Attachments- HALEU Transportation Package NOFO.pdf

Notice of Funding Opportunity: DE-FOA-0002967

High-Assay Low-Enriched Uranium (HALEU) Transportation Package

DOE Provided Templates

Per NOFO Part 1, Application Content Requirement—Required Application Documents, the following templates, forms, and documents are being provided for the administrative convenience of the applicant as part of this funding opportunity package. See attached.

Any additional templates, forms, and documents stated as a requirement in NOFO Part 1, Application Content Requirement—Required Application Documents can be downloaded from various sites as indicated in each of their sections in NOFO Part 2.

It is the applicant's responsibility to ensure that all requirements for application submissions align with NOFO Part 1 & 2.

1. Application for Federal Assistance

2. Statement of Project Objectives

3. Project Management Plan

4. Research and Related Budget – Section A-B Form

5. Budget Justification – Applicant (same document to be used for prime and sub-recipients)

6. Current and Pending Support

7. Location(s) of Work

8. Offeror Environmental Report

9. Environmental Impact Checklist

10. Disclosure of Lobbing Activities

11. Certification Regarding Lobbing

12. FFRDC-Field Work Proposal

13. Summary for Public Release

OMB Number: 4040-0004 Expiration Date: 11/30/2025

Application for Federal Assistance SF-424

*1. Type of Submission:

Preapplication

Application

Changed/Corrected Application

*2. Type of Application

New

Continuation

Revision

* If Revision, select appropriate letter(s):

* Other (Specify)

*3. Date Received: 4. Applicant Identifier:

5a. Federal Entity Identifier: *5b. Federal Award Identifier:

State Use Only:

6. Date Received by State: 7. State Application Identifier:

8. APPLICANT INFORMATION:

*a. Legal Name:

*b. Employer/Taxpayer Identification Number (EIN/TIN): *c. UEI:

d. Address:

*Street 1:

Street 2:

*City:

County/Parish:

*State:

*Province:

*Country:

*Zip / Postal Code

e. Organizational Unit:

Department Name: Division Name:

f. Name and contact information of person to be contacted on matters involving this application:

Prefix: *First Name:

Middle Name:

*Last Name:

Suffix:

Title:

Organizational Affiliation:

*Telephone Number: Fax Number:

*Email:

*9. Type of Applicant 1: Select Applicant Type:

Type of Applicant 2: Select Applicant Type:

Type of Applicant 3: Select Applicant Type:

*Other (Specify)

*10. Name of Federal Agency:

11. Catalog of Federal Domestic Assistance Number:

CFDA Title:

*12. Funding Opportunity Number:

*Title:

13. Competition Identification Number:

Title:

14. Areas Affected by Project (Cities, Counties, States, etc.):

*15. Descriptive Title of Applicant’s Project:

Attach supporting documents as specified in agency instructions.

16. Congressional Districts Of:

*a. Applicant: *b. Program/Project:

Attach an additional list of Program/Project Congressional Districts if needed.

17. Proposed Project:

*a. Start Date: *b. End Date:

18. Estimated Funding ($):

*a. Federal

*b. Applicant

*c. State

*d. Local

*e. Other *f. Program Income *g. TOTAL

*19. Is Application Subject to Review By State Under Executive Order 12372 Process?

a. This application was made available to the State under the Executive Order 12372 Process for review on

b. Program is subject to E.O. 12372 but has not been selected by the State for review.

c. Program is not covered by E.O. 12372.

*20. Is the Applicant Delinquent On Any Federal Debt?

Yes No

If “Yes”, explain:

21. *By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. (U. S. Code, Title 218, Section 1001)

** I AGREE

** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency specific instructions.

Authorized Representative:

Prefix: *First Name:

Middle Name:

*Last Name:

Suffix:

*Title:

*Telephone Number: Fax Number:

* Email:

*Signature of Authorized Representative: *Date Signed:

Federal Award Identifier:

Applicant Identifier Field:

Federal Entity Identifier Field:

FundingTite:

CDFAtitle: Airport Improvement Program

FundFedShare: 0

FundApplicant: 0

FundTotal: 0

FundState: 0

FundLocal: 0

FundOther: 0

FundPgmIncome: 0

SubmisisonType: Off

LegalName:

AppType: Off

TypeAppRevLetters:

AppTypeOther:

DateStateRcv:

StateAppnID:

EINTIN:

Street2:

City:

County:

State:

Province:

Country: USA: United States

ApplicantOther:

CatalogNum: 20.106

FedAgencyName: Federal Aviation Administration

FundOpportunityNum:

CompetitionIDNum:

CompetitionTitle:

AffectedAreas:

CongDistrictOfc:

CongDistrictApt:

DelinquentExplain:

AppnStateRvw: Off

AppnEO: Off

AppnNoEO: Off

StateAppnRvwDate:

AuthRepNamePrefix: [ ]

AuthRepNameSuffix: [ ]

AuthRepFirstName:

AuthRepMidName:

AuthRepLastName:

AuthRepTitle:

AuthRepPhoneNum:

AuthRepFaxNum:

AuthRepEmail:

AuthRepSignDate:

AppnDelinquent: New

CertAgree: Off

ZIPcode:

RcvDate:

ProjStartDate:

ProjEndDate:

DeptName:

DivName:

NamePrefix: [ ]

POCFirstName:

POCMiddleName:

POCLastName:

NameSuffix: [ ]

POCTitle:

POCOrgAffiliatn:

POCphone:

POCFAX:

POCEmail:

Street1:

TitleDescript:

ApplicantType1: [Pick an applicant type]

ApplicantType2: [Pick an applicant type]

ApplicantType3: [Pick an applicant type]

UEI - Unique Entity ID:

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Disclosure of Lobbying Activities (SF-LLL)

D:20061124112418- 05'00'

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10. a. Name and Address of Lobbying Registrant:

9. Award Amount, if known:$

* Street 1

* City

State

Zip

Street 2

* Last Name

Prefix

* First Name

Middle Name

Suffix

DISCLOSURE OF LOBBYING ACTIVITIES

Complete this form to disclose lobbying activities pursuant to 31 U.S.C.1352

OMB Number: 4040-0013

Expiration Date: 02/28/2025

1. * Type of Federal Action:

Type of Federal Action: 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 action. This field is required.

Type of Federal Action is required: 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 action.

2. * Status of Federal Action:

Status of Federal Action: Identify the status of the covered Federal action. This field is required.

Status of Federal Action: Identify the status of the covered Federal action. This field is required.

Status of Federal Action is required: Identify the status of the covered Federal action.

3. * Report Type:

Report Type: Identify the appropriate classification of this report. If this is a follow up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the previously submitted report by this reporting entity for this covered Federal action. This field is required.

For Material Change Only:

year quarter date of last report

4. Name and Address of Reporting Entity:

Reporting Entity: 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 entity that designates if it is, or expects to be, a prime subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. This field is required.

Reporting Entity is required: 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 entity that designates if it is, or expects to be, a prime subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.

Tier if known:

* Name

* Street 1

Street 2

* City

State

Zip

Congressional District, if known:

Congressional District, if known:

* Name

* City

State

* Street 1

Street 2

Zip

6. * Federal Department/Agency:

7. * Federal Program Name/Description:

CFDA Number, if applicable:

8. Federal Action Number, if known:

b. Individual Performing Services (including address if different from No. 10a)

Prefix

* First Name

Middle Name

* Street 1

* City

State

Zip

Street 2

11.

* Last Name

Suffix

Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when the transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

* Signature:

*Name:

Prefix

* First Name

Middle Name

* Last Name

Suffix

Title:

Telephone No.:

Date:

Federal Use Only:

Authorized for Local Reproduction

Standard Form - LLL (Rev. 7-97)

XDPFirstField:

Mandatory:

Disclosure Statement: Click the button to read the "Review Public Burden Disclosure Statement".:

Type of Federal Action: 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 action. This field is required.

Contract: Click if the Type of Federal Action is a contract.:

Type of Federal Action: 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 action. This field is required.

Grant: Click if the Type of Federal Action is a grant.:

Type of Federal Action: 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 action. This field is required.

Cooperative Agreement: Click if the Type of Federal Action is a cooperative agreement.:

Type of Federal Action: 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 action. This field is required.

Loan: Click if the Type of Federal Action is a loan.:

Type of Federal Action: 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 action. This field is required.

Loan Guarantee: Click if the Type of Federal Action is a loan guarantee.:

Type of Federal Action: 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 action. This field is required.

Loan Insurance: Click if the Type of Federal Action is a loan insurance.:

Status of Federal Action: Identify the status of the covered Federal action. This field is required.

Bid, Offer, Application: Click if the Status of Federal Action is a bid, an offer or an application.:

Status of Federal Action: Identify the status of the covered Federal action. This field is required.

Initial Award: Click if the Status of Federal Action is an initial award.:

Status of Federal Action: Identify the status of the covered Federal action. This field is required.

Post Award: Click if the Status of Federal Action is a post-award.:

Report Type: Identify the appropriate classification of this report. If this is a follow up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the previously submitted report by this reporting entity for this covered Federal action. This field is required.

Initial Filing: Click if the Report Type is a initial filing.:

Report Type: Identify the appropriate classification of this report. If this is a follow up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the previously submitted report by this reporting entity for this covered Federal action. This field is required.

Material Change: Click if the Report Type is a material change.:

Year: If this is a follow up report caused by a material change to the information previously reported, enter the year in which the change occurred.:

Quarter: If this is a follow up report caused by a material change to the information previously reported, enter the quarter in which the change occurred.:

Date of last report: Enter the date of the previously submitted report by this reporting entity for this covered Federal action.:

ReportTypeAttr:

ReportingEntityEntityType:

Reporting Entity: 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 entity that designates if it is, or expects to be, a prime subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. This field is required.

Prime: Click to designate the organization filing the report as the Prime Federal recipient.:

SubAwardee: Click to designate the organization filing the report as the SubAwardee Federal recipient. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.:

ReportEntityType:

Tier: Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. :

Reporting Entity Organization Name: Enter the name of reporting entity. This field is required.:

Street 1: Enter the first line of the street address for the Reporting Entity. This field is required.:

Street 2: Enter the second line of the street address for the Reporting Entity.:

City: Enter the city of the Reporting Entity. This field is required.:

State: Select the state for the Reporting Entity's address from this pull down menu.:

Zip / Postal Code: Zip Code (or ZIP+4) of the Reporting Entity.:

Congressional District: If known, the Congressional District of the reporting entity. Should be numeric characters.:

Section5Text:

Prime Organization Name: If the organization filing the report in item 4, checks "Subawardee", enter the full name of the prime Federal recipient.:

Street 1: If the organization filing the report in item 4, checks "Subawardee", enter the address of the prime Federal recipient.:

Street 2: If the organization filing the report in item 4, checks "Subawardee", enter the address of the prime Federal recipient.:

City: If the organization filing the report in item 4, checks "Subawardee", enter the city of the prime Federal recipient.:

State: If the organization filing the report in item 4, checks "Subawardee", select the appropriate state from this pull down menu.:

Zip / Postal Code: If the organization filing the report in item 4, checks "Subawardee", enter the zip code.:

Congressional District: If the organization filing the report in item 4, checks "Subawardee", enter the Congressional District of the prime Federal recipient, if known. Should be numeric characters.:

EntityType: Prime

Federal Department/Agency: Enter the name of the Federal Department or Agency making the award or loan commitment. This field is required.:

Federal Department/Agency: Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. :

CFDA Number: Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments.:

Federal Action Number: Enter the most appropriate Federal identifying number available for the Federal action, identified 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".:

Award Amount: For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment of the prime entity identified in item 4 or 5.:

Prefix: Enter the prefix (e.g., Mr., Mrs., Miss), if appropriate, for the Lobbying Registrant.:

First Name: Enter the first name of Lobbying Registrant. This field is required.:

Middle Name: Enter the middle name of Lobbying Registrant.:

Last Name: Enter the last name of Lobbying Registrant. This field is required.:

Suffix: Enter the suffix (e.g., Jr. Sr., PhD), if appropriate, for the Lobbying Registrant.:

Street 1: Enter the first line of street address for the Lobbying Registrant.:

Street 2: Enter the second line of street address for the Lobbying Registrant.:

City: Enter the city of the Lobbying Registrant.:

State: Select the appropriate state of the Lobbying Registrant.:

Zip / Postal Code: Enter the Zip Code (or ZIP+4) of the Lobbying Registrant.:

DataEntered1:

Prefix: Enter the prefix (e.g., Mr., Mrs., Miss), if appropriate, for the Individual Performing Services.:

First Name: Enter the first name of the Individual Performing Services. This field is required.:

Middle Name: Enter the middle name of the Individual Performing Services.:

Last Name: Enter the last name of the Individual Performing Services. This field is required.:

Suffix: Enter the suffix (e.g., Jr. Sr., PhD), if appropriate, for the Individual Performing Services.:

Street 2: Enter the second line of street address for the Individual Performing Services.:

City: Enter the city of the Individual Performing Services. :

State: Select the state for the address of the Individual Performing Services from this pull down menu.:

Zip / Postal Code: Enter the Zip Code (or ZIP+4) of the Individual Performing Services.:

Street 1: Enter the first line of street address for the Individual Performing Services.:

DataEntered2:

Prefix: Enter the prefix (e.g., Mr., Mrs., Miss), if appropriate, for the Certifying Official.:

First Name: Enter the first name of Certifying Official. This field is required.:

Middle Name: Enter the middle name of the Certifying Official.:

Last Name: Enter the last name of the Certifying Official. This field is required.:

Suffix: Enter the suffix (e.g., Jr. Sr., PhD), if appropriate, for the Certifying Official.:

Title: Enter the title of the Certifying Official.:

Telephone Number: Enter the telephone number of the certifying official.:

LastField:

Signature: Enter the Signature. This field is required.

Date: Enter the date signed. Enter in the format mm/dd/yyyy. This field is required.:

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Grants.gov Lobbying Form

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D:20061122134148- 05'00'

Certification for Contracts, Grants, Loans, and Cooperative Agreements

(2) If any funds other than Federal appropriated funds have been paid or will be paid to 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 this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard

Form-LLL, ''Disclosure of Lobbying Activities,'' 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 subcontracts, subgrants, and contracts 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.

If any funds have been paid or will be paid to 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 this commitment providing for the United States to insure or guarantee a loan, the undersigned shall complete and submit Standard Form-LLL, ''Disclosure of Lobbying Activities,'' 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.

* APPLICANT'S ORGANIZATION

* SIGNATURE:

* DATE:

* PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE

Suffix:

Middle Name:

* Title:

* First Name:

* Last Name:

Prefix:

CERTIFICATION REGARDING LOBBYING

(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence 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 the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

The undersigned certifies, to the best of his or her knowledge and belief, that:

Statement for Loan Guarantees and Loan Insurance

The undersigned states, to the best of his or her knowledge and belief, that:

OMB Number: 4040-0013

Expiration Date: 02/28/2025

Mandatory:

Applicant's Organization: Enter the legal name of the organization that will undertake the assistance activity. This should normally be the name under which the organization has registered with the Business Partner Network.:

Prefix: Select the prefix (e.g., Mr., Mrs., Rev.) for the name of the Authorized Representative.:

Suffix: Select the suffix (e.g., Jr, Sr, PhD) for the name of the Authorized Representative.:

First Name: Enter the first (given) name of the Authorized Representative who is signing this form.:

Middle Name: Enter the middle name of the Authorized Representative.:

Title: Enter the title of the Authorized Representative who is signing this form.:

Last Name: Enter the last (family) name of the Authorized Representative signing this form.:

Signature: It is the organization's responsibility to assure that only properly authorized individuals sign in this capacity and/or submit the application to Grants.gov. Enter the Signature of Authorized Representative.:

Date Signed: Enter the date the AOR signed the application.:

XDPFirstField:

LastField:

U.S. Department of Energy ORDER

Washington, D.C. DOE O 412.1A

Approved: 4-21-05

Admin Chg 1: 5-21-14

SUBJECT: WORK AUTHORIZATION SYSTEM

1. OBJECTIVES. To establish a work authorization and control process for work performed by designated site and facility management contractors, and other contractors as determined by the procurement executive, consistent with the budget execution and program evaluation requirements of the Department of Energy’s (DOE’s) Planning, Programming, Budgeting, and Evaluation process.

2. CANCELLATIONS. DOE O 412.1 Work Authorization System, dated 4-20-99.

Cancellation of a directive does not, by itself, modify or otherwise affect any contractual obligation to comply with such a directive. Cancelled directives that are incorporated by reference in a contract remain in effect until the contract is modified to delete the references to the requirements in the cancelled directives.

3. APPLICABILITY.

a. Primary DOE Organizations, Including National Nuclear Security Administration

(NNSA) Organizations. Except for the exclusions in paragraph 3c, this Order applies to all Primary DOE Organizations that direct work to be performed by site and facility management contractors and other contractors determined by the procurement executive. (See current listing at https://www.directives.doe.gov/references/DepartmentalElements).

The Administrator of NNSA shall assure that NNSA employees and contractors comply with their respective responsibilities under this Order.

b. Site/Facility Management Contractors. This Order will be applicable to contractors by provisions within the Department of Energy Acquisition

Regulation (DEAR).

c. Exclusions.

(1) Facilities and activities of the NNSA Office of Naval Reactors and

Bonneville Power Administration are excluded from the requirements of this Order.

(2) Work involving reimbursable work for others and services, products, or materials regularly produced for sale at scheduled rates under DOE programs (e.g., routine irradiation services, radioisotopes, production or transmission of electricity) are excluded from the requirements of this

Order.

AVAILABLE ONLINE AT: INITIATED BY:

http://www.directives.doe.gov Office of Acquisition and Project Management http://www.directives.doe.gov/ https://www.directives.doe.gov/references/DepartmentalElements

2 DOE O 412.1A

4-21-05

4. REQUIREMENTS.

a. Authorizations and deauthorizations for all DOE funded work must be documented in work authorizations. [Paperless generation and electronic transfer are preferred (see Attachment 2 for sample format).]

(1) A program office may request a contractor to use a suggested standard work proposal (Attachment 3) to provide information for program planning, budget formulation, or documentation of part or all of a work assignment.

(2) A site and facility management contractor may use a work proposal to propose work to a program office (see Attachment 3 for sample format).

b. At a minimum, each work authorization will contain the following information:

(1) project title and reference to work proposal number, if applicable;

(2) Headquarters programmatic point of contact, organization, and telephone number;

(3) Headquarters budget point of contact, organization code, and telephone

(4) responsible program;

(5) responsible program Secretarial Officer;

(6) responsible field organization;

(7) responsible contracting officer if different from 4b(6) above;

(8) site/facility management contractor name, point of contact, and telephone

(9) work authorization number (see paragraph 4c below), with revision number if applicable;

(10) budget and reporting code and funding level;

(11) dates for performance period, work start, and work completion;

(12) statement of work (see paragraph 4d below);

(13) reporting requirements, including (a) project management or status reports and (b) reports or publications for the purpose of informing DOE, the

3 DOE O 412.1A

scientific community, and the public of the project results (e.g., scientific advances or technical progress); and

(14) Headquarters, field organization, contractor, and if involving changes to scope, schedule, or funding, contracting officer signature blocks.

c. Each work authorization must have a unique, standardized identification number, which must remain unchanged for the total life of the work assignment.

d. The statement of work will include the following information as appropriate:

(1) detailed statement of work to be performed or reference to a work proposal, project plan, or similar document describing the scope of work in detail;

(2) required milestone dates;

(3) deliverables, including technical information as required by DOE

O 241.1B, Scientific and Technical Information Management, dated 12-

13-10; and

(4) associated performance-based indicators/targets consistent with DOE

G 120.1-5, Guidelines for Performance Measurement, dated 6-30-96, and any additional guidance that will assist the contractor in the performance of the work.

e. DOE field organizations (contracting officers) must receive a work authorization signed by the appropriate Primary DOE Organization, who must review and approve the work as acceptable for the contractor before obligating funds for the contract.

(1) Program offices may delegate some of the program managers’ responsibilities and authorities to DOE field organizations (e.g., assignment of tasks and/or distribution of funds to contractors under their cognizance).

(2) When responsibilities have been delegated, the field organization is responsible for preparing and issuing the work authorization.

f. A signed copy of each work authorization accepted by the contractor must be forwarded to DOE (preferably electronically) as evidence of acceptance of the authorized work.

(1) If the authorization does not change scope, schedule, or cost (e.g., incremental funding), then contractor signatures are not necessary. (Note, however, that if any changes are made, this information should still be forwarded to DOE as noted above.)

4 DOE O 412.1A

(2) Work is not authorized to commence until the contractor receives both funding (via a signed contract modification) and the related work authorization.

g. Funding guidance necessary to support work authorizations will be provided through the existing approved funding program (AFP) process.

(1) The contractor retains the flexibility to manage individual tasks within the work assignment.

(2) Manpower and dollars may be shifted, as necessary, subject to

Government imposed constraints and program office direction.

h. Authorizations for work planned in the current fiscal year are to be issued by the beginning of the fiscal year to the maximum extent possible.

(1) Work authorizations should be transmitted to the field promptly following the issuance of the advice of allotment by the Office of Management, Budget and Evaluation.

(2) Paperless generation and electronic transfer are preferred.

5. RESPONSIBILITIES.

a. Under Secretaries. Establish DOE policy for assignment and control of work authorization for designated site and facility management contractors.

b. Primary DOE Organizations.

(1) Inform other DOE organizations of restrictions or constraints on the use of facilities under their cognizance.

(2) Recommend to the cognizant Under Secretary appropriate changes in the policies for work authorization for designated site and facility management contractors.

c. Program Secretarial Officers.

(1) Provide general approval of work to be accomplished under the provisions of this Order, normally as part of institutional planning, budget formulation or execution, or similar processes. (Approval of specific work authorizations and associated documentation may be delegated.)

(2) Prepare work authorizations in accordance with paragraph 4, aggregating related work assignments at the highest appropriate level.

5 DOE O 412.1A

(3) To the maximum extent possible, issue full annual funding and associated work authorizations to site and facility management contractors as early in the fiscal year as possible.

(4) Ensure work to be assigned by work authorization—

(a) is appropriate for performance by a contractor;

(b) has clearly articulated requirements and technically and programmatically adequate documentation; and

(c) will be performed in a manner compliant with the terms and conditions of the contract, including security and environmental, safety, and health (ES&H) requirements.

(5) As needed, revise and issue work authorizations to DOE field organizations and request necessary AFP changes through the Chief

Financial Officer in accordance with established procedures for administrative control of funds.

(6) Transmit work authorizations to the field promptly with submission of the

AFP to the Chief Financial Officer.

(7) Ensure that formal agreement is reached with DOE field organizations anytime they are delegated technical assessment or technical oversight and control of work assignments.

(8) Monitor performance and reports submitted by contractors, unless this function is delegated, to ensure contractors comply with all work requirements defined in their contracts, including the statement of work, reporting requirements, documentation, data, cost management, work products, milestone schedules and deliverables.

d. DOE Field Organizations.

(1) Ensure work to be assigned by work authorization—

(a) is within the contracting officer’s representative’s (COR’s) delegated authority and

(b) is not duplicative of other ongoing work under the contractor’s responsibility.

(2) Ensure work performed by contractors does not violate constraints on use of DOE-controlled facilities and is carried out in a manner that protects the workers, the public, and the environment against ES&H hazards and safeguards and security risks arising from the performance of contract work.

6 DOE O 412.1A

(3) Ensure work authorization requirements have been satisfied before authorization to proceed and that the contractor has a clear understanding of what is required by the sponsoring program office before work commences.

(4) Review all work authorizations under their cognizance to ensure they are appropriate for performance; within mission; and for institutional plans as applicable, within scope and agreed to general levels of effort.

(5) Issue and revise work authorizations for assigned work if the assignment decision has been delegated.

(6) Ensure the contractor provides a signed copy of the work authorization and all required reports to Program Secretarial Officers as required.

(7) Monitor performance and reports submitted by contractors to ensure that work performed and costs incurred conform to work authorizations issued.

(8) Authorize work in accordance with the AFP, programmatic guidance, contract-specific COR appointment letters, and established procedures for administrative control of funds.

(9) Ensure costs related to work authorizations can be adequately tracked before issuing authorizations.

(10) Review work proposals prepared by contractors for consistency with program and other guidance.

(11) Transmit work proposals, with any comments and recommendations, to program offices in accordance with program guidance and budget time frames issued by the Chief Financial Officer.

(12) Ensure contractors provide technical information to the Director of

Scientific and Technical Information in accordance with reference 7e below.

(13) Perform contract oversight activities in accordance with the contract-specific COR appointment letter.

e. Office of the Chief Financial Officer. Performs tasks of an accounting and budgetary nature associated with the process described in this Order such as issuing allotments, AFPs, and financial reports.

7 DOE O 412.1A

6. REFERENCES.

a. Title XXXII of P.L. 106-65, National Nuclear Security Administration Act, dated

October 5, 1999, as amended.

b. DOE G 120.1-5, Guidelines for Performance Measurement, dated 6-30-96, provides guidance on performance measurement in DOE.

c. DOE O 130.1, Budget Formulation, dated 9-29-95, establishes policy provisions and defines roles and responsibilities of Departmental organizations and contractors participating in the Department’s annual budget formulation process.

d. DOE O 135.1A, Budget Execution Funds Distribution and Control , dated 1-9-06, describes DOE systems, policies, and assignment of requirements for control of the budget execution process

e. DOE O 241.1B, Scientific and Technical Information Management, dated 12-13-

10, provides guidance concerning the reporting and dissemination of technical information. Scientific and technical information resulting from work funded by

DOE is to be made broadly available to the scientific community and the public, within appropriate adherence to statutorily mandated protections.

f. DOE P 450.4A, Integrated Safety Management Policy, dated 4-25-11, provides for a formal process to plan, perform, assess, and improve the safe conduct of work.

g. DOE P 226.1B, Department of Energy Oversight Policy, dated 4-25-11, provides policy for DOE line management oversight of ES&H.

h. DOE O 452.1D, Nuclear Explosive and Weapon Surety Program, dated 4-14-09, establishes requirements and responsibilities for the DOE Nuclear Explosive and

Weapon Surety Program to ensure adequate safety, security, and control of nuclear explosives and nuclear weapons.

i. DOE O 452.2D, Nuclear Explosive Safety, dated 7-10-13, establishes requirements and responsibilities for ensuring the safety of both routine and planned DOE nuclear explosive operations and associated activities and facilities.

j. DOE O 452.4A, Security and Control of Nuclear Explosives and Nuclear

Weapons, dated 12-17-01, establishes DOE, including NNSA, requirements and responsibilities to prevent the deliberate unauthorized use of U.S. nuclear explosives and U.S. nuclear weapons.

k. NNSA Policy Letter NAP-24, Weapon Quality Policy, dated 6-20-13.

8 DOE O 412.1A

l. DOE O 414.1D Admin Chg 1, Quality Assurance, dated Apr 25, 2011.

m. DOE O 470.4B Admin Chg 1, Safeguards and Security Program, dated 7-

21-11, provides requirements and responsibilities for the appropriate protection levels against unauthorized access; theft, diversion, loss of custody, or destruction of nuclear weapons or components; espionage;

loss or theft of classified matter or Government property; and other hostile acts that impact national security, the health and safety of employees, the public, or the environment.

n. DOE O 534.1B, Accounting, dated 1-6-03, establishes requirements for financial management of cash, advances, receivables, inventories, and investment of funds;

accountability for plant and capital equipment; current and long-term liabilities;

and accounting for equity revenues, collections, expenses, and reimbursable work performed by DOE on behalf of Federal and non-Federal entities.

7. CONTACT. For assistance, contact the Office of Acquisition and Project

Management, 202-287-1310.

SAMUEL W. BODMAN

Secretary of Energy

DOE O 412.1A Attachment 1

SAMPLE WORK AUTHORIZATION

U.S. DEPARTMENT OF ENERGY

CONTRACT WORK AUTHORIZATION

1a. Project Title: 1b. Work Proposal Number (if applicable):

2. Headquarters Program Point of Contact.

Name: Organization Code: Telephone No.:

3. Headquarters Budget Point of Contact.

Name: Organization Code: Telephone No.:

4. Responsible Program: 5. Responsible Secretarial Officer:

6. Responsible Field Organization:

7a. Site and Facility Management Contractor:

10. Funds Authorized ($ in thousands).

7b. Contractor Point of Contact.

Name: Telephone No.:

8. Work Authorization Number: 9. Revision Number:*

Budget and Reporting Code: Previous: Change: Current:

11. Performance Period Covered by Funds. 12. Work Start Date: 13. Expected Completion Date:

From: To:

14. Statement of Work:

(Attach a detailed description of work to be performed or reference to a work proposal, project plan, or similar document that describes the scope of work, milestones, deliverables, performance measures/expectations.)

15. Reporting Requirements (Status reports, scientific and technical information or similar):

16. Work Authorization Program Official.

Name : Signature: Date:

17. DOE Field Organization Official.

Name (typed): Signature: Date:

18. Contractor’s Authorized Representative.

19. DOE Contracting Officer (or delegated representative).

*The revision number will consist of a 2-digit program identifier, 4-digit sequential number, and the last digit of the fiscal year.

DOE O 412.1A Attachment 2

SAMPLE WORK PROPOSAL

U.S. DEPARTMENT OF ENERGY

WORK PROPOSAL

1. Work Proposal Number: 2. Revision Number: 3. Date Prepared:

4. Work Proposal Title: 5. STARS Accounting Flexfield string (as available):

6. Work Proposal Term: Begin End

9. DOE Field Organization Work Proposal 10. DOE Field Organization:

Reviewer:

7. Name (Last, First, MI) and Phone Number 8. Headquarters Organization:

of the Headquarters Program Manager:

11. Contractor Work Proposal Manager: 12. Contractor Name:

13. Proposal Description (Approach, anticipated benefits in 200 words or less):

14. Contractor Work Proposal Manager: 15. DOE Field Organization Official:

(Signature) (Date) (Signature) (Date)

16. Detail Attachments: (See Specific Attachments)

a. Facility Requirements g. Future Accomplishments m. ES&H Considerations

b. Publications h. Relationships to Other Projects n. Human/Animal Subjects

c. Purpose (mandatory) i. NEPA Requirements o. Security Requirements

d. Background j. Milestones p. Other (specify)

e. Approach k. Deliverables

f. Technical Progress l. Performance Measures/ Expectations

WORK PROPOSAL REQUIREMENTS FOR OPERATING/EQUIPMENT

OBLIGATIONS AND COSTS

CONTRACTOR NAME: WORK PROPOSAL

NO.:

REV. NO.: DATE PREPARED:

Prior Years BY -1 Budget Year (BY) BY +1 BY +2

Total to Complete

17. Staffing (staff years):

a. Scientific

b. Other Direct

c. Total Direct.

Request

Authorized

18. Operating Expense:

a. Total Obligations

b. Total Costs

19. Equipment:

a. Equipment Obligations

b. Equipment Costs

20. Milestone Schedule: Proposed Authorized

21. Reporting Requirements (Description):

DOE WORK PROPOSAL INSTRUCTIONS

A. Pages 1 and 2 of the Work Proposal are optional but may be required by a program office for planning and budget formulation. It may be used as all or part of the documentation of a Work Authorization. The form may also be used by a site and facility management contractor to describe prospective work. The form is intended to provide an overview of the effort, including each of the tasks necessary for project completion. Proposals should be limited to a single project to allow reporting of costs, obligations, and other information.

B. Page 1 of the form.

Item 1. Enter a unique number for the proposal.

The first two characters of this number are to signify the DOE organizational code used when assigning regular contract numbers. The third character is to be the letter “W.” The remaining four characters will be a unique sequential number assigned by the requesting organization.

Item 2. If the initial proposal is changed, a revision is indicated by placing a number in this space, starting with the number “1” and proceeding in sequence.

Item 3. The month, day, and year the form is prepared (e.g., 10/01/03).

Item 4. A descriptive title of the work being proposed.

Item 5. The STARS Accounting Flexfield

(AFF) string in accordance with the AFF values and the B&R Classification Codes set forth on the Chief Financial Officer iPortal website athttps://iportalwc.doe.gov/webcenter/content/co nn/iPortalContent/path/MyWebCenterSpaces/EF

ASC1/BARC/index.htm.

Item 6. The start and estimated completion dates of the proposal. Use a two-number format for month, day, and year (e.g., 10/01/03). For proposals initiated for an indefinite period of time, the completion date should be shown as

“OPEN.”

Item 7. When known, enter the name and phone number of the DOE/NNSA program manager responsible for the overall program.

Item 8. The DOE/NNSA Headquarters office responsible for the overall program.

Item 9. When known, enter the name and phone number of the DOE field organization individual responsible for reviewing the proposal.

Item 10. The DOE field organization responsible for the work proposal.

Item 11. When known, enter the name and phone number of the contractor individual responsible for the proposal.

Item 12. Enter the name of the contractor responsible for the proposal.

Item 13. A description of the proposal, in

200 words or less, highlighting the purpose, approach, and anticipated benefits the proposal will provide in the program’s mission.

Item 14. The signature of the contractor representative responsible for the proposal and the date are to be entered when the proposal is given to the reviewing official.

Item 15. The signature of the reviewing official and the date are to be entered when the proposal is forwarded to the program manager.

https://iportalwc.doe.gov/webcenter/content/conn/iPortalContent/path/MyWebCenterSpaces/EFASC1/BARC/index.htm https://iportalwc.doe.gov/webcenter/content/conn/iPortalContent/path/MyWebCenterSpaces/EFASC1/BARC/index.htm https://iportalwc.doe.gov/webcenter/content/conn/iPortalContent/path/MyWebCenterSpaces/EFASC1/BARC/index.htm

DOE WORK PROPOSAL INSTRUCTIONS CONTINUED

Item 16. Detailed attachments are to be completed if they are necessary to understand or will enhance the proposal. Any attachments accompanying the proposal should be indicated by checking the appropriate blocks. Each attachment page should include the contractor name, the proposal number, and the date prepared.

a. Facility Requirements. If execution of the proposal requires the use of existing or approved facilities, briefly describe the required use and location, with associated gross square footage and impact on site utility services by fiscal year in which the proposal begins and each subsequent fiscal year during the anticipated life of the proposal. Facility needs will be reviewed in context of overall site planning and utilization and expressed in terms of space function (e.g., office, storage space, site utilities)

b. Publications. List all publications pertaining to the proposal during the prior fiscal year.

Provide the title or subject and planned date of publications of all topical reports over the life of the proposal. Periodic progress reports are to be listed in this section.

c. Purpose. Provide the reasons for the proposal and the objectives that will accomplish the stated purpose. Each objective should be the single highest level of measurable achievement that can serve as a criterion for measuring the success or failure of the proposal.

d. Background. Present a brief historical overview of the proposal or preview work or theories that have led to the proposal.

e. Approach. Explain the management controls and methodology that will be used to execute the proposal in all fiscal years.

f. Technical Progress. Attach the last Technical

Progress Report if required by the program.

Also, describe the technical progress in BY-3 (the last complete fiscal year) and expected progress for BY-2, BY-1, and BY.

g. Future Accomplishments. Describe any anticipated benefits that will accrue in the future which are attributable to the proposal.

h. Relationship to Other Projects. Provide a description of any relationships, interrelationships, or dependencies which the proposal has with other known federally funded projects.

i. NEPA Considerations. In accordance with the

National Environmental Policy Act of 1969, describe the long-term and short-term potential impacts and effects of the work package upon the ecosystem and NEPA documentation that must be prepared.

j. Milestones (if applicable). A detailed explanation of the milestones presented on the second page of the proposal (item 20) should be given. For basic research, the only milestone may be the submission of a yearly progress report.

k. Deliverables. An itemized list of deliverables under the proposal excluding reports in item 21.

l. Performance Measures and Expectations. A description of the performance measures described as outcomes and the expectations for achieving those measures by which the success of the proposal will be measured.

m. ES&H Considerations. A description of the

ES&H hazards arising from performance of the proposed work and mitigating actions to protect the workers, the public, and the environment.

DOE WORK PROPOSAL INSTRUCTIONS CONTINUED

n. Human/Animal Subjects Research. Briefly describe any anticipated human subjects or animal subjects research activity that may occur as part of the proposed work.

o. Security Requirements. Identification of applicable security requirements.

p. Other. Any other attachments should be specified in the space provided on the work proposal form.

C. Page 2 of the Form—General. Header information on this page should be filled in as it appears on page 1. The “Authorized” column is not completed unless requested by the program when funds have been authorized. The column heading designations on page 2 of the

DOE/NNSA Work Proposal form are defined below. The relationship between the fiscal years

(FYs) and budget years (BYs) for which information is being provided is illustrated in the table below.

Prior Years. For proposals related to projects, information for all prior years in which work was performed should be provided to allow calculation of total project cost and other information. This column is optional and should only be completed when requested by the program in the program guidance.

Item 17. Designate personnel staffing in full-time equivalent person-years. Enter the numbers of scientific and other direct person-years for all columns.

Item 18. Enter estimates for total obligations and total costs per year for all columns. This should include inventories.

Item 19. Enter estimates for total obligations and total costs per year for all columns for equipment directly related to the proposal.

Item 20. Enter the titles of supporting tasks in the “Milestone Schedule” column. Each task should be followed by the total obligations in thousands of dollars in the “Proposed BY” column. The dates (MO/YR) on which the tasks are projected for start and completion should be entered in the “Proposed Schedule” columns and will be completed, if requested by the program manager, when funds have been authorized.

Based on the allocation of funds, enter the dates for planned start and completion of the respective tasks when requested.

Item 21. Enter all reporting…