Appendix A- FOA CDC-RFA-CE21-2107 DFC Competing Continuation NOFO Checklist.docx

Appendix A. Pre-Submission Verification Checklist

Use the checklist below to ensure that the application meets all submission requirements.

Please provide proof the coalition meets the Statutory Eligibility Requirements

Requirement 1: 12 Sectors Evidence to provide: Sector Table and Coalition Involvement Agreements for each of the 12 sector members (Attachment 1)

Requirement 2: Six Month Existence Evidence to provide: One set of coalition meeting minutes that took place between January 2020 and the deadline for this application (Attachment 2) and General Applicant Information (Attachment 8)

Requirement 3: Mission Statement Evidence to provide: Mission statement detailed in the Project Narrative Background section and the mission statement response in General Applicant Information (Attachment 8)

Requirement 4: Multiple Drugs of Misuse Evidence to provide: Multiple drugs of misuse response in General Applicant Information (Attachment 8)

Requirement 5: Evaluation and Performance Measurement Plan Evidence to provide: Project Narrative Evaluation and Performance Measurement Section and the Evaluation and Performance Measurement Plan (Attachment 3)

Requirement 6: Entity Eligible to Receive Federal Grants Evidence to provide: Either an Assurance of Legal Eligibility or a Memorandum of Understanding between Grant Award Recipients/Legal Applicant and Coalition (Attachment 4)

Requirement 7: Substantial Support from Non-Federal Sources Evidence to provide: SF-424, Section 18 and SF-424A Budget Narrative.

Requirement 8: Federal Request Evidence to provide: SF-424, Section 18 and SF-424A Budget Narrative. The budget may not exceed $125,000 per year.

Requirement 9: Zip Code Overlap Evidence to provide: Letter of Mutual Cooperation or a statement that there is no overlap between the applicant and other coalitions (Attachment 5); General Applicant Information (Attachment 8)

Requirement 10: One Grant at a Time Evidence to provide: Assurance of One DFC Grant at a Time (Attachment 6)

Requirement 11: No More than 10 Years of DFC Funding Evidence to provide: Assurance of DFC 10-Year Funding Limit (Attachment 7)

Please assure your Project and Budget Narratives align with the following requirements

Project Narrative is no longer than 15 pages

Project Narrative addresses each of the sections under the Review and Selection Process section of the NOFO CDC-RFA-CE21-2107 (Background, Approach and Work Plan, Applicant Evaluation and Performance Measurement Plan, and Organizational Capacity of Applicants to Implement the Approach)

A Work Plan (i.e., 12-Month Action Plan) is included as per the Approach Section of the NOFO

A 12-Month Budget Narrative

If applicable, a lease agreement and floor plan for proposed cost for rent is included

If applicable, an Indirect Cost Rate Agreement for proposed indirect cost is included

Indirect costs are those associated with operating and maintaining facilities, depreciation, and administrative salaries

Please submit all other required documents

Application for Federal Assistance Form (SF-424) is signed and completed

Sections B, C, and E of the Non-Construction Budget Worksheet (SF-424A) are completed

CDC Assurances and Certifications, Risk Questionnaire, and other relevant forms have been completed (See Section 5. Application and Submission Information in the NOFO CDC-RFA-CE21-2107)

Submission contains a Table of Contents (please upload as a PDF under “Other Attachment Forms” at grants.gov)

Project Abstract is included and is no longer than 1 page

General Applicant Information form is complete (Attachment 8)

Notice of Congressional Notification is complete (Attachment 9)

Resumes or CVs are included for Key Personnel (Organizational Capacity Section of this NOFO and Attachment 10)

Disclosure of All Prior DFC Funding is complete (Attachment 11)