2002-051-RES ACCEPT GANG RESISTANCE EDUCATION AND TRAINING (GREAT) PROGRAM GRANT
RESOLUTION NO. 2002-051
A RESOLUTION OF THE CITY OF PARIS, PARIS, TEXAS, ACCEPTING
THE GANG RESISTANCE EDUCATION AND TRAINING (G.R.E.A.T.)
PROGRAM GRANT; AUTHORIZING THE EXECUTION OF
COOPERATIVE AGREEMENT NO. ATC020223; MAKING OTHER
FINDINGS AND PROVISIONS RELATED TO THE SUBJECT; AND
DECLARING AN EFFECTIVE DATE.
WHEREAS, the City of Paris Police Department has been involved in the Gang Resistance
Education and Training (G.R.E.A.T.) Program since 1996; and,
WHEREAS, the Department ofthe Treasury, Bureau of Alcohol, Tobacco, and Firearms,
has issued its Grant Award entitled "G.R.E.A.T. Program" grant for the period beginning January
16, 2002, and ending January 15, 2003, in the total amount of $48,282.50, which requires no
matching funds from the City of Paris; and,
WHEREAS, acceptance of the same requires the execution of Cooperative Agreement No.
ATC020223 by and between the City of Paris and the Bureau of Alcohol, Tobacco, and Firearms,
and it is deemed to be in the best interests of the citizens of Paris that the City of Paris accept said
Grant Award and continue to improve the G.R.E.A.T. Program in the City of Paris; and,
WHEREAS, the form of Cooperative Agreement No. ATC020223, attached hereto as
Exhibit A, should, in all things, be approved, and the City Manager should be authorized to execute
the same; NOW, THEREFORE,
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF PARIS, PARIS,
TEXAS:
Section 1. That the findings set out in the preamble to this resolution are hereby in all things
approved.
Section 2. That the "Gang Resistance Education and Training (G.R.E.A.T.) Program" grant
for the period beginning January 16, 2002, and ending January 15,2003, in the total amount of
$48,282.50, requiring no matching funds from the City of Paris, be, and the same is hereby, accepted.
Section 3. That the form of Cooperative Agreement No. ATC020223, attached hereto as
Exhibit A, be, and the same is hereby, approved.
Section 4. That the City Manager be, and he is hereby, authorized and directed to execute,
on behalf of the City of Paris, Cooperative Agreement No. ATC020223, under the terms and
conditions and in the form shown in Exhibit A, attached hereto.
Section 5. That this resolution shall become effective from and after its date of passage.
PASSED AND APPROVED this 11th day of March, 2002.
ATTEST:
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COOPERATIVE AGREEMENT NO. ATC020223
BETWEEN
The City of Paris, Texas
AND
BUREAU OF ALCOHOL, TOBACCO AND FIREARMS
1. PURPOSE
The purpose of this Cooperative Agreement (agreement) is to
establish a legal relationship between the Bureau of
Alcohol, Tobacco and Firearms (ATF) and the Paris Police
Department, Paris, Texas (LOCAL GOVERNMENT). This agreement
sets forth the responsibilities for the operation of the
gang prevention program known as Gang Resistance Education
and Training (G.R.E.A.T.) in the City of Paris, Texas. All
terms and conditions herein are binding upon execution of
the agreement by both parties.
2. PERIOD OF PERFORMANCE
This agreement is limited to the operation of the G.R.E.A.T.
Program. The period of performance begins January 16, 2002
and ends January 15, 2003. However, ATF intends to continue
the legal relationship in the future, subject to continuing
congressional appropriations. In future years, no legal
liability on the part of ATF or the Federal Government shall
accrue unless funds are made available to the CAO and the
LOCAL GOVERNMENT receives written notification of the amount
of funds available. The continuation of the agreement in
future years will be subject to a reapplication process by
the LOCAL GOVERNMENT.
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3. SCOPE OF WORK
In the Treasury, Postal Service and General Government
Appropriation Bill for the Fiscal Year ending
September 30, 2001, ATF was directed to continue operation
of the G.R.E.A.T. Program, which was originally started as
PROJECT OUTREACH in the Fiscal Year 1992 appropriation.
G.R.E.A.T. is a project which uses the skills of ATF, State
and local law enforcement personnel, as well as individuals
from community and civic groups, to develop a program that
educates youth about the dangers associated with joining
EXHIBIT A
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COOPERATIVE AGREEMENT NO. ATC020223
street gangs.
G.R.E.A.T. consists of three major phases:
Phase I
Phase II
Phase III
School-Based Education
Summer Education/Recreation
Parent Involvement Program
4. COOPERATIVE AGREEMENT PLAN
During the period of performance the G.R.E.A.T. Program will
be implemented and continued as follows: '
A. RESPONSIBILITIES OF the City of Paris., Texas
The City of paris, Texas, through the Paris Police
Department, will participate in the G.R.E.A.T. Program as
specified below:
(1) Phase I - The LOCAL GOVERNMENT shall arrange with
local area middle/junior high schools, to schedule 13 one
period classes, (for those agencies whose officers have
been re-certified in the new G.R.E.A.T. Curriculum. All
others will continue to teach the nine class curriculum
until they have been re-certified) in a sufficient number
of instructional blocks so as to instruct a minimum of
576 students per year on the dangers of gangs in
accordance with the G.R.E.A.T. Program lesson plans.
Classes will be taught in an appropriate education time
slot as determined by local school officials. These
classroom lessons are to be presented during the school
year of the performance period of the agreement as
specified in Section 2 of this agreement. The lessons
will be taught to middle/junior high school students
within the City of Paris school system or approved after-
school settings.
The LOCAL GOVERNMENT is required to order graduation
certificates from the G.R.E.A.T. Program Office for
student participants of the program. Certificates are
provided free of charge and should be ordered at least 8
weeks prior to graduation. Requests for certificates
should be mailed to the address listed in Section IS.C.
The number of certificates ordered shall reflect the'
actual number of students enrolled in the program, as
this information will be used as a factor in determining
future funding.
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COOPERATIVE AGREEMENT NO. ATC020223
PHASES II and III OF G.R.E.A.T.
The LOCAL GOVERNMENT shall submit an implementation plan
for phases II and III by May I, 2002. Implementation of
Phases II and III must support Phase I of this agreement
and be in accordance with the following guidelines:
Phase II
The LOCAL GOVERNMENT will be required to coordinate summer
education/recreation activities at sites selected by the
cognizant police department.
Additionally, the LOCAL GOVERNMENT will attempt to match
available existing community programs and resources with
G.R.E.A.T. students and graduates.
These summer components must be in accordance with the
G.R.E.A.T. programs guidelines for this section. Copies
of approved activities and educational components can be
obtained from the G.R.E.A.T. program Branch.
Phase III
The LOCAL GOVERNMENT will institute an education program
for parents of youth involved in gangs and/or at risk of
joining gangs, and for parents of other Phase I
participants.
These family components must be in accordance with the
G.R.E.A.T. programs guidelines for this section. Copies
of approved activities and educational components can be
obtained from the G.R.E.A.T. program Branch.
Under the terms of this agreement, ATF will not
reimburse the LOCAL GOVERNMENT for any expenses
incurred after the end of the period of performance
specified in Section 2.
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(3) The LOCAL GOVERNMENT agrees to provide an officer(s}
part-time, to assist the G.R.E.A.T. Program as a Team
Leader(s). The LOCAL GOVERNMENT agrees to allow an
officer(s} to complete G.R.E.A.T. Officer Training,
teach the G.R.E.A.T. curriculum, complete G.R.E.A.T.
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COOPERATIVE AGREEMENT NO. ATC020223
I
Management Leader training, and assist the National
Training Team as a Team Leader. The LOCAL GOVERNMENT
agrees to provide the services of said Team Leader(s} for
G.R.E.A.T. training sessions during the period of
performance of this agreement at the rate of 2 weeks per
$50,000 dollars of award.
$50,000 2
$100,000 4
$150,000 6
$200,000 8
$250,000 10
$300,000 12
$350,000 14
$400,000 16
Amount of Award
Required Weeks
Local governments that are in their first year of federal
funding are excluded from the above requirement. However,
it is suggested that the LOCAL GOVERNMENT designate an
officer to complete team leader training. In the event
funding becomes available for the following year, the
LOCAL GOVERNMENT will be required to provide an
officer(s} in accordance with paragraph 4 above.
(4) It is the responsibility of the LOCAL GOVERNMENT to
plan, initiate and oversee the completion of the
G.R.E.A.T. Program; to prepare quarterly progress
reports and quarterly requests for payments; to certify
the accuracy of contractor and vendor billings; to
ensure the cost efficient and timely completion of the
project; and to immediately notify ATF, in writing, of
any issues or problems, real or anticipated, which might
affect the successful completion of the project within
the time frame and funding established in the agreement.
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(5) It is the responsibility of the LOCAL GOVERNMENT to
ensure that Officer's regular and overtime salaries shall
not exceed 70% of the total amount obligated under this
agreement. It is also the responsibility of the LOCAL
GOVERNMENT to ensure that any funds requested for regular
or overtime salaries must be G.R.E.A.T. related and the
funds must be for certified G.R.E.A.T. officers or
exceptions approved by the Branch.
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COOPERATIVE AGREEMENT NO. ATC020223
(6) Expenditures for equipment, furniture or other
capital assets may be reimbursed, but only if prior
written approval for the purchase is ,obtained from the
Government Technical Representative (GTR). "Equipment
means an article of non-expendable, tangible personal
property having a useful life of more than one year.
"Other Capital Assets" means buildings, land, and
improvement to buildings or land that materially increase
their value or useful life.
Expenditure requests must be submitte~ in writing to the
GTR. The request shall include the item(s) to be '
purchased, quantity, per item cost, extended cost, useful
life and a justification as to why such an expenditure is
required and how it benefits the G.R.E.A.T. program. The
request must also include any previous purchases of the
same or similar item. Total of expenditures for
equipment, furniture or other capital assets shall not
exceed 20% of the total amount obligated under this
agreement. Upon receiving written approval from the GTR
and once this equipment is purchased, the LOCAL
GOVERNMNET must submit a list of this equipment and any
applicable serial numbers to the GTR for accountability
purposes.
(7) The LOCAL GOVERNMENT must submit to the GTR a
semi-annual report within 45 days of the close of each
calendar quarter. This report shall describe the
programmatic and financial status of the project. The
GTR shall be advised of any significant programmatic or
financial adjustments/modifications. A progress report
format is provided in Attachment V. Failure to submit the
first 2 quarterly reports will result in a non-compliance
judgment with the agreement and any further expenditures
will not be reimbursed.
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.A final agreement report must be submitted by the LOCAL
GOVERNMENT within 45 days after the completion of the
project. This final report will contain the date of
completion, final costs, and a statement that the
agreement is completed.
Failure to submit semi-annual progress reports or the
final agreement report may be interpreted as
non-compliance with this agreement and will be utilized
in any further requests for funding.
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COOPERATIVE AGREEMENT NO. ATC020223
B. RESPONSIBILITIES OF ATF FOR REIMBURSEMENT
(1) (a) ATF
$48,282.50
G.R.E.A.T.
LOCAL
has obligated, to the City of Paris, Texas,
for the school-based education phase of the
Program. Funds are provided to reimburse the
GOVERNMENT's cost incurred as follow$:
* Officers' time, regular and overtime, must be
G.R.E.A.T. related and documented with a
signature from an authorizing official;
* G. R. E . A. T. training expenses,' such as.
instructional materials, workbooks, instructor
fees, and guest speakers' fees;
* Expenses incurred in connection with officers
receiving G.R.E.A.T. officer training. This
includes transportation, lodging and per diem in
accordance with Federal Travel Regulation.
Officer's time (regular and overtime) will be
paid during training. Overtime shall not exceed
10 hours per week during training;
* Printed materials such as student handbooks,
and awards;
* Administrative expenses, directly supporting
G.R.E.A.T. activities, such as general office
supplies, office space leases, and clerical
support directly supporting G.R.E.A.T.
activities, during the term of this agreement;
and
* Expenses for G.R.E.A.T. promotional materials
such as pamphlets, bu~per stickers, hats,
T-shirts, buttons, pens and pencils.
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* Any items bearing the G.R.E.A.T. name or logo
must be purchased from one of the following
authorized vendors:
Best Expression
21606 N. 3rd Ave.
Phoenix, AZ 85027
800-932-8931
www.bestexpression.com
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Creative Impression
5305 E. 18~ Street
Vancouver, WA 98661
800-654-0724
COOPERATIVE AGREEMENT NO. ATC020223
Treadway Graphics
1401 Cannon Circle
Fairbault, MN 55021
800-653-7063
www.treadwayqraphics.com
Sav-on Printing
4520 N. 19th Ave.
Phoenix, AZ 85015
602-242-2308
Industries for the Blind,
3220 West. Vilet Street
Milwaukee, WI 53208
414-933-4319
www.ibmilw.com
Inc.
* Any expenditure in excess of $1,000, for other than
equipment, furniture or other capital assets and excluding
those made from the authorized G.R.E.A.T. vendors above, must
be pre-approved, in writing, by the GTR. In addition, any
expenditures for guest speakers, training, (other than
G.R.E.A.T. Officer training), or ceremonies must be pre-
approved in writing with the GTR.
* Any expenditure in excess of $5,000 made from the G.R.E.A.T.
vendors above, must be pre-approved, in writing, by the GTR.
(b) Reimbursements will be made only when a completed
SF-270, Request for Advance or Reimbursement form,
attachment I, is provided by the Local Government in
accordance with the terms of this agreement.
(2) It is the responsibility of the GTR or designee to
monitor the project status, to review and certify interim
and final payment requests submitted by the LOCAL
GOVERNMENT and; to ensure that the funding limitations in
paragraphs 4.A.5, 4.A.6, 4.B.1.A and 4.B.1.D have not
been exceeded.
C. THIRD/FOURTH GRADE SCHOOL-BASED EDUCATION PROGRAM
In addition to the G.R.E.A.T. middle/junior high school
component, the LOCAL GOVERNMENT may elect to teach a
third/fourth grade G.R.E.A.T. component.
The LOCAL GOVERNMENT shall arrange with local area
elementary schools, to schedule four one-period sessions
to instruct third and fourth grade students on the
dangers of gangs, in accordance with the G.R.E.A.T.
Program lesson plans. Classes will be taught in an
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COOPERATIVE AGREEMENT NO. ATC020223
I I
appropriate education time slot, as determined by local
school officials. These classroom lessons are to be
presented during the school year of the performance
period of the agreement as specified in section 2 of
this agreement. The lessons will be taught to third and
fourth grade students within the City of Paris school
system.
Under the terms of this agreement, ATF will not
reimburse the LOCAL GOVERNMENT for any expenses
incurred after the end of the period of performance.
D. Limitations - Other than the administrative costs
expressly set out in paragraph B(l) (a), above, no
administrative expenses or costs, whether direct or
indirect, shall be reimbursed under this agreement.
5. FUNDING, PAYMENT AND SUBMISSION OF INVOICES
A. ATF will obligate $48,282.50 for reimbursement under this
agreement. Requests for reimbursement for work completed
will be made by the LOCAL GOVERNMENT on a SF-270, Request
for Advance or Reimbursement, attachment I, to the GTR for
review and certification. Payments will only be issued to
the LOCAL GOVERNMENT, and not vendors or contractors.
ATF will not provide funding in excess of the amount
specified for each year the agreement is in effect. The
LOCAL GOVERNMENT accepts responsibility for all costs
associated with the G.R.E.A.T. Program which exceed the
level of funding provided by ATF.
B. Requests for Reimbursements shall be submitted by the
LOCAL GOVERNMENT on a quarterly basis as follows:
(1) Original SF-270, Request for Advance or Reimbursement
form, along with receipts/invoices supporting
reimbursement request to the GTR. Requests for travel
reimbursements must include the TRAVEL REIMBURSEMENT
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COOPERATIVE AGREEMENT NO. ATC020223
SHEET Attachment II). The GTR's address is as follows:
Bureau of Alcohol, Tobacco and Firearms
ATTN: Cooperative Reimbursement Section
P.O. Box 50418
Washington, DC 20091-0418
The LOCAL GOVERNMENT will provide ATF with whatever
payment information is necessary to transfer funds
(electronic payment information, bank account numbers,
etc.) to the LOC~L GOVERNMENT.
C. Title 31 of" the Code of Federal Regulations,' Part 208,
effective July 01, 1997, mandates that Federal payments
under cooperative agreements be made via electronic
funds transfer (Waiver: Department of the Treasury
check(s) will be issued ONLY when the LOCAL GOVERNMENT
certifies in writing that the recipient does not have an
account at a financial institution or authorized payment
agent) .
(1) The following applies only to Direct Deposit
payments:
The LOCAL GOVERNMENT shall forward a completed SF-
3881, ACH Vendor/Miscellaneous Payment Enrollment
Form, attachment III with this signed agreement.
(a) The Agency Information is preprinted to issue
payment from ATF.
(b) The Payee/Company Information is to be
completed by the Payee. The Taxpayer
Identification Number (TIN) must be provided.
The TIN is the Employer +dentification Number.
Notice of each Direct Deposit will be
forwarded to the address listed.
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(c) The Financial Institution Information should be
completed by the Payee's Financial Institution.
(d) All payments will be made to checking or
savings accounts, not lockboxes.
(e) Financial Institutions must list their nine
digit American Bankers Association (ABA)
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COOPERATIVE AGREEMENT NO. ATC020223
identifying number. This number is used for the
routing of direct deposited funds. (Provide this
number only if the receiving financial institution
has access to the Federal Reserve Communications
System).
(f) If the receiving financial institution does not
have access to the Federal Reserve Communications
System, provide the name of the correspondent
financial institution through which the receiving
financial institution receives electronic funds
transfer messages.
(2) Any changes to funding and payment information
shall be furnished to ATF at the address in
paragraph 15.B, in writing, at least 30 days before
the effective date of the change. It is the LOCAL
GOVERNMENT'S responsibility to furnish these
changes promptly to avoid payments to erroneous
addresses or bank accounts.
(3) All documents furnishing payee information from the
agreement recipient must be dated and contain the
signature, title, and telephone number of the
agreement recipient official authorized to provide
it, as well as the agreement recipient's name.
D. The LOCAL GOVERNMENT certifies, by signing the SF-270
form, attachment I, that all requests for reimbursement
submitted shall be supported by valid receipts/invoices
which are in accordance with the project authorized in .
this agreement. Copies of paid invoices shall be clearly
marked with the appropriate agreement number to which
they are charged and maintained in the agreement project
file by the LOCAL GOVERNMENT.' All such documentation
shall be made available for review upon the request of
ATF or any Federal audit agency.
Funds specified and approved for G.R.E.A.T. shall not be
transferred to another project or be used for any other
purpose, unless authorized by a written modification to
this agreement signed by the LOCAL GOVERNMENT and the
CAO or his designee.
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E. The LOCAL GOVERNMENT certifies that no request for
payment will be submitted for work, materials or
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COOPERATIVE AGREEMENT NO. ATC020223
services which have been previously funded by any other
source.
F. The LOCAL GOVERNMENT will maintain such books, records,
documents and other records that will accurately
document all costs relating to this agreement in
accordance with State laws and procedures for expending
and accounting for its own funds. This documentation
must be kept for a period of at least three years
following the end of the agreement's period of
performance and final payment. All such documents will
be subject to. periodic on-site review as deemed
necessary by ATF and any Federal audit agencies
including any Contractor hired by the Federal Government
to perform audit services.
6. INSPECTION/ACCEPTANCE
Inspection and acceptance of all supplies and services under
this agreement shall be accomplished by ATF's GTR or someone
otherwise designated by the CAO.
7. MODIFICATIONS
A. The CAO may at any time, by written order, make changes
within the general scope of this agreement in anyone or
more of the following:
(I) Description of services to be performed.
(2) Period of Performance
B. Modifications that change any part of the agreement or
the responsibilities of the LOCAL GOVERNMENT must be made
by mutual agreement of both parties. Failure to agree to
any modification shall be a dispute under the DISPUTES
clause (Section 11) of this agreement. However, nothing
in this clause shall excuse the LOCAL GOVERNMENT from
proceeding with the agreement as changed.
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C. Notwithstanding the terms and conditions of paragraphs A
and B above, the estimated cost of this cooperative
agreement shall not be increased or considered increased
except by specific written modification of the agreement
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COOPERATIVE AGREEMENT NO. ATC020223
indicating the new agreement total. Until this
modification is made, the LOCAL GOVERNMENT is not
authorized to incur costs beyond those specified under
Section 5.A of this agreement.
8 . ASSURANCES
This agreement provides for Federal participation in an
education and public awareness program to warn youth about
the dangers of gangs. A local government receiving Federal
funds under this agreement is required to assure and certify
that it will, as a condition of receiving the funds, comply
with applicable Federal laws and regulations governing
cooperative agreements. By acceptance of this agreement the
LOCAL GOVERNMENT assures and certifies that it will comply
with the regulations in Attachment IV of this agreement, as
well as other listed regulations, policies, guidelines, and
requirements listed in the agreement, including OMB Circular
A-87-Cost Principles for State, Local and Indian Tribal
Governments, A-102-Uniform Administrative Requirements for
Grants and Cooperative Agreements to State and Local
Governments, and A-133-Audits of State and Local
Governments, as they relate to participation in the
G.R.E.A.T. Program.
In this agreement, the term "Contractor" used in Attachment
IV Clauses and Provisions refers to the "LOCAL GOVERNMENT."
9. PUBLICATIONS AND NEWS RELEASES
A. Definition. For the purpose of this clause,
"publication" includes:
(1) Any document containing information for public
consumption; or,
(2) The act of, or any act which may result in,
disclosing information to the public.
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B. The results of this program are planned to be made
available to the public through such means as the Director
of ATF shall determine.
C. Federal Government Ownership of Official Products of
Work.
All interim and final reports and information, data
analyses, special methodology, findings, and their related
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COOPERATIVE AGREEMENT NO. ATC020223
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documents and work products, including reports, work sheets,
survey instruments, computer tapes, and any other physical
materials and products produced directly under this
agreement are considered Official Products of Work, owned by
the Federal Government and held for the benefit of the
public. Further, the LOCAL GOVERNMENT acknowledges that it
will not acquire any rights in data or goodwill for any of
the materials or products produced under this agreement.
D. Independent and Special Products
During the term of this agreement, works, authored,
composed, or developed by the LOCAL GOVERNMENT and approved
by the G.R.E.A.T. National Policy Board, including but not
limited to brochures, curriculum, student handbooks,
instructor manuals, newsletters, pamphlets, and other
products developed to enhance the G.R.E.A.T. Program are
considered to be Independent and Special Products.
E. Publication of Official Products of Work
Official Products of Work, quotations therefrom,
paraphrasing, or disclosures of interim findings may not be
published without the written approval of the GTR for a
period of 60 days after acceptance of the product by the
GTR. Thereafter, the LOCAL GOVERNMENT shall be free to
publish without ATF approval.
F. Acknowledgement and Disclaimer
(1) All Official Products of Work, or any part
thereof, developed through the use of funds provided
for under this instrument, when published by the
LOCAL GOVERNMENT or other participants in the work,
shall contain the following acknowledgement and
disclaimer:
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"The work that provided the basis for this
publication was supported by funding under a
Cooperative Agreement with the Bureau of Alcohol,
Tobacco and Firearms. The substance and findings
of the work are dedicated to the public. The,
author and publisher are solely responsible for
the accuracy of the statements and interpretations
contained in this publication. Such
interpretations do not necessarily reflect the
views of the Federal Government."
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COOPERATIVE AGREEMENT NO. ATC020223
(2) All Independent and Special Products, or any parts
thereof, developed through the use of funds provided for
under this instrument, when published by the Local
Government or other participants in the work, shall
contain the following acknowledgement and disclaimer:
"The work that provided the basis for this
publication was supported in part by funding under
a cooperative agreement with the Bureau of
Alcohol, Tobacco and Firearms, which maintains its
rights in this publication as set forth in 41
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C.F.R. 3105-71.134. The author and publisher are
solely responsible for the accuracy of the
statements and interpretations contained in this
publication. Such interpretations do not
necessarily reflect the views of the Federal
Government."
G. Notice of News Release and Public Announcements
Two copies of all press releases, formal announcements, and
other planned, written issuance's containing news or
information concerning this agreement that may be made by
the LOCAL GOVERNMENT or its staff, or any subcontractor or
other person or organization participating in the work of
this agreement shall be provided to the GTR at the earliest
possible time. News releases and other public announcements
may not disclose any interim finding or quote or paraphrase
any part of any Official Product of Work without complying
with paragraphs (E) and (F) above. .
10. COLLECTION 'OF DATA
Collection of information from ten or more persons and
sponsored by ATF, shall be subject to 5 CFR 1320. A
collection of information undertaken by a recipient of a
Federal cooperative agreement is considered to be sponsored
by ATF only under the following conditions:
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A. The recipient of a cooperative agreement is collecting
information at the specific request of the agency; or
The terms and conditions of the cooperative agreement
require specific approval by the agency of the
collection of information or the collection procedures.
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COOPERATIVE AGREEMENT NO. ATC020223
J.1. DISPUTES
A. It is hereby agreed upon that this agreement is subject
to the Contract Disputes Act of 1987, as amended (41
U.S.C. 601-613).
B. Except as provided in the Act, all disputes arising
under or relating to this agreement shall be resolved
under this clause.
C. "Claim," as us'ed in this clause, means a written demand
or written assertion by one of the agreement parties
seeking, as matter of right, the payment of money in a
sum certain, the adjustment or interpretation of
agreement terms, or other relief arising under or
relating to this agreement. A claim arising under a
cooperative agreement, unlike a claim relating to that
agreement, is a claim that can be resolved under a
cooperative agreement clause that provides for the
relief sought by the claimant. However, a written
demand or written assertion by the LOCAL GOVERNMENT
seeking the payment of money exceeding $100,000 is not a
claim under the Act until certified as required by
subparagraph D(2) of this clause. A voucher, invoice,
or other routine request for payment that is not in
dispute when submitted is not a claim under the Act.
The submission may be converted to a claim under the
Act, by complying with the submission and certification
requirements of this clause, if it is disputed either
as to liability or amount or is not acted upon in a
reasonable time.
D. (1). A claim by the LOCAL GOVERNMENT shall be made in "
writing and, unless otherwise stated in this cooperative
agreement, submitted within 3 years after accrual of the
claim to the CAO for a written decision. A claim by the
Government against the LOCAL GOVERNMENT shall be subject
to a written decision by the CAO.
(2). The LOCAL GOVERNMENT shall provide the
certification specified in subparagraph D(4) of this
clause, in writing, when submitting any claim.
16
I I
COOPERATIVE AGREEMENT NO. ATC020223
(a) Exceeding $100,000; or
(b) Regardless of the amount claimed, when using.
1. Arbitration conducted pursuant to 5 U.S.C.
575-580; or
2. Any other alternative means of dispute
resolution (ADR) technique that the agency
elects to handle in accordance with the
Administrative Dispute Resolution Act
(ADRA) .
(3). The certification requirement does not apply to
issues in controversy that have not been submitted
as part of a claim.
(4). The certification shall state as follows: "I
certify that the claim is made in good faith; that the
supporting data are accurate and complete to the best of
my knowledge and belief; that the amount requested
accurately reflects the agreement adjustment for which
the LOCAL GOVER~MENT believes the Government is
liable; and that I am duly authorized to certify the
claim on behalf of the LOCAL GOVERNMENT."
(5). The certification may be executed by any person
duly authorized to bind the LOCAL GOVERNMENT with
respect to the claim.
E. For LOCAL GOVERNMENT claims of $100,000 or less, the CAO
must, if requested in writing by the LOCAL GOVERNMENT,
render a decision within 60,'~ays of the request. For ~
LOCAL GOVERNMENT-certified claims over $100,000, the CAO
must, within 60 days, decide the claim or notify the
LOCAL GOVERNMENT of the date by which the decision will
be made.
F. The CAO's decision shall be final unless the LOCAL
GOVERNMENT appeals or files a suit as provided in the
Act.
17
COOPERATIVE AGREEMENT NO. ATC020223
G. If the claim by the LOCAL GOVERNMENT is submitted to the
CAO or a claim by the Government is presented to the
LOCAL GOVERNMENT, the parties, by mutual consent, may
agree to use AOR. If the LOCAL GOVERNMENT refuses an
offer for alternative disputes resolution, the LOCAL
GOVERNMENT shall inform the CAO, in writing, of the
LOCAL GOVERNMENT's specific reasons for rejecting the
request. When using arbitration conducted pursuant to
5 U.S.C. 575-580, or when using any other AOR technique
that the agency elects to handle in accordance with the
AORA, any claim, regardless of amount, shall be
accompanied by the certification described in
subparagraph 0(4) of this clause, and executed in
accordance with subparagraph 0(5) of this clause.
H. The Government shall pay interest on the amount
found due and unpaid from (1) the date that the CAO
receives the claim (certified, if required); or (2) the
date that payment otherwise would be due, if that date
is later, until the date of payment. With regard to
claims having defective certifications, as defined in
(FAR) 48 CFR 33.201, interest shall be paid from the
date that the CAO initially receives the claim. Simple
interest on claims shall be paid at the rate, fixed by
the Secretary of the Treasury as provided in the Act,
which is applicable to the period during which the CAO
receives the claim and then at the rate applicable for
each 6-month period as fixed by the Treasury Secretary
during the pendency of the claim.
I. The LOCAL GOVERNMENT shall proceed diligently with
performance of this agreement, pending final resolution
of any request for relief, claim appeal, or action
arising under the contract, and comply with any decision
of the CAO.
,
..
12. STOP WORK
A. The CAO or his designee may issue, and the LOCAL
GOVERNMENT will accept, a written order to hold or stop
Work on the G.R.E.A.T. Program funded under this
agreement for a period of up to 30 days. Such orders
will be issued only for sufficient cause, such as reason
to believe work is being performed outside of the terms
18
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COOPERATIVE AGREEMENT NO. ATC020223
of the agreement, for financial improprieties found
during a monitoring inspection or voucher and records
review, or a change in relevant laws or regulations.
B. A Stop Work Order may be continued, cancelled or
reissued as termination.
C. The LOCAL GOVERNMENT is responsible for any costs'
incurred after the issuance of a Stop Work Order
unless such work, material, equipment or services
were purchased prior to the issuance of the Stop
Work Order anq delivery cannot be ca~celled.
13. TERMINATION
A. The Government may terminate performance of work
under this agreement in whole, or in part, if the CAO
determines that a termination is in the Government's
interest. The CAO shall terminate by delivering to the
LOCAL GOVERNMENT a Notice of Termination specifying the
extent of termination and the effective date.
(1) After receipt of a Notice of Termination and except
as directed by the CAO, the LOCAL GOVERNMENT shall
immediately proceed with the following obligations:
(a) Stop work as specified in the notice.
(b) Place no further orders, except as necessary to
complete the continued portion of the
agreement.
(c) Terminate all applicable subcontracts and cancel
or divert applicable commitments covering
personal services that extend beyond the
effective date of termination.
..
..
(d) Take any action that may be necessary for the
protection and preservation of the property
related to this agreement that is in the
possession of the LOCAL GOVERNMENT and in
which the Government has or may acquire an
interest.
19
COOPERATIVE AGREEMENT NO. ATC020223
(e) Within 60 days after the date of termination,
the LOCAL GOVERNMENT shall submit a final report
along with a final SF-270, Request for Advance
or Reimbursement (ATTACHMENT I), to the GTR.
B. This Agreement may be terminated in-full or in-part by
the LOCAL GOVERNMENT at anytime prior to the completion
of the Program listed in the Agreement. The LOCAL"
GOVERNMENT shall notify the CAO, in writing, prior to
the proposed date of termination.
14. REPORTS
A. The LOCAL GOVERNMENT shall submit to the GTR a semi-
annual report within 45 days of the close of each
six month period. This report shall describe the
programmatic and financial status of the project.
The GTR shall be advised of any significant
programmatic or financial adjustments/modifications. A
progress report format is provided in Attachment V.
B. A final agreement report shall be submitted by the LOCAL
GOVERNMENT within 45 days after the completion of the
project. This final report will contain the date of
completion, final costs, and a statement that the
agreement is completed.
C. Failure to submit semi-annual progress reports or the
final agreement report may be interpreted as
non-comRliance with this agreement.
15. GOVERNMENT REPRESENTATIVES
A. The Cooperative Agreement Officer (CAO) is the Chief or
Deputy Chief, Acquisition and, Property Management
Division, located at 650 Massachusetts Avenue, NW, Room
3290, Washington, DC 20226, phone number (202) 927-8820.
,
,
B. The Cooperative Agreement Administrator (CAA) is
Kevin R. Merriweather, located at 650 Massachusetts
Avenue, NW, Room 3290, Washington, DC 20226, phone number
(202) 927-7716.
20
COOPERATIVE AGREEMENT NO. ATC020223
C. The Government Technical Representative (GTR) is
Juanita Wright, located at P.O. Box 50418, Washington,
DC 20091-0418, phone number (202) 927-2160.
16. LIMITATION OF TECHNICAL DIRECTION FROM THE GTR
A. Performance of work under this agreement shall be '
subject to the technical direction of the GTR identified
in paragraph 15.C. of this agreement, or a designated
representative. The term "technical direction" is
defined to include, without limitation, direction to the
LOCAL GOVERNMENT which directs or redirects the labor
effort, shifts the work between work areas or locations,
further defines tasks and otherwise serves to ensure
that the tasks outlined in the agreement are
accomplished in a satisfactory manner.
B. Technical direction must be within the scope of the
agreement. The GTR does not have the authority to, and
may not, issue any technical direction which:
(1) Constitutes a change of assignment or additional
work outside the scope of work of the agreement;
(2) Constitutes a change in the agreement that
requires a modification as specified in Section 7
"Modifications."
(3) In any manner cause an increase or decrease in the
agreement price, or the time required for agreement
performance.
(4) Changes any of the terms, conditions or scope of
work of the agreement; or
(5) Interferes with the LOCAL GOVERNMENT's right to
perform under the terms and conditions of the
agreement.
..
,
C. Technical directions may be oral or in writing, by GTR
or a designee with written delegated authority from the
CAO. Oral directions shall be confirmed in writing
within two working days of issuance.
D. The LOCAL GOVERNMENT shall proceed promptly with the
21
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COOPERATIVE AGREEMENT NO. ATC020223
performance resulting from technical directions issued
by the GTR, or his designee. If in the opinion of the
LOCAL GOVERNMENT, any instruction or direction of the
GTR, or his designee, falls within the purview defined
in paragraph b.1. through 5. above, the LOCAL GOVERNMENT
shall immediately notify the CAO no later than the
beginning of the next Government workday.
E. Failure of the LOCAL GOVERNMENT and the CAO to agree
that the technical directions are within the scope of
the agreement shall be subject to the terms of the
clause entitl~d Disputes in Section 11.
17. COOPERATIVE AGREEMENT OFFICER'S AUTHORITY
The CAO is the only person authorized to approve
modifications to this agreement. This authority remains
solely with the CAO. In the event the LOCAL GOVERNMENT
affects any modifications at the direction of any person
other than the CAO, the modifications will be considered to
have been made without authority and no adjustment will be
made to the agreement. The CAO shall be the only individual
authorized to "accept non-conforming work, waive any
requirement of the agreement, and/or modify any term or
condition of the agreement. The CAO is the only individual
who can legally obligate the Government to expend public
funds.
18. Attachments I (SF-270 REQUEST FOR ADVANCE OR REIMBURSEMENT),
II (Travel Reimbursement Sheet), III (ACH
VENDOR/MISCELLANEOUS PAYMENT ENROLLMENT FORM), IV (Additional
Clauses and provisions) and V (QUARTERLY COOPERATIVE
AGREEMENT PROGRESS REPORT) are hereby incorporated to form an
integral part of this Agreement.
19. FORMS
,
..
The following standard forms, provided, must be
completed and submitted with the agreement:
* SF-LLL
Disclosure of Lobbying Activities;
* SF-3881
ACH Vendor/Miscellaneous Payment
Enrollment Form (ATTACHMENT III);
* SF-424A
Budget Information - Non-Construction
22
"'-.-..,.
COOPERATIVE AGREEMENT NO. ATC020223
Programs (with instructions);
* SF-424B
Assurances - Non-Construction Programs;
The following reimbursement forms, provided, must be
completed and submitted with each request for
reimbursement:
* SF-270
Request for Advance or Reimbursement
(ATTACHMENT I) (make copies as needed)
Travel Reimbursement Sheet (ATTACHME~T
II) (make copies as needed)
Also complete and submit quarterly, the form provided
as attachment V - QUARTERLY PROGRESS REPORT (make
copies as needed) .
*
..
.
23
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COOPERATIVE AGREEMENT NO. ATC020223
LOCAL GOVERNMENT's signature
Date
PRINTED NAME AND TITLE
ATF COOPERATIVE AGREEMENT OFFICER'S signature
Date
~
.
y
y
24
COOPERATIVE AGREEMENT NO. ATC020223
ATTACHMENT IV
Additional Clauses and Provisions
a. The LOCAL GOVERNMENT possesses legal authority to apply for
the cooperative agreement, that a resolution, motion or
similar action has been duly adopted or passed as an
official act of tpe applicant's governing body authorizing
the filing of the application, including all understandings
and assurances contained therein, and directing and
authorizing the person identified as the official
representative of the applicant to act in connection with
the application and to provide such additional information
as may be required (SF-424 attached).
b. The LOCAL GOVERNMENT will comply with Title VI of the Civil
Rights Act of 1964 (P.L. 88-352) and in accordance with
Title VI of that Act, no person in the United States shall,
on the ground of race, color, or national origin, be
excluded from participation in, be denied the benefits of,
or be otherwise subjected to discrimination under any
program or activity for which the applicant receives Federal
financial assistance and will immediately take any measures
necessary to execute this agreement.
c. The LOCAL GOVERNMENT will comply with the provisions of the
Hatch Act, which limits the political activity of employees,.
d.
The LOCAL GOVERNMENT will establish safeguards to prohibit
employees from using their positions for a purpose that is
or gives the appearance of being motivated by a desire for
private gain for themselves or o~hers, particularly those
that have family, businesses or other ties.
..
,
e. The LOCAL GOVERNMENT will give the ATF or the Comptroller
General through any authorized representative access to and
the right to examine all records, books, papers, or
documents related to the cooperative agreement.
f. The LOCAL GOVERNMENT will comply with 28 C.F.R., Part 66,
Administrative Requirement for Grants and Cooperative
agreements to state and local Governments concerning
requirements of law, program requirements, and other
administrative requirements. The regulations were published
25
COOPERATIVE AGREEMENT NO, ATC020223
in Federal Register of March 11, 1988 (pages 8034-8069).
g. The LOCAL GOVERNMENT will ensure that the facilities under
its ownership, lease or supervision which shall be utilized
in the accomplishment of G.R.E.A.T. are not listed on the
Environmental Protection Agency's (EPA) list of Violating
Facilities and that it will notify ATF of the receipt of any
communication from the Director of the EPA Office of Federal
Activities indicating that a facility to be used in the
Program is under consideration for listing by the EPA.
h. The LOCAL GOVERNM~NT will comply with the minimum wage and
maximum hours provisions of the Federal Fair Labor Standards
Act, as they apply to law enforcement employees of s~ate and
local governments.
i. LIMITATION ON PAYMENTS TO INFLUENCE CERTAIN FEDERAL
TRANSACTIONS (DEVIATION - DEPARTMENT OF THE TREASURY, NOV
1990) (JUN 1997)
(a) Definitions.
"Agency," as used in this clause, means executive agency as defined in 2.101.
"Covered Federal action." as used in this clause, means any of the following Federal actions:
(a) The awarding of any Federal contract.
(b) The making of any Federal grant,
o The making of any Federal loan.
(d) The entering into of any cooperative
agreement.
(e) The extension. continuation, renewal. amendment. or modification of any Federal contract, grant, loan. or cooperative agreement.
"Indian tribe' and "tribal organization," as uscd in this clause, have the meaning provided in section 4 of the Indian Self-Determination and Education Assistance
Act (25 U.S.C, 450B) and include Alaskan Natives.
"Influencing or attempting to influence," as used in this clause, means making. with the intent to influence. any communication to or appearance before an officer
or employee of any agency, a Member of Congress, an officer or employee of Congress. or an employee of a Member of Congress in connection with any covered
Federal action,
"Local goverMlent," as used in this clause, means a unit of goverMlent in a State and. if chartered, establisheil, or otherwise recognized by a State for the
performance of a
goverMlental duty, including a local public authority. a special district, an intrastate district. a council of goverMlents, a sponsor group representative
organization, and any other instrumentality of a local goverMlent,
"Officer or employee of an agency." as used in this clause. includes the following individuals who are employed by an agency:
(a) An individual who is appointed to a position in the GoverMlent under title 5, United States Code, including a position under a temporary
appointment,
(b) A member of the uniformed services, as defined in subsection 101(3), title 37. United States Code.
o A special Govenunent employee. as defined in section 202, title 18. United States Code,
(d) An individual who is a member of a Federal advisory committee, as defined by the Federal Advisory Committee Act, title S. United States Code,
appendix 2.
"Person," as used in this clause, means an individual corporation, company, association, authority, firm. partner-ship, society. State, and local goverMlent.
regardless of whether such entity is operated for profit, or not for profit. This term excludes an Indian tribe, tribal organization, or any other Indian organization
with respect to expenditures specifically permitted by other Federal law,
"Reasonable compensation," as used in this clause means, with respect to a regularly employed officer or employee of any person, compensation that is consistent
with normal compensation for such officer or employee for work that is not furnished to, not funded by. or not furnished in cooperation with the Federal
GoverMlent.
"Reasonable payment." as used in this clause, means, with respect to professional and other technical services, a payment in an amount that is consistent with
amount normally paid for such services in the private sector.
"Recipient," as used in this clause, includes the Contractor and all subcontractors, This term excludes an Indian tribe, tribal organization, or any other Indian
organization with respect to expenditures specifically permitted by other Federal law .
"Regularly employed," as used in this clause, means, with respect to an officer or employee of a person requesting or receiving a Federal contract, an officer or
employee who is employed by such person for at least 130 working days within 1 year immediately preceding the date of the submission thaI Initiates agency
consideration of such person for receipt of such contract, An officer or employee who is employed by such person for less than 130 working days within I year
immediately preceding the date of the submission that initiates agency consideration of such person shall be considered to be regularly employed as soon as he or
0'
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26
COOPERATIVE AGREEMENT NO. ATC020223
she is employed by such person for 130 working days.
.State,. as used in this clause, means a State of the United States, the District of Columbia, the Commonwealth of Puerto Rico. a tcrritory or possession of the
United States, an agency or instrumentality of a State, and multi-State, regional, or interstate emity having goverrunental duties and powers.
(b) Prohibitions,
(I) Section 1352 of title 31. United Slates Code, among other things, prohibits a recipiem ofa Federal comract, gram, loan, or cooperative agreement from using
appropriated funds to pay any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress. an officer or
employee of Congress, or an employee of a Member of Congress in connection with any of the following covered Federal actions: the awarding of any Federal
contract; the making of any Federal gram; the making of any Federal loan; the entering into of any cooperative agreement; or the modification of any Federal
comract, grant. loan. or cooperative agreement.
(2) The Act also requires Contractors to furnish a disclosure if any funds other than Federal appropriated funds (including profit or fee received under a covered
Federal transaction) have been paid. or will be paid, to any person for influencing or auempting to influence an officer or employee of any agency, a Member of
Congress. an officer or employee of Congress. or an employee of a Member of Congress in conneclion a Federal comract, gram, loan, or cooperative agreement.
(3) The prohibitions of the Act do not apply under the following conditions:
(I) Agency and legislative liaison by own employees.
(A) The prohibition on the use of appropriated funds, in subparagraph (b)( I) of this clause, does not apply in the case of a payment of reasonable
compensation made to an officer or employee of a person requesting or receiving a covered Federal action if the paymem is for agency and legislative liaison
activities not directly related to a covered Federal action.
(B) For purposes of subdivision (b)(3)(I)(A) of this clause, providing any information specifically requested by an agency or Congress is permiited at
any time.
o The following agency and legislative liaison activities are penniued at any time where they are not related to a specific solicitation for any covered
Federal action:
(I) Discussing with an agency the qualities and characteristics (including individual demonstrations) of the person's products or services, conditions
or terms of sale, and service capabilities.
(2) Technical discussions and other activities regarding the application or adaptation of the person's products or services for an agency's use.
(D) The following agency and legislative liaison activities are permiued where they are prior to formal solicitation of any covered Federal action--
(I) Providing any information not specifically requested but necessary for an agency to make an informed decision about initiation of covered Federal
action;
(2) Technical discussions regarding the preparation of an unsolicited proposal prior to its official submission; and
(3) Capability presentations by persons seeking awards from an agency pursuant to the provisions of the Small Business Act, as amended by Pub. L.
95-507. and subsequent amendmems.
(E) Only those services expressly authorized by subdivision (b)(3)(I)(A) of this clause are permiued under this clause.
(ii) Professional and technical services,
(A) TIle prohibition on the use of appropriated funds. in subparagraph (b)(I) of this clause, does not apply in the case of--
(I) A payment of reasonable compensation made to an officer or employee of a person requesting or receiving a covered Federal action or an
extension. continuation. renewal. amcndmem, or modification of a covered Federal action, if paymem is for professional or technical services rendered directly in
the preparation, submission, or negotiation of any bid, proposal. or application for that Federal action or for meeting requirements imposed by or pursuant to law
as a condition for receiving that Federal action.
(2) Any reasonable paymem to a person, other than an officer or employee of a person requesting or receiving a covered Federal action or an
extension, continuation, renewal. amendment, or modification of a covered Federal action if the payment is for professional or technical services rendered
directly in the preparation, submission. or ncgotiation of any bid, proposal, or application for that Federal action or for mceting requirements imposed by or
pursuant to law as a condition for recciving that Fcderal action. Persons other than officers or employees of a person requesting or receiving a covered Federal
action include consultants and trade associations.
(B) For purposes of subdivision (b)(3)(ii)(A) of this clause, .professional and technical services. shall be limited to advice and analysis directly
applying any professional or technical discipline, The following examples are not imended to be all inclusive. to limit the application of the professional or
technical exemption provided in the law, or to limit the exemption to licensed professionals. For example. drafting of a legal documem accompanying a bid or '
proposal by a lawyer is allowable. Similarly, technical advice provided by an engineer on the performance or operational capability of a piece of equipmem
rendered directly in the negotiation of a contract is allowable, However, communications with the iment to influence made by a professional (such as a licensed
. lawyer) or a technical person (such as a licensed accountant) are not allowable under this section unless they provide advice and analysis directly applying their
professional or technical expertise and unless the advice or analysis is rendered directly and solely in the preparation, submission or negotiation of a covered
Federal action. Thus, for example, communications with the intent to influence made by a la....oyer that do not provide legal advice or analysis directly and solely
related to the legal aspects of his or her cliem's proposal, but generally advocate one proposal over another are not allowable under this section because the lawyer
is not providing professional legal services. Similarly, communications with the imem to influence made by an engineer providing an engineering analysis prior to
the preparation or submission of a bid or proposal are not allowable under this section since the engineer is providing technical services but not directly in the
preparation, submission or negotiation of a covered Federal action.
o Requirements imposed by or pursuant to law as a condition for receiving a covered Federal award include those required by law or regulation and
any other requirements in the actual award documents,
(D) Only those services expressly authorized by subdivisions (b)(3)(ii)(A)(I) and (2) of this clause are permitted under this clause,
(E) The reporting requirements of FAR 3,803(a) shall not apply with respect to payments of reasonable compensation made to regularly employed
orticers or employees of a person,
(iii) Selling activities by independent sales
representatives,
The prohibition on the use of appropriated funds, in subparagraph (b)(I) of this clause. does not apply to the following selling activities before an
agency by independent
sales representatives, provided such activities are prior to fonnal solicitation by an agency and are specifically limited to the merits of the mailer:
(A) Discussing with an agency (including individual demonstrations) the qualities and characteristics of the person's products or services, conditions or terms
of sale, and service capabilities; a
",
(B) Technical discussions and other activities regarding the application or adaptation of the person's products or services for an agency's use.
27
COOPERATIVE AGREEMENT NO. ATC020223
o Disclosure,
(I) The Contractor who requests or receives from an agency a Federal contract shall lite with that agency a disclosure form, OMB standard form
LLL. Disclosure of Lobbying Activities, if such person has made or has agreed to make any payment using nonappropriated funds (to include profits from any
covered Federal action), which would be prohibited under subparagraph (b)(I) of this clause, if paid for with appropriated funds.
(2) The Contractor shall lite a disclosure form at the end of each calendar quarter in which there occurs any event that materially affects the accuracy
of the infomlation contained in any disclosure foml previously Iited by such person under subparagraph (c)(I) of this clause, An event that materially affects the
accuracy of the information reported includes-
(I) A cumulative increase of S25.000 or morc in the amount paid or expected to be paid for innuencing or attempting to innuence a covered Federal
action; or
(ii) A change in the person(s) or individual(s) innuencing or allempting to innuence a covered Federal or action; or
(iii) A change in the officer(s), employee(s), or Members(s) contacted to innuence or attempt to innuence a covered Federal action.
(3) The Contractor shall require the submillal of a certification, and if required, a disclosure form by any person who requests or receives any
subcontract exceeding SIOO,OOO under the Federal contract.
(4) All subcontractor disclosure fomls (but not certifications) shall be forwarded from tier to tier until received by the prime Contractor, The prime
Contractor shall submit all disclosures to the Contracting Officer at the end of the calendar quarter in which the disclosure form is submilled by the subcontractor.
Each subcontractor certification shall be retained in the subcontract file of the awarding Contractor,
(d) agreement. The Contractor agrees not to make any payment prohibited by this clause.
(e) Penalties,
(I) Any person who makes an expenditure prohibited under paragraph (a) of this clause or who fails to file or amend the disclosure form to be Iited or
amended by paragraph (b) of this clause shall be subject to civil penalties as provided for by 31 V.S.C. \352. An imposition of a civil penalty does not prevent the
GoverMlent from seeking any other remedy that may be applicable.
(2) Contractors may rely without liability on the representation made by their subcontractors in the certification and disclosure form.
(I) Cost allowability. Nothing in this clause makes allowable or reasonable any costs which would otherwise be unallowable or unreasonable, Conversely, costs
made specifically unallowable by the requirements in this clause will not be made allowable under any other provision.
j. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER
RESPONSIBILITY MATTERS--PRIMARY COVERED TRANSACTIONS (MAR
1996)
Instructions for Certification
I. By signing and submining this proposal. the prospective primary
participant is providing the certification set out below.
2. The inability of a person to provide the certification required below will
not necessarily result in denial of participation in the covered transaction.
The prospective participant shall submit an explanation of why it cannot
provide the certification set out below, The certification or explanation
will be considered in cOMection with the department or agency's
determination whether to enter into this transaction. However, failure of
the prospective primary participant to furnish a certification or an
explanation shall disqualify such person from participation in this
transaction.
3. The certification in this clause is a material representation of fact upon
which reliance was placed when the department or agency determined to
enter into this transaction, If it is later determined that the prospective
primary participant knowingly rendered an erroneous certification. in
addition to other remedies available to the Federal Govenunent, the
department or agency may terminate this transaction for cause of default.
4. The prospective primary participant shall provide immediate written
notice to the department or agency to whom this proposal is submilled if at
any time the prospective primary participant learns that ilS certification was
erroneous when submilled or has become erroneous by reason of changed
circumstances,
5, The terms "covered transaction," "debarred," "suspended,"
"ineligible," "lower tier covered transaction,. "participant," 'person,"
"primary covered transaction," "principal." "proposal." and "voluntarily
excluded." as used in this clause. have the meanings set out in the
Definitions and Coverage sections of the rules implementing Executive
Order 12549, You may contact the department or agency to which this
proposal is being submilled for assistance in obtaining a copy of those
regulations,
6. The prospectivc primary participant agrees by submining this proposal
that, should the proposed covered transaction be entered into, it shall not
knowingly enter into any lower tier covered transaction with a person who
is debarred, suspended, declared ineligible, or voluntarily excluded from
participation in this covercd transaction, unless authorized by the
department or agency entering into this transaction,
7, The prospective primary participant further agrees by submitting this
proposal that it will include the clause titled "Certification Regarding
Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier
Covered '(ransaction, " provided by the department or agency into this
covered transaction, without modification, in all lower tier covered
transactions and in all solicitations for lower tier covered transactions,
8. A participant in a covered transaction may rely upon a certification of a
prospective participant in a lower tier covered transaction that it is not
debar,red. suspended, ineligible. or voluntarily excluded from the covered
transaction, unless it knows that the certification is erroneous. A
participant may decide the method and frequency by which it determines
the eligibility of its principals, Each participant may. but is not required
to, check the Nonprocurement List (202-783-3238),
9, Nothing contained in the foregoing shall be construed to require
establishment of a system of records in order to render in good faith the
certification required by this clause, The knowledge and information of a
participant is not required to exceed that which is normally possessed by a
prudent person in the ordinary course of business dealings.
10. Except for transaction authorized under paragraph 6 of these
instructions. if a participant in a covered transaction knowingly enters into
a lower tier covered transaction with a person who is suspended, debarred,
ineligible, or voluntarily excluded from participation in this transaction, in
addition to other remedies available to the Federal GoverMlent, the
department or agency may terminate this transaction for cause or default,
28
COOPERATIVE AGREEMENT NO. ATC020223
Certification Regarding Debarment. Suspension. and Other
Responsibility Matters-Primary Covered Transactions
(I) The prospective primary participant certifies to the best of its
knowledge and belief, that it and its principals:
(a) Are not presently debarred. suspended. proposed for
debarment. dcclared incligible. or voluntarily excluded from covered
transactions by any Federal department or agency;
(b) Have not within a three-year period preceding this
proposal been convicted or had a civil judgment rendered against them for
commission of fraud or a criminal offense in cOMection with obtaining.
attempting to obtain, or performing a public (Federal, State. or local)
transaction or contract under a public transaction; violation of Federal or
Statc antitrust statutes or commission of embezzlement, theft, forgery,
bribery, falsification or destruction of records, making ,false statements. or
receiving stolen property:
o Arc not presently indicted for or otherwise criminally or
civilly charged by a goverrunental entity (Federal. State or local) with
commission of any of the offenses enumerated in paragraph (I)(b) of this
certification; and
(d) Have not within a three-year period preceding this
application/proposal had one or more public transaction (Federal, State or
local) terminated for cause or default.
(2) Where the prospective primary participant is unable to certify to any of
the statements in this certification, such prospective participant shall attach
an explanation to this proposal.
k. CERTIFICATION REGARDING DRUG-FREE WORKPLACE
REQUIREMENTS
Instructions for Certification
1. By signing and/or submitting this application or grant agreement, the grantee is providing the certification set out below.
2. The certification set out below is a material representation of fact upon which reliance is placed when the agency awards the grant. If it is later determincd that
the grantce knowingly rendered a false certification, or otherwise violates the requirements of the Drug-Free Workplace Act, the agency, in addition to any other
remcdies available to the Federal Goverrunent, may take action authorized under the Drug-Free Workplace Act,
3. For grantecs other than individuals. Alternate I applies,
4. For grantees who are individuals. Alternate 11 applies.
5. Workplaccs under grants, for grantees other than individuals, need not be identified on the certification. If known, they may be identified in the grant
application. If thc grantee does not identify the workplaces at the time of application. or upon award. if thcre is no application, the grantee must keep the identity
of the workplace(s) on ftlc in its officc and make the information available for Federal inspection. Failure to identify all known workplaces constitutes a violation
of the grantee's drug-free workplace requirements,
6. Workplace identifications must include the actual address of building (or parts of buildings) or other sitcs where work under the grant takes place. Categorical
descriptions may be used (e.g.. all vehicles of mass transit authority or State highway department whilc in operation, State employees in each local unemployment
officc, pcrformers in conccrt halls or radio studios).
7. If the workplace identified to thc agency changes during the perfonnance of the grant, thc grantec shall inform the agcncy of thc change(s), if the previously
identified thc workplaces in question (see paragraph five).
8. Definitions of terms in thc Nonprocurement Suspension and Debarment common rule and Drug-Free Workplace common rule apply to this certification,
Grantees' attention is called, in particular, to the following definitions from these rules:
Controllcd substance means a controlled substance in Schedules I through V of the Controlled Substances Act (21 U .S.C, 812) and as further defined
by rcgulation (21 CFR 1308,11 through 1308.15);
Conviction means a finding of guilt (including a plea of nolo contendere) or imposition of sentence, or both, by any judicial body charged with the
responsibility to determine violations of the Federal or State criminal drug statutes;
Criminal drue statute means a Federal or non-Federal criminal statute involving the manufacture, distribution. dispensing, use, or possession of any
controlled substance;
~ means the employee of a grantee directly engaged in the performance of work under a grant, including: (I) All direct charge employees:
(ii) All indirect charge employees unless their impact or involvement is insignificant to the p~'rformance of the grant; and, (iii) Temporary persoMel and
consultants who are directly engaged in the performance of work under the grant and who are on the grantee's payroll, This definition does not include workers
not on the payroll of the grantee (e.g,. volunteers, even if used to meet a matching requirement; consultants or independent contractors not on the grantee's
payroll; or employees of subrecipients or subcontractors in covered workplaces,)
..
,
Certification Regarding Drug-Frce
Workplace Requirements
Alternate J. (Grantees Other Than Individuals)
A. The grantee certifies that it will or will continue to provide a drug-free
workplace by:
(a) Publishing a statement notifying employees that the unlawful
manufacture, distribution, dispensing, possession. or use of a controlled
substance is prohibited in the grantee's workplace and specifying the
actions that will be taken against employees for violation of such
prohibition:
(b) Establishing an ongoing drug-free awareness program to inform
employees about--
(I) The dangers of drug abuse in the workplace;
(2) The grantee's policy of maintaining a drug-free
workplace:
(3) Any available drug counseling, rehabilitation, and
employee assistance programs; and
(4) The penalties that may be imposed upon employees for
drug abuse violations occurring in the workplace;
29
. -'~.......
COOPERATIVE AGREEMENT NO. ATC020223
o making it a requirement that each employee to be engaged in the
perfonllance of the grant be given a copy of the statement required by
paragraph (a);
(d) Notifying the employee in the statement requircd by paragraph (a) that,
as a condition of employment under the grant, the employee will-
(I) Abide by the tenns of the statement; and
(2) Notify the employer in writing of his or her conviction for
a violation of a criminal drug statute occurring in the workplace no later
than five calendar days after such conviction;
(e) Notifying the agency in writing, within ten calendar days after
receiving notice undcr paragraph (2) from an employee or otherwise
receiving actual notice of such conviction. Employers of convictcd
employees must provide notice, including position title. to every grant
activity the convicted employee was working. unless the Federal agency
has designated a central point for the receipt of such notices. Notice shall
include the identification number(s) of each affected grant;
(0 Taking on of the following actions within 30 calendar days of receiving
notice under paragraph (d)(2), with respect to any employee who is so
convicted-- .
(I) Taking appropriate personnel action against such an
employee. up to and including termination, consistent with the
requirements of the Rehabilitation Act of 1973, as amended; or
(2) Requiring such employee to participate satisfactorily in a
drug abusc assistance or rehabilitation program approved for such purposes
by a Federal, State, or local health, law enforcement, or other appropriate
agency;
(g) Making a good faith effort to continue to maintain a drug-free
workplace through implementation of paragraphs (a). (b), (c), (d), (e) and
(t).
B, The grantee may insert in the space provided below the site(s) for the
performance of work done in connection with the specific grant: Place of
Performance (Street address, city, county, state, zip code)
Check [ ] if there are workplaces on file that are not identified here.
Alternate II. (Grantees Who Are Individuals)
(a) The grantee certifies that, as a condition of the grant, he or she will not
engage in the unlawful manufacture, distribution, dispensing. possession.
or use of a controlled substance in conducting any activity with the grant;
(b) If convicted of a criminal drug offense resulting from a violation
occurring during the conduct of any grant activity, he or she will report the
conviction, in writing, within 10 calendar days of the conviction. to every
grant officer or other designee. unless the Federal agency designates a
central point for the receipt of such notices. When notice is made to such a
central point, it shall include the identification number(s) of each affected
grant.
1. CERTIFICATION FOR CONTRACTS, GRANTS, LOANS, AND
COOPERATIVE AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief, that:
(I) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for innuencing or attempting to innuence
an officer or employee of an agency. a Mcmber of Congress. an officer or employee of Congress, or an employee of a Member of Congress in connection with the
awarding of any Federal contract. the making of any Federal loan, the entering into any cooperative agreement, and the extension, continuation, renewal,
amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for innuencing or attempting to innuence an officer or
employee of any agency. a Member of Congress, an officer of employee of Congress, or an employee of a Member of Congress in conncction with this Federal
contract, grant, loan. or cooperative agreement. the undersign shall complete and submit Standard Form-lll, "Disclosure Form to Report lobbying, " in
accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including
subcontractors, subgrants, and contract under grants. loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this
certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31. U,S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
The undersigned states, to the best of his or her knowledge and belief, that:
Statement for loan Guarantees and loan Insurance
0'
..
If any funds have been paid or will be paid to any person for innuencing or attempting to innuence an officer or employee of an agency. a Member of
Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this conunitment providing for the United States to
insure or guarantee a loan, the undersigned shall complete and submit Standard Form-lll, "Disclosure Fonn to Report lobbying," in accordance with its
instructions,
Submission of this statement is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U,S, Code. Any person who fails
to file the required statement shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure,
30
ATTACHMENT II
TRAVEL REIMBURSEMENT SHEET
This form must be completed and submitted along with the SF-270,
Request for Advance or Reimbursement for travel reimbursements.
Travel expenses will be, reimbursed in accordance with current
Federal Government Travel Regulations.
TRAVEL
DATE(s)
TRANSPORTATION
EXPENSE
MODE
TRANSPORTATION
LODGING
EXPENSE
PER
DIEM
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
OTHER TRAVEL EXPENSES:
WHAT
AMOUNT
$
$
$
$
TOTAL TRAVEL REIMBURSEMENT REQUESTED: $
Reason for travel:
SUBMITTED BY:
LOCAL Governmentts signature
"
,
APPROVED:
GTR's signature
31
...-.---.
ATTACHMENT V
QUARTERLY COOPERATIVE AGREEMENT PROGRESS REPORT
INSTRUCTIONS: It is the responsibility of the LOCAL GOVERNMENT
to prepare a progress report quarterly for the G.R.E.A.T.
program, which have .been authorized in the agreement. The LOCAL
GOVERNMENT should copy additional copies of the report for future
quarterly submission. If additional space is needed, this report
can be continued on plain white bond paper. The complete report
should be forwarded to:
Bureau of Alcohol, Tobacco and Firearms
ATTN: Juanita Wright
P.O. Box 50418
Washington, DC 20091-0148
If you have any questions or need additional guidance, please
contact Juanita Wright, Government Technical Representative, on
202-927-2160.
1. Local Government Name:
2. Cooperative Agreement No.:
3. Program:
G.R.E.A.T. Proqram
4. Quarterly Start Date:
5. Quarterly Completion Date:
6. Funding Status:
Funds Approved
Funds Obliqated to Date
Balance Remaininq
$
$
$
7. Progress to Date:
# of students attending Phase I :
# of students attending Phase II:
# of students attending Phase III:
# of students graduated this quarter:
,
"
8. Describe G.R.E.A.T. activities taking place this quarter: to
include number of officers teaching, grade levels, conferences
attended, summer program, events, etc.
32
....----....;.
9. Problems Noted (need for modifications, delays anticipated,
etc.) State NONE if applicable.
PREPARED BY:
Name of LOCAL GOVERNMEN~ Official and Title
.
"
SIGNATURE:
DATE:
REVIEWED BY:
DATE:
Government Technical Representative
33
G.R.E.A.T. Program
---.
OMB APPROVAl. NO. PAGE . OF
, 0348-0004 I PAGES
REQUEST FOR ADVANCE .. ox. OM 01" boIh boJtN 2. BASIS OF REQUEST
OR REIMBURSEMENT 1. o ADVANCE 0 REIMBURSE-
TYPE OF MENT o CASH
. PAYMENT b. ?(" 1M appllubM bolt
(See Instructions on back) REQUESTED o FINAL o PARTIAL o ACCRUAL
3. FEDERAL SPONSORING AGENCY AND ORGANIZATIONAl ELEMENT TO .. FEDERAL GRANT OR OTHER 5. PARTIAl. PAYMENT REQUEST
WHICH THIS REPORT IS SUBMITTED IDENTIFYING NUMBER ASSIGNED NUMBER FOR THIS REQUEST
.. " ,. ... 'BY FEDERAL AGENCY . .- '"
e. EMPLOYER IDENTIACATlON 7. RECIPIENrS ACCOUNT NUMBER 8. PERIOD COVERED BY THIS REQUEST
NUMBER OR IDENTIFYING NUMBER FROM (month, tMy, yeeQ TO (month, day. )'HIj
9. RECIPIENT ORGANIZATION 10. PAYEE (WIler9 check Is to be sent Ifdltrerent than Item 9)
Name: Name:
Number Number
and Street: and Street:
City. State City, State
and ZIP Code: and ZIP Code:
11.
COMPUTATION OF AMOUNT OF REIMBURSEMENTS/ADVANCES REQUESTED
(a) (b) (c)
PROGRAMS/FUNCTIONS/ACTIVITIES ~
TOTAL
a. Total program (A3 01 dele) $ $ $ $
outlays to date
b. Less: Cumulallve program Income
c. Net program outlays (Une a minus
'ne b)
d. Estimated net cash outlays for advance
Derlod
e. Total (Sum o( 'nes c & d)
,
f. Non-Federal share of amount on line e
g. Federal share of amount on line e
h. Federal payments prevtouslY reQuested
I. Federal share now requested (Une 9 ,
minus Ine h) ,
J. Advances required by
month, when requested 1 st month
by Federal grantor 2nd month
agency for use In making
prescf1eduled advances 3rd month
,
"
12.
ALTERNATE COMPUTATION FOR ADVANCES ONLY
a. Estimated Federal cash outla that will be made durl
the advance
$
b. Less: Estimated balance of Federal cash on hand as of
$
(Continued on Reverse)
STANDARD fORM 270 (RaY. 7.01)
Prescribed by OMS Circulars A-102 and A.110
13.
CERTIFICATION
SIGNATURE OR AlITHORIZED CERTIFYING OFFICIAL
DAne REQUEST
SUBMITTED
I certify that to the best of my
~owIedge and belief the data on the
reverse are correct and that all outlays
were made In accordance with the
grant conditions or other agreement
and that payment Is due and has not
been prevtously requested.
This space for agency use
TYPED OR PRINTED NAME AND TITLE
TELEPHONE (AREA
CODE, NUMBER,
EXTENSION)
.~.. -~-_.. --.- -..-. . .-..--..-....----...-.. - -....-..- -. --.-.---...- -.._.
Public reporting burden for this collection of Information Is estimated to average 60 minutes per
response, Including time for reviewing Instructions, searching exlsllng data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of Infonnation. Send
comments regarding the burden estimate or any other aspect of this collection of Infonnatlon,
Including suggestions for reducing this burden, to the Offlce of Management and Budget, Paperwork
Reduction Project (0348-0004), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT
AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
INSTRUCTIONS
Please type or print legibly. Items 1, 3,.5, 9, 10, 11e, 11f, 11g, 11 i, 12 and 13 are self-explanatory; specific
instructions for other items are as follows:
Item Entry Item Entry
2 Indicate whether request is prepared on cash or accrued
expenditure basis. All requests for advances shall be
prepared on a cash basis.
activity. If additional columns are needed, use as many
additional forms as needed and indicate page number in
space provided in upper right; however, the summary
totals of all programs, functions, or activities should be
shown in the "total" column on the first page.
4 Enter the Federal grant number, or other identifying
number assigned by the Federal sponsoring agency. If
the advance or reimbursement is for more than one grant
or other agreement, insert N/A; then, show the aggregate
amounts. On a separate sheet, list each grant or
agreement number and the Federal share of outlays
made against the grant or agreement.
11a
Enter in "as of date," the month, day, and year of the
ending of the accounting period to which this amount
applies. Enter program outlays to date (net of refunds,
rebates, and discounts), in the appropriate columns. For
requests prepared on a cash basis, outlays are the sum
of actual cash disbursements for goods and services,
the amount of indirect expenses charged, the value of in-
kind contributions applied, and the amount of cash
advances and payments made to subcontractors and
subrecipients. For requests prepared on an accrued
expenditure basis, outlays are the sum of the actual
cash disbursements, the amount of Indirect expenses
incurred, and the net increase (or decrease) In the
amounts owed by the recipient for goods and other
property received and for services performed by
employees, contracts, subgrantees and other payees.
E~ter the cumulative cash Income received to date, if
requests are prepared on a cash basis. For requests
prepared on an accrued expenditure basis, enter the
cumulative Income earned to date. Under either basis,
enter only the amount applicable to program Income that
was required to be used for the project or program by
the terms of the grant or other agreement.
6 Enter the employer identification number assigned by the
U.S. Internal Revenue Service, or the FleE (institution)
code if requested by the Federal agency.
7 This space is reserved for an account number or other
identifying number that may be assigned by the recipient.
8 Enter the month, day, and year for the beginning and
ending of the period covered In this request. If the request
is for an advance or for both an advance and
reimbursement, show the period that the advance will
cover. If the request is for reimbursement, show the
period for which the reimbursement is requested.
11b
Note: The Federal sponsoring agencies have the option of
requiring recipients to complete items 11 or 12, but not
both. Item 12 should be used when only a minimum
amount of information is needed to make an advance and
outlay information contained in item 11 can be obtained In
a timely manner from other reports.
11d
Only when makIng requests for advance payments,
enter the total estimated amount of cash outlays that will
be made during the period covered by the advance.
11 The purpose of the vertical columns (a), (b), and (c) Is to
provide space for separate cost breakdowns when a
project has been. planned and budgeted by program,
function, or
13 Complete the certification before submitting this request.
STANDARD FORM 270 (Rev. 7.97) Beck
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CII
N
INSTRUCTIONS FOR THE SF-424A
Public reporting burden for this collection of Information is estimated to average 180 minutes per response, 'fncluding time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or any other aspec:,t of this collection of information, including suggestions for
reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0044), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET.
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
General Instructions
This form is designed so that application can be made for funds
from one or more grant programs. In preparing the budget,
adhere to any existing Federal grantor agency guidelines which
prescribe how and whether budgeted amounts should be
separately shown for different functions or activities within the
program. For some programs, grantor agencies may require
budgets to be separately shown by function or activity. For other
programs, grantor agencies may require a breakdown by function
or activity. Sections A, B, C, and D should include budget
estimates for the whole project except when applying for
assistance which requires Federal authorization in annual or
other funding period increments. In the latter case, Sections A, B,
C, and D should. provide the budget for the first budget period
(usually a year) and Section E should present the need for
Federal assistance in the subsequent budget periods. All
applications should contain a breakdown by the object class
categories shown in Lines a-k of Section B.
Section A. Budget Summary Lines 1-4 Columns (a) and (b)
For applications pertaining to a single Federal grant program
(Federal Domestic Assistance Catalog number) and not requiring
a functional or activity breakdown, enter on Line 1 under Column
(a) the Catalog program title and the Catalog number in Column
(b).
For applications pertaining to a single program requiring budget
amounts by multiple functions or activities, enter the name of
each activity or function on each line in Column (a), and enter the
Catalog number in Column (b). For applications pertaining to
multiple programs where none of the programs require a
breakdown by function or activity, enter the Catalog program title
on each line in Column (a) and the respective Catalog number on
each line in Column (b).
For applications pertaining to multiple programs where one or
more programs require a breakdown by function or activity,
prepare a separate sheet for each program requiring the
breakdown. Additional sheets should be used when one form
does not provide adequate space for all breakdown of data
required. However, when more than one sheet is used, the first
page should provide the summary totals by programs.
Lines 1-4, Columns (c) through (g)
For new applications, leave Column (c) and (d) blank. For each
line entry in Columns (a) and (b), enter in Columns (e), (t), and
(g) the appropriate amounts of funds needed to support the
project for the first funding period (usually a year).
For continuing grant program applications, submit these forms
before the end of each funding period as required by the grantor
agency. Enter in Columns (c) and (d) the estimated amounts of
funds which will remain unobligated at the end of the grant
funding period only if the Federal grantor agency instructions
provide for this. Otherwise, leave these columns blank. Enter in
columns (e) and (t) the amounts of funds needed for the
upcoming period. The amount(s) in Column (g) should be the
sum of amounts in Columns (e) and (t).
For supplemental grants and changes to existing grants, do not
use Columns (c) and (d). Enter in Column (e) the amou'nt of the
increase or decrease of Federal funds and enter in Column (t) the
amount of the increase or decrease of non-Federal funds. In
Column (g) enter the new total budgeted amount (Federal and
non-Federal) which includes the total previous authorized
budgeted amounts plus or minus, as appropriate, the amounts
shown in Columns (e) and (t). The amount(s) in Column (g)
should not equal the sum of amounts in Columns (e) and (t).
Line 5 - Show the totals for all columns used.
Section B Budget Categories
In the column headings (1) through (4), enter the titles "f the
same programs, functions, and activities shown on Lines 1-4,
Column (a), Section A. When additional sheets are prepared for
Section A, provide similar column headings on each sheet. For
each program, function or activity, fill in the total requirements for
funds (both Federal and non-Federal) by object class categories.
Line 6a-1 - Show the totals of Lines 6a to 6h in each column.
Line 6j - Show the amount of indirect cost.
Line 6k - Enter the total of amounts on Lines 6i and 6j. For all
applications for new grants and continuation grants the total
amount in column (5), Line 6k, should be the same as the total
amount shown in Section A, Column (9), Une 5. For
supplemental grants and changes to grants, the total amount of
the increase or decrease as shown in Columns (1)-(4), Line 6k
should be the same as the sum of the amounts in Section A,
Columns (e) and (t) on Line 5.
Line 7 - Enter the estimated amount of Income, if any, expected
to be generated from this project. Do not add or subtract this
amount from the total project amount, Show under the program
"
SF-424A (Rev. 7-97) Page 3
-.--.
INSTRUCTIONS FOR THE SF-424A (continued)
I
Line 15 - Enter the totals of amounts on Lines 13 and 14.
narrative statement the nature and source of income. The
estimated amount of program Income may be considered by the
Federal grantor agency in determining the total amount of the
grant.
Section C. Non-Federal Resources
Lines 8-11 Enter amounts of non-Federal resources that will be
used on the grant. If in-kind contributions are included, provide a
brief explanation on a separate sheet.
Column (a) - Enter the program titles identical to
Column (a), Section A. A breakdown by function or
activity is not necessary.
Column (b) - Enter the contribution to be made by the
applicant. .
Column (c) - Enter the amount of the State's cash and
in-kind contribution if the applicant is not a State or
State agency. Applicants which are a State or State
agencies should leave this column blank.
Column (d) - Enter the amount of cash and in-kind
contributions to be made from all other sources.
Column (e) - Enter totals of Columns (b), (c), and (d).
Line 12 - Enter the total for each of Columns (b)-(e). The amount
in Column (e) should be equal to the amount on Line 5, 'Column
(t), Section A.
Section D. Forecasted Cash Needs
Line 13 - Enter the amount of cash needed by quarter from the
grantor agency during the first year.
Line 14 - Enter the amount of cash from all other sources needed
by quarter during the first year.
Section E. Budget Estimates of Federal Funds Needed for
Balance of the Project
Lines 16-19 - Enter in Column (a) the same grant program titles
shown In Column (a), Section A. A breakdown by function or
activity Is not necessary. For new applications and continuation
grant applications, enter in the proper columns amounts of Federal
funds which will be needed to complete the program or project over
the succeeding funding periods (usually in years). This section
need not be completed for revisions (amendments, changes, or
supplements) to funds for the current year of existing grants.
If more than four lines are needed to list the program titles, submit
additional schedules as necessary.
Line 20 - Enter the total for each of the Columns (b)-(e). When
additional schedules are prepared for this Section, annotate
accordingly and show the overall totals on this line.
Section F. Other Budget Information
Line 21 - Use this space to explain amounts for individual direct
object class cost categories that may appear to be out of the
ordinary or to explain the details as required by the Federal grantor
agency.
Line 22 - Enter the type of indirect rate (provisional, predetermined,
final or fixed) that will be in effect during the funding period, the
estimated amount of the base to which the rate is applied, and the
total indirect expense. .
Line 23 - Provide any other explanations or comments deemed
necessary.
.
SF-424A (Rev. 7-97) Page 4
OMS Approval No. 0348-0040--'
ASSURANCES - NON-CONSTRUCTION PROGRAMS
I
Public reporting burden for this collection of information Is estimated to average 15 minutes per response, Including time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0040), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET.
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
NOTE: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the
awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such
is the case, you will be notified.
As the duly authorized representative of the applicant, I certify that the applicant:
3. Will establish safeguards .to prohibit employees from
using their positions for a purpose that constitutes or
presents the appearance of personal or organizational
conflict of interest, or personal gain.
Act of 1973, as amended (29 U.S.C. ~794), which
prohibits discrimination on the basis of ha'ndicaps; (d)
the Age Discrimination Act of 1975, as amended (42
U.S.C. ~~6101-6107), which prohibits discrimination
on the basis of age; (e) the Drug Abuse Office and
Treatment Act of 1972 (P.L. 92-255), as amended,
relating to nondiscrimination on the basis of drug
abuse; (f) the Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation
Act of 1970 (P.L. 91-616), as amended, relating to
nondiscrimination on the basis of alcohol abuse or
alcoholism; (g) ~~523 and 527 of the Public Health
Service Act of 1912 (42 U.S.C. ~~290 dd-3 and 290 ee
3), as amended, relating to confidentiality of alcohol
and drug abuse patient records; (h) Title VIII of the
Civil Rights Act of 1968 (42 U.S.C. ~~3601 et seq.), as
amended, relating to nondiscrimination in the sale,
rental or financing of housing; (I) any other
nondiscrimination provisions In the specific statute(s)
under which application for Federal assistance is being
made; and, (j) the requirements of any other
nondiscrimination statute(s) which may apply to the
application.
1. Has the legal authority to apply for Federal assistance
and the institutional, managerial and financial capability
(including funds sufficient to pay the non-Federal share
of project cost) to ensure proper planning, management
and completioFl .of the project described in this
application.
2. Will give the awarding agency, the Comptroller General
of the United States and, if appropriate, the State,
through any authorized representative, access to and
the right to examine all records, books, papers, or
documents related to the award; and will establish a
proper accounting system in accordance with generally
accepted accounting standards or agency directives.
4. Will initiate and complete the work within the applicable
time frame after receipt of approval of the awarding
agency.
6. Will comply with all Federal statutes relating to
nondiscrimination. These include but are not limited to:
(a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352)
which prohibits discrimination on the basis of race, color
or national origin; (b) Title IX of the Education
Amendments of 1972, as amended (20 U.S.C. ~~1681-
1683, and 1685-1686), which prohibits discrimination on
the basis of sex; (c) Section 504 of the Rehabilitation
7. Will comply, or has already complied, with the
requirements of Titles II and 1\1 of the Uniform
Relocation Assistance and Real Property Acquisition
Policies Act of 1970 (P.L. 91-646) which provide for
fair and equitable treatment of persons displaced or
whose property is acquired as a result of Federal or
federally-assisted programs. These requirements apply
to all interests in real property acquired for project
purposes regardless of Federal participation in
purchases.
5. Will comply with the Intergovernmental Personnel Act of
1970 (42 U.S.C. ~~4728-4763) relating to prescribed
standards for merit systems for programs funded under
one of the 19 statutes or regulations specified In
Appendix A of OPM's Standards for a Merit System of
Personnel Administration (5 C.F.R. 900, Subpart F).
8. Will comply, as applicable, with prOVISions of the
Hatch Act (5 U.S.C. ~~1501-1508 and 7324-7328)
which limit the political activities of employees whose
principal employment activities are funded in whole or
In part with Federal funds.
Previous Edition Usable
Authorized for Local Reproduction
Standard Form 4246 (Rev. 7-97)
Prescribed by OMS Circular A-102
9. Will comply, as applicable, with the provisions of the Davis-
. Bacon {\ct (40 U.S.C. ~~276a to 276a-7), the Copeland Act
(40 U.S.C. ~276c and 18 U.S.C. ~874), and the Contract
Work Hours and Safety Standards Act (40 U.S.C. ~~327-
333), regarding labor standards for federally-assisted
construction subagreements.
10. Will comply, if applicable, with flood insurance purchase
requirements of Section 102(a) of the Flood Disaster
, ,',~" protection . Act .of 191.3,....(I?:.oL.," 93-234) .which ., requlres,c",
recipients in a special flood hazard area to participate in the
program and to purchase flood insurance If the total cost of
insurable construction and acquisition is $10,000 or more.
11. Will comply with environmental standards which may be
prescribed pursuant to the following: (a) Institution of
environmental quality control measures under the National
Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order (EO) 11514; (b) notification of violating
facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in
floodplains In accordance with EO 11988; (e) assurance of
project consistency with the approved State management
program developed under the Coastal Zone Management
Act of 1972 (16 U.S.C. ~~1451 et seq.); (f) conformity of
Federal actions to State (Clean Air) Implementation Plans
under Section 176(c) of the Clean Air Act of 1955, as
amended (42 U.S.C. ~~7401 et seq.); (g) protection of
underground sources of drinking water under the Safe '
Drinking Water Act of 1974, as amended (P.L. 93-523);
and, (h) protection of endangered species under the
Endangered Species Act of 1973, as amended (P.L. 93-
205).
12. Will comply with the Wild and Scenic Rivers Act of
1968 (16 U.S.C. ~91271 et seq.) related to protecting
components or potential components I of the national
wild and scenic rivers system.
13. Will assist the awarding agency In assuring compliance
with Section 106 of the National Historic Preservation
Act of 1966, as amended (16 U.S.C. ~470), EO 11593
(identification and protection of historic properties), and
.O' c:JheArchaeologicaL and Historic ~ Preservation Act of
1974 (16 U.S.C. ~9469a-1 et seq.).
14. Will comply with P.L. 93-348 regarding the protection of
human subjects involved in research, development, and
related activities supported by this award of assistance.
15. Will comply with the laboratory Animal Welfare Act of
1966 (P.L. 89-544, as amended, 7 U.S.C. ~~2131 et .
seq.) pertaining to the care, handling, and treatment of
warm blooded animals held for research, tea~hing, or
other activities supported by this award of assistance.
16. Will comply with the lead-Based Paint Poisoning
Prevention Act (42 U.S.C. 994801 et seq.) which
prohibits the use of lead-based paint in construction or
rehabilitation of residence structures.
17. Will cause to be performed the required financial and
compliance audits in accordance with the Single Audit
Act Amendments of 1996 and OMB Circular No. A-133,
"Audits of States, local Govemments, and Non-Profit
Organizations. "
18. Will comply with all applicable requirements of all other,
Federal laws, executive orders, regulations, and policies
governing this program.
""
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE
APPLICANT ORGANIZATION DATE SUBMITTED
Standard Form 4248 (Rev. 7-97) Back
ACH VENDOR/MISCELLANEOUS PAYMENT
ENROLLMENT FORM
OMB No. 1510-0056
Expiration Date 01/31/2000
This form is used for Automated Clearing House (ACH) payments with an addendum record that contains
payment-related information processed through the Vendor Express Program. Recipients of these
payments should bring this information to the attention of their financial institution when presenting this
form for completion.
PRIVACY ACT STATEMENT
The following information is provided to comply with the Privacy Act of 1974 (P.L. 93-579). All
information collected on this form is required under the provisions of 31 U.S.C. 3322 and 31 CFR
210. This information will be used by the Treasury Department to transmit payment data, by
electronic means to vendor's financial institution. Failure to provide the requested information may
delay or prevent the receipt of payments through the Automated Clearing House Payment System.
,
AGENCY INFORMATION
FEDERAL PROGRAM AGENCY BUREAU OF ALCOHOL. TOBACCO AND FIREARMS
AGENCY IDENTIFIER: 303 IAGENCY LOCATION CODE (ALC): 20-10-0001 I ACH FORMAT:
n CCD+ 0 CTX DCTP
ADDRESS: PO BOX 51071, WASHINGTON, DC 20091-1071
CONTACT PERSON NAME: WilliAM T. WRIGHT 1(202)927-7725 T.
ADDITIONAL INFORMATION:
PAYEE/COMPANY INFORMATION
NAME ISSN NO. OR TAXPAYER 10 NO.
ADDRESS
CONTACT PERSON NAME: ITELEPHONE NUMBER:
( )
FINANCIAL INSTITUTION INFORMATION
NAME:
ADDRESS:
ACH COORDINATOR NAME: TELEPHONE NUMBER:
( )
NINE.DIGIT ROUTING TAANSIT NUMBER:
- - --- --- -
DEPOSITOR ACCOUNT TITLE:
DEPOSITOR ACCOUNT NUMBER: ILOCKBOX NUMBER:
TYPE OF ACCOUNT:
D CHECKING o SAVINGS o LOCKBOX
SIGNATURE AND TITLE OF AUTHORIZED OFFICIAL: TELEPHONE NUMBER:
(Could be the I_a as ACH Coordinator)
( )
~I' alllll IHav l;tII:lUI
..
"
NSN 7540.01.274.9925
AGENCY COPY
Prelcribed by Depertmant of Treasury
31 US C 3322; 31 CFR 210
Instructions for Completing SF 3881 Form
1 . Agency Information Section - Federal agency prints or types the name and address of
the Federal program agency originating the vendor/miscellaneous payment, agency
identifier, agency location code, contact person name and telephone number of the
agency. Also, the appropriate box for ACH format is checked.
2. Payee/Company Information Section - Payee prints or types the name of the
payee/company and address that will receive ACH vendor/miscellaneous payments,
social security or taxpayer ID number, and contact person name and telephone number
of the payee/company. Payee also verifies depositor account number, account title,
and type of account entered by your financial institution in the Financial Institution
Information Section.
3. Financial Institution Information Section - Financial institution prints or types the name
and address of the payee/company's financial institution who will receive the ACH'
payment, ACH coordinator name and telephone number, nine-digit routing transit
number, depositor (payee/company) account title and account number. Also, the box
for type of account is checked, and the signature, title, and telephone number of the
appropriate financial institution official are included.
Burden Estimate Statement
The estimated average burden associated with this collection of information is 15 minutes
per respondent or record keeper, depending on individual circumstances. Comments
concerning the accuracy of this burden estimate and suggestions for reducing this burden
should be directed to the Financial Management Service, Facilities Management Division,
Property and Supply Branch, Room B-1 01, 3700 East West Highway, Hyattsville, MD
20782 and the Office of Management and Budget, Paperwork Reduction Project
(1510-0056), Washington, DC 20503.
.'
,
DISCLOSURE OF LOBBYING ACTIVITIES
-~-.....-.
Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352
Approved by OMB
0348-0046
(See reverse for Dublic burden disclosure.)
1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: I
D a. contract Da. bid/offer/application D a. Initial filing
b. grant b. Initial award b. material change
c. cooperative agreement c. post-award For Material Change Only:
d.loan year quarter
e. loan guarantee date of last report
f. loan insurance
4. Name and Address of Reporting Entity: 5. If Reporting Entity In No.4 Is a Subawardee, Enter Name
o Prime o Subawardee and Address of Prime:
Tier I If known:
Congressional District, If known: ConQresslonal District, If known:
6. Federal Department/Agency: 7. Federal Program Name/Description:
CFDA Number,'lf app/icable:' .
8. Federal Action Number, If known: 9. Award Amount, if known:
$
10. a. Name and Address of Lobbying Entity b. Individuals Performing Services (including address if
(ifindividual, last name, first name, M/): different from No. 10a)
(last name, first name, M/):
(attach Continuation Sheet(s) SF-LLLA. if necessary)
11. Amount of Payment (check ai/ that apply): 13. Type of Payment (check all that apply):
$ o actual o planned o a. retainer
o b. one-time fee
12. Form of Payment (check all that apply): o c. commIssIon
D a. cash D d. contingent fee
o b. In-kInd; specify: nature o e. deferred
value o f. other; specify:
14. Brief Description of Services Performed or to be Performed and Date(s) of Service, Including offlcer(s),
employee(s), or Member(s) contacted, for Payment Indicated In It~m 11:
(attach ConUnuation Sheet(s) SF-LLLA. if necessary)
15. Continuation Sheet(sl SF-LLLA attached: DYes DNo
16 1nI0000000Uon requested IIvough INs fonn Is authorized by uUe 31 U.S.C. section Signature:
. 1352. ThIs dlsdosunl 01 lobbying activities Is a materiel representallon oIlact
upon whIc:h ,.aance was p'-d by the tier above when INs lranHcUon was made Print Name:
or ante*, Into. ThIs dIsdosIn Is rwquIred pursuant to 31 U.S.c. 1352. ThIs
InlOllTlolUon wlI be reported to !he Congress Mml-ennuelly and wlI be avaUable for Title:
public Inspection. Any....-. who '''' to lIle the requInMI disclosure wi be
aubjecl to a dvI penefly of not less that $10,000 and not more than $100.000 tor Telephone No.: Date:
each auc:h tarura.
.. I Authorized for Local Reproducllon
Federal Use Only: Standard Form LLL (Rev. 7-97)
,
"
INSTRUCtiONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure form shall be completed by the reporting entity. whether subawardee or prime Federal reclplent, at the Initiation or receipt of a covered Federal
action, or a material change to a previous filing, pursuantto titie 31 U.S.C. sectlO? 1352. The filing of a fann Is required for each payment or agreementto make
paymentto any lobbying entity for Influencing or attempting to Influence an officer or employee of any agency, a Member of Congress, an officer or employee of
Congress, or an employeeof a Member of Congress In connection with a covered Federalacllon. Use the SF-LLLA ContinuationSheetfor additlonallnformationif
the space on the form Is Inadequate. Complete all Items that apply for both the Initial filing and material change report. Refer to the Implementing guidance
published by the Office of Management and Budget for addlllonallnformallon.
1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to Influence the outcome of a covered Federal acllon.
2. Identify the status of the covered Federal action.
3. Identify the appropriate classification of this report. If this Is a followup report caused by a material change to the information prevtously reported, enter
the year and quarter In which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal
action.
4. Enter the full name, address. city, State and zip code of the reporting entity. Include Congressional District, If known. Check the appropriate classification
of the reporting enllty that designates if it Is, or expects to be, a prime or subaward reciplenl.ldenllfy the ller of the subawardee. e.g., the first subawardee
of the prime is the 1 st ller. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.
5. If the organlzallon filing the report In item 4 checks "Subawardee: then enter the full name, address. city, State and zip code of the prime Federal
recipient. Include Congressional District, If known. .
6. Enter the name of the Federal agency making the award or loan commitment. Include at least one o..gilnlzationallevel below agencyname, if known. For
example, Department of Transportation, United States Coast Guard.
7. Enter the Federal program name or description for the covered Federal acllon (item 1). If known, enter the full Catalog of Federal Domesllc Assistance
(CFDA) number for grants, cooperative agreements, loans, and loan comm:tments.
8. Enter the most appropriate Federal idenllfylng number available for the Federal action idenllfied In item 1 (e.g., Request for Proposal (RFP) number;
Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number
assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001."
9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the awardlloan
commitment for the prime entity identified in item 4 or 5.
10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to Influence the covered
Federal acllon.
(b) Enter the full names of the individual(s) performing services, and include full address if different from 10 (a). Enter Last Name, First Name, and
Middle Inillal (MI).
11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying enllty (item 10). Indicate whether
the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this Is a material change report, enter the cumulallve
amount of payment made or planned to be made.
12. Check the appropriatebox(es). Check all boxes that apply. If payment is made through an In-kind contribution, specify the nature and value of the In-kind
payment.
. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature.
14. Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to perform, and the date(s) of any services
rendered. Include all preparatory and related activity, not just time spent In actual contact with Federalofficlals. Idenllfy the Federalofficlal(s) or
employee(s) contacted or the officer(s), employee(s), or Member(s) of Congress that were contacted.
15. Check whether or not a SF-LLLA Continuation Sheet(s) Is attached.
16. The certifying official shall sign and date the form, print hlslher name, title, and telephone number.
According to the Paperwork Reducllon Act, as amended, no persons are required to respond to a collecllon of Information unless It displays a valid OMB Control
Number. The valid OMB control number for this Information collection is OMB No. 0348-0046. Public reporting burden for this collection of Information is
estimated to average 30 minutes per response, Including time for reviewing Instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collecllon of Information. Send comments regarding the burden estimate or any other aspect of this collection of
Information,lncludlng suggestions for reducing this burden, to the Office of Managementand Budget, Paperwork Reducllon Project (0348-0046), Washington,
DC 20503.