Forms and Regulatons for Grants to States for Construction and Acquisition of State Home Facilities

Forms for Grants to States for Construction and Acquisition of State Home Facilities

2900-0661 Forms_Support_List[1]

Forms and Regulatons for Grants to States for Construction and Acquisition of State Home Facilities

OMB: 2900-0661

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State Home Construction Grant Forms


Form No.

Form Title

Usage

10-0388-1

Documents & Information Required for State Home Construction & Acquisition Grants-Initial Application

State certifies all initial application requirements have been submitted to VA to request consideration for grant award for Construction or renovation project

10-0388-2

Certification of Compliance with Provisions of Davis-Bacon Act, (40 U.S.C. Sections 276a to 276a-7)

State completes this form certifying they are in compliance with the wage rates as determined by DOL for the State project

10-0388-3

State Home Construction Grant Program – Space Program Analysis – Nursing Home & Domiciliary

State completes this form for review by VA Construction & Facilities for Space requirements for Nursing Homes & Domiciliary

10-0388-4

State Home Construction Grant Program – Space Program Analysis – Adult Day Health Care

State completes this form for review by VA Construction & Facilities for Space requirements for Adult Day Health Care facilities

10-0388-5

Additional Documents & Information Required for State Home Construction & Acquisition Grants Application

State certifies all additional grant requirements have been submitted to VA prior to grant award

10-0388-6

Certification of State Matching Funds to Qualify for Group 1 on the Priority List

State completes this form and submits to VA to certify 35% matching funds for State Home project

10-0388-7

Certification Regarding Debarment, Suspension, and other Responsibility Matters

State completes this form and submits to VA to show compliance with the Federal laws regarding covered transactions

10-0388-8

Certification Regarding Drug-Free Workplace Requirements for Grantees Other Than Individuals

State completes this form and submits to VA to certify they maintain a drug-free workplace

10-0388-9

Certification Regarding Lobbying

State completes this form and submits to VA to certify no funds have been utilized to influence a Federal Government Agency or Congress

10-0388-10

Certification of Compliance with Federal Requirements-State Home Construction Grant

State completes this form and submits to VA to certify that all requirements for State Home Construction project are met

10-0388-12

Certification Regarding Debarment, Suspension, Ineligibility & Voluntary Exclusion – Lower Tier Covered Transactions

The Contractor employed by the State completes this form and the State submits to VA to ensure Federal laws regarding covered transactions

10-0388-13

Documents and Information Required for State Home Construction & Acquisition Grants – Post Grant Requirements

State completes this form and submits to VA prior to the final payment of grant funds


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleState Home Construction Grant Forms
Authorvacorobins
File Modified0000-00-00
File Created2021-02-01

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