A10 - Special Supplemental Nutrition Program for Women, Infants and Children – Special Projects and Concept Papers

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FY XXXX WIC SPECIAL PROJECT GRANTS

Full and Mini Grants

REQUEST FOR APPLICATIONS

CFDA# 10.578

Application Deadline: XXXX; 11:59 PM

Letter of Intent is due XXXX

U.S. Department of Agriculture

Food and Nutrition Service

Table of Contents

General Information 3

• Purpose 3

• Eligible Applicants 3

• FY XXXX Project Focus Area 3

• Funding and Duration 4

• Important Dates 5

• Submission of Application 5

Grant Application Format and Content Requirements 7

• Application Format 7

• Application Content 9

Grant Requirements 20

• Terms and Conditions of Award 20

• Full Grant Performance Period, Reporting and Meeting Attendance 21

• Mini Grant Performance Period, Reporting and Meeting Attendance 23

Evaluation and Selection of Grant Applications 25

• Evaluation 25

• Selection 28

List of Attachments 30

1. Letter of Intent 31

2. Application Checklist 32

3. Terms and Conditions of Award 35

4. Budget Narrative Checklist and Certification Forms 37

SPECIAL SUPPLEMENTAL NUTRITION PROGRAM

FOR WOMEN, INFANTS, AND CHILDREN (WIC)

FISCAL YEAR (FY) XXXX SPECIAL PROJECT GRANTS

REQUEST FOR APPLICATION (RFA)

for

FULL and MINI GRANTS

GENERAL INFORMATION

Purpose

The purpose of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Special Project Grants is to help WIC State Agencies develop, implement, and evaluate new or innovative methods of service to meet the changing needs of WIC participants. Section 17(h)(10)(III) of the Child Nutrition Act authorizes funding of special State projects of regional or national significance to improve WIC services. The WIC Special Project Grants are intended to encourage innovative and creative projects that improve the delivery of WIC services and that:

• Demonstrate national or regional significance;

• Produce results which have a demonstrable impact and are sustainable in the absence of special funding;

• Are transferrable to other WIC Programs in the region or nationally;

• Can be evaluated with measurable results; and

• Can be replicated by other WIC Programs.

Eligible Applicants

Grants may be awarded to individual WIC State agencies or to a consortium of WIC State agencies, as long as one of the agencies is designated the lead agency. FNS encourages smaller State agencies and ITOs to consider collaborating with other WIC State agencies or ITOs on grant applications. Individual State agencies may submit only one application for a Full or Mini Grant per year. If a State agency submits an application as part of a consortium of agencies, it may not also submit a separate individual application.

FY XXXX Project Focus Area

The focus area of the FY XXXX WIC Special Project Full and Mini Grants is Retention of Children Participating in WIC. This focus area is intended for applicants who would like to implement and evaluate innovative strategies for retaining children (ages 1 through 4 years) currently participating in WIC. WIC participation rates for children have been shown to drop significantly after the child reaches one year of age.  Indicators are that this abrupt decrease is largely due to discontinuation of the availability of infant formula through the WIC food package.  However, young children between the ages of 2 and 5 are still developmentally vulnerable to a wide variety of nutrition-related problems that have been proven to be mitigated by continued WIC participation.

The USDA Food and Nutrition Service (FNS) will consider Full and Mini Grant applications proposing to evaluate other focus areas as long as the projects are aimed at helping State agencies develop, implement and evaluate new or innovative methods of service delivery to meet the changing needs of WIC participants. For example, ideas stemming from the Planning a WIC Research Agenda conference will be considered¹.

Information about past WIC Special Project Grants awarded can be found at: http://www.fns.usda.gov/wic/wic-special-project-grants.

Funding and Duration

FNS expects to have approximately $2,000,000 in fiscal year (FY) XXXX available for Special Project Grants to WIC State agencies. These grant awards are contingent upon the availability of funding. Grant funds will be available only to the 90 WIC State agencies responsible for administering WIC in the States, Territories, and Indian Tribal Organizations (ITOs). These projects will be awarded as cooperative agreements.

There are three types of WIC Special Project Grants: Full Grants, Mini Grants, and Concept Paper Development Grants. This RFA is for Full or Mini Grants only. A separate RFA is available for States planning to submit a proposal for a Concept Paper Development Grants.

Full Grants - FNS anticipates awarding up to 4 Full Grants for $300,000-$400,000 each, depending on the number and quality of applications received and requested budget amounts. The performance period will be from the date of the award through September 30, 2018. (Note: While all major project activities must be completed by September 30, 2017, Grantees will be required to present project findings to FNS in spring 2018. See Grant Requirements for more information.)

Mini Grants - FNS anticipates awarding up to 10 Mini Grants for up to $50,000 - $75,000 each, depending on the number and quality of applications received and requested budget amounts. The performance period will be from the date of the award through March 30, 2016. (Note: While all major project activities must be completed by March 30, 2016, Grantees will be required to present project findings to FNS in summer 2016. See Grant Requirements for more information.)

FNS reserves the right to reduce, increase, or revise proposed budgets based on the availability of funds. FNS also reserves the right to cancel this RFA in whole or in part if funds are not available.

Important Dates

XXXX – Letter of Intent to submit an application (optional) is due to FNS. See Attachment A: Letter of Intent.

XXXX– Applications are due to FNS.

September XXXX – WIC Special Project Grants will be awarded.

Submission of Application

1. The complete application package must be uploaded on www.grants.gov on or before Thursday, XXXX at 11:59 PM, Eastern Daylight Savings Time. FNS will not accept applications sent via U.S. Mail, email, fax, or those that are hand-delivered. Applications received after the deadline date and/or time will be deemed ineligible and will not be reviewed or considered. FNS WILL NOT consider any additions or revisions to applications once they are received. Only WIC State Agencies may apply. The web site grants.gov is a government-wide web site designed for electronic submission of applications/proposals. We advise that you allow ample time to familiarize yourself with the system’s requirements. We strongly recommended that you begin the submission process sufficiently in advance of the due date to ensure your application package is received on or before the deadline in case there are problems with the government-wide website.

2. In order to submit your application via www.grants.gov, you must have obtained a Data Universal Numbering System (DUNS) number and registered in both the new System for Award Management (SAM) and on Grants.gov. All applicants must have current SAM status at the time of application submission and throughout the duration of a Federal Award in accordance with 2 CFR Part 25. Please visit the following websites to obtain additional information on how to obtain a DUNS number (www.dnb.com) and register in SAM (https://www.sam.gov/portal/public/SAM/). Additional information is contained under the section entitled “Application Format”.

 

3. Please be aware that the Grants.gov system provides several confirmation notices; you need to be sure that you have confirmation that the application was accepted. Please send an e-mail to [email protected] advising that your application has been submitted through the www.grants.gov portal and that you have received a confirmation notice from www.grants.gov.

4. Applications submitted without all the required supporting documents, forms, certification, and signatures will not be considered for competition. See Attachment B: Application Checklist for a list of everything that must be included in the application.

5. The number of pages for the entire Application should be no more than 25 pages for Full Grants and 12 pages for Mini Grants, excluding appendices or attached resumes. Narrative may not be in a font size smaller than 12 point. There is no page limit to resumes. Other Appendices may not exceed 15 pages for Full Grants and 8 pages for Mini Grants.

6. Applications should clearly indicate submission of a Full or Mini WIC Special Project Grant.

All questions regarding the application should be referred to Leslie Byrd at [email protected].

GRANT APPLICATION FORMAT AND CONTENT REQUIREMENTS

In general the grant proposals should:

1. Include a clear description of the planned project or intervention and how it would address its focus area.

2. Identify major goals, and clearly defined objectives and outcome measures of the project.

3. Explain how the project would be implemented and discuss its sustainability and transferability.

4. Include plans for an evaluation component. See Project Evaluation below for Full or Mini Grant for more information.

Application Format

See Attachment B: Application Checklist for more information.

Additional Submission Information

In order to submit your application via www.grants.gov, you must have obtained a Data Universal Numbering System (DUNS) number and registered in both the new Systems for Award Management (SAM) and on Grants.gov. The applicant is strongly advised to allow ample time to initiate its grants.gov application submission. All applicants must have current CCR status at the time of application submission and throughout the duration of a Federal Award in accordance with 2 CFR Part 25. Please visit the following websites to obtain additional information on how to obtain a DUNS number (www.dnb.com) and register in SAM (https://www.sam.gov/portal/public/SAM/).

What is SAM?
The System for Award Management (SAM) is combining Federal procurement systems and the Catalog of Federal Domestic Assistance into one new system. This consolidation is being done in phases. The first phase of SAM incorporated the functionality from several systems, including the Central Contractor Registry (CCR).

For additional information regarding SAM see the following link:

https://www.acquisition.gov/SAM_Guides/Quick%20Guide%20for%20Grants%20Registrations%20v1.pdf

Below is some additional information that should assist the applicant through this process:

DUNS Number: In order to obtain a DUNS number, if your organization does not have one, or if you are unsure of your organization’s number you can contact Dun and Bradstreet via the internet at http://fedgov.dnb.com/webform or by calling 1-888-814-1435, Monday thru Friday, 8am-9pm EST. There is no fee associated with obtaining a DUNS number. Obtaining a DUNS number may take several days to obtain.

SAM Registration: For applicant organizations that were previously registered in the CCR, relevant applicant information is already in SAM; set up a SAM account as necessary to update any information. To register in SAM, the applicant’s DUNS number, Tax ID Number (TIN), and taxpayer name (as it appears on the applicant’s last tax return) are all required.. SAM verifies all information submitted by the applicant using several systems. This verification takes at least 48 hours after your registration is submitted to SAM. Applicants must have a valid SAM registration no later than 3 days prior to the application due date of this solicitation. Applicants that do not receive confirmation that SAM registration is complete and active should contact SAM at: https://www.fsd.gov/app/answers/list.

Grants.gov Registration: In order to apply for a grant, your organization must have completed the above registrations as well as register on Grants.gov. The Grants.gov registration process can be accessed at www.grants.govapplicants/get_reistered.jsp. Generally, the registration process takes between 3-5 business days.

Allow your entity ample time to complete the necessary steps, for the submission of your grant application package, on grants.gov.

Please be aware that the grants.gov system provides several confirmation notices; applicants should ensure receipt of confirmation that the application was accepted.

PLEASE BE AWARE: In some instances the process to complete the migration of permissions and/or the renewal of the entity record will require 5-7 days or more. We strongly encourage grantees to begin the process at least 3 weeks before grant the due date of the grant solicitation.

NOTICE: Special Characters not Supported

All applicants MUST follow grants.gov guidance on file naming conventions. To avoid submission issues, please follow the guidance provided in the grants.gov Frequently Asked Questions (FAQ):

Are there restrictions on file names for any attachment I include with my application package?

File attachment names longer than approximately 50 characters can cause problems processing packages. Please limit file attachment names. Also, do not use any special characters (example: &,–,*,%,/,#’, -), this includes periods (.), spacing followed by a dash in the file and for word separation, use underscore (example: Attached_File.pdf) in naming the attachments. Please note that if these guidelines are not followed, your application will be rejected. FNS will not accept any application rejected from www.grants.gov portal due to incorrect naming conventions.

Please be aware that the grants.gov system provides several confirmation notices; you need to be sure that you have confirmation that the application was accepted.

Application Content

For Full Grants, FNS requires applicants to partner with academic universities or research institutions/entities which bring specific expertise in developing grant applications and conducting research projects. This partnership does not need to be fully executed by the time the application is submitted in order to receive project funding, but must be in place – and documentation to that effect provided to FNS -- by 3 months post award in order for the grant award and funding to be continued.

FNS encourages, to the extent appropriate, but does not require collaboration with outside entities for Mini Grant applications

Applicants must respond to all of the sections described below. Please use this organizational format as it will make it easier for grant reviewers to locate the requested information and to evaluate each application. If this format is not used it may result in reviewers’ being unable to locate the requested information within the application. Included in this RFA is Attachment B Application Checklist to assist applicants.

I. Introductory Material

A. Cover Letter

B. Title Page with:

• Project Summary: A one-paragraph description of your project covering both the planned intervention and its evaluation. This paragraph will provide the basis for any short summaries of the proposed grant that FNS prepares during the procurement process.

• Single Point of Contact: Designate a single point of contact for your application. Provide the individual’s name, title, mailing address, phone number, fax number, and email address.

C. Table of Contents

II. Abstract

Full Grant: Approximately 2-3 pages

Mini Grant: One page

Provide a summary of your project that includes:(1) a description how your project meets the focus area*; (2) a description of your planned intervention that specifies the nature of the intervention, the targeted audience (e.g., WIC staff, all WIC participants, WIC participants meeting specified criteria), and how the intervention will be implemented; (3) goals and objectives of the intervention; (4) project environment; (5) project evaluation, including its basic research questions, research design, and planned data collection (required for full grants only), and (6) key personnel.

*The Focus Area for the FY XXXX WIC Special Projects grants is Retention of Children Participating in WIC. For both Full and Mini Grants, FNS will consider grant applications proposing to evaluate other focus area(s) as long as the projects are aimed at helping State agencies develop, implement and evaluate new or innovative methods of service delivery to meet the changing needs of WIC participants. See General Information for more information.

III. Project Design and Implementation

Full Grant: Approximately 4-6 pages.

Mini Grant: Approximately 2-3 pages.

Provide a description of the following:

A. Need for Project: Discuss the problem that the proposed project addresses and how the expected results of the project can be used to improve program services in your State and at either the regional or national level. A post award Needs Assessment with input from WIC local agencies is recommended to refine the project design and implementation plans.

B. Goals: List and discuss each goal of the project design and implementation.

C. Objectives: For each of the goals, list and discuss the associated objective(s). Objective(s) should be specific, measurable, and realistic (e.g. increase participation of children ages 1-4 by 25%; increase parents’ servings of whole grain foods by one serving per day; reduce no-show rates of child recertification appointments by 30%).

D. Tasks: Discuss tasks that will be undertaken during both project design and implementation (e.g., design a nutrition education intervention, select participants for the intervention, train staff to perform the intervention, modify or develop training materials) and evaluation (e.g., assign or recruit local offices to intervention and comparison groups, develop and test data collection instruments, collect data, analyze data, and report evaluation findings). Planned tasks must be necessary to meet the project’s stated goals and objectives.

E. Environment: Depending on the structure of your project, respond to one and only one of the following. Choose the one that is most appropriate for your particular project.

• For projects that are intended to operate solely at the State agency level (e.g., analysis of data from participation reports), provide a State-level description of relevant characteristics that impact the operation of the project (e.g., participant characteristics, equipment, space, staffing, program operations, etc.). Provide a justification for operating the project at the State agency level.

• For interventions that will be implemented only within selected local WIC clinics and/or partner agencies, provide a local level description of relevant characteristics that impact the operation of the project (e.g., participant characteristics, equipment, space, staffing, and program operations, etc.). Provide a justification for your proposed choice of local clinics and/or partner agencies.

• For interventions that will be implemented only within selected local WIC clinics and/or partner agencies in which clinics or agencies have not yet been selected, provide a description of how you intend to select appropriate clinics or agencies. Provide a justification for your selection criteria.

Note that FNS does not recommend interventions that will be implemented State-wide in every local WIC clinic or agency. Without a control or comparison group (e.g., local WIC clinics or agencies in which the intervention has not been implemented), it is very difficult to develop a research design that can adequately evaluate the impacts of an intervention.

F. Letters of Support: If applicable, provide documentation of agreements or memoranda of understanding with local WIC clinics and/or partner agencies in an appendix to the proposal that does not exceed 15 pages in length (does not count toward the 25-page limit on proposal length).

IV. Project Evaluation:

Full Grant: Approximately 3-5 pages

Mini Grant: One page

Project Evaluation for Full Grants: FNS recognizes that many WIC State agencies may not have available staff experienced in preparing evaluation plans. State agencies applying for funding for a Full Grant should include a staff person with experience in designing, developing, implementing and evaluating social or public health research projects. This person could be a social scientist or someone with a public health nutrition or public health research background from a university, consulting firm, institute, or government agency. The following publications are available for assistance in developing the evaluation component:

• WIC Evaluation Resource Guide, available at: http://www.fns.usda.gov/wic-evaluation-resource-guide

• Nutrition Education: Principles of Sound Impact Evaluation, available at: http://www.fns.usda.gov/nutrition-education-principles-sound-impact-evaluation.

A. Type of Evaluation (Full Grants): There are three types of evaluations commonly used to assess WIC and other social programs. Process or implementation evaluations provide detailed descriptive information on the way a program operates or an intervention is implemented. Outcome assessments or impact evaluations are usually more quantitative in nature and are designed to rigorously estimate actual project outcomes or impacts. The third type of evaluation, cost-benefit analysis, compares the estimated cost of a project with its estimated benefits. Mixed-method evaluations are acceptable. Indicate the type(s) of evaluation methods you are planning to use.

B. Research Design (Full Grants):

Note: As state previously, for Full Grants, FNS requires applicants to partner with academic universities or research institutions/entities which bring specific expertise in developing grant applications and conducting research projects. This partnership does not need to be fully executed by the time the application is submitted in order to receive project funding, but must be in place – and documentation to that effect provided to FNS -- by 3 months post award in order for the grant award and funding to be continued.

1. Research Questions: For each of the objectives of the project design and implementation, list and discuss specific research questions that will be answered during the evaluation (e.g., Does the proposed intervention increase child participation, if so, by how much? Do the results of the intervention differ by participant characteristics such as ethnicity and age of child?).

2. Measures: For each research question, discuss specific measures that you will use (e.g., participation reports by child age and other demographics, surveys of participants and /or staff, etc.). Discuss the strengths and weaknesses of the proposed measures.

3. Research Methods: Discuss the methods that will be used to answer the research questions, including:

• Sampling plan(s) and expected sample size(s).

• Data collection methods (how, by whom, how often, when).

• Data analysis methods (how and by whom).

• Strengths and weaknesses of the research methods.

Project Evaluation for Mini Grants: For project evaluation purposes, please describe the data elements you will collect and submit to FNS and how often the data will be collected. For example, you may describe how Program participation data is collected from your existing Management Information System and how you will share this data with FNS as part of the quarterly progress reports (see Grant Requirements for more information about reporting requirements). Please also identify and define your baseline participation.

V. Sustainability and Transferability:

Full Grant: Approximately 2 pages

Mini Grant: One page

A. Sustainability: Confirm that the planned intervention meets all WIC regulations and guidance. Discuss how your project and its results will be sustained financially and administratively once the grant ends. If the project is a one-time project designed only to be performed during the grant period, discuss why it is sufficient as a one-time project and how the results will be used in the future.

B. Transferability: Discuss how your project and its results might inform other WIC State agencies and the feasibility (both financial and administrative) of implementing it in other states. Discuss plans for preparing and disseminating a final report, resources and materials developed as a result of the project, including how and with whom the report and materials will be shared (e.g., FNS, National WIC Association, conferences, universities, and journals). Extensive dissemination of project results, resources and materials is expected so that other State agencies will have the opportunity to replicate the project and/or learn from its results. (Note: FNS reserves a royalty-free, nonexclusive, and irrevocable license to reproduce, publish or otherwise use, and to authorize others to use, for Federal Government purposes any work developed under a grant. For more information see 40 CFR Part 31.34 in Attachment C, Terms and Conditions.) For an application to be successful, it is essential that the project results be used to improve WIC Program services, and that they are applicable at the State and/or local agency levels. FNS is especially interested in projects that utilize the WIC Works Resource System to disseminate information/resources. Information about this system may be found at http://www.nal.usda.gov/wicworks/.

VI. Key Personnel:

Full Grant: Approximately 3-4 pages.

Mini Grant: One page.

A. Applicants are responsible for identifying the individuals in their applications that qualify as key personnel. Key personnel can include individuals receiving funding through this grant, individuals who are making an in-kind contribution, and contractors/sub-contractors. Key personnel generally are identified as those individuals who:

• Have a direct bearing on the outcome of the project by their participation.

• Bear a substantive responsibility for developing, modifying and achieving the objectives of the project.

• Are responsible for managing, administering, conducting or providing oversight for a significant component of the project.

B. Please provide the following information for all identified key personnel,:

• Indicate the individual’s current position and what their title will be on the proposed project.

• Describe the individual’s specific role and duties on the project. Where possible, make reference to the project design/ implementation or project evaluation narrative (i.e., Jane Doe will be responsible for developing the training curriculum described on page 10 of the application).

• Identify time commitment for each key staff with percentages of FTE or total work hours per month for each of the three years of the project.

For Full Grant applications only, please provide the following additional information for all identified key personnel:

• Describe prior relevant experience and how it relates to project duties.

• In an appendix, provide a current resume or curriculum vitae for the individual.

• In an appendix, provide a letter of commitment from the individual’s supervisor indicating the individual’s time commitment to the project.

• For key project positions that are currently vacant that must be filled in the course of the project, provide the following information: 1) the position title; 2) in an appendix, a detailed position description with required qualifications, skills, and knowledge; 3) a description of specific roles and duties on the project, making reference back to the project or evaluation narrative; 4) an anticipated date of hire; and 5) what arrangements will be made if the position is not filled in a timely manner.

• Identify all other projects, job positions (governmental and/or contractual), and other work-related commitments that each key staff member will be scheduled to work on during the grant or concept paper time-frame.

C. For key personnel (and especially evaluation personnel or organizations), please identify any potential conflicts of interest (actual or perceived) that might prevent an independent and objective assessment of the implementation, impacts, or benefits of the proposed intervention (e.g., having a contractor both develop and assess an intervention). If any conflicts are identified, provide a discussion of what steps the State agency will take to ensure an objective and complete evaluation.

VII. Management and Budget Plan: (Approximately 3-5 pages)

Full Grant: Approximately 3-5 pages.

Mini Grant: Approximately 2-3 pages.

A. Management Plans

1. Chain of Command and Responsibilities: Provide an organizational chart that indicates who has authority over whom, with a written description. Discuss how task leaders will be held accountable to keep the project on time and within budget. Describe how and by whom quarterly performance reports to FNS will be prepared as required by 7 CFR Part 3016.40.²

2. Contingency Plans: Discuss contingency plans for ensuring that the project is not unduly disrupted by problems in development of intervention materials, development or clearance of data collection instruments, recruitment of sites or participants, availability of key personnel, or other unforeseen factors. With regard to key personnel, identify specific individuals who will be able to take over project tasks if proposed staff is not available during the project, and indicate their qualifications to do so. Otherwise, discuss the process you will use to select qualified replacements.

3. Outside Personnel: Discuss how and by whom relationships with all personnel outside of the primary Grantee agency will be managed (e.g., personnel from local WIC clinics or partner agencies, personnel from other State agencies, university personnel, consultants, contractors).

4. Task Table: Present a table which includes, in chronological order, every distinct task involved in both the project design and implementation and the project evaluation (e.g., implementation of new procedures pertinent to the project, survey development, training activities, data collection, data analysis, report writing), the beginning and ending date of each task, and the key staff person(s) responsible for overseeing/working on the task. The sample task table below, though neither comprehensive nor complete, demonstrates the first few project design, implementation and evaluation tasks of a sample project.

Sample Task Table

Task No.	Task Name	Description	Date Begins	Date Ends	Responsible Staff
1	Develop Curriculum	Develop Curriculum for use in the infant feeding practices nutrition education intervention	9/29/05	12/31/05	Jane Doe, Project Director & Suzy Que, Nutritionist
2	Test Curriculum	Field test the curriculum with 15 participants and 3 staff, hold focus groups with staff and with participants to identify necessary changes	1/1/06	2/1/06	Suzy Que, Nutritionist
3	Analyze Focus Group Data	Code, enter, and analyze data gathered in focus groups, identify necessary curriculum changes.	2/1/06	2/15/06	Jack Data, research analyst
4	Revise Curriculum	Revise curriculum based on results of focus groups	2/15/06	3/15/06	Suzy Que, Nutritionist
5	Develop KAB pre & post tests	Develop surveys to test infant feeding knowledge of participants before and after intervention	2/15/06	3/15/06	Lori Sample, Evaluation Consultant
6	Pre-test surveys	Field test the KAB pre & post test surveys with 15 participants	3/16/06	4/10/06	Jack Data, research analyst.

B. Budget and Justification:

1. Budget: Provide line item detail and calculations for each budget object class identified in Section B, Budget Categories (a-j), of SF 424A. Details of calculation(s) must include estimation methods, quantities, unit costs, and other similar detail sufficient for it to be duplicated. Budget details must be provided for both Federal and non-Federal resources.

The budget narrative should provide enough detail for reviewers to easily understand how costs were determined and how they relate to the goals and objectives of the project. (Please see Attachment D, Budget Narrative Checklist and Forms.)

For purposes of preparing the budget, “Federal resources” refers only to the requested WIC Special Project Grant funds. Non-Federal resources are all other Federal and non-Federal resources, including in-kind contributions. It is suggested that budget amounts and computations be presented in a columnar format: first column, object class categories; second column, Federal resources; next column, non-Federal resources; and last column, total budget. A separate budget page is required for each budget year requested as well as a total across all years. As part of your budget, please assume the following:

• Full Grant: One meeting per year for four years (including the final meeting and presentation of results to occur within 9 months of completion of the project) at FNS headquarters. Project expenditures through the final meeting must be included in the budget and expended prior to the grant expiration date. The annual meetings will be scheduled for 2 days (travel may be necessary the day before and/or after a meeting). Each State agency should plan to send up to two participants. It is required that one participant be from the WIC State agency, and is strongly recommended that one participant be an evaluator.

• Mini Grant: One meeting at the end of the project period (Tentatively Spring 2016) at FNS Headquarters. Project expenditures through the meeting date must be included in the budget and expended prior to the grant expiration date. The meeting will be scheduled for 2 days (travel may be necessary the day before and/or after a meeting). Each State agency should plan to send one participant.

A sample budget table is provided for illustrative purposes on page 19. It is not comprehensive and the unit costs and rates of pay are not necessarily intended to represent standard or reasonable costs.

2. Budget Justification: For each part of Section B, Budget Categories, applicants must submit a written justification for each budget category. The written justification should: 1) describe how the categorical costs were derived (i.e., price comparisons, standard government cost, estimates by proposed local vendor, prior experience with similar projects, etc.); 2) discuss the necessity, reasonableness, and allocability of proposed costs; and 3) when possible, link expenditures to specific project activities/tasks. For any contractual costs, please also provide a justification for the proposed selection method (i.e., competitive or sole source).

3. Indirect cost rate agreements (ICRA): Applicants claiming indirect costs must provide a copy (in an appendix) of an approved ICRA for all indirect costs and a written explanation for how the indirect costs were applied to the budget. If indirect costs are not being claimed, then please indicate such.

4. Use of subcontractors: According to 7 CFR 3016 (c), any contract that a State agency procures under this grant (if awarded) must be competitive unless FNS approves an exception for the State agency and allows it to use a sole-source contract.  Please identify any contracts that you expect to award if this grant is awarded to you. Indicate whether the procurement will be competitive or sole-source.  If sole-source procurement is planned, include a written request for an exception as part of your application.  The request should include the name of the proposed contractor, a brief explanation of why the state has decided to award this contract as sole-source, and a description of how the state determined the proposed cost of the contract to be fair and reasonable.

VIII. Grantmaking Forms

The following forms must be included:

• Standard Form 424 – Application for Federal Assistance

• Standard Form 424A – Budget Summary

• Standard Form 424B – Assurances – Non-Construction Programs

• Certification Regarding Lobbying (See Attachment D)

• Disclosure of Lobbying Activities (See Attachment D)

• AD-1047- CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS

• AD-1048- CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION- LOWER TIER COVERED TRANSACTIONS

• AD-1052- CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS, STATE AND STATE AGENCIES

These forms are at the USDA Forms site: http://www.ocio.usda.gov/policy-directives-records-forms/forms-management/approved-computer-generated-forms.

IX. Appendices

Full Grant: Not to exceed 15 pages for items B-E below.

Mini Grant: Not to exceed 8 pages for items B-E below.

Each of the following sections may be included as a separate appendix:

1. Resumes and curriculum vitae for key personnel (No page limit).

2. Letters of commitment from supervisors of key personnel.

3. Job descriptions for key personnel that must be hired.

4. Copies of agreements, memoranda of understanding, letters of intent with local WIC clinics and/or partner agencies. (For Full Grants the partnership with academic universities or research institutions/entities does not need to be fully executed by the time the application is submitted in order to receive project funding, but must be in place – and documentation to that effect provided to FNS -- by 3 months post award in order for the grant award and funding to be continued.)

5. Any other supporting documentation.

Sample Budget Table (Year 1)

Object Class Categories	Federal Resources	Non-Federal Resources	Total
Personnel	$25,000	$10,500	$35,500
Jane Doe, Project Director	$50,000 [email protected] FTE=$20,000		$20,000
Suzy Que, Nutritionist		$35,000 [email protected] FTE=$10,500	$10,500
Jack Data, Research Analyst	$50,000 salary @.10 FTE=$5,000		$5,000
Fringe Benefits	$5,000	$2,100	7,100
Jane Doe, Project Director	$20,000*.20 fringe rate=$4,000		$4,000
Suzy Que, Nutritionist		$10,500*.20 fringe rate=$2,100	$2,100
Jack Data, Research Analyst	$5,000*.20 fringe rate=$1,000		$1,000
Travel	$2,356		$2,356
Travel to FNS headquarters	Airfare@$600 x 2 staff + perdiem@$145 x 2 staff x 2 days = $1780		$1780
Meetings between staff	.32 per mile@150 miles x 4 trips x 3 staff = $576		$576
Equipment	$2,000		$2,000
Computer	1 computer @ $2,000		$2,000
Supplies	$150		$150
Photocopying	1000 copies @ .05/copy = $50		$50
Fedex	20 Fedex packages @ $5.00 = $100		$100
Contractual	$50,000		$50,000
Evaluation Consultant	$50,000		$50,000
Construction	$0		$0
Other	$1400		$1400
Long-distance	3000 minutes @ .30/minute = $900		$900
Conference call with FNS and other grantees	1 call @ $100		$100
Total Direct	$85,506	$12,600	$98,106
Indirect Charges	$9,000	$3,780	$12,780
	.30 indirect rate * $30,000 salaries and fringe = $9,000	.30 indirect rate * $12,600 salaries and fringe = $3,780
Totals	$94,506	$16,380	$110,886

GRANT REQUIREMENTS

Terms and Conditions of Award

All grants will be awarded as cooperative agreements. The Grantee shall be responsible for managing the cooperative agreement consistent with legislation, administrative rules, regulations, and procedures of the WIC Program, including coordination and approval of all accounting procedures and with applicable Federal administrative requirements contained in OMB Circulars A-21, A-87, A-122, and A-133 and the regulations implementing them. Also, adherence is required to the 2 CFR Parts 25, 170, and 175, 180, 417, and 421; 7 CFR Parts 15, 3015, 3016, 3018, 3019, and 3052; 40 CFR Part 31.34; and 41 CFR 1-15.2 (FAR Part 31). A full listing of the applicable documents can be found in Attachment C, Terms and Conditions of Award.

Suspension/Debarment: (a) The Grantee agrees to ensure that all sub-Grantees are neither excluded nor disqualified under the Suspension and Debarment rules found at 2 CFR part 180.300 by doing any one of the following:

• Checking the System for Awards Management (SAM). This information can be found at www.sam.gov.

• Collecting a certification that the entity is neither excluded nor disqualified. Because a Federal certification form is no longer available, the Grantee or sub-Grantee electing this must devise its own.

• Including a clause to this effect in the sub-grant agreement and in any procurement contract expected to equal or exceed $25,000, awarded by the Grantee or a sub-Grantee under its grant or sub-grant.

(b) As a condition of this award, the grantee will ensure that all sub-Grantees are informed and comply with the requirements of 2 CFR part 180, subpart C.

(c) The grantee agrees to comply with the requirements of 2 CFR part 180.335, and will provide notification to FNS if the organization or principal officials:

• Are presently excluded or disqualified;

• Have been convicted within the preceding 3 years of any offenses listed at 2 CFR part 180.800(a), including: (1) Commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public or private agreement or transaction; (2) Violation of Federal or State antitrust statutes, including those proscribing price fixing between competitors, allocation of customers between competitors, and bid rigging; (3) Commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, receiving stolen property, making false claims, or obstruction of justice; or (4) Commission of any other offense indicating a lack of business integrity or business honesty that seriously and directly affects your present responsibility;

• Are presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with commission of any offense listed at 2 CFR part 800(a); or

• Have had a transaction (Federal, State or local) terminated within the preceding 3 years for cause or default.

Full Grant Performance Period, Reporting & Meeting Attendance

Performance Period

The period of performance for the cooperative agreement shall be from the date of the award through September 30, 2018. All expenditures for authorized activities for the project (other than those for the final reports and FY 2018 meeting and presentation) must be incurred by September 30, 2017. The final project and financial reports are due to FNS by December 31, 2017 and all expenditures associated with the final report must be incurred by December 31, 2017. The only allowable expenditures on or after January 1, 2018 are those associated with preparation for attendance and presentation at the FNS-sponsored FY 2018 WIC Special Project Grant annual meeting, filing the associated expenditure reports and grant close-out. See Reporting and Meeting Requirements below for more information.

Reporting Requirements

Quarterly Progress Reports: A signed electronic file of the Quarterly Progress Report shall be submitted to the FNS Program Officer (see below for contact information). The first report should reflect progress up to the end of the first fiscal quarter after the effective date of the Grant Agreement. At a minimum all Quarterly Progress Reports should include:

• Narrative description of the project’s progress, tasks completed, and roadblocks or problems.

• Identification of tasks or activities initiated, or completed, from proposed timeline with a description and rational for deviations.

• For each major task, a description of activities performed or completed during the quarter.

• Identification and description of any major problems or delays encountered, with a discussion of how they will be resolved and/or how they may impact the schedule, outcome measures, budget, or the Grantees ability to utilize funds within the specified time period.

• A description of key tasks and activities planned for the upcoming quarter.

• Any other pertinent information, which may include deliverables.

Final Project Report: An original and electronic copy of the Final Report shall be submitted to the FNS Program Officer by December 31, 2017. This report shall contain a project summary including, but not limited to, a full description of implementation, evaluation approach, results of evaluation, impact, lessons learned, future implications within the State agency, and information on how the project will be sustained. In instances where there is a lead State agency involved, the lead State agency shall compile the results from all funded State agencies into a single report and submit it to FNS. The final report should be accompanied by copies of materials developed by and used in the project (e.g., notices, brochures, instructions, lesson plans, software, press releases, and data collection instruments).

FNS Project Officer: The Quarterly Progress Reports and Final Report shall be submitted to the FNS Project Officer:

Marta Kealey

XXXX WIC Special Project Grant Program Officer

USDA Food and Nutrition Service

3101 Park Center Drive, 5^th Floor

Alexandria, VA 22302

[email protected]

Quarterly Financial Reports: Grantees will electronically enter their quarterly and final financial status reports (SF-425) into the FNS Food Programs Reporting System (FPRS). This report must be certified by the Recipient's chief fiscal officer or an officer of comparable rank. Final reporting requirements and instructions will be provided to all awarded Grantees.

Final Close-Out Financial Report: As stated above, the Grantees are expected to enter the final financial status report (SF-425) into the FNS Food Programs Reporting System (FPRS) electronically, unless otherwise notified.  The Grantee shall enter its SF-425 data within 90 days of the expiration date of the grant agreement. This report must be certified by the Grantee’s chief fiscal officer or an officer of comparable rank. 

In an effort to maintain the integrity of these funds, FNS will continually monitor the expenditures and will work with the Grantees to recover any funds that cannot be obligated by the grant expiration date of September 30, 2018.  Funds not obligated within the cooperative agreement period must be returned to FNS by September 30, 2018.

Attendance at Meetings

State agencies awarded Full Grant funding will interact with other Grantees and FNS staff on a regular basis to share project information. To that end, FNS hosts annual WIC Special Project Grant Meetings through the course of the projects. The Grantee shall send two representatives (one representative must be from the WIC State Agency) to four meetings at FNS headquarters as specified below:

• An annual meeting of all Grantees in the first year of the grant.

• An annual meeting of all Grantees in the second year of the grant.

• An annual meeting of all Grantees in the third (and final) year of the grant project.

• A final meeting within 9 months of completion of the project (i.e., May, 2018 to present project findings to FNS.

Mini Grant Performance Period, Reporting & Meeting Attendance

The period of performance for the cooperative agreement shall be from the date of the award through September 30, 2016. All expenditures for authorized activities for the project (other than those for the final reports and FY 2016 meeting and presentation) must be incurred by March 30, 2016. The final project and financial reports are due to FNS by June 30, 2016 and all expenditures associated with the final report must be incurred by June 30, 2016. The only allowable expenditures on or after June 30, 2016 are those associated with preparation for attendance and presentation at the FNS-sponsored FY 2016 WIC Special Project Grant annual meeting, filing the associated expenditure reports and grant close-out. See Reporting and Meeting Requirements below for more information.

Reporting Requirements

Quarterly Progress Reports: A signed electronic file of the Quarterly Progress Report shall be submitted to the FNS Program Officer (see below for contact information). The first report should reflect progress up to the end of the first quarter after the effective date of the Grant Agreement. At a minimum all Quarterly Progress Reports should include:

• A narrative description of the project’s progress, tasks completed, and roadblocks or problems.

• Identification of tasks or activities initiated, or completed, from proposed timeline with a description and rational for deviations.

• For each major task, a description of activities performed or completed during the quarter.

• Identification and description of any major problems or delays encountered, with a discussion of how they will be resolved and/or how they may impact the schedule, outcome measures, budget, or the Grantee’s ability to utilize funds within the specified time period.

• A description of key tasks and activities planned for the upcoming quarter.

• A participation report with data elements agreed to with FNS.

• Any other pertinent information, which may include deliverables.

Final Project Report: An original and electronic copy of the Final Report shall be submitted to the FNS Program Officer by June 30, 2016. This report shall contain a project summary including, but not limited to, a full description of implementation, evaluation approach, results of evaluation, impact, lessons learned, future implications within the State agency, and information on how the project will be sustained. In addition, all materials developed as a result of the grant funding shall be submitted with the Final Report. In instances where there is a lead State agency involved, the lead State agency shall compile the results from all funded State agencies into a single report and submit it to FNS. The final report should be accompanied by copies of materials developed by and used in the project (e.g., notices, brochures, instructions, lesson plans, software, press releases, and data collection instruments).

FNS Project Officer: The Quarterly Progress Reports and Final Report shall be submitted to the FNS Project Officer:

Marta Kealey

XXXX WIC Special Project Grant Program Officer

USDA Food and Nutrition Service

3101 Park Center Drive, 5^th Floor

Alexandria, VA 22302

[email protected]

Quarterly Financial Reports: Grantees will electronically enter their quarterly and final financial status reports (SF-425) into the FNS Food Programs Reporting System (FPRS). This report must be certified by the Recipient's chief fiscal officer or an officer of comparable rank. Final reporting requirements and instructions will be provided to all awarded Grantees.

Final Close-Out Financial Report: As stated above, the Grantees are expected to electronically enter the final financial status report (SF-425) into the FNS Food Programs Reporting System (FPRS), unless otherwise notified.  The Grantee shall enter its SF-425 data within 90 days of the expiration date of the grant agreement. This report must be certified by the Grantee’s chief fiscal officer or an officer of comparable rank. 

In an effort to maintain the integrity of these funds, FNS will continually monitor the expenditures and will work with the Grantees to recover any funds that cannot be obligated by the grant expiration date of September 30, 2016.  Funds not obligated within the cooperative agreement period must be returned to FNS by September 30, 2016.

Attendance at Meetings

State agencies awarded Mini Grant funding will interact with other Grantees and FNS staff on a regular basis to share project information. FNS will host a WIC Special Project Grant Meeting after the Mini Grant projects have been completed. The Grantee shall send one WIC State Agency representative to one meeting at FNS Headquarters in the Summer of 2016.

EVALUATION AND SELECTION OF GRANT APPLICATIONS

Evaluation

All applications will undergo an initial screening to verify completeness and adherence to proposal preparation instructions (see Grant Application Format and Content Requirements and Attachment C, Terms and Conditions). Applications that do not meet this initial screen will not be evaluated further. After initial screening, FNS will convene a panel of FNS staff and external representatives to review and determine the technical merit of each grant application. The panel will evaluate each grant application according to how well it addresses each application component. The panel will assign each application a score using the evaluation criteria and weights specified below.

Project Design and Implementation (25 points)

The significance of the problem to be addressed is demonstrated and specific gaps or weaknesses in regional or national services have been identified and will be addressed through the proposed project.

A Needs Assessment (to include WIC local agency input) process is included in the project design.

Project goals, objectives, and outcome measures are clearly identified and appropriate.

Project design and implementation tasks follow directly from project goals and objectives and the necessity of the tasks are adequately explained.

The environment in which the project will operate is appropriate and compatible with project goals and objectives, and proper justifications for the choice of the environment are provided. If applicable, letters of support or memoranda of understanding are included in the application.

Project Evaluation – Full Grant Applications Only (20 points)

Extent to which the research/project design, including research questions, measures, sampling, data collection, and data analysis is thorough, feasible and appropriate to the goals and objectives of the project.

Research plan includes appropriate and feasible use of a pre-post and/or treatment/comparison design with randomization. If such a research design is not appropriate for the proposed project, the proposal explains why, indicates the range of alternative designs considered, and provides a thoughtful explanation for the design proposed.

Extent to which the research plan incorporate the findings of the Needs Assessment.

Potential problems and weaknesses with the research/project design are acknowledged and discussed.

Project Evaluation – Mini Grant Applications Only (20 Points)

Extent to which the project evaluation component is feasible and consistent with this project’s goals and objectives.

Quality of the applicant’s proposed data collection and evaluation plans.

Potential problems and weaknesses with the research/project design are acknowledged and discussed.

Sustainability and Transferability (20 points)

Feasibility of incorporating project purposes, activities, or results into the ongoing program of the agency at the end of Federal funding.

Transferability of the project and its results for adaptation and implementation by other State WIC agencies.

A dissemination plan to enable WIC State agencies to access and reproduce resources and materials developed as a result of the project.

Key Personnel (15 points)

Key personnel have the necessary education, skills, and experience for their proposed roles on the project. Supporting documentation (e.g., resume/vita, position descriptions for vacant positions) is included for all key personnel.

The time commitment, duties, staffing mix, and concurrent staff responsibilities within and outside the grant (i.e. staff responsibilities with other projects, job positions, consultant work, etc.), contingency plans, and a clearly defined chain of command of key personnel are reasonable and appropriate to successfully complete the grant. Supporting documentation (i.e., letters of commitment from supervisors) should be included for all key personnel.

Management and Budget Plan (20 points)

The management plan provides a task description and table that demonstrates a thorough understanding of the tasks, timeline, and staffing needed to complete the project successfully. The management plan also provides the oversight necessary to ensure high quality products, services, or outcomes, and to keep the project on time and within budget (including appropriate plans for managing outside personnel).

The budget request is adequate to support the project and detailed calculations and budget for both Federal and non-Federal resources are provided.

Appropriate budget justifications are provided, including descriptions of how categorical costs were derived, discussions of necessity, reasonableness, and allocability of costs, and links between expenditures and activities/tasks. If applicable, justifications for contract selection methods (especially sole source procurements) are provided.

Projects that Include U.S. Department of Agriculture (USDA) Place Based Initiatives (Five Bonus Points)

Proposals with projects that include interventions in communities that have been designated USDA Place Based Initiatives will receive five bonus points. The USDA Place Based Initiatives include but are not limited to:

1. StrikeForce for Rural Growth and Opportunity (SF) – StrikeForce aims to create self-sustaining, long-term economic development in persistent poverty rural communities by increasing investment through intensive outreach and stronger partnership with community leaders, businesses, and foundations. StrikeForce seeks to improve food security by increasing access to safe and nutritious foods. 

2. Promise Zones (PZ) - Promise Zones are part of the President's plan where the Federal government partners with and invests in selected high-poverty urban, rural, and tribal communities.  Promise Zones leverage Federal resources to build up existing local capacity to create jobs, increase economic security, leverage private investment, expand educational opportunities, increase access to quality affordable housing, reduce violent crime and improve public safety.

3. White House Council on Strong Cities, Strong Communities (SC2) – As part of the President's priority to strengthen the middle class, create jobs, and build ladders of opportunity, SC2 seeks to increase cooperation between community organizations, local leadership, and the federal government.  SC2 pairs on the ground Federal inter-agency teams with the Mayor and city leadership to support the community’s vision for economic development. These SC2 Teams offer technical assistance and expertise to help leverage existing Federal resources to grow local capacity and stimulate economic growth in distressed areas.

4. Partnership for Sustainable Communities - The Partnership for Sustainable Communities works to coordinate federal housing, transportation, water, and other infrastructure investments to make neighborhoods more prosperous, allow people to live closer to jobs, save households time and money, and reduce pollution.

5. Know Your Farmer, Know Your Food (KYF2) - KYF2 strengthens the connection between farmers and consumers to better meet critical goals, including reinvigorating rural economies, promoting job growth, and increasing healthy and local food access in America. Through KYF2, USDA integrates programs and policies that stimulate food- and agriculturally-based community economic development, foster new opportunities for farmers and ranchers, and cultivate healthy eating habits and educated consumers.

Selection

After evaluation and scoring, grant applications will be arrayed by score, starting with the highest score. In general, awards will be made in ranking order until available funds are committed. However, if the selecting officials determine that, based upon their scores, few of the applications are of technical merit, FNS can award no grants or less than the total amount of funds set aside for this purpose. In addition, FNS reserves the option to select grantees out of ranking order to ensure geographic diversity or agency priority, or to select an ITO in order to achieve diversity and regional representation.

Once the grant is awarded, the State agency must sign an agreement containing the terms and conditions of the grant contained in the regulations listed below. (A copy of these regulations may be obtained at http://www.gpoaccess.gov/cfr/index.html.) Applicants must agree to comply with the USDA regulations below, which codify Office of Management and Budget (OMB) circulars, as follows:

2 CFR Part 25: “Universal Identifier and Central Contractor Registration”

2 CFR Part 170: “Reporting Subaward and Executive Compensation

Information”

2 CFR Part 175: “Trafficking Victims Protection Act;”

2 CFR Part 180: “OMB Guidelines to Agencies on Governmentwide Debarment and Suspension (Nonprocurement)”

2 CFR Part 417: “Office of the Chief Financial Officer: Department of Agriculture Implementation of OMB Guidance on Non-Procurement Debarment and Suspension”

7 CFR Part 15: “Regulation Prohibiting Discrimination in Programs Receiving

Federal Financial Assistance from USDA

7 CFR Part 3015: “Uniform Federal Assistance Regulations;”

7 CFR Part 3016: “Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments” (Reference OMB Circular A-102 Common Rule);

7 CFR Part 3018: “New Restrictions on Lobbying;”

7 CFR Part 3019: OMB Circular A-110, “Uniform Requirements for Grants and Other Agreements with Institutions of Higher Education, Hospitals, and Other Non-Profit Organizations;”

7 CFR Part 3052: OMB Circular A-133, “Audits of States, Local Governments and Non-Profit Organizations.”

40 CFR Part 31.34:    “Copyrights”

41 CFR 1-15.2 (FAR Part 31): Cost Principles for For-Profit Organizations.

Code of Federal Regulation Cost Principles:

2 CFR, Subtitle A, Chapter II, Part 225 State, Local, and Indian Tribal

2 CFR, Subtitle A, Chapter II, Part 220 Education Institutions

2 CFR, Subtitle A, Chapter II, Part 230- Non Profit Organizations

OMB Circular A-133: Audits of State, Local Governments and Nonprofit Organizations.

LIST OF ATTACHMENTS

1. LETTER OF INTENT

2. APPLICATION CHECKLIST

3. TERMS AND CONDITIONS OF AWARD

4. BUDGET NARRATIVE CHECKLIST AND CERTIFICATION FORMS

• BUDGET NARRATIVE CHECKLIST

• CERTIFICATION REGARDING LOBBYING

• DISCLOSURE OF LOBBYING ACTIVITIES

ATTACHMENT A

LETTER OF INTENT

If you intend to submit an application for a Full or Mini WIC Special Grant, please complete the section below and return this form by XXXX. This intent does not obligate a State agency in any way, but will provide useful information to us as we prepare for the review and selection process. The intent may be e-mailed or faxed. Thank you for your interest. Please submit your Letter of Intent to:

Marta Kealey

XXXX WIC Special Project Grant Program Officer

USDA Food and Nutrition Service

3101 Park Center Drive, 5^th Floor

Alexandria, VA 22302

[email protected]

Fax: 703-305-2196

XXXX WIC Special Project Grant

Intent to Submit an Application

Applicant (State agency name and address):

Project Director or Contact Person:

Telephone:

E-mail:

Applying for (check one):

	Full Grant
	Mini Grant

ATTACHMENT B

APPLICATION CHECKLIST

PROPOSAL REQUIREMENTS

_____ Format:

_____ Full Grant - Up to 25 pages excluding up to 15 pages of appendices (No page limit to resumes)

_____ Mini Grant – Up to 12 pages excluding up to 8 pages of appendices (No page limit to resumes)

_____ Font size no smaller than 12 point

_____ 8 ½” X 11” paper

_____ Single-sided

_____ Single-spaced

_____ I. Introductory Material

_____ A. Cover Letter

_____ B. Title Page with Summary and Single Point of Contact

_____ C. Table of Contents

_____ II. Abstract

_____ III. Project Design and Implementation

_____ A. Need for Project

_____ B. Goals

_____ C. Objectives

_____ D. Tasks

_____ E. Environment

_____ F. Letter of Support

_____ IV. Project Evaluation

_____ A. Type of Evaluation

_____ B. Research Design

_____ V. Sustainability and Transferability

_____ A. Sustainability

_____ B. Transferability

_____ VI. Key Personnel

_____ VII. Management and Budget Plan

_____ A. Management Plans

_____ B. Budget and Budget Justification

_____ VIII. Budget Forms

ATTACHMENT B (continued)

_____ IX. Appendices (15 page maximum)

_____ A. Resumes and vitae for key personnel

_____ B. Letters of commitment from supervisors of key personnel

_____ C. Job descriptions for key personnel that must be hired

_____ D. Copies of agreements and memoranda of understanding with local WIC clinics and/or partner agencies

_____ E. Any other supporting documentation

REQUIRED FORMS

_____ Standard Form 424, Application for Federal Assistance

_____ Standard Form 424A, Budget Summary

_____ Standard Form 424B, Assurances - Non-Construction Programs

REQUIRED FORMS FOR STATE AGENCIES ONLY

_____ AD-1047- CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS

_____ AD-1048- CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION- LOWER TIER COVERED TRANSACTIONS

____ AD-1052- CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS, STATE AND STATE AGENCIES

The above listed forms are at the USDA Forms site: http://www.ocio.usda.gov/policy-directives-records-forms/forms-management/approved-computer-generated-forms.

CERTIFICATION FORMS (see Attachment D)

_____ Certification Regarding Lobbying - Contracts, Grants, Loans, and Cooperative Agreements

_____ SF-LLL Disclosure of Lobbying Activities

OBTAIN A DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER

_____ Registered and obtained a Data Universal Numbering System (DUNS) number.

ATTACHMENT B (continued)

SYSTEM FOR AWARD MANAGEMENT (SAM) REGISTRY REGISTRATION

_____ Registered in the Federal Government’s System for Award Management (SAM).

ATTACHMENT C

TERMS AND CONDITIONS OF AWARD

The Agency awarded the grant must be conducting the Women, Infants, and Children (WIC) Special Project Grant as authorized under Public Law 108-447. This grant will be awarded and administered in accordance with the applicable regulations and OMB grant circulars, as described below. Copies of these documents are available from the Grants Officer upon request.

2 CFR Part 25: “Universal Identifier and Central Contractor Registration”

2 CFR Part 170: “Reporting Subaward and Executive Compensation Information”

2 CFR Part 175: “Trafficking Victims Protection Act”

2 CFR Part 180: “OMB Guidelines to Agencies on Governmentwide Debarment and Suspension (Nonprocurement)”

2 CFR Part 417: “Office of the Chief Financial Officer: Department of Agriculture Implementation of OMB Guidance on Non-Procurement Debarment and Suspension”

7 CFR Part 15: “Regulation Prohibiting Discrimination in Programs Receiving

Federal Financial Assistance from USDA”

7 CFR Part 3015: “Uniform Federal Assistance Regulations”

7 CFR Part 3016: “Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments”

7 CFR Part 3018: “New Restrictions on Lobbying”

7 CFR Part 3019: “Uniform Administrative Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals and Other Non-Profit Organizations”

7 CFR Part 3052: “Audits of States, Local Governments and Non-Profit Organizations”

40 CFR Part 31.34:    “Copyrights”

41 CFR 1-15.2 (FAR Part 31): Cost Principles for For-Profit Organizations.

Code of Federal Regulation Cost Principles:

2 CFR, Subtitle A, Chapter II, Part 225 State, Local, and Indian Tribal

2 CFR, Subtitle A, Chapter II, Part 220 Education Institutions

2 CFR, Subtitle A, Chapter II, Part 230- Non Profit Organizations

OMB Circular A-133: Audits of State, Local Governments and Nonprofit Organizations.

40 CFR Part 31.34  -  Copyrights

The Federal awarding agency reserves a royalty-free, nonexclusive, and irrevocable license to reproduce, publish or otherwise use, and to authorize others to use, for Federal Government purposes:

(a) The copyright in any work developed under a grant, subgrant, or contract under a grant or subgrant; and

(b) Any rights of copyright to which a Grantee, subgrantee or a contractor purchases ownership with grant support.

2 CFR Part 25 – Universal Identifier and System for Award Management Registration

Effective October 1, 2010, all grant applicants must obtain a Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number as a universal identifier for Federal financial assistance. Active grant recipients and their direct sub-recipients of a sub-grant award also must obtain a DUNS number. To request a DUNS number visit: http://fedgov.dnb.com/webform.

The grant recipient must also register its DUNS number in the new Systems for Award Management (SAM). If you were registered in the CCR, your company’s information is already in SAM and you will just need to set up a SAM account. To register in SAM you will need your entity’s DUNS and your entity’s Tax ID Number (TIN) and taxpayer name (as it appears on your last tax return). Registration should take 3-5 days. If you do not receive confirmation that your SAM registration is complete, please contact SAM at https://www.fsd.gov/app/answers/list..

FNS may not make an award to an applicant until the applicant has complied with the requirements described in 2 CFR 25 to provide a valid DUNS number and maintain an active SAM registration with current information.

Debarment and Suspension 2 CFR Part 180 and 2 CFR Part 417

A recipient chosen for an award shall comply with the non-procurement debarment and suspension common rule implementing Executive Orders (E.O.) 12549 and 12669, “Debarment and Suspension,” codified at 2 CFR Part 180 and 2 CFR Part 417. This common rule restricts sub-awards and contracts with certain parties that are debarred, suspended or otherwise excluded from or ineligible for participation in Federal assistance programs or activities. The approved grant recipient will be required to ensure that all sub-contractors and sub-grantees are neither excluded nor disqualified under the suspension and debarment rules prior to approving a sub-grant award by checking the Excluded Parties List System (EPLS) found at www.epls.gov.

ATTACHMENT D

BUDGET NARRATIVE CHEKCLIST AND FORMS

Budget Narrative Checklist – This checklist will assist you in completing the budget narrative portion of the application. Please review the checklist to ensure the items below are addressed in the budget narrative. NOTE: The proposal project description (statement of work) must capture the bona fide need. The budget and budget narrative must be in line with the proposal project description. FNS reserves the right to request information not clearly addressed.

	YES	NO
Personnel
Did you include all key employees paid for by this grant under this heading?
Are employees of the applicant’s organization identified by name and position title?
Did you reflect the current yearly salary as a percentage of time to be devoted to the project?
Fringe Benefits
Did you include your organization’s fringe benefit amount along with the basis for the computation?
Did you list the type of fringe benefits to be covered with Federal funds?
Travel
Are travel expenses itemized? For example origination/destination points, number and purpose of trips, number of staff traveling, mode of transportation and cost of each trip.
Are the Attendee Objectives and travel justifications included in the narrative?
Is the basis for the lodging estimates identified in the budget? For example include excerpt from travel regulations.
Equipment
Is the need for the equipment justified in the narrative?
Are the types of equipment, unit costs, and the number of items to be purchased listed in the budget?
Is the basis for the cost per item or other basis of computation stated in the budget?
Supplies
Are the types of supplies, unit costs, and the number of items to be purchased reflected in the budget?
Is the basis for the costs per item or other basis of computation stated?
Contractual: (FNS reserve the right to request information on all contractual awards and associated costs after the contract is awarded.)
Has the bona fide need been clearly identified in the project description to justify the cost for a contract or sub-grant expense(s) shown on the budget?
A justification for all Sole-source contracts must be provided in the budget narrative prior to approving this identified cost.
Other
Consultant Services. – Has the bona fide need been clearly identified in the project description to justify the cost shown on the budget? The following information must be provided in the justification: description of service, the consultant’s name and an itemized list of all direct cost and fees, number of personnel including the position title (specialty and specialized qualifications as appropriate to the costs), Number of estimated hours X hourly wages, and all expenses and fees directly related to the proposed services to be rendered to the project.
For all other line items listed under the “Other” heading, list all items to be covered under this heading along with the methodology on how the applicant derived the costs to be charged to the program.
Indirect Costs
Is the amount requested based upon a rate approved by a Federal Agency? If yes, a copy of the negotiated rate agreement must be provided along with the application.
If the applicant does not have a negotiated indirect cost agreement approved by a cognizant federal agency used to determine the base rate of these costs; the application should show this cost as a direct cost to the budget.

FOR GRANT APPLICANT USE ONLY. DO NOT RETURN THIS FORM WITH THE APPLICATION

ATTACHMENT D (continued)

CERTIFICATION REGARDING LOBBYING

CERTIFICATION FOR CONTRACTS, GRANTS, AND COOPERATIVE AGREEMENTS

The undersigned certifies, to the best of his or her knowledge and belief, that:

1. No Federal appropriated-funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of congress, or an employee of a member of congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

2. If any funds other than Federal-appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL,  Disclosure Form to Report Lobbying,  in accordance with its instructions.

3. The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including sub-contracts, sub-grants, and contracts under grants, loans and cooperative agreements) and that all sub-recipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

By Date:

_{(Signature of Official [Executive Director] Authorized to Sign Application)}

By Date:

(Signature of Official (Chief Financial Officer) Authorized to Sign Application)

For

Name of Grantee

Title of Grant Program

ATTACHMENT D (continued)

DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB

Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 0348-0046

(See reverse for public burden disclosure)

Type of Federal Action: a. contract b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance	Status of Federal Action: a. bid/offer/application b. initial award c. post-award		Report Type: a. initial filing b. material change For material change only: Year _______ quarter _______ Date of last report___________
Name and Address of Reporting Entity: Prime Subawardee Tier______, if known: Congressional District, if known:		If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional District, if known:
6. Federal Department/Agency:		7. Federal Program Name/Description: Federal Program Name/Description: CFDA Number, if applicable: __________________
8. Federal Action Number, if known:		9. Award Amount, if known: Award Amount, if known: $
10. a. Name and Address of Lobbying Registrant (if individual, last name, first name, MI):		Individuals Performing Services (including address if different from No. 10a) (last name, first name, MI):
11. Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.		Signature: ______________________________________ Print Name:_____________________________________ Title:__________________________________________ Telephone No.: _________________ Date: ___________
Federal Use Only				Authorized for Local Reproduction Standard Form - LLL (Rev. 7-97)

ATTACHMENT D (continued)

INSTRUCTIONS FOR COMPLETION OF SF-LLL DISCLOSURE OF LOBBYING ACTIVITIES

This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required within 30 days of each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with a covered Federal action. Use the SF-LLL-A Continuation Sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information.

1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action.

2. Identify the status of the covered Federal action.

3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action.

4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the lst tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.

5. If the organization filing the report in item 4 checks subawardee, then enter the full name, address, city, state and zip code of the prime Federal recipient. Include Congressional District, if known.

6. Enter the name of the federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard.

7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments.

8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 [e.g., Request for Proposal (RFP) number: Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency]. Include prefixes, e.g., RFP-DE-90-001.

9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5.

10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influence the covered Federal action.

2. Enter the full names of the individual(s) performing services, and include full address if different from 10 (a). Enter Last Name, First Name, and Middle Initial (MI).

11. The certifying official shall sign and date the form, print his/her name, title, and telephone number.

Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503.

1 At the request of the Food and Nutrition Service, in July 2010 the Institute of Medicine held a workshop: “Health Impacts of WIC — Planning a WIC Research Agenda” [see final report at http://www.iom.edu/Reports/2010/Planning-a-WIC-Research-Agenda.aspx]. While some proposed ideas are too large to fit within the Special Project Grants framework, other proposed ideas could be conducted as a WIC Special Project Grant.

2Copies of 7 CFR Part 3016.40 may be requested from the FNS Grants Management Division.

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