ORDER NO. 30122 LETTER OF INTENT TO USDOJ SAFE HAVEN Came to be heard this the 22nd day of January, 2007, with a motion made by Commissioner Letz, seconded by Commissioner Williams. The Court unanimously approved by vote of 4-0-0 to: Approve the non-binding Letter of Intent, based on the sample provided, to the Office of Violence Against Women, United States Department of Justice for the OVW FY 2007 Safe Havens: Supervised Visitation and Safe Exchange Programs, CDFA 16,527; OVW-2007-1525, fora 3 year grant to be administered under a Memorandum of Understanding with the Hill County Crisis Council. ~, ~ COMMISSIONERS' COURT AGENDA REOUEST 3~/s 3- PLEASE FURNISH ONE ORIGINAL AND NINE COPIES OF THIS REOUEST AND DOCUMENTS TO BE REVIEWED BY THE COURT. MADE BY: Ilse Bailey MEETING DATE: 1/22/07 OFFICE: County Attorney TIME PREFERRED: 10:00 a.m. SUBJECT: Consider, discuss and approve application to USDOJ Safe Haven: Supervised Visitation and Safe Exchange Program (OVW-2007-1525) for athree-year grant to be administered under a Memorandum of Understanding with the Hill Country Crisis Council EXECUTIVE SESSION REQUESTED: (PLEASE STATE REASON) N/A NAME OF PERSON ADDRESSING THE COURT: Sheryl Howard, Letty Turkett ESTIMATED LENGTH OF PRESENTATION: 15 minutes IF PERSONNEL MATTER -NAME OF EMPLOYEE: N/A Time for submitting this request for Court to assure that the matter is posted in accordance with Title 5, Chapter 551 and 552, Government Code, is as follows: Meeting scheduled for Mondays: THIS REQUEST RECEIVED BY: THIS REQUEST RECEIVED ON: 5:00 P.M. previous Tuesday. All Agenda Requests will be screened by the County Judge's Office to determine if adequate information has been prepared for the Court's formal consideration and action at time of Court Meetings. Your cooperation will be appreciated and contribute towards you request being addressed at the earliest opportunity. See Agenda Request Rules Adopted by Commissioners' Court. ,;~p;C E pF: . ~? . T\ Vary o~~i/ COUNTI'JUOGE PAT TINLEY COMMISSIONERS COURT H.A. °DUSTER° BALRWIN~ PCT. ~ WILLIAM "HILL° WILLIAMS, PQ. 2 JONATHAN LErz, PCr. 3 DAVE N¢xolson, Pcr. J January 22, 2007 THE COUNTY COURT of KERRCOUNTY,TEXAS 700 Mnuu Ri~xxvu u:, Texns 78028 TEt.. (830)792-2211 Fnx: B30)792-22IR E-mna. kerrcacc(~kic.com Office of Violence Against Women United States Department of Justice 800 K Street, N.W., Suite 920 Washington, DC 20530 V1A:OVW.SunervisedVistation~c usdoj.~ To Whom It May Concern: The County of Kerr, Texas intends to apply for funds under OVW FY 2007 Safe Havens: Supervised Visitation and Safe Exchange Programs, CDFA 16.527; OVW- 2007-1525. NAME: The Honorable Pat Tinley DATE: January 22, 2007 Position: Kerr County Judge Organization: County of Kerr, Texas; Kerr County Commissioners Court Address: Kerr County Courthouse, 700 Main Street City/State/ZIP: Kerrville, Texas 78028 Phone:830-792-2211 FAX: 830-792-2218 E-mail: ptinleyr?co.kerr.tx.us Thant: you, Sincerely, "~,~ `~The~onbta le~ at Tinley Kerr County Judge CLERK JANNET' PIEPE0. COURT COORUINATO ~I.ATIIY I~JITCNEL SAMPLE Letter of Intent January 8, 2007 Office of Violence Against Women United States Department of Justice 800 K Street, N.W., Suite 920 Washington, DC 20530 VIA: OV W.SupervisedVisitation(ci,usdol.~o_v To Whom It May Concern: The County of Kerr, Texas intends to apply for funds under the OV W FY 2007 Safe Havens: Supervised Visitation and Safe Exchange Program. NAME: The Honorable Pat Tinley DATE: January 8, 2007 Position: Kerr County Judge Organization: County of Kerr, Texas; Kerr County Commissioners Court Address: Ken County Courthouse, 700 Main Street City/State/ZIP: Kerrville, Texas 78028 Phone: 830-792-2211 FAX: 830-792-2218 E-mail: Thank you. Sincerely. The Honorable Pat Tinley Kerr County Judge LAW OFFICES OF STEPHEN R. TURKETT, P.C. 8151effersoq Suite 130 Kerrville, Texas 78028 STEPHEN TURKETT ATTORNEY A.ND COUNSELOR AT LAW (830) 257-1927 www.[urkettlaw.com (830) 257-1937 Fax sNrkett@Nrkettlaw.com ZHill Country CRISIS ~-, Council „~„~~~, uu~ ~t,~ p,e, ,s ha~~~ SHERYL L HOWARD Office 830-257-7088 P.O. Box 291 & 17 Ext. 31 Kerrville, TX 78029-1877 Fax 830-257-7097 sherylhoward kv hillcountryu isiscouncil.org ,... U.S. Department of Justice - Office on Violence Against Women The U.S. Department of Justice, Office on Violence Against Women (OVW) (www.usdoi.aov/ovw) is pleased to announce that it is seeking applications for the Safe Havens: Supervised Visitation and Safe Exchange Program. This program furthers the Department's mission by providing an opportunity for communities to support the supervised visitation and safe exchange of children in situations involving domestic violence, dating violence, child abuse, sexual assault, or stalking. OVW FY 2007 Safe Havens: Supervised Visitation and Safe Exchange Program Eligibility i" Applicants are limited to states, Indian tribal governments, and units of local government. (See "Eligibility," page 4) Deadline Letters of intent to apply should be submitted by Tuesday, January 23, 2007. All Applicants should register online with Grants.gov by Tuesday, January 23, 2007. All applications are due by 8:00 p.m. E.S.T. on Tuesday, February 13, 2007. (See "Deadline: Application," page 4) Contact Information For assistance with the requirements of this solicitation; contact the Office on Violence Against Women at (202)307-6026. This application must be submitted through Grants.gov. For technical assistance with submitting the application, caN the Grants.gov Customer Support Hotline at 1-800-518-4726. Grants.gov Number assigned to announcement OVW-2007-1525 CONTENTS Overview of the OVW Safe Havens: Supervised Visitation and Safe Exchange Grant Program Deadline: Letter of Intent Deadline: Registration Deadline: Application Eligibility • Faith-Based and Other Community Organizations OVW Safe Havens: Supervised Visitation and Safe Exchange Information • Types of Applicants • Availability of Funds • Award Period • Award Amounts • Program Scope • Activities That May Compromise Victim Safety • Unallowable Activities Performance Measures How to Apply What An Application Must Include: Standard Form 424 Standard Assurances and Certifications Program Narrative Budget and Budget Narrative MOU Letter of Nonsupplanting Financial Capability Questionnaire Indirect Cost Rate Agreement Selection Criteria Review Process Additional Requirements Application Checklist Appendices p. 3 p. 3 p. 4 p. 4 p. 4 p. 5 p. 6 p. 6 p. 8 p. 8 p. 8 p. 8 p.10 p.10 p.10 p.11 p.11 p.20 p.20 p.21 p.22 p.26 2 OVW Safe Havens: Supervised Visitation and Safe Exchange Grant Program (CFDA 16.527) Overview About the Office on Violence Against Women The Office on Violence Against Women (OVW) is a component of the U.S. Department of Justice. Created in 1995, OVW implements the Violence Against Women Act (VAWA) and subsequent legislation and provides national leadership against domestic violence, dating violence, sexual assault, and stalking. Since its inception, OVW has launched a multifaceted approach to responding to these crimes. By forging state, local and tribal partnerships among police, prosecutors, the judiciary, victim advocates, health care providers, faith leaders and others, OVW grants help provide victims with the protection and services they need to pursue safe and healthy lives and enable communities to hold offenders accountable. About the Safe Havens: Supervised Visitation and Safe Exchange Grant Program The Safe Havens: Supervised Visitation and Safe Exchange Grant Program (Supervised Visitation Program) provides an opportunity for communities to support the supervised visitation and safe exchange of children in situations involving domestic violence, dating violence, child abuse, sexual assault, or stalking. Studies have shown that the risk of violence is often greater for victims of domestic violence and their children after separation from an abusive situation.' Even after separation, batterers often use visitation and exchange of children as an opportunity to inflict additional emotional, physical, and/or psychological abuse on victims and their children. Visitation and exchange services provided through the Supervised Visitation Program should reflect a clear understanding of the dynamics of domestic violence, dating violence, sexual assault and stalking; the impact of domestic violence on children; and the importance of holding offenders accountable for their actions. Deadline: Letter of Intent All applicants who intend to apply for FY 2007 funding under this program are encouraged to submit anon-binding letter of intent, (Please see http //www usdoi oov/ovw/docs/samole letter of intent odf) to OVW by Tuesday, January 23, 2007. You may send the letter to OVW at OVW.SuoervisedVisitationCc~usdoi.gov. OVW will use these letters to forecast the number of peer review panels needed to review competitive applications. ' Jaffe, P.G., "Children of Domestic Violence: Special Challenges in Custody and Visitation Dispute Resolution." In J. Carter, C. Heisler, & M. Runner (Eds.), Domestic Violence and Children: Resolving Custody and Visitation Disputes, A National Judicial Curriculum (San Francisco: Family Violence Prevention Fund), pp. 22-30. Deadline: Registration The Grants.gov registration deadline is Tuesday, January 23, 2007. Registering with Grants.gov is a one-time process; however, if you are afirst-time registrant, it could take several weeks to have your registration validated and confirmed and to receive your user password. It is highly recommended that you start the registration process as early as possible to prevent delays in submitting your application package to our agency by the deadline specified. There are three steps that you must complete before you are able to register: 1) register with Central Contractor Registry (CCR), 2) be authorized as an Authorized Grantee/Recipient Official (AGO) in your organization, and 3) register yourself as an (AGO}. For more information, go fo wvnv.grants.gov. Note: Your CCR registration must be renewed once a year. Failure to renew your CCR registration will prohibit submission of a grant application through Grants.gov. Deadline: Application The due date for applying for funding under this announcement is 8:00 pm E.S.T., Tuesday, February 13, 2007. Eligibility It is very important that you review this information carefully. Applications that are submitted by non-eligible entities will be screened out during an initial review process. By statute, eligible entities for the Supervised Visitation Program are states,2 Indian tribal governments, and units of local governments. Applicants must enter into or expand the scope of existing contracts and cooperative agreements with public or private nonprofit entities, including faith-based and community organizations, to provide supervised visitation and safe visitation exchange of children in situations involving domestic violence, dating violence, child abuse, sexual assault, or stalking. All applicants are required to enter into a collaborative working relationship with state or local courts and a faith and/or community-based nonprofit, nongovemmental domestic violence or sexual assault victim services organization that represents the views and concerns of domestic violence and sexual assault victims. Unit of Local Government For the purposes of this Program, a unit of local government is any city, county, township, town, borough, parish, village, or other general-purpose political subdivision of a State3; an Indian tribe that performs law enforcement functions as determined by the Secretary of the Interior; or, for the purpose of assistance eligibility, any agency of the District of Columbia government or the United States Government performing law enforcement functions in and for the District of Columbia or any Trust Territory of the United States. Local courts, police departments, pre-trial service agencies, district or city attorneys' offices, sheriffs' departments, probation and parole departments, shelters, nonprofit, nongovernmental victim services 2 Far the purposes of this grant program, a state is defined to include all states, the District of Columbia, the Commonwealth of Puerto Rico, and the Virgin Islands, American Samoa, Guam and the Northern Mariana Islands. ' As defined in 42 U.S.C. § 3791, "unit of local government" also includes any law enforcement distr~d or judicial enforcement district that is established under applicable State law and has the authority to, in a manner independent -- of other State entities, establish a budget and impose taxes. agencies, and universities are not considered units of local government for the purposes of this grant program unless they meet the "unit of local government" definition under 42 U.S.C. § 3791 (see footnote 3 below). Applications from typically "non-eligible" entities that want to assert "unit of local government" under 42 U.S.C. § 3791 must include proof of such status. These agencies or organizations may administer grant funds and assume responsibility for the development and implementation of the project, but they may not apply directly to OVW for funding support. Indian Tribe For the purposes of this Program, Indian tribe is defined as any tribe, band, pueblo, nation, or other organized group or community of Indians, including any Alaska Native village or regional or village corporation (as defined in or established under the Alaska Native Claims Settlement Act, 43 U.S.C. §1601 et seq.), that is recognized as eligible for the special programs and services provided by the United States to Indians because of their status as Indians (25 U.S.C. § 450b (e)). Any applicant representing a consortium of tribal governments and/or organizations must submit a resolution from the constituent tribal governments andlor organizations supporting the application. Notice to Tribal Applicants The Violence Against Women Act of 2005 created a new program, the Grants to Tribal Governments Program, which is tailored to the needs of tribal governments in responding to domestic violence, dating violence, sexual assault, and stalking. This program combines the purpose areas from several existing programs including this one. While tribal governments are still eligible applicants within this program, there is no longer a tribal set aside; the new statute requires the set-aside funds to be transferred to the new program. Tribes will no longer need to ""' submit several applications for multiple purposes. They will now be able to apply for all of the purposes, including supervised visitation and exchange, within one application for the new program. The solicitation for the Grants to Tribal Governments Program is expected to be available in January, 2007. Notwithstanding the new grant program, all eligible applications from Indian Tribal governments submitted under this solicitation will be considered for funding. Funding to Faith-Based and Community Organizations Consistent with President George W. Bush's Executive Order 13279, dated December 12, 2002, and 28 C.F.R. Part 38, it is DOJ policy that faith-based and community organizations that statutorily qualify as eligible applicants under DOJ programs are invited and encouraged to apply for assistance awards to fund eligible grant activities. Faith-based and community organizations will be considered for awards on the same basis as any other eligible applicants and, if they receive assistance awards, will be treated on an equal basis with all other grantees in the administration of such avrards. No eligible applicant or grantee will be discriminated for or against on the basis of its religious character or affiliation, religious name, or the religious composition of its board of directors or persons working in the organization. Faith-based organizations receiving DOJ assistance awards retain their independence and do not lose or have to modify their religious identity (e.g., removing religious symbols) to receive assistance awards. DOJ grant funds, however, may not be used to fund any inherently religious activity, such as prayer or worship. Inherently religious activity is permissible, although it cannot occur during an activity funded with DOJ grant funds; rather, such religious activity must be separate in time or place from the DOJ-funded program. Further, participation in such activity by individuals receiving services must lie voluntary. Programs funded by DOJ are not perrnitted to discriminate in the provision of services on the basis of a beneficiary's religion. Applicants are encouraged to review the Civil Rights Compliance section under "Additional Requirements" in this announcement. OVW Safe Havens: Supervised Visitation and Safe Exchange Grant Program -Specific Information Types of Applicants In FY 2007, OVW will accept applications for the Supervised Visitation Program from new applicants and current grantees. New applicants are former grantees or applicants that have never received Supervised Visitation Program funds. Please note that a current grantee whose grant award will have expired by February 13, 2007 must apply as a new applicant. Grantees that received 24 months of funding in FY 2005, received 12 months of funding in FY 2006, or whose current grant award wilt expire after February 13, 2007 are eligible to apply for continuation funding. FY 2006 grantees who received a 24-month grant award are not eligible to apply for FY 2007 Supervised Visitation Program grant funds. In FY 2007, new grantees are only eligible to apply for athree-year Supervised Visitation development project grant. Current grantees are eligible to apply for two types of continuation project grants: a five-year project or a standard two-year project (please note: State applicants are only eligible to apply for a standard two-year project). The development and continuation project grants are described below. Development Projects New applicants are invited to apply for a development project grant. This includes former ~°- Supervised Visitation grantees who did not receive funding in FY 2005, or a 24 month award in FY 2006, or whose current grant award will have expired before February 13, 2007. The duration of this development grant is three-years (36 months) divided into 2 phases,° a planning phase and an implementation phase. 1) Planning Phase: The grantee will allocate a set amount of funds (limited to $50,000) for the planning phase of the grant. These grantees (communities with established visitation centers seeking to incorporate a Supervised Visitation Program component into their services or communities seeking to establish a new visitation and exchange center) will work with OVW and Supervised Visitation Technical Assistance providers to establish the groundwork for developing a Supervised Visitation Program. The planning phase may be for up to 18 months, depending upon the length of time it takes the grantee to successfully complete this phase and meet program requirements. The planning phase may include, but is not limited to, the following activities: • Conducting a community needs assessment; • Funding a project coordinator; • Coordinating and conducting planning meetings; • Establishing an advisory/consulting committee; and • Developing visitation center policies and protocols. 2) Implementation Phase: Upon successfully completing the planning phase, grantees will begin implementing supervised visitation and exchange services over the remainder of `Notwithstanding the "phased" implementation, applicants will submit 1 budget reflecting 36 months of activity. the project period. Funds are limited to $350,000 for the course of the implementation phase. The grantee will continue working with OVW and OVW Technical Assistance providers to implement their Supervised Visitation project. Please see Appendix A for a sample development budget. Applicants applying for a development project grant are required to set aside $50,000 for OVW training and technical assistance. Continuation Protects Current grantees are eligible to apply for supplemental funds to continue and/or enhance their existing programs. a Multi-jurisdictional and state initiatives must meet statutory and program requirements for each jurisdiction involved in the project. In FY 2007, the Supervised Visitation Program is offering two different funding options for current grantees: 1) the standard two-year project; or 2) the optional five-year project. Please note that state applicants are only eligible to apply for the standard two-year project. Five-Year Protect Under the five-year project, successful local and tribal applicantsfi, including non-state multi- jurisdictional' local applicants, will receive funding in descending amounts over alive-year period and will not be required to compete for continuation funding after the first two-year (24 month) cycle. Subsequent funding for years three through five is contingent upon continued appropriations for the program, and grantee compliance with program requirements and grant award special conditions. Continuation funding is, therefore, not guaranteed. Additionally, OVW may choose to discontinue the five-year project, in which case participants would be eligible to apply for any funds available generally to continuation applicants. Successful °~ applicants will also be required to submit afve-year strategic plan describing their commitment and capacity to continue the project when federal funds are decreased or no longer available. Subject to the stated contingencies, awards will be made in the following manner: successful applicants will receive an initial award in FY 2007, based on a 24 month budget for no more than $250,000; a subsequent award will be made in FY 2009 for no more than $175,000 for 24 months; and in FY 2011 the final award will be based on a 12 month budget for no more than $75,000, for a total of no more than $500,000. At the completion of the five-year project, successful grantees and their supervised visitation/safe exchange provider subgrantee partner(s) will not be eligible to apply to a Supervised Visitation solicitation for 12 calendar months after their final financial and progress reports have been submitted.e OVW has the discretion to make grants for greater or lesser amounts than requested and to negotiate the scope of work and budget with applicants prior to award of a grant. Standard Two-year Protect State, local and tribal applicants may elect to submit an application and budget reflecting a standard two-year (24 month) project. Local and tribal applicants (including multi-jurisdictional local applicants) may apply for up to $200,000 for 24 months of funding. State applicants may apply for up to $750,000 for 24 months of funding, depending upon the number ofjurisdictions s In future years, funding priority will be given to fve-year grant projects. s State applicants may not apply for five-year project funding. ' A local unit of government proposing two or more supervised visitation centers in two or more jurisdictions. a Please note that the next OVW Safe Havens Solicitation for which you may be eligible to apply after the completion of your five-year award could be more than 12 months from the time your final financial and progress reports are submitted. For example, if a grantee's project ends on 9/30/2012, but the final financial and progress reports are not submitted until 111/2013, the grantee will have to wait until 1/1/2014 to apply for the next open Sate Havens Solictation, which based on current solicitation release patterns may not occur until December 2014. in which supervised visitation centers are being proposed. State applicants must propose supervised visitation centers in at least two jurisdictions. State applicants proposing supervised visitation centers in two jurisdictions can apply for up to $200,000 for 24 months. State applicants proposing supervised visitation centers in more than two jurisdictions are eligible to apply for $200,000 for the first two jurisdictions and up to $150,000 for each additional jurisdiction in which a supervised visitation center is proposed, not to exceed a total budget request of $750,000. State applicants proposing supervised visitation centers in six or more jurisdictions may not exceed the $750,000 budget cap. Please note that OVW reserves the right to make awards for lesser or greater amounts. Availability of Funds All awards are subject to the availability of appropriated funds and any modifications or additional requirements that may be imposed by law. Award Period The award period for these grants will be: • Development project applicants: three-years (36 months) • Continuation project applicants: two-years (24 months) Budgets must reflect the fuN length of project activity, and the total "estimated funding" (block 15) on the SF-424 must reflect either 24 or 36 months. Award Amounts Applicants should carefully consider the resources needed to successfully implement the proposed project and present a realistic budget that accurately reflects project costs. Supervised Visitation Program funds for FY 2007 will be awarded based on the following guidelines: up to $400,000 for athree-year (36 months) development project; up to $250,000 for the first two years (24 months) of a five-veer local or tribal continuation project; up to $200,000 for a standard two-year (24 months) local or tribal continuation project; and from $200,000 to $750,000 for a standard two-year (24 months) state continuation project depending upon the number of jurisdictions in which supervised visitation centers are being proposed. Please see page 16 for a table listing the budget caps for the development and continuation projects. Funds for years three through five of the five-year Continuation Project will be awarded upon successful completion of the prior years' grant activities and continued appropriation of the Supervised Visitation Program. OVW reserves the right to make awards for lesser or greater amounts. Program Scope The scope of the Supervised Visitation Program is defined by the following statutory considerations and minimum requirements. Applicants must address these considerations and requirements in the Project Narrative section of the application. Statutory Program Purposes: By statute 42 U.S.C. § 10420 (a), funds under the Supervised Visitation Program may be used for the following purposes: • Provide supervised visitation and safe exchange of children by and between parents in situations involving domestic violence, dating violence, child abuse, sexual assault, or stalking; Protect children from the trauma of witnessing domestic or dating violence or experiencing abduction, injury, or death during parent and child visitation exchanges; Protect parents or caretakers who are victims of domestic and dating violence from experiencing further violence, abuse, and threats during child visitation exchanges; and Protect children from the trauma of experiencing sexual assault or other forms of physical assault or abuse during parent and child visitation and visitation exchanges. Grant funds may be used for, but are not limited to, the following activities: • Establishing supervised visitation and safe exchange services to meet a demonstrated need; • Strengthening existing program operations; • Expanding center services; • Establishing statewide training and technical assistance projects; • Increasing center staff; • Enhancing security; and • Developing training for staff and volunteers. Statutory Considerations The following statutory considerations will be taken into account when awarding grants: • The number of families to be served by the proposed visitation programs and services; • The extent fo which the proposed supervised visitation programs and services serve underserved populations;9 ~'^ The extent to which the applicant demonstrates cooperation and collaboration with non- profit, nongovernmental entities in the local community served, including the state or tribal domestic violence coalitions, state or tribal sexual assault coalitions, faith-and/or community- based shelters, and programs for domestic violence and sexual assault victims; and • The extent to which the applicant demonstrates coordination and collaboration with state and local court systems, including mechanisms for communication and referral. Minimum Requirements Under 42 U.S.C. § 10420(c), all applicants for the Supervised Visitation Program must: • Demonstrate expertise in the area of family violence, including the areas of domestic violence or sexual assault, as appropriate; • Ensure that any fees charged to individuals for use of programs and services are based on the income of those individuals, unless otherwise provided by court order; • Demonstrate that adequate security measures, including adequate facilities, procedures, and personnel capable of preventing violence, are in place for the operation of supervised visitation programs and services or safe visitation exchange; and • Prescribe standards by which supervised visitation or safe visitation exchange will occur. e The term "underserved populations" (42 U.S.C.§ 13925(a)(33)) includes populations underserved because of geographic location, underserved racial and ethnic populations, populations underserved because of special needs (such as language barriers, disabilities, alienage status, or age), and any other population determined to be underserved by the Attorney General. Activities That Mav Compromise Victim Safetv Ensuring victim safety is a guiding principle underlying this Program. Experience has shown that certain practices may compromise victim safety rather than enhance it. Certain responses by the authorities may have the effect of minimizing or trivializing the offenders criminal behavior. Accordingly, consistent with the goals of ensuring victim safety while holding perpetrators accountable for the criminal conduct, applicants are strongly discouraged from proposing projects that include any activities that may compromise victim safety, such as the following: • Mediation, alternative dispute resolution, or family counseling as a response to domestic violence, sexual assault, or stalking; • Offering perpetrators the option of entering pre-trial diversion programs; • Batterer intervention programs that do not use the coercive power of the criminal justice system to hold batterers accountable for their behaviors; and • Provision of services on the condition that victims seek protection orders, counseling, or some other course of action with which they disagree. Unallowable Activities Grant funds under the Supervised Visitation Program may not be used for any unauthorized purposes, including but not limited to the following activities: • Lobbying, or lobbying -related activities; • Fundraising; • Research projects; • Therapeutic visitation; • Parent EducationlBatterer Intervention Programs; • Individual, group, and family counseling; and • Physical modifications to buildings, including minor renovations. Performance Measures To assist in fulfilling the Department's responsibilities under the Government Pertormance and Results Act (GPRA), Public Law 103-62, applicants who receive funding under this solicitation must provide data that measures the results of their work. Performance measures for this solicitation are as follows: Objective Performance Measures Data Grantee Provides Strengthen 1) the number of supervised visitation This information will be partnerships for and exchange centers supported by the provided to OVW through safer program; semi-annual progress report communities and forms. Please see enhance the 2} the number of supervised visits http:/lmuskie.usm.maine.edu/v Nation's capacity between parents and children; and, awameiJformhavens.htm#dwnf to prevent, solve, rm for a sample form. and control crime. 3) the number of supervised exchanges behveen parents and children. 10 How to Apply DOJ is participating in the e-Government initiative, one of 25 initiatives included in the President's Management Agenda. Part of this initiative -- Grants.gov - is a "one-stop storefront" that provides a unified process for all customers of federal grants to find funding opportunities and apply for funding. Grants.gov Instructions Complete instructions can be found at www.grants.gov. Please note that Grants.gov is not the Grants Management System (GMS) through which OVW applicants have submitted applications in previous years. If you experience difficulties at any point during this process, please call the Grants.gov Customer Support Hotline at 1-800-518-4726. In addition, applicants must send via overnight delivery a complete hard-copy original of the application, including signed copies of all required Assurances and Certifications, postmarked by Tuesday. February 13 2007 to: The Office on Violence Against Women c/o Lockheed Martin Aspen Systems Corporation OVW Safe Havens: Supervised Visitation and Safe Exchange Program Mail Stop 2K 2277 Research Boulevard Rockville, MD 20850 (301)519-5000 r CFDA Number The Catalog of Federal Domestic Assistance number fer this program is 16.527, titled "Supervised Visitation Program" and the funding opportunity number is OVW-2007-1525. A DUNS Number is Required The Office of Management and Budget requires that all business and nonprofit applicants for Federal funds include a DUNS (Data Universal Numeric System) number in their application for a new award or renewal of an award. Applications without a DUNS number are incomplete. A DUNS number is a unique nine-digit sequence recognized as the universal standard for identifying and keeping track of entities receiving Federal funds. The identifier is used for tracking purposes and to validate address and point of contact information. The DUNS number will be used throughout the grant life cycle. Obtaining a DUNS number is a free, simple, one- time activity. Obtain one by calling 1-866-705-5711 or by applying online at http://www.dunandbradstreet.com. Individuals are exempt from this requirement. What an Application Must Include Applicants must complete each of the following sections as part of their response to this solicitation. It is the responsibility of the applicant to ensure that the application is complete. OVW will remove the application from consideration prior to peer review if the application is incomplete. For each section listed below, please note the corresponding maximum point value that may be assigned during the review process. The proposal should follow the order below for easy reading. Please be sure to number each page of the application Peer reviewers will not receive materials submitted beyond those required by this solicitation. 11 Applications must use the following page format requirements: • Double spaced • 8'/ x 11 inch paper • One inch margins • Type no smaller than 12 point, Times New Roman font • No more than one page each for Summary Data Sheet and Abstract • No more than 5 pages for Status of the Current Project (if applicable) • No more than 20 pages for the Project Narrative (Items D through G below) Application for Federal Assistance (SF-424) The SF-424 will be filled out online through Grants.gov. However, it should also be printed out and included in the hard copy that is submitted. The Catalog of Federal Domestic Assistance number for this program is 16.527 (block 10). Please be sure that the amount requested matches the amount in the submitted budget. Budgets must reflect the full length of project activity, and the total "estimated funding" (block 15) on the SF-424 must reflect either 24 or 36 months. Applicants must ensure that the information for the authorizing official and alternate contact is filled out correctly. The authorizing official is the individual authorized to accept grant funds on behalf of the jurisdiction applying. Standard Assurances and Certifications Regarding Lobbying; Debarment, Suspension, and Other Responsibility Matters; and Drug-Free Workplace Requirements (Form 406116) Review the assurances and certification forms. Agreement to these assurances and certifications will be assumed upon receipt of an application received through Grants.gov. Narrative (Total 65 Points) The following narrative will be submitted as an attachment in Grants.gov. A. Summary Data Sheet (not to exceed one nape) Please identify the following: • Name, title, address, phone number, and a-mail address for the authorized official; • Legal name of the applicant and type of agency (i.e., state government, local unit of government, or tribal government); • The nonprofit, non-governmental victim services program collaborating on this project; • Name, address, phone number, and fax number for the visitation center(s) involved in the project (for jurisdictions in which centers are being proposed but are not yet in existence, provide the name of each jurisdiction in which a center is being proposed); • Whether this is a new or continuation application (including the type of continuation project for which the grantee is applying); and • Contact information, including an email address for the project director or primary person to be contacted on matters involving the application. B. Abstract/Prooosal Summary (not to exceed one nape) A project abstract, when read separately from the rest of the application, is meant to serve as a succinct and accurate description of the proposed project and should concisely describe the project goals and objectives. Summaries of past accomplishments should be avoided in the abstract. 12 Abstracts will be reviewed by the peer review panels according to the following criteria: • Conciseness; and • Accuracy in summarizing the Project Narrative. C. Status of the Current Proiect (not to exceed 5 pages) Only applicants for continuation funding need to complete this section. This section will just be used for internal review. Applications that do not meet the criteria below may receive a deduction in points. This section should be provided on a separate page as it is a separate section from the program narrative and does not count toward the page limits of the narrative. State what has been accomplished with previous funding under the Supervised Visitation Program, including the following: • A description of the goals and objectives from the prior grant period and a brief discussion of the status of the existing project; • The status of any project products; • Any unanticipated obstacles to project implementation; • The approximate unobligated amount of award funds remaining as of February 13, 2007, the anticipated time line for expenditure of all remaining funds within the grant award period, whether the grantee anticipates requesting a no-cost extension of the award, and the likely timeline for such a request; and • A list of all OVW-sponsored technical assistance events attended during the life of the current award, including the title, location, and date(s) of each. This section should be as clear and succinct as possible. Additionally, current projects will be rated by OVW using the following criteria: • Whether progress reports submitted by the applicant, in conjunction with monitoring conducted by OVW, demonstrate the effectiveness of the current project, indicating progress toward meeting project goals and objectives, and demonstrate that the current project has progressed in a timely manner as outlined in the original proposal; • Whether the grantee has demonstrated that past activities supported with Supervised Visitation funds have been limited to program Purpose Areas; • Whether the grantee has complied with all special conditions of its existing grant award from the Department of Justice; • Whether the grantee has adhered to programmatic and financial reporting requirements; • Whether the grantee has demonstrated a commitment to sustaining the project after federal funds are no longer available; • Whether the grantee appropriately utilized and actively participated in OVW- sponsored workshops and other technical assistance events as required by a special condition of the current award; • Whether the grantee has received financial clearances on all current grants from DOJ; • Whether the grantee has complied with the Office of Management and Budget audit requirement, if applicable; and • Whether grant funds have been spent in a timely manner. 13 Please note, applicants with an OVW grant history that have failed to meet grant deadlines, did not comply with Office of Justice Programs' (OJP) financial requirements, or did not comply with special conditions from previous grants, will not be considered for funding. D. Purpose of Application (10 points) This section should briefly: • Describe the problem to be addressed and how funding would alleviate it; • Identify the target population and state how the target population would benefit from the proposed project (please use current demographic information of the service area in order to be as specific and detailed as possible when describing the population to be served); • Describe current services and gaps; • Describe the community's service area in which the project would be implemented, including location, population, and demographic information; and • Describe how the proposed project complements the State's STOP Violence Against Women Implementation Plan. E. What Will Be Done (40 points) Development grant applicants should submit a statement describing how the proposed project would assist the jurisdiction(s) in addressing the identified need, the issues to be addressed during the planning process, and the expected outcomes. ..__ Applicants for development grants should provide detailed information on the project goals and objectives, describe the specific tasks and activities necessary for accomplishing each goal and objec#ive, and include a timeline that identifies when those activities will be accomplished. Applicants should also include a letter certifying that the development project will meet the statutory and minimum requirements of the grant program (see minimum requirements on page 9). Continuation grant applicants should submit a statement describing how the proposed collaborative project would assist the jurisdiction in addressing the identified need. Applicants should also provide detailed information on the project goals and objectives, mechanisms for referrals to the visitation and exchange center, a description of the specific tasks and activities of each collaborative partner, and include a timeline that identifies when the project activities will be accomplished. In addition, applications, if applicable, must include a description of services currently offered by the existing program and how these services will be enhanced by the proposed collaborative project. In addition to the above criteria, this section will also be rated on the following: The extent to which the application clearly demonstrates continued development and/or implementation of a program to increase supervised visitation and exchange options for families with a history of domestic violence, dating violence, child abuse, sexual assault, or stalking; The extent to which the application addresses the minimum requirements of the Supervised Visitation Program; 14 The extent to which the application clearly describes the community to be served, including the diverse, traditionally underserved populations of victims of domestic violence, dating violence, child abuse, sexual assault, or stalking; The extent to which the proposed project activities reflect sound development and thoughtful innovation; and The extent to which the development and implementation strategy, the organization and staff capability, the project components, and the general timeline are clearly described. Program Specifications - Gontinuation Appticants Only Continuation applicants should submit a detailed description of the proposed visitation and exchange center(s). This description should include information on the following program specifications: • The purpose of the visitation center and how it reflects an understanding of the impact of domestic violence, child abuse, sexual assault, dating violence, and stalking on families; • Scope of proposed visitation and exchange services; • Types of families to be served by the project; • Hours of operation; • Program security; • Record keeping and confidentiality; • Referral process; • intake procedures; -^ • Fee protocols; • Proposed level of staffing; • Job descriptions and resumes for key staff (this information should be appended to the application); • Training requirements for staff and volunteers; and • Composition and role of the existing or proposed advisory committee (see description of required Consulting/Advisory Committee on page 20). Who Will Implement the Protect (t0 points) All applicants are required to coordinate with state or local courts and nonprofit, nongovernmental domestic violence and/or sexual assault victim service programs. All applicants must identify the court and faith- and/or community-based victim services program(s) partnering on the proposed project and all other project partners, and specify their respective roles and responsibilities. Victim service organizations should meet all of the following criteria: Provide services to victims of domestic violence, sexual assault, dating violence, or stalking as one of their primary purposes and have a demonstrated history of effective work concerning such issues; Address a demonstrated need in their communities by providing services that promote the dignity and self sufficiency of victims, improve their access to resources, and create options for victims seeking safety from perpetrator violence; and Do not engage in activities that compromise victim safety. IS G. Sustainabilitv Plan (5 points) As this is a competitive, discretionary program, there is no guarantee of continuation funding. Applicants are required to include a plan describing their commitment and capacity to continue the project if Federal funding through the Supervised Visitation Program were no longer available. Applicants are encouraged to describe any past federally or state supported projects which the applicant or its partners sustained once funding had expired. The plan will be evaluated on whether it proposes feasible strategies to preserve project activities long-term. Continuation or supplemental funding is not guaranteed and applicants are always encouraged to seek additional means of support to sustain their current projects. Budget Detail Worksheet and Narrative (15 Points) Each application must include a detailed budget and budget narrative for the project. This will be submitted as an attachment in Grants.gov as well as in the hard copy. The budget must be complete, reasonable, and cost-effective in relation to the proposed project. The budget should provide the basis for the computation of all project-related costs. It should cover the cost of all components of the project. There must be a clear link between the proposed activities and the proposed budget items. The budget should include only those activities, products, and resources that are necessary for project implementation and discussed in the project narrative. In developing the budget, applicants should fairly compensate all project partners for their participation in any project-related activities, including but not limited to, compensation for time and travel expenses to attend or provide project development, training, and implementation. """ The budget must include compensation for all services rendered by project partners, including nonprofit, nongovernmental domestic violence and/or sexual assault victim services programs, and state and tribal domestic violence and/or sexual assault coalitions. Additionally, subgrantee center staff members must be fairly compensated if they will be providing services under the Supervised Visitation Program. Budget Caps The following award limits are firm and apply even to applications for continuation funding. Under no circumstances should the proposed budget exceed the following limits: Development Projects $400,000 for 3 years (new grantees) ($50,000 for planning phase; $350,000 for im lementation) Local and Tribal Continuation $250,000 for first 24 months ~ five-year Projects (Funding for the remaining 36 months will be awarded upon the grantee's successful completion of initial grant activities and continued a ro riation of the ro ram. Local and Tribal Standard $200,000 Continuation two-year Projects includin multi- urisdictional) State Standard Continuation $200,000 (2 jurisdictions with centers) two-year Projects $350,000 (3 jurisdictions with centers) $500,000 (4 jurisdictions with centers) $650,000 (5 jurisdictions with centers) $750,000 6 or more 'urisdictions with centers l6 OVW has the discretion to make grants for greater or lesser amounts than requested and to negotiate the scope of work and budget with applicants prior to the award of a grant. Budget Requirements The following is a short list of budget guidelines: • Applicants are strongly discouraged from requesting consultant rates in excess of $450 per day, because they require prior approval from the Director of the Office on Violence Against Women. • Applicants may not allocate any funds for building renovations. This includes such seemingly minor activities as painting or carpeting. Applicants may not use any OVW funds for conducting research. However, up to 1 % of the budget may be allocated for the purpose of assessing the effectiveness of funded activities. For example, funds may be used to conduct pre and post testing of training recipients or victim satisfaction surveys. !n conducting such testing or surveys, grantees may not collect, analyze or disseminate any information identifiable to a private person during the course of assessing the effectiveness of funded activities. • A contribution of non-Federal dollars ("match") is not required for this program, but applicants are encouraged to maximize the impact of Federal dollars by contributing to the costs of their projects. Supplemental contributions may be cash, in-kind services, or a combination of both. Any non-Federal contributions can be discussed in the project narrative; however, these supplemental contributions should not be included in the budget or budget narrative. Access to current research and practice on violence against women through training and technical assistance can reduce staff burnout, improve project performance, and impact project sustainability. Therefore, OVW offers a wide range of training and technical assistance opportunities to alt of its grantees. These offerings are specifically designed to assist grantees in meeting their goals and objectives and in complying with all relevant statutory and programmatic requirements. All development project applicants are required to allocate funds in the amount of $50,000 and all continuation project applicants are required to set aside $20,000 to support travel costs associated with technical assistance and capacity-building activities sponsored by OVW-designated technical assistance providers. Applications selected for funding that do not include the entire recommended amount will not receive additional funds for this purpose, but will be required to adjust their budgets to cover these costs prior to final approval of the proposal. This required amount must be included in the "travel" category. Please provide an estimated breakdown for this amount (include the number of trips, number of travelers, airfare or mileage, lodging, per diem, etc.). These funds are to be used only for OVW-designated technical assistance unless otherwise approved by OVW. Any training and technical assistance funds not used by the end of the grant period may not be reprogrammed and must be returned to OVW. Travel funds should be used to support travel costs by all partners, including nonprofit, nongovernmental victim services providers, court partners, and other MOU partners. • Applicants are also encouraged to include funds in their budgets to attend Financial Management Training Seminars sponsored by the Office of Justice Programs (OJP), Office of the Comptroller These seminars instruct participants in the financial administration of 17 OVW formula and discretionary grant programs. A schedule listing the financial training seminars is available at htto://www.oio.usdoi.aov/oc/fmts.htm. A Sample Budget Detail Worksheet for Implementation applicants is available at http://www.oio.usdoi.aov/Forms/budget fillable.odf. Please refer to Appendix A for a Sample Budget Detail Worksheet if you are a development project applicant. The budget and budget narrative should be submitted online as one attachment. When preparing these items, please use the Budget Detail Worksheet as a guide and be sure to include all necessary budget categories. The budget should clearly describe the proposed amounts and uses of grant funds for the duration of the grant period and how the amounts of the specific budget items were determined. Memorandum of Understanding (MOU) and Letter of Intent to Collaborate (20 points) Applicants are required to provide documentation that demonstrates they have consulted and coordinated in a meaningful way with state or local courts and a faith and/or community-based nonprofit, nongovernmental domestic violence or sexual assault victim services organization that represents the views and concems of domestic violence and sexual assault victims. OVW requires this to be done by the submission of an MOU for continuation applicants and Letters of Intent to Collaborate for development applicants. All continuation applicants must include, as an attachment, a current (i.e., a single document, signed and dated during the development of the proposal) MOU created and signed by the chief executive officer(s) andlor director(s) of all relevant agencies participating in the project's development or implementation, such as the unit of government; the visitation center; the courts; nonprofit, nongovernmental domestic violence victim organizations, including -- faith-based andlor community organizations that represent the views and concerns of domestic violence victims; and other community agencies or organizations (i.e., law enforcement, prosecutors, and probation} that will collaborate to implement the proposed project. Please refer to Appendix B for a sample MOU. Continuation applicants must develop a new MOU that reflects the continuation of project activities and include current dates and signatures from all relevant project partners. The MOU must do the following: Identify the partners and provide a brief history of the collaborative relationship among those partners, including when and under what circumstances the relationship began and when each partner entered into the relationship; • Identify the representatives of the planning and development team who will be responsible for developing and implementing project activities and describe how the team members will work together and with project staff; • Demonstrate a commitment on the part of all project partners to work together to achieve stated project goals; Indicate approval of the proposed project budget by all signing parties; and • Describe the resources each partner would contribute to the project, either through time, in- kind contributions, or grant funds (e.g., office space, project staff, and training). The MOU should be a single document that includes signatures and dates from all partners. Signatories should be sure to include their titles and agencies under their signatures. 18 Letters of support may not be submitted in lieu of the MOU. Only applicants for development projects may submit Letters of Intent to Collaborate in lieu of an MOU. Please refer to Appendix C for a sample Letter of Intent to Collaborate. All applicants are required to enter into formal collaborations with state or local courts and a nonprofit, non-govemmental organization serving victims of domestic violence and/or sexual assault. Applicants must demonstrate that they have consulted and coordinated in a meaningful way with afaith- and/or community-based nonprofit, non-governmental domestic violence, and/or sexual assault victim services program, and that this organization will be involved in the development and implementation of the proposed project. The faith- and/or community-based non-profit, non-governmental domestic violence andlor sexual assault victim services program should meet all of the following criteria: • Provides services to victims of domestic violence, sexual assault, dating violence, or stalking as one of their primary purposes; • Reflects an understanding that the violence perpetrated against victims is grounded in an abuse of power by offenders, reinforced through intimidation and coercion; • Addresses a demonstrated need in their communities by providing services that promote the integrity and self-sufficiency of victims, improve their access to resources, and create options for victims seeking safety from perpetrator violence; and • Does not engage in activities that compromise victim safety. Letter of Nonsupplanting Applicants must submit a letter to OVW's Director, certifying that Federal funds will not be used to supplant State or local funds should a grant award be made. Please refer to http:/lwww.usdoi.aov/ovwldocs/nonsup letter.pdf for a sample letter. Financial Capability Questionnaire All nonprofit, nongovernmental organizations that apply for funding with OVW that have not previously (or within the last 3 years) received funding from OVW or OJP must complete a Financial Capability Questionnaire. The form can be found at http://www.oip.usdoi.oov/oc. You should also include the cognizant Federal audit agency and fiscal year on the first page. In addition, be sure to submit your current year's audit report with the Financial Capability Questionnaire. Indirect Cost Rate Agreement If your organization is requesting indirect costs for this project, please include a copy of your current, signed indirect cost rate agreement. If you need additional information on this requirement, please go to http:l/www.oip.usdoi.aov/FinGuidelpart3chap17.htm. Additional Program Requirements Technical Assistance Grant recipients are required to work collaboratively with staff from OVW and OVW-designated technical assistance providers. Grant recipients will be asked to identify advocates from local domestic violence or sexual assault victim service programs, law enforcement officers, 19 prosecutors, judges, and other representatives from the community to participate in technical assistance events. Participation in technical assistance events will often involve out-of-state travel, therefore applicants are required to include funds in the project budget to support travel cost associated with these activities. Consulting/Advisory Committee Visitation programs that serve families with a history of domestic violence, dating violence, child abuse, sexual assault, and stalking should develop formal affiliations with organizations that will be available to provide services and consultation to programs that work with children and parents. Applicants must establish a consulting committee, which includes experts in the following fields: child abuse and neglect, mental health, substance abuse, counseling, batterers' intervention, law enforcement, child protection services, and advocacy for victims of domestic violence and sexual assault. In addition, grantees serving underserved and diverse communities should include experts who are knowledgeable on domestic violence, dating violence, child abuse, sexual assault and/or stalking within these communities on the consulting committee. Selection Criteria In addition to the criteria above, all applications will also be rated on the following: • The extent to which all project activities fall within the statutory scope of the program; • The extent to which proposed activities would address the need described; • The extent to which project activities seem feasible and likely to succeed; • The extent to which the proposal does not include activities that compromise victim safety; °' The extent to which activities are clearly described and reflect sound and innovative strategies to improve victim safety; and • The extent to which the budget is reasonable and within established limits. In awarding grants, OVW shall also take into account: • The number of families to be served by the proposed visitation programs and services; • The extent to which the proposed supervised visitation programs and services serve underserved populations; • With respect to an applicant for a contract or cooperative agreement, the extent to which the applicant demonstrates cooperation and collaboration with nonprofit, nongovernmental entities in the local community served, including the State or tribal domestic violence coalition, State or tribal sexual assault coalition, local shelters, and programs for domestic violence and sexual assault victims; and • The extent to which the applicant demonstrates coordination and collaboration with State and local court systems, including mechanisms for communication and referral. Review Process All applications will be subject to internal review by OVW staff and peer review and will be scored according to the criteria set forth in this solicitation. If the application fails to meet the criteria listed below during the initial internal review, the application will not receive further consideration. If applications that are partially beyond the scope of the program are sent to formal peer review, only those sections of the application that are within .... scope will be reviewed. Criteria for the initial internal review follow: 20 • Whether the application is complete; • Whether the proposed activities are within the scope of the program (see page 8); • Whether all statutory eligibility criteria are met (see page 4); • Whether the minimum requirements for the program are met (see pages 9); • Whether the application proposes significant activities that may compromise victim safety (see page 10); and • Whether the proposed budget is within the established limits (see page 16). In addition, applications for continuation funding will be reviewed for prior compliance with program and office requirements and the status of current grant-funded activities. (See page 13 for further details on criteria for this review.) Applicants with an OVW grant history that failed to meet grant deadlines, did not comply with Office of Justice Programs' (OJP) financial requirements, or did not comply with special conditions from previous grants, will not be considered for funding. OVW will establish panels of experts and practitioners to review applications. Each panel will review the information provided in the application against the selection criteria for the program. Following formal peer review, a second internal review will be conducted, considering, for example, the geographic distribution of the applications for a national perspective, the ratio of population to services, and the type of projects already funded within an applicant's state or community. Tribal applications will be reviewed by a panel of experts on supervised visitation, domestic violence, child abuse, sexual assault, and stalking in the Native American Community. The total points possible for an application are 100 (65 points for Narrative, 15 points for Budget, and 20 points for the MOU or Letters of Intent to Collaborate). Applications with the highest composite scores will be considered for funding. Additional Requirements • Civil Rights Compliance • Confidentiality and Human Subjects Protections regulations • Anti-Lobbying Act • Financial and Government Audit Requirements • National Environmental Policy Act (NEPA) compliance • DOJ Information Technology Standards • Single Point of Contact Review • Non-Supplanting of State or Local Funds • Criminal Penalty for False Statements • Compliance with Office of the Comptroller Financial Guide 21 • Suspension or Termination of Funding Alt OVW grantees must comply with these additional requirements. Additional information for each can be found at htto://www.oio.usdoi.gov/funding/otherceauirements htm. References to the Office of Justice Programs and its components are deemed to refer to the Office on Violence Against Women, as applicable. OVW Application Checklist Applicants must submit a fully executed application to OVW via overnight delivery, including all required supporting documentation. Applications will not be accepted via facsimile or email. Although most parts of the application need to be submitted through Grants.gov as well as in hard copy form, it is the hard copy that will be reviewed. Applications submitted via Grants.gov must be in the following word processing formats: Microsoft Word (.doc), PDF files (.pdf), or Text Documents (.txt). Complete applications should include the following: • The SF-424; • Standard Assurances and Certifications Regarding Lobbying; Debarment, Suspension and Other Responsibility Matters; and Drug Free Workplace Requirements; • The summary data sheet, project abstract, project narrative, and for continuation applicants, the status of the project; • The budget, budget summary, and budget narrative; • Letter of nonsupplanting; • An MOU (for continuation project applications) or Letters of Intent to Collaborate (for development project applications) • Letter certifying that the development project will be developed to meet the statutory and minimum requirements of the grant program (development applicants only) • A current Indirect Cost Rate Agreement (if applicable); and • Resumes of key staff members. Detailed instructions on how to use the Grants.gov system to submit your application online are available at www.grants.gov. Also, atoll-free telephone number has been established for you to receive technical assistance as you work through the online application process, 1-800-518- 4726. To help expedite the review process, applicants must send via overnight delivery a complete hard-copy original of the application, postmarked by Tuesday, February 13, 2007 to: The Office on Violence Against Women c/o Lockheed Martin Aspen Systems Corporation OVW Safe Havens: Supervised Visitation and Safe Exchange Program Mail Stop 2K 2277 Research Boulevard Rockville, MD 20850 (301) 519-5000 22 U.S. Department of Justice , ~ = ,~ Y LAV/SV Partnership Initiative: Call for Concept Papers OVW is committed to building the capacity of victim service organizations to effectively respond to domestic violence, sexual assault, dating violence, and stalking and to foster partnerships between organizations that have not traditionally worked together to address violence against women. OVW believes that the public would be better served with enhanced collaborative efforts between organizations providing legal services to victims of violence and agencies providing supervised visitation and safe exchanges through the LAV/SV Partnership Initiative (The Initiative). The purpose of the Initiative is to enable Safe Havens: Supervised Visitation and Safe Exchange Grant Program (Supervised Visitation Program) recipients to access legal services for their clients and extend the scope of services provided by Legal Assistance for Victims (LAV) grantees. It is envisioned that the results of this initiative will be a resource and model for community organizations to coordinate their services to victims of violence on a higher level. OVW will select up to 5 five concept papers for further development and funding considerations. The concept paper must provide a detailed plan addressing how the Supervised Visitation grantee will partner with the LAV grantee to provide legal services to victims of domestic violence receiving visitation and exchange services. Eligibility All current OVW Supervised Visitation grantees (including FY 2006 grantees) and FY 2007 Supervised Visitation applicants are eligible to submit a concept paper to participate in the LAV/SV Special Initiative. FY 2007 Supervised Visitation Program applicants interested in submitting a concept paper must submit the concept paper separate from their Supervised Visitation Program application. Any concept papers included with or in a Supervised Visitation Program application will not be considered. The lead partner proposed in the concept paper may be either a current Supervised Visitation grantee or an LAV grantee. Of the partnering agencies, one agency must be selected as fiscally responsible for the grant. Applicants will also need to demonstrate an existing working relationship with a supervised visitation service provider. Award Period The award period will be 24 months. Award Amount Selected projects will receive up to $200,000 for 24 months, although OVW reserves the right to make awards for lesser or greater amounts. 23 How to Apply Applicants must send via overnight delivery a complete hard-copy original of the concept paper; postmarked by Wednesday, January 24, 2007 to: The Office on Violence Against Women 800 K Street, NW, Suite 920 Washington, DC 20530 Attn: LAV Special Initiative Phone: (202) 307-6026. We strongly recommend that you use a trackable shipping method that will allow you to confirm the delivery of your concept paper. Applicants should retain proof of timely submission. What a Concept Paper Must Include Applicants must complete each of the following sections as part of their response to this Call for Concept Papers. It is the responsibiliiy of the applicant to ensure that the concept paper is complete. OVW will remove the concept paper from consideration prior to internal review if the concept paper is incomplete. The proposal should follow the order below for easy reading. Please be sure to number each oage of the concept paper. Internal reviewers will not receive materials submitted beyond those required by this call for concept papers. °°- Concept papers must use the following page format requirements: • No more than 10 pages; • Double spaced; • 8'/z x 11 inch paper; • One inch margins; and • Type no smatler than 12 point, Times New Roman font. Narrative A. Summary Data Sheet The Summary Data Sheet must include the following: • Name of applicant; • Project partner (must be either a current LAV grantee or a Safe Havens supervised visitation center partner); • Target audience; • Geographic focus; • Estimated project cost; and • A list of all current OVW grants and anticipated project completion dates from both the LAV grantee and the Safe Havens supervised visitation partner. 24 B. What Will Be Done This section should include the following: • A description of the target audience; • A statement of the goals and objectives of the proposal including: • A plan for the development of policy and practice standards for providing collaborative services; • A partnership commitment to participate in 3-4 regional or national meetings; and • Participation in initiative assessment and follow-up by OVW designated Technical Assistance providers. • A summary of activities that will be undertaken to accomplish the project goals and objectives and provide a corresponding timeline for the completion of each activity; • A description of what services are currently offered in the community being served; and • A description of what services are currently offered to those accessing the Safe Havens Supervised Visitation center. C. Who Will Implement the Protect This section should include the following: • An identification of the LAV and Supervised Visitation recipient organizations and individuals who wilt implement the project and describe the rote of each; • A description of the capacity of the organization/s to undertake the project; • A description of the proposed staffing (including consultants) for the initiative; • A list of the qualifications and experience of proposed staff/consultants; and • If you are proposing to utilize consultants, an indication of the estimated daily rate for each consultant. D. Letters of Suooort Letters of Support must be included from all project partners. Letters of Support should be provided by the supervised visitation center(s) currently funded by a Supervised Vistation grantee and LAV grantee. Letters should describe the partners' role in the project, as well as their commitment to the collaboration. Note: A Memorandum of Understanding (MOU), a budget and budget narrative are not required for the concept paper. Those concept papers that receive the highest overall scores will be invited to submit a full application, which will include a budget and budget narrative, and possibly an MOU. Review Process Complete concept papers will be subject to internal OVW review. OVW staff will contact selected applicants to submit a full application. At that time, those applicants will be required to submit full applications, including budgets. Applicants with an OVW grant history that failed to meet grant deadlines, did not comply with Office of Justice Programs' (OJP) financial requirements, or did not comply with special conditions from previous grants, will not be considered for funding. 25 Appendix A Sample Budget Detail Worksheet for Development Applicants 26 SAMPLE 12/2006 Budget Detail Worksheet: Development Applicants Purpose: The Budget Detail Worksheet may be used as a guide to assist you in the preparation of the budget and budget narrative. You may submit the budget and budget narrative using this form or in the format of your choice (plain sheets, your own form, or a variation of this form). However, all required information (including the budget narrative) must be provided. Any category of expense not applicable to your budget may be deleted. Please note: This sample budget assumes a 36-month budget period with 12 months for planning and 24 months for implementation. Please draft your budget to reflect the amount of time you will need to successfully complete each phase of the development project. A. Personnel -List each position by title and name of employee, if available. Show the annual salary rate and the percentage of time to be devoted to the project. Compensation paid for employees engaged in grant activities must be consistent with that paid for similar work within the applicant organization. Name/Position Computation Cost Project Director ($50,000 x 40% x year 1) $ 20,000 ($50,000 x 100% x years 2 and 3) $100,000 TOTAL 120 000 The Project Director will oversee the Supervised Visitation project, all supervised visitation center(s) activities, provide supervision to the visitation supervisor and monitors, and conduct case reviews on a monthly basis with project staff. The Project Director is also responsible for developing funding for the center. This individual will write monthly case reports and updates to be sent to judicial oversight committees, as well as complete the OVW progress reports. B. Fringe Benefits -Fringe benefits should be based on actual known costs or an established formula. Fringe benefits are for the personnel listed in budget category (A) and only for the percentage of time devoted to the project. Fringe benefits on overtime hours are limited to FICA, Workman=s Compensation, and Unemployment Compensation. Name/Position Computation Cost Employer's FICA $ 20,000 x 7.65% (year 1) $ 1,530 $100,000 x 7.65 % (years 2 and 3) $ 7,650 Retirement $ 20,000 x 6% (year 1) $ 1,200 $100,000 x 6% (years 2 and 3) $ 6,000 Health Insurance $20,000 x 12% (year 1) $ 2,400 ~7 $100,000 x 12% (years 2 and 3) $12,000 Workman's Compensation $20,000 x 1% (year 1) $ 200 $100,000 x 1% (years 2 and 3) $ 1,000 Unemployment Compensation $20,000 x 1% (year 1) $ 230 $100,000 x 1% (years 2 and 3) $ 1,000 TOTAL 34180 C. Travel -Itemize travel expenses of project personnel by purpose (e.g., meetings with advisory council, field interviews, advisory group meeting, etc.). Show the basis of computation (e.g., four people to 3-day training at $X airfare; $X lodging, $X subsistence). In training projects, travel and meals for trainees should be listed separately. Show the number of trainees and unit costs involved. Identify the location of travel, if known. Indicate source of Travel Policies applied, Applicant or Federal Travel Regulations. Purpose of Travel Location Items Computation Partner meetings Unknown mileage 1,000 miles x .445 (year 1) (local travel) 1,500 miles x .445 (years 2 OVW Training and travel Unknown Airfare $20,000 (year 1) Ground $30,000 (years 2 & 3) Transportation Per Diem Lodging Technical Assistance TOTAL Cost $ 445.0 and 3)$ 667.5 $ 20,000 $ 30;000 51 112.5 Mileage for meetings with partners and advisory council members throughout the service area will be reimbursed to the project director. OVW Training and travel funds are allocated to support OVW training and TA support expenses. D. Equipment -List non-expendable items that are to be purchased (Note: the organization's own capitalization policy for classification of equipment should be used). Expendable items should be included in the "Supplies" category. Applicants should analyze the cost benefits of purchasing versus leasing equipment, especially high cost items and those subject to rapid technical advances. Rented or leased equipment costs should be listed in the "Contractual" category. Explain how the equipment is necessary for the success of the project. Attach a narrative describing the procurement method to be used. Item Computation Cost Desktop Computer $2,500 x 1 (years 2 and 3) $2,500 1 -Building Security System $6,960 x 1 (years 2 and 3) $6,960 3 -Metal Detector Wands $250 x 3 (years 2 and 3) $ 750 28 TOTAL 12 710 The computer will be used by the Site Supervisor (purchase in years 2 and 3) to record participant information, compose case notes and reports, and manage information on supervised visitation and safe exchange services. The building security system will be installed at the project site to ensure participant and staff safety. The system will include 3 cameras, 2 monitors, recording system for cameras, as well as door sensors. The metal detector wands wilt be used by the security staff and the site supervisor to inspect participants for weapons before they visit with or drop off children. E. Supplies -List items by type (office supplies, postage, training materials, copying paper, and expendable items such as books, hand held tape recorders) and show the basis for computation. Generally, supplies include any materials that are expendable or consumed during the course of the project. Supply Items Comoutation Cost Office Supplies $55/mo x 12 month (year 1) $ 660 $55/mo x 24 month (years 2 and 3) $1 ,320 Postage $25/mo x 12 month (year 1) $ 300 $25/mo x 24 month (years 2 and 3) $ 600 Training Materials - staff and project partners $4/set x 50 sets (year 1) $ 200 $4/set x 50 sets (years 2 and 3) $ 200 Children's Books $5 x 80 books (years 2 and 3) $ 400 Snacks $400/yr x 12 months (year 1) $ 400 $400/yr x 24 months (years 2 and 3) $ 800 Games, stuff animals, art suppl ies toys, and activities (years 2 and 3) $ 800 TOTAL 5 680 Office supplies and postage are needed for general operation of the program. Training materials will be developed and used by the Site Supervisor and Project Director to conduct trainings for staff and project partners. The children's books will be available to family members for use during visits. Snacks will be made available to children who are visiting for more than one hour and for the first year will be used for pre-planning meetings. One time purchase of games, toys, art supplies to be used by children that are waiting for parents. F. Construction - As a rule, construction costs are not allowable. In some cases, minor repairs or renovations may be allowable, consult with the program office before budgeting funds in this category. Purpose Description of Work Cost TOTAL 29 G. Consultants/Contracts -Indicate whether applicant's formal, written Procurement Policy or the Federal Acquisition Regulations are followed. Consultant Fees: For each consultant enter the name, if known, service to be provided, hourly or daily fee (8-hour day), and estimated time on the project. Consultant fees in excess of $450 per day require additional justification and prior approval from OVW. Name of Consultant Service Provided Jane Doe Domestic Violence Trainer John Doe Personal Safety Trainer Computation Cost $250/day x 6 days $ 1,500 (years 2 and 3) $250/day x 6 days $ 1,500 (years 2 and 3) Security Guards 2 guards @ $13.00 per hour x $ 24,960 40 hrs per month x 24 months (years 2 and 3) Center partner 1 program supervisor $20 per hour x 25 hrs/week x 104 weeks (years 2 and 3) $ 52,000 1 visitation/exchange monitor $10 per hour x 25 hrs/week x 104 weeks (years 2 and 3) $ 26,000 Fringe benefits for program supervisor $ 14,378 Fringe benefits for visitation/exchange monitor $ 7,189 TOTAL 127 527 Jane Doe, Domestic Violence Trainer, will be hired to assist with the education of new center staff, volunteers, local domestic violence advocates, court representatives, and law enforcement officers collaborating with the center. The training sessions will be held three times per year. John Doe, Personal Safety Trainer, will be hired to teach center staff and volunteers techniques for protecting themselves against physical assault and general safety tips. These training sessions will also be held three times per year. Funding will be used to support some of the funds needed for independent security guards to support the center staff during visitation hours. The Center will hire one program supervisor and 1 visitation/exchange monitor with these funds to implement the project. H. Other Costs -List items (e.g., rent, reproduction, telephone, janitorial or security services, and investigative or confidential funds) by major type and the basis of the 30 computation. For example, provide the square footage and the cost per square foot for rent, and provide a monthly rental cost and how many months to rent. Description Computation Cost Telephone $100/mo. X 12 months (year 1) $ 1,200 $100/mo. X 24 months (years 2 and 3) $ 2,400 Printing/Reproduction $75/mo. x 12 months (year 1) $ 900 $75/mo. X 24 months (years 2 and 3} $ 1,800 TOTAL 6 300 I. Indirect Costs -Indirect costs are allowed only if the applicant has a Federally approved indirect cost rate. A copy of the rate approval, (a fully executed, negotiated agreement), must be attached. If the applicant does not have an approved rate, one can be requested by contacting the applicant's cognizant Federal agency, which will review all documentation and approve a rate for the applicant organization, or if the applicant's accounting system permits, costs may be allocated in the direct costs categories. Description Computation No indirect cost is requested. Cost TOTAL 31 Budget Summary -When you have completed the budget worksheet, transfer the totals for each category to the spaces below. Compute the total direct costs and the total project costs. Indicate the amount of Federal requested and the amount of non-Federal funds that will support the project. Budget Cateoorv Year 1 Year 2 and 3 Total Amount A. Personnel 20 000 100 000 120 000 B. Fringe Benefits 5 530 27 650 33 180 C. Travel 20 445 30 667.5 $51,112.50 D. Equipment ~ 10 210 10 210 E. Supplies 1 560 4 120 5 680 F. Construction ~0 _ 0~ ~_ G. Consultants/Contracts ~ 127 527 127 527 H. Other 2 100 4 200 6 300 Total Direct Costs 49 635 $304.374.5 360 392 I. Indirect Costs ~_ ~ ~_ TOTAL PROJECT COSTS 360 392 Federal Request 360 392 No n-Federal Amount NA 32 Appendix B Sample Memorandum of Understanding 33 SAMPLE MEMORANDUM OF UNDERSTANDING The County of is the lead Safe Havens: Supervised Visitation and Safe Exchange Grant Program applicant, and supports the Locat Supervised Visitation Center (LSVC). The County of enters into a Memorandum of Understanding (MOU) with the Community Domestic Violence Agency (CDVA), LSVC and the local court system. I. History of Relationship The Local Supervised Visitation Center began collaborating with the Community Domestic Violence Agency in 1999. The LSVC and CDVA Directors met regularly to discuss the provision of visitation services to victims of domestic violence. Throughout this relationship, CDVA provided training for LSVC staff and volunteers in the following areas: recognizing signs of domestic violence; methods and strategies for working with victims of domestic violence; and, domestic the potential impact of domestic violence on children and the battered person. LSVC accepts referrals from CDVA and the local court system for women in need of supervised visitation services. Additionally, the LSVC and CDVA Directors continue to meet on a monthly basis to develop a comprehensive plan for building a larger collaboration focused on supporting domestic violence response and supervised visitation. The partnering organizations' ultimate goal is the protection of domestic violence victims and their children in all settings. As a result, LSVC and CDVA are striving to develop an expanded collaboration including child abuse and neglect organizations, law enforcement, courts, hospitals, legal advocates, families, and community groups. The LSVC and CDVA Directors have identified the local court system as a partner, and a court representative has begun attending their monthly planning meetings. The group's immediate goal is to develop an awareness and understanding among the potential collaborators of the unique circumstances surrounding supervised visitation in cases of domestic violence. Development of Application Discussions regarding the collaborative effort that is proposed in the application and detailed in this Memorandum began in earnest in June, 2000. During their regular monthly meetings, the agency directors and court representative discussed the elements of the application and the appropriate roles for each partner. The LSVC Director met with center staff to develop a grant application response. This draft was supplemented with key judicial and CDVA staff recommendations. The LSVC Director also conducted an independent study of similar supervised visitation programs in other jurisdictions. This information 34 enhanced the quality of proposed programmatic elements. Additionally, the Directors discussed the application process and expectations with the potential members of the evolving collaboration. These representatives provided input in the initial development phase and feedback throughout the process. Recent meetings among the Executive Directors, County representatives and local court representatives have led to the agreement reflected in this Memorandum and the submission of the grant application. III. Roles and Responsibilities Community Domestic Violence Agency The CDVA Executive Director will provide co-leadership with the Director of the LSVC for all non-administrative duties related to developing across-agency collaboration among the child abuse and neglect organizations, law enforcement, courts, hospitals, legal advocates and community groups. The CDVA training staff will provide up to three domestic violence awareness training sessions per year to the LSVC. Additional collaboration members will be invited to participate in these sessions. Refer all domestic violence victims with children in need of supervised visitation or exchange services to LSVC and follow-up on the outcome of the referrals. Promote training/education of local law enforcement agencies and court representatives regarding domestic violence issues and supervised visitation. The CDVA may enter into agreements with these agencies as to the number of training sessions to be provided. Supervised Visitation Center Dedicate X number of staff and volunteers to providing supervised visitation services to families impacted by domestic violence, child abuse, sexual assault and stalking. Provide facilities (e.g. rooms, enclosed playground, etc.) for the program service objectives. The Director will support the growth of the collaborative effort, and supervise all LSVC activities. Additionally, the Director will submit program evaluation information to local and national evaluators as required by the grantor. Submit financial documentation for accounting as needed. Maintain the confidentiality of individuals and families using the LSVC's services. 35 Local Court System Submit referrals and relevant case information to LSVC, and follow-up on the outcome of the referrals. Provide training for collaboration partners on the legal system and its role in working with victims of domestic violence, child abuse, sexual assault and stalking. Continue to designate a representative and alternate representative to participate in the collaboration meetings. County of The County will act as the fiscal agent for the grant project and ensure compliance with the reporting requirements of the Office on Violence Against Women. Additionally, the County will support the collaboration efforts of the project by providing a conference room for monthly partner meetings. IV. Time Line The roles and responsibilities described above are contingent on the county receiving the funds requested for this project in the OVW grant application. The -- beginning and end dates of this collaborative effort would coincide with the grant period, anticipated to be MM/DD/YY through MM/DD/YY. Approval We, the undersigned have read and agree with this MOU. Further, we have reviewed the portion of the proposed project budget pertaining to the collaborative effort described here, and approve it. By Director, Supervised Visitation Center By Director, Community Domestic Violence Agency Date By County Official Date By Local Court Representative Date Date 36 Appendix C Sample Letter of Intent to Collaborate 37 Sample Letter of Collaboration Dear OVW Representative, This letter confirms Community Domestic Violence Agency's (CDVA) intent to collaborate with the City of Lake Western to plan and develop visitation and exchange services for victims of domestic violence, child abuse, sexual assault, and stalking. As part of the planning process, CDVA intends to enter into a memorandum of understanding with the City of Lake Western and all other partners to implement the supervised visitation plan. CDVA completed a needs assessment last year to determine the gaps in visitation and exchange service provision. The outcome of this assessment indicated a need for improved methods of providing supervised visitation and exchanges. The assessment confirmed that battered individuals and their children were at risk for further abuse because of the lack of safe supervision and exchange sites. As a result of this assessment, CDVA is committed to supporting the City of Lake Western's Project Coordinator in creating a safe place for visitation and exchanges. CDVA's Executive Director will consult with the Project Coordinator to ensure that victim safety is not compromised by using the center. Additionally, CDVA staff members will have an opportunity to participate on a committee ~-- researching existing supervision centers and best practice methods with a domestic violence focus. A function of this committee is the development of a time-line and task plan for the implementation of a supervised visitation center. This committee will also provide training to all staff and volunteers hired to work in the center. As the project becomes more defined, CDVA intends to fulfill any other appropriate roles determined by the Project Coordinator and Executive Director. After the center becomes operational, CDVA will provide training and consultation services on an as needed basis. CDVA will also refer clients to the center for supervised visitation and exchange services. The Executive Director and designated staff person will also participate on the City of Lake Western's advisory board. CDVA is committed to the development and successful implementation of the Supervised Visitation Center in the City of Lake Western. Sincerely, CDVA Executive Director Hill Country Crisis Council ~..- Proposal to the Kerr County Commissioner's Court January 22, 2007 Kid CARES Safe Haven Project Table of Contents TAB 1 Briefmg Paper for the Kerr County Commissioners Court TAB 2 Grant Announcement from the US Department of Justice, Office on Violence Against Women for "Safe Havens: Supervised Visitation and Safe Exchange Program" OVW-2007-1525 TAB 3 Proposed Memorandum of Understanding Between the Kerr County Commissioner's Court and the Hill Country Crisis Council to Operate a Safe Haven Project TAB 4 Draft Letter of Intent TAB 5 Other Required Deliverables Standard Form 424 with Budget Information, Key Contact Form, and Project Abstract Form Standard Assurances Certifications Regarding Lobbying, Debarment, Suspension and Other Responsibility Matters; and Drug-Free Workplace Requirements Draft Letter ofNon-Supplanting ~.. Assurances-Non-Construction Programs Accounting System and Financial Capability Questionnaire Hill Country Crisis Council ~, Kid CARE5 Safe Haven Project Briefing Paper To the Kerr County Commissioner's Court January 22, 2007 The Hill Country Crisis Council is proposing a Safe Haven Project for supervised visitation and safe exchange services to families where volatile child custody situations require either supervised visits of a non custodial family member or where a safe, neutral exchange site between parents is warranted. The Hill Country has lacked such services and HCCC has been approached on several occasions by the Ken• County prosecutor's office, other elements of the local criminal justice system and other agencies of interest to offer such a service. HCCC staff has long recognized that the absence of a program such as this represents a significant hole in our service delivery system, but funding for such program has not been available. The US Department of Justice, Office on Violence Against Women (OVW) is soliciting applications for grant funding for safe haven programs. Lacking any ongoing services to date, this azea is eligible for athree-year, up to $400,000 grant from the OVW. Yeaz 1 would be development ($SQ000) and yeazs 2 and 3 would be operations (up to $300,000) with $50,000 allocated for OVW technical assistance to the project. Eligible applicants are limited to local units of government and other official agencies. To ,_ apply, HCCC would need to partner with a local unit of government, and it is requested that this partner be Kerr County. HCCC would enter into a Memorandum of Understanding (MOU} with Kerr County to develop and operate the proposed Kid CARES Safe Haven Project. Similaz to existing government grants which HCCC manages, monthly performance and financial reporting would be made to the County for its submission to the OVW. In exchange, the County, as fiscal agent for the grant, would administer the grant funds to HCCC. The grant application is due on February 13., 2007, which means that a MOU would have to be negotiated now and approval to make application through the County proposed to the Kerr County Commissioner's Court on Monday, January 22, 2007. The non-binding Letter of Intent is due January 23, 2007. While HCCC will be responsible for developing the actual proposal and application package, significant documents will need to be completed by the County. HCCC stands ready to assist in any document preparation and submission. Applications must be submitted in both electronic and hard copy form. An explanation of the general purposes of the project are found in the following information taken from the National Supervised Visitation Network website. can be made by a neutral party (the visit supervisor) and there does not have to be --- contact before, during, or after the visits. ^ You can relax and feel comfortable allowing your child to have contact with the other pazent-and can get some valuable time to yourself. FOR THE NON-CUSTODIAL PARENTS: • You can be sure that your contact with your children does not have to be interrupted regazdless of any personal or interpersonal problems you may be having. • If allegations have been made against you, which is often the case when supervision is ordered, you can visit without fear of any new accusations because there is someone present who can verify what happened during your time together. When using a professional service, you can also be assured that the supervisors are neutral and objective. Supervision in the case of parental separation: When pazents separate, the children most often will have primary residence with one parent and regularly spend time with the other. Visitation, contact, and access are words used to refer to post separation contact with the non-residential parent or another significant person, such as a grandparent, sibling, or other relative. When the courts feel it is appropriate, they may order that such visitation take place in the presence of a third party. Supervised exchanges may be court ordered or arranged by the parent and are generally appropriate when there is no question about the safety of the child but when one or both pazents do not feel safe or comfortable interacting directly with the other. It is always better for the child to not be put into a situation where he/she is exposed to the anger and conflict of the pazents. Supervision in the case ofout-of--home placement: When a child comes under the jurisdiction of child protective services and is removed from the home because of a risk of child abuse or neglect, it is usually important that the pazent/child relationship continue. Child Protective Services generally provide these services. However, they may have limited resources that restrict the frequency, duration, and nature of the contact. In some areas, they have found it useful to contract with outside supervised visitation programs to provide services. Since supervision in the case ofout-of--home placement is generally controlled very closely by the state or local CPS regulations, the information here applies primarily to supervision in the case of parental separation. Why not use a friend or relative rather than a professional service, particularly when there is a fee involved? Often there is nothing to prohibit you from using a "non-professional" relative, friend, or acquaintance. Many court orders will allow that as an option providing both parents can agree on who to use. That often does not work out for the following reasons: First and foremost is the difficulty in finding someone on whom you both agree. If you are having sufficient conflict that supervision was deemed necessary, then chances aze very slim you will be able to fmd an individual that both of you will trust and feel comfortable with. Secondly, it puts a real strain on friendships. Many well-meaning friends and relatives will agree to provide the service but will quickly tire of the regulaz commitment and/or being in the middle of your conflicts. It is difficult for friends and relatives to restrain from taking sides. Once neutrality is lost, then the credibility of the "supervisor" will come into question and much of the feeling of security and safety will be gone. And, finally, it may actually detract from the quality of the parentJchild time together. It is often tempting to spend time interacting with the acquaintance rather than focusing on the child. Children may then come to resent the visits because they feel that they are secondary and not primary in the interaction. " Service Description To meet the needs in the rural Hill Country service area, it is proposed that HCCC operate both a dedicated site in Kerrville and a mobile safe haven unit to bring the services to specific locations on established dates. Administrative services would be assumed by existing HCCC infrastructure. U.S. Department of Justice Office on Violence Against Women The U.S. Department of Justice, Office on Violence Against Women (OVW) (www.usdoi.oov/ovw) is pleased to announce that ft is seeking applications for the Safe Havens: Supervised Visitation and Safe Exchange Program. This program furthers the Department's mission by providing an opportunity for communities to support the supervised visitation and safe exchange of children in situations involving domestic violence, dating violence, child abuse, sexual assault, or stalking. OVW FY 2007 Safe Havens: Supervised Visitation and Safe Exchange Program Eligibility Applicants are limited to states, Indian tribal governments, and units of local government. (See "Eligibility," page 4) Deadline Letters of intent to apply should be submitted by Tuesday, January 23, 2007. All Applicants should register online with Grants.gov by Tuesday, January 23, 2007. All applications are due by 8:00 p.m. E.S.T. on Tuesday, February 13, 2007. (See "Deadline: Application," page 4) Contact Information For assistance with the requirements of this solicitation, contact the Office on Violence Against Women at (202)307-6026. This application must be submitted through Grants.gov. For technical assistance with submitting the application, call the Grants.gov Customer Support Hottine at 1-800-5i8-4726. Grants.gov Number assigned to announcement OVW-2007-1525 CONTENTS Overview of the OVW Safe Havens: Supervised Visitation and Safe Exchange Grant Program Deadline: Letter of Intent Deadline: Registration Deadline: Application Eligibility . Faith-Based and Other Community Organizations OVW Safe Havens: Supervised Visitation and Safe Exchange Information • Types of Applicants • Availability of Funds • Award Period • Award Amounts • Program Scope • Activities That May Compromise Victim Safety • Unallowable Activities Performance Measures How to Apply What An Application Must Include: Standard Form 424 Standard Assurances and Certifications Program Narrative Budget and Budget Narrative MOU Letter of Nonsupplanting Financial Capability Questionnaire Indirect Cost Rate Agreement Selection Criteria Review Process Additional Requirements Application Checklist Appendices p. 3 p. 3 p. 4 p. 4 p. 4 p. 5 p. 6 p. 6 p. 8 p. 8 p. 8 p. 8 p.10 p.10 p.10 p.11 p.11 p.20 p.20 p.21 p.22 p.26 OVW Safe Havens: Supervised Visitation and Safe Exchange (CFDA Grant Program 16.527) Overview About the Office on Violence Against Women The Office on Violence Against Women (OVW) is a component of the U.S. Department of Justice. Created in 1995, OVW implements the Violence Against Women Act (VAWA) and subsequent legislation and provides national leadership against domestic violence, dating violence, sexual assault, and stalking. Since its inception, OVW has launched a multifaceted approach to responding to these crimes. By forging state, local and tribal partnerships among police, prosecutors, the judiciary, victim advocates, health care providers, faith leaders and others, OVW grants help provide victims with the protection and services they need to pursue safe and healthy lives and enable communities to hold offenders accountable. About the Safe Havens: Supervised Visitation and Safe Exchange Grant Program The Safe Havens: Supervised Visitation and Safe Exchange Grant Program (Supervised ~, Visitation Program) provides an opportunity for communities to support the supervised visitation and safe exchange of children in situations involving domestic violence, dating violence, child abuse, sexual assault, or stalking. Studies have shown that the risk of violence is often greater for victims of domestic violence and their children after separation from an abusive situation.' Even after separation, batterers often use visitation and exchange of children as an opportunity to inflict additional emotional, physical, and/or psychological abuse on victims and their children. Visitation and exchange services provided through the Supervised Visitation Program should reflect a clear understanding of the dynamics of domestic violence, dating violence, sexual assault and stalking; the impact of domestic violence on children; and the importance of holding offenders accountable for their actions. Deadline: Letter of Intent All applicants who intend to apply for FY 2007 funding under this program are encouraged to submit anon-binding letter of intent, (Please see http:!/www.usdoj.oov/ovw/docs/sample letter of intent.pdf) to OVW by Tuesday, January 23, 2007. You may send the letter to OVW at OVW.SupervisedVisitation anusdoi.aov. OVW will use these letters to forecast the number of peer review panels needed to review competitive applications. ' Jaffe, P.G., "Children of Domestic Violence: Special Challenges in Custody and Visitation Dispute Resolution." In J. Carter, C. Heisler, & M. Runner (Eds.), Domestic Violence and Children: Resolving Custody and Visitation Disputes, A National Judicial Curriculum (San Francisco: Family Violence Prevention Fund), pp. 22-30. Deadline: Registration The Grants.gov registration deadline is Tuesday, January 23, 2007. Registering with Grants.gov is a one-time process; however, if you are afirst-time registrant, it could take several weeks to have your registration validated and confirmed and to receive your user password. It is highly recommended that you start the registration process as early as possible to prevent delays in submitting your application package to our agency by the deadline specified. There are three steps that you must complete before you are able to register: 1) register with Central Contractor Registry (CCR), 2) be authorized as an Authorized Grantee/Recipient Official (AGO) in your organization, and 3) register yourself as an (AGO}. For more information, go to www.arants.aov. Note: Your CCR registration must be renewed once a year. Failure to renew your CCR registration will prohibit submission of a grant application through Grants.gov. Deadline: Application The due date for applying for funding under this announcement is 8:00 pm E.S.T., Tuesday, February 13, 2007. Eligibility It is very important that you review this information carefully. Applications that are submitted by non-eligible entities will be screened out during an initial review process. By statute, eligible entities for the Supervised Visitation Program are states,Z Indian tribal governments, and units of local governments. Applicants must enter into or expand the scope of existing contracts and cooperative agreements with public or private nonprofit entities, inctudina faith-based and community organizations, to provide supervised visitation and safe visitation exchange of children in situations involving domestic violence, dating violence, child abuse, sexual assault, or stalking. All applicants are required to enter into a collaborative working relationship with state or local courts and a faith and/or community-based nonprofit, nongovemmental domestic violence or sexual assault victim services organization that represents the views and concerns of domestic violence and sexual assault victims. Unit of Local Government For the purposes of this Program, a unit of local government is any city, county, township, town, borough, parish, village, or other general-purpose political subdivision of a State'; an Indian tribe that performs law enforcement functions as determined by the Secretary of the Interior; or, for the purpose of assistance eligibility, any agency of the District of Columbia govemment or the United States Government performing law enforcement functions in and for the District of Columbia or any Trust Territory of the United States. Local courts, police departments, pre-trial service agencies, district or city attorneys' offices, sheriffs' departments, probation and parole departments, shelters, nonprofit, nongovernmental victim services ~ For the purposes of this grant program, a state is defined to include all states, the District of Columbia, the Commonwealth of Puerto Rico, and the Virgin Islands, American Samoa, Guam and the Northern Mariana Islands. ' As defined in 42 U.S.C. § 3791, "unit of local government' also includes any law enforcement district orjudicial enforcement district that is established under applicable State law and has the authority to, in a manner independent of other State entities, establish a budget and impose taxes. the project period. Funds are limited to $350,000 for the course of the implementation phase. The grantee will continue working with OVW and OVW Technical Assistance providers to implement their Supervised Visitation project. Please see Appendix A for a sample development budget. Applicants applying for a development project grant are required to set aside $50,000 for OVW training and technical assistance. Continuation Projects Current grantees are eligible to apply for supplemental funds to continue and/or enhance their existing programs. a Multi-jurisdictional and state initiatives must meet statutory and program requirements for each jurisdiction involved in the project. In FY 2007, the Supervised Visitation Program is offering two different funding options for current grantees: 1) the standard two-year project; or 2) the optional five-year project. Please note that state applicants are only eligible to apply for the standard two-year project. Five-Year Project Under the five-year project, successful local and tribal applicants6, including non-state multi- jurisdictional' local applicants, will receive funding in descending amounts over alive-year period and will not be required to compete for continuation funding after the first two-year (24 month) cycle. Subsequent funding for years three through five is contingent upon continued appropriations for the program, and grantee compliance with program requirements and grant award special conditions. Continuation funding is, therefore, not guaranteed. Additionally, OVW may choose to discontinue the five-year project, in which case participants would be eligible to apply for any funds available generally to continuation applicants. Successful ^- applicants will also be required to submit alive-year strategic plan describing their commitment and capacity to continue the project when federal funds are decreased or no longer available. Subject to the stated contingencies, awards will be made in the following manner: successful applicants will receive an initial award in FY 2007, based on a 24 month budget for no more than $250,000; a subsequent award will be made in FY 2009 for no more than $175,000 for 24 months; and in FY 2011 the final award will be based on a 12 month budget for no more than $75,000, for a total of no more than $500,000. At the completion of the five-year project, successful grantees and their supervised visitation/safe exchange provider subgrantee partner(s) will not be eligible to apply to a Supervised Visitation solicitation for 12 calendar months after their final financial and progress reports have been submitted.e OVW has the discretion to make grants for greater or lesser amounts than requested and to negotiate the scope of work and budget with applicants prior to award of a grant. Standard Two-Year Proiect State, local and tribal applicants may elect to submit an application and budget reflecting a standard two-year (24 month) project. Local and tribal applicants (including multi-jurisdictional local applicants) may apply for up to $200,000 for 24 months of funding. State applicants may apply for up to $750,000 for 24 months of funding, depending upon the number of jurisdictions s In future years, funding priority will be given to fve-year grant projects. e State applicants may not apply for five-year project funding. ' A local unit of government proposing two or more supervised visitation centers in two or more jurisdictions. e Please note that the next OVW Safe Havens Solicitation for which you may be eligible to apply after the completion of your five-year award could be more than 12 months from the time your foal financial and progress reports are submitted. For example, if a grantee's project ends on 9/30/2012, but the final financial and progress reports are not submitted until 1/1/2013, the grantee will have to wait until 1/1/2014 to apply for the next open Safe Havens ,~, Solicitation, which based on current solicitation release patterns may not occur until December 2014. in which supervised visitation centers are being proposed. State applicants must propose supervised visitation centers in at least two jurisdictions. State applicants proposing supervised visitation centers in two jurisdictions can apply for up to $200,000 for 24 months. State applicants proposing supervised visitation centers in more than two jurisdictions are eligible to apply for $200,000 for the first two jurisdictions and up to $150,000 for each additional jurisdiction in which a supervised visitation center is proposed, not to exceed a total budget request of $750,000. State applicants proposing supervised visitation centers in six or more jurisdictions may not exceed the $750,000 budget cap. Please note that OVW reserves the right to make awards for lesser or greater amounts. Availability of Funds All awards are subject to the availability of appropriated funds and any modifications or additional requirements that may be imposed by law. Award Period The award period for these grants will be: • Development project applicants: three-years (36 months) • Continuation project applicants: two-years (24 months) Budgets must reflect the full length of project activity, and the total "estimated funding" (block 15) on the SF-424 must reflect either 24 or 36 months. Award Amounts Applicants should carefully consider the resources needed to successfully implement the proposed project and present a realistic budget that accurately reflects project costs. Supervised Visitation Program funds for FY 2007 will be awarded based on the folowing guidelines: up to $400,000 for athree-year (36 months) development project; up to $250,000 for the first two years (24 months) of a five-vear local or tribal continuation project; up to $200,000 for a standard two-year (24 months) local or tribal continuation project; and from $200,000 to $750,000 for a standard two-year (24 months) state continuation project depending upon the number of jurisdictions in which supervised visRation centers are being proposed. Please see page 16 for a table listing the budget caps for the development and continuation projects. Funds for years three through five of the five-year Continuation Project will be awarded upon successful completion of the prior years' grant activities and continued appropriation of the Supervised Visitation Program. OVW reserves the right to make awards for lesser or greater amounts. Program Scope The scope of the Supervised Visitation Program is defined by the following statutory considerations and minimum requirements. Applicants must address these considerations and requirements in the Project Narrative section of the application. Statutory Program Purposes: By statute 42 U.S.C. § 10420 (a), funds under the Supervised Visitation Program may be used for the following purposes: • Provide supervised visitation and safe exchange of children by and between parents in situations involving domestic violence, dating violence, child abuse, sexual assault, or stalking; the project period. Funds are limited to $350,000 for the course of the implementation phase. The grantee will continue working with OVW and OVW Technical Assistance providers to implement their Supervised Visitation project. Please see Appendix A for a sample development budget. Applicants applying for a development project grant are required to set aside $50,000 for OVW training and technical assistance. Continuation Projects Current grantees are eligible to apply for supplemental funds to continue and/or enhance their existing programs. a Multi-jurisdictional and state initiatives must meet statutory and program requirements for each jurisdiction involved in the project. In FY 2007, the Supervised Visitation Program is offering two different funding options for current grantees: 1) the standard two-year project; or 2) the optional five-year project. Please note that state applicants are only eligible to apply for the standard two-year project. Five-Year Project Under the five-year project, successful local and tribal applicantsfi, including non-state multi- jurisdictional' local applicants, will receive funding in descending amounts over afive-year period and will not be required to compete for continuation funding after the first two-year (24 month} cycle. Subsequent funding for years three through five is contingent upon continued appropriations for the program, and grantee compliance with program requirements and grant award special conditions. Continuation funding is, therefore, not guaranteed. Additionally, OVW may choose to discontinue the five-year project, in which case participants would be eligible to apply for any funds available generally to continuation applicants. Successful -- applicants will also be required to submit afive-year strategic plan describing their commitment and capacity to continue the project when federal funds are decreased or no longer available. Subject to the stated contingencies, awards will be made in the following manner: successful applicants will receive an initial award in FY 2007, based on a 24 month budget for no more than $250,000; a subsequent award will be made in FY 2009 for no more than $175,000 for 24 months; and in FY 2011 the final award will be based on a 12 month budget for no more than $75,000, for a total of no more than $500,000. At the completion of the five-year project, successful grantees and their supervised visitation/safe exchange provider subgrantee partner(s) will not be eligible to apply to a Supervised Visitation solicitation for 12 calendar months after their final financial and progress reports have been submitted.e OVW has the discretion to make grants for greater or lesser amounts than requested and to negotiate the scope of work and budget with applicants prior to award of a grant. Standard Two-year Proiect State, local and tribal applicants may elect to submit an application and budget reflecting a standard two-year (24 month) project. Local and tribal applicants (including multi-jurisdictional local applicants) may apply for up to $200,000 for 24 months of funding. State applicants may apply for up to $750,000 for 24 months of funding, depending upon the number ofjurisdictions s In future years, funding priority will be given to five-year grant projects. s State applicants may not apply for five-year project funding. ' A local unit of government proposing two or more supervised visitation centers in two or more jurisdictions. a Please note that the next OVW Safe Havens Solicitation for which you may be eligible to apply after the completion of your five-year award could be more than 12 months from the time your final financial and progress reports are submitted. For example, if a grantee's project ends on 9/3 012 0 1 2, but the final financial and progress reports are not submitted until 1/1/2013, the grantee will have to wait until 1/1/2014 to apply for the next open Safe Havens Solicitation, which based on current solicitation release patterns may not occur until December 2014. in which supervised visitation centers are being proposed. State applicants must propose supervised visitation centers in at least two jurisdictions. State applicants proposing supervised visitation centers in two jurisdictions can apply for up to $200,000 for 24 months. State applicants proposing supervised visitation centers in more than two jurisdictions are eligible to appy for $200,000 for the first two jurisdictions and up to $150,000 for each additional jurisdiction in which a supervised visitation center is proposed, not to exceed a total budget request of $750,000. State applicants proposing supervised visitation centers in six or more jurisdictions may not exceed the $750,000 budget cap. Please note that OVW reserves the right to make awards for lesser or greater amounts. Availability of Funds All awards are subject to the availability of appropriated funds and any modifications or additional requirements that may be imposed by law. Award Period The award period for these grants will be: • Development project applicants: three-years (36 months) • Continuation project applicants: two-years (24 months) Budgets must reflect the full length of project activity, and the total "estimated funding" (block 15) on the SF-424 must reflect either 24 or 36 months. Award Amounts Applicants should carefully consider the resources needed to successfully implement the proposed project and present a realistic budget that accurately reflects project costs. Supervised Visitation Program funds for FY 2007 will be awarded based on the folowing guidelines: up to $400,000 for athree-year (36 months) development project; up to $250,000 for the first two years (24 months) of a five-year local or tribal continuation project; up to $200,000 for a standard two-year (24 months) local or tribal continuation project; and from $200,000 to $750,000 for a standard two-year (24 months) state continuation project depending upon the number of jurisdictions in which supervised visitation centers are being proposed. Please see page 16 for a table listing the budget caps for the development and continuation projects. Funds for years three through five of the five-year Continuation Project will be awarded upon successful completion of the prior years' grant activities and continued appropriation of the Supervised Visitation Program. OVW reserves the right to make awards for lesser or greater amounts. Program Scope The scope of the Supervised Visitation Program is defined by the following statutory considerations and minimum requirements. Applicants must address these considerations and requirements in the Project Narrative section of the application. Statutory Program Purposes: By statute 42 U.S.C. § 10420 (a), funds under the Supervised Visitation Program may be used for the following purposes: • Provide supervised visitation and safe exchange of children by and between parents in situations involving domestic violence, dating violence, child abuse, sexual assault, or stalking; How to Apply DOJ is participating in the e-Government initiative, one of 25 initiatives included in the President's Management Agenda. Part of this initiative -- Grants.gov - is a "one-stop storefront" that provides a unified process for all customers of federal grants to find funding opportunities and apply for funding. Grants.gov Instructions Complete instructions can be found at www.grants.gov. Please note that Grants.gov is not the Grants Management System (GMS) through which OVW applicants have submitted applications in previous years. If you experience difficulties at any point during this process, please call the Grants.gov Customer Support Hotline at 1-800-518-4726. In addition, applicants must send via overnight delivery a complete hard-copy original of the application, including signed copies of all required Assurances and Certifications, postmarked by Tuesday. February 13. 2007 to: The Office on Violence Against Women c/o Lockheed Martin Aspen Systems Corporation OVW Safe Havens: Supervised Visitation and Safe Exchange Program Mail Stop 2K 2277 Research Boulevard Rockville, MD 20850 (301) 519000 CFDA Number The Catalog of Federal Domestic Assistance number fer this program is 16.527, titled "Supervised Visitation Program' and the funding opportunity number is OVW-2007-1525. A DUNS Number is Required The Office of Management and Budget requires that all business and nonprofit applicants for Federal funds include a DUNS (Data Universal Numeric System) number in their application for a new award or renewal of an award. Applications without a DUNS number are incomplete. A DUNS number is a unique nine-digit sequence recognized as the universal standard for identifying and keeping track of entities receiving Federal funds. The identifier is used for tracking purposes and to validate address and point of contact information. The DUNS number will be used throughout the grant life cycle. Obtaining a DUNS number is a free, simple, one- time activity. Obtain one by calling 1-866-705-5711 or by applying online at http://www.dunandbradstreet.com. Individuals are exempt from this requirement. What an Application Must Include Applicants must complete each of the following sections as part of their response to this solicitation. It is the responsibility of the applicant to ensure that the application is complete. OVW will remove the application from consideration prior to peer review if the application is incomplete. For each section listed below, please note the corresponding maximum point value that may be assigned during the review process. The proposal should follow the order below for easy reading. Please be sure to number each page of the aoolication. Peer reviewers will not receive materials submitted beyond those required by this solicitation. 11 Applications must use the following page format requirements • Double spaced • 8'/ x 11 inch paper • One inch margins Type no smaller than 12 point, Times New Roman font No more than one page each for Summary Data Sheet and Abstract No more than 5 pages for Status of the Current Project (if applicable) • No more than 20 pages for the Project Narrative (Items D through G below) Application for Federal Assistance (SF-424) The SF-424 will be filled out online through Grants.gov. However, it should also lie printed out and included in the hard copy that is submitted. The Catalog of Federal Domestic Assistance number for this program is 16.527 (block 10). Please be sure that the amount requested matches the amount in the submitted budget. Budgets must reflect the full length of project activity, and the total "estimated funding" (block 15) on the SF-424 must reflect either 24 or 36 months. Applicants must ensure that the information for the authorizing official and alternate contact is filled out correctly. The authorizing official is the individual authorized to accept grant funds on behalf of the jurisdiction applying. Standard Assurances and Certifications Regarding Lobbying; Debarment, Suspension, and Other Responsibility Matters; and Drug-Free Workplace Requirements (Form 4061/6) Review the assurances and certification forms. Agreement to these assurances and certifications will be assumed upon receipt of an application received through Grants.gov. Narrative (Total 65 Points) The following narrative will be submitted as an attachment in Grants.gov. A. Summary Data Sheet (not to exceed one page) Please identify the following: • Name, title, address, phone number, and e-mail address for the authorized official; • Legal name of the applicant and type of agency (i.e., state govemment, local unit of government, or tribal government); • The nonprofit, non-governmental victim services program collaborating on this project; • Name, address, phone number, and fax number for the visitation center(s) involved in the project (for jurisdictions in which centers are being proposed but are not yet in existence, provide the name of each jurisdiction in which a center is being proposed); • Whether this is a new or continuation application (including the type of continuation project for which the grantee is applying); and Contact information, including an email address for the project director or primary person to be contacted on matters involving the application. B. AbstracUProoosal Summary (not to exceed one pane) A project abstract, when read separately from the rest of the application, is meant to serve as a succinct and accurate description of the proposed project and should concisely describe the project goals and objectives. Summaries of past accomplishments should be avoided in the abstract. 12 How to Apply DOJ is participating in the e-Government initiative, one of 25 initiatives included in the President's Management Agenda. Part of this initiative -- Grants.gov - is a "one-stop storefront" that provides a unified process for all customers of federal grants to find funding opportunities and apply for funding. Grants.gov Instructions Complete instructions can be found at www.grants.gov. Please note that Grants.gov is not the Grants Management System (GMS) through which OVW applicants have submitted applications in previous years. if you experience difficukies at any point during this process, please tail the Grants.gov Customer Support Hotline at 1-800-518-4726. In addition, applicants must send via overnight delivery a complete hard-copy original of the application, including signed copies of all required Assurances and Certifications, postmarked by Tuesday. February 13. 2007 to: The Office on Violence Against Women c/o Lockheed Martin Aspen Systems Corporation OVW Safe Havens: Supervised Visitation and Safe Exchange Program Mail Stop 2K 2277 Research Boulevard Rockville, MD 20850 (301519-5000 CFDA Number The Catalog of Federal Domestic Assistance number for this program is 16.527, titled "Supervised Visitation Program" and the funding opportunity number is OVW-2007-1525. A DUNS Number is Required The Office of Management and Budget requires that all business and nonprofit applicants for Federal funds include a DUNS (Data Universal Numeric System) number in their application for a new award or renewal of an award. Applications without a DUNS number are incomplete. A DUNS number is a unique nine-digit sequence recognized as the universal standard for identifying and keeping track of entities receiving Federal funds. The identifier is used for tracking purposes and to validate address and point of contact information. The DUNS number will be used throughout the granf life cycle. Obtaining a DUNS number is a free, simple, one- time activity. Obtain one by calling 1-866-705-5711 or by applying online at htto:l/www.dunandbradstreet.com. Individuals are exempt from this requirement. What an Application Must Include Applicants must complete each of the following sections as part of their response to this solicitation. It is the responsibility of the applicant to ensure that the application is complete. OVW will remove the application from consideration prior to peer review if the application is incomplete. For each section listed below, please note the corresponding maximum point value that may be assigned during the review process. The proposal should follow the order below for easy reading. Please be sure to number each oage of the application. Peer reviewers will not receive materials submitted beyond those required by this solicitation. 11 Applications must use the following page format requirements • Double spaced • 8Y x 11 inch paper • One inch margins • Type no smaller than 12 point, Times New Roman font • No more than one page each for Summary Data Sheet and Abstract • No more than 5 pages for Status of the Current Project (if applicable) • No more than 20 pages for the Project Narrative (Items D through G below) Application for Federal Assistance (SF-424) The SF-424 will be filled out online through Grants.gov. However, it should also be printed out and included in the hard copy that is submitted. The Catalog of Federal Domestic Assistance number for this program is 16.527 (block 10). Please be sure that the amount requested matches the amount in the submitted budget. Budgets must reflect the full length of project activity, and the total "estimated funding" (block 15) on the SF-424 must reflect either 24 or 36 months. Applicants must ensure that the information for the authorizing ofrcial and alternate contact is filled out correctly. The authorizing official is the individual authorized to accept grant funds on behalf of the jurisdiction applying. Standard Assurances and Certifications Regarding Lobbying; Debarment, Suspension, and Other Responsibility Matters; and Drug-Free Workplace Requirements (Form 4061/6) Review the assurances and certification forms. Agreement to these assurances and certifications will be assumed upon receipt of an application received through Grants.gov. Narrative (Total 65 Points) The following narrative will be submitted as an attachment in Grants.gov. A. Summary Data Sheet (not to exceed one page) Please identify the following: • Name, title, address, phone number, and a-mail address for the authorized official; Legal name of the applicant and type of agency (i.e., state government, local unit of government, or tribal government); • The nonprofit, non-governmental victim services program collaborating on this project; • Name, address, phone number, and fax number for the visitation center(s) involved in the project (for jurisdictions in which centers are being proposed but are not yet in existence, provide the name of each jurisdiction in which a center is being proposed); • Whether this is a new or continuation application (including the type of continuation project for which the grantee is applying); and • Contact information, including an email address for the project director or primary person to be contacted on matters involving the application. B. AbstracVProaosal Summary (not to exceed one oaoel A project abstract, when read separately from the rest of the application, is meant to serve as a succinct and accurate description of the proposed project and should concisely describe the project goals and objectives. Summaries of past accomplishments should be avoided in the abstract. 12 The extent to which the application clearly describes the community to be served, including the diverse, traditionally underserved populations of victims of domestic violence, dating violence, child abuse, sexual assault, or stalking; The extent to which the proposed project activities reflect sound development and thoughtful innovation; and The extent to which the development and implementation strategy, the organization and staff capability, the project components, and the general timeline are clearly described. Program Specifications -Continuation Applicants Only Continuation applicants should submit a detailed description of the proposed visitation and exchange center(s). This description should include information on the following program specifications: • The purpose of the visitation center and how it reflects an understanding of the impact of domestic violence, child abuse, sexual assault, dating violence, and stalking on families; • Scope of proposed visitation and exchange services; • Types of families to be served by the project; • Hours of operation; • Program security; • Record keeping and confidentiality; • Referral process; • Intake procedures; ~' • Fee protocols; • Proposed level of staffing; • Job descriptions and resumes for key staff (this information should be appended to the application); • Training requirements for staff and volunteers; and • Composition and role of the existing or proposed advisory committee (see description of required ConsultinglAdvisory Committee on page 20). Who WiII Implement the Project (10 points) All applicants are required to coordinate with state or local courts and nonprofit, nongovernmental domestic violence and/or sexual assault victim service programs. All applicants must identify the court and faith- and/or community-based victim services program(s) partnering on the proposed project and all other project partners, and specify their respective roles and responsibilities. Victim service organizations should meet all of the following criteria: Provide services to victims of domestic violence, sexual assault, dating violence, or stalking as one of their primary purposes and have a demonstrated history of effective work concerning such issues; Address a demonstrated need in their communities by providing services that promote the dignity and self sufficiency of victims, improve their access to resources, and create options for victims seeking safety from perpetrator violence; and Do not engage in activities that compromise victim safety. 15 G. Sustainability Plan (5 points) As this is a competitive, discretionary program, there is no guarantee of continuation funding. Applicants are required to include a plan describing their commitment and capacity to continue the project if Federal funding through the Supervised Visitation Program were no longer available. Applicants are encouraged to describe any past federally or state supported projects which the applicant or its partners sustained once funding had expired. The plan will be evaluated on whether it proposes feasible strategies to preserve project activities long-term. Continuation or supplemental funding is not guaranteed and applicants are always encouraged to seek additional means of support to sustain their current projects. Budget Detail Worksheet and Narrative (15 Points) Each application must include a detailed budget and budget narrative for the project. This will be submitted as an attachment in Grants.gov as well as in the hard copy. The budget must be complete, reasonable, and cost-effective in relation to the proposed project. The budget should provide the basis for the computation of all project-related costs. It should cover the cost of all components of the project. There must be a clear link between the proposed activities and the proposed budget items. The budget should include only those activities, products, and resources that are necessary for project implementation and discussed in the project narrative. In developing the budget, applicants should fairly compensate all project partners for their participation in any project-related activities, including but not limited to, compensation for time and travel expenses to attend or provide project development, training, and implementation. The budget must include compensation for all services rendered by project partners, including nonprofit, nongovernmental domestic violence and/or sexual assault victim services programs, and state and tribal domestic violence and/or sexual assault coalitions. Additionally, subgrantee center staff members must be fairly compensated if they will be providing services under the Supervised Visitation Program. Budget Caps The following award limits are firm and apply even to applications for continuation funding. Under no circumstances should the proposed budget exceed the following limits: Development Projects $400,000 for 3 years (new grantees) ($50,000 for planning phase; $350,000 for im lementation Local and Tribal Continuation $250,000 for first 24 months five-year Projects (Funding for the remaining 36 months will be awarded upon the grantee's successful completion of initial grant activities and continued a ro riation of the ro ram. Local and Tribal Standard $200,000 Continuation two-year Projects includin multi-Jurisdictional State Standard Continuation $200,000 (2 jurisdictions with centers) twa-year Projects $350,000 (3 jurisdictions with centers) $500,000 (4 jurisdictions with centers) $650,000 (5 jurisdictions with centers) $750,000 6 or more'urisdictions with centers 16 The extent to which the application clearly describes the community to be served, including the diverse, traditionally underserved populations of victims of domestic violence, dating violence, child abuse, sexual assault, or stalking; The extent to which the proposed project activities reflect sound development and thoughtful innovation; and The extent to which the development and implementation strategy, the organization and staff capability, the project components, and the general timeline are clearly described. Program Specifications -Continuation Applicants Only Continuation applicants should submit a detailed description of the proposed visitation and exchange center(s). This description should include information on the following program specifications: • The purpose of the visitation center and how it reflects an understanding of the impact of domestic violence, child abuse, sexual assault, dating violence, and stalking on families; • Scope of proposed visitation and exchange services; • Types of families to be served by the project; Hours of operation; • Program security; • Record keeping and confidentiality; • Referral process; Intake procedures; ""' • Fee protocols; Proposed level of staffing; Job descriptions and resumes for key staff (this information should be appended to the application); • Training requirements for staff and volunteers; and • Composition and role of the existing or proposed advisory committee (see description of required Consulting/Advisory Committee on page 20). Who Will Implement the Protect (10 points) All applicants are required to coordinate with state or local courts and nonprofit, nongovernmental domestic violence and/or sexual assault victim service programs. All applicants must identify the court and faith- and/or community-based victim services program(s) partnering on the proposed project and all other project partners, and specify their respective roles and responsibilities. Victim service organizations should meet all of the following criteria: Provide services to victims of domestic violence, sexual assault, dating violence, or stalking as one of their primary purposes and have a demonstrated history of effective work concerning such issues; Address a demonstrated need in their communities by providing services that promote the dignity and self sufficiency of victims, improve their access to resources, and create options for victims seeking safety from perpetrator violence; and Do not engage in activities that compromise victim safety. 15 G. Sustainabilitv Plan (5 points) As this is a competitive, discretionary program, there is no guarantee of continuation funding. Applicants are required to include a plan describing their commitment and capacity to continue the project if Federal funding through the Supervised Visitation Program were no longer available. Applicants are encouraged to describe any past federally or state supported projects which the applicant or its partners sustained once funding had expired. The plan will be evaluated on whether it proposes feasible strategies to preserve project activities long-term. Continuation or supplemental funding is not guaranteed and applicants are always encouraged to seek additional means of support to sustain their current projects. Budget Detail Worksheet and Narrative (t5 Points) Each application must include a detailed budget and budget narrative for the project. This will be submitted as an attachment in Grants.gov as well as in the hard copy. The budget must be complete, reasonable, and cost-effective in relation to the proposed project. The budget should provide the basis for the computation of all project-related costs. It should cover the cost of all components of the project. There must be a clear link between the proposed activities and the proposed budget items. The budget should include only those activities, products, and resources that are necessary for project implementation and discussed in the project narrative. In developing the budget, applicants should fairly compensate all project partners for their participation in any project-related activities, including but not limited to, compensation for time and travel expenses to attend or provide project development, training, and implementation. The budget must include compensation for all services rendered by project partners, including nonprofit, nongovernmental domestic violence and/or sexual assault victim services programs, and state and tribal domestic violence and/or sexual assault coalitions. Additionally, subgrantee center staff members must be fairly compensated if they will be providing services under the Supervised Visitation Program. Budget Caps The following award limits are firm and apply even to applications for continuation funding. Under no circumstances should the proposed budget exceed the following limits: Development Projects $400,000 for 3 years (new grantees) ($50,000 for planning phase; $350,000 for im lementation Local and Tribal Continuation $250,000 for first 24 months five-year Projects (Funding for the remaining 36 months will be awarded upon the grantee's successful completion of initial grant activities and continued a ro riation of the ro ram. Local and Tribal Standard $200,000 Continuation two-year Projects includin multi=urisdictional State Standard Continuation $200,000 (2 jurisdictions with centers) two-year Projects $350,000 (3 jurisdictions with centers) $500,000 (4 jurisdictions with centers) $650,000 (5 jurisdictions with centers) $750,000 6 or more 'urisdictions with centers 16 Letters of support may not be submitted in lieu of the MOU. Only applicants for development projects may submit Letters of Intent to Collaborate in lieu of an MOU. Please refer to Appendix C for a sample Letter of Intent to Collaborate. All applicants are required to enter into formal collaborations with state or local courts and a nonprofit, non-governmental organization serving victims of domestic violence and/or sexual assault. Applicants must demonstrate that they have consulted and coordinated in a meaningful way with afaith- andlor community-based nonprofit, non-governmental domestic violence, and/or sexual assault victim services program, and that this organization will be involved in the development and implementation of the proposed project. The faith- and/or community-based non-profit, non-governmental domestic violence and/or sexual assault victim services program should meet all of the following criteria: • Provides services to victims of domestic violence, sexual assault, dating violence, or stalking as one of their primary purposes; • Reflects an understanding that the violence perpetrated against victims is grounded in an abuse of power by offenders, reinforced through intimidation and coercion; Addresses a demonstrated need in their communities by providing services that promote the integrity and self-sufficiency of victims, improve their access to resources, and create options for victims seeking safety from perpetrator violence; and • Does not engage in activities that compromise victim safety. Letter of Nonsupplanting Applicants must submit a letter to OVW's Director, certifying that Federal funds will not be used to supplant State or local funds should a grant award be made. Please refer to http:/lwww.usdoi_aov/ovw/dots/nonsuo letter.odf for a sample letter. Financial Capability Questionnaire All nonprofit, nongovernmental organizations that apply for funding with OVW that have not previously (or within the last 3 years) received funding from OVW or OJP must complete a Financial Capability Questionnaire. The form can be found at http://www.oio.usdoi.aov/oc. You should also include the cognizant Federal audit agency and fiscal year on the first page. In addition, be sure to submit your current year's audit report with the Financial Capability Questionnaire. Indirect Cost Rate Agreement If your organization is requesting indirect costs for this project, please include a copy of your current, signed indirect cost rate agreement. If you need additional information on this requirement, please go to http:/lwww.oio.usdoi.oov/FinGuide/oart3chao17.htm. Additional Program Requirements Technical Assistance Grant recipients are required to work collaboratively with staff from OVW and OVW-designated technical assistance providers. Grant recipients will be asked to identify advocates from local domestic violence or sexual assault victim service programs, law enforcement officers, 19 prosecutors, judges, and other representatives from the community to participate in technical assistance events. Participation in technical assistance events will often involve out-of-state travel, therefore applicants are required to include funds in the project budget to support travel cost associated with these activities. Consulting/Advisory Committee Visitation programs that serve families with a history of domestic violence, dating violence, child abuse, sexual assault, and stalking should develop formal affiliations with organizations that will be available to provide services and consultation to programs that work with children and parents. Applicants must establish a consulting committee, which includes experts in the following fields: child abuse and neglect, mental health, substance abuse, counseling, batterers' intervention, law enforcement, child protection services, and advocacy for victims of domestic violence and sexual assault. In addition, grantees serving underserved and diverse communities should include experts who are knowledgeable on domestic violence, dating violence, child abuse, sexual assault and/or stalking within these communities on the consulting committee. Selection Criteria In addition to the criteria above, all applications will also be rated on the following: • The extent to which all project activities fall within the statutory scope of the program; The extent to which proposed activities would address the need described; • The extent to which project activities seem feasible and likely to succeed; • The extent to which the proposal does not include activities that compromise victim safety; • The extent to which activities are clearly described and reflect sound and innovative strategies to improve victim safety; and • The extent to which the budget is reasonable and within established limits. to awarding grants, OVW shall also take into account: • The number of families to be served by the proposed visitation programs and services; • The extent to which the proposed supervised visitation programs and services serve underserved populations; • With respect to an applicant for a contract or cooperative agreement, the extent to which the applicant demonstrates cooperation and collaboration with nonprofit, nongovernmental entities in the local community served, including the State or tribal domestic violence coalition, State or tribal sexual assault coalition, local shelters, and programs for domestic violence and sexual assault victims; and • The extent to which the applicant demonstrates coordination and collaboration with State and local court systems, including mechanisms for communication and referral. Review Process All applications will be subject to internal review by OVW staff and peer review and will be scored according to the criteria set forth in this solicitation. If the application fails to meet the criteria listed below during the initial internal review, the application will not receive further consideration. If applications that are partially beyond the scope of the program are sent to formal peer review, only those sections of the application that are within scope will be reviewed. Criteria for the initial internal review follow: 20 • Whether the application is complete; • Whether the proposed activities are within the scope of the program (see page 8); • Whether all statutory eligibility criteria are met (see page 4); • Whether the minimum requirements for the program are met (see pages 9}; • Whether the application proposes significant activities that may compromise victim safety (see page 10); and • Whether the proposed budget is within the established limits (see page 16). In addition, applications for continuation funding will be reviewed for prior compliance with program and office requirements and the status of current grant-funded activities. (See page 13 for further details on criteria for this review.) Applicants with an OVW grant history that failed to meet grant deadlines, did not comply with Office of Justice Programs' (OJP) financial requirements, or did not comply with special conditions from previous grants, will not be considered for funding. OVW will establish panels of experts and practitioners to review applications. Each panel will review the information provided in the application against the selection criteria for the program. Following formal peer review, a second internal review will be conducted, considering, for example, the geographic distribution of the applications for a national perspective, the ratio of population to services, and the type of projects already funded within an applicant's state or community. Tribal applications will be reviewed by a panel of experts on supervised visitation, domestic violence, child abuse, sexual assault, and stalking in the Native American Community. The total points possible for an application are 100 (65 points for Narrative, 15 points for ^° Budget, and 20 points for the MOU or Letters of Intent to Collaborate). Applications with the highest composite scores will be considered for funding. Additional Requirements • Civil Rights Compliance • Confidentiality and Human Subjects Protections regulations • Anti-Lobbying Act • Financial and Government Audit Requirements • National Environmental Policy Act (NEPA) compliance • DOJ Information Technology Standards • Single Point of Contact Review • Non-Supplanting of State or Local Funds • Criminal Penalty for False Statements • Compliance with Office of the Comptroller Financial Guide 21 • Suspension or Termination of Funding All OVW grantees must comply with these additional requirements. Additional information for each can be found at htto://www.oia.usdoi.aov/funding/otherreauirements.htm. References to the Office of Justice Programs and its components are deemed to refer to the Office on Violence Against Women, as applicable. OVW Application Checklist Applicants must submit a fully executed application to OVW via overnight delivery, including all required supporting documentation. Applications will not be accepted via facsimile or email. Although most parts of the application need to be submitted through Grants.gov as well as in hard copy form, it is the hard copy that wilt be reviewed. Applications submitted via Grants.gov must be in the following word processing formats: Microsoft Word (.doc), PDF files (.pdf), or Text Documents (.bct). Complete applications should include the following: • The SF-424; • Standard Assurances and Certifications Regarding Lobbying; Debarment, Suspension and Other Responsibility Matters; and Drug Free Workplace Requirements; • The summary data sheet, project abstract, project narrative, and for continuation applicants, the status of the project; • The budget, budget summary, and budget narrative; • Letter of nonsupplanting; • An MOU (for continuation project applications) or Letters of Intent to Collaborate (for development project applications) • Letter certifying that the development project will be developed to meet the statutory and minimum requirements of the grant program (development applicants only) • A current Indirect Cost Rate Agreement (if applicable); and • Resumes of key staff members. Detailed instructions on how to use the Grants.gov system to submit your application online are available at www.arants.aov. Also, atoll-free telephone number has been established for you to receive technical assistance as you work through the online application process, 1-800-518- 4726. To help expedite the review process, applicants must send via overnight delivery a complete hard-copy original of the application, postmarked by Tuesday, February 13, 2007 to: The Office on Violence Against Women c/o Lockheed Martin Aspen Systems Corporation OVW Safe Havens: Supervised Visitation and Safe Exchange Program Mail Stop 2K 2277 Research Boulevard Rockville, MD 20850 (301)519-5000 22 U.S. Department of Justice LAVISV Partnership Initiative: Call for Concept Papers OVW is committed to building the capacity of victim service organizations to effectively respond to domestic violence, sexual assault, dating violence, and stalking and to foster partnerships between organizations that have not traditionally worked together to address violence against women. OVW believes that the public would be better served with enhanced collaborative efforts between organizations providing legal services to victims of violence and agencies providing supervised visitation and safe exchanges through the LAV/SV Partnership Initiative (The Initiative). The purpose of the Initiative is to enable Safe Havens: Supervised Visitation and Safe Exchange Grant Program (Supervised Visitation Program) recipients to access legal services for their clients and extend the scope of services provided by Legal Assistance for Victims (LAV) grantees. It is envisioned that the results of this initiative will be a resource and model for community organizations to coordinate their services to victims of violence on a higher level. OVW wi0 select up to 5 five concept papers for further development and funding considerations. The concept paper must provide a detailed plan addressing how the Supervised Visitation grantee will partner with the LAV grantee to provide legal services to victims of domestic „_ violence receiving visitation and exchange services. Eligibility All current OVW Supervised Visitation grantees (including FY 2006 grantees) and FY 2007 Supervised Visitation applicants are eligible to submit a concept paper to participate in the LAV/SV Special Initiative. FY 2007 Supervised Visitation Program applicants interested in submitting a concept paper must submit the concept paper separate from their Supervised Visitation Program application. Any concept papers included with or in a Supervised Visitation Program application will not be considered. The lead partner proposed in the concept paper may be either a current Supervised Visitation grantee or an LAV grantee. Of the partnering agencies, one agency must be selected as fiscally responsible for the grant. Applicants will also need to demonstrate an existing working relationship with a supervised visitation service provider. Award Period The award period will be 24 months. Award Amount Selected projects will receive up to $200,000 for 24 months, although OVW reserves the right to make awards for lesser or greater amounts. 23 How to Apply Applicants must send via overnight delivery a complete hard-copy original of the concept paper, postmarked by Wednesday, January 24, 2007 to: The Office on Violence Against Women 800 K Street, NW, Suite 920 Washington, DC 20530 Attn: LAV Special Initiative Phone: (202) 307-6026. We strongly recommend that you use a trackable shipping method that will allow you to confirm the delivery of your concept paper. Applicants should retain proof of timely submission. What a Concept Paper Must Include Applicants must complete each of the following sections as part of their response to this Call for Concept Papers. It is the responsibility of the applicant to ensure that the concept paper is complete. OV W will remove the concept paper from consideration prior to internal review if the concept paper is incomplete. The proposal should follow the order below for easy reading. Please be sure to number each page of the conceal oaoer. Internal reviewers will not receive materials submitted beyond those required by this call for concept papers. Concept papers must use the following page format requirements: • No more than 10 pages; • Double spaced; • 8Y~ x 11 inch paper; • One inch margins; and • Type no smaller than 12 point, Times New Roman font. Narrative A. Summary Data Sheet The Summary Data Sheet must include the following: • Name of applicant; • Project partner (must be either a current lAV grantee or a Safe Havens supervised visitation center partner); • Target audience; • Geographic focus; • Estimated project cost; and • A list of all current OVW grants and anticipated project completion dates from both the LAV grantee. and the Safe Havens supervised visitation partner. 24 B. What Will Be Done This section should include the following: A description of the target audience; A statement of the goals and objectives of the proposal including: • A plan for the development of policy and practice standards for providing collaborative services; • A partnership commitment to participate in 3-4 regional or national meetings; and • Participation in initiative assessment and follow-up by OVW designated Technical Assistance providers. A summary of activities that will be undertaken to accomplish the project goals and objectives and provide a corresponding timeline for the completion of each activity; A description of what services are currently offered in the community being served; and A description of what services are currently offered to those accessing the Safe Havens Supervised Visitation center. C. Who WiII Implement the Project This section should include the following: • An identification of the LAV and Supervised Visitation recipient organizations and individuals who will implement the project and describe the role of each; • A description of the capacity of the organization/s to undertake the project; -^- A description of the proposed staffing (including consultants) for the initiative; • A list of the qualifications and experience of proposed staff/consultants; and • If you are proposing to utilize consultants, an indication of the estimated daily rate for each consultant. D. Letters of Suooort Letters of Support must be included from all project partners. Letters of Support should be provided by the supervised visitation center(s) currently funded by a Supervised Visitation grantee and LAV grantee. Letters should describe the partners' role in the project, as well as their commitment to the collaboration. Note: A Memorandum of Understanding (MOU}, a budget and budges narrative are not required for the concept paper. Those concept papers that receive the highest overall scores will be invited to submit a full application, which will include a budget and budget narrative, and possibly an MOU. Review Process Complete concept papers wilt be subject to internal OVW review. OVW staff will contact selected applicants to submit a full application. At that time, those applicants will be required to submit full applications, including budgets. Applicants with an OVW grant history that failed to meet grant deadlines, did not comply with Office of Justice Programs' (OJP) financial requirements, or did not comply with special conditions from previous grants, will not be considered for funding. 25 Appendix A Sample Budget Detail Worksheet for Development Applicants ?6 SAMPLE 12/2006 Budget Detail Worksheet: Development Applicants Purpose: The Budget Detail Worksheet may be used as a guide to assist you in the preparation of the budget and budget narrative. You may submit the budget and budget narrative using this form or in the format of your choice (plain sheets, your own form, or a variation of this form). However, all required information (including the budget narrative) must be provided. Any category of expense not applicable to your budget may be deleted. Please note: This sample budget assumes a 36-month budget period with 12 months for planning and 24 months for implementation. Please draft your budget to reflect the amount of time you will need to successfully complete each phase of the development project. A. Personnel -List each position by title and name of employee, if available. Show the annual salary rate and the percentage of time to be devoted to the project. Compensation paid for employees engaged in grant activities must be consistent with that paid for similar work within the applicant organization. Name/Position Computation Cost Project Director ($50,000 x 40% x year 1) $ 20,000 ($50,000 x 100% x years 2 and 3) $100;000 TOTAL 120 000 The Project Director will oversee the Supervised Vsitation project, all supervised visitation center(s) activities, provide supervision to the visitation supervisor and monitors, and conduct case reviews on a monthly basis with project staff. The Project Director is also responsible for developing funding for the center. This individual will write monthly case reports and updates to be sent to judicial oversight committees, as well as complete the OEM/ progress reports. B. Fringe Benefits -Fringe benefits should be based on actual known costs or an established formula. Fringe benefits are for the personnel listed in budget category (A) and only for the percentage of time devoted to the project. Fringe benefits on overtime hours are limited to FICA, Workman=s Compensation, and Unemployment Compensation. Name/Position Computation Cost Employer's FICA $ 20,000 x 7.65% (year 1) $ 1,530 $100,000 x 7.65 % (years 2 and 3) $ 7,650 Retirement $ 20,000 x 6% (year 1) $ 1,200 $100,000 x 6% (years 2 and 3) $ 6,000 Health Insurance $20,000 x 12% (year 1) $ 2,400 ~7 $100,000 x 12% (years 2 and 3) $12,000 Workman's Compensation $20,000 x 1% (year 1) $ 200 $100,000 x 1°fo (years 2 and 3) $ 1,000 Unemployment Compensation $20,000 x 1°I° (year 1) $ 230 $100,000 x 1% (years 2 and 3) $ 1,000 TOTAL 34 180 C. Travel -Itemize travel expenses of project personnel by purpose (e.g., meetings with advisory council, field interviews, advisory group meeting, etc.). Show the basis of computation (e.g., four people to 3-day training at $X airfare, $X lodging, $X subsistence). In training projects, travel and meals for trainees should be listed separately. Show the number of trainees and unit costs involved. Identify the location of travel, if known. {ndicate source of Travel Policies applied, Applicant or Federal Travel Regulations. Purpose of Travel Location Items Computation Cost Partner meetings Unknown mileage 1,000 miles x .445 (year 1) $ 445.0 (loca{ travel) 1,500 miles x .445 (years 2 and 3)$ 667.5 OVW Training and travel Unknown Airtare $20,000 (year 1) $ 20,000 Ground $30,000 (years 2 & 3} $ 30,000 Transportation Per Diem Lodging Technical Assistance TOTAL 51 112.5 Mileage for meetings with partners and advisory council members throughout the service area will be reimbursed to the project director. OVW Training and travel funds are allocated to support OVW training and TA support expenses. D. Equipment -List non-expendable items that are to be purchased (Note: the organization's own capitalization policy for classification of equipment should be used). Expendable items should be included in the "Supplies" category. Applicants should analyze the cost benefits of purchasing versus leasing equipment, especially high cost items and those subject to rapid technical advances. Rented or leased equipment costs should be listed in the "Contractual" category. Explain how the equipment is necessary for the success of the project. Attach a narrative describing the procurement method to be used. Item Computation Cost Desktop Computer $2,500 x 1 (years 2 and 3) $2,500 1 -Building Security System $6,960 x 1 (years 2 and 3) $6,960 3 -Metal Detector Wands $250 x 3 (years 2 and 3) $ 750 28 TOTAL 12 710 The computer will be used by the Site Supervisor (purchase in years 2 and 3) to record participant information, compose case notes and reports, and manage information on supervised visitation and safe exchange services. The building security system will be installed at the project site to ensure participant and staff safety. The system will include 3 cameras, 2 monitors, recording system for cameras, as well as door sensors. The metal detector wands will be used by the security staff and the site supervisor to inspect participants for weapons before they visit with or drop off children. E. Supplies -List items by type (office supplies, postage, training materials, copying paper, and expendable items such as books, hand held tape recorders) and show the basis for computation. Generally, supplies include any materials that are expendable or consumed during the course of the project. Supply Items Computation Cost Office Supplies $55/mo x 12 month (year 1) $ 660 $55Jmo x 24 month (years 2 and 3) $1 ,320 Postage $25/mo x 12 month (year 1) $ 300 $25lmo x 24 month (years 2 and 3) $ 600 Training Materials -staff and project partners $4/set x 50 sets (year 1) $ 200 $4/set x 50 sets (years 2 and 3) $ 200 Children's Books $5 x 80 books (years 2 and 3) $ 400 Snacks $400Jyr x 12 months (year 1) $ 400 $400/yr x 24 months (years 2 and 3) $ 800 Games, stuff animals, art supp lies toys, and activities (years 2 and 3) $ 800 TOTAL 5 680 Office supplies and postage are needed for general operation of the program. Training materials will be developed and used by the Site Supervisor and Project Director to conduct trainings for staff and project partners. The children's books will be available to family members for use during visits. Snacks will be made available to children who are visiting for more than one hour and for the first year will be used for pre-planning meetings. One time purchase of games, toys, art supplies to be used by children that are waiting for parents. F. Construction - As a rule, construction costs are not allowable. In some cases, minor repairs or renovations may be allowable, consult with the program office before budgeting funds in this category. Purpose Description of Work Cost TOTAL ~0 29 G. Consultants/Contracts -Indicate whether applicant's formal, written Procurement Policy or the Federal Acquisition Regulations are followed. Consultant Fees: For each consultant enter the name, if known, service to be provided, hourly or daily fee (8-hour day), and estimated time on the project. Consultant fees in excess of $450 per day require additional justification and prior approval from OVW. Name of Consultant Service Provided Jane Doe Domestic Violence Trainer John Doe Personal Safety Trainer Comautation Cost $250/day x 6 days $ 1,500 (years 2 and 3) $250/day x 6 days $ 1,500 (years 2 and 3) Security Guards 2 guards @ $13.00 per hour x $ 24,960 40 hrs per month x 24 months (years 2 and 3) Center partner 1 program supervisor $20 per hour x 25 hrs/week x 104 weeks (years 2 and 3) $ 52,000 1 visitationlexchange monitor $10 per hour x 25 hrs/week x 104 weeks (years 2 and 3) $ 26,000 Fringe benefits for program supervisor $ 14,378 Fringe benefits for visitation/exchange monitor $ 7,189 TOTAL 127 527 Jane Doe, Domestic Violence Trainer, will be hired to assist with the education of new center staff, volunteers, local domestic violence advocates, court representatives, and taw enforcement officers collaborating with the center. The training sessions will be held three times per year. John Doe, Personal Safety Trainer, will be hired to teach center staff and volunteers techniques for protecting themselves against physical assault and general safety tips. These training sessions will also be held three times per year. Funding will be used to support some of the funds needed for independent security guards to support the center staff during visitation hours. The Center will hire one program supervisor and 1 visitation/exchange monitor with these funds to implement the project. H. Other Costs -List items (e.g., rent, reproduction, telephone, janitorial or security services, and investigative or confidential funds) by major type and the basis of the 30 computation. For example, provide the square footage and the cost per square foot for rent, and provide a monthly rental cost and how many months to rent. Description Computation Cost Telephone $1001mo. X 12 months (year 1) $ 1,200 $100/mo. X 24 months (years 2 and 3) $ 2,400 Printing/Reproduction $75/mo. x 12 months (year 1) $ 900 $75/mo. X 24 months (years 2 and 3) $ 1,800 TOTAL 6 300 I. Indirect Costs -Indirect costs are allowed only if the applicant has a Federally approved indirect cost rate. A copy of the rate approval, (a fully executed, negotiated agreement), must be attached. If the applicant does not have an approved rate, one can be requested by contacting the applicant's cognizant Federal agency, which will review all documentation and approve a rate for the applicant organization, or if the applicant's accounting system permits, costs may be allocated in the direct costs categories. Description Computation No indirect cost is requested. Cost TOTAL 31 Budget Summary -When you have completed the budget worksheet, transfer the totals for each category to the spaces below. Compute the total direct costs and the total project costs. Indicate the amount of Federal requested and the amount of non-Federal funds that will support the project. Budoet Cateoory Year 1 Year 2 and 3 Total Amount A. Personnel 20 000 100 000 120 000 B. Fringe Benefits 5 530 27 650 3$ 3 180 C. Travel 20 445 30 667.5 $51.112.50 D. Equipment ~! 10 210 10 210 E. Supplies 1560 $4.120 $5.680 F. Construction $ ~ ~_ ~- G. Consultants/Contracts ~_ 127 527 $127.527 H. Other 2 100 4 200 6 300 Total Direct Costs 49 635 $304.374.5 360 392 I. Indirect Costs ~0 ~ ~Q. 0~_ TOTAL PROJECT COSTS 360 392 Fe deral Request 360 392 No n-Federal Amount ~. NA 32 A endix B Sample Memorandum of Understanding ,~- 33 SAMPLE MEMORANDUM OF UNDERSTANDING The County of is the lead Safe Havens: Supervised Visitation and Safe Exchange Grant Program applicant, and supports the Local Supervised Visitation Center (LSVC). The County of enters into a Memorandum of Understanding (MOU) with the Community Domestic Violence Agency (CDVA), LSVC and the local court system. I. History of Relationship The Local Supervised Visitation Center began collaborating with the Community Domestic Violence Agency in 1999. The LSVC and CDVA Directors met regularly to discuss the provision of visitation services to victims of domestic violence. Throughout this relationship, CDVA provided training for LSVC staff and volunteers in the following areas: recognizing signs of domestic violence; methods and strategies for working with victims of domestic violence; and, domestic the potential impact of domestic violence on children and the battered person. LSVC accepts referrals from CDVA and the local court system for women in need of supervised visitation services. Additionally, the LSVC and CDVA Directors continue to meet on a monthly basis to develop a comprehensive plan for building a larger collaboration focused on supporting domestic violence response and supervised visitation. The partnering organizations' ultimate goal is the protection of domestic violence victims and their children in all settings. As a result, LSVC and CDVA are striving to develop an expanded collaboration including child abuse and neglect organizations, law enforcement, courts, hospitals, legal advocates, families, and community groups. The LSVC and CDVA Directors have identified the local court system as a partner, and a court representative has begun attending their monthly planning meetings. The group's immediate goal is to develop an awareness and understanding among the potential collaborators of the unique circumstances surrounding supervised visitation in cases of domestic violence. Development of Application Discussions regarding the collaborative effort that is proposed in the application and detailed in this Memorandum began in earnest in June, 2000. During their regular monthly meetings, the agency directors and court representative discussed the elements of the application and the appropriate roles for each partner. The LSVC Director met with center staff to develop a grant application response. This draft was supplemented with key judicial and CDVA staff recommendations. The LSVC Director also conducted an independent study of similar supervised visitation programs in other jurisdictions. This information 34 enhanced the quality of proposed programmatic elements. Additionally, the Directors discussed the application process and expectations with the potential members of the evolving collaboration. These representatives provided input in the initial development phase and feedback throughout the process. Recent meetings among the Executive Directors, County representatives and focal court representatives have led to the agreement reflected in this Memorandum and the submission of the grant application. III. Roles and Responsibilities Community Domestic Violence Agency The CDVA Executive Director will provide co-leadership with the Director of the LSVC for alt non-administrative duties related to developing across-agency collaboration among the child abuse and neglect organizations, law enforcement, courts, hospitals, legal advocates and community groups. The CDVA training staff will provide up to three domestic violence awareness training sessions per year to the LSVC. Additional collaboration members will be invited to participate in these sessions. Refer all domestic violence victims with children in need of supervised visitation "° or exchange services to LSVC and follow-up on the outcome of the referrals. Promote training/education of local law enforcement agencies and court representatives regarding domestic violence issues and supervised visitation. The CDVA may enter into agreements with these agencies as to the number of training sessions to be provided. Supervised Visitation Center Dedicate X number of staff and volunteers to providing supervised visitation services to families impacted by domestic violence, child abuse, sexual assault and stalking. Provide facilities (e.g. rooms, enclosed playground, etc.) for the program service objectives. The Director will support the growth of the collaborative effort, and supervise all LSVC activities. Additionally, the Director will submit program evaluation information to local and national evaluators as required by the grantor. Submit financial documentation for accounting as needed. Maintain the confidentiality of individuals and families using the LSVC's services. 35 Local Court System Submit referrals and relevant case information to LSVC, and follow-up on the outcome of the referrals. Provide training for collaboration partners on the legal system and its role in working with victims of domestic violence, child abuse, sexual assault and stalking. Continue to designate a representative and alternate representative to participate in the collaboration meetings. County of The County will act as the fiscal agent for the grant project and ensure compliance with the reporting requirements of the Office on Violence Against Women. Additionally, the County will support the collaboration efforts of the project by providing a conference room for monthly partner meetings. IV. Time Line The roles and responsibilities described above are contingent on the county receiving the funds requested for this project in the OVW grant application. The beginning and end dates of this collaborative effort would coincide with the grant period, anticipated to be MM/DD/YY through MM/DD/YY. Approval We, the undersigned have read and agree with this MOU. Further, we have reviewed the portion of the proposed project budget pertaining to the collaborative effort described here, and approve it. ey Director, Supervised Visitation Center By Director, Community Domestic Violence Agency Date By County Official Date Date sy Local Court Representative Date 36 Memorandum of Understanding °~ Between the Kerr County Commissioner's Court and The Hill Country Crisis Council, Inc. to operate a Safe Haven Project The County of Kerr (County) is the lead Safe Havens: Supervised Visitation and Safe Exchange Grant Program applicant, and supports the Kid CARES Center. The County enters into a Memorandum of Understanding (MOU) with the Hill Country Crisis Council, Inc. (HCCC) as the contract provider of the Kid CARES Center, and the local court system. I- History of Relationship HCCC is the battered women's center and rape crisis center for Kerr County, and has explored operating a Safe Haven Project for Kerr County and surrounding areas with the encouragement of the former Ken County Special Prosecutor for Crimes Against Women (now, Assistant County Attorney) and the County's Crime Victims' Coordinator. HCCC has retained staff trained in Safe Haven operations and is undergoing cross training on issues of domestic violence, sexual assault and child abuse. HCCC is partnering with these offices and local courts including the Child Protective Services Master, Judge Camille Dubose, of Uvalde, Texas. HCCC also operates the court-mandated domestic violence offender intervention program for afour-county area, bringing to the table this special expertise on risks to children and spouses in battering relationships. The grant partnering organizations' ultimate goal is the protection of children in all settings. As a result, the County and HCCC are striving to develop and expanded collaboration including child abuse and neglect prevention organizations, law enforcement, courts and other elements of the criminal justice system, Sid Peterson Hospital and local clinics, legal advocates, families and community groups. HCCC will additionally invite members of an Advisory Committee from its other collaborative partners in the area including K'Star (emergency shelter and counseling services for children victimized by abuse), Kid's Advocacy Place (providing forensic evaluations of child abuse victims, CASA (providing court advocates for children), and other community resources. These organizations have a substantial history of working together to educate professionals, families and the community at large on issues surrounding child safety and child abuse. The group's immediate goal is to develop an awareness and understanding among the collaborators of the unique circumstances surrounding supervised visitation in cases of domestic violence, and to plan for special needs to provide Safe Haven services accessible in our largely rural area. II. Development of Application Based on this history of work on child abuse issues and the specific discussions with County offices regarding the need for supervised visitation and safe exchange services. HCCC has brought the Kid CARES Safe Haven (the Project) proposal to the County Commissioner's Court for its consideration on January 22, 2007. Negotiations with County officials have lead to the development of this MOU and the submission of the grant application. ""` Ill. Roles and Responsibilities Hill Country Crisis Council The HCCC will develop the Safe Haven project under the Kid CARES division. The HCCC has hired a project director, trained in Safe Haven projects and a member of the National Supervised Visitation Network. The HCCC Executive Director and the Kid CARES Safe Haven director will be responsible for all non-administrative duties related to collaboration with the courts and other referring agencies or agencies of interest, and will be responsible for implementing the Advisory Committee. Training HCCC will provide up to three domestic violence awareness training sessions per year for collaborators and partners in the Project. Project staff will be fully trained in domestic violence, sexual assault and child abuse identification, awareness, effects and prevention as all other HCCC staff. Proiect Oaerations HCCC will dedicate three staff and volunteers as applicable to provide supervised visitation services to families impacted by domestic violence, child abuse, sexual assault and stalking -- or as otherwise identified by the courts and referring child protection agencies needing such services HCCC will provide facilities, materials and security for the program service objections. HCCC will maintain the confidentiality of individuals and families using the Project services. The Executive Director will submit financial documentation and program evaluation information to the County on a monthly basis consistent with the requirements of the grant. HCCC financial records and any records pertaining to the Program's operations shall be available to the County for inspection during normal business hours. HCCC will indemnify the County from any obligation to repay funds to the US Department of Justice Office on Violence Against Women for any failure in services, performance evaluation or financial reporting to the County, except in the instance of the County's failure to meet reporting deadlines to the OV W for reports timely received from HCCC. HCCC shall submit to the County its annual audit report, within 30 days of the completed outside audit approved by the HCCC Board of Directors, for each year of the grant period. County of Kerr, Texas The County will act as the fiscal agent for the grant project and ensure compliance with the reporting requirements of the Office on Violence Against Women. The County will be responsible to submitting timely reports on performance evaluation and financial reporting to the US Department of Justice OV W as required by the grant, The County and District Courts will submit referrals and relevant case information to Kid -- CARES Safe Haven and follow up on the outcome of referrals. IV. Time Line The roles and responsibilities described above are contingent on the County receiving funds requested Cor the Project in the OV W grant application. '1 he beginning and end dates of this collaborative effort would coincide with the grant period, anticipated to be June 1, 2007 through May 31, 2010. IIV. Continuation Funding HCCC agrees to seek continuation funding beyond the grant award period from sources other than the County and understands that nothing in this agreement obligates the County to continue funding Kid CARES Safe Haven beyond the grant funding. Approval We, the undersigned, have read and agree with this MOU. Further, we have reviewed the portion of the proposed project budget pertaining to the collaborative effort described here, and approve it. _._ Kerr County, Texas Hill Country Crisis Council, Inc. The Honorable Pat Tinley Kerr County Judge Sheryl L. Howard Executive Director Date SAMPLE Letter of Intent January 22, 2007 Office of Violence Against Women United States Department of Justice 800 K Street, N.W., Suite 920 Washington, DC 20530 VIA: OV W.SupervisedVisitation'a~usdol.aov To Whom It May Concern: The County of Kerr, Texas intends to apply for funds under the OVW FY 2007 Safe Havens: Supervised Visitation and Safe Exchange Program, CDFA 16.527; OVW- 2007-1525. NAME: The Honorable Pat Tinley DATE: January 22, 2007 '~ Position: Kerr County Judge Organization: County of Kerr, Texas; Kerr County Commissioners Court Address: Kerr County Courthouse, 700 Main Street City/State/ZIP: Kerrville, Texas 78028 Phone: 830-792-2211 FAX: 830-792-2218 E-mail• Thank you. Sincerely. The Honorable Pat Tinley Kerr County Judge VMH NumbC[ 4U4U-UVU4 spiratiun Date: 011312UU9 Application for Federal Assistance SF-424 Version 02 *1. Type of Submission: '2. Type of Application * If Revision, select appropriate letter(s) ^ Preapplication ^ New ^ Application ^ Continuation 'Other (Specify) ^ ChangedlCorrected Application ^ Revision 3. Date Received: 4. Applicant Identifier 5a. Federal Entity Identifier: *5b. Federal Award Identifier: State Use Only: 6. Date Received by State: 7. State Application Identifier: B. APPLICANT INFORMATION: *a. Legal Name: 'b. Employer/Taxpayer Identification Number (EIN(1'IN): 'c. Organizational DUNS: d. Address: 'Street 1 Street 2: 'City: County: "State: Province: "Country: "Zip /Postal Code e. Organizational Unit: Department Name: Division Name: f. Name and contact information of person to be contacted on matters involving this application: Prefix: 'First Name: Middle Name: "Last Name: Suffix: Title: Organizational Affiliation: .T..i,,..r.,...e nn...,~,e.~ Fax Number: 'Email: OMB Numbcr' 404U-0004 Eepiration Date: 01;312009 Application for Federal Assistance SF-424 Version o2 '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: *72 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: OMF3 Number. 4040-(1004 [zpiration Datr. 01/31/2009 Application for Federal Assistance SF-424 Version 02 16. Congressional Districts Of: *a. Applicant: `b. Program7Projed: 17. Proposed Project: *a. Start Date: `b. End bate: 18. Estimated Funding ($): 'a. Federal *b. Applicant `c. State 'd. Local 'e. Other *f. Program Income `g. TOTAL '19. Is Application Subject to Review By State Under Executive Order 12372 Process? ^ a. This application was made available to the State under the Executive Order 12372 Process for review on ^ b. Program is subject to E.O. 12372 but has not been selected by the State for review. ^ c. Program is not wvered by E. O 12372 '20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes", provide explanation.) ^ Yes ^ No 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) ^ "IAGREE *` 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: Prefix: `First Name: Middle Name: 'Last Name: Suffix: `Title: 'Telephone Number: Fax Number: * Email: 'Signature of Authorized Representative: 'Date Signed: Authorized for Local Reproduction Standard Form 424 (Revised 10/2005) Prescribed by OMB Circular A-102 OMf3 Number- 4040-0004 Expiration Date: 01/31/2009 Application for Federal Assistance SF1124 Version 02 'Applicant Federal Debt Delinquency Explanation The following should contain an explanation if the Applicant organization is delinquent of any Federal Debt. INSTRUCTIO'iS Fu:R THE SF-d23 =:Wic repcrireg burden }c•ttis o.• ecion of inFcT*a:rsn i=_ esP•mat=.:a sverag_ 2C rcnutes rer -spd^se in:wd~.ng t rte i.• rev~,ew^~ -s:mcIrons, sesrcn ^•; axs4ny data aouroes. pat =•inp a^o main:a•.ning the data ^eaaed, aw da^+: atng ant revexing t^e doileetc^ o` Informal.^. Send :%~emenr regarding t^e c.rden es:ir^a:e a a^y vt^=r aspect of :his d_•!ec:tan of ~.afcrna:ivn ir:6;diny suggesticns fcr reducing :Ws c.': en. tr_ :he Cfce cF Management an: budge: sPenv. rk Ra:.c:ien Prole :.SCSLC~?~~. 5k a>h~..ng:vn DC "CcC?. PLEASE DO NOT RETURN YDUR COMPLETE6 F:TRA1 TO THE OFFICE DF MANAGEMENT AND BilDGET SEND IT TG THE ADDRESS PRDYIDE7 -Ls is a s sadard :o:c!racladi~g ire colzuaanoL shezu rec ¢rad :o: we a; a ca ~ e: street for saby:w:ou of p:eappi;csrou; azi app:::anois s~i related :oEararadca ucder di__:e_aaan p: ogratrs. Scutt of :Ire ;:eras ere retries aid tome :xe opvoaai a: rLe d;screrica of r'se applicav ar the Federal ageLCr ~;aserrn; Regssred :revs are :decd`ei nth a asrersk oL : fo:-~ acd ate speci5ad is :be iasm:mcas baton'. .a addidca:o tke :astra:raos Faotid~d belae~. appYcarr[s atwr cousui: age>_cy iast;t;cdaas :o Seteraiae spe::5c :equiteaea:s I:er•. Ent rem .n. : i. Type of Submission: ~ 3equ'e:5: Select one ttpe of s.srrs=_ •:^ n iC. Name OF Federal Agency: iRe;luired; En[_r :he ^ant c' :he axordance with agency ^s:rucivns. =edera! agency f-on rr:^ ch assistance s being requester xttt °r~pplics:icn :his applecatian Apo ica:ion ChangedrCartec:ed npplidati~^ - ii •equesxd by the ag envy, the.[ 11. Catabg Of Federal Domestic Assistance Nranber.+Title: ~~ his subrrssion s to c^ange or correct a :~rer c sly submT.ed ?nter he CaW:cg c' =edera G_ ns[ c Assistance nur•¢er a^d apt ca:ion..,nless requestee 6y:he agency acplica^s may no: title of Y•e p~prarc unce° whic^ ass stance is rec.zs:ed, as use:hs :o submk oranges aiter;he clcsireg Bats. 'oared in :he oragram a^^aano-ne^. ~~ a.c cab e. Type of Application: f R_:uiredl Select ane Type of applicatc^ in 12 Funding Opportunity Number.?ider ;?eG: 2d'. E^ter [re accordance with a; _vcy ^strua;iana =unding bpperuny IJ;nebe• and tae oft^e epp~nurd:y under he.v - nn applica-cn t^;t is being =_:ani1_. m a^ age^=year :he wh+c^ assists^.:x is requas:ec+, as `sand !n :he pragrarn 5rs::ime. annc,ncenten:. Cantoustc°-An es:ens an for an a:dta^al vnding.'budge: c_riad 13. Competition identification Nrateber.?i[le:_;er t^e `ar a prc,_ct with a projected mop :tan date. -^ s car keclude Camp-t:icn Iden:ifira:icn Number seed tl:le Mthe anpa:kiar. re-axals. +md=_• whic^ ass Stan; -_ is req.esred i` ap cab e. ?ev sicn - any d^anpe ^ :he Fede-a Gcaernmen[=_ franc cb ga4c^orm^:kege^: iabkity ird ~t an existing obiiga:ion fa Friore tra^ doer may 6e revis Wn enter Yee appropriate etens! , . seledted. If' Cher' is selee-tec. t4ease sped ty in ter.[ 6cx prat ee... iz Areas AHeaed B Pro'ect: List the areas ^r a^:hies usin Y 1 B A Increase Rwarcl ?. D<:tease Axa^: :he caxgaries ~ e.g , a:ies, x.^fes, saxs. etc.:• s:~ec fled in C Increass Curaton D Cecrease Carat an age::^cy inst:clans. Use the :r-:inuaion ste=t is en ter E. Cher +s ew]i add :ions! areas, iF treedaae [-i=_ to d Wa^2 This dare •niC be assigned by t^e 1? Descr'rytive Title of Applirani's Project::4eq. -_d'+?^ter a Feda^a ag= cy, brief cescrip[iae t ale of t^e prc,a_;. f apprcp•iate. at:a:^ a map shc•xireg prajeM Iodaticn ie. g.. const•.cNar, r rea -0. Applicant Identifier: Ente- :he entity idenaf ass •,rad ay the Federal prvpe-ry p. Jjep-si. Fcr preat:• cations, a[•ach a s.nmary agency i` any a appi cant s a •^trcl number, k ape tab e. desc-atc^ o` :he rgea. 5a Federal Entity MenUfier Erite^the ^~~nebe^ass~g^ed :a your 12. Congress tonal Distrie[s q:jRequired; i6a Enxr the ~rpanitaticr by Y+e Federal Rge^py, if any. app •can-: s Cangressic• a! District a^c iZa. Ente- aN C sTi: is; 5b. Federal Award IdenSFer.:=or °ew applicate^s feaan Marx. =ar s a4ect~d by :he program c.r pn~4c:. Erker in t^e'orrcat: dcntinua:ian •_r r=viskm ;v an existing award enxr the preriausy characters °ia:e ~.bbrev atidr - 3 dharacte5 Dist•c: numc~er, assigned Fr:erai award iden:ife-nunelrer Fa cha^ged~cortectea e. g.. CF-CC5'ar Caf`amia 5"'dist-_[. CA~_"2 ar Ca famia t2r' applicaticn. a^ter t^e =edera: icentifier in s:mrlance wit^age^dy dist•cL NC-1036x f.art^Camlkta's'CS°cs:rct ns:ructicns. I' a eangress c^a.l dis[•v:=_ in a stare a•e affacxd. enter B. Date Receired by State: Leav=_ Yt+s f eld p~ ank. This d.sx m 6e 'aN' ice t^e dist• ct number e.g , hiC-all b.' all ass ned b" t^.e tax, i livable. cc ^gresseanal districts in Mary and r. State Application Identifier: Leave :Ws `field Wank. -tt s den[fier rr F ^aticnxide .e. a: distncts wihin alt states a•e stetted, ce ass fined py t^e Sate. d applicable. ent_r .:S-a!I. 1` :he pragram~trra!ec: a autsiee the +15, enter G~= ~3G. S. Applicant Information =^ter [^.e?aNmeinp ^ acx-xsnce w>h agency ns:rucicns: a. Legal Name ';?eq~~ir*_-:r: En[ •;t+e egal ^ane of app can: :ha: will 1?. Proposed Project Start and End Dates: iRe:uired; En~•:he :ndertaket^e asssano- ad[vity. This is;he,ane that t^e crg~s.^izaicn prc:•tsed sar.dre and end tale of the•c•,ec-. ^a=_ registe.=a srt^ the ~enaal ~cn:ractcr Ragistry. In~armaliar on ^ isxrin a'th CCR ma•~ be obtained v skin :he Gran:s. or' websrte b. EmployerfTaxpayer Humber (EI N+TIM): iRequired;: c^ter [^e Enp aver ar Tazpay<_r demfda[cn frumber ; EIA cr TIR f as assigned by 12. Estimated Funding: !zequire;i =nrer the am:,un[ requzsted :he !^:ems Reve:^.e s'eraice. If your orpanizatic^ is nd; ^ :he JS er:er cr to be x^aibured during the f-zt Tundingrbudge: pernd cy gq_}{¢¢eeq. each ccn:ribu:ar. Vaius a° in-rind ce^aibu:ions shvu'd 6e c. Organizational OUliS: ~ Required; Enxr ate arganizatan-e CJCrS cd included on appropriate nes. as applicable. f G^e acta^ will D.;M5+4 ^unbe^ received from Dun and ?adstree:. In'arna:icn on resuk in a aal;ar change ~- an exiting axa^d. ndicate only [he obta ^ ^p a CJPS ^un6e• may 6e abtsined ay v sk np ;he Grarmgar- amount c' :he cha^ge. For dscreases, env:•=_e [^e amauns in wehsite. par=^theses. d. Address: Enxr are coatpleroe adores=_ as fciiaxs: Sareet add: _ss :_ ^e 'revs °edi.Oily:?eg'i ^-_. +. County, State iRequired iccuntry is .;Si. t6 Is Application Subject to Review by Sate Under Fxxutire =rav nce Country iRequired:2ip.'POS:al Ccce~Requir :. Tco.^trys Order 12372 Prtacess?App cans s^auld cen:aa the State JS ~ ~ ^ ~ 'c+^: ci Cc ^ sat i SPOCt far FsaEral _xecutve Drder 3in e. Organizational Unit: Enter he name cf ate primary organ zat:xal y 123 < :a c -:ermine a°he-t^e acpN:ation is s-psc: :o :he ;nk+andde an1rcEMarirsion rat€ficaea Y+atwi!IU^:ertaxethe sssis:ance ;::w!r~.faa linable. 3:ats ~.n:erga:emrcenta resiea~prn_ess "_=ec ;he i. Name and contact+niormation of person io be contacted on app-: uat-_ bdx. I"a' s se eae, enter :he ~aL the matters involving this app3ication :er t'-a na^te iF -st and last rarce app .a°an~nas subrcrt:ed tc t^e 3:ar_ z~oired; c-g aniz>- cna. afii!;tian nF affi;~,aYd .•~t. an c^;.a n:za:ion ak^sr Bran [^s ap: =an: rganizaocn7.:e~ep ^cne n.nrbe• iReauirec; *az 2~.. Es *.he Applicant Delenquen: an any Federal Debt? ^ur ~•, and er+a add-ess•4egvr_:: c`:he pers:,=:a _an7aa: ~.^ required: Se',eat^ear. rapria:e c-cx This quests^a:r;esG ^raa_s rela[ea :q :hs a: c!~ca:icn :he a: pi~.a": arganizab=^, nat the c_r=_c• ,c!'•a signs as :he au:harze: ,pies=nta:iva. Ca;egc-a; ai deb:-nclude ce! ^:.peat aua.^!=_a c+rrances. loans and taxes. i • s. ;nc!ude an ex !av.~cn an tha a=nu-.atcn s^eek. e. Type q`A.: can:: iRequired; 21 Authorsaed Represen?atire ;4ea~ ^adi Te to signed and 5elec:.p:o Three appi6=an::ypes; !n a_cardance rrit^ aga^_y dared by t^=_ au hadzed •epresant;tia'e ct :he applicant ns:ructicns. crga^ za:ign, corer the name ,First and las: ^ane requ =n s':at_ Gcwemmen: M16. N•cnprof: .r.:h 5~_iC2 1RS ae tRegcired; :etepho_. rn:~tber iR_quiredl `a:~ number ~? Caunty Gavarnrent .^-,Caras :CNe-[^an lnst:,;b]^ and ercal a:dress tRe:. ved; cFtha persan as^cr¢ea to s;gn city arTa~^sh~: Gavermment cf-i~her Educaac^: `ar :he appliaant. ~t-:ial C srcict Gwent^ten: P.. PtenpraF: er:hqu: °_'va Iag F cr y of [^e geremr^.y 6cdy'S au:har:zatc- b• you 4c sgn _ =,egiana: Drgan zaroon itarus;~the•t^a°!nsnvt~c- :his appilcat on a; :he aFica'. -c~rese^a:iv_m::=_"=cnF ertr °_.-er .cry c-Pcssassian aF-igner Eduaa:ro^: The acphoa^a cif .e ~Certa~,n Fede•; age^aes •nay re.•ire ndepenca^t :>q^~: o!~ri5:riat C. Ptsata i^s:a.:inn aFh goer ;hatt^aut^or¢a:icn be subarited as pars?tlte app :adaa, ~ =.c ::Stare Cc^ac!ie: Ed~:cat^n ns:it.tc^a`-igher Eduaaric- ' !^:iv r.ai ndian:Ha:we Raredcan Triba :. For-PwFt Drgan'~.zak :- ^zcvemmerr.;=ederay iD:herhan Srcai; ?.=_;neszl oeo_gniz>:1 4. §rcall?ain=_ss J ndian:FJatio•eF+rer;canTrba 3. Hspa^•:-serv-g nsi;uecr Gc•vemmem ~~7:her tha^ T. Hs;ariaa:ty Flack G ewes =ederal;y ~xcagaze~i and U^~versites ;HBvU=_; k. ndian: Fla:we A~renaan T^ta:ly Conte led ~al!eges Tribally Des gnar_w arm U^versd es :-C:CJsi C^yan¢a;ian b'. Alaska NaGVe arta ".at ve _ ' ~~ Cina arraus:ng Haaa~ a^ s'eT sing I°skilucians Authar.y ::. M:n4arces:ic incn-J5; Enkiry ri. Ot•er spegifyrl BUDGET INFORMATION -Non-Construction Programs ~eo rte,%,a arsoaa~oe SECTION A -BUDGET SUMMARY Gren[ Program Function Catalog of Federal oomeatk Assbtance Estimatetl Unobligated Funds New or Revised Budget or Activity 101 Number ID) Federal (cl Non-Federal Idl Federal 101 Non-federal RI Total (9) 1. ~_ J ' ~ J S ~I S jr j S ~~~ E i J 5~-, Z. ~--. j ~. _ I ~ 1 I I - 4. - ~ ~ ~ _ ~ ~ _.. -. 8. Totals S i j S ~~ S ~~ S SECTION B-BUDGET CATEGORIES 8. Object Class Categories _ __- ___ _. total . . - 111; lal ~ i lal~~ al' (s) a. Personnel _~ S~ S -i ~ ____.___ r ___-.___-_.~ S s i -~~ ~~--- i 8 b. Fringe Bene£ds l Ji o. Travel i.__. __-_ ~ ~~ ~ ~-__._J d. Equipment ~I ~ ~ ~_. . _ .~! ~ __ _ ___. 1 L~ e. SuPWiaa L ~ ~ ~_~ f. Contractual .1 r -__ _ __ _J r L. _. ._.. _ ..._ _~ r L .. ______..~ L_~ g. Construction ~ ~~ ~ ~ ~ _ h. Other ~~ ~ ~~ `___~ I. Tool Dlract Charges (sum of Ba-Bh) ~_ _] j _~ [ ~ ~~ S j. Indirect Charges ~ ~ -_J ~ _,,. ~~ E~-____ -_J k. TOTALS (sum of 81 antl 6j) S ~~ f ~~ S ~~ S ~~ S ~~ Y. Program Income i ~ S ~ ~ E ~~ E 't~ S ~~ Authorized for Local Reproduction etamlard Fam szaA (tta. ]- s]I PrturAaOOY OYB IGrcWara -105} SECTION C -NON-FEDERAL RESOURCES (al Grant Program (b) Applicant (c) State Idl Other Sources (e) TOTALS 8. i I s ~ s ~.__ s i~ _~ f ~ 10. ~I -.... 7 - i_ I ~_ J I I 1 __ -.__ ~ I r _ - ~ ~- 12. TOTAL (sum of lines 8-11) ~ S ~_ J ~ f %- _ I - - - ~ f ~ ~ I fL SECTION D -FORECASTED CASH NEEDS TWlfor istYwr 1st Qwner ma Owner 3rtl Waner 4e Wader 18. Federal ~ ~- --, 14. Non-Federal S L _ ~ i ___ __ ~ ~~ _~ ~ _...~ _ ~ ~ 15. TOTAL (sum of lines 13 and 14) 9 ~ ~ 9 ~ i S I~_ ~ S ~ ~ S ~_ ~ SECTION E -BUDGET ESTIMATES OF FEDERAL FUNDS NEEDED fOR BALANCE OF THE PROJECT (a) Grant Program _ ___ _ (b) First c Secontl (d) Third a Fourth .. i6. __-_- __. __.. f _.. _ i s ~-. J s ~. _~ t L_- 17.,i _.._ _. __ ~ ~_ _ -i ~-. _ ~I ~ _..___- i ~- __._J i 20. TOTAL Isum of lines l6-191 -_. S ~ _~ f ~ J = ~ ~ _ § f .__ 1 SECTION F - 07HER BUDGET INFORMATION 21. Direct Charges: __ 22. IrMirect Charges: ._ __ ___. _... r 23. Remarks: ~- -~ Authorized for Local Reproduction stanGrp Form IT911IRav. )-aTl Pape I 'Applicant Organization Name: L_- _ Enter the intlividual's role on me project (e.g ' Contact 1 Project Role: ~__ Prefix: ~. " Firsl Name: Mitldle Name' "Last Name: r L Suffix: Title: I rOrganizational Affiliation: l __- __ _ `Streetl: I Sheet2: ' City: ~ __ County: `State: Province: ~~~ ' Country: `Zip / Poslal Cooe: ' Telephone Number: fax: ' Email: Enter the intlividual's role on the project (e.g., project manager, fiscal contact). 'Contact 2 Protect Role: ~_.__ __ ___ _ _. _ Prefix: `First Name: Mitltlle Name: i, r _ _ - ..__.___. -___- -_. 'Last Name: ~ Suffix: L _ f Title: Organizational Affiliation: i I -____ _. 'Streetl: ~ --~- -- ~~ Key Contacts Form OMB Number: 4040-0003 ~~ Expiration Date: 09/30/2005 Version 01 project manager, fiscal contact). __.' _._- -- ___ J ___ __~ Streetl: • City. -- -T County - _ _. _.. ' State: Province: ~~ `Country: ~ __. 'Zip /Postal Code: r . .--r- ._--z-___ ___ ~_ ~~._ . 'Telephone Number: Fax: ' Email: ~ ~ ___ ____ - ____. -__.. ~ ~ _ OMB Number: 4040-0003 Expiration Dare: 09/90!2005 Enter the individual's role on the project (e g., project manager, fscal contact). Version Oi `Contact 3 Project Role: ~ ~ Firsf Name: I __ _ - -~ -_- - ~_ - __~ _. _ 1 • Mitltlle Name: i ____ __ ' Ldst Name: Suffix: i Title: (IOrganizational Affiliation: _ 1. _. _ - ___. --_ __-__. ` StreetY f-_ _ F _. - ___... - . Street2: City. _~ Coun ' b _.._._ ___. ' 'State. ___ _._.- _ _-~ Province: i `Country: r `Zip /Postal Code 'Telephone Number ~~ --~ Fax: __ ` EmaiCl Enter the individual's role on the project (e.g., project manager, fiscal contact). ' Contact 4 Project Role: Prefix: __ _ _~ "First Name: Middle Name:, 1 _._..._.. `Last Name: T ___ -. __.. ..__-_ Suffix: Title: ` Streetl: Stree@: `city: County: "State: Province: ' Country: ' Zip /Postal Gotle: ' Telephone Number. Faz: ' Email: L-__ OMB Number: 4040-0003 ExDirafion Date:09/30/2005 Version 01 Project Abstract The Project Abstract must not exceetl one page and must contain a summary of the Droposed activity suitable for dissemination to the public. I[ should be aself-contained tlescription of the project and shoultl contain a statement of objectives and methotls to be employed. II should be informative to other persons working in the same or related fields and insofar as possible understandable to a technically literate lay reader. This Abstract must not include any proprietary/confidential information. `Please click the add attachment button to complete this entry. __ -_ Add Attptdlmenk,_ L - - _ _J OMB AYPROVAI. N0.1121-014, ,r F,XPIRES O7/31/2006 STANDARD ASSURANCES The Applicant hereby assures and certifies compliance with all applicable Federal statutes, regulations, policies, guidelines, and requirements, including OMB Circulars A-21, A-87, A-102, A-I IQ A-122, A- 133; Ex. Order 12372 (intergovernmental review of federal programs); and 28 C.F.R. pts. 66 or 70 (administrative requirements for grants and cooperative agreements). The applicant also specifically assures and certifies that: 1. It has the legal authority to apply for federal assistance and the institutional, managerial, and financial capability (including funds sufficient to pay any required non-federal share of project cost) to ensure proper planning, management, and completion of the project described in this application. 2. It will 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. 3. It will give the awarding agency or the General Accounting Office, through any authorized representative, access m and the right to examine all paper or electronic records related to the financial assistance. 4. It will comply with all lawful requirements imposed by the awarding agency, specifically including any applicable regulations, such as 28 C.F.R. pts. 18, 22, 23, 30, 35, 38, 42, 61, and 63. 5. It will assist the awarding agency (if necessary) in assuring compliance with section 106 of the National Historic Preservation Act of 1966 (16 U.S.C. § 470), Ex. Order ] 1593 (identification and protection of historic properties), the Archeological and Historical Preservation Act of 1974 (16 U.S.C.§ 469 a-I et sue.), and the National Environmental Policy Act of 1469 (42 U.S.C. § 4321). 6. It will comply (and will require any subgrantees or contractors to comply) with any applicable statutorily-imposed nondiscrimination requirements, which may include the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. § 3789d); the Victims of Crime Act (42 U.S.C. § 10604(e)); The Juvenile Justice and Delinquency Prevention Act of 2002 (42 U.S.C. § 5672(b)); the Civil Rights Act of 1964 (42 U.S.C. § 2000d); the Rehabilitation Act of 1973 (24 U.S.C. §7 94); the Americans with Disabilities Act of 1990 (42 U.S.C.§ 12131-34); the Education Amendments of }972 (20 U.S.C. §§I681, 1683, 1685-86); and the Age Discrimination Act of 1975 (42 U.S.C. §§ 6101-07); see Ex. Order 13279 (equal protection of the laws for faith-based and community organizations). 7. If a governmental entity- a) it will comply with the requirements of the Uniform Relocation Assistance and Real Property Acquisitions Act of 1470 (42 U.S.C.§ 4601 et sue.), which govern the treatment of persons displaced as a result of federal and federally-assisted programs; and b) it will comply with requirements of 5 U.S.C.§§ 1501-OS and §§7324-28, which limit certain political activities of State or local government employees whose principal employment is in connection with an activity financed in whole or in part by federal assistance. Signature U S. DEPARTMENT OF JUSTICE (~ OFFICE OF JUSTICE PROGRAMS ,.- OFFICE OF THE COMPTROLLER CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY MATTERS; AND DRUG-FREE WORKPLACE REQUIREMENTS Applicants should refer to the regulations cited below to determine the certification to which they are required to attest. Applicants should also review the instructions for certif cation included in the regulations before completing this form. Signature of this form provides for compliance with certification requirements under 28 CFR Part 69, "New Restrictions on Lobbying" and 28 CFR Part 67, "Government-wide Debarment and Suspension (Nonpro-curement) and Government-wide Requirements for Drug-Free Workplace (Grants):' The certifications shall be treated as a material representation of fact upon which reliance will be placed when the Department of Justice determines to award the covered transaction, grant, or cooperative agreement. 1. LOBBYING As required by Section 1352, Title 31 of the U. S. Code, and implemented al 28 CFR Part 69, for persons entering into a grant or cooperative agreement over SiGG,00g, as defined at 28 CFR Part 69, the applicant certifies that: (a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for in- fluencing 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 con- nection with the making of any Federal grant, the entering into of any cooperahve agreement, and the extension, continuation, renewal, amendment, or modification of any Federal grant or cooperative agreement; (b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or at- tempting 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 grant or cooperative agreement, the undersigned shall complete and submit Standard Form - LLL, "Disclosure of Lobbying Activities," in accordance with its instructions; (c) The undersigned shall require that the language of this cer- tification be included in the award documents for all subawards at all tiers (including subgrants, contracts under grants and cooperative agreements, and subcontracts) and that all sub- recipients shall certify and disclose accordingly. 2. DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS (DIRECT RECIPIENT) As required by Executive Order 12549, Debarment and Suspension, and implemented at 28 CFR Parf 67, for prospec- tive participants in primary covered transactions, as defined at 28 CFR Part 67, Section 67.510- A. The applicant certifies that it and its principals: (a) Are not presently debarred, suspended, proposed for debar- ment, declared ineligible, sentenced to a tlanial of Federal benefits by a State or Federal court, or voWntarily excluded from covered transactions by any Federal department or agency; !b) Have not within athree-year period preceding this apphca- Lon been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connec- tion 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 cr commission of embeulement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) Are not presently indicted for or otherwise criminally or civilly chargetl by a governmental entity (Federal, State; or local) with commission of any of the offenses enumerated in paragraph (1 )(b) of this certification; and (d) Have not within athree-year period preceding this applica- tion had one or more public transactions (Federal, State, cr local) terminated for cause or default; and B. Where the applicant is unable to certify to any of the statements in this certification, he or she shall attach an explanation to this application. 3. DRUG-FREE WORKPLACE {GRANTEES OTHER THAN INDIVIDUALS} As required by the Drug-Free Workplace Act of 1968, and implemented at 28 CFR Par[ 67. Subpart F, for grantees, as defined at 28 CFR Part 67 Sections 67.615 and 67.620- A. The applicant certifies that it will or wdl continue to provide a drug 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; fb) Establishing an en-going drug-free awareness program to inform employees about- (1)The dangers of drug abuse in the workplace; (2) The grantee's policy of maintaining adrug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; antl (4) The penalties that may be imposed upon employees for drug abuse viclaticns occurring in the workplace: (c) Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the state- ment required by paragraph (a); (d) Notifying the employee in the statement required by para- graph (a) that, as a condition of employment under the grant, the employee wlll- DJP FORM d061!fi (391) REPLACES OJP FORMS 40fi L2, 406113 AND SOfi ".;3 WHICH ARE OBSOLETE. 7 t Abide fry the terms of the statement, and (2) Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring m the workplace no toter than five caientlar days after such conviction; fe) No[ify~ng the agency, in writing, wdhin 10 calendar days after receiving notice under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such convic-lion. Employers of convicted employees must provide notice, including position title, to: Department of Justice, Office of Justice Programs, ATTN: Control Desk, 633 Indiana Avenue, N W., Washington, D C. 20531, Notice shall include the iden- tification numberfs) of each affected grant; (f) Taking one of the following actions, within 30 calendar tlays of receiving notice under subparagraph (d)(2), with respect to any employee who is so eonvicled- (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 io participate satisfactorily in a tlrug abuse assistance or rehabilitation program approvetl for such purposes by a Federal, State, or local health, law enforce- ment, or other appropriate agency; (g) Making a good faith effort to continue to maintain a tlrug- free workplace through implementation of paragraphs (a). (b), Ic), (d), (e), and (f). H. The grantee may Insert in the space provided below the site(s) for the performance of work tlone in connection with the specific grant: Place of Performance (Street atldress, city, county, state, zip code) Check ^ if there are workplaces on file that are not indentified here. Section 67, 630 of the regulations provides that a grantee chat is a State may elect to make ene certification in each Federal fiscal year. A copy of which should be included with each ap- plication for Department of Justice funding. States and State agencies may elect to use OJP Form 406117 Check [7 it the State has elected to complete OJP Form 4061/7 DRUG-FREE WORKPLACE (GRANTEES WHO ARE INDIVIDUALS) As required by the Drug-Free Workplace Act of 1988, and implementetl at 28 CFR Part 67, Subpart F, for grantees, as defined at 28 CFR Part 6?; Sections 67.515 and 67 620 A. As a condition of the grant, 1 certify that I will not engage in the unlawful manufacture, distribution, dispensing, posses- sion, or use of a controlled substance in conducting any activity with the grant; and B. If convicted of a criminal drug offense resulting from a violation occurring during the conduct of any grant activity, I will report the conviction, in writing, within 10 calendar days of the conviction, to: Department of Justice, Office of Justice Programs, ATTN: Control Desk, 633 Indiana Avenue, N.W., Washington, D.C. 20531 As the duly authorized representative of the applicant, 1 hereby certify that the applicant will comply with the above certifications 1. Grantee Name and Address: 2. Application Number and/or Project Name 3. Grantee IRSIVendor Number 4 Typed Name and Title of Authorized Representative 5. Signature 6. Date 'U 5 Gnvemment Printing O(f1e>3. 9996- dP5-03~/6p014 January 22,2007 Director Office on Violence Against Women US Department of Justice 800 K Street, Suite 920 Washington, DC 20530 The County of Kerr, Texas, Kerr County Commissioners Court. certifies that any funds awazded through the Safe Havens: Supervised Visitation and Safe Exchange Program will be used to supplement existing funds for program activities and will not replace (supplant) nonfederal funds that have been appropriated for the purpose of providing services to victims of domestic violence, dating violence and child victimization. The County of Kerr, Texas, Kerr County Commissioners Court understands that supplanting violations can result in a range of penalties, including suspension of future funds under this ,._. program, suspension or debarment from federal grants, recoupment of monies provided under this grant, and civil and/or criminal penalties. Sincerely, The Honorable Pat Tinley Kerr County Judge OMB Approval No. 4040-0007 Expiration Date 04/30/2008 ASSURANCES -NON-CONSTRUCTION PROGRAMS ^°° Public reporting burden for this collection of information is estimated to average 15 minutes per response, induding time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and cempleling and reviewing the collection of information. Send comments regarding the burden estimate or any other asped of this collection of information, including suggestions for retlucing this burden, to the Office of Management and Budget, Paperwork Retluction Projed (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 agendes may require applicants to certify to additional assurances. If such is the rase, 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 (induding funds sufficient to pay the non-Federal share of project cost) to ensure Droper planning, management antl completion of the project tlescribed in this application. 2. Will 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 tlocuments related to the awartl; antl will establish a proper accounting system in accordance with generally accepted accounting standards or agency Oiredives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or .~-.... pmsents the appearance of personal or organizational conflict of interest, or personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. Act of 1973, as amended (29 U.S.C. §794), which prohibits discdmination on the basis of handicaps; (d) the Age Discrimination Ad of 1975, as amended (42 U.S.C. §§6101-6107), which prohibits tliscrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amentled, relating to nondiscrimination on the basis oT drug abuse; (f) the Comprehensive Alcohol Abuse antl Alcoholism Prevention, Treatment and Rehabilitation Ad of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §§523 and 527 of the Public Health Service Ad of 1912 (42 U.S.C. §§280 dd-3 antl 290 ee- 3), as amended, relating to confitlenlialily of alcohol and drug abuse patient records; (h) Tide VIII of the Civil Rights Ad of 1988 (42 U.S.C. §§3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) untler which application for Federal assistance is being made: and, Q) the requirements of any other nondiscrimination statute(s) which may apply to the application. 5. Will Comply with the Irrtergovemmental Personnel Ad of 1970 (42 U.S.C. §§4728-4763) relating to prescribed standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F). 6. Will comply with all Federal statutes relating to nondiscnmination. These include but are not limited to: (a) Title VI of the Civil Rights Ad of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX 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) Sedion 504 of the Rehabilitation 7. WiII compfy, ar has already complied, with the requirements of Tilles II and III of the Uniform Relocation Assistance and Real Property Acquisition Polities Act of 1970 (P.L. 91-646) which provide for fair antl equitable treatment of persons tlisplaced or whose property is acquiretl as a result of Federal or fetlerally-assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases. 8. Will comply, as applicable, with provisions of the Hatch Act (5 U.S.C. §§1501-1508 and 7324-7328) which limit the political activities of employees whose prindpal employment activities are funded in whole or in part with Federal funds. Previous Etlnlon Usable Stantlartl Fonn 4318 (Rev. 7-97) Authorized for LOCdI Reproduction Preacdbed by OMB Circular A-102 9. Will 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 antl 18 U.S.C. §874), antl the Contract Work Hours and Safety Standartls Act (40 U.S.C. §§327- 333), regarding labor standards for federally-assisted censtruction subagreements. 10. Will 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 the program and to purchase Flood insurance if the total cost of insurable construction and arqulsitfon is $10,000 or more. 11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures untler the National Environmental Policy Act of 1969 (P.L. 91-190) antl Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11736; (c) protection of wetlantls pursuant to EO 11990; (d) evaluation of flood hazards in flootlplains in accertlance with EO 11988; (e) assurance of project consistency with the approved State management program tleveloped under the Coastal Zone Management Act of 1972 (16 U.S.C. §§1451 et seq.); (t) conformity of federal actions to State (Clean Air) Implementation Plans under Section 176(c) of the Clean Air Acl of 1955, as amended (42 U.S.C. §§7401 et seq.); (g) protection of undergrountl sources of dunking 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 Wild and Scenic Rivers Acl 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_ Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1986, as amended (16 U.S.C. §470), EO 11593 (itlentification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. §§469a-1 et seq.). 14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by lhls award of assistance. 15. Will comply with the Laboratory Animat Welfare Act of 1966 (P.L. 89-544, as amentletl, 7 U.S.C. §§2131 et seq.) pertaining to the rare, handling, antl treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will 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 construction or rehabilhation of residence structures. 17. Wrll cause to be performed the required financial and compliance audits in accordance witty the Single Audit Act Amendments of 1996 and OMB Circular No. A-133, "Audits of States, Local Governments, and Non-Profit Organizations." 18. Will comply with all applicable requirements of all other Federal laws, execuflve orders, regulations, and policies governing this program. ' SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL "TITLE C^^`,^.IE{Eu Ors. SLCtpj5E0.^. 'O GiaOiS 9C~i 'APPLICANT ORGANIZATION 'DATE SUBMITTED Con~a,etad cn subnlss;o~ tc Grants gov stantlard Form 4R4a (Rev. 7-97) aatk OMB APPROVAL NO. 1121-0021, EXPIRES: 7/31/94 ~r'""°'~.y U.S. DEPARTMENT OF JUSTICE '®~ OFFICE OF JUSTICE PROGRAMS ACCOUNTING SYSTEM AND FINANCIAL CAPABILITY QUESTIONNAIRE SECTION A: PURPOSE The financial responsibility of grantees must be such Nat the grantee ran propedy discharge the public trust which accompanies the authority to expend public funds. Adequate accounting systems should meet Ne following criteria as outlined in the OJP guideline manual entitled,'Financial and Administrative Guide for Grants" (1) Accounting records should provide information needed to adequately identify the receipt of funtls under each grant awarded and Ne expenditure of funds for each grant, for each action program covered by a State's grenLS and for each subgrent awarded by Ne State. (2) Entries in accounting rewrds stroufd refer to subsidiary records acrd/a dacumentalfon which support the entry and which can be readily loceted. (3) The accounting system should provide accurate and current financial reporting information. (4) The accounting system should be integrated with an adequate system of internal conVOls to safeguard Ne funds and assets covered, check fhe axuracy and reWability of accounting data, promote operafional efficiency, and encourage adherence to prescribed management policies. SECTION B: GENERAL 1. If your firm publishes a general information pamphlet setting forth Ne history, purpose and organizational structure of your business, please provide this office wiN a copy; otherwise, complete the following items: a. When was Ne wganization founded/ b. PdnGpal Officers Titles incorporated? (month, day, year) c. Employer Idenfifiration Number: d. Number of Employees Full Time: Part Time: 2. Is Ne firm affiliated wiN any other firm? f_] Yes ^ No 3. Total SaleslRevenues in most recent If'yes", provide details: accounting period. (12 months) SECTION C: ACCOUNTING SYSTEM 1. Has any Government Agency rendered an official written opinion concerning the adequacy of the accounting system for the cdledion, identifica- tion and allocation of costs under Federal centrects/grants? ^ YES .~l NO a. If yes, provide name and address of Agency performing b. Attach a copy d the latest review and any subsequent review: ~ cortespondence, Gearence documents, etc. Note: If review occurred within Ne past Nree years, omit questions 2-9 of Nis Section and Section D. 2. Which of Ne folowing best describes the accounting system? n Manual a Automated ^ Combination 3. Does the organization use adouble-entry system in accounting for program (ands? ^ Yes ^ No L Not Sure 4. Does the accounting system identify Ne receipt and expenditures of program funds ^ Yes -~ No ^ Not Sure separately for each contrad/grent7 5. Does the accounting system provide for the recerding of expenditures for each grentl ^ Yes I:7 No ^ Not Sure contract by Ne component project and budget cost cetegodes shown in Ne approved budget? 6. Are time disMbufion records maintained for an empbyee when hismer effort can be spedficelly ^ Yes f 1 No ^ Not Sure identified to a particular cost objective? 7. If the organization proposes an ovemead rate, does the accounting system provide for the G Yes L l No C Nol Sure segregation of direct and indirect expenses? 8. Does the accounting/financlal system include budgetary controls to preclude incurring obligations in excess of: a. Total funds available for a grant? u Yes n No I I Not Sure b. Total funds available for a budget cost category (e.g. Personnel, Travel, etc.)? ^ Yes ^ No ^ Not Sure 9. Is Ne firm generally familiar with the existing regulations and guidelines containing Ne cost J Yes ^ No ^ No[ Sure prtnciples and procedures for the determination and allowance of costs in connection with Federel centrects/grants? OJP FORM 7120/1 (Rev. 8/91) (continued on reverse) SECTION D: FUND CONTROL 1. Is a separate bank account maintained for granUCOntiad funtls? i ] Ves ^ No _1 Not Sure 2. If Federal grantlcontract funds are commingled with organization funds, can the ^ Yes I 1 No ^ Not Sure Federal grant funds and related costs antl expenses be readily identified? 3. Are the officials of the firm bonded? G Yes ~ No a Not Sure SECTION E: FINANCIAL STATEMENTS 1. Did an rntlependent certified public accountant (CPA) ever examine Cl Yes i ~. No the financial statements? 2. N an independent CPA review was performed please provide this office with ^ Enclosed C I NIA a copy of their latest report antl any management letlers issued. 3. if an independent CPA was engaged to perform a review and no report was issued, please provide details antl an explanation below: 4. If an independent CPA has never examined your financial statements, please develop and provide this office with a wpy of the following financial statements: a. A detailed 'Balance Sheep fa the most curtent antl previous year; and 6. A defailed'Income StatemenC for Ne most current and previous yeas SECTION F: ADDITIONAL INFORMATION - 1. Use this space for any additional information (indicate section and item numbers i(a continuation) ,; SECTION G: APPLICANT CERTIFICATION I certify that the above information is complete and correct to the best of my knowledge. 1. Signature b. Firm Name, Address, and Telephone Number a. TNe c, Application Identifier Number ' ~ '~ SECTION H: CPA CERTIFICATION '' `'- The purpose of the CPA certificatlon is to assure the Federal agency that the recipient can establish fiscal controls and accounting procedures which assure that Federal and Statellocal funds available for the conduct of the grant programs and projects are disbursed and accounted for properly. 7. Signature b. Firm Name, Address, and Telephone Number a. Title PUBLIC REPORTING BURDEN FOR THIS COLLECTION OF INFORMATION IS ESTIMATED TO AVERAGE 4 HOURS PER RESPONSE, INCLUDING THE TIME FOR REVIEWING INSTRUCTIONS, SEARCHING EXISTING DATA SOURCES, GATHERING AND MAINTAINING THE DATA NEEDEO, ANO COMPLETING AND REVIEWING THE COLLECTION OF INFORMATION. SEND COMMENTS REGARDING THIS BURDEN ESTIMATE OR ANV OTHER ASPECTS OF THIS COLLECTION OF INFORMATION, INCLUDING ~" SUGGESTIONS FOR REDUCING THIS BURDEN, TO THE OFFICE OF THE COMPTROLLER, OFFICE OF JUSTICE PROGRAMS, U.S. DEPARTMENT OF JUSTICE, WASHINGTON. D.C. 20537; AND TO THE PUBLIC USE REPORTS PROJECT, 1121-0027, OFFICE OF INFORMATION AND REGULATORY AFFAIRS, OFFICE OF MANAGEMENT AND BUDGET, WASHINGTON, D.C. 20503.