Figure A.1 — National Estuary Program Application Checklist for 

 Assistance Agreements 



YES NO NA 



Preapplication assistance provided by regional office 



Proposal approved for funding by the management committee 

 (date) 



Proposal reviewed and approved by the scientific and technical ad- 

 visory committee or designated worl< group (date) 



EPA application form (Standard Form 5700-33) (state and local agen- 

 cies) or 



EPA application form 5700-12 (educational institutions and others) 



• Agency/organization name, address, and contact person, including 

 phone number 



• Correct budget and project periods 



• Proposed funding dollars correct: appropriate federal cost share 

 (75 pecent) and non-federal cost share (25 percent), calculated as 

 aggregate for all estuary program participants each fiscal year 



• Executive Order 12372 (replaces 0MB Cir. A-95) requirements ack- 

 nowledged 



• Official signature - original enclosed 

 Budget 



• All budget categories properly identified and correctly totaled 



• Indirect cost rate and base shown; if previously negotiated, a state- 

 ment of when and with what federal agency 



• Completed Procurement System Certification (EPA 5700-48) at- 

 tached 



Statement of Work 



• Annual Work Plan 



• Clearly written statement of work attached; contains schedule for 

 products and deliverables, including periodic progress reports to 

 the region, state project officer, and management committee 



• Statement of work discussion describes relationship between 

 proposal and approved fiscal year work plan elements 



• Statement of work contains requirements that newly generated data 

 is In ODES format and machine-readable form 



• Separate pages of detailed project budget; project dollars justified 

 with statement of work and reflected in total budget categories 



• Statement of work contains "substantial federal Involvement" re- 

 quired for cooperative agreement(s) 



Quality Assurance/Quality Control 



• Quality assurance certification attached 



• Project officer's negative quality assurance statement attached 

 Special Conditions 



• Separate list of conditions of substantial federal Involvement iden- 

 tified in statement of work and/or other negotiated special condi- 

 tions 



• A special condition applicable to all grants is that all final products 

 must be submitted to the National Technical Information Service (11 

 copies plus applications) 



• Financial Status Report due annually (Sept. 30) 

 Distribution of Form Application 



• Original plus three copies to EPA regional estuary program coor- 

 dinator 



Project Off icer/Reviewer_ 



Date 



A9 



