Attachment C_Chart-of-Past-Performance.pdf

OMB Control #: 1293-0014 Expires: 01/31/2027

U.S. Department of Labor Veterans’ Employment and Training Service VETS-705 Chart of Past Performance

Applicant Name

Grant or Cooperative Agreement Award History Select the response that best describes the organization’s grant or cooperative agreement award history. Applicants that have received a Homeless Veterans' Reintegration Program (HVRP) grant must only select option #2.

1. No Grant or Cooperative Agreement History

2. Homeless Veterans' Reintegration Program (HVRP) Award History

3. Other Entity Award History

The organization has never been awarded a grant or cooperative agreement from any entity.

The organization has been awarded an HVRP, Homeless Women Veterans and Homeless Veterans with Children (HWVHVWC), or Incarcerated Veterans’ Transition Program (IVTP) (collectively known as “HVRP”) grant.

The organization has never received an HVRP award but has been awarded a grant or cooperative agreement from another entity.

Form complete; no further information is required.

The application will receive zero points for past performance.

Continue to Section I. HVRP Award History

Skip to Section II. Other Entity Award History

I. Homeless Veterans' Reintegration Program (HVRP) Award History Select one response based on the grant’s period of performance (PoP) start date in the Department of Labor (DOL) Notice of Award (NoA) from the options below.

DOL reserves the right to award zero points for responses that misrepresent the organization’s HVRP award history.

https://www.dol.gov/

Category A.

HVRP Grant Award PY24+ No Other Entity Award

Category B.

HVRP Grant Award PY24/pre-PY20 + Other Entity Award

Category C.

HVRP Grant Award in

PY20-PY23

The organization has only ever been awarded one HVRP grant with a PoP start date of July 1, 2024, and has never been awarded a grant or cooperative agreement from any other entity.

The organization has only ever been awarded one HVRP grant with a PoP start date of July 1, 2024, and has been awarded a grant or cooperative agreement from any other entity.

--OR--

The organization’s most recently awarded HVRP grant had a PoP start date on or before July 1, 2019, and has been awarded a grant or cooperative agreement from any other entity.

The organization was awarded at least one HVRP grant with a PoP start date of July 1, 2020, 2021, 2022, or 2023.

Applicants that meet the Category C criteria must select the Category C check box.

Form complete; no further information is required.

The application will receive zero points for past performance.

Skip to Section II. Other Entity Award History

Continue to Category C.

HVRP Grant Award in

PY20-PY23

Category C. HVRP Grant Award in PY20-PY23 C1. Enter all HVRP grant number(s) the organization was awarded for the PoP dates below.

PoP Start and End Dates

7/1/2023 to 6/30/2026

23560HV0000##

7/1/2022 to 6/30/2025

HV38###2260###

7/1/2021 to 6/30/2024

HV36###2160###

7/1/2020 to 6/30/ 2023

HV35###2060###

Grant Number(s)

Grant Number(s)

Grant Number(s) Grant Number(s)

Grant Number(s) Grant Number(s)

Grant Number(s)

Grant Number(s)

Category C applicants stop here; no further information is required. Points for past performance will be awarded as described in Section IV. Scoring Criteria.

II. Other Entity Award History Select either a Yes or No response based on one grant or cooperative agreement awarded by another entity.

• It may be a federally or non-federally funded grant or cooperative agreement, but not a contract.

• All three questions must have a “Yes” response for the grant or cooperative agreement to meet the minimum requirements for past performance. For any question with a “No” response, DOL reserves the right to assign zero points for past performance.

Other Entity Award Past Performance Requirements Yes No

The grant or cooperative agreement was similar in size, scope, funding, and relevance to the application grant type.

The period of performance (PoP) end date is within three years of the Funding Opportunity Announcement’s (FOA) posted date.

Example: If the FOA posted date is January 15, 2025, the grant or cooperative agreement’s PoP end date must be no earlier than January 15, 2022.

The grant or cooperative agreement was in operation for at least 12 consecutive months.

1. Previous grantor information

Grantor Name Grantor Type

Federal State Local

Foundation Corporation Other

Grantor Email Address Grantor Telephone

2. Applicant/Grant Recipient information

Name of Organization (at the time of grant award) Employer Identification Number (EIN)

Grant/Cooperative Agreement Number or FAIN 1 PoP Start Date

(MM/DD/YYYY)

PoP End Date

(MM/DD/YYYY)

Type of Population Served (Relevance) Funding Amount (align to PoP) (Funding)

# of Participants Served/Enrolled (align to PoP) (Size)

Project Description (Scope)

Continue to Section III. Past Performance Indicators.

1 Federal Award Identification Number (FAIN): a unique ID within the federal agency for each financial assistance award

III. Past Performance Indicators Select either Yes or No in response to the questions below.

Category Indicator Yes No Definition Grant termination

Has your organization terminated a grant prior to the conclusion of the PoP established by the FOA you applied for except for unanticipated circumstances beyond the reasonable management control of the grant recipient (e.g., natural disaster)?

A termination is defined as an action initiated by either the grant recipient or the awarding entity that terminated the grant prior to the conclusion of the PoP.

High-risk designation or drawdown restriction

Has your organization been designated as high risk by a grantor, or met the grantor’s criteria for performance-based high-risk designation?

--OR--

Has your organization been placed on a drawdown restriction?

A grant recipient may be considered “high risk” if they fail or are unable to comply with statutes/laws, regulations, or the terms and conditions of the federal award. Grantors establish performance-based risk in policy, the FOA, and/or the terms and conditions of award.

A drawdown restriction requires payments to the grant recipient on a reimbursement basis, rather than advance payments.

3 Unexpended funds (>10%)

Did your organization have unexpended funds exceeding 10% of planned expenditures?

Unexpended funds exceeding 10% of planned expenditures for the PoP (if completed) or for the most recent operating year/program year (operating for at least 12 consecutive months).

Example: The organization has a PoP consisting of three funding years (FY).

It received $500,000 in FY1 and $400,000 in FY2 for a total of $900,000. If at the end of FY2, the organization has $90,000 or more of unexpended or “carryover” funds, the answer to this question is “Yes”. (10% of $900,000 = $90,000)

Category Indicator Yes No Definition Timeliness of Performance reports or Financial reports

Did your organization fail to submit required performance documents on time?

--OR--

Did your organization fail to submit required financial documents on time?

Required financials include closeout documentation, if applicable.2

“On time” for performance documents means it was submitted to the grantor by the reporting deadline.

Example: Performance reports are due no later than 30 days after the end of the quarter. If Quarter 4 ends on June 30; the report must be submitted to the grantor no later than July 30. If the organization submitted the report on July 1, the answer to this question is “Yes”.

“On time” for financial documents is defined as submitted to the grantor in the financial system of record by the reporting deadline.

Example: SF-425 Federal Financial Reports (FFRs) are due no later than 30 days after the end of the quarter. If Quarter 1 ends on September 30, the report must be submitted to the grantor no later than October 30. If the organization submitted the report in the system of record on October 31, the answer to this question is “Yes.”

2 Closeout requirements are defined in eCFR :: 2 C.F.R. 200.344 -- Closeout.

https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-D/subject-group-ECFR682eb6fbfabcde2/section-200.344

IV. Scoring Criteria DOL reserves the right to assign zero points if responses are incomplete and/or if the grant or cooperative agreement awarded by another entity is not sufficiently similar in size, scope, funding, and relevance to the application grant type, has a PoP end date that is not within three years of the FOA posted date, or has not been in operation for at least 12 consecutive months.

DOL will examine GrantSolutions3 grant history and notes, quarterly performance reports, the Payment Management System4 and other grants management repositories to score Category C applicants. All other applicants will receive points based on their responses in Section II and III.

Category Indicator Response Point Value Yes

1 Grant termination 0 5 2 High-risk designation or Drawdown restriction 0 5 3 Unexpended funds (>10%) 0 5 4 Timeliness of Performance or Financial reports 0 5

- Score Minimum/Maximum 0 20

Public Burden Statement – According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is 1293-0014. The time required to complete this information collection is 30 minutes per response, including the time to review instructions, search existing data sources, gather the data needed, and complete and review the information collection. The obligation to respond is required to obtain or retain a benefit (38 U.S.C. 2021 and 2023). If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Labor, Veterans’ Employment and Training Service, 200 Constitution Avenue, N.W., Washington, D.C. 20210.

3 GrantSolutions is DOL’s system for managing grant awards, amendments (award modifications), and award closeouts.

4 The Payment Management System (PMS) is a system that DOL utilizes for financial reporting, as well as grant recipient cash and payment management services.

Response Point Value No https://home.grantsolutions.gov/home/about/ https://pms.psc.gov/find-pms-liaison-accountant.html