BEN-25-048 Exhibit I FFATA.docx
DOCX document 38 KB Posted
- Attached to
- BEN-25-048 SNAP/50
- Solicitation number
- RFP-125291
- Issued by
- Virginia
About this file
This is a Federal Funding Accountability and Transparency Act (FFATA) Subrecipient Required Data form associated with the Commonwealth of Virginia's Department of Social Services (VDSS) Request for Proposal BEN-25-048 for SNAP Employment and Training (E&T) program services. The form serves as the required documentation for entities responding to the RFP, which seeks proposals from eligible organizations to provide employment and training services to SNAP recipients throughout Virginia. The SNAP E&T program delivers evidence-based, innovative service approaches designed to support SNAP recipients in achieving career objectives through tailored services that promote career pathway development and wage growth.
The FFATA form requires subawardees to provide critical organizational and registration information, including legal entity name, Data Universal Numbering System (DUNS) number, System for Award Management (SAM) registration status, and complete business address details along with the primary place of performance location and corresponding congressional districts. The form mandates disclosure of executive compensation for the top five highly-compensated officers if the organization received eighty percent or more of annual gross revenues from federal funding sources and exceeds twenty-five million dollars in annual federal contract revenue, with exemptions provided for state and local government entities. All subawardees must certify the accuracy and completeness of submitted information and commit to maintaining current registration throughout the award period.
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EXHIBIT- I (FFATA FORM)
FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA)
SUBRECIPIENT REQUIRED DATA
This form must be completed, certified, and returned with the response to the RFA.
For VDSS Use Only – To be completed by Program Unit
1. Federal Award Identifier Number (FAIN)
2. Award Title
3. CFDA
4. Subaward Number
To be completed by Subawardee
5. Subawardee Legal Name
6. Data Universal Numbering System (DUNS) number – 9 digits
7. Are you registered in the System for Award Management (SAM)?
If Yes, continue to question 8. If No, please go to question 9.
|_| Yes
|_| No
8. Is your registration in SAM current and active?
If Yes, enter expiration date.
If No, continue to question 9.
|_| Yes
Expiration Date: ___________
9. In your business or organization’s previous fiscal year, did your business or organization (including parent organization, all branches, and all affiliates worldwide) receive (1) 80 percent or more of your annual gross revenues in U.S. federal contracts, subcontracts, loans, grants, subgrants, and/or cooperative agreements; AND (2) $25,000,000 or more in annual gross revenues from U.S. federal contracts, subcontracts, loans, grants, subgrants, and/or cooperative agreements?
If Yes, continue to question 10. If No, please go to question 12.
|_| Yes
10. Does the public have access to information about the compensation of the executives through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986? (To determine if the public has access to the compensation information, see the U.S. Security and Exchange Commission total compensation filings at www.sec.gov/answers/execomp.htm.)
If Yes, please go to question 12. If No, please continue to question 11.
|_| Yes
11. List the names and total compensation of the top five highly compensated officers.
Total Compensation is the cash and noncash dollar value earned by the executive during the preceding fiscal year and includes the following: salary and bonus; awards of stock, stock options, and stock appreciation rights; earnings for services under non-equity incentive plans; change in pension value, etc. (for more information see 17 CFR 229.402 (c)
Note: State and local governments are exempt from reporting executive compensation.
Officer 1 Name:
Officer 1 Compensation:
Officer 2 Name:
Officer 2 Compensation:
Officer 3 Name:
Officer 3 Compensation:
Officer 4 Name:
Officer 4 Compensation:
Officer 5 Name:
Officer 5 Compensation:
12. Awardee Street Address 1
13. Street Address 2
14. City
15. State
16. Zip + 4
17. Congressional District
18. Place of Performance – primary site where the work will be performed (POP) Awardee Street Address 1
19. POP Street Address 2
20. POP City
21. POP State
22. POP Zip + 4
23. POP Congressional District
Dun & Bradstreet website: http://www.dnb.com/us/ System for Award Management website: https://www.sam.gov I certify that the above Subawardee information is correct, accurate, and will be maintained/updated as required to keep registration current.
Name Title Date
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