United States Pollution Prevention EPA 742-B-01-001

Environmental Protection and Toxics February 2001

Agency www.epa.gov/oppt/ejp2

2001 Grant Guidance

Environmental

Justice

Through

Pollution 

Prevention













Appendix A Page A-1

APPENDIX A: CHECKLIST OF APPLICATION MATERIALS

Please be sure to include all the items listed on the checklist in your application packet. Each item

should be clearly identified and arranged in the following order. In order to help conserve paper, please

provide double sided copies whenever possible.

G A 1 page summary cover sheet.

G Narrative of the proposal not to exceed 5 pages.

G Letters of commitment, memoranda of understanding, or other documents.

G Resumes or biographical information regarding the lead investigator, and other key personnel in

the grant application.

G Any additional information deemed useful by the applicant.

G Key Contacts Information Sheet

G Application of Federal Assistance, SF 42 4A.

G The Federal Standard Form SF 424A.

G Detailed, itemized budget.

G Certification of Non-Construction, SF 424B 

G Certification Regarding Debarment, Suspension, and Other Responsibility Matters.

The total number of pages per application may not exceed 25 double-sided pages.

Please include one original (with original signatures where appropriate) and one copy of the application

packet.

Grant application must be received by EPA at the following address not later than 5 p.m. e.s.t.,

April 20, 2001:

 EJP2 Grant Program

 c/o ERG

 2200 Wilson Boulevard, Suite 400

 Arlington, VA 22201

For questions concerning the grant program guidance, or for additional information please call 703 841-

0483.
Appendix B Page B-1

APPENDIX B: APPLICATION FORMS AND INSTRUCTIONS

Appendix B contains the following forms and instructions necessary for submitting a grant application:

 Key Contacts Information Sheet.

 Application for Federal Assistance, SF 424.

 Federal Standard Form SF 424A.

 Instructions for Detailed, Itemized Budget.

 Certification of Non-Construction, SF 424B.

 Certification Regarding Debarment, Suspension, and Other Responsibility Matters.
Appendix B Page B-2

KEY CONTACTS INFORMATION SHEET

Authorized Representative: Original awards and amendments will be sent to this individual for review

and acceptance, unless otherwise indicated.

Name: 

Title: 

Complete Address: 

 

 

Phone Number: 

Payee: Individual authorized to accept payments.

Name: 

Title: 

Complete Address: 

 

 

Phone Number: 

 

Administrative Contact: Individual from Sponsored Programs Office to contact concerning

administrative matters (i.e., indirect cost rate computation, and rebudgeting requests, etc.)

Name: 

Title: 

 

Complete Address: 

 

 

Phone Number: 

Project Manager: Individual responsible for the technical completion of the proposed work.

Name: 

Title: 

 

Complete Address: 

 

 

Phone Number: 
APPLICATION FOR OMB Approval No. 0348-0043

FEDERAL ASSISTANCE 2. DATE SUBMITTED Applicant Identifier

1. TYPE OF SUBMISSION: 3. DATE RECEIVED BY STATE State Application Identifier

 Application Preapplication

4. DATE RECEIVED BY FEDERAL AGENCY Federal Identifier

5. APPLICANT INFORMATION

Legal Name: Organizational Unit:

Address (give city, county, State, and zip code): Name and telephone number of person to be contacted on matters involving

this application (give area code)

6. EMPLOYER IDENTIFICATION NUMBER (EIN): 7. TYPE OF APPLICANT:(enter appropriate letter in box)

 A. State H. Independent School Dist.

8. TYPE OF APPLICATION: B. County I. State Controlled Institution of Higher Learning

 C. Municipal J. Private University

 D. Township K. Indian Tribe

If Revision, enter appropriate letter(s) in box(es) E. Interstate L. Individual

 F. Intermunicipal M. Profit Organization

 A. Increase Award B. Decrease Award C. Increase Duration G. Special District N. Other (Specify) ____________________

 D. Decrease Duration Other (specify):

9. NAME OF FEDERAL AGENCY:

10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: 11. DESCRIPTIVE TITLE OF APPLICANT’S PROJECT:

TITLE:

12. AREAS AFFECTED BY PROJECT(Cities, Counties, States, etc.):

13. PROPOSED PROJECT 14. CONGRESSIONAL DISTRICTS OF:

Start Date Ending Date a. Applicant b. Project

15. ESTIMATED FUNDING: 16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE

 ORDER 12372 PROCESS?

a. Federal $ .00

 a. YES. THIS PREAPPLICATION/APPLICATION WAS MADE

b. Applicant $ .00 AVAILABLE TO THE STATE EXECUTIVE ORDER 12372

 PROCESS FOR REVIEW ON:

c. State $ .00

 DATE _____________________

d. Local $ .00

 b. No. PROGRAM IS NOT COVERED BY E. O. 12372

e. Other $ .00 OR PROGRAM HAS NOT BEEN SELECTED BY STATE

 FOR REVIEW

f. Program Income $ .00

17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT?

g. TOTAL $ .00

18. TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS APPLICATION/PREAPPLICATION ARE TRUE AND CORRECT, THE

 DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE

 ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED.

a. Type Name of Authorized Representative b. Title c. Telephone Number

d. Signature of Authorized Representative e. Date Signed

Previous Edition Usable Standard Form 424 (Rev. 7-97)

Authorized for Local Reproduction Prescribed by OMB Circular A-102

Construction

Non-Construction Non-Construction

Construction

Yes If "Yes," attach an explanation. No

New Continuation Revision
Appendix B Page B-4

U.S. ENVIRONMENTAL PROTECTION AGENCY

EJP2 GRANT PROGRAM

CUSTOMIZED INSTRUCTIONS FOR THE SF 424

This is a standard form used by applicants as a required factsheet for applications submitted for federal assistance. Certain states have established a

review and comment procedure pursuant to Executive Order 12732 and have selected this program to be included in their process. The applicant

will use this form to certify that the State has been given an opportunity to review this submission. It will be used by EPA to obtain applicant

certification that states that have established a review and comment procedure in response to Executive Order 12372 and have selected the program

to be included in their process, have been given an opportunity to review the applicant’s submission. 

Item: Entry: Item: Entry:

1. For the purpose of the EJP2 grant program, all applicants 11. Enter a brief descriptive title of the project. If more than

are completing applications for nonconstruction programs one program is involved, you should append an 

only. explanation on a separate sheet. If appropriate (e.g., 

2. Date application submitted to EPA (or state if applicable) showing project location.

& applicant’s own control number (if applicable).

3. State use only (if applicable). counties, and cities).

4. If this application is to continue or revise an existing 13. All EJP2 grant projects must have a starting date on or

award, enter present federal identifier number. If this after October 1, 1999, and a ending date no later than

application is for a new project, leave blank. September 30, 2001.

5. Legal name of the applicant, name of primary 14. List the applicant’s Congressional district and any

organizational unit that will undertake the assistance district(s) affected by the program or project.

activity, complete address of the applicant, and name and

telephone number of the person to contact on matters 15. Please refer to Section III of the EJP2 grant application

related to this application. package for information regarding cost sharing or matching

6. Enter Employer Identification Number (EIN) as assigned government for the entire life of the grant should go into

by the Internal Revenue Service. box (a). Cost-sharing or matching amount by the applicant

7. Enter the appropriate letter in the space provided. Please matching amount by the applicant should equal to the

note that for-profit organizations, federal agencies, and determined percentage of the total cost of the project (e.g.,

individuals are not eligible for award under the EJP2 grant if the total cost of the project is $100,000, and the

program. mandated applicant cost-sharing or matching amount is 25

8. Check appropriate box and enter appropriate letter(s) in the applicant portion would equal $25,000). The total (box

the space(s) provided: (g)) should reflect the cost for the entire life of the

--“New” means a new assistance award.

--“Continuation” means an extension for an additional 16. Applicant should contact the State Single Point of Contact

funding and budget period for a project with a projected (SPOC) for Federal Executive Order 12372 to determine

completion date. whether the application is subject to the State inter-

--“Revision” means any change in the Federal government review process. A complete listing of SPOC’s

Government’s financial obligation or contingent liability are attached in Appendix D of the grant guidance.

from an existing obligation.

9. Name of the federal agency from which assistance is being person who signs as the authorized representative. 

requested with this application: U.S. Environmental Categories of debt include delinquent audit disallowances,

Protection Agency loans, and taxes.

10. The EJP2 grant program does not have a Catalog of 18. To be signed by the authorized representative of the

Federal Domestic Assistance number. Please fill in “EJP2 applicant. A copy of the governing body’s authorization

grant program” for the title. for you to sign this application as official representative

construction or real property projects), attach a map

12. List only the largest political entities affected (e.g., state,

requirements. Amount requested from the Federal

should go into box (b). Please note that the cost-sharing or

percent then the federal portion would equal $75,000, and

program.

17. This question applies to the applicant organization, not the

must be on file in the applicant’s office. (Certain Federal

agencies may require that this authorization be submitted

as part of the application).
BUDGET INFORMATION - Non-Construction Programs OMB Approval No. 0348-0044

SECTION A - BUDGET SUMMARY

Grant Program 

Function

Catalog of Federal 

Domestic Assistance Estimated Unobligated Funds New or Revised Budget

or Activity Number Federal Non-Federal Federal Non-Federal Total

(a) (b) (c) (d) (e) (f) (g)

1. $$$$$5. Totals4.3.2.

$$$$$

SECTION B - BUDGET CATEGORIES

GRANT PROGRAM, FUNCTION OR ACTIVITY Total

(1) (2) (3) (4) (5)

a. Personnel $$$$$i. Total Direct Charges h. Otherg. Constructionf. Contractuale. Suppliesd. Equipmentc. Travelb. Fringe Benefits

(sum of 6a-6h)

k. TOTALS j. Indirect Charges

(sum of 6i and 6j) $$$$$

7. Program Income $$$$$

Authorized for Local Reproduction Standard Form 424A (Rev. 7-97)

Previous Edition Usable Prescribed by OMB Circular A-102

6. Object Class Categories
SECTION C - NON-FEDERAL RESOURCES

(a) Grant Program (b) Applicant (c) State (d) Other Sources (e) TOTALS

12. TOTAL 11.10.9.8. $ $ $ $

(sum of lines 8-11) $ $$$

SECTION D - FORECASTED CASH NEEDS

Total for 1st Year 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter

13. Federal $$ $$$15. TOTAL 14. Non-Federal

(sum of lines 13 and 14) $$ $$$

SECTION E - BUDGET ESTIMATES OF FEDERAL FUNDS NEEDED FOR BALANCE OF THE PROJECT

(a) Grant Program FUTURE FUNDING PERIODS (Years)

(b) First (c) Second (d) Third (e) Fourth

20. TOTAL 19.18.17.16. $ $ $ $

(sum of lines 16-19) $ $$$

SECTION F - OTHER BUDGET INFORMATION

23. Remarks:21. Direct Charges: 22. Indirect Charges:

Authorized for Local Reproduction Standard Form 424A (Rev. 7-97) Page 2
Appendix B Page B-7

U.S. ENVIRONMENTAL PROTECTION AGENCY

EJP2 GRANT PROGRAM

CUSTOMIZED INSTRUCTIONS FOR THE SF 424A

This is a standard form used by applicants as a required budget information for applications submitted for

federal assistance. It will be used by the EPA to obtain budget information regarding the application.

Please note that a detailed, itemized budget is also required as a part of the EJP2 grant application. Please

refer to Appendix B for guidelines for completing the detailed, itemized budget. 

Section: Entry:

A. Please leave blank.

B. Please complete column 1 and column 5

of this Section. The totals for column 1

and column 5 should equal. If the

proposed project is expected to generate

income as a result of project activity,

please complete column 1 and column

5, row 7, Program Income. If no

income is expected, please leave blank.

C. Please leave blank.

D. Please leave blank.

E. Please leave blank.

F. Direct charges (box 21) should equal to

the total cost of project from section B. 

If you have an approved indirect charge

rate, include estimate for indirect

charges in box 22. 
Appendix B Page B-8

INSTRUCTIONS FOR CONSTRUCTING

 DETAILED BUDGET INFORMATION

Please follow the format of the sample detailed budget below when constructing your detail budget

information form. Whenever possible, include an explanation for specific budget item.

I. Personnel

0.2 Full time equivalent (FTE) Executive Director at $40,000 per year $ 8,000.00

0.2 FTE Project Coordinator at $12.00 per hour 4,600.00

0.5 FTE Community Outreach Worker at $10.00 per hour 9,600.00

 22,200.00

II. Fringe Benefits at 10 percent

0.2 FTE Executive Director $ 800.00

0.2 FTE Project Coordinator 460.00

0.5 FTE Community Outreach Worker 960.00

 2,220.00

III. Travel

Local travel at $0.26 per mile: outreach coordinator $ 500.00

travel to outreach communities

2 conference travel: from Chicago, IL to Washington, DC

 at $500 per person to present

results of project at the end of project 1,000.00

 1,500.00

IV. Equipment (Rental)

Audio visual and projector rental: for community outreach

presentations $ 500.00

Computer equipment 500.00

 1,000.00

V. Supplies

Paper and office supplies $ 500.00

Postage 500.00

Printing, 1,000 copies of report 1,500.00

Telephone 500.00

 3,000.00

TOTAL: $ 29,920.00
OMB Approval No. 0348-0040

ASSURANCES - NON-CONSTRUCTION PROGRAMS

NOTE:

As the duly authorized representative of the applicant, I certify that the applicant:

Previous Edition Usable Standard Form 424B (Rev. 7-97)

Authorized for Local Reproduction Prescribed by OMB Circular A-102

Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing

instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of

information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for

reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0040), Washington, DC 20503.

PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET.

SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.

Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the

awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such

is the case, you will be notified.

Has the legal authority to apply for Federal assistance

and the institutional, managerial and financial capability

(including funds sufficient to pay the non-Federal share

of project cost) to ensure proper planning, management

and completion of the project described in this

application.

Will give the awarding agency, the Comptroller General

of the United States and, if appropriate, the State,

through any authorized representative, access to and

the right to examine all records, books, papers, or

documents related to the award; and will establish a

proper accounting system in accordance with generally

accepted accounting standards or agency directives.

Will establish safeguards to prohibit employees from

using their positions for a purpose that constitutes or

presents the appearance of personal or organizational

conflict of interest, or personal gain.

Will initiate and complete the work within the applicable

time frame after receipt of approval of the awarding

agency.

Will comply with the Intergovernmental Personnel Act of

1970 (42 U.S.C. §§4728-4763) relating to prescribed

standards for merit systems for programs funded under

one of the 19 statutes or regulations specified in

Appendix A of OPM's Standards for a Merit System of

Personnel Administration (5 C.F.R. 900, Subpart F).

Will comply with all Federal statutes relating to

nondiscrimination. These include but are not limited to:

(a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352)

which prohibits discrimination on the basis of race, color

or national origin; (b) Title IX of the Education

Amendments of 1972, as amended (20 U.S.C. §§1681-

1683, and 1685-1686), which prohibits discrimination on 

the basis of sex; (c) Section 504 of the Rehabilitation

Act of 1973, as amended (29 U.S.C. §794), which

prohibits discrimination on the basis of handicaps; (d)

the Age Discrimination Act of 1975, as amended (42

U.S.C. §§6101-6107), which prohibits discrimination

on the basis of age; (e) the Drug Abuse Office and

Treatment Act of 1972 (P.L. 92-255), as amended,

relating to nondiscrimination on the basis of drug

abuse; (f) the Comprehensive Alcohol Abuse and

Alcoholism Prevention, Treatment and Rehabilitation

Act of 1970 (P.L. 91-616), as amended, relating to

nondiscrimination on the basis of alcohol abuse or

alcoholism; (g) §§523 and 527 of the Public Health

Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290 ee3), as amended, relating to confidentiality of alcohol

and drug abuse patient records; (h) Title VIII of the

Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as

amended, relating to nondiscrimination in the sale,

rental or financing of housing; (i) any other

nondiscrimination provisions in the specific statute(s)

under which application for Federal assistance is being

made; and, (j) the requirements of any other

nondiscrimination statute(s) which may apply to the

application.

Will comply, or has already complied, with the

requirements of Titles II and III of the Uniform

Relocation Assistance and Real Property Acquisition

Policies Act of 1970 (P.L. 91-646) which provide for

fair and equitable treatment of persons displaced or

whose property is acquired as a result of Federal or

federally-assisted programs. These requirements apply

to all interests in real property acquired for project

purposes regardless of Federal participation in

purchases.

Will comply, as applicable, with provisions of the

Hatch Act (5 U.S.C. §§1501-1508 and 7324-7328)

which limit the political activities of employees whose

principal employment activities are funded in whole or

in part with Federal funds.

1.

2.

3.

4.

5.

6.

7.

8.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE

APPLICANT ORGANIZATION DATE SUBMITTED

Standard Form 424B (Rev. 7-97) Back

Will comply, as applicable, with the provisions of the DavisBacon Act (40 U.S.C. §§276a to 276a-7), the Copeland Act

(40 U.S.C. §276c and 18 U.S.C. §874), and the Contract

Work Hours and Safety Standards Act (40 U.S.C. §§327-

333), regarding labor standards for federally-assisted

construction subagreements.

Will comply, if applicable, with flood insurance purchase

requirements of Section 102(a) of the Flood Disaster

Protection Act of 1973 (P.L. 93-234) which requires

recipients in a special flood hazard area to participate in the

program and to purchase flood insurance if the total cost of

insurable construction and acquisition is $10,000 or more.

Will comply with environmental standards which may be

prescribed pursuant to the following: (a) institution of

environmental quality control measures under the National

Environmental Policy Act of 1969 (P.L. 91-190) and

Executive Order (EO) 11514; (b) notification of violating

facilities pursuant to EO 11738; (c) protection of wetlands

pursuant to EO 11990; (d) evaluation of flood hazards in

floodplains in accordance with EO 11988; (e) assurance of

project consistency with the approved State management

program developed under the Coastal Zone Management

Act of 1972 (16 U.S.C. §§1451 et seq.); (f) conformity of

Federal actions to State (Clean Air) Implementation Plans

under Section 176(c) of the Clean Air Act of 1955, as

amended (42 U.S.C. §§7401 et seq.); (g) protection of

underground sources of drinking water under the Safe

Drinking Water Act of 1974, as amended (P.L. 93-523);

and, (h) protection of endangered species under the

Endangered Species Act of 1973, as amended (P.L. 93-

205).

Will comply with the Wild and Scenic Rivers Act of

1968 (16 U.S.C. §§1271 et seq.) related to protecting

components or potential components of the national

wild and scenic rivers system.

Will assist the awarding agency in assuring compliance

with Section 106 of the National Historic Preservation

Act of 1966, as amended (16 U.S.C. §470), EO 11593

(identification and protection of historic properties), and

the Archaeological and Historic Preservation Act of

1974 (16 U.S.C. §§469a-1 et seq.).

Will comply with P.L. 93-348 regarding the protection of

human subjects involved in research, development, and

related activities supported by this award of assistance.

Will comply with the Laboratory Animal Welfare Act of

1966 (P.L. 89-544, as amended, 7 U.S.C. §§2131 et

seq.) pertaining to the care, handling, and treatment of

warm blooded animals held for research, teaching, or

other activities supported by this award of assistance.

Will comply with the Lead-Based Paint Poisoning

Prevention Act (42 U.S.C. §§4801 et seq.) which

prohibits the use of lead-based paint in construction or

rehabilitation of residence structures.

Will cause to be performed the required financial and

compliance audits in accordance with the Single Audit

Act Amendments of 1996 and OMB Circular No. A-133,

"Audits of States, Local Governments, and Non-Profit

Organizations."

Will comply with all applicable requirements of all other

Federal laws, executive orders, regulations, and policies 

governing this program.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.
 

EPA Project Control Number

 

United States Environmental Protection Agency

Washington, DC 20460

Certification Regarding

Debarment, Suspension, and Other Responsibility Matters

The prospective participant certifies to the best of its knowledge and belief that it and its principals:

(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily

excluded from covered transactions by any federal department or agency;

(b) Have not within a 3-year period preceding this proposal been convicted of or had a civil judgment

rendered against them for commission of fraud or a criminal offense in connection with obtaining,

attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public

transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,

bribery, falsification or destruction of records, making false statements, or receiving stolen property;

(c) Are not presently indicated for or otherwise criminally or civilly charged by a government entity

(federal, state, or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this

certification;

(d) Have not within a 3-year period preceding this application/proposal had one or more public

transactions (Federal, State, or local) terminated for cause or default.

I understand that a false statement on this certification may be grounds for rejection of this proposal or

termination of the award. In addition, under 18 USC Sec. 1001, a false statement may result in a fine of

up to $10,000 or imprisonment for up to 5 years, or both.

Typed Name and Title of Authorized Representative

Signature of Authorized Representative Date

 I am unable to certify to the above statements. My explanation is attached.
Appendix B Page B-12

INSTRUCTIONS

Under Executive Order 12549, an individual or organization debarred or excluded from participation in

federal assistance or benefit programs cannot receive any assistance award under a federal program, or a

subagreement thereunder for $25,000 or more.

Accordingly, each prospective recipient of an EPA grant, loan, or cooperative agreement and any contract

or subagreement participant thereunder must complete the attached certification or provide an explanation

why they cannot. For further details, see 40 CFR 32.510, participants’ responsibilities, in the attached

regulation.

Where to Submit

The prospective EPA grant, loan, or cooperative agreement recipient must return the signed certification or

explanation with its application to EPA Headquarters or the appropriate regional office as required in the

application instructions.

A prospective prime contractor must submit a completed certification or explanation to the individual or

organization awarding the contract.

Each prospective subcontractor must submit a completed certification or explanation to the prime contractor

for the project.

How To Obtain Forms:

EPA includes the certification form, instruction, and a copy of its implementing regulation (40 CFR Part 32)

in each application kit. Applicants may reproduce these materials as needed and provide them to their

prospective prime contractor, who, in turn, may reproduce and provide them to prospective subcontractors.

Additional copies and assistance may be requested by calling the Grants Administrative Division at 202

564-5315 or by writing to:

Compliance Branch

Grants Administrative Division (PM-216F)

U.S. Environmental Protection Agency

401 M Street, SW

Washington, DC 20460
10

9

8

7

6

5

4

3

2

1

2 10 9

WA

MT

ID

OR

NV

CA

AK

WY

UT CO

AZ NM

ND

TX

OK

KS

NE

SD

MN

IA

MO

IL

WI

MI

IN OH

KY

TN AR

LA

MS AL

GA SC

NC

WV

PA

NY

ME

FL

VA MD

DE

NJ

CT RI

MA

VT

NH

HI

PR VI

GU

AS

Alabama 4

Alaska 10

Arizona 9

Arkansas 6

California 9

Colorado 8

Connecticut 1

Delaware 3

District of Columbia 3

Florida 4

Georgia 4

Hawaii 9

Idaho 10

Illinois 5

Indiana 5

Iowa 7

Kansas 7

Kentucky 4

Louisiana 6

Maine 1

Maryland 3

Massachusetts 1

Michigan 5

Minnesota 5

Mississippi 4

Missouri 7

Montana 8

Nebraska 7

Nevada 9

New Hampshire 1

New Jersey 2

New Mexico 6

New York 2

North Carolina 4

North Dakota 8

Ohio 5

Oklahoma 6

Oregon 10

Pennsylvania 3

Rhode Island 1

South Carolina 4

South Dakota 8

Tennessee 4

Texas 6

Utah 8

Vermont 1

Virginia 3

Washington 10

West Virginia 3

Wisconsin 5

Wyoming 8

American Samoa 9

Guam 9

Puerto Rico 2

Virgin Islands 2

Region 1 Connecticut

Maine

Massachusetts

New Hampshire

Rhode Island

Vermont

Region 2 New Jersey

New York

Puerto Rico

Virgin Islands

Region 3 Delaware

Districtof

Columbia

Maryland

Pennsylvania

Virginia

West Virginia

Region 4 Alabama

Florida

Georgia

Kentucky

Mississippi

North Carolina

South Carolina

Tennessee

Region 5 Illinois

Indiana

Michigan

Minnesota

Ohio

Wisconsin

Region 6 Arizona

Louisiana

New Mexico

Oklahoma

Texas

Region 7 Iowa

Kansas

Missouri

Nebraska

Region 8 Colorado

Montana

North Dakota

South Dakota

Utah

Wyoming

Region 9 Arizona

California

Hawaii

Nevada

American 

Samoa

Guam

Region 10 Alaska

Idaho

Oregon

Washington

Appendix C: Map of EPA Regions

EPA Regional Offices and State Breakdown

Appendix C Page C-1
Appendix D Page D-1

APPENDIX D: STATE SINGLE POINTS OF CONTACT

Your application to an EPA program may be subject to your state's inter-governmental review process and/or

consultation requirements under Section 204, Demonstration Cities and Metropolitan Development Act.

Listed below are the Single Point- of- Contacts for the states and U.S. territories with a designated Single

Point-of-Contact. Please check the list not see if such review is required in your state or territory. Those

states and U.S. territories that are not listed do not have an established single point-of-contact. For further

information regarding Single Points-of-Contact, please call EPA at (202) 260-9266. Please also note that

federally recognized tribal organizations are not required to comply with this procedure. 

ARIZONA 

Ms. Joni Saad 

Arizona State Clearinghouse 

3800 N. Central Avenue 

Fourteenth Floor 

Phoenix, AZ 85012 

Phone (602) 280-1315 

Fax (602) 280-8144 

ARKANSAS 

Mr. Tracy L. Copeland 

Manager, State Clearinghouse 

Office of Intergovernmental Services 

Department of Finance and Administration 

1515 W. 7th Street, Room 412 

Little Rock, AR 72203 

Phone (501) 682-1074 

Fax (501) 682-5206 

CALIFORNIA 

Grants Coordinator 

Office of Planning and Research 

1400 Tenth Street, Room 121 

Sacramento, CA 95814 

Phone (916) 323-7480 

Fax (916) 323-3018 

DELAWARE

Mrs. Francine Booth 

Federal Aid Coordinator 

State Single Point of Contact 

Executive Department, Office of the Budget 

Thomas Collins Building 

P.O. Box 1401 

Dover, DE 19903 

Phone (302) 739-3326 

Fax (302) 739-5661 

DISTRICT OF COLUMBIA 

Mr. Charles E. Nichols 

State Single Point of Contact 

Office of Grants Management and Development

717 14th Street, NW, Suite 500 

Washington, DC 20001 

Phone (202) 727-6554 

Fax (202) 727-1617 

FLORIDA 

Florida State Clearinghouse 

Department of Community Affairs 

2740 Centerview Drive

Tallahassee, FL 32399-2100 

Phone (904) 922-5438 

Fax (904) 487-2899 

GEORGIA 

Mr. Tom Reid, III, Coordinator 

Georgia State Clearinghouse 

270 Washington Street, SW, Eighth Floor 

Atlanta, GA 30334 

Phone (404) 656-3855 

Fax (404) 656-3828 

ILLINOIS 

Ms. Virginia Bova 

State Single Point of Contact 

Dept. of Commerce & Community Affairs 

James R. Thompson Center

100 West Randolph, Suite 3-400

Chicago, IL 60601 

Phone (312) 814-6028 

Fax (312) 814-1800 
Appendix D Page D-2

INDIANA 

Ms. Frances E. Williams 

State Budget Agency 

212 State House 

Indianapolis, IN 46204 

Phone (317) 232-5619 

Fax (317) 233-3323 

IOWA 

Mr. Steven R. McCann 

Division for Community Progress 

Iowa Department of Economic Development 

200 East Grand Avenue 

Des Moines, IA 50309 

Phone (515) 242-4719 

Fax (515) 242-4809 

KENTUCKY 

Mr. Ronald W. Cook 

Office of the Governor 

Department of Local Government 

1024 Capital Center Drive 

Frankfort, KY 40601-8204 

Phone (502) 573-2382 

Fax (502) 573-2512 

MAINE

Ms. Joyce Benson 

State Planning Office 

184 State Street

State House Station #38 

Augusta, ME 04333 

Phone (207) 287-3261 

Fax (207) 287-6489 

MARYLAND 

Mr. William G. Carroll, Manager 

Plan and Project Review 

Maryland Office of Planning 

301 West Preston Street, Rm. 1104 

Baltimore, MD 21201-2365 

Phone (410) 225-4490 

Fax (410) 225-4480 

 

MICHIGAN 

Mr. Richard Pfaff 

Southeast Michigan Council of Governments 

660 Plaza Drive, Suite 1900

Detroit, MI 48226 

Phone (313) 961-4266 

Fax (313) 961-4869 

MISSISSIPPI 

Ms. Cathy Mallette, Clearinghouse Officer 

Department of Finance and Administration 

455 North Lamar Street

Jackson, MS 39202-3087 

Phone (601) 359-6762

Fax (601) 359-6764 

MISSOURI 

Ms. Lois Pohl 

Federal Assistance Clearinghouse 

Office of Administration 

P.O. Box 809 

Room 760, Tnunan Building 

Jefferson City, MO 65102 

Phone (314) 751-4834 

Fax (314) 751-7819 

NEVADA 

Department of Administration 

State Clearinghouse 

Capital Complex 

Carson City, NV 89710 

Phone (702) 687-4065 

Fax (702) 687-3983 

NEW HAMPSHIRE 

Mr. Jeffrey H. Taylor, Director

New Hampshire Office of State Planning 

Attn: Intergovernmental Review Process 

2 1/2 Beacon Street 

Concord, NH 03301 

Phone (603) 271-2155 

Fax (603) 271-1728 

NEW JERSEY 

Mr. Andrew J. Jaskolka 

State Review Process 

Intergovernmental Review Unit 

Department of Community Affairs 

101 South Broad Street 

CN 800 (Room 813A) 
Appendix D Page D-3

Trenton, NJ 08625-0800 

Phone (609) 292-9025 

Fax (609) 633-2132 

NEW MEXICO 

Mr. Robert Peters 

State Budget Division 

Bataan Memorial Building, Room 190 

Santa Fe, NM 87503 

Phone (505) 827-3640 

NEW YORK 

New York State Clearinghouse 

Division of the Budget 

State Capitol 

Albany, NY 12224 

Phone (518) 474-1605

FAX: (518) 486-5617 

NORTH CAROLINA 

Mrs. Chrys Baggett, Director 

North Carolina State Clearinghouse 

Office of the Secretary of Administration 

116 West Jones Street, Suite 5 106 

Raleigh, NC 27603-8003 

Phone (919) 733-7232 

Fax (919) 733-9571 

NORTH DAKOTA 

Mr. Jim Void 

North Dakota Single Point of Contact 

Office of Intergovernmental Assistance 

600 East Boulevard Avenue 

Bismarck, ND 58505-0170 

Phone (701) 224-2094 

Fax (701) 224-2308 

OHIO

Ms. Linda Wise 

State Clearinghouse 

Office of Budget and Management 

30 East Broad Street, 34th Floor 

Columbus, OH 43266-0411 

Phone (614) 466-0698 

FAX: (614) 466-5400 

RHODE ISLAND 

Mr. Kevin Nelson, Review Coordinator 

Department of Administration 

Office of Strategic Planning 

One Capitol Hill, 4th Floor 

Providence, RI 02908-5870 

Phone (401) 277-2656 

Fax (401) 277-2083 

SOUTH CAROLINA 

Mr. Rodney Grizzle 

State Single Point of Contact 

Grant Services 

Office of the Governor 

1205 Pendleton St., Room. 331 

Columbia, SC 29201 

Phone (803) 734-0494 

Fax (803) 734-0356 

TEXAS 

Mr. Tom Adams, Director 

Intergovernmental Coordination 

Governor's Office

P.O. Box 12428 

Austin, TX 78711 

Phone (512) 463-1771 

Fax (512) 936-2681 

UTAH 

Ms. Carolyn Wright 

Utah State Clearinghouse 

Office of Planning and Budget 

State Capitol, Room 116 

Salt Lake City, UT 84114 

Phone (801) 538-1535 

Fax (801) 538-1547 

VERMONT 

Ms. Jeanine Crosby 

State Single Point of Contact 

Pavilion Office Building 

109 State Street 

Montpelier, VT 05609 

Phone (802) 828-3326 

Fax (802) 828-3339 

WEST VIRGINIA 

Mr. Fred Cutlip, Director 
Appendix D Page D-4

Community Development Division 

West Virginia Development Office 

Building #6, Room 553 

Charleston, WV 25305 

Phone (304) 558-4010 

Fax (304) 558-3248 

WISCONSIN 

Mr. Jeff Smith 

Federal/State Relations Office 

Wisconsin Department of Administration 

101 East Wilson St., 6th Floor 

P.O. Box 7868 

Madison, WI 53707 

Phone (608) 266-0267 

Fax (608) 267-6931 

WYOMING 

Mr. Matthew Jones

State Single Point of Contact 

Office of the Governor

200 West 24th Street

State Capitol, Room 124

Cheyenne, WY 82002 

Phone (307) 777-7446 

Fax (307) 632-3909 

GUAM 

Mr. Giov T. Sgambelluri, Director 

Bureau of Budget & Management Research 

Office of the Governor 

P.O. Box 2950 

Agana, Guam 96910 

Phone 011-671-472-2285 

Fax 011-671-472-2825 

PUERTO RICO 

Ms. Norma Burgos, Chairwoman 

Mr. Jose E. Caro, Director 

Puerto Rico Planning Board 

Federal Proposals Review Office 

Minillas Government Center 

P.O. Box 41119 

San Juan, Puerto Rico 00940-1119 

Phone (809) 727-4444 or (809) 723-6190 

Fax (809) 724-3270 or (809) 724-3103 

MARIANA ISLANDS 

Ms. Jacoba T. Seman, Federal Programs

Coordinator

State Single Point of Contact 

Planning and Budget Office 

Office of the Governor 

Saipan, MP 96950

Phone (670) 664-2289

Fax (670) 664-2272 

VIRGIN ISLANDS 

Ms. Linda Clark 

Office of Management & Budget 

#41 Norregade Emancipation 

Garden Station, Second Floor 

Saint Thomas, Virgin Islands 00802 

Phone (809) 774-0750 

Fax (809) 776-0069