Form 10-2063 2020 State Project Notification

NPS Form 10-2063 (Rev. 11/2020)
National Park Service

OMB Control Number 1024-0038
Expiration Date: xx/xx/xxxx

Historic Preservation Fund Grants Manual
Chapter 8 Subgrants, Contracts, and Third-Party Agreements

8-22

PROJECT NOTIFICATION
TITLE:

GRANT NUMBER:

AREA AFFECTED BY PROJECT
(counties):

TOTAL PROJECT COST:
FEDERAL SHARE:
NONFEDERAL SHARE:
CONGRESSIONAL DISTRICT:

TYPE: NEW [ ] REVISION [ ]

1. SUBGRANTEE:

2. NONFEDERAL MATCHING SHARE:
Donor:
Source:
Kind:
Amount:
3. BUDGET:

Donor:
Source:
Kind:
Amount:

4. PURPOSE:

Products:

5. BEGINNING/ENDING DATES:
6. An Environmental Certification indicating the applicable categorical exclusions is attached.
7. No program income will be generated.
2.

November 2020 Release
Historic Preservation Fund Grants Manual

8-23 Chapter 8 Subgrants, Contracts, and Third-Party Agreements

GRANT NUMBER:
8. CERTIFICATION: As the duly authorized representative, I certify that this subgrant will be administered and
work will be performed under the supervision of a professional meeting appropriate 36 CFR 61 requirements, in
accordance with the Historic Preservation Fund Grants Manual, and the Secretary of the Interior's "Standards and
Guidelines for
." All documentation required by the Historic Preservation Fund Grants Manual will
be maintained on file for audit and State Program Review purposes. All proposed costs for personal
compensation charged to the Federal or nonfederal share of this subgrant are within the maximum limit imposed
by Chapter 13, Section B.34.e. of the HPF Grants Manual. These costs have been assessed by knowledgeable
SHPO staff and found to be within the normal and customary range of charges for similar work in the local labor
market, and appear to be appropriate charges for the product to be achieved with grant assistance.

_______________________________
Signature

_____________________
Date
NOTICES

PRIVACY ACT STATEMENT
Authority: 54 U.S.C. 300101 et. seq., the National Historic Preservation Act and 36 CFR 61, Procedures for State,
Tribal, and Local Government Historic Preservation Programs.
Purpose: The National Park Service collects this information as part of the process for reviewing the procedures and
programs of State, tribal, and local governments participating in the National Historic Preservation Program and the
Historic Preservation Fund grant program.
Routine Uses: The information collected will be used to evaluate programs and procedures for consistency with the
National Historic Preservation Act, as amended, (54 U.S.C. 300101 et. seq.) and compliance with government-wide
grant requirements.
Disclosure: Your response is required to obtain or retain a benefit under these programs. Failure to provide the
information requested may impede the processing of your form.
PAPERWORK REDUCTION ACT STATEMENT
We are collecting this information subject to the Paperwork Reduction Act (44 U.S.C. 3501) to provide Historic
Preservation Program managers the information needed to administer program participation and grant management. All
applicable parts of the form must be completed in order for your request to be considered. You are not required to
respond to this or any other Federal agency-sponsored information collection unless it displays a currently valid OMB
control number. OMB has approved this collection of information and assigned Control No. 1024-0038.
ESTIMATED BURDEN STATEMENT
The public reporting burden for the collection of this information is estimated to average 6 hours per response, including
the 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 this burden estimate or any other
aspect of this collection of information, including suggestions for reducing the burden, to the Information Collection
Clearance Officer, National Park Service, 112201 Sunrise Valley Drive, Reston, Virginia 20192. Do not send your
completed form to this address.