Attachment H - Certificate of Non-Supplantation.pdf

This is a Certificate of Non-Supplantation form required for the State of Oregon's Request for Grant Application (RFGA) for Mediation and Parenting Time Support Services (S-13700-00012751). The certificate serves as an assurance document that must be completed and signed by the fiscal officer of any public agency applicant. The form certifies compliance with The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (Welfare Reform) by confirming that federal grant funds will not be used to supplant or replace funds or other resources that would otherwise have been made available for access and visitation services.

The document requires the applicant agency's fiscal officer to provide both a signature and printed name along with the date of certification. This mandatory attachment is a compliance requirement specific to public agencies applying for the grant and represents a standard provision in federally-funded programs to ensure that awarded funds supplement rather than replace existing service funding. Applicants must complete this certification accurately and submit it as part of their complete RFGA proposal package by the established deadline.