oppDHS-17-GPD-134-00-01-cfda97.134.pdf

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Submission D:20061219143208- 05'00' D:20061219143305- 05'00' Grant Application Package Grants.gov Grant Application Package Grants.gov CFDA Number:

Opportunity Title:

Offering Agency:

Agency Contact:

Opportunity Open Date:

Opportunity Close Date:

CFDA Description:

Opportunity Number:

Competition ID:

Application Filing Name:

Select Forms to Complete Mandatory Optional Instructions About the Application Package.

· This application package is used to apply for the specific Federal funding opportunity referenced in this application package. Please verify that you have downloaded and completed the application package for the correct funding opportunity announcement.

· This application can be completed in its entirety offline using Adobe Reader.

· You can save your application at any time by clicking the "Save" button at the top of your screen.

Using the Application Package.

· The application package is a compilation of forms, such as the SF-424, budget forms, attachment forms, and narratives.

· It is recommended that the SF-424 cover page be the first form completed for the application package. Some data entered on the SF-424 cover page will pre-populate data fields in other subsequent forms in the application package.

· Forms identified as Mandatory are required to be filled out to successfully submit your grant application at a minimum. Optional Forms are used to provide additional support for this application or may be required for specific types of grant activity. Reference the application package instructions for more information regarding Optional Forms.

· Select the check box next to the form's name to add the form to the application package. To navigate to the form in the application package, click on the underlined form name. To remove a form from the application package, uncheck the box next to the form name.

· When you open a form, required fields are highlighted in yellow with a red border. Optional fields and completed fields are displayed in white. If you enter invalid or incomplete information in a field, you will receive an error message.

· Your application will be rejected if you do not follow the Agency and Grants.gov guidance on file naming conventions. Please review the application instructions for this Opportunity Package for specific guidelines and refer to FAQs in the Grants.gov Applicants tab.

Submitting the Application Package.

· You can save the application as you work on it by clicking on the "Save" button.

· Click on the "Check Package for Errors" button to ensure that you have completed all required data fields. Correct any errors. If no errors are found, save the application package. The "Save & Submit" button will also become active.

· You need to be registered with Grants.gov and granted the role of Authorized Organizational Representative by your organization's eBIZ POC in order to successfully submit your application.

· Click on the "Save & Submit" button to begin the application submission process. (You must be connected to the Internet at this time.) You will be taken to the applicant login page to enter your Grants.gov username and password. Follow all onscreen instructions for submission. Upon submission, you will be provided with a Grants.gov Tracking Number.

· You will receive a series of emails after submission: 1. Successful transmission to Grants.gov and your application is undergoing a series of system checks, 2. An email either indicating specific errors in your application OR an email indicating that your submission is being prepared for agency download, and 3. Your application has been retrieved from Grants.gov by the funding agency for further review only after the agency acknowledges the download. If you receive an email with an error, please correct your application and resubmit.

Additional Application Package Information.

· Additional instructions and FAQs about the Application Package can be found in the Grants.gov Applicants tab.

This electronic grants application is intended to be used to apply for the specific Federal funding opportunity referenced here.

If the Federal funding opportunity listed is not the opportunity for which you want to apply, close this application package by clicking on the "Cancel" button at the top of this screen. You will then need to locate the correct Federal funding opportunity, download its application and then apply.

Name- Version Form Tag Name Mandatory Name- Version Form Tag Name Optional Name- Version Form Tag Name SelectedOptional Name- Version Form Tag Name SelectedMandatory Grant Application Package Grants.gov Grant Application Package Grants.gov

ERROR!

This application package has been opened and saved with a version of Adobe Acrobat or Adobe Reader that is not compatible with Grants.gov.

THIS PACKAGE IS NO LONGER VALID AND CANNOT BE SUBMITTED.

To download the Grants.gov required version visit:

http://www.grants.gov/web/grants/applicants/adobe-software-compatibility.html For more information:

http://www.grants.gov/web/grants/applicants/applicant-faqs.html Also the Grants.gov Contact Center is available for further assistance. The Contact Center is available 24 hours a day, 7 days a week excluding federal holidays.

Email: support@grants.gov Phone: 1-800-518-4726 (local toll free). For international callers, please dial 1-606-545-5035 to speak with a Contact Center representative.

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You have attempted to open this document with a version of Adobe Acrobat or Adobe Reader that is not compatible with Grants.gov.

YOU CANNOT PROCEED WITH THIS DOCUMENT!

You are using the incorrect version:

Install the required version and try again.

To download the Grants.gov required version visit:

http://www.grants.gov/web/grants/applicants/adobe-software-compatibility.html For more information:

http://www.grants.gov/web/grants/applicants/applicant-faqs.html Also the Grants.gov Contact Center is available for further assistance. The Contact Center is available 24 hours a day, 7 days a week excluding federal holidays.

Email: support@grants.gov Phone: 1-800-518-4726 (local toll free). For international callers, please dial 1-606-545-5035 to speak with a Contact Center representative.

OMB Number: 4040-0004 Expiration Date: 10/31/2019

* 1. Type of Submission:

* 2. Type of Application:

* 3. Date Received:

4. Applicant Identifier:

5a. Federal Entity Identifier:

5b. Federal Award Identifier:

6. Date Received by State:

7. State Application Identifier:

* a. Legal Name:

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

* c. Organizational DUNS:

* Street1:

Street2:

* City:

County/Parish:

* State:

Province:

* Country:

* Zip / Postal Code:

Department Name:

Division Name:

Prefix:

* First Name:

Middle Name:

* Last Name:

Suffix:

Title:

Organizational Affiliation:

* Telephone Number:

Fax Number:

* Email:

* If Revision, select appropriate letter(s):

* Other (Specify):

State Use Only:

8. APPLICANT INFORMATION:

d. Address:

e. Organizational Unit:

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

Application for Federal Assistance SF-424 Type of Submission is required. Select one type of submission in accordance with agency instructions.

Type of Submission: Select one type of submission in accordance with agency instructions. One selection is required.

Type of Application: Select one type of application in accordance with agency instructions. One selection is required.

Type of Application is required. Select one type of application in accordance with agency instructions.

* 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.

Application for Federal Assistance SF-424 Form Attachments:

* a. Federal

* b. Applicant

* c. State

* d. Local

* e. Other

* f. Program Income

* g. TOTAL Prefix:

* First Name:

Middle Name:

* Last Name:

Suffix:

* Title:

* Telephone Number:

* Email:

Fax Number:

* Signature of Authorized Representative:

* Date Signed:

18. Estimated Funding ($):

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) ** 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:

Application for Federal Assistance SF-424

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

* b. Program/Project

* a. Start Date:

* b. End Date:

16. Congressional Districts Of:

17. Proposed Project:

E.O. 12372 Review selection is required: Select status of Review.

Application Subject to Review: One selection is required.

Applicant Delinquent on Federal Debt: A selection is required.

Applicant Delinquent on Federal Debt is required: Select an option.

* 20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.)

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

If "Yes", provide explanation and attach 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:

ATTACHMENTS FORM

Instructions: On this form, you will attach the various files that make up your grant application. Please consult with the appropriate Agency Guidelines for more information about each needed file. Please remember that any files you attach must be in the document format and named as specified in the Guidelines.

Instructions: On this form, you will attach the various files that make up your grant application. Please consult with the appropriate Agency Guidelines for more information about each needed file. Please remember that any files you attach must be in the document format and named as specified in the Guidelines.

15) Please attach Attachment 15

1) Please attach Attachment 1

2) Please attach Attachment 2

3) Please attach Attachment 3

4) Please attach Attachment 4

5) Please attach Attachment 5

6) Please attach Attachment 6

7) Please attach Attachment 7

8) Please attach Attachment 8

9) Please attach Attachment 9

10) Please attach Attachment 10

11) Please attach Attachment 11

12) Please attach Attachment 12

13) Please attach Attachment 13

14) Please attach Attachment 14 Important: Please attach your files in the proper sequence. See the appropriate Agency Guidelines for details.

Important: Please attach your files in the proper sequence. See the appropriate Agency Guidelines for details.

Select if the type of submission is a Preapplication.:

Submission Type - Application: Select one type of submission in accordance with agency instructions. One selection is required.

Select if the type of submission is an Application.:

Submission Type - Changed Application: Select one type of submission in accordance with agency instructions. One selection is required.

Select this submission if requested by the agency to change or correct a previously submitted application. Unless requested by the agency, applicants may not use this to submit changes after the closing date.:

Application Type - New: Select one type of application in accordance with agency instructions. One selection is required..

Select New if the application is being submitted to an agency for the first time.:

Application Type - Continuation: Select one type of application in accordance with agency instructions. One selection is required.

Select Continuation if the submission is an extension for an additional funding/budget period for a project with a projected completion date. This can include renewals.:

Application Type - Revision: Select one type of application in accordance with agency instructions. One selection is required.

Select Revision if the submission is a change in the Federal Government’s financial obligation or contingent liability from an existing obligation. :

If outside the US, enter 00-000.

This field is required.:

Program District: Enter the Congressional District in the format: 2 character State Abbreviation - 3 character District Number. Examples: CA-005 for California's 5th district, CA-012 for California's 12th district.

If all districts in a state are affected, enter "all" for the district number. Example: MD-all for all congressional districts in Maryland.

If nationwide (all districts in all states), enter US-all.

If the program/project is outside the US, enter 00-000.

This field is required.: