include a statement to this effect.); and,
3. Specifications as to how the grantee will provide oversight of
the third party for the life of the agreement. Also, the agreement will
specify that the third party will maintain documentation related to the
expenditure of grant funds loaned to or invested in the third party and
grant objectives as specified in the agreement and will provide the
grantee and HHS access to that documentation.
If a signed third party agreement is not available when the
application is submitted, the applicant must submit, as part of the
narrative, as much of the above-mentioned information as possible in
order to enable reviewers to evaluate the proposal.
Note: The funds for a third party agreement will not be released
until the agreement has been approved by OCS.
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 are encouraged
to 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 from those 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 a solution. The need
for assistance must be demonstrated and the principal and subordinate
objectives of the project must be clearly stated; and 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, and 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 for Benefits Expected
Identify the results and benefits to be derived. For example,
describe the population to be recruited into the JOLI program, how many
jobs and/or businesses are projected to be created, and how the project
will assist participants to move toward self-sufficiency.
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 or 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 and the number of jobs to be
created, if applicable. When accomplishments cannot be quantified by
activity or function, list them in chronological order to show the
schedule of accomplishments and their target dates.
If any data are to be collected, maintained, and/or disseminated,
clearance may be required from the 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. Organization Profiles
Provide information on the applicant organization(s) and
cooperating partners such as organizational charts, Board of Directors,
Employer Identification Numbers, contact persons and telephone numbers,
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 must submit proof of its non-profit status with
its application. The non-profit agency can accomplish this by providing
a copy of one of the following: the applicant's listing in the IRS'
most recent list of tax-exempt organizations described in Section
501(c)(3) or (4) of the IRS code; a copy of the currently valid IRS tax
exemption certificate; 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, SF-424A.
Detailed calculations must include estimation methods, quantities, unit
costs, and other similar quantitative detail sufficient for the
calculation to be duplicated. The detailed budget narrative 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 shall be detailed
and justified in the budget and the budget justification. For purposes
of preparing the budget and budget justification, ``Federal resources''
refers only to the ACF grant applied for. ``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.
[[Page 8080]]
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.
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 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 travelers,
travel destination, duration of trip, per diem, mileage allowances, if
privately owned vehicles will be used, and other transportation costs
and subsistence allowances. Travel costs for key staff to attend ACF-
sponsored workshops should be detailed in the budget.
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. Include
ancillary charges, such as taxes, duty, protective in-transit
insurance, freight and installation with acquisition cost in
accordance with the organization's regular written accounting
practices.
Justification: For each type of equipment requested, provide a
description, the cost per unit, the number of units, the total cost,
and a plan for use in the project, as well as use or disposal 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 Part 92 procedures, must justify any anticipated
procurement action that is expected to be awarded without competition
and exceed the simplified acquisition threshold fixed at 41 USC
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
Description: Enter the total of all other costs. Such costs, where
applicable and appropriate, may include but are not limited to
insurance, food, medical and dental costs (non-contractual),
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. 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. The firm
commitment of these resources must be documented and submitted with the
application for credit in the review process. A detailed budget must be
prepared for each funding source.
I. Evaluation Criteria
Proposal Elements and Review Criteria for Applications
Each application which passes the initial screening will be
assessed 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:
(1) Adhere to the requirements in PART II and incorporate each of
the Elements and Sub-Elements below into their proposals, so as to:
(2) Describe convincingly a project that will develop new
employment or business opportunities for TANF recipients and other low-
income individuals that can lead to a transition from dependency to
economic self-sufficiency;
(3) Propose a realistic budget and time frame for the project that
will support the successful implementation of the work plan to achieve
the projects goals in a timely and cost effective manner; and,
(4) Provide for the collection and validation of relevant data to
support the national evaluation.
In order to simplify the application preparation and review
process, OCS seeks to keep grant proposals cogent and brief.
Applications with project narratives (excluding Project Summaries,
Budget Justifications and Appendices) of more than 30 letter-sized
pages of 12 c.p.i. type or equivalent on a single side will not be
reviewed for funding.
Applicants should prepare and assemble their project description
using the following outline of required project elements. They should,
furthermore, build their project concept, plans, and application
description upon the guidelines set forth for each of the project
elements.
Project descriptions are evaluated on the basis of substance, not
length. Pages should be numbered and a table of contents should be
included for easy
[[Page 8081]]
reference. For each of the Project Elements or Sub-Elements below there
is at the end of the discussion a suggested number of pages to be
devoted to the particular element or sub-element. These are suggestions
only, but the applicant must remember that the overall Project
Narrative must not be longer than 30 pages.
Evaluation Criteria 1: Organizational Profile
Element I--Organizational Experience in Program Area and Staff Skills,
Resources and Responsibilities
Sub-Element I(a)--Agency's Experience and Commitment in Program Area
(Weight of 0-10 points in proposal review)
Applicants should cite their organization's capability and relevant
experience in developing and operating programs which deal with poverty
problems similar to those to be addressed by the proposed project. They
should also cite the organization's experience in collaborative
programming and operations which involve evaluations and data
collection. Applicants should identify agency executive leadership in
this section and briefly describe their involvement in the proposed
project and provide assurance of their commitment to its successful
implementation.
The application should include documentation that briefly
summarizes two similar projects undertaken by the applicant agency and
the extent to which the stated and achieved performance targets,
including permanent benefits to low-income populations, have been
achieved. The application should note and justify the priority that
this project will have within the agency, including the facilities and
resources that it has available to carry it out.
It is suggested that applicants use no more than 2 pages for this
sub-element.
Note: The maximum number of points will be given only to those
organizations with a demonstrated record of achievement in promoting
job creation and enterprise opportunities for low-income people.
Sub-Element I(b)--Staff Skills, Resources and Responsibilities
(Weight of 0-10 points in proposal review)
The application must identify the two or three individuals who will
have the key responsibility for managing the project, coordinating
services and activities for participants and partners, and for
achieving performance targets. The focus should be on the
qualifications, experience, capacity and commitment to the program of
the executive officials of the organization and the key staff persons
who will administer and implement the project. The person identified as
project director should have supervisory experience, experience in
finance and business, and experience with the target population.
Because this is a new project, within an already-established agency,
OCS expects that the key staff person(s) would be identified, if not
hired, or provide an estimated hiring time line for each individual to
be on board.
The application must also include a resume of the third party
evaluator, if identified or hired; or the minimum qualifications and
position description for the third party evaluator, who must be a
person with recognized evaluation skills who is organizationally
distinct from and not under the control of the applicant. (See Element
IV: Project Evaluation, below, for fuller discussion of evaluator
qualifications.)
Actual resumes of key staff and position descriptions should be
included in an appendix to the proposal.
It is suggested that applicants use no more than 3 pages for this
sub-element.
Evaluation Criteria 2: Approach 1
Element II: Project Theory, Design, and Plan
OCS seeks to learn from the application why and how the project, as
proposed, is expected to lead to the creation of new employment
opportunities for low-income individuals, which can lead to significant
improvements in individual and family self-sufficiency.
Applicants are urged to design and present their project in terms
of a conceptual cause-effect framework. In the following paragraphs, a
framework is described that suggests a way to present a project so as
to show the logic of the cause-effect relations between project
activities and project results. Applicants are not required to use the
exact language described; but it is important to present the project in
a way that makes clear the cause-effect relationship between what the
project plans to do and the results it expects to achieve.
Sub-Element II(a)--Description of Target Population, Analysis of Need,
and Project Assumptions
(Weight of 0-10 points in application review)
The project design or plan should begin by identifying the
underlying program assumptions. These are the beliefs on which the
proposed program is built. These assumptions include: the needs of the
population to be served; the current services available to that
population, and where and how they fail to meet their needs; why the
proposed services or interventions are appropriate and will meet those
needs; and the impact the proposed interventions will have on the
project participants.
In other words, the underlying assumptions of the program are the
applicant's analysis of the needs and problems to be addressed by the
project, and the applicant's theory of how its proposed interventions
will address those needs and problems to achieve the desired result.
Thus a strong application is based upon a clear description of the
needs and problems to be addressed and a persuasive understanding of
the causes of those problems.
In this sub-element of the proposal, the applicant must precisely
identify the target population to be served. The geographic area to be
impacted should then be described briefly, citing the percentage of
low-income individuals and TANF recipients, as well as the unemployment
rate and other data relevant to the project design.
The application should include an analysis of the identified
personal barriers to employment, job retention and greater self-
sufficiency faced by the target population. (These might include such
problems as illiteracy, substance abuse, family violence, lack of
skills training, health or medical problems, need for childcare, lack
of suitable clothing or equipment, or poor self-image.)
The application should also include an analysis of the identified
community systemic barriers which the project will seek to overcome.
These might include lack of jobs (high unemployment rate); lack of
public transportation; lack of markets; unavailability of financing,
insurance or bonding; inadequate social services (employment service,
childcare, job training); high incidence of crime; inadequate health
care; or environmental hazards (such as toxic dumpsites or leaking
underground tanks).
Applicants should be sure not to overlook the personal and family
services and support that might be needed by project participants after
they are on the job which will enhance job retention and advancement.
If the jobs to be created by the proposed project are themselves
designed to fill one or more of the needs, or remove one or more of the
barriers so identified, this fact should be highlighted in the
discussion, e.g., jobs
[[Page 8082]]
in child care, health care, or transportation.
It is suggested that applicants use no more than 4 pages for this
sub-element.
Sub-Element II(b)--Project Strategy and Design: Interventions,
Outcomes, and Goals
(Weight of 0-10 points in proposal review)
The work plan must describe the proposed project activities, or
interventions, and explain how they are expected to result in outcomes
which will meet the needs of the program participants and assist them
to overcome the identified personal and systemic barriers to
employment, job retention, and self-sufficiency. In other words, what
will the project staff do with the resources provided to the project
and how will what they do (interventions) assist in creating and
sustaining employment and business opportunities for program
participants in the face of the needs and problems that have been
identified.
The underlying assumptions concerning client needs and the theory
of how they can be effectively addressed, which are discussed above,
lead in the project design to the conduct of a variety of project
activities or interventions, each of which is assumed to result in
immediate changes, or outcomes.
The immediate changes lead to intermediate outcomes; and the
intermediate outcomes lead to the attainment of the final project
goals.
The applicant should describe the major activities, or
interventions, which are to be carried out to address the needs and
problems identified in Sub-Element II(a); and should discuss the
immediate changes, or outcomes, which are expected to result. These are
the results expected from each service or intervention immediately
after it is provided. For example, a job readiness training program
might be expected to result in clients having increased knowledge of
how to apply for a job, improved grooming for job interviews, and
improved job interview skills; or business training and training in
bookkeeping and accounting might be expected to result in project
participants making an informed decision about whether they are suited
for entrepreneurship.
At the next level are the intermediate outcomes, which result from
these immediate changes. Often an intermediate project outcome is the
result of several immediate changes resulting from a number of related
interventions such as training and counseling. Intermediate outcomes
should be expressed in measurable changes in knowledge, attitudes,
behavior, or status/condition. In the above examples, the immediate
changes achieved by the job readiness program, coupled with technical
assistance to an employer in the expansion of a business, could be
expected to lead to intermediate outcomes of creation of new job
openings and in the participant applying for a job with the company.
The acquisition of business skills, coupled with the establishment of a
loan fund, could be expected to result in the actual decision by the
participant to go into a particular business venture or seek the
alternative track of pursuing job readiness and training.
Finally, the application should describe how the achievement of
these intermediate outcomes will be expected to lead to the attainment
of the project goals: employment in newly created jobs, new careers in
non-traditional jobs, successful business ventures, or employment in an
expanded business, depending on the project design. Applicants must
remember that if the major focus of the project is to be the
development and startup of a new business or the expansion of an
existing business, then a business plan which follows the outline in
Attachment L to this announcement must be submitted as an appendix to
the proposal. (See Part II, U.)
Applicants do not have to use the exact terminology described
above, but it is important to describe the project in a way that makes
clear the expected cause-and-effect relationship between what the
project plans to do: the activities or interventions, the changes that
are expected to result, and how those changes will lead to attainment
of the project goals of new employment opportunities and greater self-
sufficiency. The competitive review of this sub-element will be based
on the extent to which the application makes a convincing case that the
activities to be undertaken will lead to the projected results.
It is suggested that applicants use no more than 4 pages for this
sub-element.
Sub-Element II(c)--Work Plan
(Weight of 0-10 points in proposal review)
Once the project strategy and design framework is established, the
applicant should present the highlights of a work plan for the project.
The plan should explicitly tie into the project design framework and
should be feasible, i.e., capable of being accomplished with the
resources, staff, and partners available. The plan should briefly
describe the key project tasks and show the time lines and major
milestones for their implementation. Critical issues or potential
problems that might affect the achievement of project objectives should
be explicitly addressed, with an explanation of how they would be
overcome, and how the objectives will be achieved notwithstanding any
such problems. The plan should be presented in such a way that it can
be correlated with the budget narrative included earlier in the
application.
Applicants may be able to use a simple Gantt or time line chart to
convey the work plan in minimal space.
The application contains a full and accurate description of the
proposed use of the requested financial assistance.
If the applicant proposes to make an equity investment or a loan to
an individual, organization, or business entity (including a wholly-
owned subsidiary), the application must include: A signed third party
agreement; a signed statement by a Certified or Licensed Public
Accountant as to the sufficiency of the third party's financial
management system; and financial statements for the third party's prior
three years of operation. (If newly formed and unable to provide the
information regarding the prior three years of operation, a statement
to that effect should be included.) If the applicant states that an
agreement is not currently in place, the application must contain in
the narrative as much information required for third party agreements
as is available.
Also, if the project proposes the development of a new or expanded
business, service, physical or commercial activity, the application
must address applicable elements of a business plan. Guidelines for a
business plan are included in Attachment L.
Special attention should be given to assure that the financial plan
element, which indicates the project's potential and timetable for
financial self-sufficiency, is included. It must include for the
applicant and the third party, if appropriate, the following exhibits
for the first three years (on a quarterly basis) of the business'
operations: Profit and Loss Forecasts, Cash Flow Projections, and
Proforma Balance Sheets. Based on these documents, the application must
also contain an analysis of the financial feasibility of the project.
Also, a narrative ``Source and Use of Funds'' statement for all project
funding must be included.
It is suggested that applicants use no more than 3 pages for this
sub-element.
[[Page 8083]]
Evaluation Criteria 3: Results or Benefits Expected
Element III: Significant and Beneficial Impact
Sub-Element III (a)--Quality of Jobs/Business Opportunities
(Weight of 0-10 points in proposal review)
The proposed project is expected to produce permanent and
measurable results that will reduce the incidence of poverty in the
community and lead welfare recipients from welfare dependency toward
economic self-sufficiency. Results are expected to be quantifiable in
terms of the creation of permanent, full-time jobs; the development of
business opportunities; the expansion of existing businesses; or the
creation of non-traditional employment opportunities. In developing
business opportunities and self-employment for TANF recipients and low-
income individuals, the applicant proposes, at a minimum, to provide
basic business planning and management concepts, and assistance in
preparing a business plan and loan package.
The application should document that:
The business opportunities to be developed for eligible
participants will contribute significantly to their progress toward
self-sufficiency; and/or jobs to be created for eligible participants
will contribute significantly to their progress toward self-
sufficiency. For example, they should provide salaries that exceed the
minimum wage, plus benefits such as health insurance, child care and
career development opportunities.
It is suggested that applicants use no more than 2 pages for this
sub-element.
Sub-Element III(b)--Community Empowerment Consideration
(Weight of 0-3 points in proposal review)
Special consideration will be given to applicants located in areas
characterized by conditions of extreme poverty and other indicators of
socio-economic distress. Examples of such distress may include: a
poverty rate of at least 20%, designation as an EZ/EC, high levels of
violence, gang activity or drug use. Applicants should document that in
response to these conditions, they have been involved in the
preparation and planned implementation of a comprehensive community-
based strategic plan to achieve both economic and human development in
an integrated manner, and they should identify how the proposed project
will support the goals of that plan.
It is suggested that applicants use no more than 2 pages for this
sub-element.
Sub-Element III(c)--Support for Noncustodial Parents
(Weight of 0-2 points in proposal review)
Applicants who have entered into partnership agreements with local
CSE Agencies will also receive special consideration upon demonstrating
they have developed and implemented innovative strategies to increase
the capability of low-income parents and families, which assists them
to fulfill their parental responsibilities. In addition, such
partnership agreements should include referrals of identified income
eligible families and noncustodial parents economically unable to
provide child support to the applicant's project.
To receive the full credit of two points, applicants should
include, as an Appendix to the application, a signed letter of
agreement with the local CSE Agency for referral of eligible
noncustodial parents will be made to the proposed project.
It is suggested that applicants use no more than 1 page for this
sub-element.
Sub-Element III(d)--Cost-Per-Job
(Weight of 0-5 points in proposal review)
The applicant should document that during the project period the
proposed project will create new, permanent jobs through business
opportunities or non-traditional employment opportunities for low-
income residents. The cost-per-job should be calculated by dividing the
total amount of grant funds requested (e.g., $500,000) by the number of
jobs to be created (e.g., 50) which would equal the cost-per-job
($10,000). If any other calculations are used, include the methodology
and rationale in this section. In making calculations of cost-per-job,
only jobs filled by low-income project participants may be counted.
(See Part II, Section S.)
Note: Except in those instances where independent reviewers
identify extenuating circumstances related to business development
activities, or high wage levels and living costs, such as in Hawaii
or Alaska, the maximum number of points will be given only to those
applicants proposing cost-per-job created estimates of $10,000 or
less of OCS requested funds. The maximum cost-per-job under the JOLI
program is $15,000 in OCS funds unless there are extenuating
circumstances as described under this sub-element. Higher cost-per-
job estimates will receive correspondingly fewer points.
It is suggested that applicants use no more than 1 page for this
sub-element.
Evaluation Criteria 4: Approach II
Element IV: Project Evaluation
(Weight of 0-15 points in the proposal review)
Sound evaluations are essential to the JOLI Program. OCS requires
each application to include a well thought through outline of an
Evaluation Plan for the project. The outline should explain how the
applicant proposes to answer the key questions about how effectively
the project is being/was implemented; whether the project activities,
or interventions, achieved the expected immediate outcomes, and why or
why not (the process evaluation); and whether and to what extent the
project achieved its stated goals, and why or why not (the outcome
evaluation). Together, the process and outcome evaluations should
answer the question: ``What did this program accomplish and why did it
work/not work?''
Applicants are not being asked to submit a complete and final
Evaluation Plan as part of their proposal, but they must include:
1. A well thought through Evaluation Plan outline that identifies
the principal cause-and-effect relationships to be tested, and that
demonstrates the applicant's understanding of the role and purpose of
both process and outcome evaluations (see previous paragraph);
2. The identity and qualifications of the proposed independent
third party evaluator, i.e., a person or organization with recognized
evaluation skills organizationally distinct from and not under the
control of, the applicant. Third party evaluator's qualifications must
include successful experience in evaluating social service delivery
programs, and the planning and/or evaluation of programs designed to
foster self-sufficiency in low-income populations; and
3. A commitment to the selection of a third party evaluator
approved by OCS and completion of a final evaluation design and plan,
in collaboration with the approved evaluator and the OCS evaluation
technical assistance contractor during the six-month startup period of
the project, if funded.
Applicants should ensure, above all, that the evaluation outline
presented is consistent with their project design. A clear project
framework of the type recommended earlier identifies the key project
assumptions about the target populations and their needs, as well as
the hypotheses, or expected cause-effect relationships to be tested in
the project; and the proposed project activities, or interventions,
that will address those needs in ways that will lead to the
[[Page 8084]]
achievement of the project goals of self-sufficiency. It also
identifies in advance the most important process and outcome measures
that will be used to identify performance success and expected changes
in individual participants, the grantee organization, and the
community.
Finally, as noted above, the outline should provide for prompt
reporting, concurrently with the semi-annual program progress reports,
of lessons learned during the course of the project, so that they may
be shared without waiting for the final evaluation report.
For all these reasons, it is important that each successful
applicant have a third party evaluator selected and performing at the
very latest by the time the work program of the project is begun, and
if possible before that time so that he or she can participate in the
final design of the program and assure that data necessary for the
evaluation will be collected and available. Plans for selecting an
evaluator should be included in the application narrative. A third
party evaluator must have knowledge of and experience in conducting
process and outcome evaluations in the job creation field, and have a
thorough understanding of the range and complexity of the problems
faced by the target population.
The competitive procurement regulations (45 CFR Part 74, Sections
74.40-74.48, esp. 74.43) apply to service contracts such as those for
evaluators.
It is suggested that applicants use no more than 3 pages for this
element, plus the resume or position description for the evaluator,
which should be in an appendix.
Evaluation Criteria 5: Non-Federal Resources
Element V: Public/Private Partnerships and Resources
(Weight of 0-10 points in the proposal review)
The proposal should briefly describe any public/private
partnerships, which will contribute to the implementation of the
project. Where partners' contributions to the project are a vital part
of the project design and work program, the narrative should describe
undertakings of the partners. A partnership agreement specifying the
roles of the partners and making a clear commitment to the fulfilling
of the partnership role must be included in an appendix to the
proposal. The firm commitment of mobilized resources must be documented
and submitted with the application in order to be given credit under
this element. The application should meet the following criteria:
Where other resources are mobilized, the application must
provide documentation that public and/or private sources of cash and/or
third party-in-kind contributions will be available in the form of
letters of commitment from the organization(s)/individual(s) from which
resources will be received. Applications that can document dollar for
dollar contributions equal to the OCS funds, and demonstrate that the
partnership agreement clearly relates to the objectives of the proposed
project will receive the maximum number of points for this criterion.
Lesser contributions will be given consideration based upon the value
documented.
Note: Even though there is no matching requirement for the JOLI
Program, grantees will be held accountable for any match, cash or
in-kind contribution proposed or pledged as part of an approved
application. (See Part II, D--Mobilization of Resources.)
Partners involved in the proposed project should be
responsible for substantive project activities and services. Applicants
should note that partnership relationships are not created via service
delivery contracts.
It is suggested that applicants use no more than 4 pages for this
element.
Evaluation Criteria 6: Budget and Budget Justification
Element VI: Budget Appropriateness and Reasonableness
(Weight of 0-5 points in proposal review)
Applicants are required to submit Federal budget forms with their
proposals to provide basic applicant and project information (SF-424)
and information about how Federal and other project funds will be used
(424A). (See Part V.) Immediately following the completed Federal
budget forms, (Attachments B and C), applicants must submit a budget
narrative, or explanatory budget information which includes a detailed
budget breakdown for each of the budget categories in the SF-424A. This
budget narrative is not considered a part of the project narrative, and
does not count as part of the 30 page limitation but rather should be
included in the application following the budget forms.
The duration of the proposed project and the funds requested in the
budget must be commensurate with the level of effort necessary to
accomplish the goals and objectives of the project. The budget
narrative should briefly explain how grant funds will be expended and
show the appropriateness of the Federal funds and any mobilized
resources to accomplish project purposes within the proposed time
frame. The estimated cost to the government of the project should be
reasonable in relation to the project's duration and to the anticipated
results, and include reasonable administrative costs if an indirect
cost rate has not been negotiated with a cognizant Federal agency.
Applicants are encouraged to use job titles and not specific names
in developing the budget. However, the specific salary rates or amounts
for staff positions identified must be included in the application
budget.
Resources in addition to OCS grant funds are encouraged both to
augment project resources and strengthen the basis for continuing
partnerships to benefit the target community. The amounts of such
resources, their appropriateness to the project design, and the
likelihood that they will continue beyond the project time frame will
be taken into account in judging the application. As noted in Element
V, above, even though there is no matching requirement for the JOLI
Program, grantees will be held accountable for any match, cash or in-
kind contribution proposed or pledged as part of an approved
application.
Applicants should include funds in the project budget for travel by
project directors and chief evaluators to attend two national
evaluation workshops in Washington, DC (See Part VII, B, Attendance at
Evaluation Workshops.)
The score for this element will be based on the budget form (SF-
424A) and the associated detailed budget narrative.
Part IV--Application Procedures
A. Availability of Forms
Attachments B-F, H, J, and M contain all of the standard forms
necessary for the application for awards under this OCS program. These
Attachments and Parts III and V of this announcement contain all the
instructions required for submittal of applications.
Additional copies may be obtained by writing or telephoning the
office listed under the section entitled FOR FURTHER INFORMATION
CONTACT: at the beginning of this announcement. In addition, this
announcement is accessible on the Internet through the OCS web site for
reading or downloading at the following address: www.acf.dhhs.gov/programs/ocs/kits1.htm
The applicant must be aware that in signing and submitting the
application for this award, it certifies compliance with the Federal
requirements covering the drug-free workplace, debarment
[[Page 8085]]
regulations and the Certification Regarding Environmental Tobacco
Smoke, set forth in Attachments E, F and J.
Part III contains instructions for the substance and development of
the project narrative. Part VI, Section A, describes the contents and
format of the application as a whole.
B. Application Submission
Mailing Address: Job Opportunities for Low-income Individuals
Program applications must be mailed to the OCS Operations Center: 1815
North Fort Meyer Drive, Suite 300, Arlington, Virginia 22209;
Attention: Application for JOLI Program.
Number of Copies Required: One signed original application and two
copies should be submitted at the time of initial submission. (OMB-
0970-0139, expiration date 12/31/2003)
Submission Instructions: Mailed applications shall be considered as
meeting an announced deadline if they are either received on or before
the deadline date or sent on or before the deadline date and received
by the OCS Operations Center in time for the independent review.
Applications that are mailed must bear a legibly dated U.S. Postal
Service postmark or a legibly dated, machine produced postmark of a
commercial mail service affixed to the envelope/package containing the
application(s). To be acceptable as proof of timely mailing, a postmark
from a commercial mail service must include the logo/emblem of the
commercial mail service company and must reflect the date the package
was received by the commercial mail service company from the applicant.
Private metered postmarks shall not be acceptable as proof of timely
mailing. (Applicants are cautioned that express/overnight mail services
do not always deliver as agreed.)
Applications that are hand carried by applicants, applicant
couriers, or by other representatives of the applicant shall be
considered as meeting an announced deadline, if they are received on or
before the closing date, between the hours of 8:00 a.m. and 4:30 p.m.,
EST, at the OCS Operations Center,1815 North Fort Meyer Drive, Suite
300, Arlington, VA 22209, 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: Application for JOLI 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 that do not meet the criteria above
are considered late applications. ACF shall notify each late applicant
that its application will not be considered in the current competition.
Extension of Deadlines: ACF may extend application deadlines when
circumstances such as acts of God (flood, hurricanes, etc.) occur, or
when there are widespread disruptions of the mail service.
Determinations to extend or waive deadline requirements rest with ACF's
Chief Grants Management Officer.
C. Intergovernmental Review
This program is covered under Executive Order 12372,
``Intergovernmental Review of Federal Programs,'' and 45 CFR Part 100,
``Intergovernmental Review of Department of Health and Human Services
Program and Activities.'' Under the Order, States may design their own
processes for reviewing and commenting on proposed Federal assistance
under covered programs.
Note: State/Territory Participation in the Intergovernmental
Review Process does not signify applicant eligibility for financial
assistance under a program. A potential applicant must meet the
eligibility requirements of the program for which it is applying
prior to submitting an application to its Single Point of Contact
(SPOC), if applicable, or to ACF.
The following jurisdictions have elected not to participate in the
Executive Order process:
Alabama, Alaska, Colorado, Connecticut, Hawaii, Idaho, Kansas,
Louisiana, Massachusetts, Minnesota, Montana, Nebraska, New Jersey,
Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Vermont,
Virginia, Washington, American Samoa, and Palau.
Applicants from these 24 jurisdictions need take no action
regarding E.O. 12372. Applicants for projects to be administered by
Federally recognized Indian tribes are also exempt from the
requirements of E.O. 12372. Otherwise, applicants should contact their
SPOC as soon as possible to alert them of the prospective applications
and receive any necessary instructions. Applicants must submit any
required material to the SPOC as soon as possible so that the program
office can obtain and review SPOC comments as part of the award
process. It is imperative that the applicant submit all required
materials, if any, to the SPOC and indicate the date of this submittal
(or the date of contact if no submittal is required) on the Standard
Form 424, item 16a. Under 45 CFR 100.8(a)(2), a SPOC has sixty (60)
days from the application deadline to comment on proposed new or
competing continuation awards.
SPOCs are encouraged to eliminate the submission of routine
endorsements as official recommendations. Additionally, SPOCs are
requested to differentiate clearly between mere advisory comments and
those official State process recommendations which may trigger the
``accommodate or explain'' rule.
When comments are submitted directly to ACF, they should be
addressed to: Department of Health and Human Services, Administration
for Children and Families, Office of Grants Management/OCSE, 4th Floor
West, Aerospace Center, 370 L'Enfant Promenade, SW., Washington, DC
20447.
A list of the Single Point of Contact for each State and Territory
is included as Attachment G to this announcement.
D. Application Consideration
Applications that meet the screening requirements below will be
reviewed competitively. Such applications will be reviewed by panel and
given a numerical score and explanatory comments based solely on
responsiveness to the guidelines and evaluation criteria published in
this announcement.
Applications will be reviewed by three persons outside of the OCS
unit. The results of these reviews will assist the Director and OCS
program staff in considering competing applications. Reviewers' scores
will weigh heavily in funding decisions, but will not be the only
factors considered.
Applications generally will be considered in order of the average
scores assigned by reviewers. However, highly ranked applications are
not guaranteed funding since other factors are taken into
consideration, including, but not limited to, the timely and proper
completion of projects funded with OCS funds granted in the last five
(5) years; comments of reviewers and government officials; staff
evaluation and input; the amount and duration of the grant requested
and the proposed project's consistency and harmony with OCS goals and
policy; geographic distribution of applications; previous program
performance of applicants; the limitations on project continuation or
refunding (See Part II, Section H); the
[[Page 8086]]
number of previous JOLI grants made to applicants; compliance with
grant terms under previous HHS grants, including the actual dedication
to program of mobilized resources as set forth in project applications;
audit reports; investigative reports; and applicant's progress in
resolving any final audit disallowances on previous OCS or other
Federal agency grants.
OCS reserves the right to discuss applications with other Federal
or non-Federal funding sources to verify the applicant's performance
record and the documents submitted.
E. Criteria for Screening Applications
All applications that meet the published deadline requirements as
provided in this Program Announcement will be screened for completeness
and conformity with the requirements. Only complete applications that
meet the requirements listed below will be reviewed and evaluated
competitively. Other applications will be returned to the applicant
with a notation that they were unacceptable and will not be reviewed.
The following requirements must be met by all applicants:
1. The application must contain a Standard Form 424 ``Application
for Federal Assistance'' (SF-424), a budget (SF-424A), and signed
``Assurances'' (SF-424B) completed according to instructions published
in Part V and Attachments C and D of this Program Announcement.
2. All JOLI applications must include a signed cooperative
partnership agreement with the designated State agency responsible for
administering the TANF Program, or a letter of commitment to such an
agreement within six months of a grant award, contingent only on
receipt of OCS funds. This cooperative partnership agreement must fully
describe the role and/or responsibilities of each partner for specific
activities and/or services to be provided which must clearly relate to
the objectives of the proposed project.
3. A project narrative must also accompany the standard forms. OCS
requires that the narrative portion of the application be limited to 30
pages, typewritten on one side of the paper only with one-inch margins
and type face no smaller than 12 characters per inch (c.p.i.) or
equivalent. The table of contents, budget narrative charts, appendices,
exhibits, resumes, position descriptions, letters of support,
cooperative agreements, letters of collaboration or substantive
commitments to the project by organizations other than designated TANF
agency, and business plans (where required) are not counted against
this page limit. It is strongly recommended that applicants follow the
format and content for the narrative set out in Part III.
4. The SF-424 and the SF-424B must be signed by an official of the
organization applying for the grant who has authority to obligate the
organization legally. Applicants must also be aware that the
applicant's legal name as required on the SF-424 (item 5) must match
that listed as corresponding to the Employer Identification Number
(item 6).
5. Application must contain documentation of the applicant's tax
exempt status as required under Part II, section A.
6. The application must contain a written third party agreement, or
a discussion of a proposed agreement, signed by the applicant and the
third party that includes all of the elements required in Part II,
section W, if the applicant proposes to make an equity investment or a
loan.
Part V--Instructions for Completing the SF-424
(Approved by the OMB under control Number 0970-0139, expiration date
12/31/2003.)
The standard forms attached to this announcement shall be used to
apply for funds under this program announcement.
It is suggested that you reproduce single-sided copies of the SF-
424 and SF-424A and type your application on the copies. Please prepare
your application in accordance with instructions provided on the forms
(Attachments B and C) as modified by the OCS specific instructions set
forth below:
Provide line item detail and detailed calculations for each budget
object class identified on the Budget Information form. Detailed
calculations must include estimation methods, quantities, unit costs,
and other similar quantitative detail sufficient for the calculation to
be duplicated. The detailed budget must also include a breakout by the
funding sources identified in Block 15 of the SF-424.
Provide a narrative budget justification, which describes how the
categorical costs are derived. Discuss the necessity, reasonableness,
and allocability of the proposed costs.
A. SF-424--Application for Federal Assistance (Attachment B)
Where the applicant is a previous Department of Health and Human
Services grantee, enter the Central Registry System Employee
Identification Number (CRS/EIN) and the Payment Identifying Number, if
one has been assigned, in the Block entitled Federal Identifier located
at the top right hand corner of the form.
Item 1. For the purposes of this announcement, all projects are
considered Applications; there are no Preapplications.
Item 7. Enter N in the box and specify nonprofit corporation on the
line marked Other.
Item 9. Name of Federal Agency--Enter HHS-ACF/OCS.
Item 10. The Catalog of Federal Domestic Assistance number for OCS
programs covered under this announcement is 93.593. The title is ``Job
Opportunities for Low-Income Individuals Program''.
Item 13. ``Proposed Project''--The ending date should be based on
the requested project period, not to exceed three years (36 months).
Item 15a. This amount should be no greater than $700,000.
Item 15b-e. These items should reflect both cash and third party
in-kind contributions for the three year budget period requested.
B. SF-424A--Budget Information-Non-Construction Programs--(Attachment
C)
In completing these sections, the Federal funds budget entries will
relate to the requested OCS funds only, and Non-Federal will include
mobilized funds from all other sources--applicant, state, local, and
other. Federal funds other than requested OCS funding should be
included as ``Non-Federal'' entries.
Section A, B, and C of SF-424A should reflect budget estimates for
each year of the budget period for which funding is being requested.
Section A--Budget Summary
You need only fill in lines 1 and 5 (with the same amounts).
Column (a): Enter Job Opportunities for Low-Income Individuals
Program.
Column (b): Catalog of Federal Domestic Assistance number is
93.593.
Columns (c) and (d): Not relevant to this program.
Column (e)-(g): Enter the appropriate amounts. (Column (e) should
not be more than $700,000.)
Section B--Budget Categories
Note: That the following information supersedes the instructions
provided with the Form SF-424A in Attachment C.
For each of the relevant Object Class Categories:
Column 1: Enter the OCS grant funds for the first year;
Column 2: Enter the OCS grant funds for the second year (where
appropriate);
[[Page 8087]]
Column 3: Enter the OCS grant funds for the third year (where
appropriate);
Column 4: Leave blank.
Column 5: Enter the total Federal OCS grant funds for the total
budget period by Object Class Categories, showing a total budget of not
more than $700,000.
Note: With regard to Object Class Categories: Only out-of-town
travel should be entered under category c. Travel. Local travel
costs should be entered under category h. Other. Equipment costing
less than $5,000 should be included in category e. Supplies.
Section C--Non-Federal Resources
This section is to record the amounts of non-Federal resources that
will be used to support the project. For the purposes of this
application, non-Federal resources means other than the OCS funds for
which the applicant is applying. Therefore, mobilized funds from other
Federal programs, such as the Job Training Partnership Act program,
should be entered on these lines. Provide a brief listing of these non-
Federal resources on a separate sheet and describe whether it is a
grantee-incurred cost or a third party cash or in-kind contribution.
The firm commitment of these resources must be documented and submitted
with the application in order to be given credit in the review process
under the Public/Private Partnerships program element.
Except in unusual situations, this documentation must be in the
form of letters of commitment from the organization(s)/individual(s)
from which resources will be received.
Note: Even though there is no matching requirement for the JOLI
Program, grantees will be held accountable for any match, cash or
in-kind contribution proposed or pledged as part of an approved
application. (See Part III, Element V.).
This section should be completed in accordance with the
instructions provided.
Sections D, E, and F May Be Left Blank
A supporting budget narrative must be submitted providing details
of expenditures under each budget category, and justification of dollar
amounts which relate the proposed expenditures to the work program and
goals of the project. (See Part III, Element VI.)
C. SF-424B Assurances-Non-Construction (Attachment D)
All applicants must fill out, sign, date and return the
``Assurances'' with the application.
Part VI--Contents of Application and Receipt Process
A. Contents of Application
Each JOLI application must include all of the following, in the
order listed below:
1. Table of Contents.
2. An Abstract of the Proposed Project--very brief, not to exceed
250 words, that would be suitable for use in an announcement that the
application has been selected for a grant award and which identifies
the type of project(s), the target population, and the major elements
of the work plan.
3. Completed Standard Form 424 that has been signed by an Official
of the organization applying for the grant who has authority to
obligate the organization legally.
Note: The original SF-424 must bear the original signature of
the authorizing representative of the applicant organization.
4. Budget Information-Non-Construction Programs--(SF-424A).
5. A narrative budget justification for each object class category
required under Section B, SF-424A.
6. Certifications and Assurances Required: Applicants requesting
financial assistance for a non-construction project must sign and
return Standard Form 424B, ``Assurances: Non-Construction Programs''
with their applications. (See Attachment D.)
Applicants must provide a Certification Regarding Lobbying. Prior
to receiving an award in excess of $100,000, applicants shall furnish
an executed copy of the lobbying certification. Applicants must sign
and return the certification with their application. (See Attachment
H.)
Applicants must make the appropriate certification of their
compliance with the Drug-Free Workplace Act of 1988. By signing and
submitting the applications, applicants are providing the certification
and need not mail back the certification with the applications. (See
Attachment E.)
Applicants must make the appropriate certification that they are
not presently debarred, suspended or otherwise ineligible for award. By
signing and submitting the applications, applicants are providing the
certification and need not mail back the certification with the
applications. (See Attachment F.)
Applicants must make the appropriate certification of their
compliance with all Federal statutes relating to nondiscrimination. By
signing and submitting the applications, applicants are providing the
certification and need not mail back a certification form.
Applicants must make the appropriate certification of their
compliance with the requirements of the Pro-Children Act of 1994 as
outlined in Certification Regarding Environmental Tobacco Smoke. (See
Attachment J.)
7. A Project Narrative of no more than 30 pages consisting of the
Elements described in Part IV of this announcement set forth in the
order therein presented and preceded by a consecutively numbered table
of contents.
The total number of pages for the narrative portion of the
application package must not exceed 30 pages. (See Part IV.E.3. for
pages that do not count against the 30-page limit.)
8. Appendices--proof of nonprofit tax-exempt status as outlined in
Part II, Section A; proof that the organization is a community
development corporation, commitments from officials of businesses that
will be expanded or franchised, where applicable; partnership agreement
with the designated State TANF agency and CSE agency; Single Point of
Contact comments, if applicable; resumes and position descriptions; a
business plan, where required; and, the Maintenance of Effort
Certification (See Part II-J and Attachment M).
Pages should be numbered sequentially throughout, including
appendices, beginning with the Abstract as page 1.
B. Application Format
Applications must be uniform in composition since OCS may find it
necessary to duplicate them for review purposes. Therefore,
applications must be submitted on white 8\1/2\ x 11 inch paper only.
Applications must not include colored, oversized or folded materials.
Applications should not include organizational brochures or other
promotional materials, slides, films, clips, etc. Such material will be
discarded if included.
Applications must be bound or enclosed in loose-leaf binder
notebooks. Preferably, applications should be two-holed punched at the
top center and fastened separately with a compressor slide paper
fastener, or a binder clip.
C. Acknowledgement of Receipt
Applicants who meet the initial screening criteria outlined in Part
IV, Section E, will receive an acknowledgement with an assigned
identification number within ten days after the deadline date for
submission of applications. This number must be referred to in all
subsequent communications with OCS concerning the application. To
facilitate receipt of
[[Page 8088]]
this acknowledgment from ACF, applicant is asked to include a cover
letter with the application containing an E-mail address and facsimile
(FAX) number if these items are available to applicant.
Applicants are requested to supply a self-addressed mailing label
with their application which can be attached to this acknowledgement
notice. This mailing label should reflect the mailing address of the
authorizing official who is applying on behalf of the organization. If
an acknowledgement is not received within three weeks after the closing
date, please notify ACF by telephone at (202) 401-5103.
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 approved
for use in the project, the project and budget periods for which
support is provided, the terms and conditions of the award, and the
total project period for which support is contemplated.
B. Attendance at Evaluation Workshops
The Project Directors and third party evaluators will be required
to attend two national evaluation workshops in Washington, DC. A three-
day program development and evaluation workshop will be scheduled
shortly after the effective date of the grant. They also will be
required to attend, as presenters, the final evaluation workshop on
utilization and dissemination to be held at the end of the project
period. Project budgets must include funds for travel to and attendance
at these workshops. (See Part III, Element VI, Budget Appropriateness
and Reasonableness.)
C. Reporting Requirements
Grantees will be required to submit semi-annual program progress
and financial reports SF-269) as well as final program progress and
financial reports within 90 days of the expiration of the grant. An
annual evaluation report will be due 30 days after each 12 months. A
final evaluation report will be due 90 days after the expiration of the
grant.
D. Audit Requirements
Grantees are subject to the audit requirements in 45 CFR Part 74
(nonprofit organization) and OMB Circular A-133.
E. Prohibitions and Requirements With Regard to Lobbying
Section 319 of Public Law 101-121, signed into law on October 23,
1989, imposes prohibitions and requirements for disclosure and
certification related to lobbying on recipients of Federal contracts,
grants, cooperative agreements, and loans. It provides limited
exemptions for Indian tribes and tribal organizations. Current and
prospective recipients (and their subtier contractors and/or grantees)
are prohibited from using appropriated funds for lobbying Congress or
any Federal agency in connection with the award of a contract, grant,
cooperative agreement or loan. In addition, for each award action in
excess of $100,000 (or $150,000 for loans) the law requires recipients
and their subtier contractors and/or subgrantees to: (1) Certify that
they have neither used nor will use any appropriated funds for payment
to lobbyists; (2) submit a declaration setting forth whether payments
to lobbyists have been or will be made out of non-appropriated funds
and, if so, the name, address, payment details, and purpose of any
agreements with such lobbyists whom recipients or their subtier
contractors or subgrantees will pay with the non-appropriated funds;
and, (3) file quarterly updates about the use of lobbyists, if an event
occurs that materially affects the accuracy of the information
submitted by way of declaration and certification.
The law establishes civil penalties for noncompliance and is
effective with respect to contracts, grants, cooperative agreements and
loans entered into or made on or after December 23, 1989. See
Attachment H for certification and disclosure forms to be submitted
with the applications for this program.
F. Applicable Federal Regulations
Attachment K indicates the regulations that apply to all
applicants/grantees under the Job Opportunities for Low-income
Individuals Program.
Dated: February 7, 2002.
Clarence H. Carter,
Director, Office of Community Services.
Job Opportunities for Low-Income Individuals; List of Attachments
A. 2001 Poverty Income Guidelines
B. Standard Form 424
C. Standard Form 424A
D. Standard Form 424B
E. Certification Regarding Drug-Free Workplace
F. Certification of Debarment
G. E.O. 12372 State Single Point of Contact List
H. Certification Regarding Lobbying Activities and Disclosure of
Lobbying Activities, SF-LLL
I. State Human Service Administrators Responsible for TANF
J. Certification Regarding Environmental Tobacco Smoke
K. DHHS Regulations Applying to All Applicants/Grantees Under
the Job Opportunities for Low-Income Individuals (JOLI) Program
L. Business Plan
M. Certification Regarding Maintenance of Effort
N. State Child Support Enforcement Agencies
O. Applicant's Checklist
BILLING CODE 4184-01-P
[[Page 8089]]
[GRAPHIC] [TIFF OMITTED] TN21FE02.000
[[Page 8090]]
[GRAPHIC] [TIFF OMITTED] TN21FE02.001
[[Page 8091]]
Attachment B
Instructions for the SF-424
Public reporting burden for this collection of of information is
estimated to average 45 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding the burden
estimate or any other aspect of this collection of information,
including suggestions for reducing the burden, to the Office of
Management and Budget, Paperwork Reduction Project (0348-0043),
Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF
MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE
SPONSORING AGENCY.
This is a standard form used by applicants as a required
facesheet for preapplications and applications submitted for Federal
assistance. It will be used by Federal agencies to obtain applicant
certification that States which have established a review and
comment procedure in response to Executive Order 12372 and have
selected the program to be included in their process, have been
given an opportunity to review the applicant's submission.
Item: Entry:
1. Self-explanatory.
2. Date application submitted to Federal agency (or State if
applicable) and applicant's control number (if applicable).
3. State use only (if applicable).
4. If this application is to continue or revise an existing
award, enter present Federal identifier number. If for a new
project, leave blank.
5. Legal name of applicant, name of primary organizational unit
which will undertake the assistance activity, complete address of
the applicant, and name and telephone number of the person to
contact on matters related to this application.
6. Enter Employer Identification Number (EIN) as assigned by the
Internal Revenue Service.
7. Enter the appropriate letter in the space provided.
8. Check appropriate box and enter appropriate letter(s) in the
spaces(s) provided:
--``New'' means a new assistance award.
--``Continuation'' means an extension for an additional funding/
budget period for a project with a projected completion date.
--``Revision'' means any change in the Federal Government's
financial obligation or contingent liability from an existing
obligation.
9. Name of Federal agency from which assistance is being
requested with this application.
10. Use the Catalog of Federal Domestic Assistance number and
title of the program under which assistance is requested.
11. Enter a brief descriptive title of the project. If more than
one program is involved, you should append an explanation on a
separate sheet. If appropriate (e.g., construction or real property
projects), attach a map showing project location. For
preapplications, use a separate sheet to provide a summary
description of this project.
12. List only the largest political entities affected (e.g.,
State, counties, cities).
13. Self-explanatory.
14. List the applicant's Congressional District and any
District(s) affected by the program or project.
15. Amount requested or to be contributed during the first
funding/budget period by each contributor. Value of in-kind
contributions should be included on appropriate lines as applicable.
If the action will result in a dollar change to an existing award,
indicate only the amount of the change. For decreases, enclose the
amounts in parentheses. If both basic and supplemental amounts are
included, show breakdown on an attached sheet. For multiple program
funding, use totals and show breakdown using same categories as item
15.
16. Applicants should contact the State Single Point of Contact
(SPOC) for Federal Executive Order 12372 to determine whether the
application is subject to the State intergovernmental review
process.
17. This question applies to the applicant organization, not the
person who signs as the authorized representative. Categories of
debt include delinquent audit disallowances, loans and taxes.
18. To be signed by the authorized representative of the
applicant. A copy of the governing body's authorization for you to
sign this application as official representative must be on file in
the applicant's office. (Certain Federal agencies may require that
this authorization be submitted as part of the application.)
BILLING CODE 4184-01-P
[[Page 8092]]
[GRAPHIC] [TIFF OMITTED] TN21FE02.002
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[GRAPHIC] [TIFF OMITTED] TN21FE02.003
BILLING CODE 4184-01-C
[[Page 8094]]
Instructions for the SF-424A
Attachment C
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 headings (1) through (4), enter the titles of the
same programs, functions, and activities shown on Lines 1-4, Column
(a), Section A. When additional sheets are prepared for Section A,
provide similar column headings on each sheet. For each program
function or activity, fill in the total requirements for funds (both
Federal and non-Federal) by object class categories.
Line 6a-i
Show the totals of Lines 6a to 6h in each column.
Line 6j
Show the amount of indirect cost.
Line 6k
Enter the total of amounts on Lines 6i and 6j. For all
applications for new grants and continuation grants the total amount
in column (5), Line 6k, should be the same as the total amount shown
in Section A, Column (g), Line 5. For supplemental grants and
changes to grants, the total amount of the increase or decrease as
shown in Columns (1)-(4), Line 6k should be the same as the sum of
the amounts in Section A, Columns (e) and (f) on Line 5.
Line 7
Enter the estimated amount of income, if any, expected to be
generated from this project. Do not add or subtract this amount from
the total project amount.
Show under the program narrative statement the nature and source
of income. The estimated amount of program income may be considered
by the Federal grantor agency in determining the total amount of the
grant.
Section C. Non-Federal Resources
Lines 8-11
Enter amounts of non-Federal resources that will be used on the
grant. If in-kind contributions are included, provide a brief
explanation on a separate sheet.
Column (a)--Enter the program titles identical to Column (a),
Section A. A breakdown by function or activity is not necessary.
Column (b)--Enter the contribution to be made by the applicant.
Column (c)--Enter the amount of the State's cash and in-kind
contribution if the applicant is not a State or State agency.
Applicants which are a State or State agencies should leave this
column blank.
Column (d)--Enter the amount of cash and in-kind contributions
to be made from all other sources.
Column (e)--Enter totals of Columns (b), (c), and (d).
Line 12
Enter the total for each of Columns (b)-(e). The amount in
Column (e) should be equal to the amount on Line 5, Column (f),
Section A.
Section D. Forecasted Cash Needs
Line 13
Enter the amount of cash needed by quarter from the grantor
agency during the first year.
Line 14
Enter the amount of cash from all other sources needed by
quarter during the first year.
Line 15
Enter the totals of amounts on Lines 13 and 14.
Section E. Budget Estimates of Federal Funds Needed for Balance of
the Project
Lines 16-19
Enter in Column (a) the same grant program titles shown in
column (a), Section A. A breakdown by function or activity is not
necessary. For new applications and continuation grant applications,
enter in the proper columns amounts of Federal funds which will be
needed to complete the program or project over the 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.
[[Page 8095]]
Section F. Other Budget Information
Line 21
Use this space to explain amounts for individual direct object-
class cost categories that may appear to be out of the ordinary or
to explain the details as required by the Federal grantor agency.
Line 22
Enter the type of indirect rate (provisional, predetermined,
final or fixed) that will be in effect during the funding period,
the estimated amount of the base to which the rate is applied, and
the total indirect expense.
Line 23
Provide any other explanations or comments deemed necessary.
Attachment D
Assurances--Non-Construction Programs
Public reporting burden for this collection of information is
estimated to average 15 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding the burden
estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of
Management and Budget, Paperwork Reduction Project (0348-0040),
Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF
MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE
SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your
project or program. If you have questions, please contact the
awarding agency. Further, certain Federal awarding agencies may
require applicants to certify to additional assurances. If such is
the case, you will be notified.
As the duly authorized representative of the applicant, I
certify that the applicant:
1. Has the legal authority to apply for Federal assistance and
the institutional, managerial and financial capability (including
funds sufficient to pay the non-Federal share of project cost) to
ensure proper planning, management and completion of the project
described in this application.
2. Will give the awarding agency, the Comptroller General of the
United States and, if appropriate, the State, through any authorized
representative, access to and the right to examine all records,
books, papers, or documents related to the award; and will establish
a proper accounting system in accordance with generally accepted
accounting standards or agency directives.
3. Will establish safeguards to prohibit employees from using
their positions for a purpose that constitutes or presents the
appearance of personal or organizational conflict of interest, or
personal gain.
4. Will initiate and complete the work within the applicable
time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970
(42 U.S.C. Secs. 4728-4763) relating to prescribed standards for
merit systems for programs funded under one of the 19 statutes or
regulations specified in Appendix A of OPM's Standards for a Merit
System of Personnel Administration (5 CFR 900, Subpart F).
6. Will comply with all Federal statutes relating to
nondiscrimination. These include but are not limited to: (a) Title
VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits
discrimination on the basis of race, color or national origin; (b)
Title IX of the Education Amendments of 1972, as amended (20 U.S.C.
Secs. 1681-1683, and 1685-1686), which prohibits discrimination on
the basic of sex; (c) Section 504 of the Rehabilitation Act of 1973,
as amended (29 U.S.C. Sec. 794), which prohibits discrimination on
the basis of handicaps; (d) the Age Discrimination Act of 1975, as
amended (42 U.S.C. Secs. 6101-6107), which prohibits discrimination
on the basis of age; (e) the Drug Abuse Office and Treatment Act of
1972 (P.L. 92-255), as amended, relating to nondiscrimination on the
basis of drug abuse; (f) the Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation Act of 1970
(P.L. 91-616), as amended, relating to nondiscrimination on the
basis of alcohol abuse or alcoholism; (g) Secs. 523 and 527 of the
Public Health Service Act of 1912 (42 U.S.C. Secs. 290 dd-3 and 290
ee 3), as amended, relating to confidentiality of alcohol and drug
abuse patient records; (h) Title VIII of the Civil Rights Act of
1968 (42 U.S.C. Secs. 3601 et seq.), as amended, relating to
nondiscrimination in the sale, rental or financing of housing; (i)
any other nondiscrimination provisions in the specific statute(s)
under which application for Federal assistance is being made; and,
(j) the requirements of any other nondiscrimination statute(s) which
may apply to the application.
7. Will comply, or has already complied, with the requirements
of Titles II and III of the Uniform Relocation Assistance and Real
Property Acquisition Policies Act of 1970 (P.L. 91-646) which
provide for fair and equitable treatment of persons displaced or
whose property is acquired as a result of Federal or federally-
assisted programs. These requirements apply to all interests in real
property acquired for project purposes regardless of Federal
participation in purchases.
8. Will comply, as applicable, with 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.
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 Clear Air Act of 1955, as amended (42 U.S.C.
Secs. 7401 et seq.); (g) protection of underground sources of
drinking water under the Safe Drinking Water Act of 1974, as
amended, (P.L. 93-523); and (h) protection of endangered species
under the Endangered Species Act of 1973, as amended, (P.L. 93-205).
12. Will comply with the Wild and Scenic Rivers Act of 1968 (16
U.S.C. Secs. 1271 et seq.) related to protecting components or
potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with
Section 106 of the National Historic Preservation Act of 1966, as
amended (16 U.S.C. 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. Sec. 4801 et seq.) which prohibits the use of lead
based paint in construction or rehabilitation or 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 the 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
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
[[Page 8096]]
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
(Instruction for Certification)
1. By signing and/or submitting this application or grant
agreement, the grantee is providing the certification set out below.
2. The certification set out below is a material representation
of fact upon which reliance is placed when the agency awards the
grant. If it is later determined that the grantee knowingly rendered
a false certification, or otherwise violates the requirements of the
Drug-Free Workplace Act, the agency, in addition to any other
remedies available to the Federal Government, may take action
authorized under the Drug-Free Workplace Act.
3. For grantees other than individuals, Alternate I applies.
4. For grantees who are individuals, Alternate II applies.
5. Workplaces under grants, for grantees other than individuals,
need not be identified on the certification. If known, they may be
identified in the grant application. If the grantee does not
identify the workplaces at the time of application, or upon award,
if there is no application, the grantee must keep the identity of
the workplace(s) on file in its office and make the information
available for Federal inspection. Failure to identify all known
workplaces constitutes a violation of the grantee's drug-free
workplace requirements.
6. Workplace identifications must include the actual address of
buildings (or parts of buildings) or other sites where work under
the grant takes place. Categorical descriptions may be used (e.g.,
all vehicles of a mass transit authority or State highway department
while in operation, State employees in each local unemployment
office, performs in concert halls or radio studios).
7. If the workplace identified to the agency changes during the
performance of the grant, the grantee shall inform the agency of the
change(s), if it previously identified the workplaces in question
(see paragraph five).
8. Definitions of terms in the Nonprocurement Suspension and
Debarment common rule and Drug-Free Workplace common rule apply to
this certification. Grantees' attention is called, in particular, to
the following definitions from these rules:
Controlled substance means a controlled substance in Schedules I
through V of the Controlled Substances Act (21 U.S.C. 812) and as
further defined by regulation (21 CFR 1308.11 through 1308.15);
Conviction means a finding of guilt (including a plea of nolo
contedere) or imposition of sentence, or both, by any judicial body
charged with the responsibility to determine violations of the
Federal or State criminal drug statues;
Criminal drug statute means a Federal or non-Federal criminal
statute involving the manufacture, distribution, dispensing, use, or
possession of any controlled substance;
Employee means the employee of a grantee directly engaged in the
performance of work under a grant, including: (i) All direct charge
employees; (ii) All indirect charge employees unless their impact or
involvement is insignificant to the performance of the grant; and,
(iii) Temporary personnel and consultants who are directly engaged
in the performance of work under the grant and who are on the
grantee's payroll. This definition does not include workers not on
the payroll of the grantee (e.g., volunteers, even if used to meet a
matching requirement; consultants or independent contractors not on
the grantee's payroll; or employees of subrecipients or
subcontractors in covered workplaces).
Certification Regarding Drug-Free Workplace Requirements
Alternate I. (Grantees Other Than Individuals)
The grantee certifies that it will or will continue to provide a
drug-free workplace by:
(a) Publishing a statement notifying employees that the unlawful
manufacture, distribution, dispensing, possession, or use of a
controlled substance is prohibited in the grantee's workplace and
specifying the actions that will be taken against employees for
violation of such prohibition;
(b) Establishing an ongoing drug-free awareness program to
inform employees about--
(1) The dangers of drug abuse in the workplace;
(2) The grantee's policy of maintaining a drug-free workplace;
(3) Any available drug counseling, rehabilitation, and employee
assistance programs; and
(4) The penalties that may be imposed upon employees for drug
abuse violations occurring in the workplace;
(c) Making it a requirement that each employee to be engaged in
the performance of the grant be given a copy of the statement
required by paragraph (a);
(d) Notifying the employee in the statement required by
paragraph (a) that, as a condition of employment under the grant,
the employee will--
(1) Abide by the terms of the statement; and
(2) Notify the employer in writing of his or her conviction for
a violation of a criminal drug statute occurring in the workplace no
later than five calendar days after such conviction;
(e) Notifying the agency in writing, within ten calendar days
after receiving notice under paragraph (d)(2) from an employee or
otherwise receiving actual notice of such conviction. Employers of
convicted employees must provide notice, including position title,
to every grant officer or other designee on whose grant activity the
convicted employee was working, unless the Federal agency has
designated a central point for the receipt of such notices. Notice
shall include the identification number(s) of each affected grant;
(f) Taking one of the following actions, within 30 calendar days
of receiving notice under paragraph (d)(2), with respect to any
employee who is so convicted--
(1) Taking appropriate personnel action against such an
employee, up to and including termination, consistent with the
requirements of the Rehabilitation Act of 1973, as amended; or
(2) Requiring such employee to participate satisfactorily in a
drug abuse assistance or rehabilitation program approved for such
purposes by a Federal, State, or local health, law enforcement, or
other appropriate agency;
(g) Making a good faith effort to continue to maintain a drug-
free workplace through implementation of paragraphs (a), (b), (c),
(d), (e) and (f).
(B) The grantee may insert in the space provided below the
site(s) for the performance of work done in connection with the
specific grant:
Place of Performance
(Street address, city, county, state, zip code)
Check if there are workplaces on file that are not identified
here.
Alternate II. (Grantees Who Are Individuals)
(a) The grantee certifies that, as a condition of the grant, he
or she will not engage in the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance in
conducting any activity with the grant;
(b) If convicted of a criminal drug offense resulting from a
violation occurring during the conduct of any grant activity, he or
she will report the conviction, in writing, within 10 calendar days
of the conviction, to every grant officer or other designee, unless
the Federal agency designates a central point for the receipt of
such notices. When notice is made to such a central point, it shall
include the identification number(s) of each affected grant.
Certification Regarding Debarment, Suspension and Other Responsibility
Matters
Certification Regarding Debarment, Suspension, and Other
Responsibility Matters--Primary Covered Transactions
Instructions for Certification
1. By signing and submitting this proposal, the prospective
primary participant is providing the certification set out below.
2. The inability of a person to provide the certification
required below will not necessarily result in denial of
participation in this covered transaction. The prospective
participant shall submit an explanation of why it cannot provide the
certification set out below. The certification or explanation will
be considered in connection with the department or agency's
determination whether to enter into this transaction. However,
failure of the prospective primary participant to furnish a
certification or an explanation shall disqualify such person from
participation in this transaction.
3. The certification in this clause is a material representation
of fact upon which reliance was placed when the department or agency
determined to enter into this
[[Page 8097]]
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
``Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion-Lower Covered Transaction,'' provided by the
department or agency entering into this covered transaction, without
modification, in all lower tier covered transactions and in all
solicitations for lower tier covered transactions.
8. A participant in a covered transaction may rely upon a
certification of a prospective participant in a lower tier covered
transaction that it is not proposed for debarment under 48 CFR part
9, subpart 9.4, debarred, suspended, ineligible, or voluntarily
excluded from the covered transaction, unless it knows that the
certification is erroneous. A participant may decide the method and
frequency by which it determines the eligibility of its principals.
Each participant may, but is not required to, check the List of
Parties Excluded from Federal Procurement and Nonprocurement
Programs.
9. Nothing contained in the foregoing shall be construed to
require establishment of a system of records in order to render in
good faith the certification required by this clause. The knowledge
and information of a participant is not required to exceed that
which is normally possessed by a prudent person in the ordinary
course of business dealings.
10. Except for transactions authorized under paragraph 6 of
these instructions, if a participant in a covered transaction
knowingly enters into a lower tier covered transaction with a person
who is proposed for debarment under 48 CFR part 9, subpart 9.4,
suspended, debarred, ineligible, or voluntarily excluded from
participation in this transaction, in addition to other remedies
available to the Federal Government, the department or agency may
terminate this transaction for cause or default.
Certification Regarding Debarment, Suspension, and Other
Responsibility Matters--Primary Covered Transaction.
(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 indicated for or otherwise criminally or
civilly charged by a governmental entity (Federal, State or local)
with commission of any of the offenses enumerated in paragraph
(1)(b) of this certification; and
(d) Have not within a three-year period preceding this
application/proposal had one or more public transactions (Federal,
State or local) terminated for cause or default.
(2) Where the prospective primary participant is unable to
certify to any of the statements in this certification, such
prospective participant shall attach an explanation to this
proposal.
Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion--Lower Tier Covered Transactions
Instructions for Certification
1. By signing and submitting this proposal, the prospective
lower tier participant is providing the certification set out below.
2. The certification in this clause is a material representation
of fact upon which reliance was placed when this transaction was
entered into. If it is later determined that the prospective lower
tier participant knowingly rendered an erroneous certification, in
addition to other remedies available to the Federal Government the
department or agency with which this transaction originated may
pursue available remedies, including suspension and/or debarment.
3. The prospective lower tier participant shall provide
immediate written notice to the person to which this proposal is
submitted if at any time the prospective lower tier participant
learns that its certification was erroneous when submitted or had
become erroneous by reason of changed circumstances.
4. The terms covered transaction, debarred, suspended,
ineligible, lower tier covered transaction, participant, person,
primary covered transaction, principal, proposal, and voluntarily
excluded, as used in this clause, have the meaning set out in the
Definitions and Coverage sections of rules implementing Executive
Order 12549. You may contact the person to which this proposal is
submitted for assistance in obtaining a copy of those regulations.
5. The prospective lower tier participant agrees by submitting
this proposal that, [[Page 33043]] should the proposed covered
transaction be entered into, it shall not knowingly enter into any
lower tier covered transaction with a person who is proposed for
debarment under 48 CFR part 9, subpart 9.4, debarred, suspended,
declared ineligible, or voluntarily excluded from participation in
this covered transaction, unless authorized by the department or
agency with which this transaction originated.
6. The prospective lower tier participant further agrees by
submitting this proposal that it will include this clause titled
``Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion-Lower Tier Covered Transaction,'' without
modification, in all lower tier covered transactions and in all
solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a
certification of a prospective participant in a lower tier covered
transaction that it is not proposed for debarment under 48 CFR part
9, subpart 9.4, debarred, suspended, ineligible, or voluntarily
excluded from covered transactions, unless it knows that the
certification is erroneous. A participant may decide the method and
frequency by which it determines the eligibility of its principals.
Each participant may, but is not required to, check the List of
Parties Excluded from Federal Procurement and Nonprocurement
Programs.
8. Nothing contained in the foregoing shall be construed to
require establishment of a system of records in order to render in
good faith the certification required by this clause.
The knowledge and information of a participant is not required
to exceed that which is normally possessed by a prudent person in
the ordinary course of business dealings.
9. Except for transactions authorized under paragraph 5 of these
instructions, if a participant in a covered transaction knowingly
enters into a lower tier covered transaction with a person who is
proposed for debarment under 48 CFR part 9, subpart 9.4, suspended,
debarred, ineligible, or voluntarily excluded from participation in
this transaction, in addition to other remedies available to the
Federal Government, the department or agency with which this
transaction originated may pursue available remedies, including
suspension and/or debarment.
Certification Regarding Debarment, Suspension, Ineligibility an
Voluntary Exclusion--Lower Tier Covered Transactions
(1) The prospective lower tier participant certifies, by
submission of this proposal, that
[[Page 8098]]
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, PAGE 1
Intergovernmental 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 of 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,
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]
WISCONSIN
Jeff Smith, Section Chief, Federal/State Relations, Wisconsin
Department of
[[Page 8099]]
Administration, 101 East Wilson Street--6th Floor, P.O. Box 7868,
Madison, Wisconsin 53707, Telephone: (608) 266-0267, Fax: (608) 267-
6931, [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]
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
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]
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]
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.
Attachment H
Certification Regarding Lobbying
Certification for Contracts, Grants, Loans, and Cooperative
Agreements
The undersigned certifies, to the best of his or her knowledge
and belief, that:
(1) No Federal appropriated funds have been paid or will be
paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of an
agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with the awarding
of any Federal contract, the making of any Federal grant, the making
of any Federal loan, the entering into of any cooperative agreement,
and the extension, continuation, renewal, amendment, or modification
of any Federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been
paid or will be paid to any person for influencing or attempting to
influence an officer or employee of any agency, a Member of
Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with this Federal contract, grant,
loan, or cooperative agreement, the undersigned shall complete and
submit Standard Form-LLL, ``Disclosure Form to Report Lobbying,'' in
accordance with its instructions.
(3) The undersigned shall require that the language of this
certification be included in the award documents for all subawards
at all tiers (including subcontracts, subgrants, and contracts under
grants, loans, and cooperative agreements) and that all
subrecipients shall certify and disclose accordingly. This
certification is a material representation of fact upon which
reliance was placed when this transaction was made or entered into.
Submission of this certification is a prerequisite for making or
entering into this transaction imposed by section 1352, title 31,
U.S. Code. Any person who fails to file the required certification
shall be subject to a civil penalty of not less than $10,000 and not
more than $100,000 for each such failure.
Statement for Loan Guarantees and Loan Insurance
The undersigned states, to the best of his or her knowledge and
belief, that:
If any funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with this
commitment providing for the United States to insure or guarantee a
loan, the undersigned shall complete and submit Standard Form-LLL,
``Disclosure Form to Report Lobbying,'' in accordance with its
instructions. Submission of this statement is a prerequisite for
making or entering into this transaction imposed by section 1352,
title 31, U.S. Code. Any person who fails to file the required
statement shall be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each such failure.
----------------------------------------------------------------------
Signature
----------------------------------------------------------------------
Title
----------------------------------------------------------------------
Organization
BILLING CODE 4184-01-M
[[Page 8100]]
[GRAPHIC] [TIFF OMITTED] TN21FE02.004
BILLING CODE 4184-01-C
Instructions for Completion of SF-LLL, Disclosure of Lobbying
Activities
This disclosure form shall be completed by the reporting entity,
whether subawardee or prime Federal recipient, at the initiation or
receipt of a covered Federal action, or a material change to a
previous filing, pursuant to title 31 U.S.C. Section 1352. The
filing of a form is required for each payment or agreement to make
payment to any lobbying entity for influencing or attempting to
influence an officer or employee of any agency, a Member of
Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with a covered Federal action. 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 the covered Federal action.
2. Identify the status of the covered Federal action.
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.
[[Page 8101]]
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 40 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. 0348-0046. Public
reporting burden for this collection of information is estimated to
average 10 minutes per response, including time for reviewing
instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding the burden
estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of
Management and Budget, Paperwork Reduction Project (0348-0046),
Washington, DC 20503.
Disclosure of Lobbying Activities Continuation Sheet
Reporting Entity:------------------------------------------------------
Page-------------------------------------------------------------------
of---------------------------------------------------------------------
Attachment I
State Human Services Administrators
Last Updated: 10/31/2001
Indexed by State Name
A
Mr. Bill Fuller, Commissioner, Alabama State Department of Human
Resource, 50 Ripley Street, Montgomery, AL 36130-4000, Phone: (334)
242-1160, FAX: (334) 242-0198
Mr. Jay Lively, Commissioner, Alaska Department of Health & Social
Services, PO Box 110601, Juneau, AK 99811-0601, Phone: (907) 465-
3030, FAX: (907) 465-3068
Dr. Uiagalelie Leaofi, Director, American Samoa Department of Human
& Social Service, PO Box 997534, Pago Pago, AS 96799, Phone: 011
(684) 633-2969, FAX: 011 (684) 633-7449
Mr. John L. Clayton, Director, Arizona Department of Economic
Security, PO Box 6123, Site Code 010A, Phoenix, AZ 85005, Phone:
(602) 542-5678, FAX: (602) 542-5339
Mr. Kurt Knickrehm, Director, Arkansas Department of Human Services,
329 Donaghey Plaza South, Seventh & Main Streets, PO Box 1437,
Little Rock, AR 72203-1437, Phone: (501) 682-8650, FAX: (501) 682-
6836
Mr. Grantland Johnson, Secretary, California Health and Human
Services Agency, 1600 Ninth Street, Room 460, Sacramento, CA 95814,
Phone: (916) 654-3345, FAX: (916) 654-3343
Ms. Rita Saenz, Director, California Department of Social Services,
744 P Street, Mail Stop 17-11, Sacramento, CA 95814, (916) 657-2598,
FAX: (916) 653-1695
Mrs. Marva Livingston Hammons, Executive Director, Colorado
Department of Human Services, 1575 Sherman Street, 8th floor,
Denver, CO 80203-1714, Phone: (303) 866-5096, FAX: (303) 866-4740
Ms. Patricia A. Wilson-Coker, Commissioner, Connecticut Department
of Social Services, 25 Sigourney Street, Hartford, CT 06106-2055,
Phone: (860) 424-5008, FAX: (860) 424-5129
D
Mr. Vincent P. Meconi, Secretary, Delaware Health & Social Services,
Herman M. Holloway Sr., Campus, Main Administration Building, 1st
floor, 1901 N. DuPont Highway, New Castle, DE 19720, Phone: (302)
577-4502, FAX: (302) 577-4510
Ms. Carolyn W. Colvin, Director, District of Columbia Department of
Human Services, 801 East Building, 2700 Martin Luther King Jr. Ave.,
SE, Washington, DC 20032-0247, Phone: (202) 279-6016, FAX: (202)
279-6014
F
Judge Kathleen Kearney, Secretary, Florida Department of Children &
Families, Building 1, Room 202, 1317 Winewood Boulevard,
Tallahassee, FL 32399-0700, Phone: (850) 487-1111, FAX: (850) 922-
2993
Mr. Ruben J. King-Shaw, Director, Florida Agency for Health Care
Administration, Fort Knox Building 3, 2727 Mahan Drive, Suite 3116,
Tallahassee, FL 32308, Phone: (850) 922-3809, FAX: (850) 488-0043
G
Mr. Jim Martin, Commissioner, Georgia Department of Human Resources,
2 Peach Tree Street, NW, Suite 29-250, Atlanta, GA 30303, Phone:
(404) 656-5680, FAX: (404) 651-8669
Ms. Juanita Blout-Clark, Director, Georgia Department of Human
Resources, Division of Family & Children Services, 2 Peachtree
Street, Atlanta, GA 30303, Phone: (404) 657-7660, FAX: (404) 657-
5105
Mr. Dennis G. Rodriguez, Director, Guam Department of Public Health
& Social Services, PO Box 2816, Agana, GU 96932, Phone: 011 (671)
734-7102, FAX: 011 (671) 734-5910
H
Ms. Susan Chandler, Director, Hawaii Department of Human Services,
PO Box 339, 1390 Miller Street, RM 209, Honolulu, HI 96813, Phone:
(808) 586-4997, FAX: (808) 586-4890
I
Mr. Karl B. Kurtz, Director, Idaho Department of Health & Welfare,
P.O. Box 83720, 450 West State Street, 10th Floor, Boise, ID 83720-
0036, Phone: (208) 334-5500, FAX: (208) 334-6558
Ms. Linda Renee Baker, Secretary, Illinois Department of Human
Services, Harris Building, 3rd floor, 210 South Grand Avenue, East,
Springfield, IL 62762, Phone: (217) 557-1601, FAX: (217) 557-1647
Mr. John Hamilton, Secretary, Indiana Family & Social Services
Administration, 402 West Washington Street, Room W-461,
Indianapolis, IN 46204, Phone: (317) 233-4690, FAX: (317) 233-4693
Mr. James M. Hmurovich, Director, Division of Family & Children,
Indiana Family & Social Services Administration, W392 Government
Center South, 402 West Washington Street, P.O. Box 7083,
Indianapolis, IN 46207-7083 Phone: (317) 232-4705, FAX: (317) 232-
4490
Ms. Jessie Rasmussen, Director, Iowa Department of Human Services,
East 13th Street and Walnut, Hoover State Office Building, Des
Moines, IA 50319-0114, Phone: (515) 281-5452, FAX: (515) 281-4597
K
Ms. Janet Schalansky, Secretary, Kansas Department of Social and
Rehabilitation Services, Docking State Office Building, 6th Floor,
915 SW Harrison, Topeka, KS 66612-1570, Phone: (913) 296-3271, FAX:
(913) 296-4685
Ms. Viola P. Miller, Secretary, Kentucky Cabinet for Families &
Children, 275 East Main Street, 4th floor West, Frankfort, KY 40621,
Phone: (502) 564-7130, FAX: (502) 564-3866
L
Ms. J. Renea Austin-Duffin, Secretary, Louisiana Department of
Social Services, P.O. Box 3776, 755 N. 3rd Street, RM 201, Baton
Rouge, LA 70821, Phone: (225) 342-0286, FAX: (225) 342-8636
[[Page 8102]]
M
Mr. Kevin W. Concannon, Commissioner, Maine Department of Human
Services, 11 State House Station, 211 State Street, Augusta, ME
04333, Phone: (207) 287-2736, FAX: (207) 287-3005
Ms. Emelda P. Johnson, Secretary, Maryland Department of Human
Resources, Saratoga State Center, 311 West Saratoga Street, 10th
Floor, Baltimore, MD 21201, Phone: (410) 767-7109, FAX: (410) 333-
0099
Mrs. Claire McIntire, Commissioner, Massachusetts Department of
Transitional Assistance, 600 Washington Street, Boston, MA 02111,
Phone: (617) 348-8410, FAX: (617) 348-8475
Mr. Douglas Howard, Director, Michigan Family Independence Agency,
235 South Grand Avenue, Lansing, MI 48909, Phone: (517) 373-2000,
FAX: (517) 335-6101
Mr. James K. Haveman, Director, Michigan Department of Community
Health, Lewis Cass Building, 320 South Walnut Street, Lansing, MI
48913, Phone: (517) 335-0267, FAX: (517) 373-4288
Mr. Michael O'Keefe, Commissioner, Minnesota Department of Human
Services, 444 Lafayette Road, St. Paul, MN 55155-3815, Phone: (615)
296-2701, FAX: (651) 296-5868
Ms. Janice Broome Brooks, Executive Director, Mississippi Department
of Human Services, 750 North State Street, Jackson, MS 39202, Phone:
(601) 359-4480, FAX: (601) 359-4477
Mr. Steve Renne, Director, Missouri Department of Social Services,
Broadway State Office Building, 221 W. High Street, Jefferson City,
MO 65102, Phone: (573) 751-4815, FAX: (573) 751-3203
Ms. Gail Gray, Director, Montana Department of Public Health & Human
Services, 111 North Sanders, P.O. Box 4210, Helena, MT 59604-4210,
Phone: (406) 444-5622, FAX: (406) 444-1970
Mr. Hank G. Hudson, Administrator, Human & Community Services
Division, Montana Department of Public Health, & Human Services,
P.O. Box 202952, Helena, MT 59620-2952, Phone: (406) 444-5901, FAX:
(406) 444-2547
N
Mr. Ron Ross, Director, Nebraska Department of Health & Human
Services, P.O. Box 59604, Lincoln, NE 68509-5044, Phone: (402) 471-
9106, FAX: (402) 471-0820
Mr. Steve Curtiss, Director, Nebraska Department of Health & Human
Services, Finance & Support, 301 Centennial Mall South, P.O. Box
95026, Lincoln, NE 68509-5026, Phone: (402) 471-8553, FAX: (402)
471-9449
Mr. Michael J. Willden, Director, Nevada Department of Human
Resources, 505 East King Street, Suite 600, Carson City, NV 89710,
Phone: (775) 687-4730, FAX: (775) 687-4733
Mr. Donald J. Shumway, Commissioner, New Hampshire Department of
Health & Human Services, State Office Park South, 129 Pleasant St.,
Brown Bldg., Concord, NH 03301-3857, Phone: (603) 271-4331, FAX:
(603) 271-4232
Mr. Richard A. Chevrefils, Assistant Commissioner, Office of Family
Services, New Hampshire Department Department of Health & Human
Services, 129 Pleasant Street, Concord, NH 033011-6505, Phone: (603)
271-4321, FAX: (603) 271-4727
Mr. James W. Smith, Jr., Acting Commissioner, New Jersey Department
of Human Services, P.O. Box 700, Trenton, NJ 08625-0700, Phone:
(609) 292-3717, FAX: (609) 292-3824
Ms. Robin Dozier Otten, Deputy Secretary, New Mexico Human Services
Department P.O. Box 2348, 2009 South Pacheco, Santa Fe, NM 87504-
2348, Phone: (505) 827-7750, FAX: (505) 827-6286
Mr. Brian Wing, Commissioner, New York State Department of Family
Assistance, Office of Temporary & Disability Assistance, 40 North
Pearl Street, Albany, NY 12243, Phone: (518) 474-9475/4152, FAX:
(518) 486-6255
Mr. John A. Johnson, Commissioner, New York State Office of Children
and Family Services, 52 Washington Street, Rensselaer, NY 12144,
Phone: (518) 473-8437, FAX: (518) 473-9131
Ms. Carmen Hooker Buell, Secretary, North Carolina Department of
Health & Human Services, 101 Blair Drive, Raleigh, NC 27603, Phone:
(919) 733-4534, FAX: (919) 715-4645
Ms. Carol K. Olson, Executive Director, North Dakota Department of
Human Services, State Capitol--Judicial Wing, 600 East Boulevard,
Bismarck, ND 58505, Phone: (701) 328-2310, FAX: (701) 328-1545
O
Mr. Thom Hayes, Director, Ohio Department of Jobs & Family Services,
30 East Broad Street, 32nd Floor, Columbus; OH 43266-0423, Phone:
(614) 466-6282, FAX: (614) 466-2815
Ms. Sandy Blunt, Assistant Director, Ohio Department of Jobs &
Family Service, 30 East Broad Street, 32nd Floor, Columbus, OH
43266-0423, Phone: (614) 466-6282, FAX: (614) 466-2815
Mr. Howard A. Hendrick, Director, Oklahoma Department of Human
Services, P.O. Box 25352 Oklahoma City, OK 73125-0352, Phone: (405)
521-3646, FAX: (405) 521-6458
Mr. Mike Fogarty, Chief Executive Officer, Oklahoma Health Care
Authority, 4545 North Lincoln Boulevard, Suite 124, Oklahoma City,
OK 73105, Phone: (405) 522-7300, FAX: (405) 522-7471
Mr. Bobby Mink, Director, Oregon Department of Human Services, 500
Summer Street, N.E., Salem, OR 97310-1012, Phone: (503) 945-5944,
FAX: (503) 378-2897
P
Ms. Feather O. Houstoun, Secretary, Pennsylvania Department of
Public Welfare, P.O. Box 2675, Harrisburg, PA 17105-2675, Phone:
(717) 787-2600, FAX: (717) 772-2062
Ms. Angie Varela-Llavona, Secretary, Puerto Rico Department of The
Family, P.O. Box 11398, San Juan, PR 00910-1398, Phone: (787) 725-
4511, FAX: (787) 723-1223
R
Ms. Christine Ferguson, Director, Rhode Island Department of Human
Services, 600 New London Avenue, Cranston, RI 02920, Phone: (401)
462-2121, FAX: (401) 462-3677
S
Ms Elizabeth G. Patterson, Director, South Carolina Department of
Social Services, 1535 Confederate Avenue, P.O. Box 1520, Columbia,
SC 29202-1520, Phone: (803) 898-7360, FAX: (803) 898-7276
Mr. James Ellenbecker, Secretary, South Dakota Department of Human
Services, 700 Governors Drive, Pierre, SD 57501-2291, Phone: (605)
773-3165, FAX: (605) 773-4855
T
Ms. Natasha Metcalf, Commissioner, Tennessee Department of Human
Services, Citizens Plaza Building, 15th Floor, 400 Deaderick Street,
Nashville, TN 37248-0200, Phone: (615) 313-4700, FAX: (615) 741-4165
Mr. Jim Hine, Commissioner, Texas Department of Human Services, 701
West 51st Street, P.O. Box 149030, Mail Code W-619, Austin, TX
78714-9030, Phone: (512) 438-3030, FAX: (512) 438-4220
Ms. Diane D. Rath, Chair & Commissioner Representing the Public,
Texas Work Force Commission, 101 East 15th Street, Austin, TX 78778,
Phone: (512) 463-2800, FAX: (512) 463-1289
U
Mrs. Robin Arnold-Williams, Executive Director, Utah Department of
Human Services, 120 North 200 West, Room 319, Salt Lake City, UT
84145-0500, Phone: (801) 538-3998/4001, FAX: (801) 538-4016
Mr. Robert C. Gross, Executive Director, Utah Department of
Workforce Services, 140 E. 300 South, Salt Lake City, UT 84103,
Phone: (801) 526-9210, FAX: (801) 526-9211
Mr. Rod Betit, Executive Director, Department of Health, P.O. Box
141000, 2288 North 1460 West, Salt Lake City, UT 84114-1000, Phone:
(801) 538-6111, FAX: (801) 538-3606
V
Ms. Eileen Elliot, Commissioner, Vermont Department of Social
Welfare, 103 South Main Street, Waterbury, VT 05671-1201, Phone:
(802) 241-2853, FAX: (802) 241-2830
Ms. Sedonia Halbert, Acting Commissioner, Virgin Islands Department
of Human Services, Knud Hansen Complex Building A, 1303 Hospital
Grounds, St. Thomas, VI 00802, Phone: (304) 774-0930, FAX: (304)
774-3466
Mr. Louis Rossiter, Secretary, Virginia Health & Human Resources,
202 North 9th Street, Suite 622, Richmond, VA 23219, Phone: (804)
786-7765, FAX: (804) 371-6984
[[Page 8103]]
Ms. Sonia Rivero, Commissioner, Virginia Department of Social
Services, Theatre Row Building, 730 East Broad Street, 9th floor,
Richmond, VA 23219-1849, Phone: (804) 692-1900, FAX: (804) 692-1949
W
Mr. Dennis Braddock, Secretary, Washington Department of Social &
Health Services, 115 Washington Street, SE, P.O. Box 45010, Olympia,
WA 98504-5010, Phone: (360) 902-7800, FAX: (360) 902-7848
Mr. Paul L. Nusbaum, Secretary, West Virginia Department of Health
and Human Resources, State Capitol Complex Bldg. 3, Room 206,
Charleston, WV 25305-0500, Phone: (304) 558-0684, FAX: (304) 558-
1130
Mr. Frederick Boothe, Commissioner, Bureau of Children & Families,
West Virginia Department of Health & Human Resources, 350 Capitol
Street, Room 730, Charleston, WV 25301-3711, Phone: (304) 558-0999,
FAX: (304) 558-4194
Ms. Phyllis J. Dube, Secretary, Wisconsin Department of Health &
Family Services, P.O. Box 7850, Madison, WI 53707-7850, Phone: (608)
266-9622, FAX: (608) 266-7882
Ms. Jennifer Reinert, Secretary, Wisconsin Department of Workforce
Development, P.O. Box 7946, Madison, MI 53707-7946, Phone: (608)
266-7552
Ms. Susan Lehman, Director, Wyoming Department of Family Services,
Hathaway Building, 2300 Capitol Avenue, Cheyenne, WY 82002-0490,
Phone: (307) 777-7564, FAX: (307) 777-7747
Mr. Garry L. McKee, Director, Wyoming Department of Health, 117
Hathaway Building, 2300 Capitol Avenue, Cheyenne, WY 82002-0490,
Phone: (307) 777-7656, FAX: (307) 777-7439
Certification Regarding Environmental Tobacco Smoke
Public Law 103227, Part C Environmental Tobacco Smoke, also
known as the Pro Children Act of 1994, requires that smoking not be
permitted in any portion of any indoor routinely owned or leased or
contracted for by an entity and used routinely or regularly for
provision of health, day care, education, or library services to
children under the age of 18, if the services are funded by Federal
programs either directly or through State or local governments, by
Federal grant, contract, loan, or loan guarantee. The law does not
apply to children's services provided in private residences,
facilities funded solely by Medicare or Medicaid funds, and portions
of facilities used for inpatient drug or alcohol treatment. Failure
to comply with the provisions of the law may result in the
imposition of a civil monetary penalty of up to $1000 per day and/or
the imposition of an administrative compliance order on the
responsible entity. By signing and submitting this application the
applicant/grantee certifies that it will comply with the
requirements of the Act.
The applicant/grantee further agrees that it will require the
language of this certification be included in any subawards which
contain provisions for the children's services and that all
subgrantees shall certify accordingly.
DHHS Regulations Applying to All Applicants/Grantees Under the Job
Opportunities for Low-Income Individuals (JOLI) Program
Title 45 of the Code of Federal Regulations:
Part 16--Department of Grant Appeals Process
Part 74--Administration of Grants (grants and subgrants to entities)
Part 75--Informal Grant Appeal Procedures
Part 76--Debarment and Suspension from Eligibility for Financial
Assistance
SUBPART F--DRUG FREE WORKPLACE REQUIREMENTS
Part 80--Non-Discrimination Under Programs Receiving Federal
Assistance through the Department of Health and Human Services
Effectuation of Title VI of the Civil Rights Act of 1964
Part 81--Practice and Procedures for Hearings Under Part 80 of this
Title
Part 83--Regulation for the Administration and Enforcement of
Sections 799A and 845 of the Public Health Service Act
Part 84--Non-discrimination on the Basis of Handicap in Programs and
Activities Receiving Federal Financial Assistance
Part 85--Enforcement of Non-Discrimination on the Basis of Handicap
in Programs or Activities Conducted by the Department of Health and
Human Services
Part 86--Nondiscrimination on the Basis of Sex in Education Programs
and Activities Receiving or Benefiting from Federal Financial
Assistance
Part 91--Non-discrimination on the Basis of Age in Health and Human
Services Programs or Activities Receiving Federal Financial
Assistance
Part 92--Uniform Administrative Requirements for Grants and
Cooperative Agreements to States and Local Governments (Federal
Register, March 11, 19880
Part 93--New Restrictions on Lobbying
Part 100--Intergovernmental Review of Department of Health and Human
Services Programs and Activities
Attachment L
Business Plan
The business plan is one of the major components that will be
evaluated by OCS to determine the feasibility of a jobs creation
project. A business plan must be included if, the applicant is
proposing to establish a new identified business, or if the
applicant will be providing assistance to a private third party
employer for the development or expansion of a pre-identified
business.
The following guidelines were written to cover a variety of
possibilities regarding the requirements of a business plan. Rigid
adherence to them is not possible nor even desirable for all
projects. For example, a business plan for a service business would
not require discussion of manufacturing nor product designs.
Therefore, the business plans should be prepared in accordance with
the following guidelines:
1. The business and its industry. This section should describe
the nature and history of the business and include background on its
industry.
a. The Business: as a legal entity; the general business
category;
b. Description and Discussion of Industry: Current status and
prospects for the industry.
2. Products and Services: This section deals with the following:
a. Description: Describe in detail the products or services to
be sold;
b. Proprietary Position: Describe proprietary features, if any,
of the product, e.g. patents, trade secrets; and,
c. Potential: Features of the product or service that may give
it an advantage over the competition.
3. Market Research and Evaluation: This section should present
sufficient information to show that the product or service has a
substantial market and can achieve sales in the face of competition;
a. Customers: Describe the actual and potential purchasers for
the product or service by market segment;
b. Market Size and Trends: State the size of the current total
market for the product or service offered;
c. Competition: An assessment of the strengths and weaknesses of
competitive products and services; and,
d. Estimated Market Share and Sales: Describe the
characteristics of the product or service that will make it
competitive in the current market.
4. Marketing Plan: The marketing plan must describe what is to
be done, how it will be done and who will do it. The marketing plan
should detail the product, pricing, distribution, and promotion
strategies that will be used to achieve the estimated market share
and sales projections. The plan should address the following
topics--Overall Marketing Strategy, Packaging, Service and Warranty,
Pricing, Distribution and Promotion.
5. Design and Development Plans: This section of the plan should
cover items such as Development Status, Tasks, Difficulties and
Risks, Product Improvement, New Products and Costs. If the product,
process or service of the proposed venture requires any design and
development before it is ready to be placed on the market, the
nature and extent and cost of this work should be fully discussed.
6. Manufacturing and Operations Plan: A manufacturing and
operations plan should describe the kind of facilities, plant
location, space, capital equipment and labor force (part and/or full
time and wage structure) that are required to provide the company's
product or service.
7. Management Team: This section must include a description of:
the key management personnel and their primary duties; compensation
and/or ownership; the organizational structure; Board of Directors;
management assistance and training needs; and, supporting
professional services. The management team is key in starting and
operating a successful business. The management team should be
committed with a proper balance of technical, managerial and
business skills, and experience in operating the proposed business.
8. Overall Schedule: This section must include a month-by-month
schedule that shows the timing of such major events,
[[Page 8104]]
activities and accomplishments involving product development, market
planning, sales programs, and production and operations. Sufficient
detail should be included to show the correlation between the timing
of the primary tasks required to accomplish each activity.
9. Critical Risks and Assumptions: This section should include a
description of the risks and critical assumptions/problems relating
to the industry, the venture, its personnel, the product's market
appeal, and the timing and financing of the venture. Identify and
discuss the critical assumptions/problems to overcome in the
Business Plan. Major problems must clearly identify problems to be
solved to develop the venture.
10. Community Benefits: The applicant should describe how the
proposed project will contribute to the local economy, community and
human economic development within the project's target area.
11. The Financial Plan: The Financial Plan is basic to the
development of a Business Plan. Its purpose is to indicate the
project's potential and the timetable for financial self-sufficiency
of the business. In developing the Financial Plan, the following
exhibits must be prepared for the first three years of business'
operation:
a. Profit and Loss Forecasts-quarterly for each year;
b. Cash Flow Projections-quarterly for each year;
c. Pro forma balance sheets-quarterly for each year;
d. Initial sources of project funds;
e. Initial uses of project funds; and
f. Any future capital requirements and sources.
12. Facilities: If rearrangement or alteration of existing
facilities is required to implement the project, the applicant must
describe and justify such changes and related costs.
Attachment M
Certification Regarding Maintenance of Effort
In accordance with the applicable program statute(s) and
regulation(s), the undersigned certifies that financial assistance
provided by the Administration for Children and Families, for the
specified activities to be performed under the __________Program by
__________(Applicant Organization, will be in addition to, and not
in substitution for, comparable activities previously carried on
without Federal assistance.
----------------------------------------------------------------------
Signature of Authorized Certifying Official
----------------------------------------------------------------------
Title
----------------------------------------------------------------------
Date
Attachment N
State Child Support Enforcement Offices
Updated February 14th, 2001
A
Alabama
Department of Human Resources, Division of Child Support, 50 Ripley
Street, Montgomery, AL 36130-1801, (334) 242-9300, FAX: (334) 242-
0606, 1-800-284-4347 [1]
Alaska
Child Support Enforcement Division, 550 West 7th Avenue, Suite 310,
Anchorage, AK 99501-6699, (907) 269-6900, FAX: (907) 269-6813, 1-
800-478-3300 [1]
Arizona
Division of Child Support Enforcement, P.O. Box 40458, Phoenix, AZ
85067, (602) 252-4045 (non toll-free number)
Arkansas
Office of Child Support Enforcement, P.O. Box 8133, Little Rock, AR
72203, Street Address: 712 West Third, Little Rock, AR 72201, (501)
682-8398, FAX: (501) 682-6002, 1-800-264-2445 [2] (Payments), 1-800-
247-4549 [2] (Program)
C
California
California Department of Child Support Services, Customer and
Community Services Branch, P.O. Box 419064, MS-30, Rancho Cordova,
CA 95741-9064, FAX: (916) 464-5065, 1-866-249-0773
Colorado
Division of Child Support Enforcement, Division of Human Services,
303 E. 17th Avenue, Suite 200, Denver, CO 80203-1241, (720) 947-
5000, FAX: (720) 947-5006, (no toll-free number)
Connecticut
Department of Social Services, Bureau of Child Support Enforcement,
25 Sigourney Street, Hartford, CT 06105-5033, (860) 424-5251, FAX:
(860) 951-2966 1-800-228-5437 [2] (problems), 1-800-647-8872 [2]
(information), 1-800-698-0572 [2] (payments)
D
Delaware
Division of Child Support Enforcement, Delaware Health and Social
Services, 1901 North Dupont Hwy., P.O. Box 904, New Castle, DE
19720, (302) 577-4863, 577-4800, FAX: (302) 577-4873, (800) 464-4357
District of Columbia
Office of Paternity and Child Support Enforcement, Department of
Human Services, 800 9th Street, SW., 2nd Floor, Washington, DC
20024-2480, (202) 724-1444, (no toll-free number)
F
Florida
Child Support Enforcement Program, Department of Revenue, P.O. Box
8030, Tallahassee, FL 32314-8030, (850) 922-9590, FAX: (850) 488-
4401, (no toll-free number)
G
Georgia
Child Support Enforcement, P.O. Box 38450, Atlanta, GA 30334-0450,
(404) 657-3851, FAX: (404) 657-3851, 1-800-227-7993 [1] (for 706 &
912 area codes), (from area codes 404 & 770, dial code + 657-2780)
Guam
Department of Law, Child Support Enforcement Office, 238 Archbishop
F.C. Flores, 7th Floor, Agana, GU 96910, 011 (671) 475-3360, (no
toll-free number)
H
Hawaii
Child Support Enforcement Agency, Department of Attorney General,
Kakuhihewa State Office Building, 601 Kamokila Boulevard, Suite 251,
Kapolei, HI 96707, (808) 587-3695, (808) 692-7134, (no Toll Free
Number)
I
Idaho
Bureau of Child Support Services, Department of Health and Welfare,
P.O. Box 83720, Boise, ID 83720-0036, (208) 334-6535, FAX: (208)
334-0666, 1-800-356-9868 [2]
Illinois
Illinois Department of Public Aid, Division of Child Support
Enforcement, Marriott Building, 509 South Sixth Street, Springfield,
IL 62701-1825, (217) 524-4602, FAX: (217) 524-4608, 1-800-447-4278
[1]
Indiana
Child Support Bureau, 402 West Washington Street, RM W360,
Indianapolis, IN 46204, (317) 233-5437, FAX: (317) 233-4932 [2],
1(800) 840-8757
Iowa
Bureau of Collections, Department of Human Services, Hoover
Building--5th Floor, Des Moines, IA 50319, (515) 242-5530, FAX:
(515) 281-8854, (888) 229-9223)
K
Kansas
Child Support Enforcement Program, Department of Social &
Rehabilitation Services, P.O. Box 497, Topeka, KS 66601, Street
Address: 300 S.W. Oakley Street, Biddle Building, Topeka, KS 66606,
(785) 296-3237, FAX: (913) 296-5206, 1-800-432-0152
[2](Withholding), 1-800-570-6743 [2](Collections), 1-800-432-3913
[2](Fraud Hotline)
Kentucky
Division of Child Support Enforcement, Cabinet for Human Resources,
P.O. Box 2150, Frankfort, KY 40602, (502) 564-2285, FAX: (502) 564-
5988, (800) 248-1163 [2]
L
Louisiana
Support Enforcement Services, Office of Family Support, P.O. Box
94065, Baton Rouge, LA 70804-4065, (225) 342-4780, FAX: (504) 342-
7397, 1-800-256-4650 [1](Payments)
[[Page 8105]]
M
Maine
Division of Support Enforcement and Recovery, Bureau of Income
Maintenance, Department of Human Services, State House Station, 11
Whitten Road, Augusta, ME 04333, (207) 287-2886, FAX: (207) 287-
5096, 1-800-371-3101 [1]
Maryland
Child Support Enforcement Administration, Department of Human
Resources, 311 West Saratoga Street, Baltimore, MD 21201, (410) 767-
7619, FAX: (410) 333-8992, 1-800-234-1528 [2]
Massachusetts
Child Support Enforcement Division, Department of Revenue, 141
Portland Street, Cambridge, MA 02139-1937, (617) 557-7200, FAX:
(617) 621-4991, 1-800-332-2733 [2]
Michigan
Office of Child Support, Family Independence Agency, P.O. Box 30478,
Lansing, MI 48909-7978, (517) 373-7570, FAX: (517) 373-4980, (no
toll-free number)
Minnesota
Office of Child Support Enforcement, Department of Human Services,
444 Lafayette Road, 4th floor, St. Paul, MN 55155-3846, (651) 296-
2542, FAX: (651) 297-4450, (no toll-free number)
Mississippi
Division of Child Support Enforcement, Department of Human Services,
P.O. Box 352, Jackson, MS 39205, (601) 359-4861, FAX: (601) 359-
4415, 1-800-434-5437 (Jackson)[2], 1-800-354-6039 (Hines, Rankin &
Madison Cnties.)
Missouri
Department of Social Services, Division of Child Support
Enforcement, P.O. Box 2320, Jefferson City, MO 65102-2320, (573)
751-4301, FAX: (573) 751-8450, 1-800-859-7999 [2]
Montana
Child Support Enforcement Division, Department of Public Health, and
Human Services, P.O. Box 202943, Helena, MT 59620, (406) 442-7278,
FAX: (406) 444-1370, 1-800-346-5437[1]
N
Nebraska
Nebraska Dept. of Health and Human Services, Child Support
Enforcement Office, P.O. Box 94728, Lincoln, NE 68509-4728, (402)
479-5555, FAX: (402) 471-9455, 1-800-831-4573[1]
Nevada
Child Support Enforcement Program, Nevada State Welfare Division,
2527 North Carson Street, Carson City, NV 89710, (775) 687-4744,
FAX: (702) 684-8026, 1-800-992-0900 x4744[1]
New Hampshire
Office of Child Support, Division of Human Services, Health and
Human Services Building, 6 Hazen Drive, Concord, NH 03301-6531,
(603) 271-4427, FAX: (603) 271-4787, 1-800-852-3345 ext. 4427[1]
New Jersey
Division of Family Development, Department of Human Services, Bureau
of Child Support and Paternity Programs CN 716, Trenton, NJ 08625-
0716, (609) 588-2915, FAX: (609) 588-2354, 1-800-621-5437[2]
New Mexico
Child Support Enforcement Bureau, Department of Human Services, P.O.
Box 25109, Santa Fe, NM 87504, Street Address: 2025 S. Pacheco,
Sante Fe, NM 87504, (505) 476-7040, FAX: (505) 827-7285, 1-800-288-
7207[1], 1-800-585-7631
New York
Office of Child Support Enforcement, Department of Social Services,
P.O. Box 14, Albany, NY 12260, Street Address: One Commerce Plaza,
Albany, NY 12260, (518) 474-9081, FAX: (518) 486-3127, 1-800-342-
3009
North Carolina
Child Support Enforcement Section, Division of Social Services,
Department of Human Resources, 100 East Six Forks Road, Raleigh, NC
27609-7750, (919) 571-4114, FAX: (919) 571-4126, 1-800-992-9457[1]
North Dakota
Department of Human Services, Child Support Enforcement Agency, P.O.
Box 7190, Bismarck, ND 58507-7190, (701) 328-3582, FAX: (701) 328-
5497, 1-800-755-8530[1]
O
Ohio
Office of Child Support Enforcement, Department of Human Services,
30 East Broad Street--31st Floor, Columbus, OH 43266-0423, (614)
752-6561, FAX: (614) 752-9760, 1-800-686-1556[1]
Oklahoma
Department of Human Services, P.O. Box 53552, Oklahoma City, OK
73125, Street Address: 2409 N. Kelley Avenue, Annex Building,
Oklahoma City, OK 73111, (405) 522-5871, FAX: (405) 522-2753, 1-800-
522-2922[2]
Oregon
Department of Justice, Division of Child Support, 1495 Edgewater
N.W., Suite 290, Salem, OR 97304, (503) 986-5950, FAX: (503) 391-
5526, 1-800-850-0228[1], 1-800-850-0294[1] Rotary
P
Pennsylvania
Bureau of Child Support Enforcement, Department of Public Welfare,
P.O. Box 8018, Harrisburg, PA 17105, (717) 783-5184, FAX: (717) 787-
9706, 1-800-932-0211[2]
Puerto Rico
Child Support Enforcement, Department of Social Services, P.O. Box
3349, San Juan, PR 00902-9938, Street Address: Majagua Street, Bldg.
2, Wing 4, 2nd Floor, Miramar, PR 00902-9938, (787) 767-1500, FAX:
(787) 723-6187, (no toll-free number)
R
Rhode Island
Rhode Island Child Support Services, Department of Human Services,
77 Dorrance Street, Providence, RI 02903, (401) 222-2847, FAX: (401)
277-6674, 1-800-638-5437[1]
S
South Carolina
Department of Social Services, Child Support Enforcement Division,
P.O. Box 1469, Columbia, SC 29202-1469, (803) 898-9341, FAX: (803)
737-6032, 1-800-768-5858[2], 1-800-768-6779[1] (Payments)
South Dakota
Office of Child Support Enforcement, Department of Social Services,
700 Governor's Drive, Pierre, SD 57501, (605) 773-3641, FAX: (605)
773-5246, (no toll-free number)
T
Tennessee
Child Support Services, Department of Human Services, Citizens Plaza
Building--12th Floor, 400 Deadrick Street, Nashville, TN 37248-7400,
(615) 313-4880, FAX: (615) 532-2791, 1-800-838-6911 [2]
Texas
Office of the Attorney General, State Office, Child Support
Division, P.O. Box 12017, Austin, TX 78711-2017, (512) 460-6000,
FAX: (512) 834-9712, 1-800-252-8014 [2]
U
Utah
Bureau of Chief Support Services, Department of Human Services, P.O.
Box 45011, Salt Lake City, UT 84145-0011, (801) 536-8500, FAX: (801)
536-8509, 1-800-257-9156 [2]
V
Vermont
Office of Child Support, 103 South Main Street, Waterbury, VT 05671-
1901, (802) 241-2313, FAX: (802) 244-1483, 1-800-678-3214 [2]
Virgin Islands
Paternity and Child Support Division, Department of Justice, GERS
Building, 2nd Floor, 48B-50C Krondprans Gade, St. Thomas, VI 00802,
(340) 775-3070, FAX: (809) 774-9710 (no toll-free number)
Virginia
Division of Support Enforcement, Department of Social Services, 730
East Broad Street, Richmond, VA 23219, (804) 692-1428, FAX: (804)
692-1405, 1-800-468-8894 [1]
[[Page 8106]]
W
Washington
Division of Child Support, Department of Social and Health Services,
P.O. Box 9162, Olympia, WA 98507-9162, Street address: 712 Pear
Street, S.E., Olympia, WA 98507, (360) 664-5000, FAX: (206) 586-
3274, 1-800-922-4306 [2]
West Virginia
Child Support Enforcement Division, Department of Health & Human
Resources, 1900 Kanawha Boulevard East, Capitol Complex, Building 6,
Room 817, Charles, WV 25305, (304) 558-3780, 1-800-249-3778 [2]
Wisconsin
Division of Economic Support, P.O. Box 7935, Madison, WI 53707-7935,
Street Address: 1 West Wilson Street, Room 382, Madison, WI 53707,
(608) 266-9909, FAX: (608) 267-2824 (no toll-free number)
Wyoming
Child Support Enforcement, Department of Family Services, Hathaway
Building, 2300 Capital Avenue, 3rd Floor, Cheyenne, WY 82002-0490,
(307) 777-6948, FAX: (307) 777-3693, 1-800-457-3659 [2]
BILLING CODE 4184-01-M
[[Page 8107]]
[GRAPHIC] [TIFF OMITTED] TN21FE02.005
[FR Doc. 02-3564 Filed 2-20-02, 8:45am]
BILLING CODE 4184-01-C