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HomeMy WebLinkAboutC03-131 Early Childhood Services C~'~-/3l-~,~-- Hrr~.r~.f+-IIV1v 1'VK FEDERAL ASSISTANCE ~DATESUBMITTED: AppGq~tltler 08Y00023 5/13/2003 1. TYPE OF SUBMISSION 3. DATE RECEIVED BY STATE: State Appligtion Identlfler App6caUon Preappllcatfon Construction ~ Construction 4. DATE RECENED BY FEDERAL AGENCY Federal Identifier Non-Construction ~ Non-Construction 5. APPLICANT INFORMATION Legal Name: Health & Human.Service Eagle County EHS Organtzatlonal Unit Early Childhood Services Address (give dty, crounty, state, and zip code) Name and telephone number of the person to be contacted on matters involving POB 660 ~~ 551 Broadway Kathleen Forinash 970-328-8858 Eagle, CO 81631 Eagle Executive Director 6. EMPLOYER IDENTIFICATION NUMBER (EIN) 7. TYPE OF APPLICANT (enter appropriate letter th box) 8 4 6 0 0 0 7 6 2 A. State H. Independent Schaal Dist. B. County I. State Corrbolled Institrrtion of Higher Leaming 8. TYPE OF APPLICATION C. Municipal J. Private UNversfiy New ~ Contlnuatian ~ Revlgion D. Township K. Indian Tribe E.Irrterstata L. Individual F. Irdermuntc~pal M. Profit Organlzatlon If Revision, errter appropriate letter(s) in box(es): ~ ~ G. Spedai District N. Other (spedfy) A. Inaease Award B. Decease Award C. Inaease Duration 9. NAME OF FEDERAL AGENCY D. Decrease Duration Other (specify): HHS -Adminbtratlon for Children & Families 10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: 9 3 ~ 6 0 0 11. DESCRIPTIVE TPfLE OF APPLICANTS PROJECT: Eagle County Early Head Start TITLE: Early Head Start 12. AREAS AFFECTED BY PROJECT Eagle County, Colorado 13. PROPOSED PROJECT: 14. CONGRESSIONAL DISTRICTS OF : Start Date Ending Date a Applicant 3 rd D~~ ~ b. Project 6/0212003 6/01/2004 ~ 15. ESTIMATED FUNDING 16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 12372 PROCESS a Federal 640 $ 31 00 a. YES THIS PREAPPLICATION/APPLICATION WAS MADE AVAILABLE TO THE STATE , . EXECUTIVE ORDER 12372 PROCESS FOR REVIEW ON b Applicant $ 7,910.00 DATE c State $ 0.00 b NO X~ PROGRAM IS NOT COVERED BY E.0.12372 d Local $ 0.00 ~ OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW e Other $ 0.00 S 17. I THE APPLICANT DELINQUENT ON ANY FEDERAL DEBTS f Program Income $ 0.00 Yes If °Yes; attach an explanation. ~ No g Total $ 39,550.00 18. TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DA TA IN THIS APPLICATION ARE TRUE AND CORRECT. THE DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND TH E APPLICANT WILL COMPLY WITH THE ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED a Typed Name of Autho epresentative ~ ' e c Telephone number Michael Gallagher Board of Eagle County, Chair 970-328.8605 b Signature A on en ~ ~ e Date Signed -t m ~ ~ _ ~ - ~~ `~ ~OLORPA 0 0 Z a 0 V a c 0 v C 0 V C 0 Z Z O LL Z ~"' W D m r~ a ~n u~ o ~- ~ co ~ ~ ~ ~ ~ ~ c 0 0~ '"~ H ~ o O v O~ ~ m v m ~ ~ W O ` Z o 3 m z ~. v ~ ~ ~ ~ m ~v a ~ M O >" p ~ V w z Vl ~ Q ~ ~ w c ~ ~ F- ~ m m Z ,~ ~ a t6 44 tL z .c ~ ° m ~ v o ~ , c o 0 0 e0~ W ~ w Q N ~ M M a ~ ~ m ,~ v41 O ¢ ~ -0 v ~ O O Z O Co (O U ~ ~ ~ t co co m 0 "~ CO c '~ a O N ~ ' (0 a d ~ a> m o S ~ o O ~' `tQA~ m v Q U m c ~ c o U H ~ E C LL O ~ E ~ y V c ~ ~ rn ~ o. _N o U ~ y m ~ D CJ y (n ~ p Q I- ~ ~ ,~ m c > ~ a. . ~ b c o ~ ~°. v p rn ~ otS ~ a LL F- W tq ~ U o c F- d H ~ cd a ~ v ai .~ ~ s !_ Y ~- ~ CV c7 ~' 49 CC 1~ ~a ~~ m U v 0 a 0 7 O J Q Cf C a c 01 E N c O O O N c p .Q Q C c~ w m Q. 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C _~ C. Z N V a 0 M ri v ch 0 0 N C9 Ea le Coun Earl Head Start g h' Y 08Y00023 Budget and Budget Justification: Item Federal Funds Non-Federal Funds Construction Plumbing repairs at Basalt Middle Scholl $9,140 Group Socialization Site includes: • Remove kitchen cabinets • Cut approximately 60 feet x 2 feet concrete flooring • Remove concrete • Repair and replace ceramic file in boys locker room • Replace vinyl file in Group Socialization area • Repaint concrete in hallway • Replace cabinets and new Formica backsplash • Garbage disposal & installation • Side spray for sink and installation Bid does not include permit fees, any unforeseen materials and labors arising from lines (telephones, electrical etc.) that might be buried in the concrete or any other unforeseen obstacles discovered when cutting the concrete. Transportation Needs One mini-van for home visit use and to $22,500 transport supplies and equipment to community sites where group socializations, Parent Committees, Policy Council and parent trainings are held. Use Allowance $7,910 Use allowance: 395.5 Square feet of donated office space in the Basalt Middle School@ a value of $20 per square foot = $7,910 per year. TOTALS $31,640 $7,910 Eagle County Early Head Start is requesting one time fending to meet critical program needs related to health and safety issues at the Basalt Groep Socialization Site and Transportation needs. The program's Group Socialization site located in the Basalt Middle School is for the exclusive use of Early Head Start. The school has been generous in the donation of this premium space. -1- Eagle County Early Head Start 08YC0023 The site was renovated in 2002 to meet safety needs of infants, toddlers, and their families. Plumbing problems have arisen since renovation. The addition of a kitchen and bathroom in the 30-year-old building has put a burden on the plumbing line leading to the area. Lines started backing up within 1 month of use following renovation. The school agreed to pay "one time only" for Roto-Rooter to come out and clean the line. While cleaning the main plumbing line the procedure was filmed. Some sawdust was removed from the line but a dip in the main line that would cause future back-up problems was discovered. The plumber who installed the new plumbing reviewed the video and stated that the dip in the line was located in a section of the main line before where it had been tapped into for renovation, therefore, the plumbing installed for the renovation was not the problem. The dip occurs approximately 30 feet from the new plumbing. The sewer will back up again if anything bulky (paper towels, feminine products, etc.) were to be put in the line. Timing is essential for repair of the plumbing. Repairs need to done ASAP due to health and safety issues. Ideally, repairs need to be complete while school is out (June through beginning of August) because important because major digging of the concrete floor will cause disruption to the school routine and use of this space. Group Socializations could be held outdoors in local parks and in the playground area in the summer during repair or in other space located in the school while out for summer vacation. The second priority for one time funding is the addition of a mini-van. We are a home based option that uses the mini-van (7 passenger) to make visits to families homes and to transport supplies and equipment to community sites where we hold group socializations, Parent Committees, Policy Council and parent trainings. . In the past the program contracted with an established home visitation program in the Roaring Fork Area, which served Eagle County in the Basalt area. In Apri12003 this contract was terminated. One of the mini vans has been transferred to the Basalt site for 1.5 fte home visitor use and the program is short a vehicle for the three home visitors in the Eagle River Area. This has left the Eagle River Valley of Eagle County Home Visitors using their own vehicle or a county owned vehicle: Use of the current two Early Head Start vehicles is 85-100% of the time. County owned vehicles are used 8-10 days each month. Home Visitors use their own vehicle 8-10 days each month. Use of personal vehicles pose problems with insurance because Eagle County Government does not provide insurance on private vehicles for work purposes. Other concerns in using personal vehicles include proper maintenance for safety, i.e., tires with good tread, safety belts and age of vehicle. Cost to the program is higher when using county owned vehicles and personal vehicles. An EHS owned vehicle costs the program 18 cents per mile; county owned vehicles cost the program 46 cent per mile; and the use of a personal vehicle costs the program 35 cents per mile. Cost savings to the program would be $1,789 per year. If the program owns the vehicle for 6 years, the cost saving would be $10,734. -2- U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPENDIUM OF REQUIRED CERTIFICATIONS AND ASSURANCES SF 4246 ASSURANCES -NON-CONSTRUCTION PROGRAMS 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 agencies may require applicants to certify to additional assurances. !f such is the case, you will be notified. As the duly authorized representative of the applicant, I certify that the applicant.• 1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non-Federal share of project costs) to ensure proper planning, management and completion of the project described in Phis application. 2. ill give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. ill establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. 4. ill initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. ill comply with the intergovernmental Personnel Act of 1970 (42 U.S.C. 4278-4763) relating to prescribed standards for merit systems for programs funded under one of the nineteen statutes or regulations specified in Appendix A of OPM=s Standards for a Merit System of Personnel Administration (5 CFR 900, Subpart F). 6. ill comply with all Federal statutes relating to non-discrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on fhe bases of race, color or national origin; (b) Title /X of the Education Amendments of 1972, as amended (20 U.S.C. 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of fhe Rehabilitation Act of 1973, as amended (29 U.S.C. 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Acf of 1975, as amended (42 U.S.C. 6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Acf of 1972 (P.L. 92-255), as amended, relating to non-discrimination on the basis of drug abuse; (t) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P. L. 91-616), as amended, relating to non-discrimination on the bases of alcohol abuse or alcoholism; (g) 523 and 527 of the Public Health Service Act of 1912 (42 U S. C. 290 dd-3 and 290 ee-3), as amended, relating to confrdentialiiy of the alcohol and drug abuse patient records; (h) TrtJe Vll of the Civil Rights Act of 1968 (42 U. S. C. 3601 et seg.), as amended, relating to non-discrimination in the sale, rental or financing of housing; (1) any other non-discrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and ~~ the requirements of any other non-discrimination statute(s) which may apply to the application. 7. X11 comply, or has already complies, with the requirements of Titles 11 and 111 of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or Federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases. _ 8. X11 comply with the provisions of the Hatch Act (5 U.S.C. 1501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. 9. ill comply, as applicable, with the provisions of the Davis-Bacon Act (40 U.S.C. 276a to 276a-7), the Copeland Act (40 U.S.C. 276c and 18 U.S.G. 874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. 327-333), regarding labor standards for Federally assisted construction subagreements. 10. ill comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in fhe program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10, 000 or more. 11. ill comply with environmental standards which maybe prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. 1451 et seq.); (fl conformity of Federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U. S. C: 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P. L 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L 93-205) 12. Will comply with the Wld and Scenic Rivers Act of 1968 (16 U.S.C. 1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 13. ill assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. 470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. 469a-1 et seq.). 14. ~1l comply with P.L 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 15. ill comply with the Laboratory Animal Welfare Act of 9966 (P. L. 89-544, as amended, 7 U. S. C. 2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. X11 comply with the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. 4801 et seq.) which prohibits the use of lead based paint in the construction or rehabilitation of residence structures. 17. ill cause to be pertom'-ed the required financial and compliance audits in accordance with the single Audit Act of 1984. 18. ill comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this program. DRUG-FREE WORKPLACE REQUIREMENTS GRANTEES OTHER THAN INDIVIDUALS By signing and/orsubmitting this application orgrant agreement, the grantee is providing the certification set out below. This cert~cation is required by regulafions implementing the Drug-Free Workplace Act of 1988, 45 CFR, Part 76, Subpart F. The regulations published in the January 31, 1989 Federal Register, require certification by grantees that they will maintain adrug-free workplace. The certification set out below is a material representation of fact upon which reliance will be placed when HHS determines to award the grant. False certification or violation of the certificafion shall be grounds for suspension of payments, suspension or termination of grants, or government wide suspension or debarment. Workplaces under grants, for grantees other than individuals, need not be ident~ed on the certification. If known, they maybe identified in the grant application. If the grantee does not identify the workplaces at the time of application, or upon award, if there is no application, the grantee must keep the identity of the workplace(s) on file in its office and make the information available for Federal inspection. Failure to identify all known workplaces constitutes a violation of the grantee's drug-free workplace requirements. Workplace identifications must include the actual address of buildings (or parts of building) or other sites where work under the grant takes place. Categorical descriptions maybe used (e.g. all vehicles of a mass transit authority of State highway department while in operation, State employees in each local unemployment office, pertormers in concert halls or radio studios). If the workplace identfied to HHS changes during the performance of the grant, the grantee shall inform the agency of the change(s), it previously idenbfied the workplaces in question (see above). Definitions of terms in the Nonprocurement Suspension and Debarment common rule and Drug-Free Workplace common rule apply to this certification. Grantees' attention is called, in particular, to the following definitions from these rules: "Controlled substance"means a controlled substance in Schedules 1 through V of the Controlled Substances Act (21 USC 812) and as fu-ther defined by regulations (21 CFR, 130811 through 1308.15). "Conviction° means a finding of guilt (including a plea of nolo contenders) or imposition of sentence, orboth, by any judicial body charged with the responsibility to determine violations of the Federal of State criminal drug statutes; "Criminal drug statute°means aFederal ornon-Federal criminal statute involving the manufacture, distribution, dispensing use, or possession of any controlled substance; "Employee" means the employee of a grantee directly engaged in the pen`ormance of work under a grant including: (~~ All "direct charge° employees; (ii) all "i~-direct charge ° employees unless their impact of involvement is insignificant to the pertormance of the gram; and (iii) temporary personnel and consultants who are directly engaged in the pertormance of work under the grant and who are on the grantee's payroll. This definition does not include workers not on the payroll of the grantee (e.g., volunteers, even if used to meet a matching requirement; consultants or independent contractors not on the grantee's payroll; or employees of subrecipients or subcontractors in covered workplaces). The grantee certifies that it will provide adrug-free workplace by.• a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for violation of such prohibition; b) Establishing adrug-free awareness program to inform employees about: (1) The dangers of drug abuse in the workplace; (2) The grantee's policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, employee assistance programs; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; c) Making it a requirement that each employee to be engaged in the performance of the grant be ghren a copy of be statement required by paragraph (a); d) Notifying the employee in the statement required by paragraph (a) that as a condition of employment under the grant, the employee will: (1) Abide by the terms of the statement; and (2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction; e) Notifying fhe agency in writing within ten days after receiving notice under subparagraph (d)(2), from an employee orotherwise receiving actual notice ofsuch conviction. Employers of convicted employees must provide notice, including position title, to every grant officer or other designee on whose grant the convicted employee was working, unless the Federal agency has designated a central point for the receipt of such notices. Notice shall include the identification number(s) of each affected grant; fl Taking one of the following actions within 30 days of receiving notice under subparagraph (d)(2), with respect to any employee who is so convicted: (1) Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation. program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency. g) Making a good faith effort to continue to maintain adrug-free workplace through implementation of paragraphs (a) through (i). CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE Public Law 103-227, also known as the Pro-Children Act of 1994 (Act), requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used routinely or regularly for the provision of health, day care, early childhood development services, education or library services to children under the age of 18, if the services are funded by Federal program either directly or through State orlocal governments, by Federal grant, contract, loan, orloan guarantee. The law also applies to children's services that are provided in indoor facilities that are constructed, operated, or maintained with such Federal funds. The law does not apply to children's services provided in private residences; portions of facilities used for inpatient drug or alcohol treatment; service providers whose sole source of applicable Federal funds in medicare of medicaid; or facilities where WIC coupons are redeemed. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. By signing this certification, the offeror/contractor (for acquisitions) or applicant/grantee (for grants) certifies that the submitting organization will comply with the requirements of the Act and will not allow smoking within any portion of any indoor facility used for the provision of services for children as defined by the Act The submitting organization agrees that it will require that the language of this cert~cation be included in any subawards which subrecipients shall certify accordingly. • CERTIFICATION REGARDING DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY MATTERS -PRIMARY COVERED TRANSACTIONS By signing and submitting this proposal, the applicant, defined as the primary participant in accordance with 45 CFR Part 76 certifies to the best of his or her knowledge and believe that it and its principals: (a) are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from covered transaction by any Federal Department or agency; (b) have not within a 3-year period preceding this proposal been convicted or had a civil judgement rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or pertorming a public (Federal, State or local) transaction or contract under a public transaction: violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statement, or receiving stolen property; (c) are not presently indicted or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (7) (b) of this certif~cafion; and (d) have not within a 3-year period precedingthis application/proposal had one ormore public transaction (Federal, State or local) terminated for cause or default The inability of a person to provide the certification required above will not necessarily result in denial of participation in this covered transaction. If necessary, the prospective participant shall submit an explanation of why it cannot provide the certification. The Department of Health and Human Services' (HHS) determination whether to enter into this transaction. However, failure of the prospective primary participant to famish a cer~cation or an explanation shall disqualify such person from participation in this transaction. The prospective primary participant agrees that by submitting this proposal, if will include the clause entitled "Certfication Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transactions, "provided below without modification in all lower tier covered transactions. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY. AND VOLUNTARYEXCLUSION -LOWER TIER COVERED TRANSACTIONS (TO BE SUPPLIED TO LOWER TIER PARTICIPANTS) By signing and submitting this lower tier proposal, the prospective lower tier participant, as defined in 45 CFR, Part 76, certifies to the best of its knowledge and belief that it and its principals: (a) are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. (b) where the prospective lower her participant is unable to certify fo any of the above, such prospective participant shall attach an explanation to this proposal. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause entitled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transactions, "without modification in all lower tier covered transactions and in all solicitations for lower tier covered transactions. ~ • CERTIFICATION REGARDING LOBBYING FOR CONTRACTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS The undersigned cerfifiies to the best of his or her knowledge and belies, that.' (1) IVo Federal appropriate funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or atfempfing 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 the awarding of any Federal contract, the making ofany Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification ofany Federal contract, grant, loan, or cooperative agreement. (2) If any funds other fhan Federal appropriated funds have been paid or will be paid to any person influencing orattempting to influence an officeroremployeeorsn agency, a memberofcong-zess, an officer or employee of congress, oran 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 Form to Report Lobbying, ° 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 certificafion 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 certificafton shall be subject to a civil penalty or not less than $10, 000 and not more than $100, 000 for each such failure. Title Date Applicant Organisation