<table>
<colgroup>
<col style="width: 20%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 15%" />
<col style="width: 9%" />
<col style="width: 0%" />
<col style="width: 10%" />
<col style="width: 7%" />
<col style="width: 12%" />
<col style="width: 0%" />
<col style="width: 20%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="2"><h4 id="filing-deadline-852005">Filing Deadline:
8/5/2005</h4>
<h4 id="section"></h4>
<h4 id="section-1"></h4>
<h4 id="section-2"></h4></td>
<td colspan="7"><p><strong>U.S. Department of Education</strong></p>
<p><strong>Impact Aid Program</strong></p>
<h5 id="washington-d.c.-20202-6244">Washington, D.C. 20202-6244</h5>
<h3 id="application-for-discretionary-construction-program">APPLICATION
FOR DISCRETIONARY CONSTRUCTION PROGRAM</h3>
<h3 id="section-8007b">SECTION 8007(b)</h3>
<p><strong>Catalog of Federal Domestic Assistance #84-041C</strong></p>
<p><strong>Send 1 copy to the State Educational Agency
(SEA).</strong></p></td>
<td colspan="2"><h4 id="form-approved">Form Approved:</h4>
<h4 id="omb-number-1810-0657">– OMB number 1810-0657</h4>
<h4 id="expiration-date-3312007">– Expiration date: 3/31/2007</h4>
<h4 id="section-3"></h4>
<h4 id="section-4"></h4>
<h4 id="section-5"></h4></td>
</tr>
<tr class="even">
<td><p id="select-one" class="heading">Select One</p>
<p><strong>Emergency Grant</strong></p>
<p><strong>Modernization Grant</strong></p></td>
<td colspan="3"><p><strong>Is the Applicant Delinquent on Any Federal
Debt?</strong></p>
<p><strong>Yes</strong> <strong>No</strong></p></td>
<td colspan="3"><h2 id="applicants">Applicant’s</h2>
<h2 id="duns-number">DUNS Number</h2></td>
<td colspan="3"><h2
id="applicants-taxpayer-identification-number">Applicant’s Taxpayer
Identification Number</h2></td>
<td><h2 id="applicants-1">Applicant’s</h2>
<h2 id="impact-aid-number">Impact Aid Number</h2></td>
</tr>
<tr class="odd">
<td colspan="3"><p>Applicant Name :</p>
<p><strong>Street/P.O. Box :</strong></p>
<p><strong>City :</strong></p>
<p><strong>County :</strong></p>
<p><strong>State &amp; Zip :</strong></p></td>
<td colspan="3"></td>
<td colspan="2"><p>Contact Person Name :</p>
<p><strong>Title :</strong></p>
<p><strong>Phone :</strong></p>
<p><strong>Fax :</strong></p>
<p><strong>E-Mail :</strong></p></td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="8"><strong>Name of the School Facility for Which Funding Is
Requested:</strong></td>
<td colspan="3"><strong>Amount Requested:</strong></td>
</tr>
<tr class="odd">
<td colspan="6"><h4 id="section-8003-applicants">Section 8003
Applicants</h4>
<h4
id="enrollment-in-this-school-facility-on-the-survey-date-reported-on-your-local-educational-agencys-leas-fiscal-year-fy-2005-section-8003-application">Enrollment
in this School Facility on the Survey Date Reported on Your Local
Educational Agency’s (LEA’s) Fiscal Year (FY) 2005 Section 8003
Application</h4></td>
<td colspan="5"><h4 id="section-8002-applicants">Section 8002
Applicants</h4>
<h4
id="enrollment-in-this-school-facility-on-the-state-count-date-in-the-fall-of-school-year-20032004">Enrollment
in this School Facility on the State Count Date in the Fall of School
Year 2003‑2004</h4>
<h4
id="enrollment-in-your-lea-on-the-state-count-date-in-the-fall-of-school-year-20032004">Enrollment
in Your LEA on the State Count Date in the Fall of School Year
2003‑2004</h4></td>
</tr>
<tr class="even">
<td colspan="11"><strong>If Applicable, Date Application Was Submitted
to State Agency for Executive Order 12372 Review:</strong></td>
</tr>
<tr class="odd">
<td colspan="11"><strong>I certify that I have read the statements
contained in this application and that these statements and all of the
data included in this application are, to the best of my knowledge and
belief, true, complete and correct. I certify that I am authorized to
make the representations and commitments in this application, for and on
behalf of the applicant, and otherwise to act as the applicant’s
authorized representative in submitting this application for funding
under section 8007(b) of the Impact Aid Program (Title VIII of the
Elementary and Secondary Education Act). I declare that the applicant
will mail a complete copy of this application to the SEA at the same
time that it mails this application to the U.S. Department of
Education.</strong></td>
</tr>
<tr class="even">
<td colspan="5"><strong>Name and Title of Authorized Representative
<em>(Please type or print.)</em></strong></td>
<td colspan="4"><h5 id="signature">Signature</h5></td>
<td colspan="2"><h4 id="date">Date</h4></td>
</tr>
</tbody>
</table>

June 2005

Page: 1

+-----------------------------------------------------------------------+
| ##### APPLICATION FOR DISCRETION                                      |
| ARY CONSTRUCTION PROGRAM -- SECTION 8007(b) -- ADDITIONAL INFORMATION |
+-----------------------------------------------------------------------+
| #### [APPLICANT'S INTEREST IN THE SCHOOL FACILITY]{.underl            |
| ine} Own Lease \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Other |
|                                                                       |
| *(Expiration date)*                                                   |
|                                                                       |
| ####  {#section-6}                                                    |
|                                                                       |
| #### If Other, Specify \_\_\_\_\_\_\_\_\_\_\_\_\_\_\                  |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
+-----------------------------------------------------------------------+
| #### [AGE OF THE SCHOOL FACILITY]{.unde                               |
| rline} Year of Original Construction \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                                                       |
| ####  {#section-7}                                                    |
|                                                                       |
| #### Year(s) and Descri                                               |
| ption(s) of Major Renovation(s) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_ |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                                                       |
| ####  {#section-8}                                                    |
|                                                                       |
| ####  \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\              |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ {#section-9} |
|                                                                       |
| ####  {#section-10}                                                   |
|                                                                       |
| ####  \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_             |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ {#section-11} |
|                                                                       |
| ####  {#section-12}                                                   |
|                                                                       |
| #### Square                                                           |
|  Footage of Existing School Facility \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
+-----------------------------------------------------------------------+
| #### [ACREAGE IN LOCAL EDUCATIONAL AGENCY (LEA)]{.underline}          |
|                                                                       |
| ####  {#section-13}                                                   |
|                                                                       |
| #### Total Acres Within Boundaries of LEA \_\                         |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Total Acres of Non­taxable Federal P |
| roperty Within Boundaries of LEA \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
+-----------------------------------------------------------------------+
| #### [BONDED INDEBTED                                                 |
| NESS AS OF THE END OF THE AGENCY'S FISCAL YEAR 2003‑2004]{.underline} |
|                                                                       |
| ####  {#section-14}                                                   |
|                                                                       |
| #### Maxim                                                            |
| um Bonding Capacity \$\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Amount of Bonded Debt \$\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
+-----------------------------------------------------------------------+
| #### [ASSESSED VALUE OF TAXABLE PROPERTY IN LEA]{.underline}          |
|                                                                       |
| ####  {#section-15}                                                   |
|                                                                       |
| #### Name of Taxing Jurisdiction (e.g., School District Name, Townshi |
| p Total Assessed Value of Real Property (Land and Improvements) That  |
|                                                                       |
| #### Name, City Name, County Name, etc.)                              |
| May Be Taxed for School Purposes for School Year 2003-2004 on Behalf  |
|                                                                       |
| ####  of the LEA                                                      |
|                                                                       |
| #### \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_ |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ {#section-16} |
|                                                                       |
| ####  {#section-17}                                                   |
|                                                                       |
| #### \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_ |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ {#section-18} |
|                                                                       |
| ####  {#section-19}                                                   |
|                                                                       |
| #### \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_ |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ {#section-20} |
+-----------------------------------------------------------------------+
| #### [STATE AVERAGE ASSESSED VALUE PER PUPIL]{.underline}             |
|                                                                       |
| #### State Average Assessed Va                                        |
| lue Per Pupil of Real Property (Land and Improvements) That Was Taxed |
|                                                                       |
| #### for School Purposes for School Year 2003‑2004 \$\_\              |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
+-----------------------------------------------------------------------+

June 2005 Form Approved: OMB number 1810-0657, Expiration date:
3/31/2007 Page 2

+---------------------+-----------------+--------------+--------------+
| ####                |                 |              |              |
| # APPLICATION FOR D |                 |              |              |
| ISCRETIONARY CONSTR |                 |              |              |
| UCTION PROGRAM -- S |                 |              |              |
| ECTION 8007(b) -- T |                 |              |              |
| AX RATE INFORMATION |                 |              |              |
+---------------------+-----------------+--------------+--------------+
| # Instr             |                 |              |              |
| uctions: Enter the  |                 |              |              |
| local real property |                 |              |              |
|  tax levy, in mills |                 |              |              |
|  or dollars and cen |                 |              |              |
| ts, that was used t |                 |              |              |
| o raise funds for c |                 |              |              |
| apital expenditures |                 |              |              |
|  for the local educ |                 |              |              |
| ational agency (LEA |                 |              |              |
| ) for fiscal year 2 |                 |              |              |
| 003-2004. If the LE |                 |              |              |
| A does not have a s |                 |              |              |
| eparate tax rate fo |                 |              |              |
| r capital expenditu |                 |              |              |
| res, enter the tota |                 |              |              |
| l tax rate for scho |                 |              |              |
| ol purposes that wa |                 |              |              |
| s used for fiscal y |                 |              |              |
| ear 2003-2004. Most |                 |              |              |
|  local taxing juris |                 |              |              |
| dictions use a sing |                 |              |              |
| le tax rate for sch |                 |              |              |
| ool operations expe |                 |              |              |
| nditures for all ty |                 |              |              |
| pes of real propert |                 |              |              |
| y under their autho |                 |              |              |
| rity. LEAs with suc |                 |              |              |
| h a single tax rate |                 |              |              |
|  will only need to  |                 |              |              |
| use one line of thi |                 |              |              |
| s table. LEAs with  |                 |              |              |
| multiple tax rates  |                 |              |              |
| should use a separa |                 |              |              |
| te line to report e |                 |              |              |
| ach type of propert |                 |              |              |
| y and corresponding |                 |              |              |
|  tax rate. *When fu |                 |              |              |
| nds for capital exp |                 |              |              |
| enditures for the L |                 |              |              |
| EA are raised by mo |                 |              |              |
| re than one taxing  |                 |              |              |
| jurisdiction, use s |                 |              |              |
| eparate lines to re |                 |              |              |
| port property types |                 |              |              |
|  and tax rates for  |                 |              |              |
| each jurisdiction.* |                 |              |              |
+---------------------+-----------------+--------------+--------------+
| **(Col. 1)**        | **(Col. 2)**    | **(Col. 3)** | **(Col. 4)** |
|                     |                 |              |              |
| **Name of Taxing    | ## Type of T    | **Tax Rate   | **Specify    |
| Jurisdiction**      | axable Property | for This     | whether the  |
|                     |                 | Type of      | tax rate     |
| ***(e.g., school    | ***(e.g.,       | Property for | reported in  |
| district name,      | residential,    | Fiscal       | Col. 3 is    |
| township name,***   | commercial,     | Year**       | for capital  |
|                     | agricultural,   |              | expenditures |
| ***city name,       | etc.)***        | *            | or total     |
| county name,        |                 | *2003-2004** | expenditures |
| etc.)***            |                 |              | for**        |
|                     |                 |              |              |
| **Use a separate    |                 |              | **school     |
| line for each       |                 |              | purposes.**  |
| different**         |                 |              |              |
|                     |                 |              |              |
| **taxing            |                 |              |              |
| jurisdiction in the |                 |              |              |
| LEA.**              |                 |              |              |
+---------------------+-----------------+--------------+--------------+
| Example:            | Example:        | Examples:    | Example:     |
|                     |                 |              |              |
| Jones County        | Agricultural    | 2.5 mills    | Capital      |
|                     |                 | per \$1 or   |              |
|                     |                 |              |              |
|                     |                 | \$2.50 per   |              |
|                     |                 | \$1,000      |              |
+---------------------+-----------------+--------------+--------------+
|                     |                 | per \$       |              |
+---------------------+-----------------+--------------+--------------+
|                     |                 | per \$       |              |
+---------------------+-----------------+--------------+--------------+
|                     |                 | per \$       |              |
+---------------------+-----------------+--------------+--------------+
|                     |                 | per \$       |              |
+---------------------+-----------------+--------------+--------------+
|                     |                 | per \$       |              |
+---------------------+-----------------+--------------+--------------+
|                     |                 | per \$       |              |
+---------------------+-----------------+--------------+--------------+
|                     |                 | per \$       |              |
+---------------------+-----------------+--------------+--------------+

June 2005 Form Approved: OMB number 1810-0657, Expiration date:
3/31/2007 Page 3

+-----------------------------------+-----------------------------------+
| ##### APPLICATION FOR DISCRET     |                                   |
| IONARY CONSTRUCTION PROGRAM -- SE |                                   |
| CTION 8007(b) -- PROJECT NARRATIV |                                   |
| E FOR EMERGENCY GRANT APPLICATION |                                   |
+-----------------------------------+-----------------------------------+
| ##### Proposed Project Start Date | #####                             |
|                                   |  Proposed Project Completion Date |
+-----------------------------------+-----------------------------------+
| ##### Describe: (1)               |                                   |
|  the emergency condition; (2) how |                                   |
|  the emergency condition adversel |                                   |
| y affects the health, safety and  |                                   |
| well-being of occupants of the sc |                                   |
| hool facility; (3) the amount of  |                                   |
| square footage to be added to the |                                   |
|  school facility, if any; (4) the |                                   |
|  age of the facility systems asso |                                   |
| ciated with this project (e.g., r |                                   |
| oofing, plumbing, HVAC, windows,  |                                   |
| electrical, etc.); (5) actions th |                                   |
| e applicant has taken to respond  |                                   |
| to the emergency condition and wh |                                   |
| y the applicant has been unable t |                                   |
| o resolve the condition; (6) how  |                                   |
| the proposed project will address |                                   |
|  the emergency condition; and (7) |                                   |
|  the proposed project and budget. |                                   |
+-----------------------------------+-----------------------------------+
|                                   |                                   |
+-----------------------------------+-----------------------------------+

**June 2005 Form Approved: OMB number 1810-0657, Expiration date:
3/31/2007 Page 4**

+-----------------------------------+-----------------------------------+
| ##### APPLICATION FOR DISCRETIONA |                                   |
| RY CONSTRUCTION PROGRAM -- SECTIO |                                   |
| N 8007(b) -- PROJECT NARRATIVE FO |                                   |
| R MODERNIZATION GRANT APPLICATION |                                   |
+-----------------------------------+-----------------------------------+
| ##### PROPOSED PROJECT START DATE | #####                             |
|                                   |  PROPOSED PROJECT COMPLETION DATE |
+-----------------------------------+-----------------------------------+
| ##### Describe: (1) the n         |                                   |
| eed for modernization of the scho |                                   |
| ol facility; (2) the amount of sq |                                   |
| uare footage to be added to the s |                                   |
| chool facility, if any; (3) actio |                                   |
| ns the applicant has taken to res |                                   |
| pond to the condition requiring m |                                   |
| odernization and why the applican |                                   |
| t has been unable to resolve the  |                                   |
| condition; (4) how the proposed p |                                   |
| roject will address the condition |                                   |
|  requiring modernization; and (5) |                                   |
|  the proposed project and budget. |                                   |
+-----------------------------------+-----------------------------------+
|                                   |                                   |
+-----------------------------------+-----------------------------------+

June 2005 Form Approved: OMB number 1810-0657, Expiration date:
3/31/2007 Page 6

+-----------------------------------------------------------------------+
| ##### APPLICATION FOR DISCRETIONARY CO                                |
| NSTRUCTION PROGRAM -- SECTION 8007(b) -- JUSTIFICATION FOR REBUILDING |
+-----------------------------------------------------------------------+
| ##### If proposing new construction, provide justification for        |
| rebuilding instead of repairing or renovating the existing school fac |
| ility. Specify the total square footage of the proposed new facility. |
+-----------------------------------------------------------------------+
| ####  {#section-21}                                                   |
+-----------------------------------------------------------------------+

June 2005 Form Approved: OMB number 1810-0657, Expiration date:
3/31/2007 Page 7

+-------+-------------------+-----+-------+---+-------------------+-----+
| ###   |                   |     |       |   |                   |     |
| ## AP |                   |     |       |   |                   |     |
| PLICA |                   |     |       |   |                   |     |
| TION  |                   |     |       |   |                   |     |
| FOR D |                   |     |       |   |                   |     |
| ISCRE |                   |     |       |   |                   |     |
| TIONA |                   |     |       |   |                   |     |
| RY CO |                   |     |       |   |                   |     |
| NSTRU |                   |     |       |   |                   |     |
| CTION |                   |     |       |   |                   |     |
|  PROG |                   |     |       |   |                   |     |
| RAM - |                   |     |       |   |                   |     |
| - SEC |                   |     |       |   |                   |     |
| TION  |                   |     |       |   |                   |     |
| 8007( |                   |     |       |   |                   |     |
| b) -- |                   |     |       |   |                   |     |
|  CHIL |                   |     |       |   |                   |     |
| DREN  |                   |     |       |   |                   |     |
| WHO A |                   |     |       |   |                   |     |
| TTEND |                   |     |       |   |                   |     |
| ED TH |                   |     |       |   |                   |     |
| IS SC |                   |     |       |   |                   |     |
| HOOL  |                   |     |       |   |                   |     |
| FACIL |                   |     |       |   |                   |     |
| ITY A |                   |     |       |   |                   |     |
| ND WH |                   |     |       |   |                   |     |
| O WER |                   |     |       |   |                   |     |
| E INC |                   |     |       |   |                   |     |
| LUDED |                   |     |       |   |                   |     |
|  ON T |                   |     |       |   |                   |     |
| ABLE  |                   |     |       |   |                   |     |
| 1 OF  |                   |     |       |   |                   |     |
| THE A |                   |     |       |   |                   |     |
| PPLIC |                   |     |       |   |                   |     |
| ANT'S |                   |     |       |   |                   |     |
|  SECT |                   |     |       |   |                   |     |
| ION 8 |                   |     |       |   |                   |     |
| 003 A |                   |     |       |   |                   |     |
| PPLIC |                   |     |       |   |                   |     |
| ATION |                   |     |       |   |                   |     |
+-------+-------------------+-----+-------+---+-------------------+-----+
| **R   |                   |     |       |   |                   |     |
| eport |                   |     |       |   |                   |     |
| chi   |                   |     |       |   |                   |     |
| ldren |                   |     |       |   |                   |     |
| inc   |                   |     |       |   |                   |     |
| luded |                   |     |       |   |                   |     |
| on    |                   |     |       |   |                   |     |
| Table |                   |     |       |   |                   |     |
| 1 of  |                   |     |       |   |                   |     |
| se    |                   |     |       |   |                   |     |
| ction |                   |     |       |   |                   |     |
| 8003  |                   |     |       |   |                   |     |
| FY    |                   |     |       |   |                   |     |
| 2005  |                   |     |       |   |                   |     |
| (s    |                   |     |       |   |                   |     |
| chool |                   |     |       |   |                   |     |
| year  |                   |     |       |   |                   |     |
| 2003- |                   |     |       |   |                   |     |
| 2004) |                   |     |       |   |                   |     |
| a     |                   |     |       |   |                   |     |
| pplic |                   |     |       |   |                   |     |
| ation |                   |     |       |   |                   |     |
| who   |                   |     |       |   |                   |     |
| att   |                   |     |       |   |                   |     |
| ended |                   |     |       |   |                   |     |
| s     |                   |     |       |   |                   |     |
| chool |                   |     |       |   |                   |     |
| fac   |                   |     |       |   |                   |     |
| ility |                   |     |       |   |                   |     |
| for   |                   |     |       |   |                   |     |
| which |                   |     |       |   |                   |     |
| fu    |                   |     |       |   |                   |     |
| nding |                   |     |       |   |                   |     |
| is    |                   |     |       |   |                   |     |
| re    |                   |     |       |   |                   |     |
| quest |                   |     |       |   |                   |     |
| ed.** |                   |     |       |   |                   |     |
+-------+-------------------+-----+-------+---+-------------------+-----+
| ##    |                   |     | ## C  |   |                   |     |
|  FEDE |                   |     | HILDR |   |                   |     |
| RAL P |                   |     | EN WI |   |                   |     |
| ROPER |                   |     | TH DI |   |                   |     |
| TY ON |                   |     | SABIL |   |                   |     |
|  WHIC |                   |     | ITIES |   |                   |     |
| H CHI |                   |     |       |   |                   |     |
| LDREN |                   |     |       |   |                   |     |
|  WITH |                   |     |       |   |                   |     |
|  DISA |                   |     |       |   |                   |     |
| BILIT |                   |     |       |   |                   |     |
| IES R |                   |     |       |   |                   |     |
| ESIDE |                   |     |       |   |                   |     |
+-------+-------------------+-----+-------+---+-------------------+-----+
| ##    | **OFFICIAL        | NUM |       |   | **CATEGORY**      | NUM |
|   {#s | NAME,**           | BER |       |   |                   | BER |
| ectio |                   | OF  |       |   | **(5)**           | OF  |
| n-22} | **ADDRESS, CITY,  | CH  |       |   |                   | CH  |
|       | STATE**           | ILD |       |   |                   | ILD |
| #     |                   | REN |       |   |                   | REN |
| # PRO | **(2)**           | ON  |       |   |                   | ON  |
| PERTY |                   | SUR |       |   |                   | SUR |
|  CODE |                   | VEY |       |   |                   | VEY |
|       |                   | D   |       |   |                   | D   |
| **NUM |                   | ATE |       |   |                   | ATE |
| BER** |                   |     |       |   |                   |     |
|       |                   | *   |       |   |                   | *   |
| **    |                   | *(3 |       |   |                   | *(6 |
| (1)** |                   | )** |       |   |                   | )** |
+-------+-------------------+-----+-------+---+-------------------+-----+
|       | ###               |     |       |   | **WITH A PARENT   |     |
|       | ##  {#section-23} |     |       |   | ON ACTIVE DUTY IN |     |
|       |                   |     |       |   | THE UNIFORMED     |     |
|       |                   |     |       |   | SERVICES OF THE   |     |
|       |                   |     |       |   | UNITED STATES**   |     |
+-------+-------------------+-----+-------+---+-------------------+-----+
|       |                   |     |       |   | **WITH A PARENT   |     |
|       |                   |     |       |   | WHO IS BOTH AN    |     |
|       |                   |     |       |   | ACCREDITED        |     |
|       |                   |     |       |   | FOREIGN           |     |
|       |                   |     |       |   | GOVERNMENT        |     |
|       |                   |     |       |   | OFFICIAL AND A    |     |
|       |                   |     |       |   | FOREIGN MILITARY  |     |
|       |                   |     |       |   | OFFICER**         |     |
+-------+-------------------+-----+-------+---+-------------------+-----+
|       |                   |     | #     |   | #                 | #   |
|       |                   |     |   {#s |   |  RESIDING ON ELIG |   { |
|       |                   |     | ectio |   | IBLE INDIAN LANDS | #se |
|       |                   |     | n-24} |   |                   | cti |
|       |                   |     |       |   |                   | on- |
|       |                   |     |       |   |                   | 25} |
+-------+-------------------+-----+-------+---+-------------------+-----+
|       |                   |     |       | # |                   |     |
|       |                   |     |       | # |                   |     |
|       |                   |     |       | # |                   |     |
|       |                   |     |       | # |                   |     |
|       |                   |     |       | # |                   |     |
|       |                   |     |       | # |                   |     |
|       |                   |     |       | # |                   |     |
|       |                   |     |       |   |                   |     |
|       |                   |     |       | T |                   |     |
|       |                   |     |       | A |                   |     |
|       |                   |     |       | B |                   |     |
|       |                   |     |       | L |                   |     |
|       |                   |     |       | E |                   |     |
|       |                   |     |       |   |                   |     |
|       |                   |     |       | 1 |                   |     |
|       |                   |     |       | - |                   |     |
|       |                   |     |       | 2 |                   |     |
|       |                   |     |       |   |                   |     |
|       |                   |     |       | T |                   |     |
|       |                   |     |       | O |                   |     |
|       |                   |     |       | T |                   |     |
|       |                   |     |       | A |                   |     |
|       |                   |     |       | L |                   |     |
+-------+-------------------+-----+-------+---+-------------------+-----+
|       |                   |     |       |   |                   |     |
+-------+-------------------+-----+-------+---+-------------------+-----+
|       |                   |     |       |   |                   |     |
+-------+-------------------+-----+-------+---+-------------------+-----+
|       |                   |     |       |   |                   |     |
+-------+-------------------+-----+-------+---+-------------------+-----+
|       |                   |     |       |   |                   |     |
+-------+-------------------+-----+-------+---+-------------------+-----+
|       | **TABLE 1-1       |     |       |   |                   |     |
|       | TOTAL**           |     |       |   |                   |     |
+-------+-------------------+-----+-------+---+-------------------+-----+

June 2005 Form Approved: OMB number 1810-0657, Expiration date:
3/31/2007 Page 8

+------------------+--------------------------------+------------------+
| #####            |                                |                  |
| APPLICATION FOR  |                                |                  |
| DISCRETIONARY CO |                                |                  |
| NSTRUCTION PROGR |                                |                  |
| AM -- SECTION 80 |                                |                  |
| 07(b) -- CHILDRE |                                |                  |
| N WHO ATTENDED T |                                |                  |
| HIS SCHOOL FACIL |                                |                  |
| ITY AND WHO WERE |                                |                  |
|  INCLUDED ON TAB |                                |                  |
| LE 2 OF THE APPL |                                |                  |
| ICANT'S SECTION  |                                |                  |
| 8003 APPLICATION |                                |                  |
+------------------+--------------------------------+------------------+
| ##               |                                |                  |
| ### Report child |                                |                  |
| ren included on  |                                |                  |
| Table 2 of secti |                                |                  |
| on 8003 FY 2005  |                                |                  |
| (school year 200 |                                |                  |
| 3-2004) applicat |                                |                  |
| ion who attended |                                |                  |
|  school facility |                                |                  |
|  for which fundi |                                |                  |
| ng is requested. |                                |                  |
+------------------+--------------------------------+------------------+
| ####             | ##                             | ##### N          |
| #  {#section-26} | ### CHILDREN WITH DISABILITIES | UMBER OF CHILDRE |
|                  |                                | N ON SURVEY DATE |
|                  | ##### (2) {#section-27}        |                  |
|                  |                                | ##### (          |
|                  |                                | 3) {#section-28} |
+------------------+--------------------------------+------------------+
| ####             | ##### WITH A PARENT ON ACTIVE  | ####             |
| #  {#section-29} | DUTY IN THE UNIFORMED SERVICES | #  {#section-30} |
|                  |                                |                  |
|                  | ##### OF THE UNITED STATES     |                  |
+------------------+--------------------------------+------------------+
| ####             | ##### WITH A P                 | ####             |
| #  {#section-31} | ARENT WHO IS BOTH AN ACCREDITE | #  {#section-32} |
|                  | D FOREIGN GOVERNMENT OFFICIAL  |                  |
|                  | AND A FOREIGN MILITARY OFFICER |                  |
+------------------+--------------------------------+------------------+

June 2005 Form Approved: OMB number 1810-0657, Expiration date:
3/31/2007 Page 9

+--------+---------------------+--------+----------------------+------+
| #####  |                     |        |                      |      |
| APPLIC |                     |        |                      |      |
| ATION  |                     |        |                      |      |
| FOR DI |                     |        |                      |      |
| SCRETI |                     |        |                      |      |
| ONARY  |                     |        |                      |      |
| CONSTR |                     |        |                      |      |
| UCTION |                     |        |                      |      |
|  PROGR |                     |        |                      |      |
| AM --  |                     |        |                      |      |
| SECTIO |                     |        |                      |      |
| N 8007 |                     |        |                      |      |
| (b) -- |                     |        |                      |      |
|  CHILD |                     |        |                      |      |
| REN WH |                     |        |                      |      |
| O ATTE |                     |        |                      |      |
| NDED T |                     |        |                      |      |
| HIS SC |                     |        |                      |      |
| HOOL F |                     |        |                      |      |
| ACILIT |                     |        |                      |      |
| Y AND  |                     |        |                      |      |
| WHO WE |                     |        |                      |      |
| RE INC |                     |        |                      |      |
| LUDED  |                     |        |                      |      |
| ON TAB |                     |        |                      |      |
| LE 3 O |                     |        |                      |      |
| F THE  |                     |        |                      |      |
| APPLIC |                     |        |                      |      |
| ANT'S  |                     |        |                      |      |
| SECTIO |                     |        |                      |      |
| N 8003 |                     |        |                      |      |
|  APPLI |                     |        |                      |      |
| CATION |                     |        |                      |      |
+--------+---------------------+--------+----------------------+------+
| **     |                     |        |                      |      |
| Report |                     |        |                      |      |
| ch     |                     |        |                      |      |
| ildren |                     |        |                      |      |
| in     |                     |        |                      |      |
| cluded |                     |        |                      |      |
| on     |                     |        |                      |      |
| Table  |                     |        |                      |      |
| 3 of   |                     |        |                      |      |
| s      |                     |        |                      |      |
| ection |                     |        |                      |      |
| 8003   |                     |        |                      |      |
| FY     |                     |        |                      |      |
| 2005   |                     |        |                      |      |
| (      |                     |        |                      |      |
| school |                     |        |                      |      |
| year   |                     |        |                      |      |
| 2003   |                     |        |                      |      |
| -2004) |                     |        |                      |      |
| appli  |                     |        |                      |      |
| cation |                     |        |                      |      |
| who    |                     |        |                      |      |
| at     |                     |        |                      |      |
| tended |                     |        |                      |      |
| school |                     |        |                      |      |
| fa     |                     |        |                      |      |
| cility |                     |        |                      |      |
| for    |                     |        |                      |      |
| which  |                     |        |                      |      |
| f      |                     |        |                      |      |
| unding |                     |        |                      |      |
| is     |                     |        |                      |      |
| reques |                     |        |                      |      |
| ted.** |                     |        |                      |      |
+--------+---------------------+--------+----------------------+------+
| ##     |                     | #      |                      | NU   |
|  FEDER |                     | # FEDE |                      | MBER |
| AL PRO |                     | RAL PR |                      | OF   |
| PERTY  |                     | OPERTY |                      | CHIL |
| ON WHI |                     |  ON WH |                      | DREN |
| CH CHI |                     | ICH PA |                      | ON   |
| LDREN  |                     | RENTS  |                      | SU   |
| RESIDE |                     | ARE EM |                      | RVEY |
|        |                     | PLOYED |                      | DATE |
|        |                     |        |                      |      |
|        |                     |        |                      | **(  |
|        |                     |        |                      | 5)** |
+--------+---------------------+--------+----------------------+------+
| ## P   | **OFFICIAL NAME,    | ## P   | **OFFICIAL NAME,     |      |
| ROPERT | ADDRESS, CITY,      | ROPERT | ADDRESS, CITY,       |      |
| Y CODE | STATE**             | Y CODE | STATE**              |      |
|        |                     |        |                      |      |
| **NU   | **(2)**             | **NU   | **(4)**              |      |
| MBER** |                     | MBER** |                      |      |
|        |                     |        |                      |      |
| *      |                     | *      |                      |      |
| *(1)** |                     | *(3)** |                      |      |
+--------+---------------------+--------+----------------------+------+
|        |                     |        |                      |      |
+--------+---------------------+--------+----------------------+------+
|        | #                   |        |                      |      |
|        | ####  {#section-33} |        |                      |      |
+--------+---------------------+--------+----------------------+------+
|        |                     |        |                      |      |
+--------+---------------------+--------+----------------------+------+
|        |                     |        |                      |      |
+--------+---------------------+--------+----------------------+------+
|        |                     |        |                      |      |
+--------+---------------------+--------+----------------------+------+
|        |                     |        |                      |      |
+--------+---------------------+--------+----------------------+------+
|        |                     |        |                      |      |
+--------+---------------------+--------+----------------------+------+
|        |                     |        |                      |      |
+--------+---------------------+--------+----------------------+------+
|        |                     |        |                      |      |
+--------+---------------------+--------+----------------------+------+
| ###    |                     |        |                      |      |
|  TOTAL |                     |        |                      |      |
+--------+---------------------+--------+----------------------+------+

June 2005 Form Approved: OMB number 1810-0657, Expiration date:
3/31/2007 Page 10

+----------+----------------+------+----------+----------------+------+
| **APP    |                |      |          |                |      |
| LICATION |                |      |          |                |      |
| FOR      |                |      |          |                |      |
| DISCR    |                |      |          |                |      |
| ETIONARY |                |      |          |                |      |
| CONS     |                |      |          |                |      |
| TRUCTION |                |      |          |                |      |
| PROGRAM  |                |      |          |                |      |
| --       |                |      |          |                |      |
| SECTION  |                |      |          |                |      |
| 8007(b)  |                |      |          |                |      |
| --       |                |      |          |                |      |
| CHILDREN |                |      |          |                |      |
| WHO      |                |      |          |                |      |
| ATTENDED |                |      |          |                |      |
| THIS     |                |      |          |                |      |
| SCHOOL   |                |      |          |                |      |
| FACILITY |                |      |          |                |      |
| AND WHO  |                |      |          |                |      |
| WERE     |                |      |          |                |      |
| INCLUDED |                |      |          |                |      |
| ON       |                |      |          |                |      |
| TABLES 4 |                |      |          |                |      |
| AND 5 OF |                |      |          |                |      |
| THE      |                |      |          |                |      |
| APP      |                |      |          |                |      |
| LICANT'S |                |      |          |                |      |
| SECTION  |                |      |          |                |      |
| 8003     |                |      |          |                |      |
| APPLI    |                |      |          |                |      |
| CATION** |                |      |          |                |      |
+----------+----------------+------+----------+----------------+------+
| #        |                |      | #        |                |      |
| ### Repo |                |      | ### Repo |                |      |
| rt child |                |      | rt child |                |      |
| ren incl |                |      | ren incl |                |      |
| uded on  |                |      | uded on  |                |      |
| Table 4  |                |      | Table 5  |                |      |
| of secti |                |      | of secti |                |      |
| on 8003  |                |      | on 8003  |                |      |
| FY 2005  |                |      | FY 2005  |                |      |
| (school  |                |      | (school  |                |      |
| year 200 |                |      | year 200 |                |      |
| 3-2004)  |                |      | 3-2004)  |                |      |
| applicat |                |      | applicat |                |      |
| ion who  |                |      | ion who  |                |      |
| attended |                |      | attended |                |      |
|  school  |                |      |  school  |                |      |
| facility |                |      | facility |                |      |
|  for whi |                |      |  for whi |                |      |
| ch fundi |                |      | ch fundi |                |      |
| ng is re |                |      | ng is re |                |      |
| quested. |                |      | quested. |                |      |
+----------+----------------+------+----------+----------------+------+
| #### F   |                | ##   | ###      |                | ##   |
| EDERAL P |                | ## N | # FEDERA |                | ## N |
| ROPERTY  |                | UMBE | L PROPER |                | UMBE |
| ON WHICH |                | R OF | TY ON WH |                | R OF |
|  CHILDRE |                |      | ICH PARE |                |      |
| N RESIDE |                | #    | NTS ARE  |                | #    |
|          |                | ###  | EMPLOYED |                | ###  |
|          |                | CHIL |          |                | CHIL |
|          |                | DREN |          |                | DREN |
|          |                |      |          |                |      |
|          |                | ##   |          |                | ##   |
|          |                | ## O |          |                | ## O |
|          |                | N SU |          |                | N SU |
|          |                | RVEY |          |                | RVEY |
|          |                |      |          |                |      |
|          |                | ###  |          |                | ###  |
|          |                | # DA |          |                | # DA |
|          |                | TE { |          |                | TE { |
|          |                | #dat |          |                | #dat |
|          |                | e-1} |          |                | e-2} |
|          |                |      |          |                |      |
|          |                | ##   |          |                | ##   |
|          |                | ## ( |          |                | ## ( |
|          |                | 3) { |          |                | 6) { |
|          |                | #sec |          |                | #sec |
|          |                | tion |          |                | tion |
|          |                | -34} |          |                | -35} |
+----------+----------------+------+----------+----------------+------+
| ##       | ####           |      | ##       | ####           |      |
| ## PROPE | OFFICIAL NAME, |      | ## PROPE | OFFICIAL NAME, |      |
| RTY CODE |                |      | RTY CODE |                |      |
|          | #### ADDRES    |      |          | #### ADDRES    |      |
| ###      | S, CITY, STATE |      | ###      | S, CITY, STATE |      |
| # NUMBER |                |      | # NUMBER |                |      |
|          | #### (2)       |      |          | #### (5)       |      |
| #### (   |  {#section-37} |      | #### (   |  {#section-39} |      |
| 1) {#sec |                |      | 4) {#sec |                |      |
| tion-36} |                |      | tion-38} |                |      |
+----------+----------------+------+----------+----------------+------+
| ###      | ####           | ###  | ###      | ####           | ###  |
| #  {#sec |  {#section-41} | #  { | #  {#sec |  {#section-44} | #  { |
| tion-40} |                | #sec | tion-43} |                | #sec |
|          |                | tion |          |                | tion |
|          |                | -42} |          |                | -45} |
+----------+----------------+------+----------+----------------+------+
| ###      | ####           | ###  | ###      | ####           | ###  |
| #  {#sec |  {#section-47} | #  { | #  {#sec |  {#section-50} | #  { |
| tion-46} |                | #sec | tion-49} |                | #sec |
|          |                | tion |          |                | tion |
|          |                | -48} |          |                | -51} |
+----------+----------------+------+----------+----------------+------+
| ###      | ####           | ###  | ###      | ####           | ###  |
| #  {#sec |  {#section-53} | #  { | #  {#sec |  {#section-56} | #  { |
| tion-52} |                | #sec | tion-55} |                | #sec |
|          |                | tion |          |                | tion |
|          |                | -54} |          |                | -57} |
+----------+----------------+------+----------+----------------+------+
| ###      | ####           | ###  | ###      | ####           | ###  |
| #  {#sec |  {#section-59} | #  { | #  {#sec |  {#section-62} | #  { |
| tion-58} |                | #sec | tion-61} |                | #sec |
|          |                | tion |          |                | tion |
|          |                | -60} |          |                | -63} |
+----------+----------------+------+----------+----------------+------+
| ###      | ####           | ###  | ###      | ####           | ###  |
| #  {#sec |  {#section-65} | #  { | #  {#sec |  {#section-68} | #  { |
| tion-64} |                | #sec | tion-67} |                | #sec |
|          |                | tion |          |                | tion |
|          |                | -66} |          |                | -69} |
+----------+----------------+------+----------+----------------+------+
| ###      | ####           | ###  | ###      | ####           | ###  |
| #  {#sec |  {#section-71} | #  { | #  {#sec |  {#section-74} | #  { |
| tion-70} |                | #sec | tion-73} |                | #sec |
|          |                | tion |          |                | tion |
|          |                | -72} |          |                | -75} |
+----------+----------------+------+----------+----------------+------+
| ###      | ####           | ###  | ###      | ####           | ###  |
| #  {#sec |  {#section-77} | #  { | #  {#sec |  {#section-80} | #  { |
| tion-76} |                | #sec | tion-79} |                | #sec |
|          |                | tion |          |                | tion |
|          |                | -78} |          |                | -81} |
+----------+----------------+------+----------+----------------+------+
| ###      | ####           | ###  | ###      | ####           | ###  |
| #  {#sec |  {#section-83} | #  { | #  {#sec |  {#section-86} | #  { |
| tion-82} |                | #sec | tion-85} |                | #sec |
|          |                | tion |          |                | tion |
|          |                | -84} |          |                | -87} |
+----------+----------------+------+----------+----------------+------+
| ###      | ####           | ###  | ###      | ####           | ###  |
| #  {#sec |  {#section-89} | #  { | #  {#sec |  {#section-92} | #  { |
| tion-88} |                | #sec | tion-91} |                | #sec |
|          |                | tion |          |                | tion |
|          |                | -90} |          |                | -93} |
+----------+----------------+------+----------+----------------+------+
| ###      | ####           | ###  | ###      | ####           | ###  |
| #  {#sec |  {#section-95} | #  { | #  {#sec |  {#section-98} | #  { |
| tion-94} |                | #sec | tion-97} |                | #sec |
|          |                | tion |          |                | tion |
|          |                | -96} |          |                | -99} |
+----------+----------------+------+----------+----------------+------+
| ####     | ####           | #### | ####     | ####           | #### |
|   {#sect | {#section-101} |   {# |   {#sect | {#section-104} |   {# |
| ion-100} |                | sect | ion-103} |                | sect |
|          |                | ion- |          |                | ion- |
|          |                | 102} |          |                | 105} |
+----------+----------------+------+----------+----------------+------+
| **TABLE  |                | #### | **TABLE  |                | #### |
| 4        |                |   {# | 5        |                |   {# |
| TOTAL**  |                | sect | TOTAL**  |                | sect |
|          |                | ion- |          |                | ion- |
|          |                | 106} |          |                | 107} |
+----------+----------------+------+----------+----------------+------+

June 2005 Form Approved: OMB number 1810-0657, Expiration date:
3/31/2007 Page 11

+--------------------------------------------------------+-------------+
| ##### AP                                               |             |
| PLICATION FOR DISCRETIONARY CONSTRUCTION PROGRAM -- SE |             |
| CTION 8007(b) -- PROGRAM ASSURANCES AND CERTIFICATIONS |             |
+--------------------------------------------------------+-------------+
| #### The applicant local educational agency (LEA)      |             |
|  declares that it has filed the certifications regardi |             |
| ng lobbying in ED Form 80-0013 with the U.S. Departmen |             |
| t of Education (Department) as part of its section 800 |             |
| 3 or section 8002 Impact Aid application. As of the da |             |
| te of the signature below, the LEA reaffirms and incor |             |
| porates by reference those assurances and certificatio |             |
| ns with respect to this grant award. The LEA certifies |             |
|  that no circumstances affecting the validity of these |             |
|  assurances have changed since their previous filing.  |             |
|                                                        |             |
| ####  {#section-108}                                   |             |
|                                                        |             |
| #### With respe                                        |             |
| ct to the Certification Regarding Lobbying, the LEA re |             |
| certifies that no 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 the making or renewal of Federal gran |             |
| ts under this program; that the LEA shall complete and |             |
|  submit Standard Form-LLL, \"Disclosure Form to Report |             |
|  Lobbying,\" when required (34 C.F.R. Part 82, Appendi |             |
| x B); and that the LEA shall require the full certific |             |
| ation, as set forth in 34 C.F.R. Part 82, Appendix A,  |             |
| in the award documents for all subawards at all tiers. |             |
|                                                        |             |
| ####  {#section-109}                                   |             |
|                                                        |             |
| #### The LEA                                           |             |
| further agrees to comply with the following Education  |             |
| Department General Administrative Regulations (EDGAR): |             |
|                                                        |             |
| ####  {#section-110}                                   |             |
|                                                        |             |
| #### 34 CFR Part 75 \                                  |             |
| -- Direct Grant Programs, except 75.600 through 75.617 |             |
|                                                        |             |
| #### 34 CFR Part 7                                     |             |
| 7 \-- Definitions that Apply to Department Regulations |             |
|                                                        |             |
| ####                                                   |             |
|  34 CFR Part 80 \-- Uniform Administrative Requirement |             |
| s for Grants and Cooperative Agreements to State and L |             |
| ocal Governments, including the procurement provisions |             |
|                                                        |             |
| #### 34 CFR Part                                       |             |
|  81 \-- General Education Provisions Act\--Enforcement |             |
|                                                        |             |
| #### 34 CFR Part 82 \-- New Restrictions on Lobbying   |             |
|                                                        |             |
| #### 34 CFR Part 84 -- Governmentwide Requi            |             |
| rements for Drug-free Workplace (Financial Assistance) |             |
|                                                        |             |
| #### 34 CFR Part 85 \-- Go                             |             |
| vernmentwide Debarment and Suspension (Nonprocurement) |             |
|                                                        |             |
| ####  {#section-111}                                   |             |
+--------------------------------------------------------+-------------+
| **Signature Of Authorized Representative**             | **Date**    |
+--------------------------------------------------------+-------------+

June 2005 Form Approved: OMB number 1810-0657, Expiration date:
3/31/2007 Page 12

+--------------------------------------------------------+-------------+
| ##### APPLICATION FOR DISCRET                          |             |
| IONARY CONSTRUCTION PROGRAM -- SECTION 8007(b) -- ADDI |             |
| TIONAL DEPARTMENT OF EDUCATION CONSTRUCTION ASSURANCES |             |
+--------------------------------------------------------+-------------+
| #### The applicant local educational ag                |             |
| ency (LEA) further certifies that it will ensure that: |             |
|                                                        |             |
| #### 20. It has or will have title or other interest   |             |
|  in the project site(s), including right of access, an |             |
| d that the site(s) will continue to be used for educat |             |
| ional purposes after the completion of the project(s). |             |
|                                                        |             |
| #### 21. Sufficient funds are available to meet an     |             |
| y share of the costs of the repair, renovation, or con |             |
| struction projects that are not covered by this grant. |             |
|                                                        |             |
| #### 22. Except for school facilities mo               |             |
| difications necessary to render public school faciliti |             |
| es accessible in order to comply with the Americans wi |             |
| th Disabilities Act (ADA) of 1990 or section 504 of th |             |
| e Rehabilitation Act of 1973, this grant will be used  |             |
| only to supplement the amount of funds that in the abs |             |
| ence of the Federal funds would be made available from |             |
|  non-Federal sources for school repair and renovation. |             |
|                                                        |             |
| #### 23. Except for modifications necessary to meet A  |             |
| DA or section 504 of the Rehabilitation Act standards  |             |
| and asbestos abatement or removal, the grant will not  |             |
| be used for repair, renovation, or construction of fac |             |
| ilities or any part of a facility that will be used fo |             |
| r religious worship, instruction, or proselytization.  |             |
|                                                        |             |
| #### 24. Competent architectural engineering           |             |
|  supervision and inspection will be maintained at the  |             |
| project's site to ensure that the work conforms to the |             |
|  drawings and specifications for the approved project. |             |
|                                                        |             |
| #### 25. Grant projects will be                        |             |
| : (a) functional; (b) economical; and (c) not elaborat |             |
| e in design or extravagant in the use of materials, co |             |
| mpared with the facilities of a similar type construct |             |
| ed in the State or other applicable geographical area. |             |
|                                                        |             |
| #### 26. Standards under the Occupational              |             |
|  Safety and Health Act of 1970 (P.L. 91-576), or State |             |
|  and local codes, if they are more stringent, will be  |             |
| observed in the design and completion of the projects. |             |
|                                                        |             |
| #### 27. Gra                                           |             |
| nt projects will comply with any applicable requiremen |             |
| ts under the ADA and section 504 of the Rehabilitation |             |
|  Act of 1973 regarding accessibility for the disabled. |             |
|                                                        |             |
| #### 28. As                                            |             |
|  applicable and to the extent feasible, the design and |             |
|  completion of grant project(s) should maximize effici |             |
| ent use of energy. Standard 90.1-1989 and 90.2-1993 of |             |
|  the American Society of Heating, Refrigerating, and A |             |
| ir-Conditioning Engineers, Inc. (ASHRAE) will be appli |             |
| ed in the design and completion of the grant projects. |             |
|                                                        |             |
| ####                                                   |             |
| 29. It will follow the \"Earthquake Hazards Reduction  |             |
| Act of 1977\" (P.L. 95-125) and Executive Order 12699, |             |
|  \"Seismic Safety of Federal and Federally Assisted or |             |
|  Regulated New Building Construction,\" as applicable. |             |
|                                                        |             |
| #### 30. If applicable,                                |             |
|  it will comply with the following Indian Preferences  |             |
| and Opportunities requirements. Section 7(b) of the In |             |
| dian Self-Determination and Education Assistance Act o |             |
| f 1975 (P.L. 93-638) requires that, to the greatest ex |             |
| tent feasible, the recipient of any grant or contract  |             |
| awarded for the benefit of Indians give to: (1) Indian |             |
| s, preferences and opportunities for training and empl |             |
| oyment in connection with the administration of the gr |             |
| ant or contract; and (2) Indian organizations and Indi |             |
| an-owned economic enterprises, as defined in section 3 |             |
|  of the Indian Financing Act of 1974 (P.L. 93-262), pr |             |
| eference in the award of contracts and subcontracts at |             |
|  any level of the administration of the grant project. |             |
|                                                        |             |
| #### 31. If it carries out repa                        |             |
| ir, renovation, or construction through a contract, an |             |
| y such contract process ensures the maximum number of  |             |
| qualified bidders, including small, minority, and wome |             |
| n-owned businesses, through full and open competition. |             |
|                                                        |             |
| #### 32. The faci                                      |             |
| lities will be operated and maintained in accordance w |             |
| ith applicable Federal, State, and local requirements. |             |
|                                                        |             |
| #### 33. When the project is complete                  |             |
| d, sufficient operational funds will be available for  |             |
| effective operation and maintenance of the facilities. |             |
|                                                        |             |
| #### 34. Fu                                            |             |
| nds received under this program will not be used to su |             |
| pplant other available non‑Federal construction money. |             |
+--------------------------------------------------------+-------------+
| **Signature Of Authorized Representative**             | **Date**    |
+--------------------------------------------------------+-------------+

June 2005 Form Approved: OMB number 1810-0657, Expiration date:
3/31/2007 Page 15