| Application item |
Required items |
Grants(7 CFR 1703.125 and 7 CFR 1703.126)
|
Comment |
| SF-424 (Application for Federal Assistance form) |
Yes |
Completelyfilled out. |
| Site Worksheet |
Yes |
Agency worksheet. |
| Survey on Ensuring Equal Opportunity for Applicants |
Optional |
OMB Form. |
| Evidence of Legal Authority to Contract with the Government |
Yes |
Documentation. |
| Evidence of Legal Existence |
Yes |
Documentation. |
| Executive Summary |
Yes |
Narrative. |
| Telecommunications System Plan and Scope of Work |
Yes |
Narrative documentation such as maps and diagrams. |
| Budget |
Yes |
Agency Worksheets with documentation. |
| Financial Information/Sustainability |
Yes |
Narrative. |
| Statement of Experience |
Yes |
Narrative 3-page, single-spaced limit. |
| Rurality Worksheet |
Yes |
Agency worksheet with documentation. |
| National School Lunch Program (NSLP) Worksheet |
Yes |
Agency worksheet with documentation. |
| Leveraging Evidence and Funding Commitments from all Sources |
Yes |
Agency worksheet and source documentation. |
| Champion Communities designation |
Yes |
Documentation. |
| Request for Additional NSLP |
Optional |
Agency Worksheet and narrative. |
| Need for and Benefits derived from Project |
Yes |
Narrative documentation. |
| Innovativeness of the Project |
Yes |
Narrative documentation. |
| Cost Effectiveness of Project |
Yes |
Narrative documentation. |
| Consultation with the USDA State Director, Rural Development, and evidence that application conforms to State Strategic Plan, if any |
Yes |
Documentation. |
| Certifications: |
| Equal Opportunity and Nondiscrimination |
Yes |
Recommend using Agency's sample form. |
| Architectural Barriers |
Yes |
Recommend using Agency's sample form. |
| Flood Hazard Area Precautions |
Yes |
Recommend using Agency's sample form. |
| Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 |
Yes |
Recommend using Agency's sample form. |
| Drug-Free Workplace |
Yes |
Recommend using Agency's sample form. |
| Debarment, Suspension, and Other Responsibility Matters—Primary Covered Transactions |
Yes |
Recommend using Agency's sample form. |
| Lobbying for Contracts, Grants, Loans, and Cooperative Agreements |
Yes |
Recommend using Agency's sample form. |
| Non-Duplication of Services |
Yes |
Recommend using Agency's sample form. |
| Environmental Impact/Historic Preservation Certification |
Yes |
Recommend using Agency's sample form. |
|
Grants |
| Lease or purchase of eligible DLT equipment and facilities |
Yes, equipment only. |
| Acquire instructional programming that is capital asset |
Yes. |
| Technical assistance, develop instructional programming that is a capital asset, engineering or environmental studies |
Yes, up to 10% of the grant. |
| Medical or education equipment or facilities necessary to the project |
Yes. |
| Vehicles using distance learning or telemedicine technology to deliver services |
No. |
| Teacher-student links located at the same facility. |
No. |
| Links between medical professionals located at the same facility |
No. |
| Site development or building alteration |
No. |
| Land of building purchase |
No. |
| Building Construction |
No. |
| Acquiring telecommunications transmission facilities. |
No. |
| Internet services, telecommunications services or other forms of connectivity |
No. |
| Salaries, wages, benefits for medical or educational personnel |
No. |
| Salaries or administrative expenses of applicant or project |
No. |
| Recurring project costs or operating expenses |
No, (equipment facility leases are not recurring project costs). |
| Internet services, telecom services, and other forms of connectivity |
No. |
| Equipment to be owned by the LEC or other telecommunications service provider, if the provider is the applicant |
No. |
| Duplicative distance learning or telemedicine services |
No. |
| Any project that for its success depends on additional DLT financial assistance or other financial assistance that is not assured |
No. |
| Application Preparation Costs |
No. |
| Other project costs not in regulation |
No. |
| Cost (amount) of facilities providing distance learning broadcasting |
No. |
| Reimburse applicants or others for costs incurred prior to RUS receipt of completed application |
No. |