ASHA Google Form Application Submission Guidance.pdf

American Schools and Hospitals Abroad Initiative Solicitation No.: 720DD123RFA00001

ASHA Google Form Application Submission Guidance

If you have any technical issues or Google Form questions, please email ASHAapplications@usaid.gov.

Google Account When you submit an application via the Google Form, the system links to the “default” Google Account that your computer is logged into. The Google Account will be a reference to access your submissions, therefore it is imperative that you Applicants use a Google Account that they have control over.

If you do not have a Google account, you can create a Google Account here. If you have a personal Google Account but do not want to use it to submit your application, please create a Google Account for your organization.

Please note that the Google Account is only used for the ASHA submission and should not replace your work email for official correspondence with ASHA.

Application Revisions Once you submit the Google Form, you will receive a confirmation email that will allow you to edit your responses and upload additional files until the deadline.

**If you submit additional files for the same upload – e.g., a revised version to replace the original submission – please add “Revision [#]” to the end of the file name. For example: “ANNEX 1a - PHASE 1 App for FY23 RFA - Revision 1” or “M1 - USO Audited Financial Statements - Revision 3”

The Selection Committee will review only the most recent file submission.

Forms There are 3 separate Google Forms:

1. Phase 1 Application

2. Phase 2 Technical Application

3. Phase 2 Business (Cost) Application

Phase 1 Application Google Form (https://forms.gle/ZYHt3qzVUSXayLsP6)

Applicants will submit the following information via the Google Form.

I. Applicant Information II. Eligibility Information III. Response to Phase 1 Merit Review Criteria

I. Applicant Information

● Applicant USO

○ Name

○ Address

○ Unique Entity Identifier (UEI) mailto:ASHAapplications@usaid.gov https://accounts.google.com/signup/v2/webcreateaccount?flowName=GlifWebSignIn&flowEntry=SignUp https://forms.gle/ZYHt3qzVUSXayLsP6 https://forms.gle/ZYHt3qzVUSXayLsP6

○ Federal Employer/Taxpayer Identification Number (EIN/TIN)

● Benefiting OSI

○ Name

○ Address

○ Unique Entity Identifier (UEI)

○ Type of OSI (School/University, Hospital Center, Library, Center of Excellence)

● Funding

○ Amount of federal funding requested

○ Amount of leveraged funds offered (if applicable)

○ The total activity cost

● Project

○ Name/Title

○ Project Area (Health-focused, Education-focused, Both Health- and Education-focused)

○ Type of Activity (Commodities only, Construction/Renovation only, Construction/Renovation plus Commodities)

○ Project Summary

○ Summary of Costs - a brief description of what the ASHA funds will provide (e.g., construction of _____, procurement of _____ equipment)

○ Public Diplomacy Benefit of the Project

● UPLOAD: Optional Photo/Sketch of the project (Max file size: 10 MB)

● UPLOAD: SAM.gov Screenshot (Max file size: 10 MB)

II. Eligibility Information

1. Is the Applicant a U.S. not-for-profit non-governmental entity (e.g. “NGOs,” foundations, and similar)?

2. a. Is the Applicant applying for the 30% Middle East Set-Aside? For purposes of this RFA, the Middle East includes the following countries and territories: Algeria, Egypt, Iraq, Jordan, Lebanon, Libya, Morocco, Syria, Tunisia, West Bank & Gaza, Israel, and Yemen.

If “Yes”:

b. Does the USO have ten or more years of experience in the Middle East region?

c. Has the USO had a relationship with the OSI for at least the past ten years?

3. Does the application identify one USO and one OSI only?

4. Do the USO and OSI share the same name?

5. a. Are the USO and OSI the “same legal entity”?

If “Yes”:

b. Does the Applicant have proof that it is registered as a legal entity in the U.S. and is authorized to operate in the foreign country?

c. If the Applicant does not have proof that it is registered as a legal entity in the U.S. and is authorized to operate in the foreign country, provide a succinct explanation:

6. a. Is the OSI founded or sponsored (sponsored refers to support provided) by United States citizens?

b. If “Yes,” does the USO have a continuing and supportive relationship with the OSI that has lasted at least two years prior to the date of application1?

1 A continuing relationship MUST include significant financial support and may include technical support, joint ventures, exchange programs, volunteer placement programs, faculty exchanges, fundraising, or other

7. Please provide a brief narrative in the space provided addressing the USO’s relationship with the

OSI:

8. Administrative Status & Audits:

a. Is the USO active in SAM?

b. USO’s SAM expiration date

c. Does it have any active exclusion?

d. Does it have any delinquent Federal debt?

e. Will the USO and OSI have independently audited financial statements from 2020 or later by the Phase 2 application deadline2?

9. Is the OSI located outside the United States?

10. Is the OSI under the control or management of a foreign government or any of its agencies as defined in Section C: Eligibility Information?

11. OSI Eligibility by type

a. If the OSI is a school:

i. Does it provide English language instruction or use English as the language of instruction in at least one course?

ii. Does it provide post-secondary education or secondary education that serve students at the equivalent of a U.S. sixth grade level or higher?

b. If the OSI is a hospital, does it provide medical education or conduct medical research?

c. If the OSI is a library, does it advance learning and understanding on issues of import to the U.S. and demonstrate promotion of English language and literature?

d. If the OSI is a Center of Excellence, does it advance learning and understanding on issues of importance to the U.S., and model American best practices and values?

12. For construction or renovation activities, will the OSI or USO have an official copy of a title, lease or similar official documentation recognized within the country where implementation will take place prior to submitting Phase 2 Application3?

13. Do the USO and OSI agree not to discriminate against any beneficiaries in the implementation of the award on the basis of race, color, religion, sex, national origin, disability, age, sexual orientation, gender identity, pregnancy, genetic information, marital status, parental status, political affiliation, and veteran’s status, or any other factor not expressly stated in the application?

3 If the applicant is asked to submit a full application for a project that involves construction or renovation activities, the applicant must submit with the Phase 2 application, an official copy of a title, lease or similar official documentation recognized within the country where implementation will take place. The documentation must demonstrate a legal right to the land (to build, renovate, retrofit according to current building codes), ideally for a period of at least 20 years from the date of the application, as well as an English translation of the lease or title, if the official copy is not in English. Applications involving a legal right to the land of 20 years (or more) will be given a greater preference, although USAID is willing to consider applications that include a title, lease or similar official documentation covering a shorter period of time; such applications will be reviewed on a case-by-case basis.

2 If the USO and OSI are separate entities, then each entity should submit an independently audited financial statement. If the USO and OSI are one entity, then one independently audited financials can be submitted. The financial statements need to be audited by an “independent” audit firm. “Independent” refers to the fact that the auditor/CPA is not an employee of the USO or OSI entity but instead is retained through a contract for services, and hence is “independent.” Please see Annex 6 of the solicitation for more information on the audit requirements arrangements, and may include in-kind contributions. Partnerships and mutual collaborations alone are insufficient; the USO must support the OSI.

III. UPLOAD: Response to Phase 1 Merit Review Criteria (Maximum File Size: 100 MB)

The Response to Phase 1 Merit Review Criteria should be one (1) file that will be uploaded in the Google Form.

Use Annex 1 to provide a Public Diplomacy response -- and Past Project Impact statement, if applicable --in no more than 3 pages per criterion response, in accordance with the instructions in Section D.4 of this

RFA.

● Public Diplomacy criterion (not to exceed 3 pages)

● Past Project Impact criterion – ONLY for Applicants applying for the Middle East Set-Aside (not to exceed 3 pages)

Phase 2 Technical Application Google Form (https://forms.gle/sZp4SgzmcyzsAVJ3A)

Phase 1 Applicants who received a Satisfactory rating or higher will be invited to submit a Phase 2 Application and receive a link to the Google Form.

Applicants will submit the following information via the Google Form.

I. Applicant Information II. Technical Application III. Mandatory Attachments IV. Mandatory as Applicable Attachments (Mandatory for Projects with Construction/Renovation)

I. Applicant Information

● Applicant USO

○ Name

○ Address

○ Unique Entity Identifier (UEI)

○ Federal Employer/Taxpayer Identification Number (EIN/TIN)

● Benefiting OSI

○ Name

○ Address

○ Unique Entity Identifier (UEI)

○ Type of OSI (School/University, Hospital Center, Library, Center of Excellence)

● Funding

○ Amount of federal funding requested

○ Amount of leveraged funds offered (if applicable)

○ The total activity cost

● Project

○ Name/Title

○ Project Area (Health-focused, Education-focused, Both Health- and Education-focused) https://forms.gle/sZp4SgzmcyzsAVJ3A https://forms.gle/sZp4SgzmcyzsAVJ3A

○ Type of Activity (Commodities only, Construction/Renovation only, Construction/Renovation plus Commodities)

○ Project Summary

○ Summary of Costs - a brief description of what the ASHA funds will provide (e.g., construction of _____, procurement of _____ equipment)

○ Public Diplomacy Benefit of the Project

II. UPLOAD: Technical Application (Maximum File Size: 100 MB)

The Phase 2 Technical Application should be one (1) file that will be uploaded in the Google Form.

● Table of Contents (1 page)

● Management Approach (not to exceed 5 pages)

● Commodities Approach and/or Construction/Renovation Approach (not to exceed 4 pages for

Commodities-only Approach, 6 pages for Construction/Renovation-only Approach, or 9 pages for an approach with both commodities and construction/renovation; PLUS 3 pages for environmental capability)

The Phase 2 Technical Application document has the following total page limits:

○ Maximum of 13 pages total for projects with Commodities-Only Approach

○ Maximum of 15 pages total for projects with Construction/Renovation-Only Approach

○ Maximum of 18 pages total for projects with Commodities plus Construction/Renovation

Approach

Phase 2 Technical Application Page Limit

Commodities-Only Projects

Table of Contents 1

Management Approach 5

Commodities-only Approach 7

Commodities-only Information 4

Environmental Capability 3

TOTAL 13

Construction-Only Projects

Table of Contents 1

Management Approach 5

Construction-only Approach 9

Construction-only Information 6

Environmental Capability 3

TOTAL 15

Projects with Both Construction/Renovation and Commodities

Table of Contents 1

Management Approach 5

Both Construction/Renovation and Commodities Approach 12

Both Construction/Renovation and Commodities Information 9

Phase 2 Technical Application Page Limit

Environmental Capability 3

TOTAL 18

Management Approach

In accordance with the instructions in Section D.4 of this NOFO/RFA, your response to the merit review criterion of Management Approach needs to include the following:

(a) Operational Approach

(b) Sustainability and OSI Strengthening

(c) Monitoring and Evaluation (M&E) Approach*

*For the monitoring and evaluation factor, Applicants should note the following:

➢ ASHA's two mandatory custom indicators are:

1. ASHA PD Custom 1: Number of American best practices implemented with the intent to improve organizational performance.

2. ASHA PD Custom 2: Number of individuals made aware of American best practices by partner institutions.

- Additional information on ASHA's PD Custom Indicators can be found here.

➢ "F" indicators can be found using this link:

https://usaidlearninglab.org/library/standard-foreign-assistance-indicators

➢ Applicants must use the M&E table found in Annex 2 as part of the response to monitoring and evaluation and should include both the ASHA PD Custom indicators and the "F" indicators.

Commodities Approach and/or Construction/Renovation Approach

In accordance with the instructions in Section D.4 of this NOFO/RFA, your response to the merit review criterion of Commodities Approach and/or Construction/Renovation Approach must use the appropriate headings below:

○ Commodities Information, if applicable (not to exceed 4 pages)

○ Construction/Renovation Information, if applicable (not to exceed 6 pages)

○ Environmental Capability (not to exceed 3 pages)

➢ If submitting for Commodities Only, 7 pages are allowed (4 commodity + 3 environmental).

➢ If submitting for Construction/Renovation Only, 9 pages are allowed (6 construction/renovation + 3 environmental).

➢ If submitting for both Commodity and Construction/Renovation, 12 pages total are allowed (9 commodity and construction/renovation + 3 environmental).

III. Mandatory Attachments (Annex 4)

Each of the Mandatory Attachments will be uploaded separately in the Google Form.

https://drive.google.com/file/d/1n_025B37Wrv_76UuxMIjEKhiDMHwjA3p/view https://usaidlearninglab.org/library/standard-foreign-assistance-indicators

If the USO and OSI are the same legal entity, there is no need to submit the documents twice. In the OSI fields, please instead submit a doc stating "[Attachment #] - N/A since USO and OSI are the same legal entity."

● UPLOAD: M1 – USO Audited Financial Statements (Maximum File Size: 100 MB)

● UPLOAD: M2 – OSI Audited Financial Statements (Maximum File Size: 100 MB)

● UPLOAD: M3 – USO Project Manager Resume (Maximum File Size: 10 MB)

● UPLOAD: M4 – OSI Project Manager Resume (Maximum File Size: 10 MB)

● UPLOAD: M5 – USO Board of Directors (Maximum File Size: 10 MB)

● UPLOAD: M6 – OSI Board of Directors (Maximum File Size: 10 MB)

IV. Mandatory Attachments for Projects with Construction/Renovation (Annex 4)

If the application is for a project that includes construction/renovation, the following documents will be required as separate uploads in the Google Form.

● UPLOAD: MA1 – Conceptual Construction Drawings (Maximum File Size: 1 GB)

○ Google Forms limits the number of file uploads to 10. ASHA will provide two (2) fields where applicants can upload drawing files, for a total of 20 file uploads.

● UPLOAD: MA2 – Conceptual Project Implementation (Maximum File Size: 100 MB)

● UPLOAD: MA3 – Land Ownership or Lease (Maximum File Size: 100 MB)

● UPLOAD: MA4 – Construction Manager (Maximum File Size: 10 MB)

● UPLOAD: MA5 – Proof of Legal Entity Registration for Same Entities (Maximum File Size: 100 MB)

○ This is applicable only to USOs and OSIs that are the same entity. If this does not apply to the Applicant, skip this question.

Phase 2 Business (Cost) Application Google Form (https://forms.gle/aj7MLDugxtbEmNeK8)

Applicants will submit the following information via the Google Form.

● UPLOAD: SF-424 Forms (Maximum File Size: 100 MB)

○ SF-424 - required for all projects

○ SF-424A and SF-424B - required for projects with commodities

○ SF-424C and SF-424D - required for projects with construction/renovation

○ Forms may be uploaded as a single file or as separate files.

● UPLOAD: Certifications and Assurances (Maximum File Size: 10 MB)

● UPLOAD: Certificate of Compliance, if applicable (Maximum File Size: 10 MB) https://forms.gle/FGYrrNJ2dihMZL4Y7 https://forms.gle/aj7MLDugxtbEmNeK8 https://www.grants.gov/web/grants/forms/sf-424-family.html https://www.usaid.gov/sites/default/files/2022-12/303mav.pdf https://www.usaid.gov/sites/default/files/2022-05/self_certification_guidance.pdf

○ This only applies if your organization's systems have been certified by USAID/Washington's Office of Acquisition and Assistance (M/OAA). If this doesn’t apply to you, please skip this question.

● UPLOAD: Budget (Maximum File Size: 100 MB)

○ Summary budget (Excel)

○ Detailed budget (Excel)

○ Commodities budget, if applicable (Excel)

○ These budgets should be submitted in one Excel workbook (see Annex 3).

● UPLOAD: Budget Narrative (Maximum File Size: 10 MB)

○ This can be a tab in the Budget Excel workbook or a separate Word doc file. If the Budget

Narrative is included as a tab in the Excel workbook, no separate upload is necessary but please mention it in the Notes field.

https://docs.google.com/spreadsheets/d/1g9DGzIIZ6YnTulOi36eNcN82Bs4jgzy-/edit?usp=sharing&ouid=105900233847351264804&rtpof=true&sd=true