Montebello City Council
May 10, 2023

21 The standard and supporting documents that must be submitted with the application are outlined below and in Appendix A - 2.2 Required Application Components of this NOFO.

All files uploaded as part of the application must be in Adobe PDF file format. See Appendix B
of this NOFO for formatting and validation requirements.

SAMHSA will not accept paper applications except under very special circumstances. If you need special consideration, SAMHSA must approve the waiver of this requirement in advance. See Appendix A
- 3.2 Waiver of Electronic Submission of this NOFO.
• SF-424 – Fill out all Sections of the SF-424.
o In Line #4 (i.e., Applicant Identifier), input the Commons Username of the PD/PI.
o In Line #17 input the following information: (Proposed Project Date: a. Start Date: 9/30/2023; b. End Date: 9/29/2028).

New applicants should review the sample of a completed SF-424 .

• SF-424A BUDGET INFORMATION FORM – Fill out all Sections of the SF-424A using the instructions below. The totals in Sections A, B, and D must match.

o Section A – Budget Summary: If cost sharing/match is not required, use the first row only (Line 1) to report the total federal funds (e) and non-federal funds (f) requested for the first year of your project only. If cost sharing/match is required, use the second row (Line 2) to report the total non-federal funds (f) for the first year of your project only.

o Section B – Budget Categories: If cost sharing/match is not required, use the first column only (Column 1) to report the budget category breakouts (Lines 6a through 6h) and indirect charges (Line 6j) for the total funding requested for the first year of your project only. If cost sharing/match is required, you must use the second column (Column 2) to report the budget category breakouts for the first year of your project only.

o Section C –If cost sharing/match is not required leave this section blank. If cost sharing/match is required use the second row (line 9) to report non- federal match for the first year only.

o Section D – Forecasted Cash Needs: Input the total funds requested, broken down by quarter, only for Year 1 of the project period. Use the first row for federal funds and the second row (Line 14) for non-federal funds.

o Section E – Budget Estimates of Federal Funds Needed for the Balance of the Project: Enter the total funds requested for the out years (e.g., Year 2, Year 3, Year 4, and Year 5). For example, if you are requesting funds for five years in total, enter the requested budget amount for each budget period in

22 columns b, c, d, and e (i.e., 4 out years). (b) First column is the budget for the second budget period; (c) Second column is the budget for the third budget period; (d) Third column is the budget for the fourth budget period. (e) Fourth column is the budget for the fifth budget period. Use Line 16 for federal funds and Line 17 for non-federal funds.

See Appendix B of this NOFO to review common errors in completing the SF-424 and the SF-424A. These errors will prevent your application from being successfully submitted.

The following pdfs are samples of completed SF-424A forms:

• Sample SF-424A (No Match Required)
• Sample SF-424A (Match Required)

A link to a sample budget form and justification is provided in Appendix L of this NOFO.

It is highly recommended that you use this sample budget format. This will expedite the review of your application.

• PROJECT NARRATIVE – (Maximum 10 pages total)
The Project Narrative describes your project. It consists of Sections A through E. (Remember that if your Project Narrative starts on page 5 and ends on page 15, it is 11 pages long, not 10 pages.) More detailed instructions for completing each section of the Project Narrative are provided in Section V.1 – Application Review Information.

• BUDGET JUSTIFICATION AND NARRATIVE
The budget justification and narrative must be submitted as a file entitled “BNF” (Budget Narrative Form) when you submit your application into Grants.gov. (See Appendix A – 2.2 Required Application Components.)

• ATTACHMENTS 1 THROUGH 9

Use only the attachments listed below. If your application includes any attachments not required in this document, they will be disregarded.

Do not use attachments to extend or replace any of the sections of the Project Narrative. Reviewers will not consider them if you do.

Label the attachments as: Attachment 1, Attachment 2, etc. (Use the Other Attachments Form if applying with Grants.gov Workspace or Other Narrative Attachments if applying with eRA ASSIST.)

23 o Attachment 1: Letters of Commitment/Service Providers/Evidence of Experience and Credentials [Identification of at least one experienced, licensed mental health/substance use treatment provider organization.

1. A list of all direct service provider organizations that have agreed to partner in the proposed project, including the applicant agency, if it is a service provider organization.

2. L etters of Commitment from these direct service provider organizations; (Do not include any letters of support. Reviewers will not consider them if you do.)

3. Statement of Certification - You must provide a written statement certifying that all participating service provider organizations listed in this application meet the two-year experience requirement and applicable licensing, accreditation, and certification requirements.

o Attachment 2: Data Collection Instruments/Interview Protocols If you are using standardized data collection instruments/interview protocols, you do not need to include these in your application. Instead, provide a web link to the appropriate instrument/protocol. If the data collection instrument(s) or interview protocol(s) is/are not standardized, you must include a copy in Attachment 2.

o Attachment 3: Sample Consent Forms
Forms to be submitted include, as appropriate, sample consent forms that provide for: (1) informed consent for participation in service intervention; (2) informed consent for participation in the data collection component of the project; and (3) informed consent for the exchange (releasing or requesting) of confidential information.

o Attachment 4: Project Timeline
This attachment is scored by reviewers. Maximum of 2 pages. See instructions in Section V, B.3 of this NOFO.

o Attachment 5: Biographical Sketches and Position Descriptions See Appendix
G of this NOFO for information on completing biographical sketches and job descriptions. Position descriptions should be no longer than one page each and biographical sketches should be two pages or less.

o Attachment 6: Letter to the Single State Agency (SSA) See Appendix J of this NOFO for Intergovernmental Review (E.O. 12372) Requirements, if applicable.

o Attachment 7: Confidentiality and SAMHSA Participant Protection/ Human Subjects Guidelines
This attachment is in response to Appendix D of this NOFO and is a required attachment.

24 o Attachment 8: Documentation of Non-profit Status
All non-profit entities must submit documentation of their non-profit status. Any of the following is acceptable documentation:
 A reference to the applicant organization’s listing in the Internal Revenue Service’s (IRS) most recent list of tax-exempt organizations described in section 501(c)(3) of the IRS Code;
 A copy of a currently valid Internal Revenue Service tax exemption certificate;
 A statement from a State taxing body, State Attorney General, or other appropriate state official certifying the applicant organization has a non-profit status;
 A certified copy of the organization’s certificate of incorporation or similar document that establishes non-profit status; or  A ny of the above proof for a state or national parent organization and a statement signed by the parent organization that the applicant organization is a local non-profit affiliate.

o Attachment 9: Form SMA 170 – Assurance of Compliance with SAMHSA Charitable Choice Statutes and Regulations. You are required to complete Form SMA 170 if your project is offering substance use prevention or treatment services. This form is posted on SAMHSA’s website at http://www.samhsa.gov/grants/applying/forms-resources
.

3. UNIQUE ENTITY IDENTIFIER AND SYSTEM FOR AWARD MANAGEMENT See Appendix A for information about the three registration processes that must be completed including obtaining a Unique Entity Identifier and registering with the System for Award Management (SAM). You must continue to maintain an active SAM registration with current information during the time your organization has an active federal award or an application under consideration by an agency (unless you are an individual or federal agency that is exempted from those requirements under 2 CFR § 25.110(b) or (c), has an exception approved by the agency under 2 CFR §

25.110(d)).

4. APPLICATION SUBMISSION REQUIREMENTS

Applications are due by 11:59 PM (Eastern Time) on May 5, 2023. If an organization is submitting more than one application, the project title should be different for each application.

If you have been granted permission to submit a paper copy, the application must be received by the above date and time. See Appendix A of this NOFO for
information on how to apply.

25 All applicants MUST be registered with NIH’s eRA Commons, Grants.gov, and the System for Award Management (SAM.gov) in order to submit this application. The process could take up to six weeks. (See Appendix A of this NOFO for all registration requirements).

If you are not currently registered with the eRA Commons, Grants.gov, and/or SAM.gov, you MUST begin the registration process immediately. If you are already registered in these systems, please confirm your SAM registration is still active and you are able to access your Grants.gov and eRA Commons accounts.

WARNING: BY THE DEADLINE FOR THIS NOFO YOU MUST HAVE

SUCCESSFULLY COMPLETED THE FOLLOWING TO SUBMIT AN
APPLICATION:
• The applicant organization MUST be registered in NIH’s eRA Commons; AND
• The Project Director MUST have an active eRA Commons account (with the PI role) affiliated with the organization in eRA Commons.

No exceptions will be made.

DO NOT WAIT UNTIL THE LAST MINUTE TO SUBMIT THE APPLICATION. If you wait until the last minute, there is a strong possibility that the application will not be received without errors by the deadline.

5. FUNDING LIMITATIONS/RESTRICTIONS
The funding restrictions for this project are below. Be sure to identify these expenses in your proposed budget.

• No more than 15 percent of the total award for the budget period may be used for developing the infrastructure necessary for expansion of services. 0 • No more than 15 percent of the total award for the budget period may be used for data collection, performance measurement, and performance assessment, including incentives for participating in the required data collection follow-up.

SAMHSA recipients must also comply with SAMHSA’s standard funding restrictions, which are included in Appendix I – Standard Funding Restrictions.

26 6. INTERGOVERNMENTAL REVIEW (E.O. 12372) REQUIREMENTS All SAMHSA programs are covered under Executive Order (EO) 12372, as implemented through Department of Health and Human Services (HHS) regulation at 45 CFR Part 100. Under this Order, states may design their own processes for reviewing and commenting on proposed federal assistance under covered programs. See Appendix
J for additional information on these requirements as well as requirements for the Public Health System Impact Statement (PHSIS).

7. OTHER SUBMISSION REQUIREMENTS

See Appendix A
for specific information about submitting your application.

V. APPLICATION REVIEW INFORMATION

1. EVALUATION CRITERIA
The Project Narrative describes what you intend to do with your project and includes the Evaluation Criteria in Sections A-E below. Your application will be reviewed and scored according to your response to the requirements in Sections A-E.

In developing the Project Narrative section of your application, use these instructions, which have been tailored to this program.
• The Project Narrative (Sections A-E) together may be no longer than 10 pages. • You must use the five sections/headings listed below in developing your Project Narrative. You must indicate the Section letter and number in your response, i.e., type “A-1”, “A-2”, etc., before your response to each question. You do not need to type the full criterion in each section. You only need to include the letter and number of the criterion. You may not combine two or more questions or refer to another section of the Project Narrative in your response, such as indicating that the response for B.2 is in C.1. Only information included in the appropriate numbered question will be considered by reviewers. Your application will be scored according to how well you address the requirements for each section of the Project Narrative. • The number of points after each heading is the maximum number of points a review committee may assign to that section of your Project Narrative. Although scoring weights are not assigned to individual questions, each question is assessed in deriving the overall Section score.
• Any cost-sharing proposed in your application will not be a factor in the evaluation of your response to the Evaluation Criteria.

27 SECTION A: Population of Focus and Statement of Need (20 points – approximately 1 page)

1. Identify and describe your population(s) of focus10, the geographic catchment area where services will be delivered, and how you will coordinate with local HUD Continuums of Care(s) to provide services in the proposed geographic catchment area. Provide a demographic profile of the population of focus in terms of race, ethnicity, federally recognized tribe (if applicable), language, sex, gender identity, sexual orientation, age, and socioeconomic status; and identify if underserved individuals are the selected population of focus.

2. Describe the extent of the problem in the catchment area, including service gaps, disparities, and document the extent of the need (i.e., current prevalence rates or incidence data) for the population(s) of focus identified in your response to A.1 as it relates to the program. Identify the source of the data.

SECTION B: Proposed Implementation Approach (30 points – approximately 5 pages not including Attachment 4 – Project Timeline)

1. Describe the goals and measurable objectives (see Appendix E of the proposed
project and align them with the Statement of Need described in A.2. Provide the following table
Number of Unduplicated Individuals to be Served with Award Funds Year 1 Year 2 Year 3 Year 4 Year 5 Total

2. Describe how you will implement all of the Required Activities in Section I. If you plan to use funds for infrastructure development, describe how those funds will be used.

3. In Attachment 4, provide a chart or graph depicting a realistic timeline for the entire five (5) years of the project period showing dates, key activities, and responsible staff. These key activities must include the requirements outlined in Section I [NOTE: Be sure to show that the project can be implemented, and service delivery can begin as soon as possible and no later than four months after the award. The timeline cannot be more than two pages and should be

10 Individuals, children, youth, and families with a serious mental illness, serious emotional disturbance, or co-occurring disorder (i.e., a serious mental illness [SMI] and substance use disorder [SUD] or a serious emotional disturbance [SED] and SUD who are experiencing homelessness or at imminent risk of homelessness (e.g., people exiting jail or prison without a place to live).

28 submitted in Attachment 4.] The recommendation of pages for this section does not include the timeline.

SECTION C: Proposed Evidence-Based Service/Practice (15 points approximately 1 page)

1. Identify the Evidence-Based Practice(s) (EBPs), evidence-informed, and/or culturally promising practices that will be used. Discuss how each intervention chosen is appropriate for your population(s) of focus and the outcomes you want to achieve. Describe any modifications (e.g., cultural) that will be made to the EBP(s) and the reason the modifications are necessary. If you are not proposing any modifications, indicate so in your response.

2. Describe how you will monitor and ensure fidelity of EBPs, evidence-informed and/or promising practices that will be implemented.

SECTION D: Staff and Organizational Experience (25 points – approximately 2 page)

1. Describe the experience of your organization with similar projects and/or providing services to individuals who are homelessness or are at risk for homelessness. Identify other organization(s) that you will partner with in the proposed project. Describe their experience providing services to the population(s) of focus, and their specific roles and responsibilities for this project.

If applicable, Letters of Commitment from each partner must be included in Attachment 1 of your application. If you are not partnering with any other organization(s), indicate so in your response.

2. Provide a complete list of staff positions for the project, including the Key Personnel (Project Director and Evaluator) and other significant personnel. For each staff member describe their:
• Role,
• L evel of Effort, and
• Qualifications, including their experience providing services to the population(s) of focus and familiarity with their culture(s) and language(s).

SECTION E: Data Collection and Performance Measurement (10 points – approximately 1 page)

1. Provide specific information about how you will collect the required data for this program and how such data will be utilized to manage, monitor, and enhance the program (See Appendix F
).

2. Describe your quality improvement efforts and explain how you will use the data to address your identified behavioral health disparity(ies) and close the gap(s).

29 2. BUDGET JUSTIFICATION, EXISTING RESOURCES, OTHER SUPPORT (Other federal and non-federal sources)

You must provide a narrative justification of the items included in your proposed budget.

You must also provide a narrative description of existing resources and other support you expect to receive for the proposed project as a result of cost matching. Other support is defined as funds or resources, non-federal, or institutional, in direct support of activities through fellowships, gifts, prizes, in-kind contributions, or non-federal means. (This should correspond to Item #18 on your SF-424, Estimated Funding.) Other sources of funds may be used for unallowable costs, e.g., meals, sporting events, entertainment.

Although a non-federal share may not be required, if an applicant proposes non-federal resources in their budget, they will be held to submission of the non-federal resources.

These must be reported on the financial reports. If recipients fail to meet their proposed amount or percentage, that could be grounds for a cost disallowance.

An illustration of a budget and narrative justification is included in Appendix L – Sample
Budget and Justification. It is highly recommended that you use this sample budget format. Your proposed budget must reflect the funding limitations/restrictions specified in Section IV-5. Specifically identify the items associated with these costs in your budget.

3. REVIEW AND SELECTION PROCESS
The Project Narratives of SAMHSA applications are peer-reviewed according to the evaluation criteria listed above.

Decisions to fund an award are based on:

The strengths and weaknesses of the application as identified by peer reviewers. The results of the peer review are advisory in nature.

The program office and approving official make the final determination for funding based on the following;
• When the individual award is over $250,000, approval by the Center for Mental Health Services National Advisory Council.
• A vailability of funds.
• SAMHSA seeks to expand its existing Homelessness portfolio - the following applicants will not be eligible to receive funding through this award process:
o TI-17-009 (GBHI) – funded in FY19
o TI-20-001 (GBHI) – funded in FY20 and FY22

30 o SM-18-014 (TIEH) – funded in FY19 with a start date of September 30, 2019, and those funded in FY20 with a start date of January 15, 2020.

• SM-18-014 (TIEH) - funded in FY19 with a start date of September 30, 2018, OR November 30, 2018, are eligible to receive funding through this funding opportunity.

• Applicants are eligible to apply for both TI-23-005 (GBHI) and SM-23-006 (TIEH). However, applicants applying for both programs will only be awarded funding under one program if both applications are in the fundable range.

• Submission of any required documentation that must be submitted prior to making an award.

• SAMHSA is required to review and consider any Responsibility/Qualification (R/Q) information about your organization located in SAM.gov In accordance with 45 CFR 75.212, SAMHSA reserves the right not to make an award to an entity if that entity does not meet the minimum qualification standards as described in section 75.205(a)(2). If SAMHSA chooses not to award a fundable application in accordance with 45 CFR 75.205(a)(2), SAMHSA must report that determination to the designated integrity and performance system accessible through the System for Award Management (SAM) [currently, the Contractor Performance Assessment Reporting System (CPARS) ]. You may review and comment on any information about your organization that a federal awarding agency previously entered. SAMHSA will consider your comments, in addition to other information in R/Q in making a judgment about your organization’s integrity, business ethics, and record of performance under federal awards when completing the review of risk posed as described in 45 CFR 75.205 HHS Awarding Agency Review of Risk Posed by Applicants.

VI. FEDERAL AWARD ADMINISTRATION INFORMATION

1. FEDERAL AWARD NOTICES
You will receive an email from SAMHSA, via NIH’s eRA Commons, that will describe the process for how you can view the general results of the review of your application, including the score that your application received.

If your application is approved for funding, a Notice of Award (NoA) will be emailed to the following: 1) the BO’s email address identified in the Authorized Representative section email field on page 3 of the SF-424; and 2) the email associated with the Commons account for the Project Director (section 8 Item f on page 1 of the SF-424).

Hard copies of the NoA will no longer be mailed via postal service. The NoA is the sole

31 obligating document that allows you to receive federal funding for work on the project. Information about what is included in the NoA can be found at: https://www.samhsa.gov/grants/grants-management/notice-award-noa.

If your application is not funded, you will receive a notification from SAMHSA, via NIH’s eRA Commons.

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS
If your application is funded, you must comply with all terms and conditions of the NoA.

SAMHSA’s standard terms and conditions are available on the SAMHSA website - https://www.samhsa.gov/grants/grants-management/notice-award-noa/standard-terms- conditions. See Appendix K for specific information about administrative and national policy requirements.

3. REPORTING REQUIREMENTS
You will be required to submit an annual progress report on project performance within 90 days of the end of each budget period. The report must discuss:
• Progress achieved in the project which should include qualitative and quantitative data (GPRA) to demonstrate programmatic progress to include updates on required activities, successes, challenges, and changes or adjustments that have been made to the project;
• Progress addressing quality care of underserved populations related to the Disparity Impact Statement (DIS);
• Barriers encountered, including challenges serving populations of focus; • Efforts to overcome these barriers;
• Evaluation activities for tracking DIS efforts;
• A revised quality improvement plan if the DIS does not meet quality-of-care requirements as stated in the DIS;
• Services level data on the number of people reached or served for each of the program activities and information on the referrals made and housing placement disaggregated by race and ethnicity, and sexual gender minority status where possible (if appropriate); and
• Systems level data on strategies, collaborations, training, and organizational changes made to implement the program activities, including linkages with local homeless Coordinated Entry systems for individuals and families served.

A final performance report must be submitted within 120 days after the end of the project period. The final performance report must be cumulative and report on all activities during the entire project period.

Management of Award:

32 Successful applicants must also comply with the following standard award management reporting requirements at https://www.samhsa.gov/grants/grants- management/reporting-requirements, unless otherwise noted in the NOFO o r NoA.

VII. AGENCY CONTACTS
For program and eligibility questions contact:

LCDR Katie Hager
Center for Mental Health Services
Substance Abuse and Mental Health Services Administration (240) 276-1268
[email protected]

For fiscal/budget questions contact:

Office of Financial Resources, Division of Grants Management Substance Abuse and Mental Health Services Administration (240) 276-1400
[email protected]

For review process and application status questions contact:

Toni Davidson
Office of Financial Resources, Division of Grant Review Substance Abuse and Mental Health Services Administration (240) 276-2571
[email protected]

33 Appendix A – Application and Submission Requirements

1. GET REGISTERED
You are required to complete three (3) registration processes:

1.1) System for Award Management (SAM);

1.2) Grants.gov; and

1.3) eRA Commons.

If you have already completed registrations for SAM and Grants.gov, you need to ensure that your accounts are still active, and then register in eRA Commons (see 1.3).

You must register in eRA Commons and receive a Commons Username in order to have access to electronic submission, receive notifications on the status of your application, and retrieve award information.

WARNING: If your organization is not registered and does not have an active eRA Commons PI/PD account by the deadline, the application will not be accepted.

No exceptions will be made.

1.1 System for Award Management Registration
You must register your organization with the System for Award Management (SAM). A Unique Entity Identifier (UEI) will be assigned as part of the registration process. (The UEI replaced the Dun and Bradstreet Number (DUNS Number). If your organization is currently registered in SAM.gov, the UEI has already been assigned and is viewable in SAM.gov. This includes inactive registrations. The Unique Entity Identifier is currently located below the DUNS Number on your entity registration record. You must be signed in to your SAM.gov account to view entity records.

You must continue to maintain active SAM registration with current information during the period your organization has an active federal award or an application under consideration by an agency (unless you are an individual or federal agency that is exempted from those requirements under 2 CFR § 25.110(b) or (c), has an exception approved by the agency under 2 CFR § 25.110(d)). To create a SAM user account, Register/Update your account, and/or Search Records, go to https://www.sam.gov . It
takes 7-10 business days for a new SAM entity registration to become active.

It is important to initiate this process well before the application deadline. You will receive an email alerting you when your registration is active.

It is also highly recommended that you renew your account before the expiration date.

SAM information must be active and up-to-date and should be updated at least

34 every 12 months to remain active (for both recipients and sub-recipients). Once you update your record in SAM, it will take 48 to 72 hours to complete the validation processes. Grants.gov rejects electronic submissions from applicants with expired registrations.

If your SAM account expires, the renewal process requires the same validation with IRS and DoD (Cage Code) as required for a new account.

1.2 Grants.gov Registration
Grants.gov
is an online portal for submitting federal award applications. It requires a one-time registration to submit applications. eRA Commons registration is separate but can be done concurrently. You can register to obtain a Grants.gov username and password at http://www.grants.gov/web/grants/register.html.

If you have already completed Grants.gov registration and ensured your Grants.gov and SAM accounts are up-to-date and/or renewed, go to the eRA Commons registration steps noted below. If this is your first time submitting an application through Grants.gov, registration information can be found at the Grants.gov “Applicants ” tab.

The person submitting your application must be properly registered with Grants.gov as the Authorized Organization Representative (AOR) for the specific UEI number cited on the SF-424 (first page). See the Organization Registration User Guide for details at the following Grants.gov link: http://www.grants.gov/web/grants/applicants/organization- registration.html.

1.3 eRA Commons Registration
eRA Commons is an online data platform managed by NIH that allows applicants, award recipients, and federal staff to securely share, manage, and process award- related information. It is strongly recommended that you start the eRA Commons registration process at least six (6) weeks before the application due date.

Organizations applying for SAMHSA funding must register in eRA Commons. This is a one-time registration separate from Grants.gov registration. Note: Grants.gov and eRA Commons Registration may occur concurrently. In addition to the organization registration, the Business Official (BO) named in the Authorized Representative section field on page 3 of the SF-424 and the Project Director details entered in the Applicant Information item f on page 1 of the SF-424 (Name and contact information of the person to be contacted on matters involving this application) must have accounts in eRA Commons and receive a Commons ID to have access to electronic submission and retrieval of application/award information. If your organization is not registered and does not have an active eRA Commons PI account by the deadline, the application will not be accepted.

For organizations registering with eRA Commons for the first time, the BO named in the Authorized Representative section of the SF-424 must complete the Register Institution

35 online process. Instructions on how to complete the online Institution Registration Form are provided on the Register in eRA Commons page.
[Note: You must have a valid and verifiable UEI number to complete the eRA Commons registration.]
After the BO named as the Authorized Representative completes the online Institution Registration Form and clicks Submit, the eRA Commons will send an e-mail notification from [email protected] with the link to confirm the email address. Once the e- mail address is verified, the registration request will be reviewed and confirmed via email. If your request is denied, the representative will receive an email detailing the reason for the denial. If the request is approved, the BO will receive an email with an eRA Commons User ID for the Signing Official account (SO) role. The representative will receive a separate email about this SO account containing a temporary password to be used for the first-time log-in. The representative will need to log into eRA Commons with the temporary password, at which time the system will provide prompts to change the temporary password to one of their choosing. Once the BO/SO signs the registration request, the organization will be active in eRA Commons. The BO/SO can then create additional accounts for the organization as needed. Organizations can have multiple user accounts with the SO role, and any user with the SO role will be able to create and maintain additional accounts for the organization’s staff, including accounts for those designated as Project Director/Principal Investigator (PD/PI) and other Signing Officials.

Important: The eRA Commons requires organizations to identify at least one BO/SO, who is the BO entered in the Authorized Representative section on the SF-424, and a PD/PI to submit an application. The primary BO/SO must create the account for the PD/PI listed as the person to contact regarding the application on page 1 of the SF-424 assigning that person the ‘PI’ role in eRA Commons. Note that you must also enter the PD/PI’s Commons Username into the ‘Applicant Identifier’ field of the SF-424 document (Line 4). The individual designated as the BO cannot also be a PD.

2. WRITE AND COMPLETE THE APPLICATION
SAMHSA strongly encourages you to sign up for Grants.gov email notifications regarding this NOFO. If the NOFO is cancelled or modified, individuals who sign up with Grants.gov for updates will be automatically notified.

2.1 Obtaining Paper Copies of Application Materials
If your organization has difficulty accessing high-speed internet and cannot download the required documents, you may request a paper copy of the application materials.

Contact the Division of Grant Review at [email protected] for
additional information on obtaining paper copies.

36 2.2 Required Application Components
After downloading and retrieving the required application components and completing the registration processes, it is time to write and complete your application. All files uploaded with the Grants.gov application MUST be in Adobe PDF file format.

Directions for creating PDF files can be found on the Grants.gov website. See Appendix B for all application formatting and validation requirements.

Standard Application Components
Applications must include the following required application components listed in the table below. This table consists of a full list of standard application components, a description of each required component, and where you can find each document. # Standard Application
Components Description Where to Find
Document
1 SF-424 (Application for
Federal Assistance)
Form
This form must be completed by applicants for all
SAMHSA awards.

The names and contact information for Project
Director (PD) and Business Official (BO) are required
for SAMHSA applications and are to be entered on
the SF-424 form.
• The PD must have an eRA Commons
account: the PD’s Commons Username
must be entered in field 4. Applicant
Identifier; and the PD’s name, phone
number and email address must be entered
in Section 8. APPLICANT INFORMATION:
item f. Name and contact information of
person to be contacted on matters
involving this application. The PD listed in
the SF-424 must match the PD in the
Personnel Costs section in the budget.
• The BO name, title, email address and
phone number must be entered in the
Authorized Representative section fields
on page three of the SF 424. The
organization mailing address is required in
section 8. APPLICANT INFORMATION
item d. Address.

All SAMHSA Notices of Award (NoAs) will be
emailed by SAMHSA via NIH’s eRA Commons to the
Project Director/Principal Investigator (PD/PI), and
the Signing Official/Business Official (SO/BO).

Grants.gov/forms
2 SF-424 A (Budget
Information – Non-
Construction Programs)
Form
Use SF-424A. Fill out Sections A, B, D and E of the
SF-424A. Section C should only be completed if
applicable. It is highly recommended that you
use the budget template. (See Section IV.2)
Grants.gov/forms

37 # Standard Application
Components Description Where to Find
Document
3 Project/Performance
Site Location(s) Form
The purpose of this form is to collect physical
location information on the site(s) where work funded
under this announcement will be performed. The
address cannot be a P.O. Box.

Grants.gov/forms
4 Project Abstract
Summary
It is recommended the abstract is no more than one
page. It should include the project name,
population(s) to be served (demographics and
clinical characteristics), strategies/interventions,
project goals and measurable objectives, including
the number of people to be served annually and
throughout the lifetime of the project, etc. In the first five lines or less of your abstract, write a summary of your project that can be used, if your project is
funded, in publications, reports to Congress, or press
releases.

5 Project Narrative
Attachment
The Project Narrative is your response to the
Evaluation Criteria found at Section V.1 of this
NOFO. It cannot be longer than 10 pages. You
must attach the Project Narrative file (Adobe PDF
format only) inside the Project Narrative Attachment
Form.

6 Budget Justification and
Narrative Attachment
You must include a detailed Budget Narrative in
addition to Budget Form SF-424A. In preparing the
budget, adhere to any existing federal award or
agency guidelines which prescribe how and whether
budgeted amounts should be separately shown for
different functions or activities within the program.

The budget justification and narrative must be
submitted as file name “BNF” when you submit your
application into Grants.gov.

SAMHSA
Website

7 SF-424 B (Assurances
for Non-Construction)
Form
You must read the list of assurances provided on the
SAMHSA website and check the box marked ‘I
Agree’ before signing the first page (SF-424) of the
application.

SAMHSA
Website

8 Disclosure of Lobbying
Activities (SF-LLL) Form
Federal law prohibits the use of appropriated funds
for publicity or propaganda purposes or for the
preparation, distribution, or use of the information
designed to support or defeat legislation pending
before Congress or state legislatures. For SAMHSA
to determine whether or not your organization
participates in lobbying activities, a signed copy
of the SF-LLL form must be submitted." If your
organization does not participate in lobbying
activities, indicate “Not Applicable” on the form.

Grants.gov/forms

38 # Standard Application
Components Description Where to Find
Document
9 Other Attachments Form Refer to the Supporting Documents below. Use the Other Attachments Form to attach all required
additional/supporting documents listed in the table
below.

Supporting Documents
In addition to the Standard Application Components listed above, the following supporting documents are necessary for the review of your application. Supporting documents must be attached to your application. For each of the following application components, attach each document (Adobe PDF format only) using the Other Attachments Form in ASSIST, Workspace, or other S2S provider. # Supporting
Documents Description
Where to
Find
Document
1 HHS 690 Form Every applicant must have a completed HHS 690 form (PDF | 291 KB) on file with the Department of Health
and Human Services.

SAMHSA
Website
2 Charitable Choice Form
SMA 170 (Attachment
9)
See Section IV-1 of the NOFO to determine if you are
required to submit Charitable Choice Form SMA 170.

SAMHSA
Website

3 Biographical Sketches
and Job Descriptions
(Attachment 5)
See Appendix G of this document for additional
instructions for completing these sections. Formatting requirements outlined in Appendix B are not applicable
for these documents.

Appendix G of
this document.
4 Confidentiality and
SAMHSA Participant
Protection/Human
Subjects (Attachment
7)
See the NOFO for requirements related to
confidentiality, participant protection, and the protection of human subject’s regulations.

Appendix D of
this document.

5 Additional Documents
in the NOFO
The NOFO will indicate the attachments you need to
include in your application.

NOFO:

Section IV.

2.3 Additional Documents for Submission (SAMHSA Website) You will find additional materials you will need to complete your application on the SAMHSA website at http://www.samhsa.gov/grants/applying/forms-resources.

39 3. SUBMIT APPLICATION

3.1 Electronic Submission (eRA ASSIST, Grants.gov Workspace, or other S2S provider)
After completing all required registration and application requirements, SAMHSA requires applicants to electronically submit using eRA ASSIST, Grants.gov Workspace, or another system to system (S2S) provider. Information on each of these options is below:

1) ASSIST – The Application Submission System and Interface for Submission Tracking (ASSIST) is an NIH sponsored online interface used to prepare applications using the SF-424 form set, submit electronically through Grants.gov to SAMHSA and other participating agencies, and track applications. [Note:

ASSIST requires an eRA Commons ID to access the system] 2) Grants.gov Workspace – You can use the shared, online environment of the Grants.gov Workspace to collaboratively work on different forms within the application.

The specific actions you need to take to submit your application will vary by submission method as listed above. The steps to submit your application are as follows:

To submit to Grants.gov using ASSIST:
eRA Modules, User Guides, and
Documentation | Electronic Research Administration (eRA) To submit to Grants.gov using the Grants.gov Workspace:
http://www.grants.gov/web/grants/applicants/workspace-overview.html Regardless of the option you use, your application will be subject to the same registration requirements, completed with the same data items, routed through Grants.gov, validated against the same agency business rules, assembled in a consistent format for review consideration, and tracked in eRA Commons. All applications that are successfully submitted must be validated by Grants.gov before proceeding to the NIH eRA Commons system and validations.

3.2 Waiver from Electronic Submission
SAMHSA will not accept paper applications except under very special circumstances. If you need special consideration, SAMHSA must approve the waiver of this requirement in advance.

If you do not have the technology to apply online, or your physical location has no Internet connection, you may request a waiver of electronic submission. You must send a written request to the Division of Grant Review at least 15 calendar days before the application due date.

40 Direct any questions regarding the submission waiver process to the Division of Grant Review at [email protected].

3.3 Deadline
On-time submission requires that electronic applications be error-free and made available to SAMHSA for processing from the NIH eRA system on or before the application due date and time. Applications must be submitted to and validated successfully by Grants.gov and eRA Commons no later than 11:59 PM Eastern Time on the application due date. Applications submitted in Grants.gov after the application due date will not be considered for review.

You are strongly encouraged to allocate additional time prior to the submission deadline to submit your application and to correct errors identified in the validation process. You are also encouraged to check the status of your application submission to determine if the application is complete and error-free.

3.4 Resources for Assistance
If you encounter problems when submitting your application in Grants.gov, you must attempt to resolve them by contacting the Grants.gov Service Desk at the following:

• By e-mail: [email protected]

• By phone: (toll-free) 1-800-518-4726 (1-800-518-GRANTS). The Grants.gov Contact Center is available 24 hours a day, 7 days a week, excluding federal holidays.

Make sure you receive a case/ticket/reference number that documents the issues/problems with Grants.gov.

Additional support is also available from the NIH eRA Service desk at:

• To submit a service request ticket: http://grants.nih.gov/support/index.html

• By phone: 301-402-7469 or (toll-free) 1-866-504-9552. (Press menu option 6 for SAMHSA). The NIH eRA Service desk is available Monday – Friday, 7 a.m. to 8 p.m. Eastern Time, excluding federal holidays.

If you experience problems accessing or using ASSIST (see below), you can:

• Access the ASSIST Online Help Site at: https://era.nih.gov/erahelp/assist/ • Or contact the NIH eRA Service Desk
SAMHSA highly recommends that you submit your application 24-72 hours before the submission deadline. Many submission issues can be fixed within that time and you can attempt to re-submit.

41 4. AFTER SUBMISSION

4.1 System Validations and Tracking
After you complete and comply with all registration and application requirements and submit your application, the application will be validated by Grants.gov. You will receive a notification that your application is being processed. You will receive two additional e- mails from Grants.gov within the next 24-48 hours (one notification email will confirm receipt of the application in Grants.gov, and the other notification email will indicate that the application was either successfully validated by the Grants.gov system or rejected due to errors). It is important that you retain this Grants.gov tracking number. Receipt of the Grants.gov tracking number is the only indication that Grants.gov has successfully received and validated your application. If you do not receive a Grants.gov tracking number, you may want to contact the Grants.gov help desk for assistance (see Resources for Assistance in Section 3.4).

If Grants.gov identifies any errors and rejects your application with a “Rejected with Errors” status, you must address all errors and resubmit. If no problem is found, Grants.gov will allow the eRA system to retrieve the application and check it against its own agency business rules (eRA Commons validations). If you use ASSIST to complete your application, you can validate your application and fix errors before submission.

After you successfully submit your application through Grants.gov, your application will go through eRA Commons validations. If no errors are found, the application will be assembled in eRA Commons. At this point, you can view your application in eRA Commons. It will then be forwarded to SAMHSA as the receiving institution for further review.

If errors are found during eRA Commons validation, you will receive a System Error and/or Warning notification regarding the problems found in the application (see 4.2 below). You must take action to make the required corrections and resubmit the application through Grants.gov before the application due date and time (See 4.4 below). Do not assume that if your application passes the Grants.gov validations that it will successfully pass eRA validations and will be received by SAMHSA. You must check your application status in eRA Commons to ensure that no errors were identified.

It is critical that you allow for sufficient time to resubmit the application if errors are detected.

You are responsible for viewing and tracking your applications in the eRA Commons after submission through Grants.gov to ensure accurate and successful submission. Once you can access your application in the eRA Commons, be sure to review it carefully as this is what reviewers will see.

4.2 eRA Commons: Warning vs. Error Notifications

42 You may receive a System Warning and/or Error notification after submitting an application. Take note that there is a distinction between System Errors and System Warnings.

Warnings – If you receive a Warning notification after the application is submitted, you are not required to resubmit the application. The reason for the Warning will be identified in the notification. It is at your discretion to choose to resubmit, but if the application was successfully received, it does not require any additional action.

Errors – If you receive an Error notification after the applications is submitted, you must correct and resubmit the application. The word Error is used to characterize any condition which causes the application to be deemed unacceptable for further consideration.

4.3 System or Technical Issues
If you encounter a system error that prevents you from completing the application submission process on time, the BO from your organization will receive an email notification from eRA Commons. SAMHSA highly recommends contacting the eRA Service Desk and submitting a web ticket to document your good faith attempt to submit your application and determining next steps. See Section 3.4 for more information on contacting the eRA Service Desk.

4.4 Resubmitting a Changed/Corrected Application
If SAMHSA does not receive your application by the application due date as a result of a failure in the SAM, Grants.gov, or NIH’s eRA Commons systems, you must contact the Division of Grant Review within one business day after the official due date at:
[email protected] and provide the following:

• A case number or email from SAM, Grants.gov, and/or NIH’s eRA system that allows SAMHSA to obtain documentation from the respective entity for the cause of the error.

SAMHSA will consider the documentation to determine if you followed Grants.gov and NIH’s eRA requirements and instructions, met the deadlines for processing paperwork within the recommended time limits, met NOFO requirements for submission of electronic applications, and made no errors that caused submission through Grants.gov or NIH’s eRA to fail. No exceptions for submission are allowed when user error is involved. Note that system errors are extremely rare.

[Note: When resubmitting an application after revisions have been made, ensure that the Project Title is identical to the Project Title in the originally submitted application (i.e., no extra spacing) as the Project Title is a free-text form field.] In addition, check the Changed/Corrected Application box in #1.

43 Appendix B - Formatting Requirements and System
Validation

1. SAMHSA FORMATTING REQUIREMENTS
SAMHSA’s goal is to review all applications submitted for funding. However, this goal must be balanced against SAMHSA’s obligation to ensure equitable treatment of applications. For this reason, SAMHSA has established certain formatting requirements for its applications. See below for a list of formatting requirements required by SAMHSA:
• Text must be legible. Pages must be typed in black, single-spaced, using a font of Times New Roman 12, with all margins (left, right, top, bottom) at least one inch each. You may use Times New Roman 10 only for charts or tables. • You must submit your application and all attached documents in Adobe PDF format, or your application will not be forwarded to eRA Commons and will not be reviewed. See Section 3 below for more details on PDF requirements.
• To ensure equity among applications, the 10-page limit for the Project Narrative cannot be exceeded. If an application exceeds the 10-page limit, the application will not be reviewed.
• Citations can be put in an Attachment. They do not have to be placed in the Project Narrative.
• Black print should be used throughout your application, including charts and graphs (no color).
• If you are submitting more than one application under the same announcement number, you must ensure that the Project Title in Field 15 of the SF-424 is unique for each submission.

2. GRANTS.GOV FORMATTING AND VALIDATION REQUIREMENTS
• Grants.gov allows the following list of UTF-8 characters when naming your attachments: A-Z, a-z, 0-9, underscore, hyphen, space, and period. Other UTF-8 characters should not be used as they will not be accepted by NIH’s eRA Commons, as indicated in item #9 in the table below.

• Scanned images must be scanned at 150-200 dpi/ppi resolution and saved as a PDF file. Using a higher resolution setting or different file type will result in a larger file size, which could result in rejection of your application.

44 • Any files uploaded or attached to the Grants.gov application must be PDF file format and must contain a valid file format extension in the filename. In addition, the use of compressed file formats such as ZIP, RAR or Adobe Portfolio will not be accepted.

3. eRA COMMONS FORMATTING AND VALIDATION REQUIREMENTS
The following are formatting requirements and system validations required by eRA Commons and will result in errors if not met. The application must be ‘error free’ to be processed through the eRA Commons. There may be additional validations which will result in Warnings but these will not prevent the application from processing through the submission process. (See Appendix A, Section 4.2)
ASSIST File Formatting Requirements
The eRA system contains file formatting requirements for uploading documents in ASSIST. The only accepted file type for submission is PDF and each file may be no larger than 6 MB. Fillable forms must be ‘flattened’ and saved as a PDF prior to upload.

Adobe Portfolio file types will not be accepted.

Files for Upload to ASSIST must be:
 PDF Format
 Under 6MB in File Size
 8.5 x 11 Page Size
 Flat (No Fillable/Editable Fields)
Files must NOT contain:
 Password- Protection
 Live hyperlinks (only plain text URLs)
 Bookmarks or Signature Boxes
 A filename exceeding 50 Characters (including spaces) Flatten Fillable Forms Prior to Upload in ASSIST
A completed fillable form (an electronic document that can be filled out and edited digitally—also called fillable, dynamic, or interactive forms) should not only be saved as a PDF; it must also be flattened to remove the interactive fields so that the final answers are saved. Flattening a form is not the same as “locking” it; locking a form restricts access to editing, printing, and copying the document.

45 Flattening a PDF document:
• Keeps form values permanent. When an interactive PDF is uploaded or emailed, every field remains open to accidental or deliberate revision. Flattening the form ensures that only the completed version of the form is visible. • Removes values on drop down lists. A flattened document will show only the selected text or value, no other values and options are shown and there is no indication that options were present.
• Simplifies the PDF. Interactive forms are larger than normal files, which may prevent upload for submission. Flattening reduces the file size which makes it easier to render and view.

To flatten a file, follow the steps below.

1. Ensure that the form is completed and the information is correct. Go to the print settings by selecting File > Print.

2. On the pull-down menu of printer options, choose Adobe PDF or Microsoft Print to PDF, then click OK.

3. After clicking OK, a pop-up will open with options to save the PDF. Be sure to select a specific location to save the document where it can easily be found and give it a unique file name. Use a file name that clearly differentiates the completed form from the original fillable form. File names cannot exceed 50 characters.

4. The flattened form should appear in the new location with the new file name.

Open it to check once more for any changes and to confirm that the conversion worked.

If you do not adhere to these requirements, you will receive an email notification from [email protected]
to take action and adhere to the requirements so that your application can be processed successfully. It is highly recommended that you submit your application 24-72 hours before the submission deadline to allow for sufficient time to correct errors and resubmit the application. If you experience any system validation or technical issues after hours on the application due date, contact the eRA Service Desk and submit a Web ticket to document your good faith attempt to submit your application.
eRA Commons Validation Table
The following table shows formatting requirements and system validations required by eRA Commons and will result in errors if not met.

46 eRA Validations eRA Error Messages
#1: Applicant Identifier (Item 4 on the SF-424):

The PD/PI Credentials must be provided

The Commons Username must be provided in the
Applicant Identifier field for the PD/PI.

Username provided must be a valid Commons
account

The Commons Username provided in the Applicant
Identifier is not a recognized Commons account.

Username must be affiliated with the
organization submitting the application and/or
have the PI role
The Commons account provided in the Applicant
Identifier field for the PD/PI is either not affiliated with the applicant organization or does not hold the
PI role. Check with your Commons Account
Administrator to make sure your account affiliation
and roles are set-up correctly.

#2. The UEI number provided must include
valid characters (12 numbers)
The UEI number provided has invalid characters
(other than 12 numbers)
#3. The documentation (forms) required for the
NOFO must be submitted
The format of the application does not match the
format of the NOFO. Contact the eRA Service
Desk for assistance.

(#4 If a change or correction is made to
address an error, “Changed/Corrected” must be
selected. Item #1 on the SF-424). Refer to
Appendix A II-4.4 for more information on
resubmission criteria.

This application has been identified as a duplicate
of a previous submission. The ‘Type of
Submission’ should be set to Changed/Corrected if
you are addressing errors/warnings.

#5. The application cannot exceed 1.2GB. The application did not follow the agency-specific size limit of 1.2 GB. Resize the application to be
no larger than 1.2 GB before submitting.

#6. The correct Notice of Funding Opportunity
(NOFO) number must be provided

The Funding Opportunity Announcement number
does not exist.
#7. All documents and attachments must be
submitted in PDF format.

“The <attachment> attachment is not in PDF
format. All attachments must be provided to the
agency in PDF format with a .pdf extension. Help
with PDF attachments can be found at
http://grants.nih.gov/grants/ElectronicReceipt/pdf_g
uidelines.htm.”

#8. All attachments must comply with the
following formatting requirements:

PDF attachments cannot be empty (0 bytes).

The {attachment} attachment was empty. PDF
attachments cannot be empty, password protected
or encrypted.

All PDF attachments cannot have Meta data
missing, cannot be encrypted, password
protected or secured documents.

The <attachment> attachment contained formatting
or features not currently supported by NIH:
<condition returned>.

47 eRA Validations eRA Error Messages
The size of PDF attachments cannot be larger
than 8.5 x 11 inches (horizontally or vertically).
[Note: It is recommended that you limit the size
of attachments to 35 MB.]

Filename <file> cannot be larger than U.S.
standard letter paper size of 8.5 x 11 inches. See
the PDF guidelines at
http://grants.nih.gov/grants/ElectronicReceipt/pdf_
guidelines.htm

PDF attachments must have a valid file name.

Valid file names must include the following
UTF-8 characters: A-Z, a-z, 0-9, underscore (_),
hyphen (-), space, period.

The <attachment> attachment filename is invalid.

Valid filenames may only include the following
characters: A-Z, a-z, 0-9, underscore ( _ ), hyphen
(-), space, or period. No special characters
(including brackets) can be part of the filename.

#9. The email addresses for the Contact
Person (SF-424 Section F) and the Authorized
Representative (SF-424 below Section 21) must
contain a ‘@’, with at least 1 and at most 64
chars preceding and following the ‘@’. Control
characters (ASCII 0 through 31 and 127),
spaces and special chars < > ( ) [ ] \ , ; : are not
valid.

The submitted e-mail address for the person to be
contacted {email address}, is invalid. Must contain
a ‘@’, with at least 1 and at most 64 chars
preceding and following the ‘@’. Control
characters (ASCII 0 through 31 and 127), spaces
and special chars < > ( ) [ ] \ , ; : are not valid.
#10. Congressional district code of applicant
(after truncating) must be valid. (SF-424, item
16 a and b)
Congressional district <Congressional District> is
invalid. To locate your district, visit
http://www.house.gov/

48 Budget Errors

eRA Validations eRA Error Messages
SF424-A: Section A – Budget Summary
The total fields at the end of rows or at the
bottom of columns must equal the sum of the
elements for that row or column

Ensure that the sum of Grant Program Function or
Activity (a) elements entered equals the total
amounts in the Total field

SF424-A: Section B – Budget Categories
The Total in Section B (Column 5 - Row k) must
equal the Total in Section A – Budget
Summary: (Row 5, Column g).

Ensure that the TOTALS Total (row k, column 5)
equals the Budget Summary Totals in section A,
row 5 column g.

SF424-A: Section D – Forecasted Cash Needs
The Federal Total for the 1st Year (Line 13)
must equal the Total in Section A (Row 5,
Column g)

Ensure that the Federal Total for 1st year, in
Section D- Forecasted Needs equals the Section
A, New or Revised Budget Federal Totals (e-5)
amount.

The Non-Federal Total for 1st Year sum must
equal Estimated Unobligated Funds Non-
Federal Totals in Section A (d-5) + New or
Revised Budget Non-Federal Totals (f-5)

Ensure that the Non-Federal Total for 1st year
equals the sum of Estimated Unobligated Funds
Non-Federal Totals (d-5) and New or Revised
Budget Non-Federal Totals (f-5) on Section A.

The Total for 1st Year TOTAL in Section D must
equal the Total (Row 5, Column G) in Section A
Ensure that the Forecasted Cash Needs: 15
TOTAL equals to SECTION A – Budget Summary:

Line 5. Totals, Column (g).

SF424-A: Section E – Budget Estimates of
Federal Funds Needed for Balance of The
Project

The number of budget years/periods must
match the span of the project. The number of
years in the project period in Block 17 on the
SF-424 must align with the future funding
periods.

Ensure that the project period years on the SF 424
block 17 matches the provided budget periods in
the SF-424A. Enter data for the first budget period
in Section D and enter future budget periods in
Section E.

49 Appendix C – General Eligibility Information
Determining whether you are eligible to apply for and receive a SAMHSA award is very important. If you are not legally eligible for a specific funding opportunity, you would spend considerable time and money completing the application process when you cannot receive the award.

There are many types of organizations generally eligible to apply for SAMHSA funding opportunities. However, eligibility is strictly tied to the statutory authority governing this award. Please be sure to double check the NOFO for eligibility. Eligibility for this NOFO may include the following:

Government Organizations
State governments and territories
County governments
City or township governments
Special district governments
Native American tribal governments (federally recognized) Native American tribal governments (other than federally recognized) State-Recognized Tribes
Other Tribal Entities
Tribal organizations
Consortia of tribes or tribal organizations
Urban Indian Organizations

Education Organizations
Independent school districts
Public and state-controlled institutions of higher education Private institutions of higher education
Education agencies/authorities serving children and youth residing in federally recognized American Indian/Alaska Native (AI/AN) tribes Non-profit Organizations
Non-profits having a 501(c)(3) status with the Internal Revenue Service (IRS), other than institutions of higher education
Non-profits that do not have a 501(c)(3) status with the IRS, other than institutions of higher education, including entities with 501(c)(4) status (civic leagues, social welfare organizations, and local associations of employees) and 501(c)(5) status (labor organizations).

Please note: For-profit organizations and foreign entities are not eligible to apply for SAMHSA awards.

50 Appendix D – Confidentiality and SAMHSA Participant
Protection/Human Subjects Guidelines
CONFIDENTIALITY AND PARTICIPANT PROTECTION:

It is important to have safeguards protecting individuals from risks associated with their participation in SAMHSA projects. As part of Attachment 7 of the application, all applicants (including those who plan to obtain Institutional Review Board (IRB) approval) must address all of the elements below. If some elements are not applicable to the proposed project, explain why the element(s) is not applicable.

In addition to addressing these elements, you will need to determine if the section below titled “Protection of Human Subjects Regulations” applies to your project. If so, you must submit the required documentation as described below. There are no page limits for your response to the elements in this appendix.

1. Protect Participants and Staff from Potential Risks
• Identify and describe the foreseeable physical, medical, psychological, social, and legal risks or potential adverse effects participants may be exposed to because of the project.
• Identify and describe the foreseeable physical, medical, psychological, social, and legal risks or potential adverse effects staff may be exposed to as a result, of the project.
• Describe the procedures you will follow to minimize or protect participants and staff against potential risks, including risks to confidentiality. • Identify your plan to provide guidance and assistance in the event there are adverse effects to participants and/or staff.

Responses that will be considered unacceptable or incomplete:
• Indicating that there are no risks to participants. If services are being delivered as part of the project, it is very unlikely that there will be no foreseeable physical, medical, psychological, social, or legal risks or potential adverse effects as a result of their involvement in the project.

• Addressing potential risks to participants but not addressing risks to staff

• Neglecting to describe how the organization will provide guidance and assistance in the event there are adverse effects to participants and whether alternative treatments will be available to participants.

51 2. Fair Selection of Participants
• Explain how you will recruit and select participants ensuring all populations have equitable opportunities to participate in the program.
• Identify any individuals in the geographic catchment area where services will be delivered who will be excluded from participating in the project and explain the reasons for this exclusion.

Responses that will be considered unacceptable or incomplete:
• Not explaining reasons for including or excluding participants

• Not identifying how participants will be selected

3. Absence of Coercion
• If you plan to compensate participants, state how participants will be awarded incentives (e.g., gift cards, bus passes, gifts, etc.) If you plan to implement a contingency management program, specify the evidence-based model you will use and briefly justify its use with your population(s) of focus. If you have included funding for incentives in your budget, you must address this item. (For specific information about incentives, see
https://www.samhsa.gov/grants/grants-
management/policies-regulations/additional-directives)
• Provide justification that the use of incentives is appropriate, judicious, and conservative and that incentives do not provide an “undue inducement” that removes the voluntary nature of participation.
• Describe how you will inform participants in a culturally competent manner that they may receive services even if they choose to not participate in or complete the data collection component of the project.

Responses that will be considered unacceptable or incomplete:
• Indicating that you do not plan to compensate participants, such as through incentives, but including funding for incentives in the budget or describing the use of incentives in the Project Narrative. • Not specifying how participants will be told that they may receive services even if they choose not to participate in the data collection component of the project.

4. Data Collection

52 • Identify from whom you will collect data (e.g., participants, clients, family members, teachers, others).
• Describe the data collection procedures and specify the sources for obtaining data (e.g., school records, interviews, psychological assessments, questionnaires, observation, or other sources). Identify what type of specimens (e.g., urine, blood) will be used, if any. State if the specimens will be used for purposes other than evaluation.
• In Attachment 2, “Data Collection Instruments/Interview Protocols,” you must provide copies of all available data collection instruments and interview protocols that you plan to use (unless you are providing the web link to the standardized instrument(s)/protocol(s). Include any culturally adapted data collection instruments and interview protocols.

Responses that will be considered unacceptable or incomplete:
• Not clearly identifying all the entities from which data will be collected. • Describing the use of drug testing in the Project Narrative but not providing the requested information about specimen collection. • Not including data collection instruments/interview protocols (or links to websites for the instruments) in Attachment 2.
• Not including how the data collection will occur (i.e., paper surveys versus electronic survey links; at a school setting or at the organization’s clinic, etc.).

5. Privacy and Confidentiality
• Explain how you will ensure privacy and confidentiality. Describe:
o Where data will be stored,
o Who will have access to the data collected, and
o How the identity of participants will be kept private, for example, using a coding system on data records, limiting access to records, or storing identifiers separately from data.
• NOTE: Recipients must maintain the confidentiality of substance use disorder client records according to the provisions of Title 42 of the Code of Federal Regulations, Part II, Subpart B.

Responses that will be considered unacceptable or incomplete:

53 • Not providing detailed information about where data is stored and how the identity of participants will be kept confidential.

• Not clearly identifying the individuals who will have access to the data.

• Not specifying that you agree to maintain the confidentiality of substance use disorder client records according to the provisions of Title 42 of the Code of Federal Regulations, Part II.

6. Adequate Consent Procedures
• Include, as appropriate, sample consent forms* that provide for:

1. informed consent for participation in service intervention;

2. informed consent for participation in the data collection component of the project, including information that participants are informed that they may receive services even if they choose not to participate in or complete this component of the project; and

3. informed consent for the exchange (releasing or requesting) of confidential information.

4. Informed consent for youth participants.

*Consent forms should be written at no higher than 8th grade reading level.

• The sample forms must be included in Attachment 3, “Sample Consent Forms”, of your application. If needed, provide translated forms. • Explain how you will obtain consent for youth, the elderly, people with limited reading skills, and people who do not use English as their first language.

Describe how the consent will be documented. For example: Will you read the consent forms? Will you ask prospective participants questions to be sure they understand the forms? Will you give them copies of what they sign? NOTE: The consent forms should never imply that the participant waives or appears to waive any legal rights. The forms should also not imply that individuals cannot end involvement with the project or that your project or its agents will be released from liability for negligence.

Responses that will be considered unacceptable or incomplete:
• Not providing copies of sample consent forms in Attachment 3. • Not providing details on how consent/assent will be obtained for youth participants.

54 • Not providing details on how consent will be obtained for non-English speaking priority populations identified in the application.

7. Risk/Benefit Discussion
• Discuss why the risks you have identified in Element 1. Protect Participants and Staff from Potential Risks are reasonable compared to the anticipated benefits to participants involved in the project.

Responses that will be considered unacceptable or incomplete:
• Indicating there are no risks to participants in the first element and noting that this element is therefore not applicable.
• Not mentioning any anticipated benefits to participants involved in the project.

PROTECTION OF HUMAN SUBJECTS REGULATIONS
SAMHSA expects that most recipients funded under this announcement will not have to comply with the Protection of Human Subjects Regulations (45 CFR 46), which requires Institutional Review Board (IRB) approval. However, in some instances, the applicant’s proposed project may meet the regulation’s criteria for research involving human subjects. Although IRB approval is not required at the time of award, you are required to provide the documentation below prior to enrolling participants into your project.

In addition to the elements above, applicants whose projects must comply with the Human Subjects Regulations must:
• Describe the process for obtaining IRB approval for your project. • Provide documentation that an Assurance of Compliance is on file with the Office for Human Research Protections (OHRP).
• Provide documentation that IRB approval has been obtained for your project prior to enrolling participants.

General information about Human Subjects Regulations can be obtained through OHRP at http://www.hhs.gov/ohrp
or (240) 453-6900. SAMHSA–specific questions should be directed to the program contact listed in Section VII of this announcement.

55 Appendix E – Developing Goals and Measurable Objectives To be able to effectively evaluate your project, it is critical that you develop realistic goals and measurable objectives. This appendix provides information on developing goals and objectives for use in your Project Narrative. It also provides examples of well- written goals and measurable objectives.

GOALS
Definition − a goal is a broad statement about the long-term expectation of what should happen because of your program (the desired result). It serves as the foundation for developing your program objectives. Goals should align with the statement of need that is described. Goals should only be one sentence.

The characteristics of effective goals include:
• Goals address outcomes, not how outcomes will be achieved. • Goals describe the behavior or condition in the community expected to change. • Goals describe who will be affected by the project.
• Goals lead clearly to one or more measurable results. • Goals are concise.

Examples
Unclear Goal Critique Improved Goal
Increase the substance use and
HIV/AIDS prevention capacity of the
local school district
This goal could be
improved by
specifying an
expected program
effect in reducing a
health problem
Increase the capacity of the local
school district to reduce high-risk
behaviors of students that may
contribute to substance use and/or

HIV/AIDS
Decrease the prevalence of marijuana,
alcohol, and prescription drug use
among youth in the community by
increasing the number of schools that
implement effective policies,
environmental change, intensive
training of teachers, and educational
approaches to address high-risk
behaviors, peer pressure, and tobacco
use.

This goal is not
concise
Decrease youth substance use in
the community by implementing
evidence-based programs within the
school district that address
behaviors that may lead to the
initiation of use.

OBJECTIVES
Definition – Objectives describe the results to be achieved and the manner in which they will be achieved. Multiple objectives are generally needed to address a single

56 goal. Well-written objectives help set program priorities and targets for progress and accountability. It is recommended that you avoid verbs that may have vague meanings to describe the intended outcomes, like “understand” or “know” because it may prove difficult to measure them. Instead, use verbs that document action, such as: “By the end of 2020, 75% of program participants will be placed in permanent housing. To be effective, objectives should be clear and leave no room for interpretation.

SMART is a helpful acronym for developing objectives that are specific, measurable, achievable, realistic, and time-bound:

Specific –
Includes the “who” and “what” of program activities. Use only one action verb to avoid issues with measuring success. For example, “Outreach workers will administer the HIV risk assessment tool to at least 100 injection drug users in the population of focus” is a more specific objective than “Outreach workers will use their skills to reach out to drug users on the street.”

Measurable –
How much change is expected. It must be possible to count or otherwise quantify an activity or its results. It also means that the source of and mechanism for collecting measurement data can be identified and that collection of the data is feasible for your program. A baseline measurement is required to document change (e.g., to measure the percentage of increase or decrease). If you plan to use a specific measurement instrument, it is recommended that you incorporate its use into the objective. Example:

By 9/20 increase by 10% the number of 8
th, 9th, and 10th grade students who disapprove
of marijuana use as measured by the annual school youth survey.

Achievable –
Objectives should be attainable within a given time frame and with available program resources. For example, “The new part-time nutritionist will meet with seven teenage mothers each week to design a complete dietary plan” is a more achievable objective than “Teenage mothers will learn about proper nutrition.”

Realistic –
Objectives should be within the scope of the project and propose reasonable programmatic steps that can be implemented within a specific time frame. For example, “Two ex-gang members will make one school presentation each week for two months to raise community awareness about the presence of gangs” is a more realistic objective than “Gang-related violence in the community will be eliminated.”

Time-bound –
Provide a time frame indicating when the objective will be measured or a time by when the objective will be met. For example, “Five new peer educators will be recruited by the second quarter of the first funding year” is a better objective than “New peer educators will be hired.”

57 Examples:

Non-SMART Objective Critique SMART Objective
Teachers will be trained on
the selected evidence-
based substance use
prevention curriculum.

The objective is not SMART
because it is not specific,
measurable, or time-bound. It
can be made SMART by
specifically indicating who is
responsible for training the
teachers, how many will be
trained, who they are, and by
when the trainings will be
conducted.

By June 1, 2022, LEA supervisory
staff will have trained 75% of
health education teachers in the
local school district on the
selected, evidence-based
substance use prevention
curriculum.

90% of youth will participate
in classes on assertive
communication skills.

This objective is not SMART
because it is not specific or time-
bound. It can be made SMART
by indicating who will conduct
the activity, by when, and who
will participate in the lessons on
assertive communication skills.

By the end of the 2022 school
year, district health educators will
have conducted classes on
assertive communication skills for
90% of youth in the middle school
receiving the substance use and
HIV prevention curriculum.

Train individuals in the
community on the
prevention of prescription
drug/opioid overdose-
related deaths.

This objective is not SMART as it
is not specific, measurable or
time-bound. It can be made
SMART by specifically indicating
who is responsible for the
training, how many people will be
trained, who they are, and by
when the training will be
conducted.

By the end of year two of the
project, the Health Department
will have trained 75% of EMS staff
in the County Government on the
selected curriculum addressing the
prevention of prescription
drug/opioid overdose-related
deaths.

58 Appendix F – Developing the Plan for Data Collection and Performance Measurement

Information in this Appendix should be taken into consideration when developing a response for criteria in Section E of the Project Narrative.

Data Collection:

In describing your plan for data collection, consider addressing the following points:
• Electronic data collection software that will be used • Frequency of data collection?
• Organizational processes that will be implemented to ensure the accurate and timely collection and input of data.
• Staff that will be responsible for collecting and recording the data. • Data source and data collection instruments that will be used to collect the data. • How well the data collection methods will take into consideration the language, norms, and values of the population(s) of focus.

• Processes and policies to keep data secure.
• If applicable, the data collection procedures to ensure that confidentiality is protected and that informed consent is obtained.
• If applicable, data collection procedures from partners and/or sub-recipients.

It is not necessary to provide information related to data collection and performance measurement in a table, but the following samples may give you some ideas about how to display the information.

Table 1 [provides an example of how information for the required performance measures could be displayed]
Performance Measures Data
Source
Data Collection
Frequency
Responsible
Staff for Data
Collection
Method of Data
Analysis

Table 2 [provides an example of how information could be displayed for the data that will be collected to measure the objectives that are included in B.1] Objective Data Source Data Collection
Frequency
Responsible Staff for
Data Collection
Method of Data
Analysis
Objective 1.a
Objective 1.b

59 Data Management and Performance Monitoring
Points to consider:
• D ata protection policies and procedures, including information about storage, retention, and access.
• F requency of reviews and monitoring of performance data • Staff conducting data analysis, including evaluation. • D ata analysis methods and how you will use data to monitor and evaluate activities and processes.
• Staff responsible for completing reports.
• How data will be reported to staff, stakeholders, SAMHSA, an Advisory Board, and other relevant project partners.

How Data Will Be Used to Enhance the Project/Quality Improvement (QI):

Points to consider:
• If applicable, the QI model that will be used.
• How will the QI process be used to track progress?
• S taff responsible for overseeing QI processes.
• Details of how to implement any needed changes to project implementation and/or project management.
o W hat decision-making processes will be used??
o When and by whom will decisions be made concerning project improvement?
o What are the thresholds for determining that changes need to be made? o Will the Advisory Board have a role in the QI process? o How will the changes be communicated to staff and/or partners/sub- recipients?

60 Appendix G – Biographical Sketches and Position
Descriptions
Include position descriptions and biographical sketches for all project staff as supporting documentation to the application. The formatting requirements outlined in Appendix B are not applicable for these documents.

Biographical Sketch
Existing curricula vitae of project staff members may be used if they are updated and contain all items of information requested below. You may add any information items listed below to complete existing documents. For development of new curricula vitae include items below in the most suitable format:

1. Name of staff member

2. Educational background: school(s), location, dates attended, degrees earned (specify year), major field of study

3. Professional experience

4. Recent relevant publications

Position Description

1. Title of position

2. Description of duties and responsibilities

3. Qualifications for position

4. Supervisory relationships

5. Skills and knowledge required

6. Amount of travel and any other special conditions or requirements

7. Salary range

8. Hours per day or week

61 Appendix H – Addressing Behavioral Health Disparities SAMHSA expects recipients to submit a Behavioral Disparity Impact Statement (DIS) within 60 days of receiving the award.

SAMHSA’s Behavioral Health Disparity Impact Statement (DIS) is a data-driven, quality improvement approach to advance equity for all, and to identify racial, ethnic, sexual and gender minority, and rural populations at highest risk for experiencing behavioral health disparities as part of their projects. The purpose of the DIS is for recipients to identify and address health disparities
11 and to develop and implement an action plan
with a disparity reduction quality improvement process to close the identified gap(s).

The aim is to achieve targeted behavioral health equity12 for disparate populations and improve systems.

SAMHSA provides a DIS Worksheet that award recipients are expected to use to respond to this special condition of award.

The main components of the DIS are:

Identify and describe the scope of the problem (i.e., behavioral health disparity) related to the program and the population(s) of focus that experience disparate access, use, and outcomes. Identify data sources that will be used to inform the DIS (this should be in alignment with the information provided in your application). Complete a table that includes this information at the individual/client, organizational or systemic level as it relates to GPRA data collection requirements.

11 Healthy People 2030 defines a health disparity as a “particular type of health differ ence that is closely linked with social, economic, and/or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; disability; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion.”
12 Behavioral health equity is the right to access high quality and affordable health care services and supports for all populations regardless of the individual’s race, age, ethnicity, gender (including gender identity), disability, socioeconomic status, sexual orientation, or geographical location. Advancing behavioral health equity involves ensuring that everyone has a fair and just opportunity to be as healthy as possible. In conjunction with quality services, this involves addressing social determinants of health, such as employment and housing stability, insurance status, proximity to services, and culturally responsive care – all of which have an impact on behavioral health outcomes.

62 • Identify Social Determinant of Health (SDOH) domain(s) that your organization will work to address and improve for the identified population(s) of focus using the NOFO. Visit Healthy People 2030 for more information on the five (5) domains. Using the Behavioral Health Implementation Guide, identify Culturally and Linguistically Appropriate Services (CLAS) standards that your organization plans to meet, expand, or improve through this funding opportunity. Review the Behavioral Health Implementation Guide for full explanations of the overarching themes and 15 CLAS Standards with behavioral health related samples, strategies, and examples.
• Develop and implement a disparity reducing quality improvement action plan to address the behavioral health disparity(ies) experienced by underserved population differences based on the GPRA data on access, use, and outcomes of activities. The plan should include realistic goals and SMART objectives (see Appendix E
), the activities that will be implemented to address disparities, the intended impact, timeline, measurement, and evaluation. Ensure documentation of the processes, progress, and outcomes on how the identified behavioral health disparity(ies) have improved.

Recipients are expected to provide, at a minimum, an annual update on the DIS (e.g., what worked, what did not work, what modifications were made) as part of the programmatic progress reports per the NOFO.

Examples of a DIS are available on the SAMHSA website at http://www.samhsa.gov/grants/grants-management/disparity-impact-statement DIS Related Terminology and Resources
Definition of Health Disparities
Healthy People 2030 defines a health disparity as a “particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; disability; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion.”
Social Determinants of Health (SDOH)
SDOH
are the conditions in the environment where people are born, live, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. SDOH can be grouped into 5 domains:

• Economic Stability
• Education Access and Quality

63 • Health Care Access and Quality
• Neighborhood and Built Environment
• Social and Community Context
For more information about SDOH Z codes and how SDOH are being used to narrow the health disparities gaps, see https://www.cms.gov/files/document/zcodes- infographic.pdf; https://www.cms.gov/files/document/cms-omh-january2020-zcode-data- highlightpdf.pdf; and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207437/pdf/18- 095.pdf
Definition of Equity
Equity is the consistent and systematic fair, just, and impartial treatment of all individuals, including individuals who belong to underserved communities that have been denied such treatment, such as Black, Latino, Indigenous and Native American persons, Asian Americans and Pacific Islanders and other persons of color; members of religious minorities; lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons; persons with disabilities; persons who live in rural areas; and persons otherwise adversely affected by persistent poverty or inequality. Addressing issues of equity should include an understanding of intersectionality and how multiple forms of discrimination impact individuals’ lived experiences. Individuals and communities often belong to more than one group that has been historically underserved, marginalized, or adversely affected by persistent poverty and inequality. Individuals at the nexus of multiple identities often experience unique forms of discrimination or systemic disadvantages, including in their access to needed services.

Definition of Health Equity
Health equity is the attainment of the highest level of health for all people. Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and health care disparities. Behavioral health equity is the right to access quality health care for all populations regardless of the individual’s race, ethnicity, gender, socioeconomic status, sexual orientation, or geographical location.

This includes access to prevention, treatment, and recovery services for mental and substance use disorders.

Underserved populations

SAMHSA applicants are routinely asked to define the population they intend to serve given the focus of a particular program (e.g., adults with opioid use disorders at risk of overdose; adults with serious mental illness [SMI]; adolescents engaged in underage drinking; populations at risk for contracting HIV/AIDS, etc.). Within these populations of focus are underserved populations that may have unequal access to, use of, or outcomes from provided services. These disparities may be the result of differences in race, ethnicity, language, culture, and/or socioeconomic factors specific to that

64 underserved population. For instance, Latino adults with opioid use disorder may be at heightened risk for overdoses due to lack of in-language prevention campaigns and treatment; African Americans with an SMI may more likely to terminate treatment prematurely due to lack of providers with whom they can develop a therapeutic relationship; Native American youth may have an increased incidence of underage drinking due to coping patterns related to historical trauma; and African American women may be at greater risk for contracting HIV/AIDS due to lack of access to education on risky sexual behaviors in urban low-income communities, etc. While these factors might not be pervasive among the general population served by a recipient, they may be predominant among underserved populations or groups vulnerable to disparities. It is imperative that recipients understand who is being served, who is underserved, and who is not being served within their community in order to provide outreach and care that will yield positive outcomes, per the focus of the award. For organizations to attend to the potentially disparate impact of their award efforts, recipients are asked to address access, use and outcomes, disaggregated by underserved populations. Underserved populations can be defined by the following factors:
• By race
• By ethnicity
• By gender identity (including transgender populations) • By sexual orientation (including lesbian, gay and bisexual populations)

Access refers to which populations/underserved populations are being served/reached by the program. Use refers to what interventions/services are received by the various populations. Outcomes refers to the outcome measures stipulated by the award and examined across underserved populations.

Culturally and Linguistically Appropriate Services in Health and Health Care (CLAS Standards)
The ability to address the quality of care provided to underserved populations served within SAMHSA’s programs is enhanced by programmatic alignment with the federal National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (CLAS Standards).

The CLAS Standards are comprised of 15 Standards that provide a blueprint for health and health care organizations to implement culturally and linguistically appropriate, respectful, and responsive services that will advance health equity, improve quality, and help eliminate health care disparities.

The CLAS Standards are grouped into a Principal Standard and three themes focused on
1) Governance and Leadership.
2) Communication and Language Assistance.
3) Engagement, Continuous Improvement and Accountability.

65 Widely embraced by States and health care systems, the National CLAS Standards are more recently being promoted in behavioral health care, which includes a Behavioral Health CLAS Implementation Guide at
https://www.minorityhealth.hhs.gov/Assets/PDF/clas%20standards%20doc_v06.28.21.p df. Y ou can learn more about the CLAS mandates, guidelines, and recommendations at: https://thinkculturalhealth.hhs.gov/clas.

Guidelines for behavioral health implementation of the CLAS Standards can be found at https://thinkculturalhealth.hhs.gov/clas. This document addresses the importance of improving access to behavioral health care, promoting quality behavioral health programs and practice, and ultimately reducing persistent disparities in mental health and substance use prevention, treatment, and recovery for underserved, minority populations and communities.

66 Appendix I – Standard Funding Restrictions
HHS codified the Uniform Administrative Requirements, Cost Principles, and Audit Requirements for HHS Awards, 45 CFR Part 75. In Subpart E, cost principles are described and allowable/unallowable expenditures for HHS recipients are delineated. 45 CFR Part 75 is available at https://ecfr.federalregister.gov/current/title-45/subtitle- A/subchapter-A/part-75. U nless superseded by program statute or regulation, follow the cost principles in 45 CFR Part 75 and the standard funding restrictions below.

Guidelines for recipients on financial management requirements are available at https://www.samhsa.gov/grants/grants-management/policies-regulations/financial- management-requirements.

SAMHSA funds may not be used to:
• P urchase, prescribe, or provide marijuana or treatment using marijuana. See, e.g., 45 CFR 75.300(a) (requiring HHS to ensure that Federal funding is expended in full accordance with U.S. statutory and public policy requirements); 21 U.S.C. 812(c)(10) and 841 (prohibiting the possession, manufacture, sale, purchase, or distribution of marijuana).

• Purchase, procure, or distribute pipes or cylindrical objects intended to be used to smoke or inhale illegal scheduled substances.

• Pay for promotional items including, but not limited to, clothing and commemorative items such as pens, mugs/cups, folders/folios, lanyards, and conference bags. (See 45 CFR 75.421(e)(3))

• Pay for the purchase or construction of any building or structure to house any part of the program. Minor alterations and renovations (A&R) may be authorized for up to 25% of a given budget period or $150,000 (whichever is less) for existing facilities, if necessary and appropriate to the project. Minor A&R may not include a structural change (e.g., to the foundation, roof, floor, or exterior or loadbearing walls of a facility, or extension of an existing facility) to achieve the following: Increase the floor area; and/or, change the function and purpose of the facility. All minor A&R must be approved by SAMHSA.

• Provide inpatient treatment or hospital-based detoxification services. Residential services are not considered to be inpatient or hospital-based services.

• P ay for housing other than recovery housing which includes application fees and security deposits.

• Make direct payments to individuals to enter treatment or continue to participate in prevention or treatment services (See 42 U.S.C. § 1320a-7b).

67 Note: A recipient or treatment or prevention provider may provide up to $30 non- cash incentive to individuals to participate in required data collection follow-up.

This amount may be paid for participation in each required follow-up interview.

For programs including contingency management as a component of the treatment program, each individual contingency must be $15 or less in value and clients may not receive contingencies totaling more than $75 per budget period.

• Meals are generally unallowable unless they are an integral part of a conference award or specifically stated as an allowable expense in the NOFO (See https://www.hhs.gov/grants/contracts/contract-policies-regulations/spending-on- food/index.html)

• Purchase firearms.

• General Provisions under Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act Public Law 117-328, Consolidated Appropriations Act, 2021, Division H, Title V, Section 526, notwithstanding any other provision of this Act, no funds appropriated in this Act shall be used to purchase sterile needles or syringes for the hypodermic injection of any illegal drug. Provided, that such limitation does not apply to the use of funds for elements of a program other than making such purchases if the relevant State or local health department, in consultation with the Centers for Disease Control and Prevention, determines that the State or local jurisdiction, as applicable, is experiencing, or is at risk for, a significant increase in hepatitis infections or an HIV outbreak due to injection drug use, and such program is operating in accordance with state and local law.

• Salary Limitation: The Consolidated Appropriations Act, 2023 (Public Law 117- 328), Division H, Title II, Section 202, provides a salary rate limitation. The law limits the salary amount that may be awarded and charged to SAMHSA awards and cooperative agreements. Award funds may not be used to pay the salary of an individual at a rate in excess of Executive Level II, which is $212,100. This amount reflects an individual’s base salary exclusive of fringe and any income that an individual may be permitted to earn outside of the duties to your organization. This salary limitation does not apply to consultants but does apply to subrecipients under a SAMHSA award or cooperative agreement. Note that these or other salary limitations will apply in the following fiscal years, as required by law.

68 Appendix J – Intergovernmental Review (E.O. 12372)
Requirements
States with SPOCs
All SAMHSA programs are covered under Executive Order (EO) 12372, as implemented through Department of Health and Human Services (DHHS) regulation at 45 CFR Part 100. Under this Order, states may design their own processes for reviewing and commenting on proposed federal assistance under covered programs.

Certain jurisdictions have elected to participate in the EO process and have established State Single Points of Contact (SPOCs). Information on the SPOC for participating states can be found at:
https://www.whitehouse.gov/wp-
content/uploads/2020/04/SPOC-4-13-20.pdf
This requirement does not apply to American Indian/Alaska Native tribes or tribal organizations. If your state participates, contact your SPOC as early as possible to alert him/her to the prospective application(s) and to receive any necessary instructions on the state’s review process. For proposed projects serving more than one state, you are advised to contact the SPOC of each affiliated state.

The SPOC should send any state review process recommendations to the following address within 60 days of the application deadline:

Director, Division of Grants Management
Office of Financial Resources,
ATTN: SPOC – Funding Announcement No. SM-23-006
Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Room 17E20
Rockville, MD 20857

States without SPOCs
If your state does not have a SPOC and you are a community-based, non-governmental service provider, you must submit a Public Health System Impact Statement (PHSIS) 13 to the head(s) of appropriate state and local health agencies in the area(s) to be affected no later than the application deadline. The PHSIS is intended to keep state and local health officials informed of proposed health services applications submitted by community-based, non-governmental organizations within their jurisdictions. If you are

13 Approved by OMB under control no. 0920-0428; Public reporting burden for the Public Health System Reporting Requirement is estimated to average 10 minutes per response, including the time for copying the first page of SF-424 and the abstract and preparing the letter for mailing. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is 0920-0428. Send comments regarding this burden to CDC Clearance Officer, 1600 Clifton Road, MS D-24, Atlanta, GA 30333, ATTN: PRA (0920-0428).

69 a state or local government or American Indian/Alaska Native tribe or tribal organization, you are not subject to these requirements.

The PHSIS consists of the following information:
• A copy of the first page of the application (SF-424); and • A summary of the project, no longer than one page in length that provides: 1) a description of the population to be served; 2) a summary of the services to be provided; and 3) a description of the coordination planned with appropriate state or local health agencies.

For SAMHSA awards, the appropriate state agencies are the Single State Agencies (SSAs) for substance abuse and mental health. A listing of the SSAs for substance abuse and the SSAs for mental health can be found on SAMHSA’s website at http://www.samhsa.gov/grants/applying/forms-resources
. If the proposed project falls
within the jurisdiction of more than one state, you should notify all representative SSAs.

Review Section IV of the NOFO carefully to determine if you must include an attachment with a copy of a letter transmitting the PHSIS to the SSA. The letter must notify the state that, if it wishes to comment on the proposal, its comments should be sent no later than 60 days after the application deadline to the following address:

Director of Grants Management
Office of Financial Resources,
ATTN: SSA – Funding Announcement No. SM-23-006
Substance Abuse and Mental Health Services Administration 5600 Fishers Lane, Room 17E20
Rockville, MD 20857

In addition, applicants may request that the SSA send them a copy of any state comments. The applicant must notify the SSA within 30 days of receipt of an award.

70 Appendix K – Administrative and National Policy
If your application is funded, you must comply with all terms and conditions of the NoA.

SAMHSA’s standard terms and conditions are available on the SAMHSA website.

HHS Grants Policy Statement (GPS)
If your application is funded, you are subject to the requirements of the HHS Grants Policy Statement (GPS) that are applicable based on recipient type and purpose of award. This includes any requirements in Parts I and II of the HHS GPS that apply to the award. The HHS GPS is available at
http://www.samhsa.gov/grants/grants-
management/policies-regulations/hhs-grants-policy-statement. T he general terms and conditions in the HHS GPS will apply as indicated unless there are statutory, regulatory, or award-specific requirements to the contrary (as specified in the NoA).

HHS Award Regulations
If your application is funded, you agree that the award and any activities thereunder are subject to all provisions of 45 CFR part 75, currently in effect or implemented during the period of the award, other Department regulations and policies in effect at the time of the award, and applicable statutory provisions. For more information see the SAMHSA website at
http://www.samhsa.gov/grants/grants-management/policies- regulations/requirements-principles.

Additional Terms and Conditions
Depending on the nature of the specific funding opportunity and/or your proposed project as identified during review, SAMHSA may negotiate additional terms and conditions with you prior to award. These may include, for example:
o actions required to be in compliance with confidentiality and participant protection/human subjects requirements.
o requirements relating to additional data collection and reporting. o requirements relating to participation in a cross-site evaluation. o requirements to address problems identified in review of the application or the budget and narrative justification.

Performance Goals and Objectives
If your application is funded, you will be held accountable for the information provided in the application relating to performance targets. SAMHSA program officials will consider your progress in meeting goals and objectives, as well as your failures and strategies for overcoming them, when making an annual recommendation to continue the award and the amount of any continuation award. In addition, you must relate financial data and accomplishments to the performance goals and objectives of the award. Failure to meet stated goals and objectives may result in suspension or termination (see 2 CFR

71 200.202, 2 CFR 200.301 and 2 CFR 200.329) of the award, or in reduction or withholding of continuation awards.

Termination of Federal Award
Note that the OMB revisions to Guidance for Grants and Agreements termination provisions located at 2 CFR § 200.340 - Termination apply to all federal awards effective August 13, 2020.

Accessibility Provisions for All Award Application Packages and Funding Opportunity Announcements
Should you successfully compete for an award, recipients of federal financial assistance (FFA) from HHS will be required to complete an HHS Assurance of Compliance form (HHS 690) in which you agree, as a condition of receiving the grant, to administer your programs in compliance with federal civil rights laws that prohibit discrimination on the basis of race, color, national origin, age, sex, and disability, and agreeing to comply with federal conscience laws, where applicable. This includes ensuring that entities take meaningful steps to provide meaningful access to persons with limited English proficiency; and ensuring effective communication with persons with disabilities. Where applicable, Title XI and Section 1557 prohibit discrimination on the basis of sexual orientation, and gender identity, the HHS Office for Civil Rights provides guidance on complying with civil rights laws enforced by HHS. See https://www.hhs.gov/civil- rights/for-providers/provider-obligations/index.html and https://www.hhs.gov/civil- rights/for-individuals/nondiscrimination/index.html.

You will administer your project in compliance with federal civil rights laws that prohibit discrimination on the basis of race, color, national origin, disability, age, and comply with applicable conscience protections. You will comply with applicable laws that prohibit discrimination on the basis of sex, which includes discrimination on the basis of gender identity, sexual orientation, and pregnancy. Compliance with these laws require taking reasonable steps to provide meaningful access to persons with limited English proficiency and providing programs that are accessible to and usable by persons with disabilities. The HHS Office for Civil Rights provides guidance on complying with civil rights laws enforced by HHS. See
https://www.hhs.gov/civil-rights/for-
providers/provider-obligations/index.html and https://www.hhs.gov/civil-rights/for- individuals/index.html.
• For guidance on meeting your legal obligation to take reasonable steps to ensure meaningful access to your programs or activities by limited English proficient individuals, see
https://www.hhs.gov/civil-rights/for-
individuals/special-topics/limited-english-proficiency/fact-sheet- guidance/index.html and https://www.lep.gov.

• For information on your specific legal obligations for serving qualified individuals with disabilities, including providing program access, reasonable

72 modifications, and to provide effective communication, see https://www.hhs.gov/ocr/civilrights/understanding/disability/index.html • HHS funded health and education programs must be administered in an environment free of sexual harassment, see
https://www.hhs.gov/civil-
rights/for-individuals/sex-discrimination/index.html.
• For guidance on administering your project in compliance with applicable federal religious nondiscrimination laws and applicable federal conscience protection and associated antidiscrimination laws, see
https://www.hhs.gov/conscience/conscience-protections/index.html and
https://www.hhs.gov/conscience/religious-freedom/index.html.

Acknowledgement of Federal Funding
As required by HHS appropriations acts, all HHS recipients must acknowledge Federal funding when issuing statements, press releases, publications, requests for proposal, bid solicitations, and other documents, such as tool-kits, resource guides, websites, and presentations describing the projects or programs funded in whole or in part with HHS federal funds. The recipient must clearly state: 1) the percentage and dollar amount of the total costs of the program or project funded with federal money; and 2) the percentage and dollar amount of the total costs of the project or program funded by non-governmental sources.

Supplement Not Supplant
Funds may be used to supplement existing activities. Award funds may not be used to supplant current funding of existing activities. “Supplant” is defined as replacing funding of a recipient’s existing program with funds from a federal award (2 CFR Part 200, Appendix XI).

Mandatory Disclosures
A term may be added to the NoA which states: Consistent with 45 CFR 75.113, applicants and recipients must disclose in a timely manner, in writing to the HHS awarding agency, all information related to violations of federal criminal law involving fraud, bribery, or gratuity violations potentially affecting the federal award. Sub- recipients must disclose, in a timely manner, in writing to the prime recipient (pass through entity), all information related to violations of federal criminal law involving fraud, bribery, or gratuity violations potentially affecting the federal award. Disclosures must be sent in writing to SAMHSA at the following address:

SAMHSA
Attention: Office of Financial Advisory Services
5600 Fishers Lane
Rockville, MD 20857

73 You may also submit a complaint via the OIG Hotline online form (see https://oig.hhs.gov/fraud/report-fraud/), by phone (1-800-447-8477),or by mail to the following address:

U.S. Dept. of Health and Human Services
Office of the Inspector General
ATTN: OIG Hotline Operations
P.O. Box 23489
Washington, DC 20026

Failure to make required disclosures can result in any of the remedies described in 45 CFR 75.371 Remedies for noncompliance; including suspension or debarment (See 2 CFR parts 180 & 376 and 31 U.S.C. 3321).”
System for Award Management (SAM) Reporting
A term may be added to the NoA that states: “In accordance with the regulatory requirements provided at 45 CFR 75.113, 2 CFR 25, and Appendix XII to 45 CFR Part 75, recipients that have currently active federal awards and procurement contracts with cumulative total value greater than $10,000,000, must report and maintain information in the System for Award Management (SAM)
about civil, criminal, and administrative
proceedings in connection with the award or performance of a federal award that reached final disposition within the most recent five-year period. The recipient also must make semiannual disclosures regarding such proceedings. Proceedings information will be made publicly available in the designated integrity and performance system (currently the Federal Awardee Performance and Integrity Information System (FAPIIS)). Full reporting requirements and procedures are found in Appendix XII to 45 CFR Part 75.”
Drug-Free Workplace
A term may be added to the NoA that states: “You as the recipient must comply with drug-free workplace requirements in Subpart B of part 382, which adopts the Government-wide implementation (2 CFR part 182) of section 5152-5158 of the Drug- Free Workplace Act of 1988 (Pub. L. 100-690, Title V, Subtitle D; 41 U.S.C. 701-707).” Smoke-Free Workplace
The Public Health Service strongly encourages all award recipients to provide a smoke- free workplace and to promote the non-use of all tobacco products. Further, 20 USC 6081 et seq., the Pro-Children Act of 1994, prohibits smoking in certain facilities (or in some cases, any portion of a facility) in which regular or routine education, library, day care, health care or early childhood development services are provided to children.

Standards for Financial Management

74 Recipients and subrecipients are required to meet the standards and requirements for financial management systems set forth in 45 CFR part 75 Subpart D. The financial systems must enable the recipient and subrecipient to maintain records that adequately identify the sources of funds for federally assisted activities and the purposes for which the award was used, including authorizations, obligations, unobligated balances, assets, liabilities, outlays or expenditures, and any program income. The system must also enable the recipient and subrecipient to compare actual expenditures or outlays with the approved budget for the award. SAMHSA funds must retain their award/subaward- specific identity and may not be commingled with non-federal funds or other federal funds. “Commingling funds” typically means depositing or recording funds in a general account without the ability to identify each specific source of funds with related expenditures. Common mistakes related to comingling are outlined below:

• Commingling of Cost Centers: Every business activity constitutes a cost center. Examples of cost centers include: a federal award, a state award, a private award, matching costs for a specific award, a self-funded project, fundraising activities, membership activities, lines of business, unallowable costs, indirect costs, etc. Recipients and subrecipients must establish a unique account(s) in the accounting system to capture and accumulate expenditures of each cost center, apart from other cost centers.
• Commingling of Cost Categories: Recipients and subrecipients must avoid budget fluctuations that violate programmatic restrictions. They must also avoid applying indirect cost rates to prohibited cost categories, such as equipment, participant support costs and subcontracts/subawards in excess of $25,000. As a result, recipients must establish unique object codes in the accounting system to capture and 59 accumulate costs by budget category (i.e., salaries, fringe benefits, consultants, travel, participant support costs, subcontracts, etc.). • Commingling of Time Worked and Not Worked: Recipients and subrecipients may not directly charge an award for employees’ time not spent working on the award. Therefore, Paid Time Off (PTO), such as vacation, holiday, sick and other paid leave, is not recoverable directly from awards, but rather must be allocated to all awards, projects, and cost centers over an entire cost accounting period through either an indirect cost or fringe benefit rate. • Unsupported Labor Costs: To support charges for direct and indirect salaries and wages, recipients and subrecipients maintaining hourly timesheets must ensure that timesheets encompass all hours worked and not worked on a daily basis. The timesheet should identify the: (a) award, project or cost center being worked on; (b) number of hours worked on each; (c) description of work performed; and (d) Paid Time Off (PTO) hours. The total hours recorded each day should coincide with an individual’s employment status in accordance with established policy (i.e., fulltime employees work 8 hours each day, etc.). • Inconsistent Treatment of Costs: Recipients and subrecipients must treat costs consistently across all federal and non-federal awards, projects, and cost centers. For example, recipients and subrecipients may not direct-charge federal awards for costs typically considered indirect in nature, unless done consistently.

75 Examples of indirect costs include administrative salaries, office rent, accounting fees, utilities, etc. Additionally, in most cases, the cost to develop an accounting system adequate to justify direct charging of the aforementioned items outweighs the benefits. As a result, use of an indirect cost rate is the most effective mechanism to recover these costs and not violate federal financial requirements of consistency, allocability and allowability. If typical indirect cost categories are included in the budget as direct costs, it is SAMHSA’s understanding that the recipient or subrecipient has developed a cost accounting system that can withstand audit scrutiny and therefore the system must be adequate to justify the direct charges and to avoid an unfair allocation of these costs to the federal government. All costs are subject to subsequent agency review and/or audit scrutiny in accordance with awards’ terms and conditions.

Trafficking in Persons
Awards issued by SAMHSA are subject to the requirements of 2 CFR part 175 and 22 USC 7104(g). For the full text of the award term, go to http://www.samhsa.gov/grants/grants-management/notice-award-noa/standard-terms- conditions.

NOTE: The signature of the AOR on the application serves as the required certification of compliance for your organization regarding the administrative and national policy requirements.

Publications
Recipients are required to notify the Government Project Officer (GPO) of any materials based on the SAMHSA-funded project that are accepted for publication. In addition, SAMHSA requests that recipients:
• Provide the GPO with advance copies of publications.
• Include acknowledgment of the SAMHSA program as the source of funding for the project.
• Include a disclaimer stating that the views and opinions contained in the publication do not necessarily reflect those of SAMHSA or the U.S.

Department of Health and Human Services and should not be construed as such.

SAMHSA reserves the right to issue a press release about any publication deemed by SAMHSA to contain information of program or policy significance to the substance use treatment/substance use prevention/mental health services community.

Prohibition on Certain Telecommunications and Video Surveillance Services or Equipment

76 As described in 2 CFR 200.216, recipients and subrecipients are prohibited to obligate or spend award funds (to include direct and indirect expenditures as well as cost share and program) to:
(1) Procure or obtain,
(2) Extend or renew a contract to procure or obtain; or (3) Enter into contract (or extend or renew contract) to procure or obtain equipment, services, or systems that use covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. As described in Pub. L. 115-232, section 889, covered telecommunications equipment is telecommunications equipment produced by Huawei Technologies Company or ZTE Corporation (or any subsidiary or affiliate of such entities).
i. For the purpose of public safety, security of government facilities, physical security surveillance of critical infrastructure, and other national security purposes, video surveillance and telecommunications equipment produced by Hytera Communications Corporation, Hangzhou Hikvision Digital Technology Company, or Dahua Technology Company (or any subsidiary or affiliate of such entities).
ii. Telecommunications or video surveillance services provided by such entities or using such equipment.
iii. Telecommunications or video surveillance equipment or services produced or provided by an entity that the Secretary of Defense, in consultation with the Director of the National Intelligence or the Director of the Federal Bureau of Investigation, reasonably believes to be an entity owned or controlled by, or otherwise, connected to the government of a covered foreign country.

77 Appendix L – Sample Budget and Justification
All applications must have a detailed budget justification and narrative that explains the federal and the non-federal expenditures broken out by the object class cost categories listed on SF-424A − Section B (Budget Category) for non-construction awards. • The detailed budget must match the costs identified on the SF-424A and the total costs on the SF-424.
• The Budget Narrative and justification must be consistent with and support the Project Narrative.

• The Budget Narrative and justification must be concrete and specific. It must provide a justification for the basis of each proposed cost in the budget and how that cost was calculated. Examples to consider when justifying the basis of your estimates can be ongoing activities, market rates, quotations received from vendors, or historical records. The proposed costs must be reasonable, allowable, allocable, and necessary for the supported activity. • NOFOs invite applications for periods of performance of one to up to five years.

Generally, awards, on a competitive basis, will be for a one-year budget period but the period of performance may be up to five years. Submission and SAMHSA approval of the progress report(s) and any other required submission or reports is the basis for the budget period renewal and release of subsequent year funds. Funding beyond the one-year budget period but within the multi-year period of performance is subject to availability of funds and satisfactory progress of the recipient. Progress will be evaluated by submission of data on required performance measures, satisfactory achievement of identified goals and objectives, providing services to the projected number of individuals specified in the application, and satisfactory resolution of barriers and challenges that arise in the implementation of the project.
• Refer to the program specific Funding Restrictions/Limitations and the Standard Funding Restrictions in the NOFO, as well as to 45 CFR Part 75 (https://www.ecfr.gov/cgi-bin/text-idx?node=pt45.1.75
, for applicable
administrative requirements and cost principles.

SAMHSA Budget Template
To expedite review of your application, it is highly recommended you use the following PDF budget template to complete the Detailed Budget and Narrative Justification for submission with your application:
• The budget template can be found on the SAMHSA Forms and Resources webpage – scroll down to “SAMHSA Budget Template” section. You must

78 download the budget template PDF to your computer first before opening it directly in Adobe Acrobat or Acrobat Reader (not your internet browser):

1. Right-click the link "SAMHSA Budget Template (PDF)"

2. Select "save link as" and save to a location on your computer

3. Go to the saved location and open the "SAMHSA Budget Template (PDF)" using Adobe Acrobat or Acrobat Reader.

Guidance

The following documents provide guidance on using the budget template:
• Key Features of the Budget Template
• Budget Template Users Guide
• Budget Review Checklist – use this checklist to review your detailed budget and narrative justification before submission to SAMHSA.

Note: For SAMHSA to view all of your budget data, you must convert the PDF to a non- editable format by PRINTING TO PDF before submission.

Sample Budgets
The following PDFs are samples of detailed budgets and narrative justification:
• Sample SF-424 - New Awards (PDF | 1.3 KB)
• Sample Budget – NON-MATCH (PDF | 697 KB)
• Sample Budget – MATCH (PDF |729 KB)
Completing the SF-424A (see Section IV)
Budget Cost Categories
Personnel Costs: Explain personnel costs by listing each staff member who will be working directly on the award by name (if possible), position title, percentage level of effort or proposed hours and annual salary. Award funds may not be used to pay the salary of an individual at a rate in excess of Executive Level II or $212,100. An individual's base salary, per se, is NOT constrained by the statutory provision for a limitation of salary. The rate limitation simply limits the amount that may be awarded and charged to SAMHSA awards and cooperative agreements. The salary limitation does not apply to consultants but does apply to all subawards and subcontracts.

79 Note: If an organization is selected for an award and chooses to move forward with hiring an individual for a Key Personnel position before receiving SAMHSA’s formal approval, this will be done at the organization’s own risk. If SAMHSA’s review of the Key Personnel request results in the proposed individual not being approved or deemed not qualified for the position, the expectation is that the organization must submit a qualified candidate to be placed in the Key Personnel position. SAMHSA will not be liable for any costs incurred or pay for salaries of a Key Personnel that is not approved or deemed not qualified for the program.

Fringe Benefits: Fringe benefits typically include items, such as health insurance, taxes, unemployment insurance, life insurance, retirement plans, tuition reimbursement and paid absences. Fringe benefits are recoverable in accordance with an organization’s federally approved indirect cost rate agreement, if applicable, or the organization’s accounting practices, provided those practices are consistent with federal cost principles and result in a fair and equitable allocation of fringe benefits.

Travel: Li
st travel cos ts according to local and long-distance travel. For local travel, outline the mileage rate, number of miles, reason for travel and staff member/consumers completing the travel. The budget should also reflect the travel expenses (e.g., airfare, lodging, parking, per diem, etc.) for each person and trip associated with participating in meetings and other proposed trainings or workshops.

Name the traveler(s) if possible, describe the purpose of the travel, provide number of trips involved, the destinations, and the number of individuals for whom funds are requested.

Equipment: Li
st equipment costs and provide justification for the need of the equipment to carry out the program’s goals. Extensive justification and a detailed status of current equipment must be provided when requesting funds for the purchase of items that meet the definition of equipment (a unit cost of $5,000 or more and a useful life of one or more years). For example, large items of medical equipment.

Supplies: Include the programmatic items necessary to implement the proposed project (e.g., examination gloves, etc.). Conversely, general office supplies (e.g., paper, pencils, etc.) should be recovered through a federally-approved indirect cost rate or de minimis rate.

Per 45 CFR § 75.321, property will be classified as supplies if the acquisition cost is under $5,000. Note that items such as laptops, tablets, and desktop computers are classified as a supply if the value is under the $5,000 equipment threshold.

Vendor Contracts/Subawards & Subcontracts/Consortiums/Consultants: Provide a clear explanation as to the purpose, the basis for how costs were estimated, and the specific deliverables. You are responsible for ensuring that your organization has adequate procurement and merit review systems with fully developed written procedures for awarding and monitoring vendor contracts and subawards/subcontracts, respectively.

Recipients must notify potential subrecipients to register in SAM and provide the

80 recipient with their UEI number (see 2 CFR part 25). For consultant services, list the total costs for all consultant services. In the budget narrative, identify each consultant, the services he/she will perform, total number of days, travel costs, and total estimated costs.

Note: To assist with classifying costs and relationships, note that vendor contracts are for the purpose of obtaining goods and services (i.e., examination gloves provided by a medical supply company). Conversely, subawards/subcontracts are for the purpose of carrying out a portion of a federal award (i.e., a health care clinic providing substance use treatment services directly to patients). Your organization must ensure proper classification of costs and relationships. For subrecipient relationships, your organization must ensure written subaward/subcontract agreements are in place.

These written agreements must require that subrecipients comply with the same terms and conditions as the prime recipient, as applicable (i.e., financial management requirements, audit requirements, etc.) In other words, the requirements imposed on the prime recipient must “flow down” to subrecipients. Written agreements should also describe the scope of work, deliverables, etc.

Other: Include all costs that do not fit into any other category and provide an explanation of each cost in this category (e.g., provider licenses, dedicated space rental, etc.).

Indirect Costs: Indirect costs are those costs incurred for common or joint objectives which cannot be readily and specifically identified with a particular project or program but are necessary to the operations of the organization, e.g., the cost of operating and maintaining facilities, depreciation, and administrative salaries. For some institutions, the term “facilities and administration” (F&A) is used to denote indirect costs.

Applicants may request full indirect costs, subject to statutory and regulatory limitations.

Applicants may request full indirect costs, subject to statutory and regulatory limitations, and submission of an approved Negotiated Indirect Cost Rate Agreement (NICRA) established by the cognizant Federal agency (typically the agency that provides the most funds). If indirect costs are claimed, a copy of the NICRA must be submitted with the application. If unable to obtain a NICRA from the cognizant agency at the time of application, the applicant may elect to recover indirect costs using a de minimis rate as explained below. Otherwise, the applicant may only be reimbursed for allowable direct costs. Violation of cost accounting principles is not permitted when re-budgeting or charging costs to awards. Rather, costs must be consistently charged as either indirect or direct costs.

Applicants may elect a 10% de minimis indirect cost rate, subject to statutory and regulatory limitations.

Applicants who cannot obtain a NICRA from their cognizant Federal agency at the time of application may elect a 10% de minimis rate, subject to statutory and regulatory limitations.

81 The 10% de minimis rate may be used indefinitely and should be applied to Modified Total Direct Costs (MTDC). MTDC means all direct salaries and wages, applicable fringe benefits, materials and supplies, services, travel, and up to the first $25,000 of each subaward (regardless of the period of performance of the subawards under the award.) MTDC excludes equipment, capital expenditures, charges for patient care, rental costs, tuition remission, scholarships and fellowships, participant support costs and the portion of each subaward in excess of $25,000. Violation of cost accounting principles is not permitted when charging costs to awards. Rather, costs must be consistently charged as either direct or indirect costs. Additionally, once elected, the 10% de minimis rate must be applied to all existing awards. If the cognizant agency issues a NICRA subsequent to the award, the negotiated rate may not be retroactively applied.

Waived Indirect Costs – An applicant may elect not to request recovery of indirect costs.

If so, the applicant should write None Requested in the same space allotted for Item J of the budget sheet.

ITEM # 24
APPROVAL OF MINUTES: FEBRUARY 27, 2023 SPECIAL CITY COUNCIL MEETING; MARCH 1, 2023 SPECIAL CITY COUNCIL MEETING; MARCH 13, 2023

SPECIAL CITY COUNCIL MEETING

CITY OF MONTEBELLO

SPECIAL CITY COUNCIL MEETING AGENDA

MINUTES
MONDAY, FEBRUARY 27, 2023 AT 6:00 PM

CITY HALL COUNCIL CHAMBERS
1600 WEST BEVERLY BOULEVARD

MONTEBELLO, CALIFORNIA

OPENING CEREMONIES
CALL TO ORDER - 6:00 P.M.

Mayor Torres called the meeting to order at 6:03 p.m.

ROLL CALL
Members present were Councilmember Melendez, Councilmember Tamayo, Mayor Pro Tem Peralta, and Mayor Torres.

Councilmember Jimenez arrived at 6:11 p.m. City Clerk Jimenez and Treasurer Matanga were also present.

City Attorney Arnold Alvarez-Glasman, Assistant City Manager Arlene Salazar, Director of Planning and Community Development Joseph Palombi, and Deputy City Clerk Kimberly Guillen.

PUBLIC COMMENTS ON AGENDA ITEMS ONLY (30 MINUTES)
At this time, the general public may only address the City Council during this Special Meeting on items which have been described in the notice of this Special meeting in accordance with Government Code Section 54954.3(a). Please be aware that the maximum time allotted for members of the public to speak on shall not exceed three (3) minutes per person. State Law prohibits the City Council from taking action or entertaining extended discussion on a topic not listed on the agenda.

Please show courtesy to others and direct all of your comments to the Mayor.

Mayor Torres stated that the Public Comment Portion would be a dialogue and that participants would have an opportunity to come up to the podium to speak after the Public Comment Section for additional comments.

The City Clerk’s Office acknowledged six (6) speaker card(s) submitted to the City Clerk's Office. Said speaker card(s) are on file at the City Clerk’s office.

REGULAR SESSION
DRAFT

February 27, 2023: City Council Meeting Minutes Page 2 of 3

CORRECTIONS TO THE AGENDA CITY MANAGER

None.

REGULAR BUSINESS

1. REVIEW OF BROWNFIELD OVERLAY DISTRICT

RECOMMENDATION: It is recommended that the City Council:

1. Receive and file.

2. Take such additional, related action that may be desirable.

Director of Planning and Community Development Joseph Palombi provided a PowerPoint presentation on the item.

The presentation covered the current areas of concern; potential damage; maps of the area; the history associated with the Brownfield Area, and objectives for future actions.

Councilmember Jimenez stated that the City should work with a consultant to understand how the City can come to a conclusion to asses the issue and help the residents and businesses affected by the issue. She believes that the residents in the southern area are not aware of what is going on.

Councilmember Melendez thanked everyone who attended the meeting and asked staff if they could clarify what issues could arise from the contaminated land. He further suggested townhall meetings in the southern area to invite the residents and business owners to discuss how to mitigate the issue.

Director Palombi stated that he was not qualified to provide clarification.

Councilmember Tamayo expressed the importance of working with businesses, residents, and the regulating agencies.

Mayor Pro Tem Peralta thanked the staff and the residents for participating in the study session.

Mayor Torres thanked everyone who was involved in understanding the history and current status. Mayor Torres asked clarifying questions, including describing a pre-regulation closed landfill, and the grant funding that was awarded to the City to study the area. Director Palombi provided clarification.

Mayor Torres asked a member of the audience, Mark Cousino, Hazard Management Consultant, clarifying questions regarding quarterly reviews conducted by Los Angeles County. Mr. Cousino provided clarification.

Mayor Torres asked if there was a representative from the Regulatory Agencies - State or Federal Office. Assistant City Manager Salazar stated that there was not.

Mayor Torres welcomed any additional comments from members of the public.

One (1) member of the public made additional comments based on the presentation provided, said speaker card is on file in the City Clerk's Office.

City Attorney Alvarez-Glasman stated that his office sent out correspondence to every business owner in the district to provide outreach for further review and analysis.

Mayor Torres suggested to any regulatory agencies that were watching to comment on the issue. Mayor Torres directed staff to create an RFP for Council consideration to understand what an analysis would entail.

Councilmember Jimenez motioned, seconded by Mayor Pro Tem Peralta to approve Mayor Torres's direction. The motion was approved unanimously.

ADJOURNMENT
The City of Montebello will adjourn to a Special City Council Meeting scheduled on Wednesday, March 1, 2023 at 6:00 p.m. which can be live streamed at https://www.montebelloca.gov (Click on Live Stream).

DRAFT

February 27, 2023: City Council Meeting Minutes Page 3 of 3

Date and Posted: February 23, 2023 at 3:00 p.m.

I, Alicia Fernandez, Sr. Deputy City Clerk for the City of Montebello hereby certify that the foregoing Notice of the Special Meeting was posted at City Hall and the City’s website and delivered to each member of the City of Montebello City Council no less than 24-hours before the start of the Special Meeting.

Alicia Fernandez, Sr. Deputy City Clerk

Mayor Pro Tem Peralta motioned, seconded by Councilmember Melendez to adjourn the meeting at 7:00 p.m.

THE MINUTES OF FEBRUARY 27, 2023 ARE HEREBY APPROVED AND ADOPTED ON THIS 10TH DAY OF MAY 2023.

DRAFT

DRAFT

AMENDED AGENDA

CITY OF MONTEBELLO

SPECIAL CITY COUNCIL MEETING AGENDA

MINUTES

WEDNESDAY, MARCH 1, 2023 AT 6:00 PM

CITY HALL COUNCIL CHAMBERS
1600 WEST BEVERLY BOULEVARD

MONTEBELLO, CALIFORNIA

OPENING CEREMONIES

CALL TO ORDER - 6:00 P.M.

Mayor Torres called the meeting to order at 6:06 p.m.

ROLL CALL

Members present were Mayor Torres, Mayor Pro Tem Peralta, Councilmember Melendez, Councilmember Tamayo; Treasurer Matanga was also present. Councilmember Jimenez arrived at 6:11 p.m. and City Clerk Jimenez was absent.

PUBLIC COMMENTS ON AGENDA ITEMS ONLY (30 MINUTES)
At this time, the general public may only address the City Council during this Special Meeting on items which have been described in the notice of this Special meeting in accordance with Government Code Section 54954.3(a). Please be aware that the maximum time allotted for members of the public to speak on shall not exceed three (3) minutes per person. State Law prohibits the City Council from taking action or entertaining extended discussion on a topic not listed on the agenda.

Please show courtesy to others and direct all of your comments to the Mayor.

The City Clerk’s Office acknowledged eight (8) speaker card(s) submitted to the City Clerk. Said speaker card(s) are on file at the City Clerk’s office.

CLOSED SESSION

Mayor Torres recessed the meeting into Closed Session at 6:36 p.m. to consider the following Closed Session items:

1. PUBLIC EMPLOYEE PERFORMANCE EVALUATION
Government Code Section 54957
Title: City Manager

DRAFT
March 1, 2023: City Council Meeting Minutes Page 2 of 3

REGULAR SESSION

CLOSED SESSION REPORT

Mayor Torres reconvened the meeting at 6:50 p.m.

All five members were present to discuss the Closed Session item. The City Attorney provided the following report to City Council: a briefing was provided on Item No. 1, no action taken and nothing to report.

CORRECTIONS TO THE AGENDA - CITY MANAGER

None.

REGULAR BUSINESS - IMMEDIATELY FOLLOWING CLOSED SESSION

2. DRAFT GENERAL PLAN

RECOMMENDATION: It is recommended that the City Council:

1. Receive and file.

2. Take such additional, related action that may be desirable.

Director Joseph Palombi provided some context of the Draft General Plan and introduced Mr. Kaiser Rangwala to provide a presentation to the City Council. The presentation included the General Plan Housing Element update, the Downtown Specific Plan, visual renderings of the City, and the fiscal element of the plan. Mr. Rangwala was available to answer any questions.

Mayor Torres asked if a policy could be drafted for residents to apply to be a historic site and offered suggestions of some historical sites in Montebello. Mr. Rangwala noted he would consult with their historical consultant to consider Mr. Torres suggestions.

Councilmember Jimenez motioned to receive and file this item, seconded by Mayor Pro Tem Peralta; the motion was approved unanimously.

3. DOWNTOWN MONTEBELLO SPECIFIC PLAN

RECOMMENDATION: It is recommended that the City Council:

1. Receive and file.

2. Take such additional, related action that may be desirable.

Councilmember Jimenez motioned to receive and file this item, seconded by Mayor Pro Tem Peralta; the motion was approved unanimously.

ADJOURNMENT
The City of Montebello will adjourn to the next Regular Meeting on Wednesday, March 8, 2023, at 6:00 p.m. which can be live streamed at https://www.montebelloca.gov (Click on Live Stream).

I, Alicia Fernandez, Sr. Deputy City Clerk for the City of Montebello hereby certify that the foregoing Notice of the Special Meeting was posted at City Hall and the City’s website and delivered to each member of the City of Montebello City Council no less than 24-hours before the start of the Special Meeting. Date and Posted: February 28, 2023 by 4:00 p.m.

Alicia Fernandez, Sr. Deputy City Clerk

DRAFT
March 1, 2023: City Council Meeting Minutes Page 3 of 3

Mayor Pro Tem Peralta motioned, seconded by Councilmember Tamayo to adjourn the meeting at 8:14 p.m.

THE MINUTES OF MARCH 1, 2023. ARE HEREBY APPROVED AND ADOPTED ON THIS 10TH DAY OF MAY 2023

SPEAKER CARDS

AMENDED AGENDA

CITY OF MONTEBELLO

SPECIAL CITY COUNCIL MEETING AGENDA

MINUTES
MONDAY, MARCH 13, 2023 AT 6:00 PM

CITY HALL COUNCIL CHAMBERS
1600 WEST BEVERLY BOULEVARD

MONTEBELLO, CALIFORNIA
TELECONFERENCE LOCATION FOR MAYOR PRO TEM PERALTA:
1027 SHIELA CT.

MONTEBELLO, CA 90640

OPENING CEREMONIES
CALL TO ORDER - 6:00 P.M.

Mayor Torres called the meeting to order at 6:09 p.m.

ROLL CALL
Members present were Mayor Torres, Councilmember Melendez, Councilmember Tamayo, and Mayor Pro Tem Peralta joined via teleconference. Councilmember Jimenez arrived at 6:14 p.m. City Clerk Jimenez and Treasurer Matanga were also present.

City Attorney Arnold Alvarez-Glasman, Assistant City Manager Arlene Salazar, and Deputy City Clerk Kimberly Guillen.

PUBLIC COMMENTS ON AGENDA ITEMS ONLY (30 MINUTES)
At this time, the general public may only address the City Council during this Special Meeting on items which have been described in the notice of this Special meeting in accordance with Government Code Section 54954.3(a). Please be aware that the maximum time allotted for members of the public to speak on shall not exceed three (3) minutes per person. State Law prohibits the City Council from taking action or entertaining extended discussion on a topic not listed on the agenda.

Please show courtesy to others and direct all of your comments to the Mayor.

The City Clerk’s Office acknowledged one (1) member(s) of the public wishing to address the City Council. Speaker(s) were provided three minutes to address the City Council and said speaker card(s) are on file at the City Clerk’s office.

DRAFT

March 13, 2023: City Council Meeting Minutes Page 2 of 5

REGULAR SESSION

CORRECTIONS TO THE AGENDA - CITY MANAGER

None

REGULAR BUSINESS

1. STUDY SESSION TO ESTABLISH RULES OF ORDER OF THE CITY COUNCIL/AGENCY MEETINGS

RECOMMENDATION: It is recommended that the City Council:

1. Review the attached draft City Council/Agency Meeting Rules of Order Handbook; and

2. Discuss and establish new rules of order of the City Council/Agency meetings and incorporate the same into a Rules of Order Handbook or by modifying Resolution No. 23-17, or both; and

3. Take such additional, related action that may be desirable.

Mayor Torres spoke about the procedures for Council Meetings that are being proposed. He provided a background on how the item came about and informed the Council that they would review each section.

Under Section II. City Council/ Agency Meetings and Agenda Materials - A. Regular Meetings, Mayor Torres stated that Council suggests that Regular Business start at 7 p.m. Additionally, Mayor Torres asked if the Agenda could be posted five business days before the meeting.

Assistant City Manager Salazar stated that it would not be feasible. City Attorney Alvarez-Glasman agreed and further stated that it takes time to review the reports.

Mayor Pro Tem Peralta stated that if staff cannot post five business days prior, then perhaps the Council should receive a copy of the draft agenda. Mayor Pro Tem Peralta suggested receiving copies of draft staff reports for voluminous items.

Assistant City Manager Salazar stated she felt uncomfortable providing draft documents. She suggested providing attachments in advance.

Under Section II. Time and Place of Council/Agency Meetings - C. Broadcasting of Meetings, Mayor Torres suggested adding YouTube Channel.

Under Section II. Time and Place of Council/Agency Meetings - D. Canceled Meetings, Assistant City Manager Salazar suggested considering going dark for the first meeting in July due to the Independence Day Holiday. The Council agreed with the consideration.

Under Section II. Time and Place of Council/Agency Meetings - E. Agenda Materials, Mayor Torres suggested adding presentations to be available on the City website and during the meeting for the public to follow along. He suggested a QR Code for the public to scan and view the presentations on their phone.

Assistant City Manager Salazar informed the Council that the Staff is looking into digital readers to install around City Hall to post all the materials. She further stated that Staff would look into different options.

Under Section II. Time and Place of Council/Agency Meetings - E. Agenda Materials - 1. Emergency Situation, Mayor Torres asked the City Attorney Alvarez for clarification on the Government Code § 54956.5 for taking action on items not listed on the agenda.

Under Section II. Time and Place of Council/Agency Meetings - E. Agenda Materials - 3. Held Over Items, Assistant City Manager Salazar requested Council clarification. She asked if this section was for particular items that meet all the criteria listed in the Resolution or for Walk-On Items.

Mayor Torres provided clarification, and City Attorney Alvarez-Glasman confirmed.

Assistant City Manager Salazar recommended a time limit for the Closed Session Public Comment Period.

DRAFT

March 13, 2023: City Council Meeting Minutes Page 3 of 5

Mayor Torres confirmed with City Attorney Alvarez that the Council could increase the comment period if needed.

Under Section 6. Order of Business; Mayor Torres stated that the order would now allow the public to pull items on the agenda to provide comments.

Under Section IV. Placement of Items on the City Council Meeting Agenda - C. Tentative Council Calendar, Mayor Torres asked Assistant City Manager Salazar to identify a reasonable time for forecasting and requested that the calendar shall be included in the agenda packet.

Assistant City Manager Salazar informed the Council that perhaps three upcoming Council Meeting Agendas stated that they would be added once adopted.

Mayor Torres asked that the Resolution be updated to reflect that.

Under Section IV. Placement of Items on the City Council Meeting Agenda - D. Consent Calendar Categories, Assistant City Manager Salazar asked Mayor Torres to clarify what is considered a high dollar value.

Mayor Torres stated that they would add that clarification and would also define a controversial item.

Under Section IV. Placement of Items on the City Council Meeting Agenda - D. Consent Calendar Categories - 1.

Ordinances, Resolutions, and Contracts, Assistant City Manager Salazar informed the Council that not all resolutions could be prepared by the City Attorney's Office. Some are prepared by the state to apply for grants and to meet their criteria.

Mayor Torres suggested updating the Resolution to reflect current practice, reviewed by the City Attorney's office.

Under Section V. General Requirements - A. Attendance; Assistant City Manager Salazar stated that there had been several occasions when Department Heads have been asked not to attend because they did not have an item for consideration.

Mayor Torres stated that it would be accepted as an approved absence for Department Heads in those cases.

Under Section V. General Requirements - C. Teleconference Attendance of Council/ Agency Members at Meetings, Mayor Torres suggested adding the new legislative provisions stating that the Council can miss up to two meetings due to an emergency. He further suggested adding language that explains bullet point 1 for posting the regular and special agendas at teleconferencing locations.

Assistant City Manager Salazar suggested that in lieu of faxing, staff could use a digital platform to send the agenda.

Under Section V. General Requirements - E. Closed Session, Mayor Torres stated that the references are very vague and suggested adding case numbers, names, and agreements.

Section V. General Requirements - F. Ceremonial Items and Presentations, Mayor Torres suggested reintroducing the Nationally Recognized Health and Heritage Months. He asked staff to begin including the ceremonial items in April.

Assistant City Manager Salazar confirmed.

Section V. General Requirements - G. Preparation of Minutes, Mayor Torres referenced the Minutes from September 14, 2022, Council Meeting and asked staff if it was possible to include light summaries of what occurred during the meeting.

Assistant City Manager Salazar informed Mayor Torres that staff would have to take a look at the minutes he referenced.

She further stated that the City Clerk's office would require more assistance to include light summaries.

Section V. General Requirements - H. Voting Procedures, Mayor Torres stated that Council should not abstain from a vote to avoid voting on an item.

Section V. General Requirements - H. Voting Procedures - 6. Disqualification for Conflict of Interest, City Attorney Alvarez- Glasman stated that they would draft a map indicating where there is any potential for conflict of interest to provide clarity for the City Clerk's Office. Additionally, indicate when Council should recuse themselves from voting.

DRAFT

March 13, 2023: City Council Meeting Minutes Page 4 of 5

Section V. General Requirements - J. Channel Communications through the Appropriate Senior City Staff, Assistant City Manager Salazar suggested changing the point of contact to the City Manager, Assistant City Manager and copied to Department Director. She further stated that the Deputy City Clerk has no role in that, and they respond to the City Manager, not the City Clerk.

Section VI. Public Comments - A. Public Comment/ Non-Agenda Matters, Mayor Torres stated that there was a request from staff to suggest a cut-off time to create order. City Clerk Jimenez suggested setting the deadline after reading the Statement of Oral Communications. Mayor Torres agreed to make that change.

Section VI. Public Comments - E. Written Comments, City Attorney Alvarez stated that regarding land use matters, the Council should consider accepting written comments. However, they do not have to be read aloud, only accepted into the record. Mayor Torres agreed.

Section VII. Procedure for the Conduct of City Council/ Agency Meetings - D. Rules of Procedure, Mayor Torres suggested adding that when Rosenberg's Rules of Order are silent, Robert's Rules would apply.

Regarding Translation for Public Comment, Assistant City Manager Salazar stated that they should extend the speaker's allotted time to six minutes to allow for translation.

Under Section X. Standards of Decorum - C. City Staff. Mayor Torres suggested changing the language restricting City Staff from engaging with the public. Assistant City Manager Salazar stated that there needed to be clarification and added language that allowed staff to step outside of the Council Chambers to speak with members of the public when needed.

City Attorney Alvarez-Glasman stated that there is new legislation that should be incorporated into the Resolution regarding enforcing decorum.

Mayor Torres asked the City Attorney's Office to bring back the Resolution to a future Council Meeting with the updated information.

Assistant City Manager Salazar stated that the Council should consider some rules for City Commissions.

Mayor Torres agreed with the consideration and further stated that they should clearly understand the Commission's purpose.

Assistant City Manager Salazar stated that Council had directed staff to implement new policies and needed further understanding of where the policies should live. An option would be to attach them to the handbook that is suggested in the Resolution or perhaps establish a tracking system.

Councilmember Jimenez stated that she was informed that there was no access to Mayor Pro Tem Peralta's teleconference location. She further stated that members of the public were informed that Mayor Pro Tem Peralta was diagnosed with covid, and members of the public were unable to participate.

ADJOURNMENT
The City of Montebello will adjourn to the next Regular Meeting on Wednesday, March 22, 2023 at 6:00 p.m. which can be live streamed at https://www.montebelloca.gov (Click on Live Stream).

Date and Posted: March 9, 2023 at 2:00 p.m.

I, Alicia Fernandez, Sr. Deputy City Clerk for the City of Montebello hereby certify that the foregoing Notice of the Special Meeting was posted at City Hall and the City’s website and delivered to each member of the City of Montebello City Council no less than 24-hours before the start of the Special Meeting.

Alicia Fernandez, Sr. Deputy City Clerk
DRAFT

March 13, 2023: City Council Meeting Minutes Page 5 of 5

Councilmember Tamayo motioned, seconded by Mayor Pro Tem Peralta, to adjourn the meeting at 7:39 p.m.

THE MINUTES OF MARCH 13, 2023, CITY COUNCIL SPECIAL MEETING ARE HEREBY APPROVED AND ADOPTED ON THIS 10TH DAY OF MAY 2023.

DRAFT

ITEM # 25
PAYMENT OF BILLS: ADOPT RESOLUTION NO. 23-30 APPROVING THE CITY WARRANT REGISTER OF DEMANDS DATED MAY 10, 2023

RESOLUTION NO. 23-30

A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF MONTEBELLO

APPROVING AND ALLOWING CERTAIN CLAIMS AND DEMANDS

NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF MONTEBELLO HEREBY RESOLVES, FINDS, AND DECLARES AS FOLLOWS:

SECTION 1. That the reference is hereby made to that certain Reg ister of Audited Demand No.1551, consisting of 10 pages, and including:

Warrant No.

General: Check No. 599630 through 599773
ACH No. 4031 through 4128

Successor Agency: Check No. 1502
ACH No. 14

On file in the office of the City Clerk, the same having been audited and approved by the Assistant Director of Finance as required by law.

SECTION 2. That the said City Council having examined each such demand does hereby approve and direct the payment of same, as set forth in said Register, except the following Warrant No.

______________________________

______________________________

______________________________

SECTION 3. That the City Clerk shall certify to the passage and adoption of this Resolution and that the same shall be in full force and effect.

APPROVED AND ADOPTED this 10th day of May 2023.

_______________________________
David N. Torres, Mayor

ATTEST: APPROVED AS TO FORM:

_______________________ ________________________________

RESOLUTION NO. 23-30

• Exhibit A – Warrant Register

Christopher Jimenez, City Clerk Arnold M. Alvarez-Glasman, City Attorney

STATE OF CALIFORNIA )
COUNTY OF LOS ANGELES ) SS:

CITY OF MONTEBELLO )

I, Christopher Jimenez, City Clerk of the City of Montebello, County of Los Angeles, State of California, hereby certify that th e foregoing Resolution No. 23-30 was p assed and adopted by the City Council of the City of Montebello, signed by the Mayor and attested by the City Clerk at a regular meet ing of said Council held on the 10th day of May 2023 and that said Resolution was adopted by the following vote, to-wit:

AYES:

NOES:

ABSTAIN:

ABSENT:

The undersigned, City Clerk of the City of Montebello, does hereby attest and certify that the foregoing Resolution is a true, full, and correct copy of a resolution duly adopted at a meeting of said City which was duly convened and held on the date stated thereon, and that said document has not been amended, modified, repealed or rescinded since its date of adoption and is in full force and effect as of the date hereof.

DATE: __
Christopher Jimenez, City Clerk

EXHIBIT A
WARRANT# DATE AMOUNT ACCOUNT DESCRIPTION VENDOR # VENDOR NAME General Account
4031 04/20/2023 $588.02 SUPPLIES 3163 BANK OF AMERICA
4032 04/20/2023 $733.66 SUPPLIES 3163 BANK OF AMERICA
4033 04/20/2023 $2,666.03 SUPPLIES 3163 BANK OF AMERICA 4034 04/20/2023 $4,029.67 DUES & SUBSCRIPTIONS 3163 BANK OF AMERICA 4035 04/20/2023 $84.40 SUPPLIES 3163 BANK OF AMERICA
4036 04/20/2023 $1,964.00 SUPPLIES 3163 BANK OF AMERICA 4037 04/20/2023 $3,875.73 TRAINING 3163 BANK OF AMERICA 4038 04/20/2023 $600.20 TRAINING 3163 BANK OF AMERICA
4039 04/20/2023 $1,139.81 DUES & SUBSCRIPTIONS 3163 BANK OF AMERICA 4040 04/20/2023 $5,059.36 SUPPLIES 3163 BANK OF AMERICA 4041 04/20/2023 $90.00 DUES & SUBSCRIPTIONS 3163 BANK OF AMERICA 4042 04/20/2023 $227.04 SUPPLIES 3163 BANK OF AMERICA
4043 04/20/2023 $23.98 SUPPLIES 3163 BANK OF AMERICA
4044 04/20/2023 $7,122.20 SUPPLIES 3163 BANK OF AMERICA 4045 04/20/2023 $487.87 CONTRACT SERVICES 3163 BANK OF AMERICA 4046 04/20/2023 $3,829.23 SUPPLIES 3163 BANK OF AMERICA 4047 04/20/2023 $262.93 MACHINERY & EQUIPMENTS 3163 BANK OF AMERICA 4048 04/20/2023 $425.85 SUPPLIES 3163 BANK OF AMERICA
4049 04/20/2023 $595.00 TRAVEL & MEETINGS 3163 BANK OF AMERICA 4050 04/20/2023 $118.99 MACHINERY & EQUIPMENTS 3163 BANK OF AMERICA 4051 04/20/2023 $116.34 SUPPLIES 3163 BANK OF AMERICA
4052 04/20/2023 $714.09 MACHINERY & EQUIPMENTS 20350 ALLSTAR FIRE EQUIPMENT INC 4053 04/20/2023 $86,391.72 CONTRACT SERVICES 16120 ALVAREZ-GLASMAN & COLVIN 4054 04/20/2023 $4,952.61 MACHINERY & EQUIPMENTS 2586 AMAZON CAPITAL SERVICES INC 4055 04/20/2023 $13,377.84 CONTRACT SERVICES 3016 ANTARES GOLF LLC City of Montebello
Register of Demands No. 1551
From Payment Date 04/14/23 - To Payment Date 04/27/2023

EXHIBIT A
WARRANT# DATE AMOUNT ACCOUNT DESCRIPTION VENDOR # VENDOR NAME City of Montebello
Register of Demands No. 1551
From Payment Date 04/14/23 - To Payment Date 04/27/2023 4056 04/20/2023 $1,476.48 CONTRACT SERVICES 1237 AZTECA LANDSCAPE 4057 04/20/2023 $2,904.75 VEHICLE MAINTENANCE/EXPENSES 1101 BLACK AND WHITE EMERGENCY VEHICLES LLC 4058 04/20/2023 $365.31 SUPPLIES 10000 CLEAN SWEEP SUPPLY CO INC 4059 04/20/2023 $705.03 CONTRACT SERVICES 2889 COMLOCK SECURITY GROUP INC 4060 04/20/2023 $500.00 CONTRACT SERVICES 1175 GRAPHIC ELECTRIC INC 4061 04/20/2023 $1,225.00 CONTRACT SERVICES 2189 HEARDS INVESTIGATIONS AND POLYGRAPH LLC 4062 04/20/2023 $100,279.07 CONTRACT SERVICES 2793 IBE DIGITAL 4063 04/20/2023 $1,300.00 CONTRACT SERVICES 1612 JCL TRAFFIC SERVICES 4064 04/20/2023 $32.50 CONTRACT SERVICES 16760 LIEBERT CASSIDY WHITMORE 4065 04/20/2023 $6,376.80 SUPPLIES 26670 LIFE-ASSIST INC 4066 04/20/2023 $700.00 CONTRACT SERVICES 26880 SEBASTIAN WATERWORKS INC 4067 04/20/2023 $45,366.30 CONTRACT SERVICES 35250 NATIONWIDE ENVIRONMENTAL SERVICES 4068 04/20/2023 $5,530.00 CONTRACT SERVICES 3147 PMC PLUMBING INC 4069 04/20/2023 $1,500.00 EDUCATION REIMBURSEMENT 2719 ANTHONY RODRIGUEZ 4070 04/20/2023 $36,776.87 CONTRACT SERVICES 3439 SPORTFIVE GOLF LLC 4071 04/20/2023 $523.77 CONTRACT SERVICES 1933 STRICTLY TECHNOLOGY LLC 4072 04/20/2023 $43,303.06 CONTRACT SERVICES 3133 ULTIMATE MAINTENANCE SERVICE 4073 04/20/2023 $4,486.95 SUPPLIES 3163 BANK OF AMERICA 4074 04/20/2023 $2,830.83 SUPPLIES 3163 BANK OF AMERICA 4075 04/20/2023 $2,228.98 UNIFORM EXPENSE 3163 BANK OF AMERICA 4076 04/20/2023 $60.25 MAIL/ POSTAL EXPENSE 3163 BANK OF AMERICA 4077 04/20/2023 $28.75 MAIL/ POSTAL EXPENSE 3163 BANK OF AMERICA 4078 04/20/2023 $1,250.00 RETIREMENT 3730 AT RETIREMENT SERVICES LLC 4079 04/20/2023 $1,250.00 RETIREMENT 3730 AT RETIREMENT SERVICES LLC 4080 04/26/2023 $1,250.00 RETIREMENT 3730 AT RETIREMENT SERVICES LLC 4081 04/26/2023 $1,250.00 RETIREMENT 3730 AT RETIREMENT SERVICES LLC 4082 04/26/2023 $1,250.00 RETIREMENT 3730 AT RETIREMENT SERVICES LLC

EXHIBIT A
WARRANT# DATE AMOUNT ACCOUNT DESCRIPTION VENDOR # VENDOR NAME City of Montebello
Register of Demands No. 1551
From Payment Date 04/14/23 - To Payment Date 04/27/2023 4083 04/26/2023 $1,250.00 RETIREMENT 3730 AT RETIREMENT SERVICES LLC 4084 04/27/2023 $180.81 UNIFORM EXPENSE 20350 ALLSTAR FIRE EQUIPMENT INC 4085 04/27/2023 $2,371.91 MACHINERY & EQUIPMENTS 2586 AMAZON CAPITAL SERVICES INC 4086 04/27/2023 $2,718.77 SUPPLIES 62880 AMERICAN MARKER 4087 04/27/2023 $40.00 CARPOOL INCENTIVE 289 ANDREA ANDRADE 4088 04/27/2023 $40.00 CARPOOL INCENTIVE 61470 ERIKA L ANDRADE 4089 04/27/2023 $600.00 CONTRACT SERVICES 2365 LETICIA TORRES 4090 04/27/2023 $538.18 WATER PURCHASE RESALE 19120 CENTRAL BASIN MUNICIPAL WATER DISTRICT 4091 04/27/2023 $30.00 CARPOOL INCENTIVE 3809 SAMANTHA CHENELIA 4092 04/27/2023 $3,886.25 SUPPLIES 10000 CLEAN SWEEP SUPPLY CO INC 4093 04/27/2023 $120.00 CARPOOL INCENTIVE 3384 ALICIA FERNANDEZ 4094 04/27/2023 $40.00 CARPOOL INCENTIVE 2572 MARLENE GIL 4095 04/27/2023 $40.00 CARPOOL INCENTIVE 3706 ALEX GILLMAN 4096 04/27/2023 $40.00 CARPOOL INCENTIVE 3123 NEIRA YESSIE GRANADOS 4097 04/27/2023 $774.67 VEHICLE MAINTENANCE/EXPENSES 22560 H & H AUTO PARTS WHOLESALE 4098 04/27/2023 $3,962.50 CONTRACT SERVICES 46870 HDL COREN & CONE 4099 04/27/2023 $40.00 CARPOOL INCENTIVE 3196 MICAH HERD 4100 04/27/2023 $40.00 CARPOOL INCENTIVE 4280 NADINE HERNANDEZ 4101 04/27/2023 $3,968.00 VEHICLE MAINTENANCE/EXPENSES 29680 INLAND KENWORTH INC 4102 04/27/2023 $6,587.68 CONTRACT SERVICES 2152 JOHNSON CONTROLS INC 4103 04/27/2023 $136.97 SUPPLIES 26670 LIFE-ASSIST INC
4104 04/27/2023 $30.00 CARPOOL INCENTIVE 3810 ALEXIS LUCERO 4105 04/27/2023 $2,138.75 CONTRACT SERVICES 26880 SEBASTIAN WATERWORKS INC 4106 04/27/2023 $40.00 CARPOOL INCENTIVE 138 BRIANNON PADILLA 4107 04/27/2023 $40.00 CARPOOL INCENTIVE 59960 JO ANN PANOSIAN 4108 04/27/2023 $1,469.00 CONTRACT SERVICES 3147 PMC PLUMBING INC 4109 04/27/2023 $40.00 CARPOOL INCENTIVE 3712 MATTHEW ROBERT RAMOS

EXHIBIT A
WARRANT# DATE AMOUNT ACCOUNT DESCRIPTION VENDOR # VENDOR NAME City of Montebello
Register of Demands No. 1551
From Payment Date 04/14/23 - To Payment Date 04/27/2023 4110 04/27/2023 $87.65 SUPPLIES 1120 BLUETRITON BRANDS INC 4111 04/27/2023 $1,468.00 CONTRACT SERVICES 952 RELIANT IMMEDIATE CARE MEDICAL GROUP INC 4112 04/27/2023 $40.00 CARPOOL INCENTIVE 3584 BRENDA RODRIGUEZ 4113 04/27/2023 $40.00 CARPOOL INCENTIVE 69960 NICOLE I SAUCEDO 4114 04/27/2023 $69,660.33 FUEL INVENTORY 1059 AMBER RESOURCES LLC 4115 04/27/2023 $40.00 CARPOOL INCENTIVE 2985 KEVIN SAYCOCIE 4116 04/27/2023 $5,394.99 CONTRACT SERVICES 3176 PHILLIP SISNEROS 4117 04/27/2023 $40.00 CARPOOL INCENTIVE 24280 MARTIN SOLANO 4118 04/27/2023 $40.00 CARPOOL INCENTIVE 3001 MICHAEL SOLORZA 4119 04/27/2023 $2,028.12 SUPPLIES 31270 STARBOARD TACK SUPPLY INC 4120 04/27/2023 $40.00 CARPOOL INCENTIVE 3053 MICHAEL TELLES 4121 04/27/2023 $40.00 CARPOOL INCENTIVE 1091 JANELLE TORRES 4122 04/27/2023 $111,440.27 CONTRACT SERVICES 3133 ULTIMATE MAINTENANCE SERVICE 4123 04/27/2023 $216.09 SUPPLIES 3066 V & V MANUFACTURING INC 4124 04/27/2023 $7,000.00 CONTRACT SERVICES 3433 VECTIS DC LLC 4125 04/27/2023 $1,402.57 SUPPLIES 3088 WAXIES ENTERPRISES LLC 4126 04/27/2023 $463.00 CONTRACT SERVICES 183 WECK LABORATORIES ENVIRONMENTAL SERVICES INC 4127 04/27/2023 $0.00 VOID-CHECK PRINTED 3657 STACEY MORALES 4128 04/27/2023 $5,463.75 CONTRACT SERVICES 38010 ADVANCED AVANT-GARDE CORPORATION ACH TOTAL $640,295.53
599630 04/20/2023 $4,500.00 VEHICLE MAINTENANCE/EXPENSES 3333 A & A FLEET PAINTING INC 599631 04/20/2023 $1,207.64 SUPPLIES 1870 ALEX & E PARTY RENTALS 599632 04/20/2023 $726.00 CONTRACT SERVICES 1287 ALTA LANGUAGE SERVICES INC 599633 04/20/2023 $855.00 DUES & SUBSCRIPTIONS 43590 THE AMERICAN SOCIETY OF COMPOSERS AUTHORS 599634 04/20/2023 $4,590.93 UTILITY SERVICES 39550 AT&T 599635 04/20/2023 $671.16 SUPPLIES 4041 BIG CITY PRINT, INC.

EXHIBIT A
WARRANT# DATE AMOUNT ACCOUNT DESCRIPTION VENDOR # VENDOR NAME City of Montebello
Register of Demands No. 1551
From Payment Date 04/14/23 - To Payment Date 04/27/2023 599636 04/20/2023 $3,856.21 SUPPLIES 159 BOUND TREE MEDICAL LLC 599637 04/20/2023 $928.00 CONTRACT SERVICES 58240 STATE OF CALIFORNIA-DEPARTMENT OF JUSTICE 599638 04/20/2023 $1,492.94 SALES TAX LIABILITY 425 JOSEPH M SEPULVEDA 599639 04/20/2023 $69.98 UTILITY SERVICES 55830 CHARTER COMMUNICATIONS 599640 04/20/2023 $2,554.20 VEHICLE MAINTENANCE/EXPENSES 45170 MONTEBELLO AUTO GROUP LLC 599641 04/20/2023 $434.50 CONTRACT SERVICES 18840 COOPERATIVE PERSONNEL SERVICES 599642 04/20/2023 $670.00 CONTRACT SERVICES 2019 DEWEY SERVICES INC 599643 04/20/2023 $777.44 CONTRACT SERVICES 3334 EAGLE PORTABLES SANITATION LLC 599644 04/20/2023 $300.00 CONTRACT SERVICES 3934 EVERYTABLE PBC 599645 04/20/2023 $1,285.06 SUPPLIES 7610 EWING IRRIGATION PRODUCTS 599646 04/20/2023 $137.20 MAIL/ POSTAL EXPENSE 22400 FEDERAL EXPRESS CORPORATION 599647 04/20/2023 $1,440.00 CONTRACT SERVICES 1117 FILE KEEPERS LLC 599648 04/20/2023 $300.00 TRAINING 4037 HECTOR FLORES
599649 04/20/2023 $1,200.00 CONTRACT SERVICES 3043 FOCUS ENVIRONMENTAL CONSULTING 599650 04/20/2023 $2,670.65 UNIFORM EXPENSE 55650 GALLS LLC 599651 04/20/2023 $400.00 CONTRACT SERVICES 3679 JOSE GUERRERO 599652 04/20/2023 $661.50 SUPPLIES 2728 H & V CUSTOM OFFICE CUBICLES CORP 599653 04/20/2023 $837.86 VEHICLE MAINTENANCE/EXPENSES 30190 IB AUTO PARTS INC 599654 04/20/2023 $2,146.50 CONTRACT SERVICES 48120 HINDERLITER DE LLAMAS & ASSOCIATES 599655 04/20/2023 $60.00 PARKS AND RECREATION 4038 PATRICIA HOLGUIN 599656 04/20/2023 $22,762.75 CONTRACT SERVICES 3302 JACOB GREEN & ASSOCIATES INC 599657 04/20/2023 $105,912.86 CONTRACT SERVICES 3422 MIKE BUBALO CONSTRUCTION CO INC 599658 04/20/2023 $57,828.38 CONTRACT SERVICES 4027 MLADEN BUNTICH CONSTRUCTION CO INC. 599659 04/20/2023 $678.63 CONTRACT SERVICES 23460 MOTOROLA SOLUTIONS INC 599660 04/20/2023 $4,318.68 SUPPLIES 47860 NATIONAL EMBLEM INC 599661 04/20/2023 $20.77 UTILITY SERVICES 36610 CITY OF PICO RIVERA 599662 04/20/2023 $493.75 SUPPLIES 56260 PRUDENTIAL OVERALL SUPPLY

EXHIBIT A
WARRANT# DATE AMOUNT ACCOUNT DESCRIPTION VENDOR # VENDOR NAME City of Montebello
Register of Demands No. 1551
From Payment Date 04/14/23 - To Payment Date 04/27/2023 599663 04/20/2023 $68.00 RECREATION CLASSES 4043 DARLINE RIVERA 599664 04/20/2023 $491,413.96 CONTRACT SERVICES 14730 SAN GABRIEL VALLEY WATER COMPANY 599665 04/20/2023 $68.00 RECREATION CLASSES 4039 MELISSA SCAPINI 599666 04/20/2023 $4,008.76 CONTRACT SERVICES 2976 JEREMY P SOMMERS 599667 04/20/2023 $7,236.81 UTILITY SERVICES 45630 SOUTHERN CALIFORNIA EDISON 599668 04/20/2023 $7,321.20 UTILITY SERVICES 40520 SOUTHERN CALIFORNIA GAS CO 599669 04/20/2023 $1,738.00 CONTRACT SERVICES 13330 STATE WATER RESOURCES CONTROL BOARD ACCOUNTING OFFICE 599670 04/20/2023 $4,630.00 CONTRACT SERVICES 6020 STRADLING YOCCA CARLSON & RAUTH 599671 04/20/2023 $2,710.00 CONTRACT SERVICES 170 SUPERIOR PAVEMENT MARKINGS INC 599672 04/20/2023 $586.50 CONTRACT SERVICES 3762 SUPERIOR PROTECTION SERVICES CA INC 599673 04/20/2023 $1,665.00 CONTRACT SERVICES 3921 SUSTAINABLE RESOURCES 599674 04/20/2023 $569.25 CONTRACT SERVICES 9270 TANK SPECIALIST OF CALIFORNIA 599675 04/20/2023 $3,188.43 SUPPLIES 2573 TELEFLEX LLC
599676 04/20/2023 $190.96 SUPPLIES 4042 TKH DESIGN, INC 599677 04/20/2023 $2,751.67 UTILITY SERVICES 72570 US TELEPACIFIC CORP 599678 04/20/2023 $17,364.38 PREPAID EXPENSES 1188 TYLER TECHNOLOGIES INC 599679 04/20/2023 $3,514.47 CONTRACT SERVICES 20070 UC REGENTS 599680 04/20/2023 $246.53 SUPPLIES 45120 ULINE INC
599681 04/20/2023 $574.77 UTILITY SERVICES 23610 VERIZON WIRELESS 599682 04/20/2023 $380.39 SUPPLIES 9470 W W GRAINGER INC 599683 04/20/2023 $285.00 CONTRACT SERVICES 22290 WESTERN ALLIED CORPORATION 599684 04/20/2023 $1,500.00 EDUCATION REIMBURSEMENT 3620 DANIEL ZANOLINI 599685 04/20/2023 $16,603.13 SUPPLIES 6390 ZOLL MEDICAL CORPORATION GPO 599686 04/20/2023 $579.70 CONTRACT SERVICES 2905 ZUTRA WATER 599687 04/20/2023 $897.00 EDUCATION REIMBURSEMENT 3547 ZACHARY HUMBER 599688 04/20/2023 $800.00 GENERAL GOVERNMENT 3993 ANGEL LARA 599689 04/20/2023 $40.00 CARPOOL INCENTIVE 3657 STACEY MORALES

EXHIBIT A
WARRANT# DATE AMOUNT ACCOUNT DESCRIPTION VENDOR # VENDOR NAME City of Montebello
Register of Demands No. 1551
From Payment Date 04/14/23 - To Payment Date 04/27/2023 599690 04/20/2023 $191.98 TRAVEL & MEETINGS 3657 STACEY MORALES 599691 04/20/2023 $1,500.00 EDUCATION REIMBURSEMENT 3657 STACEY MORALES 599692 04/20/2023 $40.00 CARPOOL INCENTIVE 3657 STACEY MORALES 599693 04/20/2023 $40.00 CARPOOL INCENTIVE 3657 STACEY MORALES 599694 04/20/2023 $40.00 CARPOOL INCENTIVE 3657 STACEY MORALES 599695 04/20/2023 $40.00 CARPOOL INCENTIVE 3584 BRENDA RODRIGUEZ 599696 04/20/2023 $12,127.50 SUPPLIES 1670 ADAMSON POLICE PRODUCTS 599697 04/20/2023 $1,140.00 ADVERTISING/PRINTING SERVICES 4004 CALI ROSE PARTY DESIGN LLC 599698 04/20/2023 $1,333.00 UNEARNED REVENUE 4044 JONATHAN TORRES 599699 04/27/2023 $2,970.50 VEHICLE MAINTENANCE/EXPENSES 3333 A & A FLEET PAINTING INC 599700 04/27/2023 $4,166.67 CONTRACT SERVICES 3557 ADVOCATE INC 599701 04/27/2023 $9,147.68 AFLAC OTHER 55860 AFLAC
599702 04/27/2023 $150.00 FUEL 22520 HENRY AGUILAR JR
599703 04/27/2023 $22,890.00 CONTRACT SERVICES 69480 ALLTECH INDUSTRIES INC 599704 04/27/2023 $6,280.51 UTILITY SERVICES 39550 AT&T 599705 04/27/2023 $54.79 UTILITY SERVICES 39550 AT&T
599706 04/27/2023 $2,241.25 UTILITY SERVICES 38380 AT&T 599707 04/27/2023 $375.00 VEHICLE MAINTENANCE/EXPENSES 278 ATLAS RADIATOR INC 599708 04/27/2023 $289.78 VEHICLE MAINTENANCE/EXPENSES 74990 AUTOZONE INC 599709 04/27/2023 $100.00 CONTRACT SERVICES 2769 KATALINA BELTRAN 599710 04/27/2023 $3,295.59 SUPPLIES 3033 OFFICE SOLUTIONS BUSINESS PRODUCTS & SERVICES LLC 599711 04/27/2023 $110.69 UTILITY SERVICES 47580 CALIFORNIA WATER SERVICE COMPANY 599712 04/27/2023 $10.18 UTILITY SERVICES 55830 CHARTER COMMUNICATIONS 599713 04/27/2023 $718.22 CONTRACT SERVICES 36870 CINTAS CORPORATION NO 3 599714 04/27/2023 $442.86 CONTRACT SERVICES 4052 CITY OF COMMERCE 599715 04/27/2023 $20,614.35 CONTRACT SERVICES 3568 CIVICPLUS LLC 599716 04/27/2023 $1,345.00 CONTRACT SERVICES 3204 COASTAL OCCUPATIONAL MEDICAL GROUP

EXHIBIT A
WARRANT# DATE AMOUNT ACCOUNT DESCRIPTION VENDOR # VENDOR NAME City of Montebello
Register of Demands No. 1551
From Payment Date 04/14/23 - To Payment Date 04/27/2023 599717 04/27/2023 $2,240.60 VEHICLE MAINTENANCE/EXPENSES 950 CUMMINS INC 599718 04/27/2023 $10,000.00 CONTRACT SERVICES 3848 CUSHMAN & WAKEFIELD WESTERN, INC. 599719 04/27/2023 $593.77 ADVERTISING/PRINTING SERVICES 1354 DAILY JOURNAL CORPORATION 599720 04/27/2023 $200.00 GENERAL 4045 ALICE DE LA CRUZ 599721 04/27/2023 $9,500.00 PREPAID EXPENSES 1168 EVERBRIDGE INC 599722 04/27/2023 $266.59 SUPPLIES 7610 EWING IRRIGATION PRODUCTS 599723 04/27/2023 $2,224.69 VEHICLE MAINTENANCE/EXPENSES 29160 FORD OF MONTEBELLO 599724 04/27/2023 $80.00 GENERAL GOVERNMENT 4048 MICHAELA GARAY 599725 04/27/2023 $68.00 PARKS AND RECREATION 4049 ZIANYA GARCIA 599726 04/27/2023 $154.21 MAIL/ POSTAL EXPENSE 3167 GLS US 599727 04/27/2023 $1,737.37 PROMOTIONS 3063 HALO BRANDED SOLUTIONS INC 599728 04/27/2023 $2,178.92 CONTRACT SERVICES 48120 HINDERLITER DE LLAMAS & ASSOCIATES 599729 04/27/2023 $236.36 VEHICLE MAINTENANCE/EXPENSES 582 HYDRAULIC ELECTRIC INC 599730 04/27/2023 $2,921.12 VEHICLE MAINTENANCE/EXPENSES 27480 R & M HANSEN ENT INC 599731 04/27/2023 $20,200.00 CONTRACT SERVICES 3235 ION SECURITY SYSTEMS 599732 04/27/2023 $3,989.84 LEASE PAYMENT 2405 JCB FINANCE 599733 04/27/2023 $1,035.70 CONTRACT SERVICES 39380 LAWRENCE ROLL-UP DOORS INC 599734 04/27/2023 $405.10 CONTRACT SERVICES 3035 LA COUNTY SHERIFF'S DEPARTMENT 599735 04/27/2023 $200.36 VEHICLE MAINTENANCE/EXPENSES 20620 LOS ANGELES TRUCK CENTERS LLC 599736 04/27/2023 $283.79 TRAVEL & MEETINGS 3658 MONICA MERCADO-RODRIGUEZ 599737 04/27/2023 $1,925.87 SALES TAX LIABILITY 2072 MICROMED DIAMOND SEAL SYSTEMS LLC 599738 04/27/2023 $14,539.89 VEHICLE MAINTENANCE/EXPENSES 54300 SHAK ENTERPRISES INC 599739 04/27/2023 $3,763.03 VEHICLE MAINTENANCE/EXPENSES 2480 SOCAL AUTO & TRUCK PARTS INC 599740 04/27/2023 $9,249.75 SUPPLIES 3002 NUTRIEN AG SOLUTIONS INC 599741 04/27/2023 $12.27 SUPPLIES 15620 OFFICE DEPOT INC 599742 04/27/2023 $40.00 CARPOOL INCENTIVE 65330 WENDY PEREZ 599743 04/27/2023 $200.00 DUES & SUBSCRIPTIONS 202 POLICE EXECUTIVE RESEARCH FORUM

EXHIBIT A
WARRANT# DATE AMOUNT ACCOUNT DESCRIPTION VENDOR # VENDOR NAME City of Montebello
Register of Demands No. 1551
From Payment Date 04/14/23 - To Payment Date 04/27/2023 599744 04/27/2023 $444.68 UNIFORM EXPENSE 56260 PRUDENTIAL OVERALL SUPPLY 599745 04/27/2023 $106.00 TRAINING 4046 FERNANDO QUEVEDO 599746 04/27/2023 $262.15 VEHICLE MAINTENANCE/EXPENSES 3095 RUSH TRUCK CENTERS OF CALIFORNIA INC 599747 04/27/2023 $750.00 TRAVEL & MEETINGS 1415 SAN GABRIEL VALLEY COMMERCE & CITIES CONSORTIUM 599748 04/27/2023 $0.00 VOID 14730 SAN GABRIEL VALLEY WATER CO 599749 04/27/2023 $588.00 TRAINING 4051 SAVE A LIFE CPR OF BEVERLY HILLS 599750 04/27/2023 $1,674.95 CONTRACT SERVICES 673 SILVER & WRIGHT LLP 599751 04/27/2023 $411.67 VEHICLE MAINTENANCE/EXPENSES 716 SOUTH BAY FORD INC 599752 04/27/2023 $36,336.58 FUEL 45630 SOUTHERN CALIFORNIA EDISON 599753 04/27/2023 $5,148.50 UTILITY SERVICES 40520 SOUTHERN CALIFORNIA GAS CO 599754 04/27/2023 $2,933.11 VEHICLE MAINTENANCE/EXPENSES 168 SOUTHERN COACH MFG CO INC 599755 04/27/2023 $858.39 FRINGE BENEFITS 1990 STANDARD INSURANCE COMPANY 599756 04/27/2023 $415.00 CONTRACT SERVICES 9270 TANK SPECIALIST OF CALIFORNIA 599757 04/27/2023 $12,209.95 VEHICLE MAINTENANCE/EXPENSES 60710 THE AFTERMARKET PARTS COMPANY LLC 599758 04/27/2023 $425.00 CONTRACT SERVICES 65440 TIERRA WEST ADVISORS 599759 04/27/2023 $1,093.93 SALES TAX LIABILITY 3110 TOMAS ALVARADO 599760 04/27/2023 $699.00 TRAINING 2699 KIM TUNRER
599761 04/27/2023 $6,200.21 CONTRACT SERVICES 1188 TYLER TECHNOLOGIES INC 599762 04/27/2023 $1,748.24 SUPPLIES 45120 ULINE INC
599763 04/27/2023 $119.77 CONTRACT SERVICES 3042 UNITED RENTALS (NORTH AMERICA) INC 599764 04/27/2023 $938.11 CONTRACT SERVICES 131 UNITED SITE SERVICES INC 599765 04/27/2023 $42,525.54 CONTRACT SERVICES 3406 UNIVERSAL PROTECTION SERVICES LP 599766 04/27/2023 $480.96 UTILITY SERVICES 23610 VERIZON WIRELESS 599767 04/27/2023 $4.00 OTHER GROUP INSURANCE PAYABLE 58990 VISION SERVICE PLAN 599768 04/27/2023 $6,539.40 VEHICLE MAINTENANCE/EXPENSES 25860 WAYNE HARMEIER INC 599769 04/27/2023 $1,105.50 VEHICLE MAINTENANCE/EXPENSES 67320 WINZER 599770 04/27/2023 $1,576.70 CONTRACT SERVICES 3006 ASBURY ENVIRONMENTAL SERVICES

EXHIBIT A
WARRANT# DATE AMOUNT ACCOUNT DESCRIPTION VENDOR # VENDOR NAME City of Montebello
Register of Demands No. 1551
From Payment Date 04/14/23 - To Payment Date 04/27/2023 599771 04/27/2023 $40.00 CARPOOL INCENTIVE 3657 STACEY MORALES 599772 04/27/2023 $514,218.26 CONTRACT SERVICES 47580 CALIFORNIA WATER SERVICE COMPANY 599773 04/27/2023 $3,900.27 UTILITY SERVICES 14730 SAN GABRIEL VALLEY WATER CO CHECK TOTAL $1,621,377.15
Successor Agency (SA)
14 04/20/2023 $2,195.40 CONTRACT SERVICES 16120 ALVAREZ-GLASMAN & COLVIN 1502 04/20/2023 $2,255.00 CONTRACT SERVICES 15180 STEARNS CONRAD AND SCHMIDT CONSULTING ENG SA TOTAL $4,450.40
GRAND TOTAL $2,266,123.08

EXHIBIT

CITY OF MONTEBELLO FORECASTED AGENDA
NOTE: The attached exhibit is a draft version that is to be used for reference purposes only; agenda items, information, and dates are subject to change. The exhibit will be placed at the end of the Agenda Packet.

Item # Description Session Department Presenter
Introduce New Police Officers Presentation Public Affairs Michael Chee Public Works Week Presentation Public Affairs Michael Chee Fire Recognition of SIR 4/13/23 Incident Presentation Fire Chief Pelaez Budget Amendments from Mid-Year Regular Business Finance Michael Solorza Budget Update for FY 2023-24 Regular Business Finance Michael Solorza Amendment No. 1 to Agr No. 3767 - Hazelrigg Consent Human Resources Nicholas Razo/John Soria Adopt a Resolution for the Fiscal Year 2023-24 Levy of Annual Assessments for the Natasha Lane Sewer and Storm Drain
Pump Station Assessment District
Consent Public Works James Enriquez
Adopt a Resolution for the Fiscal Year 2023-24 Levy of Annual Assessments for the Natasha Lane Landscape Assessment
District
Consent Public Works James Enriquez
Approval of the Fiscal Year 2022-23 Annual Plan for the Los Angeles Region Measure W (Safe, Clean Water Program)
Expenditures
Consent Public Works James Enriquez
Approval of the Fiscal Year 2023-24 Annual Plan for the Los Angeles Region Measure W (Safe, Clean Water Program)
Expenditures
Consent Public Works James Enriquez
Approval of B-Map – Final Tract Map No. 82725 for the
development of 300 Detached Single Family Dwelling Units and 551 Attached Residential Dwelling Units for Phase “B” of the Montebello Hills Specific Plan Project
Consent Public Works James Enriquez
Emergency Storm Repairs at Various Locations – City
Manager’s Final Report
Consent Public Works James Enriquez
City Council Forecasted Agenda Calendar - May
MAY 24TH
Updated

Item # Description Session Department Presenter
City Council Forecasted Agenda Calendar - May
MAY 24TH
Approve and Appropiate Grand Award from the Board of
State and Community Corrections, Proposition 64 Public
Health and Safety Grant Program
Consent Fire Chief Pelaez/Angelica
Palmeros
Apply for the Climate Adaptation & Resiliency Grants Consent Fire Chief Pelaez/Angelica Palmeros
Transit Bathroom Renovation Project Consent Transit Adrianna Kendricks Adoption of Property Tax override Consent Finance Michael Solorza Minutes Consent Administration ACM Salazar
Reso No. ___ Warrant Register Consent Finance Michael Solorza Updated