zilongwang/ReadingBank huggingface dataset:
Form 5 TTF Redaction Request Form Date: FIPS: Clerk’s Name: Locality: Clerk’s Signature: Vendor: Certified to Provide SRA: YES NO Date SRA Provided: Back-File Historical Purpose Code L Purpose Code N Deeds / Deeds of Trust Plats / Maps Judgments / Liens Financing Statements Wills / Fiduciary Marriage Licenses / Court Records Images # Span of Years COST per Image Cost $ Total Images: Total Cost: $ Check () all that apply Purchase from Vendor: OCR Software + No Manual Review OCR Software + 1 Manual Review OCR Software + 2 Manual Reviews Software purchase by Clerk Accuracy Rate: % Manual Review: ALL Images Reviewed ONLY Flagged Images Reviewed Manual Review by Vendor Manual Review In-House Day Forward Purpose Code L Purpose Code N Deeds / Deeds of Trust Plats / Maps Judgments / Liens Financing Statements Wills / Fiduciary Marriage Licenses / Court Records Images # Span of Years FISCAL YEAR = COST per Image Cost $ Total Images: Total Cost: $ Check () all that apply Purchase from Vendor: OCR Software + No Manual Review OCR Software + 1 Manual Review OCR Software + 2 Manual Reviews Software purchase by Clerk Accuracy Rate: % Manual Review: ALL Images Reviewed ONLY Flagged Images Reviewed Manual Review by Vendor Manual Review In-House FY10 TTF Redaction Request: Back-File + Day Forward $ = $4 Redaction Request $ + $1 Fund Redaction Request $ Purpose Code L = Land records; Purpose Code N = Not Land Records; Areas of the Court not related to land records
Form 6 TTF Mid-Year Non-Docket Request Form Locality: FIPS: Clerk’s Name: Date: Email: Phone: Clerk Signature: Contact Name: Line Item Change Code: U=Update A=Add D=Delete V=Vendor Name S=Line Item Description All that Apply $4 $1 Purpose Code L Purpose Code N Line item description: Vendor: Original Amount: $ Current Amount: $ New Amount: $ Difference: circle one plus minus Difference Amount: $ COIN Maintenance Screen: All That Apply $4 $1 Purpose Code L Purpose Code N Line item description: Vendor: Original Amount: $ Current Amount: $ New Amount: $ Difference: circle one plus minus Difference Amount: $ COIN Maintenance Screen: COMPENSATION BOARD USE ONLY COMPENSATION BOARD USE ONLY COMPENSATION BOARD USE ONLY Approved COIN Reimbursement Not Approved Budget Spreadsheet Executive Secretary: Date: Robyn M. de Socio Purpose Code L = Land Records Purpose Code N = Not Land Records; Areas of the court not related to Land Records
$ $ Description of Supply / Item (explain what the supply/item is and how it will be used; describe portions used as cash or in-kind match, if applicable): Justification for Supply / Item (explain why the supply/item is needed and how it is allowable under this grant): Supply / Item Requested: Is ALL or PART of this Supply/Item cost used as MATCH? NO YES Cost Per Item / Monthly Cost: Total Number of Items / Months: Total Cost: $ $ Description of Supply / Item (explain what the supply/item is and how it will be used; describe portions used as cash or in-kind match, if applicable): Justification for Supply / Item (explain why the supply/item is needed and how it is allowable under this grant): Supply / Item Requested: Is ALL or PART of this Supply/Item cost used as MATCH? NO YES Cost Per Item / Monthly Cost: Total Number of Items / Months: Total Cost: $ $ Description of Supply / Item (explain what the supply/item is and how it will be used; describe portions used as cash or in-kind match, if applicable): Justification for Supply / Item (explain why the supply/item is needed and how it is allowable under this grant): Supply / Item Requested: Is ALL or PART of this Supply/Item cost used as MATCH? NO YES Cost Per Item / Monthly Cost: Total Number of Items / Months: Total Cost:
Our organization will convey in all materials promoting the event that we will provide the following programmatic accommodations (see Self-Assessment Survey – Effective Communication and Programs & Services Sections): Accommodation Check if you will provide accommodation or service without prior request Check if you will provide accommodation upon request. If so, include length of advance notice required Check if not applicable for this type of program or project. Assistive listening system Sign interpretation Audio description Open captioning Tactile exhibits Braille publications Large print publications Publications on audio cassette Other: Yes No Has your organization budgeted to provide for programmatic and service access accommodations? Note that you may use grant funds for cost of accommodations, except those related to facility renovation/construction or purchase of equipment. If no, please explain why budgeting is not required. Yes No Employment: Does your organization have a board-approved policy that states it will not discriminate against potential staff, volunteers, artists or others due to a disability in the engagement of services (see Self-Assessment Survey – Management Practices Section/Employment)? Yes No Sensitivity Training: Have/will key personnel having contact with the public been/be provided with appropriate information/training in disability awareness and service to audiences with disabilities (see Self-Assessment Survey – Management Practices Section/Policies)? Yes No Grievance Procedure: Does your organization have a procedure for addressing grievances or complaints in regard to accessibility for people with disabilities (see Self-Assessment Survey – Management Practices section/Grievance Procedure and Appendix for Sample Grievance Procedures)?
9. Check which, if any, of the descriptors below comprise a significant portion (50% or more) of your organization’s activities. Check all that apply. If none apply, or if the below descriptors apply to a small or indeterminate portion of your funding/activities, do not check any boxes. There is no penalty for leaving this question unanswered. Accessibility – increasing access for people with disabilities International – grantees visiting other countries, foreign artists visiting the US, cultural exchange programs, linkages with artists/organizations in other countries, and other international programs Presenting/Touring – movement of artists and artworks for performances, screenings, exhibits, etc. in different geographic areas as either the presenter or touring group Technology – for creation or dissemination of artworks or for organizational management Youth at Risk – programs designed primarily to serve at-risk youth, including drug, violence, alcohol, crime intervention Older Adults – programs involving older adults as the primary artists, participants, or beneficiaries as well as programs in elder care settings, senior centers, or retirement residences Health/Healing – programs using the arts specifically to promote good physical or mental health or to aid in healing, serving individuals, institutions or communities, e.g. in response to natural disasters or tragedies Economic Development – use of the arts as an economic development tool Cultural Heritage Tourism – activities that promote cultural events specifically to tourist populations and/or use arts, heritage or history offerings as traveler destinations and integration of culture into tourism development plan 10. Describe any noteworthy partnerships or collaborations (e.g. with other arts organizations, organizations including social service agencies, educational institutions, businesses or government other than GCC&H) in which your organization is or will be involved. If you are not currently engaged in any collaboration, leave blank. Although the GCC&H encourages partnerships or collaborations, there is no penalty for leaving this blank. Arts Grant Application GENERAL OPERATING SUPPORT BUDGET
Each year, all LEAs will be asked to complete the Monitoring and Risk Assessment Checklist. The completed checklist will be emailed to LPlan () with a copy sent to their CTAE Region Coordinator by the established deadline. The following High Risk Intervention Elements will be used to determine each LEAs score. Those LEAs with a score between 0 to 40 points will be determined low risk. The LEAs with a score between 50 to 90 points will be determined medium risk. The LEAs with a score of 100 or greater will be determined high risk. The goal for an LEA will be to have a low risk rating score. Intervention Risk Assessment Strategies have been determined for each risk rating group and are on the page 3. High Risk Intervention Elements Elements Point Values Has the current CTAE Director been in the position since July 1, 2015? Yes = 0 points No = 10 points Did the CTAE Director attend two or more CTAE sponsored workshops: Winter Conference, GACTE, or Technical Assistance Meeting? Yes = 0 points No = 10 points Did the CTAE System Director complete the training for New CTAE Directors? Yes = 0 points No = 10 points Did the LEA meet its Perkins IV local budget match requirement? (As reported on the FTE/QBE Perkins Expenditure Chart) Yes = 0 points No = 50 points Did the LEA submit all budget amendments to the Program Improvement Grant prior to the deadline of June 6, 2016? Yes = 0 points No = 10 points Did the LEA submit all Perkins IV Grants (Program Improvement, Perkinsplus, & Carryover) Completion Reports by the July 31, 2016, deadline? Yes = 0 points No = 30 points Did the LEA meet Core Indicator 2S1 (Technical Skill Attainment) on the most recently published data? Yes = 0 points No = 10 points Did the LEA sign off on the Program Improvement Grant application through the consolidated application process by May 15, 2016? Yes = 0 points No = 10 points Did the LEA sign off on the Program Improvement Grant budget detail through the consolidated application process by September 30, 2016? Yes = 0 points No = 10 points Did the LEA use the state recommended equipment inventory management form, or did the form used by the LEA have all the required information? Yes = 0 points No = 10 points
COIN Main Menu Enter the four-letter code main as the last system access to the COIN Main Menu. Continue Press ENTER to continue the logon process. Screen 4 COIN Main Menu TTF Budget Request On the COIN Main Menu, Enter 7 to choose the TTF Budget Request. TTF Fiscal Year FY 2019 is the default fiscal year on the TTF Budget Request Main Menu. You may view a previous fiscal year by changing the supplied year. Continue Press ENTER to continue to the TTF Budget Request Main Menu. Screen 5 FY19 Technology Trust Fund (TTF) Budget Request Introduction TTF Introduction Please review the FY19 TTF Request Introduction screen prior to TTF budgeting: TTF MONEY IS AVAILABLE FOR SPECIFIC PURPOSES ONLY. THE CODE OF VIRGINIA RESTRICTS THE USE OF $4 AND $1 MONIES. TTF was established to finance automation and technology improvements in the Clerk’s office in order to provide secure remote access (SRA) to land records. TTF IS A LINE ITEM BUDGET REQUEST PROCESS. BUDGET REQUESTS IN AUGUST MUST BE ENTERED INTO THE COIN SYSTEM BY LINE ITEM IN WHOLE DOLLARS. Required fields for $4 and $1 Fund budgeting are: SEL, Vendor Name, Item Description, Description Code, Purpose Code, and Total Cost. TTF BUDGETING REQUIRES CERTIFICATIONS. THE CODE OF VIRGINIA REQUIRES CERTIFICATION OF SECURE REMOTE ACCESS TO LAND RECORDS, COMPLIANCE WITH VITA SECURITY STANDARDS, AND VIRGINIA PUBLIC PROCUREMENT ACT. TTF IS A REIMBURSEMENT SYSTEM. TTF REIMBURSEMENT REQUESTS MAY BE MADE BY LINE ITEM IN DOLLARS AND CENTS FROM OCTOBER THROUGH MAY, DURING THE MONTHLY REIMBURSEMENT PERIOD IN COIN. TTF DOES NOT PREPAY TECHNOLOGY EXPENDITURES. Clerks
Documentation and justification for your Equipment and Services budget requests must be copied to your local governing body. Certification To concur, enter your Logon ID, an alpha-numeric code supplied by the Compensation Board. The first three characters of your ID are letters of the alphabet. This is a required field. Save Press ENTER to save your certification. An UPDATE SUCCESSFUL message should appear in the bottom center of your screen. Print the screen for your records. PF Keys F1 Help screen F2 Authorized Budget screen F3 TTF Main Menu F4 TTF Totals screen F12 COIN Main Menu Screen 15 Option 9: Submit FY19 TTF Budget Request TTF Budget Submission Option 9 completes the FY19 TTF Budget Request process. If the Clerk has opted to budget their $4 available balance (greater than $0) then the $4 certification (Option 6) must be complete for COIN to accept this logon. If the Clerk has requested $1 Fund monies then the $1 Fund certification (Option 8) must be complete for COIN to accept this logon. Officer Logon Enter your Logon ID, an alpha-numeric code supplied by the Compensation Board. The first three characters of your ID are letters of the alphabet. This is a required field. Save Press ENTER to save your certification. A message should appear in the bottom center of your screen: YOUR FY19 TTF BUDGET REQUEST HAS BEEN SUCCESSFULLY SUBMITTED. THANK YOU. Print the screen for your records. PF Keys F1 Help screen F2 Authorized Budget screen F3 TTF Main Menu F4 TTF Totals screen F12 COIN Main Menu Screen 16 FY19 $4 and $1 Fund Budget Request Totals
Form 5 FY19 TTF Redaction Request Form Date: FIPS: Clerk’s Name: Locality: Clerk’s Signature: Vendor: Certified to Provide SRA: YES NO Date SRA Provided: Back-File Historical Purpose Code L Purpose Code N Deeds / Deeds of Trust Plats / Maps Judgments / Liens Financing Statements Wills / Fiduciary Marriage Licenses / Court Records Images # Span of Years COST per Image Cost $ Total Images: Total Cost: $ Check () all that apply Purchase from Vendor: OCR Software + No Manual Review OCR Software + 1 Manual Review OCR Software + 2 Manual Reviews Software purchase by Clerk Accuracy Rate: % Manual Review: ALL Images Reviewed ONLY Flagged Images Reviewed Manual Review by Vendor Manual Review In-House Day Forward Purpose Code L Purpose Code N Deeds / Deeds of Trust Plats / Maps Judgments / Liens Financing Statements Wills / Fiduciary Marriage Licenses / Court Records Images # Span of Years COST per Image Cost $ Total Images: Total Cost: $ Check () all that apply Purchase from Vendor: OCR Software + No Manual Review OCR Software + 1 Manual Review OCR Software + 2 Manual Reviews Software purchase by Clerk Accuracy Rate: % Manual Review: ALL Images Reviewed ONLY Flagged Images Reviewed Manual Review by Vendor Manual Review In-House FY18 TTF Redaction Request: $4 Redaction Request $ + $1 Fund Redaction Request $ = Backfile and Day-Forward $ Purpose Code L = Land records; Purpose Code N = Not Land Records; Areas of the Court not related to land records
Expenditures for Rural and Low-Income Schools Grant FY18 ________________________(b) Cash balance (“a” less “b”) ________________________ (Cash balance should be returned, payable to “State of Indiana.” If less than one dollar, balance may be transferred to general fund.) “By signing this report, I certify to the best of my knowledge and belief that the report is true, complete and accurate and the expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the terms and conditions of the federal award. I am aware that any false, fictitious, or fraudulent information or the omission of any material fact, may subject me to criminal civil or administrative penalties for fraud, false statements, false claims, or otherwise.” ______________ ____________________________ _________________________ Date Treasurer’s Signature Superintendent’s Signature Submit one copy of this report as soon as project is complete between now and December 31, 2020. All funds must be obligated or encumbered by September 30, 2020 and funds must be liquidated by December 15, 2020 or the funds must be returned to IDOE’s Finance Office. Return form to: Cole Dietrich at
Name of Vendor Signature of Authorized Official / Date Vendor's Address Print Name / Title of Signer City / State / Zip Code Vendor’s EIN Phone Number Email Address Sworn to before me this ________ day of ______________________, 20____________ Notary Public or Commissioner of Deeds EXHIBIT C LOBBYING CERTIFICATION FORM EXHIBIT C LOBBYING CERTIFICATION FORM The City Council has asked City agencies to require vendors funded by City Council discretionary awards to certify that they are in compliance with New York City and New York State Lobbying Laws. For questions concerning this form, contact the agency awarding the contract associated with the discretionary award. For information about lobbying filing requirements, visit: LOBBYING CERTIFICATION The undersigned affirms and declares that the Vendor is in compliance with the lobbying registration requirements of the New York City and New York State Lobbying Laws. See Administrative Code of the City of New York (“Administrative Code”) § et seq. and Legislative Law §1-a et seq., respectively. The Vendor’s registration status is disclosed below. Legal Name of Vendor: Address: City: State: Zip: EIN/TIN: Tel. No.:
26019830312A Henry Street Settlement 265 Henry Street , New York, New York 10002-4899 $151,113.00 26019820514A Italian American Civil Rights League 1460 Pennsylvania Avenue, Brooklyn, New York 11239 $115,200.00 26019840104A Jacob A. Riis Neighborhood Settlement 10-25 41st Avenue, Long Island City, New York 11101 $100,542.00 26019840105A Jacob A. Riis Neighborhood Settlement 10-25 41st Avenue, Long Island City, New York 11101 $99,884.00 26019840106A Jacob A. Riis Neighborhood Settlement 10-25 41st Avenue, Long Island City, New York 11101 $44,186.00 26019850108A Jewish Community Center of Staten Island, Inc. 1466 Manor Road, Staten Island, New York 10314 $99,982.00 26019821304A Jewish Community Council of Greater Coney Island, Inc. 3001 West 37th Street, Brooklyn, New York 11224-1479 $473,713.00 26019821107A Edith and Carl Marks Jewish Community House of Bensonhurst 7802 Bay Parkway, Brooklyn, New York 11214 $208,174.00 26019810806A Kingsbridge Heights Community Center 3101 Kingsbridge Terrace, Bronx, New York 10463 $133,567.00 26019810410A Neighborhood Association for Inter-Cultural Affairs (NAICA) 15 Clarke Place , Ste. 1, Bronx, New York 10452 $213,621.00 26019810411A Neighborhood Self-Help by Older Persons Projects, Inc. 953 Southern Boulevard, Bronx, New York 10459 $199,318.00 26019810511A Neighborhood Self-Help by Older Persons Projects, Inc. 953 Southern Boulevard, Bronx, New York 10459 $203,134.00 26019810905A Neighborhood Self-Help by Older Persons Projects, Inc.
IV. Budget Staff AND DEPARTMENT ASSIGNMENTS During this annual process, the Budget Office is available to answer questions or provide informal training to new employees. If you have any questions, below is the contact information for the Budget Office: CONTACT DEPARTMENTS Rita Kovach Director Email: Phone: x6300 Non-academic President’s Office (includes General Counsel, Office of Compliance, University Relations, and Public Safety) Finance (includes HR, Technology Services, and Facilities) Institutional Advancement (includes Alumni Relations) Student Life (includes Athletics and Auxiliary Services) Enrollment Management (includes Public Affairs) Tom Peters Assistant Director, Financial Planning Email: Phone: x6356 Performance-based budgeting Zero-based budgeting Income Cost Model Provost and Academic Departments (includes Columbus School of Law) Paula Blackwell, Enterprise Budget Systems Email: Phone: x6283 Non-academic President’s Office (includes General Counsel, Office of Compliance, University Relations, and Public Safety) Finance (includes HR, Technology Services, and Facilities) Institutional Advancement (includes Alumni Relations) Student Life (includes Athletics and Auxiliary Services) Enrollment Management (includes Public Affairs) Allyson Handley Senior Budget Analyst Email: Phone: x6108 Provost and Academic Departments (includes Columbus School of Law) Jonathan Aaron Budget Analyst Email: Phone: x6355 Provost and Academic Departments (includes Columbus School of Law)
INVOICE ALL FORMS MUST BE TYPED AND NOT HAND WRITTEN. THEY MUST ALSO BE COMPLETED IN FULL. FAILURE TO DO THIS WILL RESULT IN PAYMENT DELAYS OR NON PAYMENT For HEKSS Use Only Invoice Number ASK533 - FY2 - Invoice Date / / PO Number XXSHREBEIRO Practice Name FAO Address Line 1 Address Line 2 Address Line 3 Town/City Post Code Health Education England – T73 KSS LETB T73 Payables F485 Phoenix House Topcliffe Lane Tingley Wakefield WF3 1WE NOTE: PLEASE ENSURE BANK DETAILS ARE ENTERED. FAILURE TO ENTER THESE DETAILS WILL RESULT IN THE REMITTANCE BEING MADE BY CHEQUE, WITH INEVITABLE PAYMENT DELAYS. Total Value of the Claim £ 2,066.93 Please fill in the breakdown of the claim on the following page Details of the claim Travel Expenses
“Applicant” means an organization that submits an application document with the required information on the Department’s approved forms and attachments as prescribed in these Program guidelines. “Applicant Investment” means the amount of funds that the applicant will contribute to the project, including its own contributions and funds from other financial partners or contributors. All proposed matching expenditures (in-kind and cash) must only be directly related project expenditures and must not include the costs or in-kind values of items that are not being used as part of the proposed project. “Application” means a request for RERP funds by submitting the required information, on the Department’s approved forms and attachments as prescribed in these guidelines. “Entity” means any applicant submitting an application to the Department. “Grant Beginning Date” means the date grantee may begin to incur costs against the agreement. "Grantee" means an entity that has been awarded a grant. “Project” means an eligible renewable energy resources project that the Department agrees to fund through the RERP. “Project Completion Date” means the date that all grant tasks are complete, aside from reporting and monitoring, and equipment is installed and operational. “Proprietary, Privileged or Confidential Commercial Information” means any process or design exclusively owned under trademark, patent or in the process of becoming patented, or other information that falls within an applicable exemption under the Illinois Freedom of lnformation Act (5 ILCS 140/1 et seq.). “Renewable Energy” means energy from wind, solar thermal energy, photovoltaic cells and panels, dedicated crops grown for energy production and organic waste biomass, hydropower that does not involve new construction or significant expansion of hydropower dams, and other alternative sources of environmentally preferable energy. Renewable energy does not include, however, energy from the incineration, burning or heating of waste wood, tires, garbage, general household, institutional and commercial waste, industrial lunchroom or office waste, landscape waste, or construction or demolition debris. “Renewable Energy Business” means the manufacturing of renewable energy products or components. Section 8.2: Grant Eligibility Criteria 8.2.1 Eligible Applicants. Eligible applicants include for-profit businesses, governmental entities, colleges and universities, and not-for-profit organizations. To be eligible for funding the
or criminal penalty (or been a party to a consent decree) within the past seven years as a result of any violation of federal, state or local law applicable to its business? If yes, identify the nature (including case number and venue) of the action and the disposition. If the action/proceeding is still pending or unresolved, provide a status identifying the unresolved issues. 2.7 Is the applicant or any principal the subject of any proceedings that are pending, or to the best of applicant’s knowledge, threatened against applicant and/or any principal that may result in any adverse change in applicant’s financial condition or materially and adversely affect applicant’s operations? Yes No If yes, provide requested information. 2.8 Does the applicant or any principal owe any debt to the State? Yes No If yes, list reason and amount: Section 3: Proposal Information 3.1 Submittal Date: 3.2 Project Title: 3.3 Brief Project Description: (Complete attached Scope of Work) (550 Character maximum) 3.4 Project Location: Street Address: City: County: 3.5 Areas Served: 3.6 Project Contact: Name: Title: Address: Phone: Fax: E-Mail: 3.7 Project Period: Start Date: End Date: 3.8 Project Costs: (Complete attached Budget) Funding provided by the applicant: Secured funding from other sources: Funding requested from DCEO: Total Project Cost $0.00 Section 4: Scope of Work Project Title Description of project: Grantee will complete the following tasks:
Exhibit 11D (2 of 3) SECTION 2 NOTES PAYABLE TO BANK AND OTHERS (Use attachments if necessary. Each attachment must be identified as part of this statement and signed). Name/Address of Note holder(s) Original Balance Current Balance Payment Amount Frequency (monthly, etc.) How Secured or Endorsed Type of Collateral SECTION 3 STOCKS AND BONDS (Use attachments if necessary. Each attachment must be identified as part of this statement and signed). Number of Shares Name of Securities Cost Market Value Quotation/Exchange Date of Quotation/Exchange Total Value SECTION 4 REAL ESTATE OWNED (List each parcel separately. Use attachments if necessary. Each attachment must be identified as part of this statement and signed). Property A Property B Property C Type of Property Name and Address of Property Date Purchased Original Cost Present Market Value Name and Address of Mortgage Holder Mortgage Account Holder Mortgage Balance Amount of Payment per Month/Year Status of Mortgage SECTION 5 OTHER PERSONAL PROPERTY AND OTHER ASSETS (Describe, and if any is pledged as security, state name and address of lien holder, amount of lien, terms of payment, and if delinquent, describe delinquency). . Exhibit 11D (3 of 3)
The following items must be completed in order for DHS to rank your proposal. Items that are not completed or completed incorrectly will lose points. Budget Matching Funds Chart Project Leveraging Letter BUDGET FOR NEW PERMANENT SUPPORTIVE HOUSING PROJECT A B C D E Case Management Personnel Services Position Name # FTE Annual Salary Total Salary Subtotal PS Fringe Case Management Subtotal Leasing Leasing Subtotal Rental Assistance Unit Type Number of Units Fair Market Rents Number of Months Total Rent (Multiply B*C*D) SRO Unit 0 Bedroom (Studio) 1 Bedroom 2 Bedroom 3 Bedroom 4 + Bedrooms Rental Assistance Subtotal Case Management + Leasing + Rental Assistance Subtotal Administrative Cost 7%
Page 1 of 2 APPENDIX XI NATIONAL RAILROAD PASSENGER CORPORATION and AGENCY AGREEMENT DATED 1 OCTOBER 2012 FOR THE PROVISION OF RAIL PASSENGER SERVICE FISCAL YEAR 2013 October 1, 2012 – September 30, 2013 (Effective October 1, 2012) Direct Costs of Extra Work All costs of labor, associated employee benefits, materials, contracted services, and other expenses incurred directly in the provision of extra work shall be considered as Direct Costs. The component categories for Direct Costs are described below. Labor costs shall include the costs of salaries and wages (including all allowances) earned by employees engaged in providing extra work, as well as pay for vacation, holiday, and other paid absences for those employees. New management positions required to perform extra work shall be agreed upon and shall be Direct Costs. Other management positions required by Amtrak for performance of extra work shall not be Direct Costs. Employee benefit and injury costs shall include prorated corporate costs to Amtrak for insurance for disability, sickness, health, and dental coverage; for life insurance and travel insurance; and an additive for employee injuries. Also included are Amtrak’s cost of the Employee Savings and Investment Plan, pension costs accrued, Railroad Retirement taxes, and other employee benefit plans. Material costs include the costs of all materials whether issued from Amtrak’s inventory (at Amtrak’s system average price) or purchased specifically for use in providing the extra work, plus a materials handling additive, including transportation costs, of 2% on track materials and 1% on all other items. Contracted services shall include all payments to third parties for provision of goods and services that are directly identified as required for the extra work.
Please quote your ordinary unit price for supplying these goods as indicated in the attached letter. Sign and submit this back to the contact by _______________________. Items to be Purchased Quantity Expected to Buy Food Supply Vendor Name: Unit Price Extended Price (Quantity x Unit Price) TOTAL $ I_________________________(name of vendor), agree to supply the above named items at the price quoted. Delivery costs and sales tax are included with this quote. Terms of payment are _______________________________________________ This contract may be voided by either party at any time. ______________________________Signature of Vendor Representative ______________Date _______________________ ___Signature of Sponsor or Institution Representative ______________Date (Sponsor or Institution Representative Signs AFTER bid has been accepted) Procurement Log (Form C)
Nonprofits must provide a copy of their organization’s mission statement along with their application. Be prequalified, prior to contract execution, by the State of New York upon application submission through the New York State Grants Gateway () Criteria for determining eligible applicants who are at high risk of terrorist attack include, but are not limited to: Identification and substantiation (e.g. police reports or insurance claims) of prior threats or attacks against the nonprofit organization or closely related organizations (within or outside the U.S.) by a terrorist organization, network, or cell Symbolic value of the site(s) as a highly recognized national or historical institution that renders the site a possible target of terrorism Role of the applicant nonprofit organization in responding to or recovering from terrorist attacks Findings from previously conducted risk assessments including threat and/or vulnerability assessments Not all organizations are guaranteed funding. Allocation decisions will be made based on risk and how well the applicant addresses program requirements through their Investment Justification submissions. Due to the competitive nature of this program, funding preference will be given to nonprofit organizations that have not received prior years funding. Program Objectives The FY 2013 NSGP plays an important role in the implementation of the National Preparedness System (NPS) by supporting the development and sustainment of core capabilities. Core Capabilities are essential for the execution of each of the five mission areas outlined in the National Preparedness Goal (NGP). Delivering core capabilities requires the combined effort of the whole community, rather than the exclusive effort of any single organization or level of government. The FY 2013 NSGP’s allowable costs support efforts to build and sustain core capabilities across the Prevention, Protection, Mitigation, Response, and Recovery mission areas. Examples of tangible outcomes from the FY 2013 NSGP include strengthening emergency management capabilities through: Building and sustaining core capabilities
Cashier’s Office Renell Lewis x6445 lewis@cua.edu Enrollment Services Kevin Woods X5300 woods@cua.edu General Accounting Mary Romain Lizy Kannarkat x6414 x5013 romain@cua.edu kannarkat@cua.edu Payroll Office Phil Harris x5512 harrisp@cua.edu Procurement and Payment Services: Accounts Payable Procurement Card Programs (Procurement/Corporate) Lisa David Yssa Ressurreccion Teresa Chandler X5854 X6033 X5045 Sponsored Accounting Paul Harrison x6402 harrisop@cua.edu Student Financial Assistance Mindy Schaffer X6369 schafferm@cua.edu
WIC Local Agency Information WIC Local Agency’s Legal Name Federal Employers ID# Type of Organization Tribe Private Non-profit DUNS # CFDA # 10.557 Tribe/Agency Administrative Mailing Address Number and Street or PO Box City, State, Zip WIC Main Clinic Street Address (provide description if no street address is available) Number and Street or intersection/description City, State, Zip WIC Clinic Mailing Address (if different) Number and Street or PO Box City, State, Zip WIC Clinic UPS/Fed Ex Shipping Address (if different) Number and Street or intersection/description City, State, Zip Primary Contact (person responsible for functions) Name Email Phone Fax Certifying Signature (person who can legally bind the WIC local agency and certify the funding application) Name Title WIC Staffing Plan *Identify at least one person for the following positions: Breastfeeding Lead & Registered Dietitian
Compliance checks (Community Strategy #3) Officers time to conduct checks Provide funding to County Sheriff’s Office for 40 additional compliance checks @ __ officers x __ hrs. per compliance check x __ compliance checks $ 3,000 $ 1,000 in-kind from Sheriff’s Office $ 4,000 Media Campaign (Community Strategy #12) Newspaper ad space Radio air time - 2 newspapers x 8 full page ads/yr x $200 - 2 newspapers x 10 quarter page ads/yr x $50 - __ radio spots/month x __ months x $__/spot $ 3,200 $ 1,000 $ 3,000 $3,000 from DFC budget $3,200 $1,000 $6,000 Responsible beverage training (Community Strategy # 16) Mailings, training materials, refreshments for each session Provide funding to ____ to provide training at $___ per training session x ___ sessions $ 500 $ 500 from ADAA Block Grant $ 1,000 Strategy X Strategy Y Strategy Z Total Funding EXAMPLES Chart (these are theoretical examples only to demonstrate what we are looking for) FY ’15 MSPF Implementation Budget Chart Jurisdiction: ____________________________ MSPF Community: ___________________________
Ms. Bruno relayed that Kathy Lowe from the Massachusetts School Library Association, who has been on the Committee since its inception, has decided not to continue. Ms. Bruno noted that Sandy Kelly, former President of MSLA and recently retired from Carlisle Schools, would like to become a member. Commissioner Quinn moved and Commissioner Cluggish seconded. that the Massachusetts Board of Library Commissioners reappoint: Susan Flannery, Director of Cambridge Public Libraries; Pat McLeod Director of the David & Joyce Milne Public Library in Williamstown; Anna Popp, Advisor at Massachusetts Library System, and Ellen MJ Keene, Head of Access and Technical Services at the University of Massachusetts Lowell Libraries to the MBLC Public Relations Advisory Committee for a two-year term, ending in 2015 and appoint Sandy Kelly, Massachusetts School Library Association, as a new member to the MBLC PR Advisory Committee for a two-year term, ending in 2015. The Board voted approval. CONSIDERATION OF ESTABLISHMENT AND APPOINTMENT OF A TRUSTEE HANDBOOK COMMITTEE April Mazza, Trustee/Friends Information Specialist, stated that the first Trustee Handbook was published in 1977 and was spearheaded by the Massachusetts Library Trustee Association. She noted that there have been two revisions since, one in 1986 and the other in 2000. She said that the MBLC now needs to revise and update its 2000 Trustee Handbook. Ms. Mazza noted that each section needs to be reviewed and that several sections need reworking of the information provided. Ms. Mazza presented the following: Committee Charge: The purpose of the Massachusetts Public Library Trustees Handbook Advisory Committee is to: Review the current transitional draft of the Handbook, Update information about the state laws which affect libraries, Incorporate information relevant to the trustee role about new or evolving issues facing libraries, Present current advice about best practices for trustees in their hiring, policy making, financial management and their fundraising and advocacy roles.
Grants Available 4 Grant Workshops & Webinar 4 Program Staff 4 Application Deadline 4 Preparing the Grant Application 5 Community Arts Grant Program Funding Source 6 Program Goals & Objectives 6 Funding Period 6 Project Assistance Grants Project Assistance Grants 6 Who is Eligible to Apply 6 Evaluation Criteria 7 What to Submit with Application 7 Domiciled 8 How Many Applications May Be 8 Submitted Grant Match Policy 8 Fiscal Agent Policies 8 Who is Not Eligible 8 Project Disciplines Funded 9 Examples of Projects 9 What We Do Not Fund 10 Funding Policies & Procedures How Funding Decisions are Made 11 Compliance and Reporting Credit Line & Logos 12 Contract & Payment Schedule 12 Standards for Financial Management 13 Final Report 13 Grant Monitoring 13 Glossary 14 The Arts Council of New Orleans is supported by contributions from individuals, corporations, foundations, and by grants from the Louisiana State Arts Council, Louisiana Division of the Arts, the Office of Culture, Recreation and Tourism, and from the National Endowment for the Arts. Specific programs are funded through contracts with the City of New Orleans, the State of Louisiana, and other public and private agencies. ARTS COUNCIL OF NEW ORLEANS WHO WE ARE Arts Council of New Orleans is a private, non-profit organization designated as the City’s official arts agency. As a multidisciplinary arts agency, the Arts Council operates in three conceptual areas: People - Community Engagement and the Creative Citizen, Place - Civic Design and the Urban Aesthetic, and Artists - Artistic Excellence and Creative Services. Each area works to advance the Arts Council’s overall mission to nurture creativity and enrich lives through inspiration, connection, transformation, and investment in the New Orleans arts and cultural community. For more information on the Arts Council of New Orleans or to become a member call (504) 523-1465 or visit . COMMUNITY ARTS GRANTS CALENDAR March 10, 2014 Grant guidelines posted at . Online application available at March 17, 2014 Webinar posted at under Grants - Webinar March 20 – 25, 2014
Based Practices Implementation for Capacity (EPIC) resource center. Probation continues its engagement with EPIC to implement motivation interviewing skill training in Probation. In addition to the required training delivered statewide by the Training Unit in the Division of Probation Services, skill training is being delivered for the new evidence-supported programs and practices mentioned throughout this section. Included is coaching training for supervisor’s to increase support for the use of new practices and to support continuous quality improvement. Juvenile probation strives to expand the use of Family Functional Therapy and Multi-Systemic Therapy for juveniles; both are evidence-based programs, as well as cognitive behavioral programs. Monthly publication and distribution of Research in Brief to all probation departments. Relevant criminal justice research is reviewed and summarized on a single page with a focus on providing enhanced understanding of current research and practical tips for application in probation. This publication has achieved a national following. Expansion of performance feedback efforts including quarterly statistical reports summarizing progress toward reaching targeted outcomes for all probation programs/populations, the statewide results of which are in the table above. Continuation of the Rural Initiative program to facilitate the training and state approval of domestic violence, sex offender and substance abuse treatment providers in rural counties. This effort is intended to provide quality treatment “close to home” for probationers who would otherwise be required to travel significant distances to secure treatment. This project has reduced technical violations and improved treatment compliance. The initiative is supported by offender pay cash funds. Utilization of a variety of mechanisms to monitor low-risk probationers in a cost effective manner that creates increased time to be devoted to the management of higher risk offenders’ supervision without the loss of accountability for a large segment of low risk probation population. Examples include telephone reporting for low risk clients and daily reporting requirements for the highest risk populations and the development of large low-risk only caseloads and smaller higher-risk only caseloads. A workload value study has been initiated to determine the amount of time needed for officers to more fully implement evidence-based principles and practices. The work of probation supervisors, the linchpins to EBPs, will also be studied to develop an adequate ratio of supervisors to staff. Importantly, a ratio of support staff to probation staff will be reviewed and determined. Individuals in all three job categories play an important role in the efficient and effective implementation of evidence-based practices.
Narrative Questions 6.1-6.7 Financial Performance Narrative Questions Explain how accurately the financial health of your institution is presented in the TA Application Excel Workbook as compared to the financial statements or Federal Regulator performance reports provided. If necessary, please provide additional information where there are discrepancies between the financial information provided in the TA Application Excel Workbook and your financial statements or Federal Regulator performance reports. Enter text for question 6.1 here. Your entry cannot exceed 2,000 characters. Discuss your organization’s performance in relation to the CDFI Fund’s Minimum Prudent Standards (MPS) for financial health and portfolio management (which are automatically calculated in the TA Application Excel Workbook Performance Tab). Describe what factors contributed to meeting or failing each ratio. For regulated CDFIs, discuss any regulatory constraints affecting your performance. Enter text for question 6.2 here. Your entry cannot exceed 2,000 characters. Explain any other financial benchmarks that are important to your CDFI achieving the strategic goals as listed in the PURPOSE section. Enter text for question 6.3 here. Your entry cannot exceed 1,000 characters. If your award request will directly impact your financial performance, explain how each pertinent TA activity will build organizational capacity to achieve the strategic goals listed in the PURPOSE section and include a justification for the associated costs. Enter text for question 6.4 here. Your entry cannot exceed 3,000 characters. Organizational Impact Narrative Questions Describe the trends shown in your Activities Level Chart (completed in the TA Application Excel Workbook-Input Sheet & Performance Tabs) and explain the circumstances driving these trends using the automatically generated graphs that appear within the TA Application Excel Workbook-Performance Sheet. Enter text for question 6.5 here. Your entry cannot exceed 1,000 characters. Discuss organizational milestones achieved and progress made toward your CDFI’s strategic goals listed in the PURPOSE section. If your CDFI is a prior TA Award Recipient, discuss the use of the previous TA award(s) and the impact the award(s) had on your CDFI achieving its strategic goals. Enter text for question 6.6 here. Your entry cannot exceed 2,500 characters.
Current Vehicle Inventory (vehicles currently used by agency/organization) Model Yr. Make / size / type FDOT control # or VIN Wheelchair Ramp or Lift (specify) Seats & W/C positions (i.e. 12+2) Avg. miles/Yr. Current Mileage Expected retirement date Other equipment (GPS, onboard computer) Funding source used to Purchase Vehicle Urban Service Area (Y/N) Anticipated / Requested Vehicles (vehicles requested through this grant, other funding sources, or already purchased but not yet in service) Replacement or Expansion Vehicle FDOT control # or VIN of Vehicle Replacing Make / size / type Ramp or lift (specify) Seats & W/C positions (i.e. 12+2) Expected Avg. miles/Yr. Expected retirement date Other equipment (GPS, onboard computer)
DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration NATIVE HAWAIIAN HEALTH CARE SYSTEM REQUIRED CLINICAL PERFORMANCE MEASURES FOR HRSA USE ONLY Grant Number Application Tracking Number 4. Focus Area: Child Health/Immunizations Performance Measure Percentage of children with their 3rd birthday during the measurement year who are fully immunized before their 3rd birthday. Target Goal Description Numerator Description Number of children among those included in the denominator who were fully immunized before their 3rd birthday. A child is fully immunized if s/he has been vaccinated or there is documented evidence of contraindication for the vaccine or a history of illness for ALL of the following: 4 DTP/DTaP, 3 IPV, 1 MMR, 3 Hib, 3 HepB, 1VZV (Varicella), and 4 Pneumococcal conjugate prior to her/his 3rd birthday. Denominator Description Number of all children with at least one medical visit during the reporting period, who had their third birthday during the reporting period. Baseline Data Baseline Year: Measure Type: Numerator: Denominator: Calculated Baseline: Data Source & Methodology Data Source: [_] EHR [_] Chart Audit [_] Other (If Other, please specify): Data Source and Methodology Description: Key Factor and Major Planned Action #1 Key Factor Type: [_] Contributing [_] Restricting Key Factor Description: Major Planned Action Description: Key Factor and Major Planned Action #2 Key Factor Type: [_] Contributing [_] Restricting Key Factor Description: Major Planned Action Description: Key Factor and Major Planned Action #3 Key Factor Type: [_] Contributing [_] Restricting Key Factor Description: Major Planned Action Description: Comments
OMB No.: 0915-0285. Expiration Date: 9/30/2016 DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration INCOME ANALYSIS FORM FOR HRSA USE ONLY Applicant Name Grant Number Application Tracking Number Part 1: Patient Service Revenue – Program Income Line # Payer Category Patients by Primary Medical Insurance Billable Visits Income per Visit Projected Income Prior FY Income:______ (a) (b) (c) (d) (e) 1 Medicaid 2 Medicare 3 Other Public 4 Private 5 Self-Pay 6 Total (Lines 1–5) Part 2: Other Income – Other Federal, State, Local and Other Income 7 Other Federal 8 State Government 9 Local Government 10 Private Grants/ Contracts 11 Contributions 12 Other 13 Applicant (Retained Earnings) 14 Total Other: (Lines 7–13) Total Non-Federal (Non-section 330) Income (Program Income Plus Other) 15 Total Non-Federal (lines 6+14) Comments/Explanatory Notes (if applicable) Public Burden Statement: An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is 0915-0285. Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 10-29, Rockville, Maryland, 20857.
DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration NATIVE HAWAIIAN HEALTH CARE SYSTEM REQUIRED AND OPTIONAL FINANCIAL PERFORMANCE MEASURES FOR HRSA USE ONLY Grant Number Application Tracking Number 3. Optional Focus Area – Medical Costs Performance Measure Medical cost per medical visit Is this Performance Measure Applicable to your Organization? [_] Yes [_] No Target Goal Description Numerator Description Total accrued medical staff and medical other costs after allocation of overhead (excludes lab and x-ray costs) Denominator Description Non-nursing medical visits (excludes nursing [RN] and psychiatrist visits) Baseline Data Baseline Year: Measure Type: Numerator: Denominator: Calculated Baseline: Projected Data (by End of Project Period) Data Source & Methodology Key Factor and Major Planned Action #1 Key Factor Type: [_] Contributing [_] Restricting Key Factor Description: Major Planned Action Description: Key Factor and Major Planned Action #2 Key Factor Type: [_] Contributing [_] Restricting Key Factor Description: Major Planned Action Description: Key Factor and Major Planned Action #3 Key Factor Type: [_] Contributing [_] Restricting Key Factor Description: Major Planned Action Description: Comments