1990-011-RES WHEREAS, under the provisions of the Anti-Drug 1988 (Public Law 100-690), Texas will receive federal
RESOLUTION NO. 90-011
WHEREAS, under the provIsIons of the Anti-Drug Abuse Act of
1988 (Public Law 100-690), Texas will receive federal funds to
provide funding for the Texas Narcotics Control Program (TNCP),
and Governor Clements has designated the Criminal Justice
Division, Office of the Governor, to administer the program in
the form of grants to units of government; and,
WHEREAS, the City Council of the City of Paris deems it to
be in the best interest of the citizens of Paris to seek such
assistance which will focus on drug law enforcement; and,
WHEREAS, an application for such grant assistance in an
amount to be determined by John Coffel, Director, Texas Narcotics
Control Program, after all applications have been received,
should be made; and,
WHEREAS, if such application for grant assistance is
approved, the pro j ec tis to be funded by 75/0 f eder al funds and
25% local matching funds; NOW, THEREFORE,
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF PARIS:
1. That an application be made to the Texas Narcotics
Control Program, Office of the Governor, Criminal Justice
Division for a Texas Narcotics Control Program, 1990 Grant, in
an amount to be determined by John Coffel, Director, Texas
Narcotics Control Program after all applications have been received,
and if such application for grant assistance is approved, the
project is to be funded by 75% federal funds and 25% local
matching funds.
2. That Michael E. Malone, City Manager of the City of
Paris, be, and he is hereby appointed as the Authorized Official
of said project and is authorized and directed to execute on
behalf of the City of Paris the application for grant in the form
attached hereto as Exhibit A.
3. That Karl Louis, Chief, Paris Police Department, be,
and he is hereby appointed as Project Director and is hereby
authorized to execute and deliver on behalf of the City of Paris
all reports, communications, assurances and documents necessary
for the completion of said project.
4. That W. E. Anderson, Director of Finance, be, and he is
hererby appointed as Financial Officer and is hereby authorized
to receive and distribute funds for purposes of said project.
Passed and adopted this 12th day of February, 1990.
---I' ./
~// /' -
),- ( . (//~
Eric S. Cliffo , Mayor
ATTEST:
;: '-" -'j ''\'
/ .;,-.:.~,..) ':~,~)
..........'-....:.1
.....:....
STATE OF TEXAS
OFFICE OF THE GOVERNOR
AUSTIN. TEXAS 78711
WILLIAM P. CLEMENTS, JR.
GOVERNOR
1990 TEXAS NARCOTICS CONTROL PROGRAM
GRANT APPLICATION FORMS AND INSTRUCTIONS
Under the mandate of the Uniform Grant and Contract Management Act of
1981, Texas Civil Statutes Article 4413(32g), specific standards have been
developed for the application and administration of grants and contracts.
The Act mandates that those standards shall be adhe~d to by state agencies
when administering grants or contracts with cIties', counties, or other
political subdivisions of the state.
In compliance with the Act, all applications for criminal justice grant funds
submitted to the Governor's Office, Criminal Justice Division, must be
submitted on the standard grant application forms prescribed by Attachment
M of the Uniform Grant and Contract Mana~ement Standards.
One set of those forms (Exhibit M-3) is specifically applicable to criminal
justice grants. The forms provide for the inclusion of "other budget
information . . . as deemed necessary. 11 For that purpose, the Criminal Justice
Division has added budget Narrative Schedules A through G as the suggested
format to be followed.
Applicants should follow these instructions in preparing grant application
forms.
Revised clanuary 1990
EXHIBIT A
! . r,',
Guidelines for Completion of Standard Form 424 J
Other Prescribed Office of Management and Budget 'Forms J
and Crimin~l Justice Division SUItf!ested Application Format
Attachment M of the Uniform Grant and Contract Management Standards
contains forms and instructions for applying for all types of state and federal
funding.
Only two of the exhibits in Attachment M apply to criminal justice related
grants -- Exhibit M-3 for non-construction proiects (pages 11-23), and
Exhibit M-4 (pages 24-37) for construction projects.
The majority of applicants will be using exhibit M-3, and should refer to the
following instructions in completing the applications. Sections marked "Not
Applicable" (N / A) do not require any information from the applicant.
For clarity in referencing, each page in the application package is given a
CJD page number (e.g., CJD-10), to which these guidelines refer.
The federal form 424 (Pages CJD-l and CJD-2) included in this package
supersedes the corresponding form printed in th~ ,current edition of the
Uniform Grant and Contract Management Standards.;' The old form may not
be used. .
In all sections of the application J express amounts in whole dollars only.
Part I - Standard Form 424 (~s CJD-l throuJth CJD-2)
The Standard Form 424 (page CJD-1) will be the front sheet of the grant
application.
Section I - Applicant/Recipient Data
1. Mark "Application, Non-Construction".
2. Enter date submitted to Council of Governments/Regional
Planning Commission or, for State Agencies: and Nonprofit
Organizations, enter date submitted to CJD.
2. a. Optional use; internal identifier code within applicant
organization.
" '
3. . Leave blank.
4.
Leave blank.
5. Legal Name: Enter the legal name of the applicant organization.
Organizational Unit: Name the sub unit within the applicant
organization that will operate or manage the project.
Address: Enter the complete address (including county) of the
applicant.
Revised January 1990
Name and telephone number: Self -explanatory. Must be
completed.
6. Enter the State Vendor Identification Code assigned by 'th~ State
Comptroller. If that number has not yet been assigned, attach
a copy of the applicant's request for such number. (Typically,
this information is available in the applicant's accounting unit.)
7 . Enter appropriate code. Nonprofit organizations should use
code "N".
8. Mark "New" if the project is not presently funded by CJD grant.
Mark "Continuation" if the project is presently funded by CJD
grant.
Mark "Revision" if the document relates to a grant presently
funded by CJD or to one that is pending CJD
approval/ disapproval.
9. The required information has been preprinted.
10. Enter the 5-digit code and the title (e.g., SF-AOl Crime
Prevention) that describes the program, ~nder' which the
application is submitted. That code and title appear in the
Program Description section of the Grant Application Kit.
11. Self-explanatory. Do not merely repeat the title ~ stated in item
#10. Briefly describe what the project will do. (Continue on
page 2, if necessary. )
12. List the cities or counties to be served by this project. State
agencies, universities, and nonprofit organizations list
"Statewide" .
13. Start Date: Enter the date on which this grant will start.
Ending Date: Enter the date on which this grant period will
end. (Grants are usually approved for a period of 12 months.)
14.a. Enter information as requested.
14.b. Enter information as requested.
15.a.
Enter information as requested.
15. b. Cash match provided by the applicant. Generally, other
state/federal grants may not be used for match purposes (see
item number 11, CJD Financial and Administrative Requirements).
Amount must agree with page CJD-8, Section C, Column b.
15.c. Grant moneys requested. Amount must agree with page CJD-8,
Section C, Column c.
15. d. Leave blank.
Revised January 1990
15.e. Cash match provided by an organization other than the applicant,
such as by a contractor who will operate the grant project.
Generally, other'state/federal grants may not be used for match
purposes (see item number 11, CJD Financial and Administrative
Requirements). Exclude program income. The sum of 15. e and
15.f must agree with page CJD-8, Section C, Column d.
15. f . Enter the estimated amount of gross income to be generated by
activities of the grant project and which will De expended, in
addition to the grant moneys and cash match stated above, to
finance the budget described in the grant application. The sum
of 15. e and 15. f must agree with page CJD-8, Section C,
Column d.
15.g. The sum of the entries in 15.a through 15.f. Amount must agree
with page CJD-8, Section C, Column e.
16. a. Enter the date on which the application was submitted to the
appropriate agency for review and comment under the Texas
Review and Comment System (TRACS). Universities, Nonprofit
Organizations, State Agencies, ancl. Regional Councils should
submit a copy of the aJ?plication to the Governor's Budget and
Planning Office. Units of local government should submit the
entire application to the respective Regional Council. . .
16.b. Leave blank.
17 . Self-explanatory. Must be completed.
18.
Enter information as requested. The person named as
"Authorized Representative" must be the authorized official for
the applicant who is empowered to apply for, accept, reject, or
cancel grants (i. e. , executive director of a state agency, county
judge, city mayor, city manager, chairman/president of the
board [of nonprofit organizations only], university chancellor,
etc. ) When such authority has been delegated to another
person/position, attach a copy of the document by which such
delegation was made. The signature must be that of the person
I named; if facsimile signature is authorized, attach a copy of the
; document that gives such authorization.
I
~ J
~, '
The Standard Form 424 includes a continuation page (application page CJD-2)
for continuation purposes, as necessary, and for additional remarks, at the
applicant's 'option.
Revised January 1990
Other PrescnDed Office of Mana2ement and BUdJ!et Forms
Part II - Project Approval Information (Pasre CJD-4}
, ,
Item 1. All applicants mark "Yesll. Local applicants: cite name of
Regional Council. Other applicants: cite own agency name.
Item 2 · Local applicants mark "Yesll and cite name of Regional Council.
COl projects also require review by the Texas Education Agency
(CJD will obtain). Other applicants mark IINolI unless applicant
agency policy dictates otherwise.
Item 3. Refers to TRACS in lieu of A-95 review. Local applicants mark
IIYes" and attach review comments from Regional Clearinghouse
(Regional Council). Other applicants mark IIYesll and attach
review comments from State Clearinghouse (Governor's Budget
and Planning Office). State Agency applicants must state
whether application also has been submitted to the Legislative
Budget Board (Form 1172).
. '
Item 4. All applicants mark "Yesll. Local applicants cite name of Regional
Council and IICriminal Justice Divisionll,":.Ot~er applicants cite
"Criminal JUstice Division 11 . .
Item 5 · Local applicants mark 11 Yes", 11 State 11, and 11 Re gional" j cite
"Criminal JUstice Division", and name of Regional Council. Other
applicants mark "Yes" and IIStatell; cite 11 Criminal JUstice
Division" . .
Item 6. Complete as stated.
Item 7.
Item 8 .
Item 9 .
Item 10;'
Item 11.
Complete as stated.
Mark IIYes" or IINolI as applicable. If IIYes", describe briefly
the possible beneficial and harmful impact 'of the proposed project
on the environment. If an adverse environmental impact is
anticipated, explain what action will be taken to minimize the
impact.
Complete as stated.
Refers to state or federal grants. Mark "Yes/No" as applicable.
If "Yesll, cite source, amount, and status of grants (lIpreviouslI,
'''existing'', or "pending") at the time this application is
prepared.
Mark IIYes/No" as applicable. If IIYesll, describe in detail. and
name the governmental entity having made the designation.
Revised January 1990
Part III - Budget Information (P~s (CJD-6 throulth CJD-8)
Section A - Budltet SummalY
Leave blank. Not applicable.
Section B - Budget Catef!Ories
This section is a summary of proposed expenditures of state criminal justice
funds, local cash contributions, and program income presented in detail on
Schedules A through G, pages CJD-10 through CJD-14.
Columns (1), (2), and (5) should be completed for each line in section 6.
Head column (1) "State CJ Funds", and transcribe total from the "CJ
Request" columns of pages CJD-10 through CJD-14. Head Column (2) "Cash
Matchll and transcribe total from the "Local Cash Contribution" columns of
pages CJD-10 through CJD-14. In column (5) enter the sum of columns (1)
and (2); these entries must agree with the corresponding. "rotaI" columns on
pages CJD-10 through CJD-14.
. '
11 Cash Matchll may be cash provided by the applicant agency, .by a nonprofit
corporation that will be affiliated with th~<~,grant project, by
private I civic I charitable. contributions, or by prograul income generated by
the grant project activities when approved by CJD. Generally, other
state/federal grant funds may not be used for match purposes (see item
number 11, CJD Financial and Administrative Requirements).
6.a. Use lITotal Direct Salaries" from Schedule A, page CJD-10.
b. Use "Total Fringe Benefits" from Schedule A, page CJD-10.
c. Use "Total Travel Budget" from Schedule C, page CJD-12.
d. Use "Total Equipment Budget" from Schedule D, page CJD-13.
e. Use "Total Supplies and Direct Operating Expense Budget" from
Schedule F, page CJD-14.
f. Use "Total Professional and Contractual Services Budget" from
Schedule B, page CJD-l1.
I,. . g.
h.
.
1.
j.
k.
7.
Use "Total Construction Budget" from Schedule E, page CJD-13.
N/A.
Sum of 6.a. through 6.g.
Use "Indirect Costs" from schedule G, page CJD-14.
Sum of 6.L and 6.j.
Estimated amount of total program income without regard to whether or
not it will be expended during this grant period. Program income
represents money earned during the grant period from grant activities
Revised January 1990
(see item 6, CJD Financial and Administrative Requirements). ITEM
MUST BE COMPLETED: DO NOT USE ftN J Aft. .
Section C - Non-Federal Resources
Complete lines 8 and 12 only.
(a) Use program description code as shown in the 1990 Texas
Narcotics Control Program Application Kit, (DB-B02, DB-D02,
etc.) under which application is made.
(b) Applicant's cash match. Generally, other state/federal grants
may not be used.
(c) Reflect the total CJD funds requested by the grant application.
(same as line 6. k., column (1), Section B, page CJD-6.)
(d) Reflect cash matching funds from all other sources, including
program income (when eligible as cash match) and which will be
expended as a part of the total budget of this project.
Generally, other state/federal grants may not be used for match
purposes (see item number 11, CJD Fipa~!al and Administrative
Requirements) . "
(e) Reflect totals of columns (b), (c), and (d).
The sum of columns (b) and (d) must equal the total ftcash
matchft on line G.k., column (2), Section B, page CJD-G.
Section D - Forecasted Cash Needs
NOTE:
Leave blank. Not applicable.
Section E - Bu~t Estimates of Federal Funds Needed for Balance of the
Project
Leave blank. Not applicable.
Section F - Other Bud~t Information
" ,
21. ~N/A.
22. N/A..
23. State the source(s) and amount(s) of grantee's cash matching
contribution (including program income if applicable). The sum of all
entries must agree with the sum of columns (b) and (d), Section C,
page CJD-8, e.g., City of Dallas $35,000; ABC Rape Crisis Center,
Inc., $10,000; United Way $18,000; Contributions $12,000, Program
Income (fund raiser) $7,800.
.
,
Revised January 1990
Part III - Budltet Information Continued
(Pa~s CJD-IO tbroulth CJD-14) .
Schedule A (Page CJD-lO) ,
Comply with instructions on page CJD -10.
Enter staff positions of the applicant agency.
Enter monthly or annual percentage rate or flat amount rate per person for
each fringe benefit listed.
Schedule A Supplement (Page Cm-lO.l)
If any of the staff positions listed on Schedule A (page CJD-10) indicate less
than 100 percent (of a 40 hour week) as being devoted to this grant project,
page CJD-10.1 must be completed to provide the supplemental information
described therein. In all other circumstances, leave this page blank.
Schedule B (Page CJD-ll)
Comply with instructions on page CJD-ll.
,.;.,
Include all professional personal services / consultant contracts.
Do not include services/products such as rent; telephones; equipment;
janitorial; vehicle lease; printing; copier lease; equipment maintenance;
temporary-agency employees, etc.
Where grant projects, in whole or in part, will be operated by a third party
under contract to the grantee, all costs payable to that contractor should
be summarized in Schedule B and should be supported by detailed information
(of the contractor's expenses) comparable to the detail and form solicited in
Schedules A, B, C, D, E, F, and G. Those Schedules, A, B, C, D, E, F,
and G, which are applicable may be used to present the required detailed
information or plain paper typewritten pages presenting the same degree of
detail may be used. If the indirect costs (Schedule G) that are allowable for
the grant will be paid to the contractor, those costs must be included in the
contract shown in Schedule B and are subject to the required matching ratio
for the grant. '
Schedule B Supplement (Page CJD-II.I)
If the program described in the grant application is to be operated by a third
party organization, under contract from the grantee, page CJD-11.1 must be
completed to show the sources and amounts of all revenue received by the
contractor organization. In all other circumstances, leave this page blank.
.
,
Schedule C (Page CJD-l2)
Comply with instructions on page CJD-12.
Local travel includes the area in which the project operates.
Revised January 1990
, ,',
Under Local Travel briefly describe the purpose(s) of such travel.
Add a continuation page (page 12a) if necessary to thoroughly explain/justify
"In-State-Travel" and "Out-of-State Travel" and to describe the applicant's
travel policy.
Registration fees, typically associated with travel, should be included in
Schedule F, not in Schedule C.
Schedule D (~ CJD-13)
Comply with instructions on page CJD-13.
Like items may be grouped on a single line j otherwise list each item
separately.
Items below $250 unit cost need not be listed as "equipment" unless
capitalized by the grantee, or as specifically required by the Program
Description section of. the Application Kit (e. g., crime prevention films,
tapes, and puppets). Otherwise, include those items in Schedule F.
.' I",.'
Unless the equipment items are thoroughly justified in the 'Program Narrative
portion of the application, add such justification on a continuation page (page
13a.). CJD will delete equipment items that are not adequately justified.
Schedule E (P~ CJD-13)
Comply with instructions on page CJD-13. Consult with CJD for further
guidance, if needed.
Schedule F (P~ CJD-14)
Comply with instructions on page CJD-14.
List major categories separately, e. g., temporary (employment agency)
typist; registration fees; building rent; telephones; janitorial services;
vehicle lease; printing j copier lease; equipment maintenance; utilities;
postage j vehicle operating costs j office supplies j confidential funds for use
of purchase of evidence, purchase of services, purchase of information; etc.
Unusual! complex items may require additional explanation/justification. Use
continuation page (page 14a), if necessary.
Entries for "miscellaneous", "contingency1', "reserve", etc., are not
acceptable.
Schedule G (P~ CJD-14)
Comply with instructions on page CJD-14.
. Applicants may not use option (A) without having an official cost allocation
plan developed in accordance with OMB Circular No. A-87.
Revised January 1990
Refer to the CJD Financial and Administrative Requirements for the CJD
Computation Table to be used with option (B).
,
Part IV - Pro~ Narrative (P8Jte eJD-15)
Present in narrative form beginning with continuation page numbered 15a
(no form provided).
Organize presentation in the following format and under the captions stated.
Presentations normally should not exceed four typewritten pages (exclusive
of attachments).
1. Objectives and Need for this Assistance:
2. Results or Benefits Expected:
3. Approach:
a. Statement of Tasks Involved:
b. Projected Accomplishments:
This section may be completed by entering "Refer to
Project Goal Achievements, pages CJD-16-a and CJD-16-b"
. and by completing application pages CJD-16-a and
CJD -16 - b . Use this section to describe any projected
accomplishments which are not quantified on pages
CJD-16-a and CJD-16-b. Applicants under program
SF-A02 must also complete application page CJD-16.1.
c. Kinds of Data to be Collected:
d. Other Participating I Cooperating Organizations:
List external key individuals and organizations who will
work on the project along with a short des,cription of the
nature of their effort.
4. Geog-raphic Lo'cation:
Name the Cities and/or counties to be served by the project.
State agencies, universities, and nonprofit organizations may cite
11 Statewide" .
5.
Research or Demonstration Projects:
If the project is of a research or demonstration nature, present
a biographical sketch including background and other qualifying
experience of the project director and of other key staff members '.
engaged in the project. Otherwise enter "N I A".
Revised January 1990
6. Accomplishments to Date:
For continuation grants list accomplishments of the project.
This requirement may be met by attaching the most recent
progress report of the ongoing grant.
Part V - Project Goal Achievements (P~ CJD-IS et. at.)
The application kit contains pages CJD-16-a, 16-b, and 16-c, a multi-
purpose form designed to be used partially with the grant application and
secondly with the required semi-annual and final progress reports. Refer
to the detailed instructions accompanying the form in the application kit for
its usage as a part of the grant application.
Texas Narcotics Control Program shall require quarterly production statistics
provided on forms that will be issued at the time of the grant award to the
su b-grantee. Additionally, each project is required to provide CJD with
offender tracking forms which are provided at the time of the grant award to
the sub-grantee.
.
In unique types of projects for which no Performance Indicators are listed
in the "Assessment Requirementsll section of the ~l'Qgram Description in the
Application Kit, applicants must consult with CJD to develop appropriate
Indicators.
Assurances (PaRes CJD-17 throuRh Cm-18)
The preprinted assurances are required of all grantees and must be included,
without change, in each application.
DesiJtnation of Grant Officials (P~ CJD-19) .
Complete the required information to show:
1. Project Director:
The employee of the applicant agency (or, at the applicant's
option, from the contractor organization that operates the
project) who will be directly responsible for operation of the
project.
" '
2 . Financial Officer:
Must be the chief financial officer of the applicant agency, i. e. ,
County Auditor or County Treasurer, City Treasurer,
Comptroller, etc.
3. Authorized Official:
The person authorized to apply for, accept, de'cline, or cancel
the grant for the applicant agency; Le., Executive Director of
Revised January 1990
a State Agency, County Judge, City Mayor, City Manager,
Chairman/President of the Board (of nonprofit' organizations
only), University Chancellor, etc. Must agree with the signature
on application page CJD-l.
AttJll!hments
1. Each application from a city, county, or school ,district must be
supported by a resolution of the governing board authorizing
submission of the application.
2. Attach comments by the appropriate clearinghouse made under the
Texas Review and Comment System (TRACS).
3. Attach other documents as required by the specific program under
which the grant application is made. (See Application Kit.)
.' I.,...
Revised January 1990
APPLICATION FOR
OMS Approval No. 03U-OO~)
FEDERAL ASSISTANCE' 2. OATE SUBMITTED Ar- t Identlfter
t. TVPE 0' SUBMISSION: J. OAT! RECEIVED BY STATE Stale Applicallon Identlflel
Appllca/lon Preapplicalion
o Con,trucllon o eon,lluCllon
4. DATE RECEIVED BY FEDERAL AGENCY Fooe'alldenlifler ~
o Non.Con5t/uclion o Non.conslruclion
I. A'PlICANT INFORMA nON .
Leqal Name Oloenlzellonel Unil:
Marm IIJ,vll City, county. Slale, and lip code) Name and telephone number of the person to be conleCled on maller, InvolVing
thl, applicallon laNs srsa COO6)
6 EMPLOYER IDENTlFICAnON NUMBER (EIN): 7, TVPE OF APPLICANT: lan/ar apprOPfliJ/a lallar In box} 0
A. Slale H. Independenl School 0151.
B County I. State Coni/oiled Inshtullon of HICJher LearnlnCJ
I. TYPE OF APPLICATION: C. MUnicipal J Pnvate UnlVel5lty
D. Township K. Indian T II be
o New o Continua lion o ReviSion E. InlerSlate L. IndiVidual
If ReVISion. enter appropllale lelter(s) in box(e,), 0 0 F. Inle/munlClpal M Proll! Organlzallon
a Speclel Dislricl N. Olher (S~IIy) ..-
A Increase Award B. Decrease Award C Increa58 Duration
Q Decrcase Qurallon Othet Isp~tfy): I. NAME OF FEDERAL AOENCY: GOVernor's Office
Crimi na 1 Justice Division
P.O. Box '12~2B, Austin, 'Texas78711
to. CATALOQ OF FEDERAL DOMESTIC I I .1 I I II. DESCRIPTIVE Tln.E OF APPLICANT'S PROJECT:
ASSISTANCE NUMBER:
TITLE.
12. AREAS AFFECTED BV PROJECT (Cllles, counll6S. Hates, e/c)'
1J. PROPOSED PROJECT: I~. CONGRESSIONAL DiSTRICTS OF:
Slart Dale Ending Dale a. Applicant b Project
15. ESTIMATED FUNDING: 16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 12J72 PROCESS?
a Federal $ .00 a. YES THIS PREAPPLlCATIONlAPPLlCATlON WAS MADE AVAILABLE TO THE
STATE EXECUTIVE ORDER 12372 PROCESS FOR REVIEW ON
b. Applicanl $ .00 DATE
C SIal\! S .00
, b NO 0 PROGRAM IS NOT COVERED BY EO 12372
d Local S .00
0 OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW
c Olher S .00 .
,
1 Program Incomo S .00 17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL OEm
I) TOT^L S .00 DYes If .Yes.. allach an explanahon. o No
.'
11 TO THE BEST OF MY KNOWLEOOE AND BELIEF. ALL DATA iN THIS APPLlCATlON,l'REAPPLlCATION ARE TRUE AND CORRECT. THE DocUMENT HAS BEEN DULY
AUTHORIZED BV THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPL Y WITH THE ATTACHED ASSURANCES IF THE ASSiSTANCE is AWARDED
J r Vpud Name 01 Aulhorlled Represenlalive b Title c Telephone numbel
d SUlnJlure 01 Aulhorlled Representallve e Dale ')IQned
PIiJVIUUS EOlllons NOI USdble Slandard Form J24 ::lEV I d!l.
CJD-l
P'esc!lbed by 01A8 ,-'f ~,,)I .~ I ;l
CONTINUATION PAGE
for continuation, if necessary, of any item on application page CJD-l.
Identify by number the item being continued.
May also be used for any other remarks, at the'applicant's option.
-------.- -
'. .
STANDARD FORM 424 PAGE 2
CJD-2
Next page number is CJD-4
aile NO. .~ A 0 III
PART II
PROJECT APPROVAllHFORMATIOH
It em l.
Do.. this auislon" .~u..I ..qui.. Stale, local,
..gionol, O' oth.. pliOlity .allng?
_ Y.i _No
Nom. 01 Goy.ming Body
Prlo.ity Rating
hem 2.
Dou ,h'i OUlilonCI ..qutll.tqulle Slot., o. local
odYlio,y, educational or hlahh d.alOncu?
__Vu__No
NOIIIf 01 Aglncy a.
Boo.d
IAlloch Documlnlationl
hem 1
Doti this OUlilonc. rcquUllCqui.. c1,o"nghouse
,evI,W In oc<ordonce wllh OMB ("<ulor A.95'
_ Y.. No
It.m t
00" Ihu aUI,lonce .cqu..' ..qui.. Stole, 10<01,
,.glonol 0' olher plonnlng opproval' "
-Y.,_No
(Alloch Commtnhl
Nome 01 Apjlfoy;ng Aglncy
Dole
Itlm 5.
-
II Ih. p.opoud prOlect cov.,ed by on approved compr..
h.nSIVe plan?
______Y.i______No
.'
"
Ch.d one: Stol.
Lo<al
Regional
Location 01 Plan
r: :
rl
rl
I'
Ilem 6.
Willlh. aUlSlonce request.d serve 0 F.dl/al
installation' _ YeI_No
Nom. 01 f IdtlOl Installation
f.dllal Population b.n.l,ting IrOln Pralect
It em 7.
W.!I ,he oui,'on" "ques,.d be on Fedl/ollond or
instollotlon?
- Vis_No
No",. 01 F .d"o Ilns 10 110' ion
L ocol ion 01 F tdllO I L ond
PIIClnl 01 PrOllCI
It.m 8.
Wdllhe aUUIOnct rcquesled hove on impact or elleel
on the Invllonmenl?
_Y'i_No
See initruclioni lor odditionollflformation to b.
jlfovlded.
Itlm 9.
Will ,h. os...tancr rcqu....d COUit "" d'iplacemlOt
01 IndiVidual" lomili.., bUiin."", or lorm,?
_Y.s______No
Nu",b" of:
Indiyiduall
F omil,"
Bu.in.""
Forml
It.m 10,
I. Ih." oth.r "lol.d oUislonCl on thil project P"ViOUI,
pending, or onticipat.d?
_ VII_No
S.. instructionl lor additional inlorlllOlion to be
p.ovid.d.
~
11th. projlcl in I d..ignlled flood h.urd .,..1
_VI._No
S.. In.truction. tOt .ddltlol\lllnlOtmtllOn to
lit pr 0\1 idld.
CJU-4
Next page number ;s CJD-6
-D
co
...
o
IlIl
6
GO
I I
~f~' .. -
. '" I
I _
..
... ."
._- -l-
-,~ VI - -.- - VI ....
- -- '-
: I i
. .
. ..
I -
. -
u. .
It I
. J-
z
I
I VI VI
I I -~-~-, -
I I .. "" VI ~.
--- - -
i I I I ! 11
I . .. .. --
.. ..... I I
Z . I
0 >- ... I '"
It UJ
I- 0( -
Ill:
0( ~ 0 i
~ --~f-- .... '" .
-~ -'- -- -- !
Ill: :J UJ
0 III I I- r
l1.. I 0( . ,.. VI .... ....
x I- .1 u ... ~- -, - r-- I--
- UJ I i
0 . l- I
t- o I LU .
0 11 . ;, ! t I
UJ :J II. 0 I
. ) 0 a:
L' II ..I I
0 1 I I I ~ 1
:l I II .
i I J
It) . ttl I
0( - ... 1IO I
I :. --
% r Z
- 0 I ~ I 0
= - r
t- I I- .... .... ....
~ t I U --
U i
Ik: w . - W
0( '" . . '"
. -
n. w .
... I
~--~" I I
I I
- -- --I-~ I I
I J~ I
, I
. .... ~ VI
.. I -- - -
. .
.. . :.
... ;...
... .
I
U
...
"
~ '"
1:.
iIi
i 11 ... s; t:
u u "
.. E
. I 7i
t i . III & ~ 8
_ 1 ~ .. .J:.
. i . ! i U ~ I :> ~ U .5
VI r: ~ 0 VI
lL . _ ~ .J ~
,) ~ .J c: f 1
0( ~ a i 1I f 1; 0(
IU. ... .. ~ l! g 15 i t- ~
~ 0 8 8 0 0
t- eL L.I. t- W VI U t- t- eL
...; N ,.; .. .n ~ .4 ..:i J .:l ti -= ... .Ii .: ..:. ... t.:
.
o
~
...
..
)
o
...
&
<(
~
CJD-6
Next page number 15 CJD-8
I
..
i
~
~
..
II
C
i
R
v'!
LU
U
It:
~
o
v'!
UJ
It:
.J
~
It:
UJ
o
W
lL
.
Z
o
Z
I
U
Z
o
t-
U
W
v'!
'"
.J
~
I-
o
l-
t
..
'"
w
U
DC
;)
~I
~I
I
I-
o
..
-
..
,
wi
;1
-
u
..
..
::
~
~
.J
a.
a.
..
..
..
~ '
t
a.
t
.
t5
..
. ",
I i
I :
I !
, I
!
I
I :
I
I
o - ...
..
..
..
..
OIl
.J
~
I-
o
..
v'!
o
w
w
Z
J:
v'!
-<
U
o
w
t-
v'!
00(
U
W
It:
o
U.
I
o
Z
o
t-
U
UJ
V!
.
)
o
.l-
.
.
.. ..
.
)
o
..
~
.. ..
.'
J
1
...
I
I.. ..
.
J
.. ..
I
.
)0
...
o
I-
.. ..
.
.
. 1 .J
.i Ii. ~
. t 0
Ii. Z I-
.;.
~ ~ -
t-
U
UJ
..,
o
It:
ll..
UJ
J:
t-
u..
o
w
U
Z
~
.J
00(
!Xl
It:
o
u..
o
w
o
UJ
W
Z
v'!
o
Z
~
lL
.J
-<
0::
W
o
UJ
u..
u..
o
v'!
UJ
I-
<
~
l-
V!
W
I-
UJ
l.:)
o
:>
!Xl
I
W
Z
o
I-
U
UJ
v'!
'"
Cl:
.. 0
w DC
)0 -
_ :r
'" I-
o -
Q :!
DC
w
a.
~
o
z
;)
Ii. ~
W Z
DC 0
::> u
I- W
;) ~
Ii. ~
I-
lI\
DC
Ii.
;!
r
i
C
.
o
-
!
CJD- 8
I
I-
DC
:l
o
Ii.
-
.!
..
..
..
..
..
z
o
-
t-
~
~
It:
o ~
lL !
.. z .
_. .
-- u
t- 1
UJ :
l.:) .
o .
:> 1
!Xl oil
It: 1
UJ!
J:
I- ..
.. 0 1
.l-
I ~
U. ~
Z
o
t-
U
w
v'!
..
.0 ....
lI\
.J
~
I-
o
..
.. I> 2
.
L
.
.I.
U
u
.
.1
o
-
...
&
'..
U
:l
..
..
III
l:
..
"
n.
.J:
u
o
..
..
-<
w
>
I-
-<
It:
It:
-<
Z
~
-<
0::
l.:)
o
It:
ll..
>
I-
0::
-<
ll..
.
L
J
u
u
.
..
1
.
..
t
.
Cl:
...
...
...
...
Next page number is CJD-10
SU\Jq0str.cJ T'ormat
()ther /ludq(~llnf()rmatiorl
Covcrnorls Criminal Justice Djvlslon
JldfllJl
~;ecl ion r
Line 21
BUDGET NARRATIVE
BC9in below and add as many continuation pages following each schedule (AI, El, etc.) as may
ho nN'rl('d to f~xrlain (lilch itf~rn of the rroject budget. Narrative shoulrl include explanation of
tllcj Ildsis for orrivinq Elt the cost of each item including Grantee Local Cash Contrihution items.
All amounts should be shown in whole doHMs.
SCHEDULE ^
PERSONNEL
). Direct Salaries
% OF TIME
TO THIS CJ LOCAL CASH
TITLE OR POSITION I PROJECT2 REQUEST CONTRIBUTION TOT A L3
(A) $ S $
(8) S S S
(C) $ S S
(0) $ :' S S
(E) S S S
-
(F) S S $
(G) S S S
(H) S S S
TOTAL DIRECT SALARIES S S S
2. Fringe Benefits 9b or S Rate
FICA @ S S s
n ETIR EMENT @ S S S
INSURANCE @ S S S
--
OTHEH (EXPLAIN) @ S S S
TOTAL FRINGE BENEFITS
01
10
$
$
$
TOTAL PERSONNEL BUDGET
s
s
s
]. Include only one position per line. Briefly describe the duties or responsibilities of each position.
2. Express ClS a percent of total time (2080 hrs. per year).
3. Should reflect employee's gross salary attributable to the project.
CJD-10
CIl
Z
o
H
8
H
CIl
~
~
CIl
~ .C: Ql Ql ~l jJ
jJ .c: .c: Ql III
Ql ',i ~J .jJ ..c: .r:;
M ~ .\oJ 1-1
j 4-lC::O
"0 (l) H ." Ql
.~ .~ >i Ql ~
U.jJ H Ul 0,
(/) . .1-1 0
Ql :~ c: .C: Ql
i-IHOQJ.j...lM
(l) 1Ilr--l ~
,g~]~4-1 ~
j .j...l 0 X
Cil.jJrl Ql
o QJ r--l
8CQJ.j...lr--l~
C QJ lt1 '"'
C Ul ." M (/)
~QJr--l~ '-'
o 0 E,
,...."OcO:>1
~ OUH.c
(l) lU U
c:: QJ ~ ,_.:.'~ lU
.8 ~ g .j...l Ul (l)
.jJr--lr--l C H
.r, ~.Q lU r--l 0
UloE ~lt14-<
(l) (l) .jJ
~ .jJUlO(l)
IH (l) lt1 ." .j...l U
4-1 ..c: .,., ..c: H
rtl .jJ H .j...l j
.jJ ~ '0
UlIH04-l(l)Ul
'0 H ~ 0 .~ tJ1
." ~ (l) .jJ ~
lU .rtl~ :0
0,1-1 0 M C
U (l) U lt1 j
:>1 (l) ..c: Ul .j.J 4-l
Hn.jJ 0
(l) 0 (l).j...l (l)
>HC..c: .c:
(l) O,.".j...l .jJ
Ul
H.j...l 11 ~
o C :>1"0 (l) '2
lH rtl H ." (l) ...
H.j...lUl""lU
c:: C ,....,
otJlQJ.jJO,
." Ul 5 'b...c:
~ .rl (l) '-' E ~
~~~UlQJ(l)
20tJ10(l)B
jJ c:: (l) ..c:
c: ." 'n .j...l "0
'r-; "0 .jJ 0 (l)
'0 (l) (l) H ~ .jJ
(jJjJ r--l 0; 0 0
HOo."-....c:>
.r-; > E Ul Ul (jJ
~~8~ "0
(!) H 0 (l)
H aJ ~ g .j...l .~
(l) .~ H .jJ
.r.:.jJ(l)~3
.jJ .jJ 0 lH
4-llUHr--lO
3 0 U (l) (l)
o ."..c:.Q (l)
.1~ ~o 'd 1-1 tJl
UlOc::O lU
o 'r-; N.jJ
o ~ ..c: C;
.~) , .1-1 (1)
o .r-; (1) U
'OCUl3CH
(1) rd ." (1)
.~J ,!; '(l) r--l ~
OJ .jJ .jJ E
r--l U 'r-; (l)
~UlQJ.j...lC:O..c:
E Ul n .jJ
o OJ 0 OJ
U""'HH~ '
(1) o"lUUUl
tIl"-....c:O.jJ
.OrdEUlr--lU
.j...l lt1 .Q OJ
In ....... H Ul 'n
o tJ'l (l) 0
~rlOOQJH
I H "0 .jJ 0..
(;00.. rd,.......
~~ r) (l) 'r-; tIl .
o U H (l) H E tIl
lH (l):>10,nJ3
(1) ..r; 0 0 H 0
Ul tJ1.jJ ,-1 H tJ1 r--l
.... lU 0 OJ 0~ 0 d
,r:: 0.. Co E OJ H 0
l.... '-' l\l (l) lU 0, ll-l
~~
8
~~
~~
0)0
~
8Z
~~
~~
o
~
H
~
~
llJ
~
CIl
,
.j...l
OJ
Ol
'tl
~~
4-l
o OJ
~
Cl ::l
OJ~
l::,.c:;
." u
HCIl
.j...l
OJ
,g
~<
4-l
o OJ
~
U~
OJ OJ
Z l::..c::
0 j~
~ .j...l
CIl OJ
H ,g'
H -
Z ~<
0 -
H 4-l
8 o OJ
H ~
tIl ~~
2
OJ OJ
l::..c::
j~
.j.J
OJ
;g
~<
4-l
o OJ
~
:~
j~
"'-..
.jJ , :>1 . . . .
..c:Ul,..., . . . . . .
. tJl OJ H . . . . . . .
~ 'r-; U j (l) ~ . . . . . .
QJ I HHO..c:QJ . . . . . .
. (l) ..c: (l) j ..c: .j...l OJ . . . . . .
(l) Ul ....1 ... .jJ "0 OJ 0 3 . . . . .
.:>
E ~j l\l .r-; ..c:Ul~'tJ . . . . . .
." U .jJ H ~ Ul .jJ o c:: H . tJ1 . . tJI
.jJ QJ 0 QJ lU ,...,.c:m OJ H . . C H . C
'n .jJ 0.. (l) o ,..., Ul 0; 0 . . ." 0 . . ."
(1) 0 ~Ul.jJm- , . . "0 . "0
H H (l) 'd . .j...l ....... Ul ~ . . c: ~ . . C
m ~..c: (1) .jJ U H E ,,..., H . 'tl j . '0 j
..c:"-...j...l~ QJOJO+lrtlj H . (l) 4-l H . (l) 4-l
Ul Ul H (l) 'n.j...l H C ::l 0 01 . .j...l Ol . .j...l
~.jJO HOC4-lrtlC..c: 0 . 0 4-1 0 . 0 4-l
+l ..c:: 3 rtl H W H C H . :> 0 H . :> 0
0 H tJl ..c: 0; >tOlrtl.-1 0; . OJ 0; . OJ
c: tJl." tIl Ul"'-.. H "-..rtl . '0 (l) . '0 (l)
o H H Ul . rtl tIl:>1.jJ H . U H . U
Ul H ::l Ul ~ ~ ,..., .,.,,..., 0 (l) .j...l OJ H QJ .j...l OJ H
OJ O;QJO OJ Ortl..c::..c::.j...l ..c:: U .~ j ..c:: u E j
0 ..c:..c: 0 H,...,tIl.jJ.jJ .jJ (l) 0 .jJ QJ ." 0
'0 H .jJ "0 tJlQJ C Ul o 'n .j...l Ul On .j...l Ul
OJ 4-l O.QMtJlO~ 0 - 0
(l) .C: 0 0 (l) H l\l C E QJ (l) H 4-l (l) (l) H 4-l (l)
(l).jJ.jJ (1) ~ "0 .j...l 'r-; "-.. (l) ~ ~ 0 ~ ~ ~ 0 ~
:>10 H :>1 QJ 0 '0 :>1 :>1
0 H QJ OH.Q.j...l::l,...,O Z o\~ Z Z 010 Z
,...,..c:(l)~ ,..., (l) ." ,...,~,...,
0...jJ .jJ o....c:H(l)U(l)O;
Q 'r-; C E.j...lU..c:CQJE . .
3 ill C rr.l 0 (jJ .jJ ." 3 (l) rtl .0
. I
rl N
0'
Q)
0'
rl
H
QJ
~
(l)
U
OJ
Cl
'0
(l)
Ul
."
:>
OJ
~
CJD-IO.l
U)
z
o
H
E-I
H
U)
~
~
E-I
U)
~.c;aJaJJ..<+J
+J..c..c<IJrO
aJ ." ~..J +J .r: ,r.:
~ ~ .j.1 .j.)
j lHCO
'\J aJ H .rl (j)
,i~ .~ ?; III ~I
U jJ J..< lfl p,
(I) 0 +J 0
<IJ 3 '-= ,r:; <IJ
..J J..< 0 <IJ +J M
01 '" M 0..
0' IU (j) (j) E
'0 .r:; ..Q c 4-l m
:Jlfl '+JOX
I1l +J rl (j)
o <IJ ~
C::O~r.:<IJ+J~<IJ
c <IJ rO <IJ
C lfl ." M (/)
~<IJMq.
o 0 B ~
,r; '0 C U J..< .
lfl 0 rO..c
<IJ 'M U
c:: (j) ~...... f1J l\J
.8 ~ g +J lfl QJ
..J~~ c: J..<
"I 0...0 f1J ~ 0
lflo r.: ~1 r nJ 4-l
<IJ III +J
0.. +JlflO(j)
Ij_1 llJ nJ .rl .j.J ~
If.! ..c ." ..c .,
f1J +J'!-l +J ;:1
_~) 01 '0
(11 4~ 0 4--1 III lfl
'0 H ~ 0 .~ 01
.,~ 0.. llJ +J c:
of f1J .rl
IU 0.. '0
Q,+J O~C'
~~~UrO~
J..<-n.plfl~4-l
OJ 0 (j) +J (j)
>!-lc::..c ..c
OJ 0..." +J ..J
lfl
J..< +J (j)
o c: ~ '0 ~OJ '0
4"j rO !--~ '" OJ C
J..<+Jlfl~ro
8 0' ~ ..J 0 ,
"'1 ::l ~ r;
IJ lfl oo..'u
nl .,j ~ '-" f:: ro
E 'S ..J lfl (j) (j)
!--. ..J
40 0 0' () (j) ..S
.~ .j ) c: llJ ,r:
L .rl '1, .jJ 'U
.rl )
'I) I 0 (\J
''0 (j) OJ J..< ~ .jJ
llJ1JMO,OO
!--I 0 P. -'-.r:; :>
,,, > f: l~ vi 01
::l (j) 0 E '0
0' 'U U rU
OJ J..< 0 (lJ
!--j (1) ~ IJ1 ..) i~
8 .0 0 'rl
('.1 .,~ !--~ +J
..c .IJ 1lJ 0.. 3
.j.l +J 0 lIj
Ijj (~ l~ M 0
:< 0 u OJ QI
o ',-1 .r: .0 (j)
.L~ \(1 '0 +J 01
lflbcO rO
O 'rj ('\1 +J
o .r: C'
.1) ,-I I) ill
. 0 ',-1 ~ U
'U ,- lfl .~ C l ~
QJ nl '." III
+J..c '<IJ,-1 0..
(j)+J+JE
,-, U 'rl llJ
o..lflOJ+JC:,.c::
E lfl'r, 0 W
o <IJ 0 11)
ll,~J..<J..<'< '
Q, n' 'u (I)
OJ Ul --, r.: 0 'J
il - ,- -.-
r05(fJ~U
..J ILJ .0 a;
...... ~ Ul "'1
~c O1CJ 0
"F.'dOOOJ!--j
. I !--j '0 .j.J D,
1::00.. rO...............
~I Ie QI .,j lfl
o U !---I 01 !--I S U;
4-1 (\1 >, 0, IU ::
<11 .1-: 0 0 l-l ()
L1 OI..J d )...1 D1 ,-j
.,~ III 0 0, 0, 0 ,j
.r:: 0, C; E 0, !--~ ()
I" '-" n1 IlJ ru 0., Ij~
~
.:tH
H
~~
~~
U)O
~
E-IZ
~~
~~
a
~
H
H
~
~
ffi
...:1
p,
p,
::>
(/)
VI . VI
e: e:
0 0
.,... .,...
+J iJ iJ .jJ
<IJ e: (Ij VI (Ij
01 s- QJ ',... e .,...
ro >- E S- o s...
~ "- QJ D- .,... D-
o U 0 .jJ 0
~ 00 s... s... (Ij s...
4-l o<;t 0 D- O'l D-
o al .. 4- 0- .,... D-
~ <;t e:.- <J: iJ (Ij
Cl ::l N QJ 0 III
ro {A s... ~ (].J >,
(!) (!) >4-> ~ 4-> > o~ iJ
c::.c:: ro(lj 0 .,... e 0 0,...
.,., U ....JO- L!) U H .- u
...:1U)
+J
<IJ
01 . iJ 4-
ro s- .- 0
::l >- ::I
CQ ......... (Ij .
~ 0 VIe: iJ
~ 00 11I0 D-
o <IJ ~N ro.,... QJ
rl " iJ Cl
U ::l 0'\ .-e: ..c:
ro V} roQJ lIIiJ
Q) (l) ::l > rclr-
Z c::.c:: , >< QJ "1 ~ ~.
0'.
a j~ (].J s... 0
(/)D- L!) f-I
~ +J iJ I
U) <IJ e I ',...
H 01 rcl(].J s... VI
...:1 ro . iJO'1 D- (].J
::l s- ercl 0 QJ
Z CQ~ >- .,... e: s... VI 4-
0 "'- (Ij"(Ij ~ ,;. D- C
H ~ 0 .-E 'D- ~o ~
~ o ~ 00 0- (Ij u.,... U
H rl ~(V) E III (].JiJ (].J
U) P=l ::l " 0111 >,111 ..c:u ..c:
~ ro L!) u (].J iJe: u (].J u
Q) (l) r- I e:4-> e: c r-
c::.c:: t4 eiJe:~ ::I''''' iJ.- o-Q iJ
.,., U 0',... (].J l.{) 04-> o 0 l.{) 0
HU) Z>EN uro IU N I
4.l
<IJ
01
ro
::l
P=l
~ 0
~ N
o Q)
rl
~~
OJ OJ
c:.c::
,,., u
...:1C1:
.......
+J ' ~ . . . 0
..clfl~ . . .
0 01 <IJ ~ . . ,
x .,., U ::l <IJ ~ , . . . .
llJ I ~~O..cl1! .
OJ .r:: (j) j..c+J<IJ . . . .
(j) lfl ,-j .... +J 'U (!) 0 3: . 0 .
.~
E -IJ rO ',1 ..c lfl 3: '0 . . .
.~ U +J ~ ~ Ul+J o C J..< 01 . 01
jJ llJ 0 (j) f1J ~..cf1J l1! ~ . r: ~ r:
-n+J 0.. (j) o ~ lfl 0.. 0 .rl 0 .rl
llJ 0 Elfl+Jnl......... , . 'U . ro
~j ~ (j) 'U .~ +J ......lfl @ 0 . r: @ 0 . c:
nJ O~..c <IJ +J U !-l E ,~ J..< . ro j 0 'U ::l
.c ....... .j.J .~ <IJ llJ 0 +J f1J ::l ~ . llJ 4-l ~ OJ 4-l
lfl III ~ llJ-n+JJ..<C::::lO 01 . +J 01 . +J
~ ~ ~ ~OC::4-lf1JC::..c 0 . 0 4-l 0 0 0 4..
~J nl ~ W ~ c: ~ . "- 0 ~ . > 0
...
0 !--~ 01 ..c 0.. ~01ro~ 0. (\J 0.. . <IJ
c: O'.rl Ul lfl....... ~ .......rO '0 <IJ . '0 llJ
o ~ H Ul orOUl~+J ~ U ~ U
lfl !-l :J lfl ~ ~ ~ .,., ~ 0 <IJ +J <IJ J..< <IJ +J <IJ J..<
11l p~ (\J 0 <IJ o f1J ..c ..c +J ..c U E ::l ..c u E ::l
0 ..c.c 0 ~M lfl+J+J +J (j) 'rl 0 +J llJ .rl 0
'0 ~j -' 'U 01(j) C lfl O-n +J III O-n +J lfl
11l 4-l O.o~010~ 0 0
ill ..c 0 0 OJ ~ nl c: E OJ OJ ~ 4-l OJ <IJ l--I 4-l l1!
(j) .j.J +J (l) 0.. '"d +J .~ ....... <IJ @ 0.. 0 @: @ 0. 0 @
~o J..< ~ llJ 0 'U ~ ~
0 H 11l OJ..<.o+J::1~O Z 0'.0 Z Z 010 Z
M'c j~ ~ M OJ 'rl M~M
0.. .j.J 0...C: J..< (j) U OJ 0..
t.: .rl C :J E+Ju..c:cOJE 0 .
[.11 3 i.tl c: W 0 lfl +J .rl 3 (j) rO -0
rl ('\J
(1'\
())
0'1
rl
~
llJ
]
(lJ
U
OJ
Cl
'U
aJ
lfl
.rl
>
OJ
~
CJD-IO.l
EXAMPLE
Suggested Format
Other Budget Information
~overnor's Criminal Justice Division
Part III
Section F
LIne 2]
SCHEDULE B
,
.M"M, _ .____ . __.'_.. ...____._._..___
PROFeSSIONAL AND CONTRACTUAL SERVICES
CJ LOCAL CASH
DESCRIPTION OF SER VICE REQUEST CONTRIBUTION TOTAL
(^ ) $ S $
(B) $ S S
- -
(e) $ S S
-
(0) S S $
(E) $ S $
_.
(F) S $ S
(G) $ $ S
(f1) S ~$ . ". S
-
TOTAL PROfESSIONAL AND
CONTRACTUAL SERVICES BUDGET
s
s
$
REQUIRED NARRATIVE: Briefly describe any anticipated contractual arrangement and work
products expected. Describe the basis for arriving at the cost of
each line item.
~IOTES: 1. Grant applications in which the proposed program will be operated by a third
party, under contract from the grantee, should complete and attach applica-
t ion CJ 0- 11 . 1.
2. Personal services (such as consultants, trainers, counselors, evaluators,
etc.) should he described by type of service, number of hours, rate per
hour, and travel costs if any.
CJD-ll
BUDGET SCfIF..DULE B
SUPPlll~Hr:N'rAL BUDGET DATA ~'OR CONTRACTORS
Sources of Revenue
'Ph is form 1 s requj red for contractor organ iza tions that., under con tract from
l.he grantee, w111 operate t.he program described in the application. Leave this
page blank under all olher circumstances.
List the Contractor's Revenue from all Sources for all Progams and Purposes
Revenue Sources For the Year Projected [or
(*Ltst each source Immediately the Period of
and amount separately) Preceding this this Grant
Grant Period
$ $
1. Sl.ate and Federal gave rnmen t *
"
I. . Ci t.y and County government*
J. lJniLed Way . . . . .. . . . . . . . . . . ..
tl . Foundations . . . . . . . . . . . . . . . . .
(' Corporat.e
.J . . .. . . . . . .. . . . . . . .. .
6. Private/individuaL......... . .
'7 . Fund ri:lU;lng (-~venls......... .
8. "'pes Clnd sales . .. . . . . . . . .. . .
~. Int.erest . . .. . " .. . . . . . . . . ....
10. Se i ?Cd property ilnd funds... .
11. Ot.her (describe)
.
'1'O'rAI. REVENUE................. I
I
Hevl~ied ,January 1989
CJD-D.l
!;\I'1fJ(~~1 r.d Formel t
(1I111'1 1111l1IJl'l In (nrrnd t ion
(;()V(\"IlO,.I~~ (;riminill Justlce Division
I'dr I II!
::t'!'lllln "
l.in(~ 1.1
SCHEDULE C
- '--'-~._._._--_._-----_._- -.--.- -... - --.-
--"',-'- -...--.---..---.....
'I'1,^VI:L
I. I.oedl Travel
POSITI () N /'1'11' I, r:
MIU:S
1'R^VI:r.r.l) S
^NNIJ^LLY H^TE
CJ
H EQUEST
LO(; ^ I. eM; 11
CONTHIBIITION TOT^f.
".~ .._~._'--_.._._._-,------_._-------- .......-.------
------- -'.,-.",,- ..", .---....-..
(A) S
.. ..... ...----.- ---_.- . .--- --'-'-----
(~~._.._----_._--- '-.-..--, $
((~) $
-'. .--..'.----.--.-------...
(I"l $
.......... .__._.._-._~_. "-'-- ...--------- ---..-....----.
(r:) S
... ...--.--------.----.. -----.-----.--
(r') S
~ ..........---.----------- ----.---.
(") S
II J
_... .." -....--------------.--- .. .-.---.------.-.
[/ / I S
-'._.~-_.._-----------~ --'-".' ...---------.
f.r)(.~^ L 1'H ^ V [1. TOT A L $
$
S
S
$
S
S
S
" $
'.
'.
S
s
s
s
s
..--------.- --....--..-... -....
S
$
$
-....--.--- -'--'---..
s
.--.----------.-..
s
-- -.-..... --- .-...-....-.--..--..-.-----------.----.
.--.---------- ----_.
2. In-Sl(il(~ Trdwl (Spr.cify Cll!ilrly)
ilIJI{POSr.
D r.STIN ^ 1'ION
s
$
$
$
S
S
s
s
s
---.-.'-----.--
s
S
$
S
S
IfJ '-S'!' l\ 1'1: T f'{ ^ V r: 1. TOT A I.
$
...----.-- ... -..---.....-- --..- ....---.,-...-.-.
I )III' i () I' - S 'I' ^ T I: T H ^ VEL TO 'I' A 1.
.L Oil j-() (. S!~ j_~_I~~ ~~U~P~~~(L~~_~iHly L_ -~----_.-____1____..__..________.~__..___ __ _..__ ____
$ S $
....-----..- ._._- .. .-.----- _._---_._-----~-_.._._...__.._._-_.__._----_. ~-,--.....-._.__.._. .-
$ S S
-~_.._-_._---_._----_.-..
S S S
S S S
, [' () 'I' ^ L T H ^ V 1: I. B 1I D GET
NOT!:: I f personally owned vp~dc]es ore to be used, transportation costs should hr. shown on
S('ilrdllll~ C; if dgl)ncy or leased vehir.les are to be used, the vehicle operotion/rnain-
tl\ndT\('I} costs should bl~ shown on Schedule P, IISuppl1es and Dirpct Operating E>:rl)nse.1I
H I:l) l i W CD N ^ n n ^ TIV f.: Briefly descrihe the applicant's travel JXJllcy (I.e., mileage rotes and
per diem rates). Specify purposes for each item of travel. Break out
costs of each In-state and each out-of-stdte trip to separately show
the spN~ific costs of transportation and of per diem.
CJD-12
Suggested Format
Other Budget Information
Covcrnor's Crimindl Justice Division
Part III
Section F
Li no 2]
SCHEDULE D
r.(\)lJIPMENT PURCHASES
L;QUIPMENT NAME OR DESCRIPTION CJ LOCAL CASH
^~~ QUANTITY REQUEST CONTRIBUTION I TOTAL
---
(Al S S S
-......-_.._-
( Il l $ S S
(e) $ S S
...--.--
(f) l $ S S
( E) $ S S
(F) $ $ $
(G) $ $ S
(Il) S $ $
(I) S $ $
--
(J) S 5 S
TOTAL EQUIPMENT BUDGET S $ $
---
iH:r)lJIHED NARRATIVE: Describe the basis for arriving at the cost of each line item.
SCHEDULE E
CONSTR UCTION
:I( ''j'IVITY I r ACILlTY
(/\ l
( !n
( ~ ; )
( I ) )
(l: )
: t,'! rL C()!ISTHUCTION AUDCET
i. Statl~ wh(:t hr.r request is for construction or renovation. Renovation of $5,000 or less shcluld
he shown on Schedule F, "Supplies and Direct Operating Expense,/I
HI:()UIHCD NAHHATIVE: Describe the basis for arriving at the cost of each line item.
CJD-13
Suggested Format
Other Budget Information
Governor's Criminal Justice Division
Part III
Sectlor F
Line 21
SCHEDULE F
"
SUPPLIES & DIRECT OPERATING EXPENSE
,
DIRECTL Y CHARGED SUPPLIES C] LOCAL CASH
& OTHER OPERA TING COSTS REQUEST CONTRIBUTION TOTAL
(A) S S $
(8) $ S S
(C) $ S S
(D) S S $
(E) S S $
(F) S $ $
(G) S S S
(H) $ S $
(I) $ S .$ .'
(J) $ 1S:r . . S
TOT AL SUPPLIES & DIRECT OPERA TING
EXPENSE BUDGET $ S . $
REQUIRED NARRATIVE: Describe the basis for arriv:fng at tIle cost of each linE: item.
SCHEDULE G
INDIRECT COSTS
CJ
REQUEST
LOCAL CASH
CONTRIBUTION
TOTAL
(A) Indirect Costs Per Approved Cost
Allocation Plan $
(8) Indirect Costs Per CJD Computation Table S
$ . . $"
. , .
$ XXXXXXXXX $
NO'l'E: Indirect costs are authorized in an amount not to exceed the computation ,table
in the CJD Financial and Administrative Requirements section of the grant
application kit, or as authori~ed per the applicant's cost allocation plan.
REQUIRED NARRATIVE: If method (A) is used, specify the rate and attach a copy of the docu-
ment by which the current cost allocation plan was approved.
CJD-14
INSTRUCTIONS
PART IV
PROGRAM NARRATIVE
c. ldenlify th. kinds 01 d.1I 10 be collecttd and m.in.
t.ined .nd discuu the criteril 10 be used 10 tv.lull.
the rlSUlu and IUCCtlStl 01 tne project. Explain the
methodology thll will be used 10 delermin. il the
needs identilied Ind ditCuued are being mel and If
the r....lts Ind benefits Idenlified in item 2 Ir. being
IChi...ed.
d. Ult organiutlons, Coop.uton, consultlnu, Ol other
key individulls who will work on the project .Iong
with 1 !hort description ollh. nl1ur. olth.ir IHOlt
Ol conlribulion.
4, GEOGRAPHIC LOCATION'.
Prepare the r
the flll/ollV'
QUilts '
tppfr
fo'
'f am n.,ralive slal,menl in lCCord.nce with
'uclions lor III new grlnl progrlms. R.
'on or refunding and chWlQM on an
, respond 10 il1m 6b onlV, Requests
· should rlSpond 10 QUtttion 6c
1.
Pinpo.
insljlutl~
onslrale th.
klbordinlle L
tllion Of olher
!hili the eppl ican I .
planning studies shou.
'f)R THIS ASSISTANCE.
'mic, UlCill, fjn~III,
'Q . SOlulion, Oem.
'he principII .nd
'lOg documen.
'rests olher
~sed on
Giv. 1 precise loc'lion of the projecl or .rel 10 be liNed
by the proposed project. M,ps ()t olher gr.phic .ids m.y be
,nached.
6, IF APPLICABLE, PROVIDE THE FOLLOWING IN.
FORMA TION:
'fl
('
,(:.
('
1
1 AESUl TS OR BENH.
Idenlifv results .nd benefits
lMlen applying tOf a grant IL
he.lth cenler prol/ide a descriptiO!.
facility. how Ihe leclllly will be Ulee..
will benelil the general public,
I. FOt rtsUrch or demormrll;on lISistanc. requlltl,
pr..nl 1 biOilllphic.1 skelch of the progr.m direclOt
with Ih. following inform'lion; name, tddreu. phon.
number, btckground, Inq olher Qu.lifying uperienc.
lOt lhe project. Also, lilllh. n.me, training ,nd back.
ground for ,0IIM-r ;key P,tr,sonnel Ingaged in lhe
projtCt.
"\11CU1S lCComplishments 10 date and lin in chrono.
',...1 Mdar 1 ICtIldJle 01 ICcomplishments, pr09rm
"manes IIIliciplled with the new funding re.
t theft haY. been lignificant changes in the
'<:tives, locllion Ipproach, or lim. dellYI,
'~ify, For other raquem for enanoes or
'1.ln the rllSOn lor Ihe chlnge/II. If
'iI/IS hili. chlnged or In .xlension
upllin the circurnstlnc" Ind
'''I has betn exceeded, or if
" changed mort thW'l the
Altkhmanl K to Of.
Circular No. A.l02,
, its .ffecl on the
I-
o
15'
V
,()
..0
<
~
..0 1-, ('
-<1 1t
-'? ~
~ -<1
/[., <
1 APPROACH.
)'0'
o
Il
.. Outline I plln of ktion pert.ining to th~
cHlliI 01 how the proposed woo. will bt.
plished lOf .ach gunl program, funclion 01 It.
prcwided in Ihe budget. Cile lacton which mighl
ceJeral' or decelerate the work and your reason fo,
lilting this approach as oPPOSed 10 others. Describe
Illy unusu.1 fUlures of the Projeclsuch IS design or
!lchnological innOllllions, reduclions in cost or lime.
or exlrlOtdlnll)' soci.1 Ind community involvemlOt.
b. PrOllide for each gr.nt prov.m, funclion or IClivity.
QUlntilltiv. monlhly Of QUlrterly projeclions 01 the
lCComplllhm.ntJ to be achieved in RJch I.nns as the
number of jobs crealed; the number of peopl. Mrvtd;
Ind 11M number of plli.nls truted. When ICCDm.
plishmentl clnnol be Quanlified by klivity or func.
lion, list thlm in chronologicll order 10 show the
ac:htdul. of 1CC0mplishm.nts Ind their Urgel dltts.
/
1t
\S'
~
'fl
V
(\
I-
/
o
1t
\S'
\,
IXJ>
projlt.
C, For IUpp..
IOn for the I
funding.
lain the rn'
1dilionll
'~, '
CJD-15
INSTIUJCTIONS ["OR COMPLETING PROGRESS RFDORT/PROJgCT GOAL
ACll mVEl\ TS FORMS CJD-16-a, CJD-16- AND C.JD-16-c
This 1H'()~~r'l~~';S l'eporl [or'm is a lnlllti-IJUrpose form. II. is lo be compl(~led, ~~~_~lpplkable,
wil It I 11(' t~:1'il1l1 applical iOll, and complet.ed fully for t h(~ **semi-allrlllal prog-r'(~SS r'(~r)(H.t
and IIH~ ***I'i nal IH'ogTess r'(~JlIH'I, Applicants must retain a (.'opy of the:-;e pages since the
information will be needed !o (:omplctc, in full, the semi-annual and final n!J}()rt~.
Additional l'or'ms will not he provided routinely.
*AT TilE TIME OF APPLlCA'l'IUN. Only pages CJD-IG-u and continuation page(s)
e.l\)- Hi-b will be compl(~ted. Columns 2 and 4 are to be left blank a.1 I his stage.
No.l....:..Grclntec Name: Entc~r name of grantee organization.
No. 2 - Grant No: L(~a ve blank.
No.3 - Project Title: I':nler ttw project title as used in theg-r'ant application,
No.4 - Report Time Period: Leave blank, .
Column. 1: In the space prov ided following numbers 1 through 20, enter the
Pel'f'ormanc(~ Indicators E~xactly as specified in the "Assessment Requirements" of
the Progr'am Description section of your Application Kit. List all Indicators, even
though some may not be applicable to your specific program. If desired, add
optional I ndicatoI's.
[n each 01' the blocks (I,Hlder lhe numbered items) for the lndicator cited, enter
I he estimated annual level of achievpment/performance as of the date on which the
~~r'anl will slal'l. 1':lIl(~I'" N I ^" if the Indicator is not applicablE! to your ~pecific
pr'()f~r'alll. .' ..'
Column :1: In each of Ihe blocks (under the numbered items) ]'ot' the indicator
ciled, enll~[' the pr'ojE~ctf~d number to be achieved during this grant period.
**FOR SEMI-ANNUAL REPORT. The report, covering the first six months of the grant
per'iod and consisting of pages e,] 1)-16-a, 16-b, and 16-c is due at CJD 20 days after the
report period ends. Headings ilnd entries on pages 16-a and I6-b, which were submitted
with the applicat.io!,!, should be entered exactly the same into this report. In addition,
complete and add the following:
IJil~e _?1.J:~~~~lt No: Enter' the grant number cited in the Statcmenll)f Ge'ant Award.
I~ine 'L.._R(~port Time Period: Enter the dates for the first six munths of the grant..
~~olu!!.1n ~: In each of the blocks, enter the actual number' (as an update of the
('al'liel' \'sl imate in Ilw cor'r'espollding block in Column I) of thf~ annual
ilchiev(:n\(~ill/peI'fot'll:ance as of the date on which this grant ~~tar'(e(i.
C<.!lumn_~~: In each of l.Iw blocks, enter the cumulative year-In-date achievement
level.
rage C~p-L6-c: Cornpletl~ llle narrative in the outline pr'ovided nn lhe form.
I r\('llld(~ ~.; i gna t.ll rl~ I dat(~, and telephone number.
***FOR FINAL REPORT. The r'E~p()['\, covering the entire granl period and consisting .
of pages C,JD"lli-a, 16-b, and IG-c is due at eJD 20 days after the {,rrant period ends. '
With the excqll ion of the" Repnr" Time Period" und entries in Column 1, all other entries
on pages Hi'.a I I G- b of I he semi-annual report should be copied identically into this
r'ep(H't. I n add it ion, comph~te and add the following:
Line 1.t-R~ Time Period: Enter the dates of the entire gr'ant period.
Column 4: I rI each of the blocks, enter t.he cumulative year-to-date achievement
lev(~l.
Pa~ CJD-16-c: Complete the narrative in the outline pr~)V ided on the form.
Incltlde sig'natur'(~, date, and telephone number.
SEE FOLLOWING PAGES FOR EXAMPLES OF COMI)LETED FORM
C 111- 'If)
PROGRESS REPORT/PROJECT GOAL ~IEVEMENTs
1. Gran tee Name:
2. Grant No:
1. Pro.i ec t T i 1.1 e :
,.,. Report 'l'ime Period: ---!,--.l_ Lo ---.1---.1_
*Column 1
UColumn 2 *Co] umn :.1 "Column 4***
Actual Number Projected Actual Number
al Start of Number at Achieved at:
Grant Period Completion 1. Semi-Annual
of Grant Report.
2. Final Report
(Circle One)
Estimated
Number at
St.art of Crant
Period
l.
[ I I
')
,. .
I I .. 1;0
.I .
I I
~ .
I I J
I'
) .
I I I
().
I I
7.
I I
B.
I I 4
,
lJ.
I I I
I () .
I I I
1:~ / 4 / f3 g CJD-16-A
PROGRESS REPORT/PROJECT GOAL ACHIEVEMENTS
1 G t N Any JJunty
. ran ee ame:
2. Grant No:
J. Project. 'I'il.lc: Special Law Enforcement Unit
1\. Report 'rime Period: -.J-.J_ to -.J-.J_
*Colurnn 1
**Colwnn 2 *Column 3 **Column 4 u*
Actual Number Projected Actual Number
at Start of Number at Achieved at.:
Grant Period Completion 1. Semi-Annual
of Grant Report
2. Final Report
(Circle One)
Estimated
Number ilt
start of GrunL
Period
1. Number of officers assigned to investigative unit.
3
JI
5
2.
Number of felony cases assigned for follow-up.
I 60 I I I 100 J .
3.
Number of misdemeanor cases assigned for follow-up.
I 1 00 I I I 165 I
~ . Number of felony arrests.
I 35 I I
5. Number of misdemeanor arrests.
65 I I
6. Number of cases cleared.
150 I I
7.
I I
B.
I I
') .
601
110
250
I I
I
10.
I I
L~/4/fJ9
CJD-16-A
EXAMPLE
J. Grantee Name:
1. projecl'l'it.le:
(Continuation Page
PHOGIU~SS REPORT/PROJECT GOAL h....d I EVEKEN'l'S
2. Grant No:
4. I{eporl. 'I'ime Period: _/~_ to ~~_
*Column
Estimated
Number at
Start of Grant
Period
Heo 1 umn 2 *Column J HColumn 4***
Actual Number Projected Actual Number
at Start of Number at Achieved at:
Grant. Period Completion 1. Semi-Annual
of Grant Report
2. Final Report
(Circle One)
PROGIL .) REPOR'I'/PItOJECT GOAL AC. .~VJt:MEN'I'S
NARRATIVE SECTION
Gr'llntee Name:
Grant No:
Itep(wt in the space provided. If more spaee is needed, please submit additional pages.
A. Explanation of dev ialions from Project Goals. (Ar'e goals being achieved'!
I f not, please (~xplain. )
H. Pr'()blem~ encounl.<~r'ed. (Special dr'curn~t.ances, etc. , affecting the project.)
"" ~'
C. Pr'ojeet achievements. (Notable or special achievements accomplished by this
project. )
D. Gener'al Comments.
E. Project Director' Certification.
Pr'ojt~(;1 Dir'ector (please type or IH'int)
Authorized Signature
I I
---
Date
(-)
Telephone Number
CJD-16-c
PART V
ASSURANCES
Th. Applicont hereby Ollurtt and cet1ifi.. that h. will comply with the r.gulation., pOliel.., guidtlinta and r.-
quirementa, including OMB Circulars No. A-95, A-l02 and No 1\.87, 01 they rtlat. to the application, acctpt-
aoc. CI'ld UI. of Federal fundi fOf thil fodorally-auilt.d project. Also the Applicant allUf'tI and certifi.a to
the grant that:
1. II poSt0tUe5 legallUthOf'Ity to epply fOf' the ~.nt; that I
moIution, motion or aimilar action has betn duly
.oopted or paued IS .n afficia' kt 01 the applicant's
governing body, IUthodling the filing of the appliCltion,
including all unders1andinos and MSUrances conUined
therein, .nd directing and authorizing the person identi.
fiod Ii the officia' representative 01 the applicant to act
in connection with the appliution and to provide IUctl
Idditional infonnation IS may be required.
2. It will comply with Title VI of the Civil Ri~tl Act of
1964 IP.L. 88-3521 a.nd in ICCOrdince with Title Viol
tNt Act. no porIOn in the United States stllIl, on the
ground of roce, color, or national origin. be excluded
from partici~tion in, be denied the benefits 01, or be
otherwi$e subjected to discrimin.tion under illY pro.
,..m Of activity for YAlidl the .pplicant ~ives Federal
fil\MlCi.1 auiu.nct .nd will immediately.take lOy mu.
RUM necesury to eHectu.te this agreement.
3. It will comply with Title VI of the Civil Rigl)ts Act of
19&4 142 use 2<XX>d) Pf'ohibiting employment discrimi.
Ntion where 11) the primary purpoSle of I orant is to
providt! employment or 111 discrimin'tory employmMt
prlC1ices will result in unequal tJ'utment of perlOlU who
are 0( should be beoefiting from the !)Bnt-lided ktivity.
4. It will comply with requirements of the provision$
of the UnifOlm RelOCJtion Assistlr'ICe Ind Rul Property
Acquilitions Act of 1970 IP.L. 91-6461 YAlich prOYidu
for fair Ind equitable treatment o~ persons displlC1d as a
mult of Fwerlland federlllv assisted programs.
5. It will comply with the provisions of the Hatch Act
which limit the politiClI activity of employees.
6. It will comply with the minimum wage and maximum
hours provisions of the Federal Fair Labor Standards
Act, IS thty apply to hospital a~ educational institu.
tK>n employees of SUte .nd locll governments.
7. It will establish lIff9J.rds to prohibit employeti from
using their politions for .' purpose that is or gives the
IppelrlOCe of being motiv.ted by . de$i" for priv.te
flin for them $elves or others. p.rtiC\Jllrly those with
whom they have fnily, business. or other ties.
B. It will give the aponsoring ogeney or the Comptroller
G.neral through any au1hotiud rtpreuntativ. the
acc'lI to and the righ: to namin. all rKorda, bOok"
popers, or docurnenh: "Iat..d to th. grant.
9. It will comply with all requirerntnh impoled by tht
Ft4.rallponaoring ag.ncy concerning apecial
,~ui,.""nh of low, program requirtrntnll, and oth.r
adminiatrativ. requirtments. _
1QlIt will insure that the facilities under its ownership, lease or
supervision which shall be utilized in the accomplishment of the
project are not listed on the Environmental Protection Agency's
(EPA) list of Violating Facilities and that it will notify the
Federal grantor agency of the receipt of any communication from
the Director of the EPA Office of Federa~ Activities indicating
that ~ fAcility to ~ used in the project is under consideration
tor listing by the EPA.
II.It will comply with the flood insurance purchase requirements of
Section 102(a) of the Flood Disaster Protection Act of 1973, Public
Law 93~234, 87 Stat. 975, approved December 31~ 1976. . Section
102(a) requires, on and after March 2, 1975, the purchase of flOOd
insuranc~ in communities where such insurance is available as a
condition for the receipt of any Federal financial assista.n~e. for
construction ,or acquisition purposes for use in any a~ea that has
been identified by the Secretary of the Department of'Rousing and
Urban Development as an area having special flood hazards.
I,.
CJD-17
PART V (Continued)
The phrase RFederal financial assistance~ includes any form
of loan, grant, guaranty, insurance payment, rebate, subsidy,
disaster assistance loan or grant, or any other form of
direct or indirect Federal assistance.
12. It will assist the Federal grantor agency in its compliance
with Section 106 of the National Historic Preservation Act
of 1966 as amended (16 U.s.e. 470), Executive Order,l1593,
and the Archeological and Historic Preservation Act of
1966 (16 u.s.e. 469a-l et seq.) by (a) consulting with the
State Historic Preservation Officer on the conduct of
investigations, as necessary, to identify properties listed
in or eligible. for inclusion in the National Register of
Historic Places that are subject to adverse effects (-see 36 CFR
Part 800.8) by the activity, and notifying the Federal
grantor agency of the existence of any such properties, and
by (b) complying with all requirements established by the
Federal grantor agency to avoid or mitigate adverse effects
upon such properties.
. " ":'::: .
13. It will comply with the. Uniform Grant and Contract Mana~e~ent Standards
(UGCMS) developed under the directive of the Uniform Grant and Contract
Management Act of 1981, Texas Civil Statutes, Article 4413(32g).
/
CJD-18
"
~ication Processing, Subsection 3.48(c), applicants must provide
the full names, titles idresses, and telephone number ~or the auth-
orized official, financ.~1 officer, and project directol for each grant
submitted for consideration by the governor.
APPLICANT:
PROJECT TITLE:
Project Director (Type or Print)
Financial Officer (Type or Print)
Title
Title
Address (Street or P. O. Box)
Address (Street or P. O. Box)
City
lip
City
Zip
. ,. 1" ~'r:'
Telephone Number
Telephone Number
Authorized Official (Type or Print)
Title
Address (Street or P. O. Box)
City
Zip
Telephone Number
1'1'1
CJD-19