fy24-optional-project-narrative-template_Final.docx

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FY 2024 National Environmental Information Exchange Network Grant Program
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EPA-OMS-24-01
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This document is an optional project narrative template for the FY 2024 Exchange Network Grant Program solicitation. The template provides guidance and a format for applicants to submit their project narratives, which are a mandatory attachment for all proposals.

The template outlines the required components of the project narrative, including: project description, goals and outcomes, key personnel, technical solutions, budget and cost details, and past performance. Applicants are instructed to edit the template as needed and remove certain sections before submitting their final narrative. The narrative has a 10-page limit and will be scored by review panels based on how well the evaluation criteria are addressed. The solicitation is issued by the Environmental Protection Agency under the National Environmental Information Exchange Network Grant Program (CFDA 66.608) to support environmental data sharing and exchange.

Optional Project Narrative Template

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Optional Project Narrative Template: Endnotes

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NOTES ON THE FY24 OPTIONAL PROJECT NARRATIVE TEMPLATE

· Note: This is an optional template and is not required; however, the project narrative is a mandatory attachment for all submitted proposals (see SN Appendix E).

· Note: The project narrative should be a maximum of ten pages single-spaced; review panels score applications based on how well the evaluation criteria are met within these ten pages.

· Any part of the project narrative that extends past 10 pages will not be reviewed/considered during application scoring.

· Note: Blue text enclosed in brackets signifies sections of text that should be edited/expanded upon by the applicant; change this text color to black and remove brackets before submitting the project narrative.

For Example:

“Table 4. Contractor/Individual Consultant/Vendor Key Contact(s) explicitly identifies that this project [will/will not] utilize [[contractor(s)] and/or [individual consultant(s)] and/or [vendor(s)]].”

à “Table 4. Contractor/Individual Consultant/Vendor Key Contact(s) explicitly identifies that this project will utilize a contractor.”

· Note: Applicants using this optional template should feel free to expand and edit the suggested text, as well as expanded bulleted lists and table row/sections as necessary for their proposed project.

· Note: Superscript numbers throughout this document link to endnotes (see document pages 8-10); to delete these, simply remove the associated superscript number (e.g., 1).

· Note: Delete this introductory page, all superscript, all endnotes, and all template notes (notes within this optional template) before submitting your project narrative.

THE OPTIONAL PROJECT NARRATIVE TEMPLATE BEGINS ON THE NEXT PAGE

Optional Project Narrative Template: Instructions/Notes

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FY 2024 Exchange Network Grant Program: Project Narrative [Month][Day], 2024

DELETE THIS PAGE BEFORE SUBMISSION

[Project Title] [State, Tribe, or Territory Name] [Name of Department or Agency]

1. Project Description The [State, Tribe or Territory Name] [Name of Department or Agency]’s [program] submits this application in support of Exchange Network (EN) Funding Area[s] [‘1’, ‘2’, and/or ‘3’][endnoteRef:2] under the following EN project opportunities[endnoteRef:3] [insert EN specific project opportunity name(s) from SN Appendices A-C][endnoteRef:4]. [2: Please note that EN Funding Area 3 and the EN Project Opportunities as listed in SN Appendix C are only open to U.S. Territories, federally recognized Indian tribes and Alaska Native Villages, and inter-tribal consortia of federally recognized tribes (e.g., the Northwest Indian Fisheries Commission).

] [3: The phrase ‘EN project opportunities’ in this context refers to specific project write-ups as available in Appendices A-C of the Solicitation Notice that provide potential applicants with the information needed to design a proposal for a particular data exchange, data service, or project type (e.g., ‘WQX’ or ‘Individual Capacity Building’).] [4: If an applicant is proposing a project which does not relate to a specific EN project opportunity, this should be clearly stated here. Be sure to still include which of the EN Funding Area(s) are supported by the proposed project.]

[Provide a brief description (2-3 sentences) of Department/Agency and the organization’s general scope of work]. [Department/Agency Name or abbreviation] is requesting funding under the EN Grant Program to address the following business [and/or administrative] needs:

· [Provided a bulleted list of general business and/or administrative needs (of the Department/Agency), which will be supported by the proposed project.]

This project supports the goals and objectives of the EPA’s FY 2022-2026 Strategic Plan[endnoteRef:5] and the achievement of associated environmental results, as described in Table 1. [5: See Solicitation Notice Section I-C. ‘Environmental Results Supported by Assistance Activities’ or read full text at https://www.epa.gov/planandbudget/strategicplan.]

Table 1. Supported EPA Strategic Goals and Objectives Strategic Goal[endnoteRef:6] [6: E.g., ‘Goal 1: Tackle the Climate Crisis’.]

Strategic Objective[endnoteRef:7] [7: E.g., ‘Objective 1.1 Reduce Emissions that Cause Climate Change’.]

Project Support Description:
Associated Environmental Output(s) and/or Outcome(s)

Goal [#]:

[Enter Full Title] Objective [#]:

[Enter Full Title]

[Briefly describe how this strategic goal & objective is supported by the proposed project.].
[List associated environmental output(s) and/or outcome(s)].

Goal [#]:

[Enter Full Title] Objective [#]:

[Enter Full Title]

[Briefly describe how this strategic goal & objective is supported by the proposed project.].
[List associated environmental output(s) and/or outcome(s)].

1. Project Goals, Outputs, and Outcomes This project proposes [#] project goals to successfully accomplish the proposed work. These project goals and their cost, as well as associated outputs, output costs, and output schedule completion dates are provided below in Table 2. A general rationale for how the listed output completion dates were selected and deemed appropriate is likewise provided. Additionally, Table 2 describes each project goal’s anticipated outcome(s), supported business/administrative needs, and the EPA Strategic Plan goal and output[endnoteRef:8] it helps to address. [8: Applicants should only list one strategic goal and objective per project goal; if there are multiple options, applicants should choose the best fit. The same EPA strategic goal and objective may be listed for multiple project goals.]

Table 2. Goals, Outputs, and Outcomes (Project Workplan)[endnoteRef:9] [9: Add or remove rows to Table 2. Goals, Outputs, and Outcomes as needed to include all project goals and outputs.]

Goal:
Output Cost:
Output(s):
Completion Date

Goal 1: [Enter Descriptive Title]

Goal 1 Cost: $[Enter] $ [Enter]

1.1: [Enter Descriptive Title]

[mm/dd/yyyy]

$ [Enter]

1.2: [Enter Descriptive Title]

[mm/dd/yyyy]

$ [Enter]
1.3: [Enter Descriptive Title]

[mm/dd/yyyy]

Anticipated Outcome(s):
[Enter outcome(s) from this goal].
Admin./Business Need(s):
[Enter admin. and/or business needs supported by this goal].
EPA Strategic Goal & Objective:
[Enter EPA strategic goal & objective most supported by this goal].

Goal 2: [Enter Descriptive Title]

Goal 2 Cost: $[Enter] $ [Enter]

2.1: [Enter Descriptive Title]

[mm/dd/yyyy]

$ [Enter]

2.2: [Enter Descriptive Title]

[mm/dd/yyyy]

$ [Enter]
2.3: [Enter Descriptive Title]

[mm/dd/yyyy]

Anticipated Outcome(s):
[Enter outcome(s) from this goal].
Admin./Business Need(s):
[Enter admin. and/or business needs supported by this goal].
EPA Strategic Goal & Objective:
[Enter EPA strategic goal & objective most supported by this goal].

Goal 3: [Enter Descriptive Title]

Goal 3 Cost: $[Enter] $ [Enter]

3.1: [Enter Descriptive Title]

[mm/dd/yyyy]

$ [Enter]

3.2: [Enter Descriptive Title]

[mm/dd/yyyy]

$ [Enter]
3.3: [Enter Descriptive Title]

[mm/dd/yyyy]

Anticipated Outcome(s):
[Enter outcome(s) from this goal].
Admin./Business Need(s):
[Enter admin. and/or business needs supported by this goal].
EPA Strategic Goal & Objective:
[Enter EPA strategic goal & objective most supported by this goal].
Rationale for Selected Output Completion Dates:
[Provide a general rationale for how the proposed completion dates were selected and deemed appropriate for the project].
a. Total Budget for (All) Goals:
$ [Enter Sum of Goal Costs]
b. Personnel Costs not otherwise included in Goal Costs:
$ [Enter, if applicable to the project]
c. Fringe Costs not otherwise included in Goal Costs:
$ [Enter, if applicable to the project]
Total Direct Costs:
$ [Enter Total Direct Costs (Sum of A-C)]

Total Indirect Costs[endnoteRef:10]: [10: Must exactly match the total indirect costs as listed in the budget narrative, if applicable to the proposed project.]

$ [Enter Total Indirect Costs, if applicable]

Total Project Budget[endnoteRef:11]: [11: Must exactly match the total requested funds, as listed in all application attachments.]

$ [Add Total Direct Costs & Indirect Costs]

1. Identifying Key Personnel and Associated Roles, Responsibilities, and Qualifications Table 3. Applicable Key Contacts below explicitly identifies which personnel roles are applicable to [State, Tribe, or Territory Name] [Name of Department or Agency]’s proposed project. This table provides the full name, current job title, current organization, anticipated project roles and responsibilities, and other mandatory role-specific details for each applicable role.

Table 3. Applicable Key Contacts[endnoteRef:12] [12: Include one key contact per applicable role type; write ‘N/A’ in the fields for any non-applicable project roles; if the role has not yet been hired:

Mark ‘Y’ for yes in the second column titled ‘applicable(?)’;

Write ‘Not Yet Hired’ in the third column titled ‘Name’;

Write ‘Not Yet Hired’ in the fourth column titled ‘Current Job Title’;

Write ‘Not Yet Hired’ in the fifth column titled ‘Organization’;

Fill out the ‘Project Role(s)/ Responsibilit(ies)’ row; and Add the following row in that role section below ‘Project Role(s)/Responsibilities’ and fill it out:

Personnel Role[endnoteRef:13] [13: The role of project manager is applicable to all projects; use this column to indicate whether the other listed roles are applicable to your project.]

Applicable (Y/N)
Name
Current Job Title
Organization
Project Manager
Y
[Enter Name]
[Enter Current Title]
[Enter Org. Name]
Project Roles and Responsibilities:
[Describe role’s proposed project roles and responsibilities].
Experience or Qualifications in Project and Financial Management:
[Enter description of project manager’s experience in project management and financial management.]

Programmatic Contact[endnoteRef:14] [14: If programmatic involvement will not be included in the project, replace the two rows titled ‘Project Roles and Responsibilities’ and ‘Programmatic Office’s Relationship to the Applicant’ with this one row:

[Enter Y/N]
[Enter Name]
[Enter Current Title]
[Enter Org. Name]
Project Role(s)/ Responsibilit(ies):
[Describe role’s proposed project roles and responsibilities].
Programmatic Office’s Relationship to the Applicant:
[Enter brief description of relationship between programmatic office and applicant office].

Formal Partner[endnoteRef:15] [15: The formal partner role only applies to applicants submitting a coalition application with an eligible EN partner, as described in SN Section III-D and IV-B.]

[Enter Y/N]
[Enter Name]
[Enter Current Title]
[Enter Org. Name]
Project Role(s)/ Responsibilit(ies):
[Describe role’s proposed project roles and responsibilities].
Partnering Organization’s Relation to the Lead Applicant:
[Enter brief description of relationship between lead applicant and the partner contact’s organization].

Formal Mentor[endnoteRef:16] [16: The mentor role only applies to applicants specifically applying under the ‘Individual Capacity Building with Mentorship’ EN project opportunity (see Solicitation Notice, Appendix C).]

[Enter Y/N]
[Enter Name]
[Enter Current Title]
[Enter Org. Name]
Project Role(s)/ Responsibilit(ies):
[Describe role’s proposed project roles and responsibilities].
Mentoring Organization’s Prior Exchange Network Experience:
[Enter brief summary of mentor organization’s EN experience/history].
Mentor’s Most Recent EN Grant:
[List grant number and fiscal year of at least one prior EN grant].
Confirmation of Mentoring Data Reporting/Publishing Requirement:
[This mentor currently [reports and/or publishes] data for [list one or more EPA environmental programs] using [EN Node, VES, or an API].

Table 4. Contractor/Individual Consultant/Vendor explicitly identifies that this project [will/will not] utilize [[contracting firm(s)] and/or [individual consultant(s)] and/or [vendor firm(s)]]. [Additionally, it provides the planned method of procurement, planned method of qualification vetting, and anticipated project roles and responsibilities for each entity.] [As the contractor procurement method is non-competitive, a detailed justification for why this is allowable per EPA’s strict guidelines is also provided.]

Table 4. Contractor/Individual Consultant/Vendor[endnoteRef:17] [17: Mark ‘no’ in the ‘applicable’ column if contractors/individual consultants/vendors are not applicable and write N/A in all other fields; also expand the table as needed to include one key contact from each contract that is applicable to the proposed project.]

Contractor Role Type
Applicable(?)
Planned Procurement Method
[Contracting Firm/Individual Consultant/Vendor Firm]
[Enter Y/N]
[Enter ‘sealed bid’, ‘request for proposals’, or ‘non-competitive procurement’][endnoteRef:18] [18: Non-competitive procurement is not allowable without EPA approval, which is provided only in select cases. Applicants must provide a detailed justification when using this procurement method. An existing relationship or a history of prior work completed by a contractor or vendor does not justify the use of non-competitive procurement. Similarly, proximity of a contracting firm to an applicant’s organization is not sufficient reasoning. An example of a valid non-competitive procurement rationale is that software required for the proposed project is proprietary and developed by the contractor; therefore, the item is available only from a single source. See 2 CFR 200.320(c) for more information. If an applicant lists the method of procurement as ‘non-competitive’ or ‘sole source’, add and fill the following row:
Method of Qualification Vetting:
[Describe method for how the applicant organization will vet the contractor to ensure they are qualified to complete assigned work].
Roles and Responsibilities:
[Describe role’s proposed project roles and responsibilities].

1. Commitment to Reuse and Register Shared Tools and Services The [State, Tribe, or Territory Name] [Name of Department or Agency] is committed to reusing existing tools developed and available for Exchange Network partner use. Specifically, the program will reuse the following product[s] as detailed below in Table 5. Reused Components[endnoteRef:19]. [19: See Solicitation Notice, Appendix D ‘Identifying Items for Reuse - Exchange Network Partner Products’ for guidance on finding components for reuse. All applicants are expected to review available products/services/etc. to see if any existing technology is appropriate for reuse while planning their project; see endnote #19 for how this should then be addressed within the project narrative.]

Table 5. Reused Components[endnoteRef:20] [20: Include table only if applicable; if no products have been identified for reuse in this project, applicants should instead explicitly state this in this section and explain in detail why available products/services/technology is not appropriate for reuse in the proposed project.]

Name/Title
Type
Description
[Enter Component Name or Title]
[Enter Component Type][endnoteRef:21] [21: IT Component types include: Software; Web-Based Service(s); Cloud-Based Service(s); Shared Platform; API; XML Schema; Monitoring Tool/Service; Mobile Data Collection Tool; Remote Sensing Tool; GIS; Data Sharing Tool; Data Flow; Data Exchange Template; Data Service and/or Download; Data Standards; Training Tools and Resources; Flow Configuration [Document]; Standard Exchange Protocols; or Other.]

[Provide a brief description of the component and why it is appropriate for the proposed project].

[Enter Component Name or Title]
[Enter Component Type]
[Provide a brief description of the component and why it is appropriate for the proposed project].

In accordance with the terms and conditions of the Exchange Network Grant Program[endnoteRef:22], the [State, Tribe, or Territory Name] [Name of Department or Agency] commits to register any new tools developed during the execution of this grant project at the time of grant close-out. [22: See Solicitation Notice, Section: VI-B. Administration and National Policy Requirements.]

In accordance with the terms and conditions of the Exchange Network Grant Program20, the [State, Tribe, or Territory Name] [Name of Department or Agency] commits to register any reuse of existing EN tools during the execution of this grant project at the time of grant close-out.

1. Technical Solutions and Data Availability In order to accomplish the goals and outputs as outlined in this project, [State, Tribe, or Territory Name] [Name of Department or Agency] will be utilizing the following [data [and/or] IT management [and/or] technological] solutions[endnoteRef:23]. [23: If specific solutions and/or technological aspects of the project are not yet known (e.g., if the applicant is utilizing a contractor), the applicant should instead:

clearly state who will make the project’s technical decisions;

describe why they are the qualified/the appropriate party; and identify which business/admin. needs the selected technology or solutions will need to address.]

· [Name of data, IT management, or technical solution or descriptive title (if unnamed)][endnoteRef:24] [24: Expand this list as needed to identify and describe each project solution, including the the four sub-bullets (‘description’, ‘necessity and appropriateness’, ‘meeting business/administrative needs’, and ‘ability to implement and maintain’) for each.]

· Description: [Provide a short description of the solution and its project purpose].

· Necessity and Appropriateness: This solution is a necessary and appropriate choice for the proposed project because [provide a short rationale addressing this].

· Meeting Business/Administrative Needs: This solution helps [Department/Agency name or abbreviation] to address [list the business/administrative need(s) this solution helps to meet, as identified in the ‘Project Description’ and/or ‘Project Goals, Outputs, and Outcomes’ sections].

· Ability to Implement and Maintain: [Department/Agency name or abbreviation] is confident in its ability to implement and maintain this solution because [provide an explanation, referencing key personnel and/or partner and/or contractor qualifications and experience, as applicable].

The [knowledge [and/or] data [and/or] technology] outputs developed during the proposed project will enhance data sharing and availability for immediate stakeholders[endnoteRef:25], including the [Department/Agency name or abbreviation] [and [name formal partner(s), if applicable]], by [provide a detailed explanation]. Additionally, this project will enhance data sharing and availability for organizations across the Exchange Network[endnoteRef:26] by [provide a detailed explanation]. [25: Immediate stakeholders include the applicant organization and any EN partnering organizations (if applicable).] [26: This excludes immediate stakeholders; applicants should address how the proposed project benefits organizations across the Exchange Network who are not directly involved in the project’s implementation.]

1. Project Alignment with the E-Enterprise Digital Strategy (EEDS) The technical solution(s) as detailed in Section Five: Technical Understanding align with the three principles of the EEDS[endnoteRef:27]. [27: See Solicitation Notice, Appendix D ‘Alignment with the E-Enterprise Digital Strategy (EEDS)’ or view the full EEDS text here: https://e-enterprisefortheenvironment.net/wp-content/uploads/2019/08/Interim-E-Enterprise-Digital-Strategy-V-2.0.pdf.]

· 1st Principle: Build with an Information-Centric Approach:

· [Describe in detail how the project’s proposed technical solution(s) align with this principle].

· 2nd Principle: Adopt Shared Platforms:

· [Describe in detail how the project’s proposed technical solution(s) align with this principle].

· 3rd Principle: Adopt Customer-Centric Approaches:

· [Describe in detail how the project’s proposed technical solution(s) align with this principle].

The technical solutions of this project [do/do not] reflect the EEDS’s API-first approach [by [describe in detail how the project’s proposed technical solution(s) reflect an API-first approach]].

This project’s goals and outputs will also enhance data sharing and availability for [Department/Agency name or abbreviation] [and [name formal partner(s), if applicable]] specifically in the context of [the first EEDs principle [and/or] an API-first approach] by [provide a detailed explanation].

1. Overview of Project Budget Costs for each project goal and their associated output were provided in Section Two: Project Goals, Outputs, and Outcomes. The appropriateness of these estimated project costs is detailed in Table 6. Project Output Budget Appropriateness, as well as in the ‘summary of project costs’ below.

Table 6. Project Output Budget Appropriateness[endnoteRef:28] [28: Add or remove sections to Table 6. Project Output Budget Appropriateness as needed to include all project outputs.]

Output Number
Project Output Title
[Goal #].[Output #] (e.g., 1.1)
[Enter project output title, as listed in Section 2 of the project narrative]
How Were Costs Estimated:
[Enter a clear and detailed rationale]
Why Costs are Necessary:
[Enter a clear and detailed rationale]
Output Number
Project Output Title
[Goal #].[Output #] (e.g., 1.2)
[Enter project output title, as listed in Section 2 of the project narrative]
How Were Costs Estimated:
[Enter a clear and detailed rationale]
Why Costs are Necessary:
[Enter a clear and detailed rationale]
[Goal #].[Output #] (e.g., 1.3)
[Enter project output title, as listed in Section 2 of the project narrative]
How Were Costs Estimated:
[Enter a clear and detailed rationale]
Why Costs are Necessary:
[Enter a clear and detailed rationale]
Output Number
Project Output Title
[Goal #].[Output #] (e.g., 2.1)
[Enter project output title, as listed in Section 2 of the project narrative]
How Were Costs Estimated:
[Enter a clear and detailed rationale]
Why Costs are Necessary:
[Enter a clear and detailed rationale]
Output Number
Project Output Title
[Goal #].[Output #] (e.g., 2.2)
[Enter project output title, as listed in Section 2 of the project narrative]
How Were Costs Estimated:
[Enter a clear and detailed rationale]
Why Costs are Necessary:
[Enter a clear and detailed rationale]
Output Number
Project Output Title
[Goal #].[Output #] (e.g., 2.3)
[Enter project output title, as listed in Section 2 of the project narrative]
How Were Costs Estimated:
[Enter a clear and detailed rationale]
Why Costs are Necessary:
[Enter a clear and detailed rationale]
Output Number
Project Output Title
[Goal #].[Output #] (e.g., 3.1)
[Enter project output title, as listed in Section 2 of the project narrative]
How Were Costs Estimated:
[Enter a clear and detailed rationale]
Why Costs are Necessary:
[Enter a clear and detailed rationale]
Output Number
Project Output Title
[Goal #].[Output #] (e.g., 3.2)
[Enter project output title, as listed in Section 2 of the project narrative]
How Were Costs Estimated:
[Enter a clear and detailed rationale]
Why Costs are Necessary:
[Enter a clear and detailed rationale]
Output Number
Project Output Title
[Goal #].[Output #] (e.g., 1.3)
[Enter project output title, as listed in Section 2 of the project narrative]
How Were Costs Estimated:
[Enter a clear and detailed rationale]
Why Costs are Necessary:
[Enter a clear and detailed rationale]
Output Number
Project Output Title
[Goal #].[Output #] (e.g., 3.3)
[Enter project output title, as listed in Section 2 of the project narrative]
How Were Costs Estimated:
[Enter a clear and detailed rationale]
Why Costs are Necessary:
[Enter a clear and detailed rationale]

Summary of Project Costs

· The total budget for this project is $[dollar amount], with $[dollar amount] in direct grants funding and $[‘dollar amount’ or ‘0’] in in-kind support.

· This project [‘is’ or ‘is not’] submitting a coalition application with [an] eligible EN partnering organization[s]. $[‘Dollar amount’ or ‘0’] of the $[total budget, dollar amount] are funds for [‘the’ or ‘these’] project partner[s].

· The proposed project budget includes $[‘dollar amount’ or ‘0’] in contractual costs. [The [[contracting firm(s)] and/or [individual consultant(s)] and/or [vendor firm(s)]] will be procured through [enter procurement method][endnoteRef:29]]. [29: Procurement methods include ‘sealed bid’, ‘request for proposals’, or ‘non-competitive procurement’.]

· This project [‘does’ or ‘does not’] include a formal mentor[endnoteRef:30], [with an associated mentorship cost of $[‘dollar amount’][endnoteRef:31]. [30: Only applicable to applicants applying specifically under the ‘Individual Capacity Building with Mentorship’ EN project opportunity (see Solicitation Notice, Appendix C).] [31: Up to $15,000; see ‘Individual Capacity Building with Mentorship’ (Solicitation Notice, Appendix C).]

· This project [‘is’ or ‘is not’] charging $[‘dollar amount’ or ‘0’] in indirect costs [at a rate of [%]]. [The associated negotiated indirect cost rate agreement is active until [insert date: mm/dd/yyyy]].

· This project is requesting a total of $[‘dollar amount’ or ‘0’] in travel costs, [as detailed below in Table 7. Project Travel].

Table 7. Project Travel[endnoteRef:32] [32: Include table only if charging travel in the proposed project; add or remove rows to Table 7. Project Travel as needed to include all project trips.]

#
Destination and Travel Purpose
# of Travelers
Total Trip Cost
1
[Enter location and purpose of trip][endnoteRef:33] [33: E.g., ‘EN Regional Conference, Seattle’.]

[Enter #]

$[Enter amount]

2
[Enter location and purpose of trip]
[Enter #]

$[Enter amount]

Total Travel Costs:

$[Enter amount]

1. Past Performance[endnoteRef:34] [34: Applicants should not list prior EN grants in this section; this information should instead be included in the separate attachment titled ‘Additional Attachment E: List of Prior Exchange Network Assistance Agreements’ (see SN Appendix E).

FY 2024 Exchange Network Grant Program: Project Narrative [Month][Day], 2024

[[State, Tribe, or Territory Name] [Name of Department or Agency] has been awarded [‘#’] Exchange Network assistance agreements since 2002] or [State, Tribe, or Territory Name] [Name of Department or Agency] has never been awarded a prior Exchange Network assistance agreement].

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