NCIDC

Community Service Block Grant Program - 2012

CSBG Contract Documents for Off-Reservation Subcontractors

Contract Forms:

• 2012 CSBG Contract
• 2012 Cover Letter to Subcontractors
• NCIDC 213: 2012 CSBG Standard Subcontract Agreement

Reporting Forms:

• NCIDC 715: Subcontract Close-Out Checklist and Certification of Documents Transmitted
• NCIDC 715C: CSBG Close-Out Program Income/Interest Earned Expenditure Report
  • Instructions
• NCIDC 715D: CSBG Close-Out Equipment Inventory Schedule
• NCIDC 425-B: Justification for Subcontract Amendment/Modification
  • Example
• NCIDC 425.ER: CSBG Monthly Expenditure Report
• NCIDC 425.FER: CSBG Final Expenditure Report

Submission Forms:

• Subcontract Agreement Checklist for Submission
• Table of Contents
• Exhibits (zip file) includes:
  • Exhibit A: Scope of Work
  • Exhibit B: Budget Detail and Payment Provisions
  • Exhibit C: General Terms and Conditions
  • Exhibit D: Special Terms ands Conditions
  • Exhibit E: Additional Provisions
  • Exhibit F: Definitions
  • Exhibit G: Certificate Regarding Lobbying
• CSBG Budget Forms (NEW- Revised 5/15 - includes)
  • 425.S: Contract Budget Summary Form
    • Instructions
  • 425.1.1: Budget Support—Personnel Costs
    • Instructions
  • 425.1.2: Budget Support—Non Personnel Costs
    • Instructions
  • 425.1.3: Other Agency Operating Funds
    • Instructions
• CSBG Sample Budget Narrative
• Transmittal No. 37: Definition and Allowability of Direct and Administrative Costs
• NCIDC IR-1: Information Request Form
• Advance Request

Resources:

• Contract Certification Clauses (.doc)
• Federal Statute, CSBG Act, 42 U.S.C. Section 9901 and following
• Federal Regulation, 45 CFR, Part 96
• California Government Code Section 12725 through 12790
• California Code of Regulations Section 100601 (.pdf) and following
• Federal Statute, Single Audit Act, 31 U.S.C. Section 7301 and following
• Office of Management and Budget Circular A-133 & appendices and supplements
• Federal Regulation, 45 CFR, Part 74 codification of OMB Circular A-110
• Office of Management and Budget Circular A-122
• CSD Supplemental Audit Guide (.pdf)
• Federal per diem and lodging rates
• HHS Poverty Guidelines for CSBG

Additional CSBG Documents

• CSD 558 Request for Pre-Approval of Purchase-Lease (doc, 2 pages)
• Breach of Security Management Memo
• CSD Self Assessment Tool

Programmatic Forms

• NCIDC CSBG Client Intake and Registration
• CSD 295: Client Characteristic (instructions included)
  • CSD 295-CCR Instructions: Completing the CSD 295 Client Characteristic Report
• CSD 801: CSBG/NPI Program Report (use for Contract Work Plan, Mid-year Report and the Annual Report)
  • 801 Instructions: (.pdf, 4 pages)
• NPI Guide (from NASCSP.pdf, 80 pages)
• CSD Cover Letter
• CSD 090: Program Accomplishments and Coordination of Funds
• CSD 425.OR: Other Resources Administered and Generated
  • Instructions
• CSD 425.OF: CSBG and Discretionary Funds
  • Instructions
• CSD 188: Board Roster and Instructions