**Pre-Award Checklist For Purchase, Construction, Major Renovation,**

**or Incidental Alterations Of A Head Start Facility with**

**Certification of Assurances**

**GRANTEE:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**GRANT #:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**FACILITY ADDRESS:**
**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**FUNDING REQUESTED:**
**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**TYPE OF PROJECT: PURCHASE\_\_\_\_\_ CONSTRUCTION\_\_\_\_\_**

> **MAJOR RENOVATION\_\_\_\_\_ INCIDENTAL ALTERATIONS\***[^1]\_\_\_\_\_

  --------- -------------------------------------- -------------------------
  Y/N       Proposal Checklist                     Comments

  **1\***   **Submit a written application         
            approved by the Board and the PC and   
            signed by the** **Board.** The         
            application must include a             
            justification of the need for the      
            project and a budget narrative that    
            indicates the breakdown of all items   
            in the budget, including unit costs    
            where appropriate. \[45 CFR §1309.10\] 

  **2**     Provide written documentation that     
            there are no alternative facilities or 
            they are not suitable without major    
            renovation and the costs are more      
            expensive than construction. \[45 CFR  
            §§1309.10(g) and 1309.11\]             

  **3**     Provide a **written statement from a** 
            **real estate professional** of how it 
            was determined that there is or was a  
            lack of alternative facilities. \[45   
            CFR §1309.10(g)\]                      

  **4**     Provide a **legal description** of the 
            site of the facility proposed, and an  
            explanation of the appropriateness of  
            the location to service area, **based  
            on the community** **assessment**.     
            Discuss the effect the facility will   
            have on transportation of children to  
            the program, collaboration with other  
            child care, social services and health 
            providers, and other program           
            activities and services. \[45 CFR      
            §1309.10(a)\]                          

  **5\***   Provide architectural drawings and     
            specifications of the proposed         
            facility including size and type of    
            structure, the number and a            
            description of the rooms, and the lot  
            on which the building is/will be       
            located (including space available for 
            playground and parking). The drawings  
            and specifications must be reviewed    
            and approved by the Regional Office    
            prior to soliciting bids or awarding   
            contracts by the grantee. \[45 CFR     
            §1309.10(b)\]                          
  --------- -------------------------------------- -------------------------

+------+--------------------------------------+------------------------+
| Y/N  | Proposal Checklist                   | Comments               |
+------+--------------------------------------+------------------------+
| **6  | Submit the **proposed schedule for   |                        |
| \*** | construction or renovation and       |                        |
|      | occupancy and a description of the   |                        |
|      | inspections which will be made       |                        |
|      | during construction or the           |                        |
|      | renovation to assure completion of   |                        |
|      | the project as planned.**            |                        |
|      |                                      |                        |
|      | **Describe the impact on the start   |                        |
|      | date for classes and enrollment      |                        |
|      | level by the expected length of time |                        |
|      | for the renovation.** \[45 CFR       |                        |
|      | §1309.10(l)\]                        |                        |
+------+--------------------------------------+------------------------+
| **7  | Describe the **intended uses of the  |                        |
| \*** | facility.** The grantee must         |                        |
|      | demonstrate that the facility will   |                        |
|      | be used principally as HS center or  |                        |
|      | a direct support facility for HS.    |                        |
|      | State if a portion of the facility   |                        |
|      | to be used for other purposes than   |                        |
|      | Head Start. \[45 CFR §1309.10(e)\]   |                        |
+------+--------------------------------------+------------------------+
| **8  | If the facility is used for other    |                        |
| \*** | purposes than Head Start, provide    |                        |
|      | information demonstrating that the   |                        |
|      | grantee will charge for use of       |                        |
|      | non-HS portion in accordance with    |                        |
|      | applicable OMB cost principles.      |                        |
|      |                                      |                        |
|      | **Provide the total number of square |                        |
|      | feet of the facility and the number  |                        |
|      | of square feet that is/will be used  |                        |
|      | by the Head Start program.**         |                        |
|      |                                      |                        |
|      | **If the facility is**/**will be     |                        |
|      | used for non-HS purpose, the grantee |                        |
|      | must submit a cost allocation plan   |                        |
|      | for cost of the renovation or the    |                        |
|      | construction or the purchase and for |                        |
|      | the on-going operations.** \[45 CFR  |                        |
|      | §1309.11(f)\]                        |                        |
+------+--------------------------------------+------------------------+
| **9  | If the facility is leased, provide   |                        |
| \*** | information on owner of the          |                        |
|      | property, details of the lease       |                        |
|      | agreement, and the benefits in terms |                        |
|      | of rent for investing Federal funds  |                        |
|      | into the landlord\'s facility that   |                        |
|      | has improved value of the property   |                        |
|      | (e.g., benefits may be lower rent).  |                        |
+------+--------------------------------------+------------------------+
| **10 | Description of the expected benefits |                        |
| \*** | of the purchase or the renovation.   |                        |
|      | Compare the current position with    |                        |
|      | the position after the purchase or   |                        |
|      | the renovation in terms of benefits  |                        |
|      | to the Head Start program.           |                        |
+------+--------------------------------------+------------------------+
| **   | Describe how it was determined that  |                        |
| 11** | **suitable** **facilities were not   |                        |
|      | available**, and explain how lack of |                        |
|      | facilities will inhibit operation of |                        |
|      | the program. \[45 CFR §1309.10(g)\]  |                        |
+------+--------------------------------------+------------------------+
| **12 | Provide terms of **any proposed or   |                        |
| \*** | existing loan(s) related to** the    |                        |
|      | purchase or the renovation and the   |                        |
|      | repayment plans, including any       |                        |
|      | restrictions or imposed conditions.  |                        |
|      | \[45 CFR §1309.10(h)\]               |                        |
+------+--------------------------------------+------------------------+

  ---------- -------------------------------------- -------------------------
  Y/N        Proposal Checklist                     Comments

  **13\***   Discuss the effect that the            
             construction or renovation will have   
             on ability to **meet non-Federal       
             share.** \[45 CFR §1309.10(i)\]        

  **14**     Provide a **certification by a         
             licensed engineer or an architect as   
             to the** cost and technical            
             appropriateness of the facility for    
             use as a Head Start facility. \[45 CFR 
             §1309.10(j)\]                          

  **15**     Discuss the effect that the            
             construction will have on the ability  
             to meet the limitation on development  
             and **administration costs** of Sec.   
             644(b). One-time fees and expenses     
             necessary to the proposed facility are 
             not subject to the 15% administrative  
             costs limitations. \[45 CFR            
             §1309.10(k)\]                          

  **16**     If not purchasing land, describe the   
             easement, right of way, or land rental 
             to allow sufficient access to the      
             facility. \[45 CFR §1309.10(m)\]       

  **17**     Provide an assessment under the        
             National Environmental Policy Act and  
             the National Historic Preservation     
             Act. \[45 CFR §1309.10(n)\]            

  **18\***   **Submit a statement describing the    
             grantee's procedures that will be used 
             to engage the persons/companies which  
             will** **construct/renovate**. \[45    
             CFR §74.48(c)\]                        

  **19**     Submit all **proposed contracts**      
             pertaining to the purchase of land and 
             construction/renovation of the         
             facility. \[45 CFR §74.44(e)(21)\]     

  **20**     The **[Contract must contain a         
             provision that the total price of the  
             contract shall remain fixed and        
             a]{.underline} provision stating that  
             the price may not be increased except  
             for reasons which are beyond the       
             builder\'s control and unforeseeable   
             at the time the contract was**         
             **entered into. [Increases must be     
             approved in writing by the Regional    
             Office.]{.underline}** \[45 CFR        
             §§74.44(c) and 1309.52(b)\]            

  **21**     Provide a detailed estimate of the     
             cost of the construction or the        
             renovation, and **compare cost** to    
             the cost of occupancy of either the    
             current facility or a facility         
             available for purchase, lease, or      
             donation. **The period of the          
             comparison is 20 years.** \[45 CFR     
             §1309.11\]                             

  **22**     Provide an **appraisal of the value of 
             the facility proposed to be            
             purchased** or renovated or            
             constructed. \[45 CFR §1309.11(b)\]    
  ---------- -------------------------------------- -------------------------

+------+--------------------------------------+------------------------+
| Y/N  | Proposal Checklist                   | Comments               |
+------+--------------------------------------+------------------------+
| **23 | Provide an **estimate of the         |                        |
| \*** | one-time costs**, including but not  |                        |
|      | limited to the down payment,         |                        |
|      | professional fees, and moving        |                        |
|      | expenses, etc. \[45 CFR              |                        |
|      | §1309.11(d)(1)\]                     |                        |
+------+--------------------------------------+------------------------+
| **   | Provide an **estimate of on-going    |                        |
| 24** | costs**, including, but not limited  |                        |
|      | to mortgage payments, insurance      |                        |
|      | premiums, maintenance costs, and     |                        |
|      | property taxes for the facility.     |                        |
|      |                                      |                        |
|      | Provide a source and application of  |                        |
|      | funds statement to determine the     |                        |
|      | grantee's ability in meeting all     |                        |
|      | occupancy operating costs for the    |                        |
|      | project.                             |                        |
+------+--------------------------------------+------------------------+
| **25 | Provide a **breakdown of the total   |                        |
| \*** | costs for** **the project (other     |                        |
|      | Federal funding, bank loan, grantee  |                        |
|      | share, foundation, state and local   |                        |
|      | government share, other funding      |                        |
|      | sources, etc.) and the share of the  |                        |
|      | costs that will be paid with ACF     |                        |
|      | grant funds.** \[45 CFR              |                        |
|      | §§1309.10(h), 1309.10(o), and        |                        |
|      | 1309.10(p)\]                         |                        |
+------+--------------------------------------+------------------------+
| **26 | Provide a **certification by a       |                        |
| \*** | licensed** **engineer or an          |                        |
|      | architect** that the building is     |                        |
|      | structurally sound and safe for use  |                        |
|      | as a Head Start facility. \[45 CFR   |                        |
|      | §1309.10(j)\]                        |                        |
+------+--------------------------------------+------------------------+
| **27 | For renovations on a **leased        |                        |
| \*** | facility**, does the grantee have a  |                        |
|      | lease that provides for occupancy    |                        |
|      | for **at least five years** **after  |                        |
|      | the completion of the renovation?**  |                        |
|      | \[45 CFR §1309.10(l)\]               |                        |
|      |                                      |                        |
|      | Submit a copy of the lease agreement |                        |
|      | for the facility to be renovated     |                        |
|      | with Federal funds for ACF review.   |                        |
+------+--------------------------------------+------------------------+
| **28 | If the facility is leased, describe  |                        |
| \*** | the owner's/landlord's obligation to |                        |
|      | finance the alteration and           |                        |
|      | renovation of the facility.          |                        |
+------+--------------------------------------+------------------------+
| **   | **The grantee must assure that it    |                        |
| 29** | will comply with the procurement     |                        |
|      | procedures pursuant to 45 CFR Parts  |                        |
|      | 74 and 92, including open** **and    |                        |
|      | free competition**.                  |                        |
|      |                                      |                        |
|      | Submit a copy of the **final bid**   |                        |
|      | (that was accepted by the grantee)   |                        |
|      | to the Regional Office. \[45 CFR     |                        |
|      | §1309.21(e)\]                        |                        |
+------+--------------------------------------+------------------------+
| **30 | If you have not submitted the most   |                        |
| \*** | recent audit to ACF, please submit a |                        |
|      | copy of the audit with the           |                        |
|      | management letter attached to it.    |                        |
+------+--------------------------------------+------------------------+
| **31 | List all previous HHS grants awarded |                        |
| \*** | (if any) to renovate this facility.  |                        |
+------+--------------------------------------+------------------------+

  ---------- -------------------------------------- -------------------------
  Y/N        Proposal Checklist                     Comments

  **32\***   Provide an indication of projected     
             useful life of the facility for Head   
             Start purposes. If the facility is     
             leased, has this been indicated in the 
             lease agreement that the grantee will  
             occupy the facility for that projected 
             period of life which the grantee has   
             already indicated?                     

  **33**     Did the president of the Board of      
             Directors of your agency sign the      
             certification of assurances at the end 
             of this checklist?                     
  ---------- -------------------------------------- -------------------------

**Definitions:**

## Incidental Alterations and Renovations: {#incidental-alterations-and-renovations .sub-heading}

Incidental alterations and renovations means improvements to a facility
which can be readily made, which are not considered major or structural
renovations as defined in the section and the total costs of which do
not exceed the lesser of \$150,000 or 25 percent of total direct costs
approved for a budget period. \[45 CFR §1309.3\]

**Major renovation:**

Major renovation means structural changes to the foundation, roof,
floor, or exterior or load-bearing walls of a facility, or the extension
of an existing facility to increase its floor area. Major renovation
also means extensive alteration of an existing facility such as to
significantly change its function and purpose, even if such renovation
does not include any structural change to the facility. \[45 CFR
§1309.3\]

**Special Note:**

For detailed information, if needed, please attach a separate sheet of
paper indicating the item number reflecting your response.

Certification of Assurances

**[this is to certify that (insert official name of the grantee ) will
comply with all the assurances listed below, as part of the head start
facility proposal application submitted for the property acquired,
constructed, or renovated at (insert address of the specific head start
facility):]{.smallcaps}**

1.  **We assure that the facility which will be purchased, constructed,
    or renovated will comply with local licensing and code requirements,
    ADA, Section 504, and Flood Disaster Protection Act. \[45 CFR
    §1309.10(f)\]**

> **As evidence of our agency's compliance with the local licensing and
> code requirements, we will submit a copy of the Certificate of
> Occupancy and a Daycare License for the facility.**

**2. If the lender requires a Subordination Agreement, then we assure
that the Subordination Agreement with the lender or the landlord, in the
case of leased property, must be evidenced by a written agreement with
the responsible HHS official and not waive the application of 45 CFR
§§1309.21(d) and 1309.22.**

> **We will submit a draft of the Subordination Agreement to the
> Regional Office for OGC clearance. \[45 CFR §1309.21(f)\]**

**3. We assure that we will submit a copy of a draft mortgage agreement
that contains the requirements of 45 CFR §§1309.22(a), (b), (c), if we
expect to take loan on the proposed facility. \[45 CFR §§1309.22(a),
(b), (c)\]**

**4. We assure that we will comply with requirements of Uniform
Relocation Assistance and Real Property Acquisition Policies Act. \[45
CFR §1309.10(o)\]**

**5. We assure that we (the grantee) will be responsible to ensure that
all laborers and mechanics employed by contractors or subcontractors
shall be paid wages at not less than those prevailing on similar
construction in the locality, in accordance with the Davis-Bacon Act.
\[Head Start Act §644(G)(3)\]**

**6. We assure that we will have the ability to meet all the operational
costs for the facility within our existing funding level. \[45 CFR
§1309.11(d)(2)\]**

**7. We assure that we will get a prior written approval from an HHS
official for unsolicited modifications of the contracts or when
materially altering the costs of the project. \[45 CFR §74.44(e)(5)\]**

**8. We assure that we will obtain insurance coverage for the facility
which includes student liability insurance, title insurance, physical
destruction insurance, etc.**

> **We will submit copies of such insurance policies to ACF within five
> days of acquiring the facility. \[45 CFR §1309.23\]**

**9. We assure that we shall maintain the facility acquired, renovated,
or constructed with grant funds in a manner consistent with the purposes
for which funds were provided and in compliance with State and local
government property standards and building codes. \[45 CFR
§1309.23(c)\]**

10. **We assure that we will comply with all the terms and conditions
    placed on the grant award regarding the project (that includes but
    is not limited to the inspection reports, use of the facility,
    default on mortgage, insurance, maintenance of facilities, copies of
    official documents, retention of records, audits, prior approval for
    use of grant funds, program income, procurement procedures, Federal
    Interest, etc.).**

**11. We assure that we will record the Notice of Federal Interest in
the appropriate office of land records for the county where the facility
is located at the time of commencement of construction or renovation or
immediately after the purchase of the facility in accordance with 45 CFR
§1309.21.**

> **We will submit a copy of the Notice of Federal Interest that
> includes all the requirements contained in 45 CFR §1309.21(f) to the
> Regional Office within 10 business days after the Notice has been
> recorded and stamped by the land records office. \[45 CFR §1309.21\]**

**12. We assure that, in the case of a leased facility where Federal
funds will be expended to complete a major renovation of that facility,
we will execute a lease amendment, and will attempt to file it with the
lease for the facility in the appropriate local land records.**

**[I have read and understood that the above indicated assurances are
required to be complied with by the (insert the official name and
address of the grantee).]{.smallcaps}**

> **Signature**
>
> **Chairperson, Board of Directors**
>
> **grantee name:**
>
> **date signed:**

*Revised October 15, 2002*

[^1]: For Incidental Alterations, the grantee will need to respond to
    the items with asterisk symbols (\*) only.