ADDITIONAL GRANT INFORMATION Federal Award Identification Number (XXXX): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: Xxxxxx Xxxxxxx, Grants Management Officer, Point of Contact is Xxxxx Xxxx, Grants Specialist, Contact Number: (000) 000-0000, Facsimile: (000) 000-0000, Email: Xxxxx.Xxxx@xxxxxx.xxx.xxx SIGNATURE PAGE FOR SYSTEM AGENCY CONTRACT NO. HHS000663700012 HEALTH AND HUMAN SERVICES COMMISSION XXXX XXXX HOME, INC Xxxxx Ita Associate Commissioner Name: Title: Xxxxxx Xxxxx Chief Executive Officer Date of execution: _July 22, 2020 Date of execution: July 22, 2020 THE FOLLOWING ATTACHMENTS TO SYSTEM AGENCY CONTRACT NO. HHS000663700012 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT X XXXXXXX’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR ADULTS SECTION I: PURPOSE Grantee shall provide substance use disorder treatment services to the target population at one or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: xxxxx://xxx.xxxxx.xxx/doing-business-hhs/provider-portals/behavioral-health-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: xxx.xxxx.xxx, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
Use of Report This report has been prepared for [Grantee name] and the department in accordance with the requirements of the grant agreement between [Grantee name] and the Commonwealth, dated [date of agreement]. We disclaim any assumption of responsibility for any reliance on this report to any persons or users other than [Grantee name] and the department, or for any purpose other than that for which it was prepared. Conclusions Based on: Our review, which is not an audit, nothing has come to our attention that causes us to believe that the statement of labour costs in the period [dd/mm/yyyy] to [dd/mm/yyyy] is not, in all material respects, fairly presented in accordance with the grant agreement dated [date of agreement] with the Commonwealth[; and The procedures we have performed and the evidence we have obtained, nothing has come to our attention that causes us to believe that the statement of employee numbers as at [dd/mm/yyyy] is not prepared, in all material respects, in accordance with the grant agreement dated [date of agreement] with the Commonwealth]. Auditor’s signature Name [enter name] Auditor’s employer [enter employer name] Employer’s address [enter address] Qualifications [enter qualification] Position [enter position] Date [dd/mm/yyyy] Attachment C - Certification of certain matters by the auditor The department also requires a certification of certain matters by the auditor in addition to the independent audit report. This should be submitted with the statement of grant income and expenditure and independent audit report. The auditor who signs this certification must also initial and date a copy of the Grantee’s statement of eligible expenditure. The department will not accept an independent audit report that lacks this attachment. The required format of certification is on the following page. [print on auditor letterhead] [addressee] Department of Industry, Science, Energy and Resources GPO Box 2013 Xxxxxxxx XXX 0000 I understand that the Commonwealth, represented by the Department of Industry, Science, Energy and Resources and [Grantee name] have entered into a grant agreement for the provision of financial assistance under the [grant opportunity name] to the Grantee for the project. A condition of funding under the grant agreement is that the Grantee provides a statement of grant income and expenditure certifying that expenditure on approved project items has been incurred within the relevant audit period and paid in accordance with the grant opportunity guidelines, and is supportable by appropriate documentation. In fulfilment of the condition, I hereby certify that: I am a member of Chartered Accountants Australia and New Zealand/ CPA Australia/ the Institute of Public Accountants (as a Public Practice Certified Member). I have prepared the independent audit report on [Grantee name]’s, statement of grant income and expenditure in accordance with the details of the grant agreement between the Grantee and the Commonwealth, project no [project no] dated [dd/mm/yyyy]. I have reviewed the grant agreement between the Grantee and the Commonwealth, project no [project no] dated [dd/mm/yyyy], and related grant opportunity guidelines and understand the requirements pertaining to financial reporting and eligible expenditure contained therein. I have signed the attached copy of [Grantee name]'s statement of eligible expenditure that I used to prepare the independent audit report. I have complied with the professional independence requirements of Chartered Accountants Australia and New Zealand/ CPA Australia/the Institute of Public Accountants. I specifically certify that I: am not, and have not been, a director, office holder, or employee of [Grantee name] or related body corporate of [Grantee name] have not been previously engaged by [Grantee name] for the purpose of preparing their [grant opportunity name] application or any report required under the grant agreement have no financial interest in [Grantee name]. Signature Name [enter name] Qualifications [enter qualification] Position [enter position] Date [dd/mm/yyyy] <Grant opportunity name>
CAPITAL GRANT 3.1 Pursuant to clause 38 of the Master Funding Agreement, the Secretary of State may, in his absolute discretion provide Capital Expenditure funding in accordance with any arrangements he considers appropriate.
- DETERMINING THE FINAL GRANT II.17.1 Without prejudice to information obtained subsequently pursuant to Article II.20, the Commission shall adopt the amount of the final payment to be granted to the beneficiaries on the basis of the documents referred to in Article II.15.4 which it has approved.
What To Do If You Find A Mistake On Your Statement If you think there is an error on your statement, write to us at the address(es) listed on your statement. In your letter, give us the following information:
Parental Grant (a) The parental grant is payable to a principal on production of a birth certificate or evidence of an approved adoption placement. This entitlement is payable if the principal qualifies for primary carer leave (refer the Parental Leave and Employment Protection Act 1987) or resigns because of pregnancy or adoption, except as follows: the parental grant is not payable where a principal has not produced a medical certificate confirming pregnancy, or confirmation from the relevant government department of suitability as an adoptive parent, before commencing leave or resigning. No provision is made for payment of a parental grant in the case of a miscarriage.
Evaluation Form The Union agrees that the Management Rights provision of this Agreement and Section 3-302 of the State Personnel and Pension Article confers upon the State the authority to make changes to the forms used to evaluate employees. Such changes may be implemented after notification to the Union.
Final Report The goal of this subtask is to prepare a comprehensive Final Report that describes the original purpose, approach, results, and conclusions of the work performed under this Agreement. The CAM will review the Final Report, which will be due at least two months before the Agreement end date. When creating the Final Report Outline and the Final Report, the Recipient must use the Style Manual provided by the CAM.
Initial Report An initial performance report no later than 30 days after FEMA has approved the first Public Assistance project.
Accurate and Timely Submission of Reports a) The reports and administrative fees shall be accurate and timely and submitted in accordance with the due dates specified in this section. Vendor shall correct any inaccurate reports or administrative fee payments within three (3) business days upon written notification by DIR. Vendor shall deliver any late reports or late administrative fee payments within three (3) business days upon written notification by DIR. If Vendor is unable to correct inaccurate reports or administrative fee payments or deliver late reports and fee payments within three
