oppF18AS00264-cfda15.665-instructions.pdf

U.S. Fish and Wildlife Service Checklist for a New Financial Assistance Award

FWS 3-2460

September 30, 2015

Program Title:

DUNS Number:

(Enter date)

RESPONSE

1.

3.

4.

A.

B.

5.

6.

7.

8.

9.

10.

For each checklist item, select a response from the drop down list provided in the Response box. Where provided, select related statements from the drop down lists and use the checkboxes to indicate the location of required file documentation.

(Enter any program-generated application #)

CFDA Number:

Recipient Name:

Program Application #:

The Service has authority to issue financial assistance awards under this program. See the Authorization section of the program’s CFDA.gov profile for authorizing legislation.

Grants.gov Funding Opportunity #:

Award instrument determination: A determination was made. The financial assistance award instrument to be used is a (select from the drop down list):

Grants.gov NOFO:

Not posted: a NOFO was not posted on Grants.gov. The justification for not posting a NOFO to Grants.gov is that the award is (select from the drop down list):

Project Title:

Follow the instructions in the "Issuing a New Financial Assistance Award Guidance" posted on the Intranet at https://inside.fws.gov/go/post/FAPO-NewAwards to complete this form. Maintain the completed form in the official award file.

Recipient Type (select from drop down):

2.

(In perf. period start date field, enter "Signature date" or specific start date)

CHECKLIST ITEM

Perf. Period Start Date: Perf. Period End Date:

Funding tool evaluation: The project to be funded is financial assistance and not a contract/acquisition. The primary purpose of the award is to support or stimulate activities that are not for the direct benefit/use by the Service.

All related documentation will be maintained in the (check one): ____ official award file or ____ centralized subject-matter file.

Single source justification: This is a discretionary single source award meeting one or more criterion under 516 FW 6. A signed FWS Form 3-2452 will be maintained in the official award file.

Posted: A complete NOFO for the program/single source award was posted on Grants.gov. The required print screens dated prior to award will be maintained in the (check one): ____ official award file or ____ centralized subject-matter file.

Indirect cost rate circumstance: The applicant's indirect cost circumstance was determined and considered during the budget review. The final approved budget and notice of award reflect those considerations. The recipient is (select the applicable circumstance from the drop down list):

Budget review: A budget review was conducted and documented following the requirements in DIG 2013-06. All related documentation will be maintained in the (check one): ____ official award file or ____ centralized subject-matter file.

Complete and final application: This award is made based on an approved application that: 1) includes complete and signed SF 424 Application (or OMB-approved alternate), SF 424 Assurances, and SF LLL Lobbying (if applicable) forms; 2) includes a complete SF 424, Budget form and a budget narrative (or OMB-approved alternates); 3) matches the award to be made in regards to funding amount and project scope; and 4) will be maintained in the official award file.

Pre-award costs: Pre-award costs are approved under this award. The recipient’s written pre-award cost request will be maintained in the official award file.

Conflict of interest certifications: All staff and peer reviewers, evaluators, panel members, or advisors participating in the review of this discretionary award signed the required conflict of interest certification. Signed certifications related to this award will be maintained in the (check one):

____ official award file or ____ centralized subject-matter file.

Merit review: A merit review of this project was conducted following the requirements in DOI-AAAP-0009. All merit review documentation related to this award will be maintained in the (check one): ____ official award file or ____ cen. subject-matter file.

U.S. Fish and Wildlife Service Checklist for a New Financial Assistance Award

FWS 3-2460

September 30, 2015

RESPONSE

11.

12.

13.

14.

16.

19.

Printed Name of person signing

Agreements Officer Sign and Date

Printed Name of person signing

I, as the last point of review before funds are obligated, certify that all required pre-award actions and documentation are complete.

15.

All related documentation will be maintained in the (check one): ____ official award file or ____ centralized subject-matter file.

Single Audit status: The recipient’s single audit status was reviewed. The entity is (select from the drop down list):

For recipients who were required to submit a Single Audit in their most recently closed FY, the required Single Audit Database screen print dated prior to award will be maintained in the (check one): ____ official award file or ____ cen. subject-matter file.

17. SAM.gov registration status: The recipient’s SAM.gov registration status was reviewed. The entity (select from the drop down

18. SAM.gov exclusions search: A search of the SAM Exclusions database was conducted for the intended recipient and key/principal project personnel. The results were that (select from the drop down list):

Dated copies of the SAM Exclusions search/review results will be maintained in the official award file.

Payment method establishment: All steps required in the “Establishing a Recipient’s Payment Method Guidance” are complete.

Risk assessment: FWS Form 3-2462 was completed. Monitoring activities will be incorporated into the notice of award following the requirements in the Service’s “Recipient Risk Assessment Guidance”. The completed form will be maintained in the (check one): ____ official award file or ____ centralized subject-matter file.

CHECKLIST ITEM

Legal review: An Office of the Solicitor review was requested. A copy of the request and any response received will be maintained in the official award file.

All related documentation will be maintained in the (check one): ____ official award file or ____ centralized subject-matter file.

All related documentation will be maintained in the (check one): ____ official award file or ____ centralized subject-matter file.

I, as the last point of review before this award is passed to the Agreements Officer for obligation, certify that all pre-award actions and documentation that the program is required to complete are complete.

Program Representative Sign and Date

Section 106 NHPA review: A Section 106 NHPA review was conducted. The NHPA circumstance for this award is (select from the drop down list):

NEPA review: A NEPA review was conducted. The NEPA circumstance for this award is (select from the drop down list):

Section 7 ESA review: A Section 7 ESA review was conducted. The Section 7 ESA circumstance for this award is (select from the drop down list):

As applicable to the above circumstance, the required approved SAM waiver or SAM Entity Overview screen print dated prior to award showing an “Active” registration will be maintained in the official award file.

FWS New Award