[Federal Register Volume 60, Number 64 (Tuesday, April 4, 1995)]
[Notices]
[Pages 17066-17084]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-8131]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families


Responsible Fatherhood Projects

AGENCY: Administration for Children and Families, (ACF), Department of 
Health and Human Services, (HHS).

 [[Page 17067]] ACTION: Announcement of the availability of funds and 
request for applications to demonstrate promising program interventions 
to encourage and increase responsible fatherhood.

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SUMMARY: The Administration for Children and Families (ACF) announces 
the availability of Federal funding to demonstrate promising program 
interventions to encourage and increase responsible fatherhood. Funding 
under this announcement is authorized by section 1110 of the Social 
Security Act governing Social Services Research and Demonstration 
activities (Catalog of Federal Domestic Assistance 93.647).

DATES: The closing date for submission of applications is June 5, 1995.

MAILING ADDRESSES: William J. McCarron, Administration for Children and 
Families, Division of Discretionary Grants--Room 6C-462, 370 L'Enfant 
Promenade SW., Washington, DC 20447. For hand delivered applications, 
use: William J. McCarron, Administration for Children and Families, 
Division of Discretionary Grants, 6th Floor, ACF Guard Station, 901 D 
Street SW., Washington, DC 20447.

FOR FURTHER INFORMATION CONTACT: Mark Fucello, Administration for 
Children and Families, Office of Policy and Evaluation, 370 L'Enfant 
Promenade SW., Washington, DC 20447. Telephone (202) 401-4538.

SUPPLEMENTARY INFORMATION: The Administration for Children and Families 
announces that competing applications are being accepted for Federal 
financial assistance to demonstrate promising program interventions to 
encourage and increase responsible fatherhood. Up to five awards will 
be made under this announcement for project periods of 24 months. Each 
successful recipient will receive a financial award for an initial 
budget period of 17 months. The second budget period, consisting of 
months 18 through 24, will be unfunded with Federal funds; applicants 
are encouraged to secure other sources of funding to cover these latter 
months of the project period. Each recipient will be expected to enter 
into a cooperative agreement with ACF which will outline the terms of 
ACF's interest and involvement in the project and the responsibilities 
of the recipient.
    This program announcement consists of three parts. Part I describes 
the activities supported by this announcement and application 
requirements. Part II describes the application review process. Part 
III provides information and instructions for the development and 
submission of applications. The forms to be used for submitting an 
application follow Part III.

Part I.--Project Design

Purpose

    The purpose of the announcement is to inform the public of the 
availability of Federal funding to demonstrate promising program 
interventions to encourage and increase responsible fatherhood. There 
is a growing body of evidence suggesting that the impact of fathers' 
participation on children's behavior is significant. Although research 
does not suggest a straightforward relationship between paternal 
participation in child rearing and child well-being, it can be 
reasonably assumed that children benefit emotionally and 
developmentally when fathers play a larger role in children's lives. 
According to this program announcement, ACF will provide funding to 
community programs designed to strengthen the role and parenting 
abilities of fathers and to enable fathers to relate positively to 
their children and their children's mothers. The target populations for 
these programs should encompass a wide range of fathers including 
disadvantaged, never-married non-custodial fathers; separated or 
divorced non-custodial fathers, as well as fathers living with their 
children.
    The recipients will operate projects designed to create an 
environment where fathers are encouraged and supported in conduct that 
allows them to improve the quality of life for their families. Projects 
should provide comprehensive services designed to assist men and their 
families for the purpose of attempting to reverse the negative trends 
among adults and youth related to at-risk behaviors such as substance 
abuse, gang involvement, school failure, and unemployment. Beyond 
encouraging and increasing basic responsible acts such as establishing 
paternity and encouraging contact between father and children, programs 
should teach fathers:
    <bullet> How to understand their children's development,
    <bullet> How to understand and positively affect their children's 
behavior,
    <bullet> How to be positive role models for their children, and
    <bullet> How to work constructively with the children's mother for 
the benefit of the children regardless of whether both parents live in 
the same household as the children.

Eligible Applicants

    Organizations eligible to apply for financial assistance under this 
announcement include States, local governments, and public or private 
nonprofit organizations. Any nonprofit organization submitting an 
application must submit proof of its nonprofit status in its 
application at the time of submission. The nonprofit agency can 
accomplish this by providing a copy of the applicant's listing in the 
Internal Revenue Service's (IRS) most recent list of tax-exempt 
organizations described in section 501(c)(3) of the IRS code or by 
providing a copy of the currently valid IRS tax exemption certificate, 
or by providing a copy of the articles of incorporation bearing the 
seal of the State in which the corporation or association is domiciled.
    ACF is interested in providing financial support to organizations: 
With experience in working with fathers and which are knowledgeable 
about the issues concerning fathers; with developed plans and methods 
to teach fathers how to act responsibly and to understand their 
children's development and positively affect their children's behavior; 
and which have significant, long-term financial support ensuring 
uninterrupted project operation beyond the projected period of federal 
assistance.

Minimum Requirements for Project Design

    In order to compete successfully in response to this announcement, 
the applicant should develop an application which:
    <bullet> Describes the applicant's experience in working with 
fathers. The description should highlight the applicant's experience in 
coordinating services from different providers or levels of government 
aimed at encouraging men to be responsible fathers and should describe 
the men whom the project has served. The types of services provided or 
to which clients are referred may include health and nutrition 
instruction, employment and career counseling, parenting education, 
peer support, and formal and informal mediation and dispute resolution 
with the children's mother, etc.
    <bullet> Explains the applicant's methods to teach fathers how to 
act responsibly and to adopt behaviors which exemplify the following 
principles: Raising children requires an active commitment from both 
parents--financially and emotionally; employment is important to being 
a responsible father not only to provide financial support but also to 
be a good role model; and successful child-rearing depends on 
understanding how children develop. The application must explain in 
detail how the proposed project aims to enable fathers at risk of 
[[Page 17068]] destructive behaviors to develop an achievement 
orientation from which they will be better able to act responsibly and 
to interact constructively with the children and the children's mother 
regardless of whether both parents live in the same household as the 
children.
    <bullet> Identifies the typical settings or points in fathers' 
lives that the applicant first engages and enrolls individuals for 
program services, e.g., in-hospital recruitment of new fathers, 
community centers where neighborhood men gather, half-way houses, etc. 
ACF is interested in funding a group of programs which together engage 
men at various points in their lives and in various settings to help 
develop for the public a better understanding about how to structure 
programs and services for fathers.
    <bullet> Includes assurance that the recipient will produce two 
major reports (in addition to regular quarterly progress reports) to be 
issued during the project. The initial major report, due mid-way into 
the project, should discuss program implementation and participation 
and activities of fathers, including a discussion of program approaches 
and activities, paternity establishment, level of employment among 
participating fathers, and level of contact of fathers with their 
children as well as with the children's mother. The final report, due 
at the end of the project (90 days after the end of the 24-month 
project period), should cover the topics discussed above with longer 
follow-up and more detailed discussion of the project's staffing 
structure; procedures for referrals to services and coordination with 
other public and private agencies; type and duration of services 
actually provided; procedures and criteria used in recruitment and 
training of staff; and recommendations for others seeking to establish 
similar projects. Recommendations should include a discussion of the 
project's contextual factors, such as the social, economic, and 
political forces that may have a bearing on the implementation of this 
type of project. These reports are intended to further the general 
knowledge of the public, community-based organizations, and social 
service departments regarding program interventions to increase 
responsible fatherhood. In addition regular quarterly progress reports 
must be submitted within 60 days of the end of each quarter of the 24-
month project period.
    <bullet> Includes assurance of the recipient's willingness and 
intention to participate in and cooperate with evaluability assessment 
activities to be funded by the Department of Health and Human Services, 
possibly leading to a full-scale program evaluation if determined to be 
feasible.
    <bullet> Includes financial support for project activities in 
addition to Federal funding to ensure uninterrupted project operation 
over the project period. ACF will give preference to applicants who 
provide evidence of significant, long-term financial support ensuring 
uninterrupted project operation beyond the period of federal 
assistance. Applicants should provide evidence of funding commitments 
from organizations such as private foundations.
    Also, the recipient must be prepared to enter into a cooperative 
agreement with ACF which will outline the terms of ACF's interest and 
involvement in the project and the responsibilities of the recipient. 
The cooperative agreement:
    (a) Will provide that ACF retain authority for review of 
significant program design changes from the model proposed in the 
original application; (b) will provide that ACF maintain involvement in 
any evaluability assessment activities to be funded by the Department 
of Health and Human Services, and (c) will provide for ACF review of 
reports (other than quarterly progress reports) before publication.

Project Duration

    This announcement is soliciting applications for project periods of 
24 months. Awards, on a competitive basis, will be for an initial 17-
month budget period, although project periods will be for 24 months, 
subject to availability of funds. Each recipient will receive an 
initial financial award for 17 months. The second budget period, 
consisting of months 18 through 24, will be unfunded with Federal 
funds; applicants are encouraged to secure other sources of funding to 
cover these latter months of the project period.

Federal Share of the Project

    The maximum Federal share of each project is not to exceed $85,000 
for the initial 17-month budget period, subject to the availability of 
funds.

Matching Requirement

    Recipients must provide at least 20 percent of the total approved 
cost of the project. The total approved cost of the project is the sum 
of the ACF share and the non-Federal share. The non-Federal share may 
be met by in-kind contributions from a third party or cash, although 
applicants are encouraged to meet their match requirements through cash 
contributions. Therefore, a project requesting $85,000 in Federal funds 
must include a match of at least $21,250 (20 percent of total project 
cost).
    If approved for funding, recipients will be held accountable for 
commitments of non-Federal resources; and failure to provide the 
required amount will result in a disallowance of unmatched Federal 
funds.

Anticipated number of Projects to be Funded

    Five projects will be funded under this announcement. A single 
organization may apply on behalf of separate project sites operated by 
the same organization. If operated by the same organization, each 
project site which applies must submit a separate application.

Part II--The Review Process

A. Review Process and Funding Decisions

    Timely applications from eligible applicants will be reviewed and 
scored competitively. Reviewers will use the evaluation criteria listed 
below to review and score the application.
    In addition ACF may refer applications for review to other Federal 
or non-Federal entities when it is determined to be in the best 
interest of the Federal Government or the applicant. It may also 
solicit comments from ACF Regional Office staff, other Federal 
agencies, interested foundations and national organizations. These 
comments along with those of the reviewers will be considered by ACF in 
making the funding decision.
    In making a funding decision, ACF may give preference to 
applications which reflect experience in working with fathers since 
such experience on the part of an applicant has the potential to 
substantially improve the theory and practice of increasing responsible 
behavior among fathers and improving the well-being of their children.
    ACF may also give preference to applicants who make a greater 
financial commitment to the demonstration since a greater total 
financial investment than the minimum required in this announcement has 
the potential of producing a high benefit in furthering knowledge about 
policies and practice of working with fathers for a low Federal 
investment.

B. Evaluation Criteria

    Using the evaluation criteria below, reviewers will review and 
score each application. Applicants should insure that they address each 
minimum requirement listed above.
    Reviewers will determine the strengths and weaknesses of each 
[[Page 17069]] application in terms of the appropriate evaluation 
criteria listed below, provide comments, and assign numerical scores. 
The point value following each criterion heading indicates the maximum 
numerical weight that each criterion may be given in the review 
process.

Review Criteria

    (1) Organizational experience (15 points) The application should 
provide evidence of organizational experience in working with fathers 
including disadvantaged, never-married non-custodial fathers; separated 
or divorced non-custodial fathers, as well as fathers living with their 
children. Evidence of this experience should include a complete 
description of past or current projects which serve fathers and are 
aimed at improving their understanding of their responsibilities to 
their children, their roles as fathers, and their children's 
development.
    (2) Staff skills and responsibilities (15 points) The application 
should list each consultant or other key individuals who will work on 
the project along with a short description of the nature of their 
contribution. Summarize the background and experience of the project 
director and key project staff. Applicants are encouraged to discuss 
staff experience in working with fathers.
    (3) Knowledge of issues concerning fathers (15 points) The 
application should provide evidence of the applicant's understanding of 
the demographics and experiences of fathers, including disadvantaged, 
never-married non-custodial fathers; separated or divorced non-
custodial fathers, as well as fathers living with their children. 
Evidence of this understanding should include (a) knowledge of key 
issues concerning fathers, any obstacles to effecting healthy levels of 
paternal involvement in their children's lives, and strengths and 
deficits of fathers in meeting their responsibilities to their 
children; and (b) if appropriate to the target population of fathers 
considered, familiarity with how men interact with child support 
enforcement systems, courts, employment and training programs, and 
social service agencies.
    (4) Approach and project design (50 points) The application should 
describe how the organization will operate projects designed to create 
an environment where fathers are encouraged and supported in conduct 
that allows them to improve the quality of life for their families. The 
application should explain the applicant's methods to teach fathers how 
to act responsibly and to adopt behaviors which exemplify the following 
principles: Raising children requires an active commitment from both 
parents--financially and emotionally; employment is important to being 
a responsible father not only to provide financial support but also to 
be a good role model; and successful child-rearing depends on 
understanding how children develop. The application must explain in 
detail the typical settings or points in fathers' lives that the 
applicant first plans to engage and enroll individuals for program 
services, e.g., in-hospital, community centers, employment agency, etc. 
The application should explain how the project plans to increase basic 
responsible acts among fathers, such as establishing paternity and 
encouraging contact between father and children, but also, and more 
important, how programs will teach fathers to understand their 
children's development, to understand and positively affect their 
children's behavior, to be positive role models for their children, and 
to work constructively with the children and the children's mother 
regardless of whether both parents live in the same household as the 
children. The application should also describe the types of services to 
be provided or to which clients will be referred, e.g., health and 
nutrition instruction, employment and career counseling, parenting 
education, peer support, formal and informal mediation and dispute 
resolution with the children's mother, etc.
    (5) Budget Appropriateness (5 points) The application should 
demonstrate that the project's costs are reasonable in view of the 
anticipated results and benefits. Applicants may refer to the budget 
information presented in the Standard Forms 424 and 424A.

Part III. Instructions for the Development and Submission of 
Applications

    This part contains information and instructions for submitting 
applications in response to this announcement. Application forms are 
provided as part of this announcement along with a checklist for 
assembling an application package.

A. Required Notification of the State Single Point of Contact

    This program announcement is covered under Executive Order 12372, 
``Intergovernmental Review of Federal Programs,'' and 45 CFR part 100, 
``Intergovernmental Review of Department of Health and Human Services 
Program and Activities.'' Under the Order, States may design their own 
processes for reviewing and commenting on proposed Federal assistance 
under covered programs.
    All States and Territories except Alabama, Alaska, Colorado, 
Connecticut, Hawaii, Idaho, Kansas, Louisiana, Minnesota, Montana, 
Nebraska, Oklahoma, Oregon, Virginia, Pennsylvania, South Dakota, 
Washington, American Samoa and Palau have elected to participate in the 
Executive Order process and have established Single Points of Contact 
(SPOCs), listed at the end of this announcement. Applicants from these 
nineteen jurisdictions need take no action regarding E.O. 12372. 
Applicants for projects to be administered by Federally-recognized 
Indian Tribes are also exempt from the requirements of E.O. 12372. 
Otherwise, applicants should contact their SPOCs as soon as possible to 
alert them of the prospective applications and receive any necessary 
instructions. Applicants must submit any required material to the SPOCs 
as soon as possible so that the program office can obtain and review 
SPOC comments as part of the award process. It is imperative that the 
applicant submit all required materials, if any, to the SPOC and 
indicate the date of this submittal (or the date of contact if no 
submittal is required) on the Standard Form 424, item 16a.
    Under 45 CFR 100.8(a)(2), a SPOC has 60 days from the application 
deadline to comment on proposed new or competing continuation awards. 
SPOCs are encouraged to eliminate the submission of routine 
endorsements as official recommendations. Additionally, SPOCs are 
requested to clearly differentiate between mere advisory comments and 
those official State process recommendations which may trigger the 
``accommodate or explain'' rule.
    When comments are submitted directly to ACF, they should be 
addressed to: Department of Health and Human Services, Administration 
for Children and Families, Division of Discretionary Grants, 370 
L'Enfant Promenade, SW, Washington, DC. 20447.

B. Deadline for Submittal of Applications

    Applications shall be considered as meeting an announced deadline 
if they are either:
    1. Received on or before the deadline date at the receipt point 
specified in this program announcement, or
    2. Sent on or before the deadline date and received by ACF in time 
for the independent review. Applicants are cautioned to request a 
legibly dated U.S. Postal Service postmark or to obtain a legibly dated 
receipt from a commercial carrier or U.S. Postal Service. Private 
[[Page 17070]] Metered postmarks shall not be acceptable as proof of 
timely mailing.
    Late applications: Applications which do not meet the criteria in 1 
and 2 above are considered late applications. ACF shall notify each 
late applicant that its application will not be considered in the 
current competition.
    Extension of deadlines: ACF may extend the deadline for all 
applicants because of acts of God such as floods, hurricanes, etc., or 
when there is a widespread disruption of the mails. However, if ACF 
does not extend the deadline for all applicants, it will not extend the 
deadline for any applicants.

C. Instructions for Preparing the Application

    In order to assist applicants in completing the application, the 
Standard Forms 424 and 424A, required certifications, and a list of 
SPOCs have been included at the end of Part III of this announcement. 
Please reproduce single-sided copies of these forms from the reprinted 
forms and type your information onto the copies. Do not use forms 
directly from the Federal Register announcement, as they are printed on 
both sides of the page.
    Please prepare your application in accordance with the following 
instructions:

1. SF 424 Page 1, Application Cover Sheet

    Please read the following instructions before completing the 
application cover sheet. An explanation of each item is included. 
Complete only the items specified.
    Item 1. ``Type of Submission''--Non-Construction.
    Item 2. ``Date Submitted'' and ``Applicant Identifier''--Date 
application is submitted to ACF and applicant's own internal control 
number, if applicable.
    Item 3. ``Date Received By State''--State use only (if applicable).
    Item 4. ``Date Received by Federal Agency''--Leave blank.
    Item 5. ``Applicant Information'' ``Legal Name''--Enter the legal 
name of applicant organization. For applications developed jointly, 
enter the name of the lead organization only. There must be a single 
applicant for each application.
    ``Organizational Unit''--Enter the name of the primary unit within 
the applicant organization which will actually carry out the project 
activity. If this is the same as the applicant organization, leave the 
organizational unit blank.
    ``Address''--Enter the complete address that the organization 
actually uses to receive mail, since this is the address to which all 
correspondence will be sent. Do not include both street address and 
P.O. box number unless both must be used in mailing.
    ``Name and telephone number of the person to be contacted on 
matters involving this application (give area code)''--Enter the full 
name and telephone number of a person who can respond to questions 
about the application. This person should be accessible at the address 
given.
    Item 6. ``Employer Identification Number (EIN)''--Enter the 
employer identification number of the applicant organization, as 
assigned by the Internal Revenue Service, including, if known, the 
Central Registry System suffix.
    Item 7. ``Type of Applicant''--Self-explanatory.
    Item 8. ``Type of Application''--New.
    Item 9. ``Name of Federal Agency''--DHHS/ACF.
    Item 10. ``Catalog of Federal Domestic Assistance Number''--93.647.
    Item 11. ``Descriptive Title of Applicant's Project''--Responsible 
Fatherhood Project.
    Item 12. ``Areas Affected by Project''--Self-explanatory.
    Item 13. ``Proposed Project''--Enter the desired start date for the 
project and projected completion date.
    Item 14. ``Congressional District of Applicant/Project''--Enter the 
number of the Congressional district where the applicant's principal 
office is located.
    Items 15 ``Estimated Funding Levels''--In completing 15a through 
15f, the dollar amounts entered should reflect the total amount 
requested for the initial 17-month budget period.
    Item 15a. Enter the amount of Federal funds requested in accordance 
with the preceding paragraph. This amount should be no greater than the 
maximum amount available under this announcement for the initial 17-
month budget period.
    Items 15b-e Enter the amount(s) of funds from non-Federal sources 
that will be contributed to the proposed project. Items b-e are 
considered cost-sharing or ``matching funds.''
    Item 15f. Enter the estimated amount of income, if any, expected to 
be generated from the proposed project. Do not add or subtract this 
amount from the total project amount entered under item 15g. Describe 
the nature, source and anticipated use of this income in the Project 
Narrative Statement.
    Item 15g. Enter the sum of items 15a-15e.
    Item 16a. ``Is Application Subject to Review By State Executive 
Order 12372 Process?--Check ``Yes'' if your State participates in the 
E.O. 12372 process. Enter the date the application was made available 
to the State for review. Select the appropriate SPOC from the listing 
provided at the end of Part IV. The review of the application is at the 
discretion of the SPOC.
    Item 16b. ``Is Application Subject to Review By State Executive 
Order 12372 Process?--Check ``No'' if the program has not been selected 
by State for review.
    Item 17. ``Is the Applicant Delinquent on any Federal Debt?''--
Check the appropriate box. This question applies to the applicant 
organization, not the person who signs as the authorized 
representative. Categories of debt include audit disallowances, loans 
and taxes.
    Item 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.''--To be signed by the authorized representative of the 
applicant. A copy of the governing body's authorization for signature 
of this application by this individual as the official representative 
must be on file in the applicant's office, and may be requested from 
the applicant.
    Item 18a-c. ``Typed Name of Authorized Representative, Title, 
Telephone Number''--Enter the name, title and telephone number of the 
authorized representative of the applicant organization.
    Item 18d. ``Signature of Authorized Representative''--Signature of 
the authorized representative named in Item 18a. At least one copy of 
the application must have an original signature. Use colored ink (not 
black) so that the original signature is easily identified.
    Item 18e. ``Date Signed''--Enter the date the application was 
signed by the authorized representative.

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

    This is a form used by many Federal agencies. For this application, 
Sections A, B, and C are to be completed. Sections D, E and F do not 
need to be completed.
    Section A--Budget Summary. Line 1:
    Column (a): Enter ``Responsible Fatherhood'';
    Column (b): Enter 93.647.
    Columns (c) and (d): Leave blank.
    Columns (e), (f) and (g): Enter the appropriate amounts needed to 
support the project for the budget period.
    Section B--Budget Categories. This budget should include the 
Federal as well as non-Federal funding for the proposed project for the 
budget period. [[Page 17071]] The budget should relate to item 15g, 
total funding, on the SF 424. Under column (5), enter the total 
requirements for funds (Federal and non-Federal) by object class 
category.
    A separate budget justification should be included to explain fully 
and justify major items, as indicated below. The types of information 
to be included in the justification are indicated under each category. 
The budget justification should immediately follow the second page of 
the SF 424A.
    Personnel--Line 6a. Enter the total costs of salaries and wages of 
applicant/grantee staff. Do not include the costs of consultants, which 
should be included on line 6h, ``Other.''
    Justification: Identify the project director, if known. Specify by 
title or name the percentage of time allocated to the project, the 
individual annual salaries, and the cost to the project (both Federal 
and non-Federal) of the organization's staff who will be working on the 
project.
    Fringe Benefits--Line 6b. Enter the total costs of fringe benefits.
    Justification: Provide a break-down of amounts and percentages that 
comprise fringe benefit costs, such as health insurance, FICA, 
retirement insurance, etc.
    Travel--6c. Enter total costs of out-of-town travel (travel 
requiring per diem) for staff of the project. Do not enter costs for 
consultant's travel or local transportation, which should be included 
on Line 6h, ``Other.''
    Justification: Include the name(s) of traveler(s), total number of 
trips, destinations, length of stay, transportation costs and 
subsistence allowances.
    Equipment--Line 6d. Enter the total costs of all equipment to be 
acquired by the project. For grants governed by the administrative 
requirements of either 45 CFR Part 92 or 45 CFR Part 74, equipment is 
defined as tangible, non-expendable personal property having a useful 
life of more than one year and an acquisition cost of $5,000 or more 
per unit.
    Justification: Equipment to be purchased with Federal funds must be 
justified. The equipment must be required to conduct the project, and 
the applicant organization or its subgrantees must not have the 
equipment or a reasonable facsimile available to the project. The 
justification also must contain plans for future use or disposal of the 
equipment after the project ends.
    Supplies--Line 6e. Enter the total costs of all tangible expendable 
personal property (supplies) other than those included on Line 6d.
    Justification: Specify general categories of supplies and their 
costs.
    Contractual--Line 6f. Enter the total costs of all contracts, 
including procurement contracts (except those which belong on other 
lines such as equipment, supplies, etc.) and contracts with secondary 
recipient organizations. Also include any contracts with organizations 
for the provision of technical assistance. Do not include payments to 
individuals on this line.
    Justification: Attach a list of contractors, indicating the names 
of the organizations, the purposes of the contracts, and the estimated 
dollar amounts of the awards as part of the budget justification. 
Whenever the applicant/grantee intends to delegate part or all of the 
program to another agency, the applicant/grantee must complete this 
section (Section B, Budget Categories) for each delegate agency by 
agency title, along with the supporting information. The total cost of 
all such agencies will be part of the amount shown on Line 6f. Provide 
backup documentation identifying the name of contractor, purpose of 
contract, and major cost elements.
    Construction--Line 6g. Not applicable. New construction is not 
allowable.
    Other--Line 6h. Enter the total of all other costs. Where 
applicable, such costs may include, but are not limited to: Insurance; 
medical and dental costs; noncontractual fees and travel paid directly 
to individual consultants; local transportation (all travel which does 
not require per diem is considered local travel); space and equipment 
rentals; printing and publication; computer use; training costs, 
including tuition and stipends; training service costs, including wage 
payments to individuals and supportive service payments; and staff 
development costs. Note that costs identified as ``miscellaneous'' and 
``honoraria'' are not allowable.
    Justification: Specify the costs included.
    Total Direct Charges--Line 6i. Enter the total of Lines 6a through 
6h.
    Indirect Charges--6j. Enter the total amount of indirect charges 
(costs). If no indirect costs are requested, enter ``none.'' This line 
should be used when the applicant (except local governments) has a 
current indirect cost rate agreement approved by the Department of 
Health and Human Services or another Federal agency.
    Local and State governments should enter the amount of indirect 
costs determined in accordance with HHS requirements. When an indirect 
cost rate is requested, these costs are included in the indirect cost 
pool and should not be charged again as direct costs to the grant. In 
the case of training grants to other than State or local governments 
(as defined in title 45, Code of Federal Regulations, part 74), the 
Federal reimbursement of indirect costs will be limited to the lesser 
of the negotiated (or actual) indirect cost rate or 8 percent of the 
amount allowed for direct costs, exclusive of any equipment charges, 
rental of space, tuition and fees, post-doctoral training allowances, 
contractual items, and alterations and renovations.
    Justification: Enclose a copy of the indirect cost rate agreement, 
if applicable.
    Total--Line 6k. Enter the total amounts of lines 6i and 6j.
    Program Income--Line 7. Enter the estimated amount of income, if 
any, expected to be generated from this project. Do not add or subtract 
this amount from the total project amount.
    Justification: Describe the nature, source, and anticipated use of 
program income in the Program Narrative Statement.
    Section C--Non-Federal Resources. This section summarizes the 
amounts of non-Federal resources that will be applied to the grant. On 
lines 8-11, list estimates for each projected budget period within the 
total project period (if an additional line is needed, use line 23 and 
label it appropriately). Enter total amounts on line 12.
    In-kind contributions are defined in title 45 of the Code of 
Federal Regulations, Sec. 74.2, as the value of non-cash contributions 
provided by non-Federal third parties. Third party in-kind 
contributions may be in the form of real property, equipment, supplies 
and other expendable property, and the value of goods and services 
directly benefiting and specifically identifiable to the project or 
program.
    Justification: Describe third party in-kind contributions, if 
included.
    Section D--Forecasted Cash Needs. Not applicable.
    Section E--Budget Estimate of Federal Funds Needed For Balance of 
the Project. Not applicable
    Section F--Other Budget Information. Not applicable.

3. Program Narrative Statement

    The Program Narrative Statement should be clear, concise, and 
address the specific requirements mentioned under Part I. The narrative 
should also provide information concerning how the application meets 
the evaluation criteria using the following headings:
    (a) Organizational Experience;
    (b) Staff Skills and Responsibilities; [[Page 17072]] 
    (c) Knowledge of Issues Concerning Fathers;
    (d) Approach and Project Design;
    (e) Budget Appropriateness.
    The specific information to be included under each of these 
headings is described in section B of Part II--Evaluation Criteria.
    The narrative should be typed double-spaced. All pages of the 
narrative (including charts, references, footnotes, tables, maps, 
exhibits, etc.) must be sequentially numbered, beginning with 
``Organizational Experience.'' The length of the application, including 
the application forms and all attachments, should not exceed 50 pages.

4. Assurances/Certifications

    Applicants are required to file an SF 424B, Assurances--Non-
Construction Programs, and the Certification Regarding Lobbying. Both 
must be signed and returned with the application. In addition, 
applicants must certify their compliance with: (1) Drug-Free Workplace 
Requirements; (2) Debarment and Other Responsibilities; and (3) 
Certification Regarding Environmental Tobacco Smoke. These 
certifications are self-explanatory. Copies of these assurances and 
certifications are reprinted at the end of this announcement and should 
be reproduced, as necessary. A duly authorized representative of the 
applicant organization must certify that the applicant is in compliance 
with these assurances and certifications. A signature on the SF 424 
indicates compliance with Drug-Free Workplace Requirements, Debarment 
and Other Responsibilities, and Environmental Tobacco Smoke 
certifications.

D. Checklist for a Complete Application

    The checklist below is for your use to ensure that your application 
package has been properly prepared.

--One original application, signed and dated, plus two copies.
--Complete application length should not exceed 60 pages.
--A complete application consists of the following items in this order:
    <bullet> Application for Federal Assistance (SF 424);
    <bullet> A completed SPOC certification with the date of SPOC 
contact entered in line 16, page 1 of the SF 424 if applicable;
    <bullet> Budget Information--Non-construction programs (SF 424A);
    <bullet> Budget Justification for SF 424A Section B--Budget 
Categories;
    <bullet> Letter from the Internal Revenue Service to prove 
nonprofit status, if necessary;
    <bullet> Copy of the applicant's approved indirect cost rate 
agreement, if appropriate;
    <bullet> Program Narrative Statement (See Part II, Section C);
    <bullet> Assurances--Non-construction programs (SF 424B); and
    <bullet> Certification Regarding Lobbying.

E. Submitting the Application

    Each application package must include an original and two copies of 
the complete application. Each copy should be stapled securely. All 
pages of the narrative (including charts, tables, maps, exhibits, etc.) 
must be sequentially numbered. In order to facilitate handling, please 
do not use covers, binders, or tabs.
    Applicant should include a self-addressed, stamped acknowledgment 
card. All applicants will be notified automatically about the receipt 
of their application.


    Dated: March 28, 1995.
Howard Rolston,
Director, Office of Policy and Evaluation.

                                                 BILLING CODE 4184-01-P
[[Page 17073]]

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BILLING CODE 4184-01-C
[[Page 17074]]

Instructions for the SF 424

    This is a standard form used by applicants as a required 
facesheet for preapplications and applications submitted for Federal 
assistance. It will be used by Federal agencies to obtain applicant 
certification that States which have established a review and 
comment procedure is response to Executive Order 12372 and have 
selected the program to be included in their process, have been 
given an opportunity to review the applicant's submission.
    Item and Entry:
    1. Self-explanatory.
    2. Date application submitted to Federal agency (or State if 
applicable) & applicant's control number (if applicable).
    3. State use only (if applicable).
    4. If this application is to continue or revise an existing 
award, enter present Federal identifier number. If for a new 
project, leave blank.
    5. Legal name of applicant, name of primary organizational unit 
which will undertake the assistance activity, complete address of 
the applicant, and name and telephone number of the person to 
contact on matters related to this application.
    6. Enter Employer Identification Number (EIN) as assigned by the 
Internal Revenue Service.
    7. Enter the appropriate letter in the space provided.
    8. Check appropriate box and enter appropriate letter(s) in the 
space(s) provided:

--``New'' means a new assistance award.
--``Continuation'' means an extension for an additional funding/
budget period for a project with a projected completion date.
--``Revision'' means any change in the Federal Government's 
financial obligation or contingent liability from an existing 
obligation.

    9. Name of Federal agency from which assistance is being 
requested with this application.
    10. Use the Catalog of Federal Domestic Assistance number and 
title of the program under which assistance is requested.
    11. Enter a brief descriptive title of the project. If more than 
one program is involved, you should append an explanation on a 
separate sheet. If appropriate (e.g., construction or real property 
projects), attach a map showing project location. For 
preapplications, use a separate sheet to provide a summary 
description of this project.
    12. List only the largest political entities affected (e.g., 
State, counties, cities).
    13. Self-explanatory.
    14. List the applicant's Congressional District and any 
District(s) affected by the program or project.
    15. Amount request or to be contributed during the first 
funding/budget period by each contributor. Value of in-kind 
contributions should be included on appropriate lines as applicable. 
If the action will result in a dollar change to an existing award, 
indicate only the amount of the change. For decreases, enclose the 
amounts in parentheses. If both basic and supplemental amounts are 
included, show breakdown on an attached sheet. For multiple program 
funding, use totals and show breakdown using same categories as item 
15.
    16. Applicants should contact the State Single Point of Contact 
(SPOC) for Federal Executive Order 12372 to determine whether the 
application is subject to the State intergovernmental review 
process.
    17. This question applies to the applicant organization, not the 
person who signs as the authorized representative. Categories of 
debt include delinquent audit disallowances, loans and taxes.
    18. To be signed by the authorized representative of the 
applicant. A copy of the governing body's authorization for you to 
sign this application as official representative must be on file in 
the applicant's office. (Certain Federal agencies may require that 
this authorization be submitted as part of the application.)

                                                 BILLING CODE 4184-01-P
[[Page 17075]]

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[[Page 17076]]

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BILLING CODE 4184-01-C
[[Page 17077]]

Instructions for the SF-424A

General Instructions

    This form is designed so that application can be made for funds 
from one or more grant programs. In preparing the budget, adhere to 
any existing Federal grantor agency guidelines which prescribe how 
and whether budgeted amounts should be separately shown for 
different functions or activities within the program. For some 
programs, grantor agencies may require budgets to be separately 
shown by function or activity. For other programs, grantor agencies 
may require a breakdown by function or activity. Sections A, B, C, 
and D should include budget estimates for the whole project except 
when applying for assistance which requires Federal authorization in 
annual or other funding period increments. In the latter case, 
Sections A, B, C, and D should provide the budget for the first 
budget period (usually a year) and Section E should present the need 
for Federal assistance in the subsequent budget periods. All 
applications should contain a breakdown by the object class 
categories shown in Lines a-k of Section B.

Section A. Budget Summary

    Lines 1-4, Columns (a) and (b)--For applications pertaining to a 
single Federal grant program (Federal Domestic Assistance Catalog 
number) and not requiring a functional or activity breakdown, enter 
on Line 1 under Column (a) the catalog program title and the catalog 
number in Column (b).
    For applications pertaining to a single program requiring budget 
amounts by multiple functions or activities, enter the name of each 
activity or function on each line in Column (a), and enter the 
catalog number in Column (b). For applications pertaining to 
multiple programs where none of the programs require a breakdown by 
function or activity, enter the catalog program title on each line 
in Column (a) and the respective catalog number on each line in 
Column (b).
    For applications pertaining to multiple programs where one or 
more programs require a breakdown by function or activity, prepare a 
separate sheet for each program requiring the breakdown. Additional 
sheets should be used when one form does not provide adequate space 
for all breakdown of data required. However, when more than one 
sheet is used, the first page should provide the summary totals by 
programs.

Lines 1-4, Columns (c) through (g)

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

Section B. Budget Categories

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

Section C. Non-Federal Resources

    Lines 8-11--Enter amounts of non-Federal resources that will be 
used on the grant. If in-kind contributions are included, provide a 
brief explanation on a separate sheet.
    Column (a)--Enter the program titles identical to Column (a), 
Section A. A breakdown by function or activity is not necessary.
    Column (b)--Enter the contribution to be made by the applicant.
    Column (c)--Enter the amount of the State's cash and in-kind 
contribution if the applicant is not a State or State agency. 
Applicants which are a State or State agencies should leave this 
column blank.
    Column (d)--Enter the amount of cash and in-kind contributions 
to be made from all other sources.
    Column (e)--Enter totals of Columns (b), (c), and (d).
    Line 12--Enter the total for each of Columns (b)-(e). The amount 
in Column (e) should be equal to the amount on Line 5, Column (f), 
Section A.

Section D. Forecasted Cash Needs

    Line 13--Enter the amount of cash needed by quarter from the 
grantor agency during the first year.
    Line 14--Enter the amount of cash from all other sources needed 
by quarter during the first year.
    Line 15--Enter the totals of amounts on Lines 13 and 14.

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

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

Section F. Other Budget Information

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

Assurances--Non-Construction Programs

    Note: Certain of these assurances may not be applicable to your 
project or program. If you have questions, please contact the 
awarding agency. Further, certain Federal awarding agencies may 
require applicants to certify to additional assurances. If such is 
the case, you will be notified.
    As the duly authorized representative of the applicant I certify 
that the applicant:
    1. Has the legal authority to apply for Federal assistance, and 
the institutional, managerial and financial capability (including 
funds sufficient to pay the non-Federal share of project costs) to 
ensure proper planning, management and completion of the project 
described in this application.
    2. Will give the awarding agency, the Comptroller General of the 
United States, and if appropriate, the State, through any authorized 
representative, access to and the right to examine all records, 
books, papers, or documents related to the award; and will establish 
a proper accounting system in accordance with generally accepted 
accounting standards or agency directives.
    3. Will establish safeguards to prohibit employees from using 
their positions for a [[Page 17078]] purpose that constitutes or 
presents the appearance of personal or organizational conflict of 
interest, or personal gain.
    4. Will initiate and complete the work within the applicable 
time frame after receipt of approval of the awarding agency.
    5. Will comply with the Intergovernmental Personnel Act of 1970 
(42 U.S.C Secs. 4728-4763) relating to prescribed standards for 
merit systems for programs funded under one of the nineteen statutes 
or regulations specified in Appendix A of OPM's Standards for a 
Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
    6. Will comply with all Federal statutes relating to 
nondiscrimination. These include but are not limited to: (a) Title 
VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits 
discrimination on the basis of race, color or national origin; (b) 
Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 
Secs. 1681-1683, and 1685-1686), which prohibits discrimination on 
the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, 
as amended (29 U.S.C. Sec. 794), which prohibits discrimination on 
the basis of handicaps; (d) the Age Discrimination Act of 1975, as 
amended (42 U.S.C. Secs. 6101-6107), which prohibits discrimination 
on the basis of age;
    (e) the drug Abuse Office and Treatment Act of 1972 (P.L. 92-
255), as amended, relating to nondiscrimination on the basis of drug 
abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism 
Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), 
as amended, relating to nondiscrimination on the basis of alcohol 
abuse or alcoholism; (g) Secs. 523 and 527 of the Public Health 
Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee-3), as amended, 
relating to confidentiality of alcohol and drug abuse patient 
records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. 
Sec. 3601 et seq.), as amended, relating to nondiscrimination in the 
sale, rental or financing of housing; (i) any other 
nondiscrimination provisions in the specific statute(s) under which 
application for Federal assistance is being made; and (j) the 
requirements of any other nondiscrimination statute(s) which may 
apply to the application.
    7. Will comply, or has already complied, with the requirements 
of Titles II and III of the uniform Relocation Assistance and Real 
Property Acquisition Policies Act of 1970 (P.L. 91-646) which 
provide for fair and equitable treatment of persons displaced or 
whose property is acquired as a result of Federal or federally 
assisted programs. These requirements apply to all interests in real 
property acquired for project purposes regardless of Federal 
participation in purchases.
    8. Will comply with the provisions of the Hatch Act (5 U.S.C. 
Secs. 1501-1508 and 7324-7328) which limit the political activities 
of employees whose principal employment activities are funded in 
whole or in part with Federal funds.
    9. Will comply, as applicable, with the provisions of the Davis-
Bacon Act (40 U.S.C. Secs. 276a to 276a-7), the Copeland Act (40 
U.S.C. Sec. 276c and 18 U.S.C. Secs. 874), and the Contract Work 
Hours and Safety Standards Act (40 U.S.C. Secs. 327-333), regarding 
labor standards for federally assisted construction subagreements.
    10. Will comply, if applicable, with flood insurance purchase 
requirements of Section 102(a) of the Flood Disaster Protection Act 
of 1973 (P.L. 93-234) which requires recipients in a special flood 
hazard area to participate in the program and to purchase flood 
insurance if the total cost of insurable construction and 
acquisition is $10,000 or more.
    11. Will comply with environmental standards which may be 
prescribed pursuant to the following: (a) institution of 
environmental quality control measures under the National 
Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order 
(EO) 11514; (b) notification of violating facilities pursuant to EO 
11738; (c) protection of 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. Secs. 1451 et seq.); (f) conformity of Federal 
actions to State (Clear Air) Implementation Plans under Section 
176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. Sec. 7401 
et seq.); (g) protection of under ground sources of drinking water 
under the Safe Drinking Water Act of 1974; as amended, (P.L. 93-
523); and (h) protection of endangered species under the Endangered 
Species Act of 1973, as amended, (P.L. 93-205).
    12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 
U.S.C Secs. 1271 et seq.) related to protecting components or 
potential components of the national wild and scenic rivers system.
    13. Will assist the awarding agency in assuring compliance with 
Section 106 of the National Historic Preservation Act of 1966, as 
amended (16 U.S.C. 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.).
    14. Will comply with P.L. 93-348 regarding the protection of 
human subjects involved in research, development, and related 
activities supported by this award of assistance.
    15. will comply with the Laboratory Animal Welfare Act of 1996 
(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.
    16. Will comply with the Lead-Based Paint Poisoning Prevention 
Act (42 U.S.C. Secs. 4801 et seq.) which prohibits the use of lead 
based paint in construction or rehabilitation of residence 
structures.
    17. Will cause to be performed the required financial and 
compliance audits in accordance with the Single Audit Act of 1984.
    18. Will comply with all applicable requirements of all other 
Federal laws, executive orders, regulations and policies governing 
this program.

Signature of Authorized Certifying Official
----------------------------------------------------------------------
Title
----------------------------------------------------------------------
Applicant Organization
----------------------------------------------------------------------
Date Submitted
----------------------------------------------------------------------

                                                 BILLING CODE 4184-01-P
[[Page 17079]]

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[[Page 17080]]

[GRAPHIC][TIFF OMITTED]TN04AP95.029


BILLING CODE 4184-01-C
[[Page 17081]]

Certification Regarding Debarment, Suspension, and Other 
Responsibility Matters--Primary Covered Transactions

    By signing and submitting this proposal, the applicant, defined 
as the primary participant in accordance with 45 CFR Part 76, 
certifies to the best of its knowledge and believe 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 antitrust statutes or commission of 
embezzlement, theft, forgery, bribery, falsification or destruction 
of records, making false statements, or receiving stolen property;
    (c) are not presently indicted or otherwise criminally or 
civilly charged by a governmental entity (Federal, State or local) 
with commission of any of the offenses enumerated in paragraph 
(1)(b) of this certification; and
    (d) have not within a 3-year period preceding this application/
proposal had one or more public transactions (Federal, State, or 
local) terminated for cause or default.
    The inability of a person to provide the certification required 
above will not necessarily result in denial of participation in this 
covered transaction. If necessary, the prospective participant shall 
submit an explanation of why it cannot provide the certification. 
The certification or explanation will be considered in connection 
with the Department of Health and Human Services (HHS) determination 
whether to enter into this transaction. However, failure of the 
prospective primary participant to furnish a certification or an 
explanation shall disqualify such person from participation in this 
transaction.
    The prospective primary participant agrees that by submitting 
this proposal, it will include the clause entitled ``Certification 
Regarding Debarment, Suspension, Ineligibility, and Voluntary 
Exclusion--Lower Tier Covered Transaction.'' Provided below without 
modification in all lower tier covered transactions and in all 
solicitations for lower tier covered transactions.

Certification Regarding Debarment, Suspension, Ineligibility and 
Voluntary Exclusion--Lower Tier Covered Transactions

    (To Be Supplied to Lower Tier Participants)
    By signing and submitting this lower tier proposal, the 
prospective lower tier participant, as defined in 45 CFR Part 76, 
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 
participation in this transaction by any federal department or 
agency.
    (b) where the prospective lower tier participant is unable to 
certify to any of the above, such prospective participant shall 
attach an explanation to this proposal.
    The prospective lower tier participant further agrees by 
submitting this proposal that it will include this clause entitled 
``Certification Regarding Debarment, Suspension, Ineligibility, and 
Voluntary Exclusion--Lower Tier Covered Transactions'' without 
modification in all lower tier covered transactions and in all 
solicitations for lower tier covered transactions.

Certification Regarding Lobbying

Certification for Contracts, Grants, Loans, and Cooperative 
Agreements

    The undersigned certifies, to the best of his or her knowledge 
and belief, that:
    (1) No Federal appropriated funds have been paid or will be 
paid, by or on behalf of the undersigned, to any person for 
influencing or attempting to influence an officer or employee of any 
agency, a Member of Congress, an officer or employee of Congress, or 
an employee of a Member of Congress in connection with the awarding 
of any Federal contract, the making of any Federal grant, the making 
of any Federal loan, the entering into of any cooperative agreement, 
and the extension, continuation, renewal, amendment, or modification 
of any Federal contract, grant, loan, or cooperative agreement.
    (2) If any funds other than Federal appropriated funds have been 
paid or will be paid to any person for influencing or attempting to 
influence an officer or employee of any agency, a Member of 
Congress, an officer or employee of Congress, or an employee of a 
Member of Congress in connection with this Federal contract, grant, 
loan or cooperative agreement, the undersigned shall complete and 
submit Standard Form-LLL, ``Disclosure Form to Report Lobbying,'' in 
accordance with its instructions.
    (3) The undersigned shall require that the language of this 
certification be included in the award documents for all subawards 
at all tiers (including subcontracts, subgrants, and contracts under 
grants, loans, and cooperative agreements) and that all 
subrecipients shall certify and disclose accordingly.
    This certification is a material representation of fact upon 
which reliance was placed when this transaction was made or entered 
into. Submission of this certification is a prerequisite for making 
or entering into this transaction imposed by section 1352, title 31, 
U.S. Code. Any person who fails to file the required certification 
shall be subject to a civil penalty of not less than $10,000 and not 
more than $100,000 for each such failure.

State for Loan Guarantee and Loan Insurance

    The undersigned states, to the best of his or her knowledge and 
belief, that:
    If any funds have been paid or will be paid to any person for 
influencing or attempting to influence an officer or employee of any 
agency, a Member of Congress, an officer or employee of Congress, or 
an employee of a Member of Congress in connection with this 
commitment providing for the United States to insure or guarantee a 
loan, the undersigned shall complete and submit Standard Form-LLL 
``Disclosure Form to Report Lobbying,'' in accordance with its 
instructions.
    Submission of this statement is a prerequisite for making or 
entering into this transaction imposed by section 1352, title 31, 
U.S. Code. Any person who fails to file the require statement shall 
be subject to a civil penalty of not less than $10,000 and not more 
than $100,000 for each such failure.
----------------------------------------------------------------------
Signature
----------------------------------------------------------------------
Title
----------------------------------------------------------------------
Organization
----------------------------------------------------------------------
Date

                                                 BILLING CODE 4184-01-P
[[Page 17082]]

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BILLING CODE 4184-01-C
[[Page 17083]]

Certification Regarding Environmental Tobacco Smoke

    Public Law 103-227, Part C--Environmental Tobacco Smoke, also 
known as the Pro-Children Act of 1994 (Act), requires that smoking 
not be permitted in any portion of any indoor facility owned or 
leased or contracted for by an entity and used routinely or 
regularly for the provision of health, day care, education, or 
library services to children under the age of 18, if the services 
are funded by Federal programs either directly or through State or 
local governments, by Federal grant, contract, loan, or loan 
guarantee. The law does not apply to children's services provided in 
private residences, facilities funded solely by Medicare or Medicaid 
funds, and portions of facilities used for inpatient drug or alcohol 
treatment. Failure to comply with the provisions of the law may 
result in the imposition of a civil monetary penalty of up to $1000 
per day and/or the imposition of an administrative compliance order 
on the responsible entity.
    By signing and submitting this application the applicant/grantee 
certifies that it will comply with the requirements of the Act. The 
applicant/grantee further agrees that it will require the language 
of this certification be included in any subawards which contain 
provisions for children's services and that all subgrantees shall 
certify accordingly.

Executive Order 12372--State Single Points of Contact

Arizona

Mrs. Janice Dunn, ATTN: Arizona State Clearinghouse, 3800 N. Central 
Avenue, 14th Floor, Phoenix, Arizona 85012, Telephone (602) 280-1315

Arkansas

Tracie L. Copeland, Manager, State Clearinghouse, Office of 
Intergovernmental Services, Department of Finance and 
Administration, P.O. Box 3278, Little Rock, Arkansas 72203, 
Telephone (501) 682-1074

California

Glenn Stober, Grants Coordinator, Office of Planning and Research, 
1400 Tenth Street, Sacramento, California 95814, Telephone (916) 
323-7480

Delaware

Ms. Francine Booth, State Single Point of Contact, Executive 
Department, Thomas Collins Building, Dover, Delaware 19903, 
Telephone (302) 736-3326

District of Columbia

Rodney T. Hallman, State Single Point of Contact, Office of Grants 
Management and Development, 717 14th Street NW., Suite 500, 
Washington, DC 20005, Telephone (202) 727-6551

Florida

Florida State Clearinghouse, Intergovernmental Affairs Policy Unit, 
Executive OFfice of the Governor, Office of Planning and Budgeting, 
The Capitol, Tallahassee, Florida 32399-0001, Telephone (904) 488-
8441.

Georgia

Mr. Charles H. Badger, Administrator, Georgia State Clearinghouse, 
254 Washington Street SW., Atlanta, Georgia 30334, Telephone (404) 
656-3855

Illinois

Steve Klokkenga, State Single Point of Contact, Office of the 
Governor, 107 Stratton Building, Springfield, Illinois 62706, 
Telephone (217) 782-1671

Indiana

Jean S. Blackwell, Budget Director, State Budget Agency, 212 State 
House, Indianapolis, Indiana 46204, Telephone (317) 232-5610

Iowa

Mr. Steven R. McCann, Division of Community Progress, Iowa 
Department of Economic Development, 200 East Grand Avenue, Des 
Moines, Iowa 50309, Telephone (515) 281-3725

Kentucky

Ronald W. Cook, Office of the Governor, Department of Local 
Government, 1024 Capitol Center Drive, Frankfort, Kentucky 40601, 
Telephone (502) 564-2382

Maine

Ms. Joyce Benson, State Planning Office, State House Station #38, 
Augusta, Maine 04333, Telephone (207) 289-3261

Maryland

Ms. Mary Abrams, Chief, Maryland State Clearinghouse, Department of 
State Planning, 301 West Preston Street, Baltimore, Maryland 21201-
2365, Telephone (301) 225-4490

Massachusetts

Karen Arone, State Clearinghouse, Executive Office of Communities 
and Development, 100 Cambridge Street, Room 1803, Boston, 
Massachusetts 02202, Telephone (617) 727-7001

Michigan

Richard S. Pastula, Director, Michigan Department of Commerce, 
Lansing, Michigan 48909, Telephone (517) 373-7356

Mississippi

Ms. Cathy Mallette, Clearinghouse Officer, Office of Federal Grant 
Management and Reporting, 301 West Pearl Street, Jackson, 
Mississippi 39203, Telephone (601) 960-2174

Missouri

Ms. Lois Pohl, Federal Assistance Clearinghouse, Office of 
Administration, P.O. Box 809, Room 430, Truman Building, Jefferson 
City, Missouri 65102, Telephone (314) 751-4834

Nevada

Department of Administration, State Clearinghouse, Capitol Complex, 
Carson City, Nevada 89710, Telephone (702) 687-4065, Attention: Ron 
Sparks, Clearinghouse Coordinator

New Hampshire

Mr. Jeffrey H. Taylor, Director, New Hampshire Office of State 
Planning, Attn: Intergovernmental Review Process/James E. Bieber, 
2\1/2\ Beacon Street, Concord, New Hampshire 03301, Telephone (603) 
271-2155

New Jersey

Gregory W. Adkins, Action Director, Division of Community Resources, 
N.J. Department of Community Affairs, Trenton, New Jersey 08625-
0803, Telephone (609) 292-6613
Please direct correspondence and questions to: Andrew J. Jaskolka, 
State Review Process, Division of Community Resources, CN 814, Room 
609, Trenton, New Jersey 08625-0803, Telephone (609) 292-9025

New Mexico

George Elliott, Deputy Director, State Budget Division, Room 190, 
Bataan Memorial Building, Santa Fe, New Mexico 87503, Telephone 
(505) 827-3640, FAX (505) 827-3006

New York

New York State Clearinghouse, Division of the Budget, State Capital, 
Albany, New York 12224, Telephone (518) 474-1605

North Carolina

Mrs. Chrys Baggett, Director, Office of the Secretary of Admin, N.C. 
State Clearinghouse, 116 W. Jones Street, Raleigh, North Carolina 
27603-8003, Telephone (919) 733-7232

North Dakota

N.D. Single Point of Contact Office of Intergovernmental Assistance, 
Office of Management and Budget, 600 East Boulevard Avenue, 
Bismarck, North Dakota 58505-0170, Telephone (701) 224-2094

Ohio

Larry Weaver, State Single Point of Contact, State/Federal Funds 
Coordinator, State Clearinghouse, Office of Budget and Management, 
30 East Broad Street, 34th Floor, Columbus, Ohio 43266-0411 
Telephone (614) 466-0698

Rhode Island

Mr. Daniel W. Varin, Associate Director, Statewide Planning Program, 
Department of Administration, Division of Planning, 265 Melrose 
Street, Providence, Rhode Island 02907, Telephone (401) 277-2656
Please direct correspondence and questions to: Review Coordinator, 
Office of Strategic Planning

South Carolina

Omeagia Burgess, State Single Point of Contact, Grant Services, 
Office of the Governor, 1204 Pendleton Street, Room 477, Columbia, 
South Carolina 29201, Telephone (803) 734-0494

Tennessee

Mr. Charles Brown, State Single Point of Contact, State Planning 
Office, 500 Charlotte Avenue, 309 John Sevier Building, Nashville, 
Tennessee 37219, Telephone (615) 741-1676 [[Page 17084]] 

Texas

Mr. Thomas Adams, Governor's Office of Budget and Planning, PO Box 
12428, Austin, Texas 78711, Telephone (512) 463-1778

Utah

Utah State Clearinghouse, Office of Planning and Budget, ATTN: 
Carolyn Wright, Room 116 State Capitol, Salt Lake City, Utah 84114, 
Telephone (801) 538-1535

Vermont

Mr. Bernard D. Johnson, Assistant Director, Office of Policy 
Research & Coordination, Pavilion Office Building, 109 State Street, 
Montpelier, Vermont 05602, Telephone (802) 828-3326

West Virginia

Mr. Fred Cutlip, Director, Community Development Division, West 
Virginia Development Office, Building #6, Room 553, Charleston, West 
Virginia 25305 Telephone (304) 348-4010

Wisconsin

Mr. William C. Carey, Federal/State Relations, Wisconsin Department 
of Administration, 101 South Webster Street, PO Box 7864, Madison, 
Wisconsin 53707 Telephone (608) 266-0267

Wyoming

Sheryl Jeffries, State Single Point of Contact, Herschler Building, 
4th Floor, East Wing, Cheyenne, Wyoming 82002, Telephone (307) 777-
7574

Guam

Mr. Michael J. Reidy, Director, Bureau of Budget and Management 
Research, Office of the Governor, PO Box 2950, Agana, Guam 96910, 
Telephone (617) 472-2285

Northern Mariana Islands

State Single Point of Contact, Planning and Budget Office, Office of 
the Governor, Saipan, CM, Northern Mariana Islands 96950

Puerto Rico

Norma Burgos/Jose H. Caro, Chairman/Director, Puerto Rico Planning 
Board, Minillas Government Center, PO Box 41119, San Juan, Puerto 
Rico 00940-9985, Telephone (809) 727-4444

Virgin Islands

Jose L. George, Director, Office of Management and Budget, #41 
Norregade Emancipation Garden Station, Second Floor, Saint Thomas, 
Virgin Islands 00802
Please direct correspondence to: Linda Clarke, Telephone (809) 774-
0750

[FR Doc. 95-8131 Filed 4-3-95; 8:45 am]
BILLING CODE 4184-01-P