Instructions
Two copies of a complete application should be submitted to the Appalachian Clean
Streams Coordinator for your State.
Applications will be accepted until all available funds have been awarded.
It is essential that the application package be complete when it is received in the appropriate
Office of Surface Mining Office. Normally, the Office of Surface Mining will not contact
proposal sources to verify and/or request supplemental data and/or materials. Those
proposals lacking required information or containing conflicting information will not be
considered for funding and will be returned to the applicant.
A complete application consists of:
- Application Facesheet, SF-424 Form (Click on the form number to download a
copy of the form and instructions in Acrobat .pdf format.)
- Item 10: Catalog of Federal Domestic Assistance number is 15-253.
- Item 16: Application is subject to review by state E.O. 12372 process; check
"a".
- Program Narrative. Provide a program narrative statement which describes:
- Need for the project.
- Purpose, goals and objectives.
- One paragraph summary of the project.
- Work to be done and by whom.
- Who owns or will own and manage the project lands/waters.
- . Does the applicant have the legal right of entry to the property for construction
purposes.
- The technology to be used.
- The expected tangible results and how they will be monitored.
- An estimate of the number of days after the award of Office of surface Mining
funding that the project will begin (e.g., contract signed).
- A timetable for accomplishment of major project activities during the
cooperative agreement performance period (maximum 2 years).
- The plan for taking care of any ongoing operational/maintenance
requirements.
The OSM-51 form may be used to write up the program narrative. However, use of this
form is optional.
- Itemized Budget Estimate. Provide budget information for the project by listing
total cost by project activity, and apportion these costs between Office of Surface
Mining cooperative agreement funding, other federal agency dollars, non-federal
funds, and valuation of in-kind services provided by the partners. All costs must be
accounted for as direct costs. The Office of Surface Mining will not reimburse any
indirect costs.
An optional Budget Information form may be used for the budget estimate.
- Budget Justification Narrative. Include a narrative justification for the project
activities.
- Your Organization. Briefly describe your organization, including the names and
titles of your principal officers/members.
- Your Financial Management System. Provide a brief description of your financial
management (accounting and internal controls) system.
- Provide a copy of your organization's IRS 501(c)(3) designation.
- Partners and Other Resources. Provide the following information:
Name(s), affiliation, roles and contributions of each participating group; and
Attach letters confirming the commitment of eligible funds or in-kind services
from each contributing partner.
- Local Support for the Project. Include letters of support for the project from local
community groups/businesses/individuals.
- Assurances, SF-424D form, Assurances for Construction Programs. Sign and
date the form.
- Certifications, DI 2010 form, Certifications Regarding Debarment, Suspension and
Other Responsibility Matters, Drug-Free Workplace Requirements and Lobbying.
Sign and date the form.
If you have any questions about the application requirements, contact the Appalachian
Clean Streams Initiative Coordinator in your state.