2000-361 OUO ANCE NO/
AN ORDINANCE AUTHORIZING THE CITY MANAGER TO EXECUTE AN
AGREEMENT FOR A GRANT WITH THE TEXAS STATE LIBRARY AND ARCHIVES
COMMISSION TO PROVIDE LIBRARY SERVICES TO PRESCHOOL CHILDREN 1N
DAYCARE CENTERS,RATIFYING THE ACTIONS OF THE CITY MANAGER,
DIRECTOR OF THE LIBRARY, AND OTHER CITY OFFICIALS IN REGARD TO THE
GRANT APPLICATION, AND PROVIDING AN EFFECTIVE DATE
THE COUNCIL OF THE CITY OF DENTON HEREBY ORDAINS
~ That the Caty Manager as hereby authorized to execute an agreement for a
grant w~th the Texas State L~brary and Archives Commission to prowde hbrary serwces to
preschool children m daycare centers m substantially the same form as Exhibit A, whaeh is
~ncorporated by reference as ff fully set forth hereto The C~ty Manager, L~brary D~rector, and
any other C~ty officml are authorized to execute any further documents and certifications
necessary for obtaining the grant
~ That all prior act~uns of the Cay Manager, L~brary D~rector, and other C~ty
offimals an executing various doemnents and certafieanons w~th regard to sa~d grant application
are hereby approved and ratified
~ That the C~ty Council has found and determined that the meeting at whach
thas ordinance as considered ~s open to the pubhc and that nonce thereof was g~ven an accordance
w~th the provisions of the Texas open meetings law, TEX GOV'T CODE ch $ 51, as amended,
and that a quorum of the C~ty Council was present
~ That this ordinance shall become effective ~mme&ately upon its passage
and approval
PASSED AND APPROVED this the ~mq~~--~Zd day of (~d~~,, 2000
EULINE BROCK, MAYOR
ATTEST
JENNIFERiWALTERS, CITY SECRETARY
// "~r~ AL FORM
APPROVED AS TO LEG
HERBERT L PROUTY, CITY ATTORNEY
F \SHARED\DEPT\LOL\Our Documents\Ordmances\00\TSLAC hbrary grant doc
Page 2
TEXAS STATE LIBRARY & ARCHIVES COMMISSION
SPECIAL PROJECTS GRANT
Grant # 478-01029
I CONTRACTING PARTIES
Grantor Texas State Library and Archives Commission (TSLAC)
Grantee C~ty of Denton, Denton Pubhc L~brary
502 Oakland
Denton, Texas 76201
II TERM OF GRANT
September 1, 2000 to August 31, 2001
III GRANTOR CERTIFICATION
The Grantor certffies that (1) the servmes spemfied below are necessary and essential for actlwt~es
that are properly w~thm the statutory functions and programs of the affected orgamzahons, (2) the
services, supphes or materials contracted for are not reqmred by Section 21 of Amcle 16 of the
Constitution of Texas to be supphed under contract g~ven to the lowest b~dder, and (3) the grant is ~n
comphance w~th Texas Government Code § 441 121 et seq, the L~brary System Act, Texas
Government Code § 441 006, General Powers and Duties, P L 104-208, the L~brary Servmes and
Technology Act (LSTA), and the State Plan for the LSTA ~n Texas
IV GRANT AMOUNTS
A The total mount of the grant shall not exceed $ 42,394
B Source of funds
CFDA # 45 310
Institute of Museum and Lthrary Servmes, State Library Program
Federal F~scal Year 2000 Carryover
TSLAC's accounting coding
Index Code 34782, Object Code 7611
Page 1 of 7
F~scal Year 2001 C~ty of Denton Speeml Projects Grant
C Budget
Personnel $15,571
Fnnge Benefits 4,716
Travel 260
Equipment/Property 0
Supplies 19,081
Contractual 500
Other 2,266
Total Direct Costs $42,394
Indirect Costs 0
Total $42,394
V WRITTEN PRIOR APPROVALS FOR FISCAL AND PROGRAMMATIC CHANGES
A The Grantor must give written prior approval for any of the following fiscal changes
1 Making cumulative transfers among budget cost categories or projects whmh are expected
to exceed ten (10) p~rcent of the total grant
2 Transfemng any funds into a budget cost category that equals zero ($0)
Written prior approval is to be requested on the Prior Approval Request form and shall be
requested when neanng the 10% hm~t or the end of the grant term This provision does not
allow the grant to be exceeded All prior approvals should be requested by August 1, 2001
B The Grantor must give written prior approval for any of the following programmatic changes to
the application (Special ProJects Grants for State F~scal Year 2001)
1 Changing key persons specified m the grant, however, none of the personnel are
considered key personnel for the purpose of this section
2 Obtmmng the servmes of a third party to perform actlwtms that are central to the purposes
of the grant
3 Changing the scope or objectives (regardless of whether there ~s an assocmted budget
revision) A change m scope is a substantive difference in the approach or method used to
reach program objectives
Wntten pnor approval ~s to be requested on the Prior Approval Request form All prior
approvals should be requested by August 1, 2001
C The Grantor hereby g~ves prior approval for the ~tems specified under the following cost
categories Before the Grantee obligates or expends grant funds for additional items m the
following cost categories, the Grantor must g~ve written prior approval Written prior approval
~s to be requested on the Prior Approval Request form Written prior approval ~s also required ff
the item's cost or features are substantially different from what the grant specifies, or from a
prewous Prior Approval Request All prior approvals should be requested by August 1, 2001
Page 2 of 7
Fiscal Year 2001 City of Denton Special ProJects Grant
COST CATEGORIES
None
2 Insurance (If not reqmred by the ~ant)
None
3 R~arrangements and Alteratmns of FacIhtIes
None
None
Subject to the obligations and conditions set forth In Umform Grant Management Standards
(UGMS) Section III, Subpart C 32 (a), title to equipment acquired under a grant will vest
upon aeqmsltlOn m the grantee
Each piece of eqmpment/property is an article &nonexpendable, tangible personal property
havmg a useful life of more than one year and an acquisition cost orS1,000 or more
However, if the Grantee's capitalization level established for financial statement purposes is
lower than $1,000, the lower capitalization level should be used Equipment/property
includes furmmre, library materials, ere, purchased wholly or an part with grant funds The
prior approval amount is the capital expendtture, which means the cost of the
equipment/property including the cost to put it in place Capital expenditure for
equipment/property means the net invoice price of the equipment/property, including the cost
of any modifications, attachments, accessories, or auxiliary apparatus necessary to make it
usable for the purpose for whmh It IS acqmred Ancillary charges, such as taxes, duty,
protective m transit insurance, freight, and ~nstallataon may be included in, or excluded from,
capital expenditure cost m accordance w~th the Grantee's regular accounting practices
VI. STATEMENT OF SERVICES TO BE PERFORMED
A The Grantee will comply with their grant apphcatlon (Special ProJects Grants for SFY 2001) as
approved by the Grantor
B The Grantee will comply with the Special ProJects Grants Program Guidelmes for SFY 2001
C The Grantee will comply with the Rules for Admimstenng the Library Systems Act Note that
Rule 1 97 (a) will not be applicable dunng the term &this grant
D The Grantee will comply wah the following two parts of the Governor's Office of Budget and
Planning Uniform Grant Management Standards (UGMS), revised January 1999, located at
http //www governor state tx us/Budget/budget_guldehnes html
1 Cost Pnnclples for State and Local Governments and Other Affected Entrees
(adapted from OMB Circular A-87)
Page 3 of 7
Fiscal Year 2001 City of Denton Special ProJects Grant
2 State Uniform Admlmstrat~ve Requirement for Grants and Cooperative Agreements
(adapted from OMB Circular A-102)
For grants funded with State funds, the Grantee w~ll comply with the third part of UGMS, the
State of Texas Single Audit Circular For grants funded with Federal funds, the Grantee will
comply with the Office of Management and Budget (OMB) Circular A-133, Audits of States,
Local Governments, and Non-Profit Orgamzatlons (revised 6/97), located at http//www
whttehouse gov/OMB/ctrculars
E The Grantee roll comply with the Institute of Museum and L~brary Services' 45 Code of Federal
Regulatmns, Part 1183, Umform Adm~mstratlve Requirements for Grants and Cooperative
Agreements to States and Local Governments (adapted from OMB C~reular A-102)
F The Grantee will send the Grantor a copy of any management letters msued by the auchtor with
the reporting package (or written notification, as appheable) The audit's Schedule of
Expen&tures of Federal and State ~lwards will list the amount of awards expended for each
award year separately
G The Grantee may not obligate grant funds after August 31, 2001 By October 31, 2001, all
obligations must be liquidated and all unexpended funds must be returned to the Grantor
H The Grantee will add any program Income to the funds committed to the grant, using such
program income for the purposes and under the conditions of the grant The source and amount
of the program income must be explmned in box 12 of the quarterly Fmancml Status Report
I As reqmred by the Institute of Museum and Library Services, the Grantee will clearly state the
following when Issuing statements, press releases, requests for proposals, bid sohcltat~ons, and
other documents describing projects or programs funded in whole or in part with Federal money
1 the pementage of the total costs of the program or project which wall be financed with
Federal money,
2 the dollar amount of Federal funds for the project or program, and
3 the pementage and dollar amount of the total costs of the project or program that will be
financed by non-government sources
J The Grantee certffies by this contract that it wall comply with the Assurances - Non-
ConStructton Programs (OMB Standard Form 124B), the Certfficat~on Regarrhng Debarment,
Suspension, Inehglblllty and Voluntary Exclusion Lower T~er Covered Transactions, and the
Certification Regarding Lobbying as submitted to the grantor Additional assurances are listed
in UGMS, Subpart B 14
K The Grantee affirms that it has not given, offered to g~ve, nor intends to give at any t~me
hereafter, any economic opportumty, future employment, gift, loan, gratuity, special discount,
trip, ~favor or service to a public servant in connection with this contract The Grantee further
affirms that ~ts employees or agents shall neither sohclt nor accept gratmt~es, favors or anything
of monetary value from contractors, potential contractors or parties to subagreements
Page 4 of 7
Fiscal Year 2001 City of Denton Spemal ProJects Grant
L The Grantee agrees to prowde the Grantor with one (1) set of all public relations materials
produced under thts grant
M The Grantee agrees to maintain records on all eqmpment/property w~th an acqms~t~on cost of
$1000 or more The Grantee will reconcile the eqmpment/property records w~th a physical
inventory of the eqmpment/pmperty every two years
The UGMS Subpart C, Sec 32, (d) (3) reqmres certmn ~tems of eqmpment (stereo systems, still
and v~deo cameras, facsimile mactunes, VCRs and VCR/TV combinations, and cellular and
portable telephones) to be mtuntmned on inventory ~f their cost is above $500
N The Grantee agrees to submit the Eqmpment/Property Acqmred form by October 31, 2001 for all
eqmpmenffpmperty purchased dunng that grant year Th~s hst must balance w~th the
eqmpment/property purchased w~th prior approval amounts
O The State Legislature has charged the Grantor w~th submitting performance measurement
reports that specify the level of services provided by its programs and serwces The Grantee
agrees to submit reports that are t~mely, accurate, aud~table, and consastent w~th defimt~ons
1 The Grantee agrees to submtt the Umform Stat~stmal Reporting Form for Specml Projects
Grants and Explanation of Variance according to the following schedule
t ~0.O.r g 1 lg.P...0X L0~ Due Date
September 1, 2000 - November 30, 2000 December 6, 2000
December 1, 2000 - February 28, 2001 March 6, 2001
March 1, 2001 - May 31, 2001 June 6, 2001
June 1, 2001 - August 31, 2001 September 6, 2001
If hbrary materials ordered w~th grant funds are received after the end of the grant year, a
final Umfonn Statistical Report may also be reqmred covering receipt of those materials
Th~s final Umform Stattstlcal Report wall be due on or before November 15, 2001
2 The Grantee will submit Evaluation Reports to the Grantor according to the following
schedule
~ Due Date
September 1, 2000 - February 28, 2001 March 30, 2001
March 1, 2001 - August 31, 2001 September 28, 2001
P The Grantee agrees to submit the quarterly Flnancml Status Report for th~s contract accordang to
the following schedule
September 1, 2000 - November 30, 2000 December 29, 2000
December 1, 2000 - February 28, 2001 March 30, 2001
March 1, 2001 - May 31, 2001 June 29, 2001
June 1, 2001 - August 31, 2001 September 28, 2001
A final Fmancml Status Report ~s due on or before November 15, 2001
Page 5 of 7
F~scal Year 2001 Caty of Denton Spemal ProJects Grant
VII. PAYMENT FOR SERVICES
The Grantee ~s restricted to one of two methods for requestmg funds from the Grantor The Grantee
may request an advance payment for estimated expenditures to be ~ncurred for the upcommg 30
days, or request a reimbursement of the actual expenditures for the Grantee's normal bflhng cycle
The Grantee will request payment on the OMB Standard Form 270, Request for Advance or
Reimbursement, usmg box 12 rather than box 11 ffrequest~ng funds ~n advance Requests may be
made monthly, quarterly or any other t~me period, but not more than once a month
To request funds, Form 270 ~s due to the Grantor by the 15t~ of the month If requesting a
reimbursement, the funds will usually be received by the Grantee w~thln 10 days after TSLAC
receives the funds from the federal government If requesting an advance, the Grantee must follow
procedures that minimize the t~me elapsing between the receipt and the d~sbursement of advanced
grant funds Requests for Advance fimds will be received by the first working day of the advance
period on the request
VIII. CONTACTS AT TSLAC
Questions or concerns about programmatm ~ssues should be d~rected to th~s grant's ProJect Manager
Kathleen Walls
Grants Coordinator
Phone 512-463-5532
E-ma~l kathleen walls~tsl state tx us
Questions or concerns about regulatory or financml ~ssues should be d~rected to
Raymond M Dmz
Manager of A¢countmg and Grants Department
Phone 512-463-6626
E-mml raymond dlaz~tsl state tx us
Fax, rather than mml, Prior Approval Request forms to thru grant's Project Manager
Kathleen Walls
Grants Coordmator
F~x 512-463-8800
Fax, rather than mml, reports to
Grants Accountant
Phone 512-463-5472
Fax 512-463-3560
Payments to the Grantor, such as those for excess advanced funds or for ~nterest earned each quarter
on advattced funds, should be ma~led w~th an explanation of the purpose of the payment and the
grant number to
Accounting and Grants Depar~ent
Texas State L~brary and Archives Commms~on
PO Box 12927
Austin, TX 78711-2927
Page 6 of 7
F~scal Year 2001 C~ty of Denton Specml ProJects Grant
IX APPLICABLE AND GOVERNING LAW
A Thru grant shall be governed by the laws of the State of Texas All duties of e~ther party shall bc
legally performable in Texas The apphcable law for any legal dmputes arising out of this
contract shall be the law of(and all actions hereunder shall be brought in) thc State of Texas, and
the forum and venue for such disputes shall be Travis County, District Court
B This grant is subject to avallabdlty of funds
X SIGNATURES
GRANTOR GRANTEE
Texas State Library and Archives Commission City of Denton, Denton Public Library
Edward Seldenberg, Assistant Stat{ Librarian Signature (I~ut--~' ' ..t st~¢nj~o~ial empowered
to enter into contr~)
Date
Michael W dez
Typewritten or Pnnted Name
~r~/~/~'~r/ Clty Manager
Raymo~ad/M Dlaz,~Aecotmtlng a~nd Grants Title
Manager
Date ~:~,,2a--tf~ Date September 26, 2000
Page 7 of 7
Fiscal Year 2001 City of Denton Special ProJects Grant
The undersigned certffies, to the best of bas or her knowledge and behef, that
1 No Federal appropriated funds have been prod or will be prod, by or on behalf of the undersigned,
to any person for influencing or attempting to ~nfluence 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 connecUon with the makang of any Federal grant, the entenng ~nto of any cooperative
agreement, and the extension, continuation, renewal, amendment, or modification of any Federal
grant or cooperative agreement
2 If any funds other than Federal appropriated funds have been prod or will be prod 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 ~n
counecUon w~th th~s Federal grant or cooperative agreement, the undersigned shall complete and
submit Standard Form -LLL, 'D~sclosure Form to Report Lobbying,' ~n accordance w~th its
instructions
3 The undersigned shall reqmre that the language of tbas certlficaUon be included ~n the award
documents for all subawards at all t~ers (including subgrants, contracts under grants and
cooperative agreements, and subcontracts) and that all subrec~p~ents shall certify and d~sclose
accordingly
Tbas certfficat~on is a material representation of fact upon which rehance was placed by the Texas State
L~brary when tlns transaction was made or entered into Submission of tbas certfficatlon ~s a
prereqms~te for maktng or entering into tbas transaction ~mposed by Section 1352, T~tle 31, U S Code
Any person who fails to file the reqmred eerUficat~on shall be subject to a mwl penalty of not less than
$10,000 and not more than $100,000 for each such failure
Denton Public L~brary C~ty of Denton Special Projects
Orgamzatton Name ProJect Grant
M~chael iW. Jez, (;ltv Manager
Name and Tttle of Authortzed Representattve
34 CFR 82 110 TSL 9304
flus certfficatton Is reqmred by the regulations tmplementlng Executive Order 12549, Debarment and
Suspension, 34 CFR Part 85, Section 85 510, Participant's msponslbdlties The regulatxons were published as
Part VH of the May' 26, 1988 ~ (pages 19160-12911) Cop~es of the regulations may be obtained
by contacting the p~rson to w~ch tlus proposal is submitted
(BEFORE,COMPLETING CERTIFICATION, READ INSTRUCTIONS ON REVERSE)
(1) The prospective lower t~er participant certifies, by submission of ttus proposal, that neither it nor ItS
pnncipals are presently debarred, suspended, proposed for debarment, declared ineligible, or volun~nly
excluded from participation m tlus transaotton by any Federal department or agency
(2) Where the ~rospective lower tier parttcipant is unable to certify to any of the statements in tlus
certification, such prospective participant shall attach an explanation to ttus proposal
Denton Public Library
~ Apphcant
Michael /W. Oez~ City Manager
Name and Ittle of Authorized Cert~fymg Officml
Instructions for Certification
1 By signing and submitting this proposal, the prospective lower tier participant is providing the certification set
out below
2 The certlficatmn ~n this clause is a material representatmn of fact upon which reliance was placed when this
transaction was entered into If it is later determined that the prospective lower her participant knowingly
rendered an erroneous certlflcatmn, in additmn to other remedies available to the Federal Government, the
department or agency with which th[s transachon originated may pursue available remedies, including
suspension and/or debarment
3 The prospecbve lower t~er part~mpant shall provide unmediate written notme to the person to which th~s proposal
is submitted, if at any time, the prospective lower bet partimpant learns that its cexhficat~on was erroneous when
submitted or has become erroneous by reason of changed circumstances
4 The terms "covered transaction," "debarred," "suspended," "mehgnble," "lower t~er covered transaction,"
"participant" "person," "primary covered transaction," "pnnmpal," "proposal," and "voluntarily excluded," as
used m this clause, have the meamngs set out m the Definitions and coverage secttuns of rules lmplemantmg
Executive Order 12549 You may contact the person to which th~s proposal Is submitted for assistance in
obtalmng a copy of those regulations
5 The prospective lower tier participant agrees by subunttmg this proposal that, should the proposed covered
transaction be entered into, it shall not knowingly enter into any lower tier covered transaction w~th a person who
is debarred, suspended, declared mehglble, or voluntarily excluded from participation m this covered transaction,
unless authorized by the department or agency with which tl~s transaction originated
6 The prospective lower tier participant further agrees by subml~ng ttus proposal that it will include the clause
t~tle "Certification Regarding Debarment, Suspension, Inehg~blhty, and Voluntary Exclusion--Lower Tier
Covered Transaction," vathout modification, in all lower t~er covered transactions and in all sohc~tatlons for
lower t~er covered transactions
7 A participant in a covered transaction may rely upon a certification of a prospective pammpant m a lower t~er
covered transaction that it ~s not debarred, suspended, mehg~ble, or voluntarily excluded from the covered
transaction, unless it knows that the certlficataon is erroneous A parhc~pant may decide the method and
frequency by which ~t determines the eligibility of Its pnnmpals Each part~mpant may, but is not reqmred to,
check the Nonprocurement L~st
8 Nothing contained in the foregoing shall be construed to require estabhslunent of a system of records in order to
render m good faith the certification required by this clause The knowledge and reformation of a participant ~s
not required to exceed that which is normally possessed by a prudent person in the ordinary course of business
deahngs
9 Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered
transaction knowingly enters into a lower t~er covered transaction w~th a person who is suspended, debarred,
mehg~ble, or voluntarily excluded from participation m this transactmn, in addition to other remedies available to
the Federal Government, the department or agency w~th which this transaction ongmated may pursue available
remedies, including suspension and/or debarment
9 W~ll comply, as applicable, with the provisions of the Davis- 12 Will comply w~th the W~ld and Scemc R~vere Act of
Bacon Act (40 U S C §{276a to 276a-7), the Copeland Act 1968 (16 U S C {{1271 et seq ) related to protecting
(40 U S C {276¢ and 18 U 8 C {874), and the Contract components or potential components of the national
Work Hours and JSafety Standards Act (40 U S C {{327- wild and scemc r~vers system
333), regarding labor standards for federally-assisted
construchon subeigreements 13 W~ll assist the awarding agency ~n assuring comphance
with Section 106 of the Natmnal Hmtonc Preservation
10 W~iI comply, ~f e~pplioable, with flood ~nsurence pumhase Act of 1966, as amended (16 U S C {470), EO 11593
requirements of, Seotmn 102(a) of the Flood Disaster (~dent~hcat~on and protectmn of historic properbes), and
Protecbon Act of 1973 (P L 93-234) which requires the Amhaeologmal and Hmtonc Preservation Act of
recipients m a special flood hazard area to participate in the 1974 (16 U S C {{469a 1 et seq )
program and to ~umhase flood ~nsuranca *f the total cost of
~nsureble construction and acquisition ~s $10,000 or more 14 W~il comply w~th P L 93 348 regarding the protectmn of
human subjects ~nvolved m reseamh, development, and
11 W~ll comply with enwronmental standards which may be related act~wt~es supported by th~s award of assistance
prescnbed pursuant to the following (a) institution of
environmental qqallty control measures under the National 15 W~il comply w~th the Laboratory Animal Welfare Act of
Enwronmantel P~ohcy Act of 1969 (P L 91-190) and 1966 (P L 89-544, as amended, 7 U S C {{2131 et
Executive Orderl(EO) 11514, (b) nctiflcation of vlolabng seq ) pertaining to the care, handhng, and treatment of
fac{htms pursuan~ to EO 11738, (o) protection of wetlands warm blooded animals held for reseamh, teaching, or
pursuant to EO 11990, (d) evaluation of flood hazards in other activitms supported by th~s award of assistance
floodplains in e~ordanca with EO 11988, (e) assurance of
project conslster~oy with the approved State management 16 W~II comply w~th the Lead-Based Paint Pomonmg
program developed under the Ccastst Zone Management Prevenhon Act (42 U S C {{4801 et seq ) which
Act of 1972 (16 ,U S C {{1451 et aeq ), (f) conformity of prohibits the use of lead-based paint in constructmn or
Federal actions 1~o State (Clean Air) Implementation Plans rehabihtat~on of residence structures
under Section 176(o) of the Clean Air ACt of 1955, as
amended (42 U!S C {{7401 et seq ), (g) protection of 17 Will cause to be performed the required financial and
underground so[Jmes of ddnklng water under the Safe comphance audits in accordance w~th the S~ngle Audit
Drinking Water Act of 1974, as amended (P L 93-523), Act Amendments of 1996 and OMB Circular No A-133,
and, (h) protection of endangered species under the "Audits of States, Local Governments, and Non-Profit
Endangered Sp~les Act of 1973, as amended (P L 93- Organizatmns"
205) 18 Will comply with all apphcable requirements of all other
Federal laws, executive orders, regulations, and pohmes
governing th~s program
SIGNATURE/~_~~_~,..,..~OF AUTHORIZED CERTIFYING OFFICIAL TITLE C3 t,y t4ana get
ApPL~.,~N~' ORGANI~TION~.~'- ~ DATE SUBMI~ED
Standa~ Form 424B (Rev 7~7) Back
OMB Approval No 0348 0040
ASSURANCES - NON-CONSTRUCTION PROGRAMS
Public reporting burden for th~s collection of information ~s estimated to average 15 minutes per response, includ~ng t~me for reviewer
instructions, seamh~ng existing data soumes, gathenng and maintaining the data needed, and completing and reviewing the collection ~
information Send comments regarding the burden estimate or any other aspect of this collection of information, ~nclud~ng suggestions f(
reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0040), Washington, DC 20503
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY
NOTE Certain of these assurances may not be applicable to your project or program If you have questions, please contact the
awarding agency Further, certain Federal awarding agencms may require applicants to certify to addit~onal assurances If such
is the case, you w~ll be not~fled
As the duly authorized representative of the applicant, I certify that the applicant
1 Has the legal authonty to apply for Federal assistance Act of 1973, as amended (29 U S C §794), which
and the inst~tut~onal, managenal end financial capab~hty prohibits discrimination on the basis of hand~caps, (d)
(including funds sufficient to pay the non-Federal share the Age Discrimination Act of 1975, as amended (42
of project cost) to ensure proper planning, management U S C §§6101-6107), which prohibits d~scnminstlon
and completion of the project descnbed ~n th~s on the basis of age, (e) the Drug Abuse Office and
application Treatment Act of 1972 (P L 92-255), as amended,
relating to nondiscflmlnation on the basis of drug
2 W~II give the awarding agency, the Comptroller General abuse, (f) the Comprehensive Alcohol Abuse and
of the United States and, ~f appropriate, the State, Alcoholism Prevention, Treatment and Rehabilitation
through any authorized representst~ve, access to and Act of 1970 (P L 91-616), as amended, relating to
the right to examine all records, books, papers, or nondiscrimination on the basis of alcohol abuse or
documents related to the award, and will establish a alcoholism, (g) §§523 and 827 of the Pubhc Health
proper accounting system in accordance with generally Service Act of 1912 (42 U S C §§290 rid-3 and 290 ee
a~epted accounting standards or agency d~roctives 3), as amended, relating to confidentiality of alcohol
and drug abuse patient records, (h) Title VIII of the
3 Will establish safeguards to prohibit employees from C~wl Rights Act of 1968 (42 U S C §§3601 et eeq ), as
using their posit~ons for a purpose that constitutes or amended, relating to nondiscrimination in the sale,
presents the appearance of personal or o~ganizat~onal rental or financing of housing, (0 any other
conffict of Interest, or personal gain nondiscrimination provisions in the specific statute(s)
under which application for Federal assistance is being
4 Will initiate end completetheworkw~thm the applicable made, end, (j) the requirements of any other
time frame after receipt of approval of the awarding nondiscrimination statute(s) which may apply to the
agency application
5 W~II comply w~th the Intergovernmental Personnel Act of 7 Will comply, or has already complied, w{th the
1970 (42 USC §§4728-4763)relating to prescribed requirements of Titles II and III of the Uniform
standards for merit systems for programs funded under Relocation Assistance and Real Property Acquisit~on
one of the 19 statutes or regulations specified in Policies Act of 1970 (PL 91-646)which provide for
Appendix A of OPM's Standards for a Medt System of fair and equitable treatment of persons displaced or
Personnel Administration (5 C F R 900, Subpart F) whose property is acquired as a result of Federal or
federally-assisted programs These requirements apply
6 Will comply w~th all Federal statutes relating to to all interests in real property acquired for project
nondiscnmlnahon These include but are not I~mried to purposes regardless of Federal participation in
(a) T~tle VI of the C~vil Rights ACt of 1964 (P L 88 352) pumhases
which prohibits d~scnmmatton on the bas~s of race, color
or national origin, (b) Title IX of the Education 8 W~II comply, as applicable, with provisions of the
Amendments of 1972, as amended (20 U S C §§1681- Hatch ACt (5 U S C §§1601-1508 and 7324-7328)
1683, end 1685-1686), which prohibits dlscnmmabon on which limit the political activities of employees whose
the basis of sex, (c) Section 504 of the Rehabihtat~on pr~ncipst employment aoflvifl&a are funded tn whole or
in part with Federal funds
Previous Edition Usable Standard Form 424B (Rev 7-97)
Authorized for Local Reproduction Prescribed by OMB Circular A-102