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REQUEST FOR APPLICATIONS

Sub-grants for Civil Society Organisations (CSOs)

USAID Defeat TB Project

RFA SOLICITATION NUMBER: FY18-RFA01-6027

DATE OF ISSUE: 22nd February 2018

DEADLINE FOR QUESTIONS: 2nd March 2018, 5:00 PM (EAT)

DEADLINE FOR SUBMISSIONS: 23rd March 2018, 12:00 PM

(EAT)

Issuance of this RFA does not constitute a commitment on the part of URC nor does it commit URC or the US

Government to pay for costs incurred in the submission of a proposal. Furthermore, URC reserves the right to

reject any and all submissions, or to award a grant without further discussion or negotiations if it is considered

to be in the best interests of the project and URC.

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Subject: Request for Applications FY18-RFA01-6027

USAID Defeat TB

Sub-grants for Civil Society Organisations (CSOs)

Issue date: 22nd February 2018

Closing date: 23rd March 2018, 12:00 PM (EAT)

Dear Applicants:

The USAID Defeat TB project (Defeat TB) is a five-year project (2017 – 2022) that aims to increase

TB case notification, case detection and treatment outcomes through health system strengthening with

the aim of ending the tuberculosis (TB) epidemic in Uganda. The project is a consortium led by

University Research Co., LLC (URC) in partnership with Infectious Diseases Institute (IDI) and The

AIDS Support Organization (TASO) and is funded by the United States Government (USG) under the

President’s Emergency Plan for AIDS Relief (PEPFAR). Defeat TB has four main implementation

result areas: increase screening and detection of all forms of tuberculosis in infants, children,

adolescents, and adults at facility and community levels; initiate and complete treatment for all patients

diagnosed with all forms of TB; ensure strong community systems to support the continuum of TB

prevention, screening, diagnosis, care, and treatment; and enhance leadership and technical capacity of

the TB program at national and subnational levels to effectively guide and manage implementation of

TB control activities.

Defeat TB is working in collaboration with the Ministry of Health of Uganda (MOH) and National

Tuberculosis and Leprosy Program (NTLP) to strengthen TB coordination structures at national and

sub-national levels. The project is providing direct service delivery support to i) drug resistant TB

treatment sites in non-USAID supported regions in Uganda namely: Mulago National Referral Hospital

TB unit, Arua, Soroti, Hoima, Masaka, Mubende and Fortportal Regional Referral Hospitals and their

DOT sites, and to ii) the districts of Kampala, Wakiso and Mukono. Additionally, Defeat TB will

collaborate with regional mechanisms to provide technical assistance to Mbarara, Kabale, Lira, Gulu,

Iganga, Mbale, Kitgum, Matany and any additional site in USAID supported regions.

Defeat TB is committed to build capacity across all multi-sectoral levels involved in TB control to

ensure effective support and delivery of comprehensive TB services. Civil Society Organizations

(CSOs) are able to reach remote and marginalized communities and can play a particularly important

role in achieving the project’s objectives. Defeat TB intends to provide grants to CSOs to implement

community-based TB activities including: 1) Conduct community awareness on TB for stigma

reduction; 2) Identify TB survivors to act as community TB champions and provide peer psychosocial

support; 3) Support TB treatment adherence through establishing peer support groups, selection and

training of treatment supporters to: i) encourage and observe daily intake of drugs (DOT), ii) update the

patient treatment card daily, iii) refer patient to health facility if patient’s condition worsens or patient

experiences side effects, iv) contact the CSO or health facility when patient’s medicines are running

low, v) remind patient to visit the health unit for follow up sputum tests at the end of 2nd month of

treatment and at the beginning of 5th and 6th months of treatment, vi) remind patients of their clinic

appointments; 4) Follow up TB patients who miss their clinic appointments; 5) Participate in TB

prevention: i) educate patient families on TB infection control, ii) screen contacts of index TB patients

for TB symptoms, iii) refer presumptive TB patients for evaluation at the health facilities and link TB

patients to economic support services in the community.

The granting process will be competitive and open to CSOs of different types including non-

governmental organizations (NGOs), faith-based organizations (FBOs), community based

organizations (CBOs), private-sector health facilities and academic organizations. Announcements for

the application will be posted in newspapers and online.

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To this effect, Defeat TB seeks applications from interested and capable local CSOs to implement

activities/interventions that will contribute to improved awareness for TB, case finding, referral and

treatment adherence in target communities.

CSOs are expected to utilize available data and information related to the stipulated scope of work to

identify and implement evidence-based, innovative interventions/activities that contribute to reduction

of TB prevalence in the country.

Defeat TB will accept applications that address community-based TB activities listed above. Specific

instructions on the application requirements follow.

Applicants must submit questions by email only to proposals@defeat-tb.urc-chs.com by 5:00 PM

(EAT) on 2nd March 2018.

Applications must be received by the closing date and time indicated at the top of this cover letter.

Applications should be submitted in hard copy (4) and electronic copy (1). Applications received after

12:00 PM (EAT) on 23rd March 2018 will not be considered. Detailed submission instructions are

provided in section 6 of this document.

USAID Defeat TB

Plot 40 Ntinda II Road, Naguru, Kampala - Uganda

P.O. Box 28745, Kampala - Uganda

Tel (Off): (256) (0)417-799-500

proposals@defeat-tb.urc-chs.com

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TABLE OF CONTENTS

Contents TABLE OF CONTENTS ........................................................................................................................ 4

LIST OF ACRONYMS .......................................................................................................................... 6

1.0 BACKGROUND ........................................................................................................................ 7

2.0 GRANT SCOPE ......................................................................................................................... 8

2.1 Statement of Purpose .............................................................................................................. 8

2.2 Geographic Scope ................................................................................................................... 8

2.3 Funding ..................................................................................................................................... 9

2.4 Period of Performance ............................................................................................................ 9

2.5 Technical Scope and Anticipated Results ............................................................................... 9

3.1 Sub-grant Solicitation ....................................................................................................... 10

3.2 Additional Guidance ......................................................................................................... 10

3.3 Selection of Sub-grants ..................................................................................................... 10

3.4 Results ............................................................................................................................... 11

4.0 MONITORING AND REPORTING REQUIREMENTS ........................................................ 11

4.1 Monitoring, Evaluation and Learning Plan ........................................................................... 11

4.2 Reporting Requirements ....................................................................................................... 11

4.3 Performance Indicators ......................................................................................................... 11

5.0 ELIGIBILITY CRITERIA ........................................................................................................ 13

5.1 Other Relevant Criteria ......................................................................................................... 13

6.0 APPLICATION OVERVIEW .................................................................................................. 14

6.1 Submission Timeline ............................................................................................................ 14

6.2 Application Instructions ........................................................................................................ 14

6.2.1 Technical Proposal ........................................................................................................ 14

6.2.2 Cost Proposal ................................................................................................................ 15

6.3 Selection Process and Evaluation ......................................................................................... 16

6.3.1 Scoring of Applications ................................................................................................ 16

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6.3.2 Approval and Award ..................................................................................................... 17

Annex 1: Technical Resources ........................................................................................................ 18

Annex 2: Contact Screening Targets by Location ............................................................................ 19

Annex 3: Budget Proposal Instructions ............................................................................................ 20

Annex 4: Past Performance Form .................................................................................................... 21

Annex 5: URC Uganda per-diem lodging ……………………………………………………….....22

Annex 6: Allowable USD funding support for Government of Uganda Entities and staff………..23

Annex 7: Certifications and Representation……………………………………………......………24

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LIST OF ACRONYMS AMELP Activity Monitoring, Evaluation, and Learning Plan

CB-DOTS Community-Based Directly-Observed Therapy Short course

CBO Community Based Organization

CHEW Community Health Extension Worker

CLF Community Linkage Facilitator

CSO Civil Society Organization

DOTS Directly Observed Therapy Short Course

DR-TB Drug Resistant TB (including Multi-Drug Resistant (MDR) TB)

DS-TB Drug Susceptible TB

EP Extra-pulmonary TB

FBO Faith-based Organization

HIV Human Immunodeficiency Virus

ICF Intensified TB Case Finding

ICT Information and Communication Technology

IDI Infectious Diseases Institute

IP Implementing Partner

MoH Ministry of Health

NTLP National Tuberculosis and Leprosy Control Program

NTPS National TB Prevalence Survey

NGO Non-governmental Organization

NICRA Negotiated Indirect Cost Rate Agreement

PEPFAR President’s Emergency Plan for AIDS Relief

PPP Public-Private Partnership

PBC Pulmonary Bacteriologically Confirmed

PCD Pulmonary Clinically Diagnosed TB

RFA Request for Applications

SMART Specific, Measurable, Achievable, Realistic, Time-bound

TASO The AIDS Support Organization

TB Tuberculosis

TSR Treatment Success Rate

URC University Research Company, Co. LLC

USAID United States Agency for International Development

USG United States Government

VHT Village Health Teams

WHO World Health Organization

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1.0 BACKGROUND

Tuberculosis (TB) is still a major cause of illness and death worldwide. The World Health Organization

(WHO) 2017 Global Tuberculosis Report cited Uganda among 30 countries in the world with a high

tuberculosis (TB)/HIV burden, despite the multiple efforts by the Uganda Ministry of Health (MoH) and

donor agencies to control TB [1]. The 2014/2015 to 2019/2020 national TB strategic plan focused on

improving TB case detection, diagnosis, and treatment outcomes at community and facility levels [2].

In 2014/2015 Uganda carried out a population-based survey of TB disease prevalence which estimated

a TB prevalence of 253/100,000 (95% CI: 196–317) and TB incidence of 234/100,000 (95% CI: 145–

345) [3]. About 89,000 individuals are infected with TB every year of which approximately 40,000 TB

cases are being missed. The survey also found that the most missed cases were among the 15-24 age

group. TB is more prevalent in urban area, but is also prevalent in rural areas. It is 4 times more prevalent

among men than women. Contrary to what the public perceives about TB, the prevalence of the disease

among HIV negative individuals was more than that of their HIV positive counterparts. Further, the

survey found that people with presumed TB had poor health seeking behavior and this was mainly

because these individuals simply ignored their illness or self-treated.

The U.S. Government believes that National TB programs must involve affected communities and

actively partner with civil society organizations and private stakeholders if they are to reach their

potential [USG Global TB Strategy 2015-2019]. Using strong coalitions with CSOs and communities

is one of the principles of WHO’s End TB strategy. However, this is greatly hampered by TB-associated

stigma affecting the whole continuum of TB care and control. Defeat TB intends to work with CSOs to

achieve one of the NTLP’s strategic goals of empowering communities to demand and utilize TB

services. The program will mainly work in the three urban districts of Kampala, Wakiso, and Mukono

where the prevalence of TB is high. The population in these districts is highly mobile and presents

unique features that influence access to TB services and adherence to treatment, such as limited

engagement of the community and private sector in TB control interventions, presence of crowded

poorly ventilated slum dwellings, supply chain constraints, lack of patient support and tracking

mechanisms, suboptimal laboratory function, and a large knowledge and skill gap in health workers due

to high provider attrition. Stigma is also rampant in urban communities. TB service delivery continues

to be significantly affected by gender-related obstacles, weak public-private partnerships, challenges in

steady supply of TB commodities, and high staff turnover leading to skill gaps. This highlights the need

to adapt and develop new gender driven strategies for TB management and control.

There is evidence to show that low treatment success rate (TSR) is due to low coverage of community-

based DOTS (CB-DOTS), which is hindered by weak community structures (especially in urban

settings), lack of unique patient identifiers/tracking mechanisms, and mobile urban/rural populations.

Defeat TB will engage CSOs to work with family members of index TB cases, volunteers, former TB

patients to: carry out intensified case finding using low-cost innovative mechanisms; support treatment

completion by providing Directly-Observed Treatment Short Course (DOTS) to TB patients in their

homes and track patients that interrupt treatment; and link experienced supervisors at the facility level

to community teams. Using collaborative efforts involving communities, regional implementing

partners (IPs), the NTLP, and The Global Fund, DR-TB patients will be encouraged with adherence

enhancers in the form of transport and food. The Defeat TB project will support a couple of CSOs to

pilot/evaluate community/home-based DR-TB DOT where patients will be referred to community DOT

supporters after completing the intensive phase of treatment.

The Defeat TB consortium will engage CSOs to implement community programs that lead to reduced

TB-related stigma, while increasing the awareness of TB and develop strong community structures

over time. Key components of the strategy include integrated patient-centered care and prevention

approaches guided by bold policies and supportive systems that encourage community engagement.

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Successful implementation of CB-DOTS is a major results theme area for Defeat TB, and CSOs that

will eventually work with the project, will be required to:

Conduct community awareness on TB for stigma reduction

Identify TB survivors to act as community TB champions and provide peer psychosocial

support

Support TB treatment adherence through establishing peer support groups, selection and

training of treatment supporters to:

o Encourage and observe daily intake of drugs (DOT)

o Update the patient treatment card daily

o Refer patient to health facility if patient’s condition worsens or patient experiences side

effects

o Contact the CSO or health facility when patient’s medicines are running low

o Remind patient to visit the health unit for follow up sputum tests at the end of 2nd month

of treatment and at the beginning of 5th and 6th months of treatment

o Remind patients of their clinic appointments

Follow up TB patients who miss their clinic appointments

Participate in TB prevention:

o Educate patient families on TB infection control

o Screen contacts of index TB patients for TB symptoms

o Refer presumptive TB patients for evaluation at the health facilities and link TB

patients to economic support services in the community

Defeat TB will work with CSOs to streamline implementation approaches to become more urban and

youth friendly, and male/gender sensitive with the aim of maximizing TB service delivery among

these populations. The Defeat TB project through CSOs will work with the newly commissioned

Community Health Extension Workers (CHEWs) to sensitize the community on TB symptoms and

where to access TB testing and treatment services. They will also be essential in overcoming barriers

to effective treatment such as transport costs, reduce treatment interruption, and increase treatment

response monitoring as well as patient and family engagement to prevent further transmission. This

model will be implemented in the three districts of Kampala, Wakiso & Mukono.

2.0 GRANT SCOPE

2.1 Statement of Purpose

Defeat TB project is implemented by University Research Co, LLC (URC), and partners The AIDS

Support Organization (TASO), and the Infectious Diseases Institute (IDI). The project is committed

to partnering with and funding CSOs to implement innovative, low-cost interventions to address

challenges in TB screening, detection, diagnosis, and treatment, including TB-related stigma, as first

steps to long-lasting and scalable solutions for reducing Uganda’s TB burden. This Request for

Applications (RFA) is announcing URC and Defeat TB’s intention to fund a limited number of CSOs

to implement interventions/activities under the project in order to increase access, demand for and

utilization of TB services and strengthen community systems to support the continuum of TB

prevention, screening, diagnosis, care, and treatment.

2.2 Geographic Scope

Sub-grants will be provided to CSOs to implement community TB control activities in any one or

more of the locations within the districts of Kampala, Wakiso and Mukono. See Annex 2 for specific

locations.

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2.3 Funding

Award amounts are dependent on the specific relevant characteristics of the district and administrative

area, and will range between UGX 72M – 144M (USD $20,000 - $40,000). See details in Annex 2.

Applicants with potential to implement interventions in multiple locations may be awarded if the

Grants Selection Committee determines that the proposed interventions and approaches are both

beneficial and feasible within the time frame.

2.4 Period of Performance

Applications must include activities with an initial period of performance of one (1) year.

2.5 Technical Scope and Anticipated Results

Specific objectives for the CSO grants are to:

1. Increase the level of community awareness & demand for TB services

2. Increase case finding for TB in the districts of Kampala, Wakiso and Mukono by 20% by May

2019.

3. Improve average treatment success rates for TB patients in Kampala, Wakiso and Mukono from

85%, 75% & 73% respectively to 90%, 80% and 78% by May 2019.

The proposed activities will contribute to the following outcomes:

Increased number of eligible individuals screened for TB at the community and facility levels.

Eligible individuals are defined as any person with a history of cough, with or without sputum.

Increased number of detected cases of DS-TB, DR-TB, and TB/HIV coinfection among the

estimated cases

Increased number of eligible individuals screened for DR-TB. The eligible individuals are

defined as any TB patient that has defaulted from TB treatment, failed on TB treatment or

relapsed TB disease, as well as close contacts of DR-TB patients.

Proposed activities funded under the grant include but are not limited to the following:

1. Sensitize communities about TB symptoms, treatment options, and prevention

o Conduct health education sessions on TB at homesteads & neighbourhoods of TB

patients

o Conduct awareness talks targeting men and youth

o Disseminate TB messages at hot spots & congregate settings such as refugee

settlements, prisons, slums, labour camps, schools and fishing villages

2. Distribute TB information, education, and communication (IEC) materials to:

o Homesteads & neighbourhoods of TB patients

o Prisons, slums, labour camps, schools and other congregate settings

o Youth & men’s groups

3. Screen household & close workplace/social contacts of smear positive TB patients (including

contacts of children with TB) for signs and symptoms of TB using intensified case finding

(ICF) forms or a mobile application at homesteads, residential institutions & workplaces of TB

patients

4. Conduct targeted TB screening at congregate settings - slums, prisons, etc.

5. Collect specimens from households & close workplace contacts of TB patients and deliver them

to a TB diagnostic unit for testing

6. Promptly refer or escort contacts of TB patient to a TB diagnostic unit for evaluation (+ chest

x-ray)

7. Trace TB patients that missed their clinic appointments, are lost or newly tested TB positive,

but have not returned to receive their results

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8. Visit contacts of TB patients and inform them of their test/evaluation results and/or subsequent

management plan

9. Follow up laboratory negative presumptive TB patients and refer them for subsequent clinical

evaluation

10. Counsel patients to adhere to treatment; monitor adherence to TB treatment by reviewing the

TB treatment card record and the TB medicine blisters.

11. Map & develop directory of congregate institutions, small drug shops, private clinics &

pharmacies, and community, institutional, cultural, religious & other leaders. Develop & submit

contact list of CHEWs, VHTs, CSO volunteers, sub-county health workers, expert patients /TB

survivors, treatment supporters and health unit TB focal persons

12. Collect sputum and refer patients for follow up tests at 2, 5 and 6 months

13. Collaborate with health facilities and maintain contact lists for all facilities, VHTs and the

community leaders such as local councils

3.0 GRANT CRITERIA

3.1 Sub-grant Solicitation

Defeat TB is soliciting applications from CSOs that will propose innovative and low-cost

interventions to empower communities in the three districts of Kampala, Wakiso and Mukono to

demand for and utilize TB services.

The granting process will be competitive and open to CSOs of different types including non-

governmental organizations (NGOs), faith-based organizations (FBOs), community based

organizations (CBOs), private-sector health facilities and academic organizations. Solicitations will be

posted in newspapers, online, and other public venues. The applications must outline specific,

measurable, achievable, relevant, and time-bound (SMART) objectives and cost-effective

interventions with measurable outputs that are in line with the key outcomes above.

Applications must clearly describe which of the above activities (listed under section 2.5) applicants

are proposing to implement, substantiated by a description of the applicant’s capacity to implement

them. Applicants are not required to implement all the activities, and may also propose to implement

activities that are not listed but are relevant and feasible in order to achieve the stated outcomes.

3.2 Additional Guidance

The following items will not be eligible for funding:

1. Purchase of major commodities for program support or distribution

2. Construction, rehabilitation, or infrastructure activities

3. Commodities and services for support of police or other law enforcement activities

4. Activities restricted by US federal government regulations

3.3 Selection of Sub-grants

A grants selection committee will be convened consisting of representatives from the District Health

Office and the Defeat TB project who will review applications based on strict criteria focused on

technical expertise of proposed interventions, geographic coverage, organizational capacity, and cost

reasonableness.

Key parameters that CSOs should highlight in their applications include:

Technical/programmatic capacity

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Operations and management systems, highlighting prior relevant work in the past performance

form (see Annex 4)

Available resources in the form of infrastructure, human resources, and available assets to

implement the proposed interventions

Relationships with community, local and civic leaders

Cost reasonableness

3.4 Results

Applicants are expected to submit proposals that have the potential for clear and measurable results.

Proposals should be cost-effective and sustainable, with clear measurements to demonstrate how the

interventions/activities will strengthen community systems for increased access to, demand for and

utilization of TB health services.

4.0 MONITORING AND REPORTING REQUIREMENTS

4.1 Monitoring, Evaluation and Learning Plan

Monitoring and evaluation is crucial for the successful implementation of the Defeat TB project

activities conducted by CSOs. The project will ensure that: Sub-grantees meet the legal requirements

of Uganda and the URC/USAID agreement; proposed activities and implementation strategies align

with the set objectives; all Sub-grantees address financial and compliance matters; and all pre-

obligation requirements are met before award. Technical advisors will monitor and provide support to

Sub-grantees through monthly visits which will, in-turn, assist Sub-grantees to realize the intended

objectives.

4.2 Reporting Requirements

All grantees are expected to monitor results of their interventions/activities through data collection and

submission of regular reports/deliverables to Defeat TB. Grantees must meet monitoring and reporting

requirements in a timely and complete manner.

Selected sub-grantees will be invited to an orientation workshop in which specific instructions for

accountability and deliverable requirements will be outlined. Payment terms based on FAAs will be

discussed. Examples of milestones that may be required, as part of the deliverable schedule for the

FAA, include quarterly reports and a final report.

Periodic field visits will be conducted by Defeat TB to monitor project implementation and to verify

reporting information submitted by the applicant.

4.3 Performance Indicators

CSOs working with the Defeat TB project will contribute to the expected indicators listed below

disaggregated by age, sex, high risk group, & other categorizes required by the project:

4.3.1 Performance Indicators

Number of all patients (PBC, PCD, EP, and DR) assigned to a CSO by TB service provider/community linkage

facilitator (new and continuing).

Number of all patients (PBC, PCD, EP, and DR) assigned to a CSO by TB service provider/community linkage

facilitator (new and continuing) whose contacts are traced and screened.

Total Screened

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No. of TB close contacts (household, work mates, school mates,

neighbors, other social networks) screened for TB using ICF in the

reporting period

Presumptive TB cases

No. of presumptive TB cases identified who were referred/sample

sent for TB investigations

# Referred for TB test

# of Samples Collected

No. of referred presumptive TB cases/samples tested. Referrals Tested

Samples Tested

No. of close contacts diagnosed with DS-TB Cases from Referrals

Cases from Samples

No. of close contacts diagnosed with DR-TB Cases from Referrals

Cases from Samples

No. of close contacts diagnosed with TB registered in the unit TB

register or DR-TB register

TB Unit register

DR-TB register

No. of close contacts diagnosed with TB initiated on TB or DR-TB

treatment in the reporting period

DS-TB treatment

DR-TB treatment

Number of patients assigned to CSO enrolled and monitored for community based/ family based DOT (new

and continuing).

Total # of patients assigned to CSO lost to follow-up in the reporting period

# of lost to follow up traced back to care by CSO

Number of infectious TB patients assigned to CSO with documented sputum smear results at the end of 2

months and 5 months of treatment.

Number of clinically diagnosed TB patients assigned to CSO documented as treatment completed in the unit

TB register.

4.3.2 Indicators for TB screening outreach in targeted high-risk populations and zones

Number of integrated TB screening and sensitization outreaches conducted in the reporting period.

No. of people reached with TB and HIV messages screened for TB

in the reporting period

Total Screened

Presumptive TB cases identified

No. of presumptive TB cases identified who were referred/sample

sent for TB investigations

# Referred for TB test

# of Samples Collected

No. of referred presumptive TB cases/samples tested. Referrals Tested

Samples Tested

No. of referred presumptive TB cases with DS-TB Cases from Referrals

Cases from Samples

No. of people diagnosed with DR-TB Cases from Referrals

Cases from Samples

No. of people diagnosed with TB registered in the unit TB register

or DR-TB register

TB Unit register

DR-TB register

No. of people diagnosed with TB initiated on TB or DR-TB

treatment in the reporting period

DS-TB treatment

DR-TB treatment

No. of TB patients that participate in the stigma index assessment

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No. of patients that report discrimination secondary to their TB ailment

5.0 ELIGIBILITY CRITERIA

Applications from a wide variety of CSOs may be eligible for award under this RFA. Examples of

eligible CSOs include:

Local Non-Governmental Organisations (NGOs)

Local Faith-Based Organisations (FBOs)

Community Based Organisations (CBOs)

Prospective applicants should demonstrate ability to manage donor funding and capacity for

accountability and program implementation.

To receive a grant, a CSO must meet the following eligibility criteria:

Be a legally registered CSO recognized under the laws of Uganda (copy of a valid registration

certificate)

Provide a copy of the organizational chart

Provide a list of past performances, including previous work for USAID related projects if

applicable

Have familiarity with the Ugandan health system

Provide evidence of active community involvement and activities

Have demonstrated capacity to implement, and monitor activities and fulfil reporting and

documentation requirements

Have demonstrated capacity to manage grant funds, and evidence of a bank account (copy of

bank reconciliation)

Possess an audited financial statement/audit report for the last one year

Possess ability and willingness to work collaboratively with Defeat TB and partner staff

5.1 Other Relevant Criteria

Other relevant and highly desirable criteria for achieving the intended results outlined in this RFA

include:

1. Evidence of working with key populations such as PLHIV, healthcare workers, migrant and

mobile populations, prisoners, slum dwellers, refugees, school-going children, and contacts of

index TB cases

2. Evidence of use of innovative, low-cost ICT technologies during implementation of previous

interventions

3. Evidence of working with youth, male gender and hard to reach communities (islands)

4. Evidence of funding for other community interventions

5. Evidence of working in TB hot spot sub counties

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6.0 APPLICATION OVERVIEW

6.1 Submission Timeline

The proposed timeline for the application and selection process is as follows:

Activity Date

1. Release of RFA 22 February 2018

2. Deadline for submission of questions 2 March 2018

3. Deadline for receipt of full applications 23 March 2018

4. Award date 18 May 2018

All applications must be in English, using Times New Roman font, regular, size 12, with pages

numbered consecutively.

Questions must be submitted no later than 5:00 PM (EAT) on 2nd March 2018 to: proposals@defeat-

tb.urc-chs.com

Please submit one (1) electronic application to proposals@defeat-tb.urc-chs.com and four (4) hard

copies to the following address:

USAID Defeat TB

Plot 40 Ntinda II Road, Naguru, Kampala - Uganda

P.O. Box 28745, Kampala - Uganda

Applications must be received no later than 12:00 PM (EAT) on 23 March 2018. Applications that

are late, incomplete, or over the page limit will not be considered. Successful applicants must obtain a

valid DUNS number and provide it to URC. Requirements for obtaining a DUNS number can be found

here: http://transition.usaid.gov/policy/ads/300/302sao.pdf

6.2 Application Instructions

Two proposals are expected including a technical proposal not exceeding 20-pages and a 5-page cost

proposal.

6.2.1 Technical Proposal

Technical proposals should be written in the English language using Microsoft Word in Times New

Roman font style and font size 12 for the main text. Applicants who wish to apply for more than one

location must submit one technical proposal per location. Please be sure that the location being

applied for is clearly identified on the application.

The technical proposal should be written according to the format described below:

Cover page (1 page)

Executive summary (1 page)

Table of contents (1 page)

List of acronyms (1 page)

Proposal

o Introduction (1 page)

o Background (1/2 page)

o Organisation history and capacity (1/2 page)

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o Project description (1/2 page)

o Project goal, objectives and intervention strategies (1/2 page)

o Technical approach to proposed interventions detailing the what, why, how, where,

when for each proposed activity (4 pages)

o Expected outputs and outcomes in form of an Activity Monitoring, Evaluation, and

Learning Plan (AMELP) (2 pages)

o A community engagement plan (1/2 page)

o A quality improvement plan (1/2 page)

o A dissemination plan of the findings locally and internationally (1/2 page)

o One-year work plan in Gantt chart form (1 page)

o References (1 page)

o Curriculum vitae of key program staff (maximum 3 pages each)

The application must include the following as annexes to the proposal (if applying for more than

one location, the below only need to be submitted once).

o Risk mitigation plan

o Letter of intent by applicant

o Letter of support by current/former partnering organizations

o Letter of support by Resident District Commissioners (RDCs)

o Recommendations from past donors

o List of past performances and reports from past or current projects (use template in

Annex 4) o Organizational chart

o Copy of certificate of registration to work in Uganda

o A bank statement and audited financial statements

The applications are encouraged to:

1. Demonstrate creative and innovative approaches to the proposed activities

2. Be explicit how the approaches are to be implemented

3. Include use of gender and youth transformative interventions

4. Demonstrate sustainability of the proposed interventions

5. Indicate specific roles of various personnel (e.g., community linkage facilitators, CHEWs,

VHTs) to conduct proposed activities

6.2.2 Cost Proposal

The Cost Proposal must be submitted in a separate document in Microsoft Excel format (with formulas)

at the time the Technical Proposal is submitted, but sent in a separate email (for electronic submissions)

and in a separate envelope (for hard copy submissions). The applicant must propose a line item budget

submitted according to the instructions in Annex 3 of this RFA. A budget template will be provided

upon request.

The detailed budget, once negotiated and approved, will be the Awardee’s budget for managing the

project.

A budget narrative in a Microsoft Word or searchable PDF document should accompany the Excel

portion of the Cost Proposal. The budget narrative should include a description of costs and how they

were determined or calculated, for each line item in the budget. Applicants should review and confirm

that all amounts and formulas are correct. Budgets should be in Ugandan Shillings (Ug Shs) with a

TOTAL column in US dollars using the exchange rate of 3,600 UGX to 1 USD. The budget narrative

should not exceed 2 pages.

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Applicants who wish to apply for more than one location must submit one cost proposal and one

budget narrative per location.

Certifications and Representations detailed in Annex 7 should be completed, signed, and submitted

with the Cost Proposal.

The applicant should submit a Negotiated Indirect Cost Rate Agreement (NICRA), if applicable, or

other documentation to support indirect cost rates. If the applicant does not have a NICRA, they have

the option to select the de minimis 10% rate. See Annex 3 for more information.

Applicants must remain in compliance with US Government regulations regarding allowable expenses.

6.3 Selection Process and Evaluation

To be successful, an application will be expected to meet these basic criteria:

Exhibit a creative approach to achieve desired results with respect to TB awareness, detection,

referral and treatment adherence

Demonstrate potential for a significant and sustainable impact in addressing key TB challenges

in respective location(s)

Show how the activity may be scaled up or replicated

Demonstrate the ability to achieve concrete and measurable results

6.3.1 Scoring of Applications

The Sub-grant applications will be scored based on the following criteria:

A) Administrative Compliance

Organisation’s physical address/location within the respective district and details of the contact

person (Name, Title, Telephone Number and e-mail)

A copy of a valid registration certificate (from the National NGO Board for NGOs/FBOs and

from Districts for CBOs/FBOs). Where applicable, a license from local authorities, e.g., a

Town Council, or Municipality to conduct business.

Full adherence to requirements stipulated under section 5.0 above.

B) Technical Design (35 points)

Technical/innovative approach to strengthen community structures and systems is clearly

articulated and presents a thorough understanding of evidence-based innovative approaches

and how to operationalize this work in the respective location(s). Approach shows insight into

district culture and alignment with Government of Uganda and USAID priorities.

Demonstration of capacity for community systems strengthening with focus on stipulated key

outcomes that contribute to Defeat TB’s project goal

Technical, economic, and social feasibility of approach, including clarity of plans for

replicating and/or scaling up the activity; additionally, the readiness of the proposed activity

for immediate implementation

Innovative ways of engaging communities to participate in TB control activities.

Sustainability of approach, including involvement of local partners, districts and communities

Potential for impact on key populations and marginalized groups, including the extent to which

activities demonstrate an understanding of gender, youth and equity concerns and gender-

based barriers to accessing services within the respective location(s)

Project Management (20 points)

Organisational capacity, including demonstrating that the organisation has the size and scope

to handle proposed community systems strengthening interventions/activities

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Characteristics of proposed partners (if applicable) and appropriateness of designated activities

Feasibility of described approaches for managing implementation of community systems

strengthening interventions/activities

Effective use of personnel

Institutional Capacity and Past Performance (20 points)

Demonstrated capacity, both administratively and technically, to implement the proposed

community systems strengthening interventions/activities and report on results.

C) Cost Reasonableness (25 points)

Reasonableness and appropriateness of stated costs, compared with the approach laid out in

the technical proposal

Established understanding of current costs in Uganda, reflected in the budget narrative by a

description of how costs were calculated.

6.3.2 Approval and Award

Submission of an application does not guarantee an award. The selection committee will review all

applications that comply with the eligibility criteria. The recommendation or selection of an application

for an award does not guarantee the award. Defeat TB must be fully satisfied that the applicant is able

to perform the activities laid out in the application and to monitor them in accordance with US

Government standards. The applicant must also complete any other necessary arrangements pre-award.

Selected applications will be submitted to USAID for final approval.

6.3.3 Rejection of Applications

Applications that deviate from the stated requirements will be automatically rejected by the submission

system and these include:

Late submission of applications after the submission deadline date and time

Incomplete applications

Applications that do not adhere to the proposal formats above

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Annex 1: Technical Resources

The following technical resources may provide useful context and information for proposals:

1. WHO | Global tuberculosis report 2017

www.who.int/tb/publications/global_report/en/

2. June 2017 Revised National Strategic Plan 2015 - Ministry of Health

health.go.ug/download/file/fid/1730

3. The Uganda National Tuberculosis Prevalence Survey, 2014-2015

health.go.ug/.../uganda-national-tuberculosis-prevalence-survey-2014-2015-survey

4. Uganda National Guidelines for Tuberculosis - Ministry of Health

health.go.ug/download/file/fid/

5. TB/HIV and Multi-drug Resistant TB | Sustain Uganda

sustainuganda.org/content/tbhiv-and-multi-drug-resistant-tb

6. WHO | Tuberculosis (TB) - World Health Organization

www.who.int/tb/

7. WHO | WHO guidelines on tuberculosis

www.who.int/publications/guidelines/tuberculosis/en/

8. Stop TB Partnership | Annual Reports

www.stoptb.org › Resources › Publications

9. 2015 Annual Report - Stop TB Partnership

www.stoptb.org/assets/documents/.../annualreports/AnnualReport2015_WEB.pdf

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Annex 2: Contact Screening Targets by Location The table below highlights the different contact screening targets for each CSO per location

(division/sub-county). Applicants may apply to more than one location where they have a

presence.

District Location Name Location

Number

Contact

screening

targets

CSO allocation

per location(s)

Kampala Central Division 1 3,019 one CSO

Kampala Kawempe Division 2 4,625 one CSO

Kampala Makindye Division 3 2,050 one CSO

Kampala Nakawa Division 4 2,482 one CSO

Kampala Rubaga Division 5 2,907 one CSO

Total Kampala 15,083

Mukono Nabbale Subcounty 6 193 one CSO

Mukono Mukono Central Division 7 865 one CSO

Mukono Nakisunga Subcounty

8 220

one CSO Mukono Ntenjeru Subcounty 162

Total Mukono 1,440

Wakiso Wakiso Town Council

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208

one CSO

Wakiso Wakiso S/c 36

Wakiso Kakiri Subcounty 344

Wakiso Nansana 170

Wakiso Nabweru 97

Wakiso Entebbe Division A

10

598 one CSO

Wakiso Entebbe Division A Subcounty 158

Wakiso Kira Town Council 11 444 one CSO

Wakiso Nangabo Subcounty 12 444 one CSO

Wakiso

Ssabagabo-Makindye

Subcounty

13 861 one CSO

Wakiso Katabi Subcounty

14 220

one CSO Wakiso Ssisa Subcounty 232

Total Wakiso 3,788

GRAND TOTAL 20,311 up to 14 CSOs

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Annex 3: Budget Proposal Instructions

1. Provide a budget in both US dollars and Uganda Shillings in EXCEL format. A budget

template will be provided upon request.

Please be sure to review and confirm that all amounts and formulas are correct and in both

US dollars and Ugandan Shillings.

2. Provide a detailed line item budget in US dollars and Ugandan Shillings in EXCEL format as

follows:

Personnel: Please list each person separately, including their title/position. The personnel line

item must clearly indicate a person’s salary or daily rate and their anticipated level of effort

(LOE) by year.

Benefits: Benefits are additional personnel costs that are either required by local law or are

provided according to common practice and your organization’s written policies applicable to

all staff. Examples include mandatory contributions to National Social Security Fund (NSSF)

and Insurance (accidents and health).

Travel: Please include all costs for travel to be charged under this sub-grant including lodging,

and M&IE. Per diem rates must be consistent with URC Uganda Per-diem and Lodging Policy

(November 2017) provided in Annex 5 and Allowable USG Funding support for GOU entities

and staff (December 2016) provided in Annex 6.

Other Direct Costs and Equipment: Other direct costs of the program include bank fees,

printing costs, postage, and telecommunications costs related to completion of the activities

detailed in this RFA. The cost proposal should clearly specify what equipment is to be procured

under the proposed activities.

Indirect Costs: An applicant may use the de minimis rate of 10% to cover indirect charges

(e.g. overhead, which includes rent, utilities, communication, etc.). If the applicant has an

Indirect Cost Rate percentage, please include how the indirect rates were determined.

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Annex 4: Past Performance Form

DONOR AWARD YEAR AMOUNT

(UGX)

PURPOSE

1.

2.

3.

4

ANNEX L: UGANDA LOCAL PER DIEM POLICY

EFFECTIVE DATE: NOVEMBER 1, 2017

1) URC EMPLOYEE AND CONSULTANTS PERDIEM RATE:

URC employees and consultants are eligible to receive per diem for official travel away from the

official duty station exceeding twelve (12) hours. Per diem is composed of two parts – M&IE

(meals and incidental expenses) and Lodging.

M&IE is intended to cover meals, snacks, laundry, personal phone calls, transportation to/from

dinner and other personal expenses which may arise during a business trip. M&IE is broken

down by the US Government in the following way:

• 15% of rate is for breakfast

• 25% of rate is for lunch

• 40% of rate is for dinner

• 20% of rate for incidentals expenses

M&IE Application

Travel is Your allowance is

More than 12 hours by less than 24 hours 75% of the applicable M&IE rate for each

calendar day you are in travel status

24 hours or more Departure Day 75% of the applicable M&IE rate

Full Travel Days 100% of the applicable M&IE rate

Last Day of Travel 75% of the applicable M&IE rate

Lodging is intended to cover the actual cost of a hotel room.

Per-diem Rate

The current per diem rate for URC employee based in Uganda is as follows:

M&IE 100,000 UGX/day

Safari Day Allowance 25,000 UGX/day

Lodging Please see below the maximum lodging rates. For any rates

exceeding the lodging rates below, please obtain Chief of

Party approval. Lodging rates should not exceed the

maximum prescribed in the Department of State Standardized

Regulations (DSSR). Lodging maximums are subject to

change based on exchange rate fluctuations and changes in

the DSSR rates.

City Lodging Maximum

Entebbe 200,000 UGX

Fort Portal 200,000 UGX

Gulu 170,000 UGX

Jinja 200,000 UGX

Kampala 450,000 UGX

Mbale 200,000 UGX

Other 150,000 UGX

Calculation

Following submission and approval of the Site Visit Approval or Activity Approval, a travel

advance will be given to all employees in the estimated amount for the duration of the trip.

Following the trip, the actual expenses will be calculated in accordance to the rules listed below.

Following the trip, each employee must fill in a Travel Expense Statement (see Appendix 3)

detailing the expenses for that trip. The actual expenses (including “other work-related

expenses” below) will be subtracted from the advance. If the advance is more than actual

expenses, the employee must return the balance. If the actual expenses are more than the

advance, URC will reimburse the difference upon approval of the Travel Expense Statement.

M&IE is calculated according to the following rules:

• M&IE is provided to staff for any trips away from the office of 12 hours or more.

• Traveler receives 75% of M&IE rate on the days of travel, specifically the day they leave

home and return home, irrespective of the time they have left or returned. For Uganda,

this means 75,000UGX on travel days.

• If a meal (breakfast, lunch, or dinner) is included in a meeting, training, workshop,

conference or other event, that meal will be deducted at the percentage listed above. A

project cannot pay an employee twice for one meal by paying per diem and covering

lunch. Please note that this is true across any projects that are paid for by the USG. For

example, on days where lunch is provided at a learning session, employees will receive

their per diem LESS 25,000UGX (25% 100,000UGX). This holds true if an employee

attends - another project’s event and is provided lunch.

• If you are traveling and having a meal paid on the same day, there will be two

deductions. For instance, on the last day of a learning session, you receive lunch and are

returning home. In this case, the base rate will be 75% or 75,000UGX for a travel day,

then an additional 25% of the total rate is deducted, or 25,000UGX, so the total amount

received for that day will be UGX 50,000.

Safari day allowance is provided to staff for field trips away from the duty office/station (city/

town) for more than 6 hours in which lunch is not provided by URC or another partner

organization.

Lodging is intended for employees who work and spend a night outside their workstation and

shall be done as below;

• The Organization shall establish formal agreements for Lodging/ accommodation for her

employees while on duty in all the places/ regions in Uganda, except where it is proved

unnecessary or impossible, then, such a request must be approved by the Chief of Party.

• The procurement process of the lodging/ accommodation facilities shall be centrally

controlled by the organization to avoid cash transactions by employees, and all the

payment shall be made by the central office either by check or direct bank transactions.

• The procurement department shall carry out strategic negotiations to ensure the best

services at a good price.

The facilities must be evaluated before agreements are formalized to ensure all hotels meet the following minimum conditions such as below;

1. Costs/ prices that are competitive and within the organization’s budget, and such

entities must be able to transact through check or bank transactions.

2. Clean, decent facilities with minimal noise interruptions.

3. Distinguished ability to demonstrate people handling.

4. Hotels that offer clean and spacious rooms for facilities and to allow staff make use of the

working tables while in the field

5. Hotels that offer adequate security to guest vehicles and to an extent, staff property.

6. Clean hotel sanitation facilities, ease of accessibility and availability of parking

space

7. Good meals prepared in a hygienically acceptable kitchen. (Quality in their service)

8. Internet services or and secretarial bureau

Upon the approval of the activity trip, the administration personnel in charge of accommodation

shall arrange and book for the employees.

The employee shall receive the accommodation/lodging invoices clearly filled and signed by the

vendor and staff member submitting the Travel Expense Statement and hand them in to the

person in charge of booking accommodation at office.

The admin personnel receiving the invoices of accommodation shall verify the details there in

and submit them to finance for payment.

If the employee is working in areas where no formal lodging agreement is established, he/she

will seek approval of the Chief of Party prior paying cash.

2) NON-URC STAFF (GoU) PERDIEM, TRANSPORTATION AND FACILITATION

RATES:

This will be paid based on the USAID Mission instructions and allowed rates

3) NON-URC STAFF PERDIEM, TRANSPORATION AND FACILITATION RATES:

Please refer to URC policies and procedures.

4) SPECIAL CIRCUMSTANCES:

Per diem: The above per diem rate for Non-URC staff includes lodging rate as well (for

travel over 12 hours). However, in certain circumstances when lodging is not available

within the maximum set forth in this policy and the participation of the non-URC staff is

essential for the project success, the Chief of Party will need to provide approval. Lodging

and M&IE rates should not exceed the maximum set forth in the Department of State

Standardized Regulations (DSSR).

5) TRANSPORTATION REFUND TO URC AND NON URC STAFF:

Transport refunds to URC staff, participants, ministry official, coaches are dealt with as below:

For participants using public means, the public

rates would be used.

Actual rate

For coaches who used their own vehicles, transport

reimbursement would be based on total distance

covered otherwise known as mileage.

UGX929/km/car

Submission of log sheet is MUST. It

should cover starting and ending km

(odometer), and vehicle number plate

Coaches who don’t have personal cars URC will arrange it based on the request

by URC staff

Ministry Officials, transport refund would be

reimbursed

In the event when URC staff uses his/her own car.

This requires prior approval from supervisor/COP

Based on actual rate of diesel or petrol

1litter/ 7km distance

N.B. The Average passenger Vehicle of

up to 7 seats consumes 1 liter for every

7 Kms. Fuel receipts MUST be provided

in this case.

For GoU officials, please refer to the

Uganda Mission Directive on payments

for GoU staff.

Certifications, Assurances, Other Statements of the Recipient and

Solicitation Standard Provisions

A Mandatory Reference for ADS Chapter 303

Partial Revision Date: 04/08/2016 Responsible Office: M/OAA/P File Name: 303mav_040816

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Certifications, Assurances, Other Statements of the Recipient and Solicitation Standard Provisions NOTE: When these Certifications, Assurances, and Other Statements of Recipient are used for cooperative agreements, the term “Grant” means “Cooperative Agreement.”

Part I – Certifications and Assurances

1. Assurance of Compliance with Laws and Regulations Governing Non-Discrimination in Federally Assisted Programs Note: This certification applies to Non-U.S. organizations if any part of the program will be undertaken in the United States. (a) The recipient hereby assures that no person in the United States will, on the bases set forth below, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under, any program or activity receiving financial assistance from USAID, and that with respect to the Cooperative Agreement for which application is being made, it will comply with the requirements of: (1) Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352, 42 U.S.C. 2000-d), which prohibits discrimination on the basis of race, color or national origin, in programs and activities receiving Federal financial assistance; (2) Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), which prohibits discrimination on the basis of handicap in programs and activities receiving Federal financial assistance; (3) The Age Discrimination Act of 1975, as amended (Pub. L. 95-478), which prohibits discrimination based on age in the delivery of services and benefits supported with Federal funds; (4) Title IX of the Education Amendments of 1972 (20 U.S.C. 1681, et seq.), which prohibits discrimination on the basis of sex in education programs and activities receiving Federal financial assistance (whether or not the programs or activities are offered or sponsored by an educational institution); and (5) USAID regulations implementing the above nondiscrimination laws, set forth in Chapter II of Title 22 of the Code of Federal Regulations. (b) If the recipient is an institution of higher education, the Assurances given herein extend to admission practices and to all other practices relating to the treatment of students or clients of the institution, or relating to the opportunity to

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participate in the provision of services or other benefits to such individuals, and must be applicable to the entire institution unless the recipient establishes to the satisfaction of the USAID Administrator that the institution's practices in designated parts or programs of the institution will in no way affect its practices in the program of the institution for which financial assistance is sought, or the beneficiaries of, or participants in, such programs.

2. Certification Regarding Lobbying The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal Cooperative Agreement, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned must complete and submit Standard Form-LLL, “Disclosure of Lobbying Activities,” in accordance with its instructions. (3) The undersigned must require that the language of this certification be included in the award documents for all subawards at all tiers (including contracts, subawards, and contracts under grants, loans, and cooperative agreements) and that all subrecipients must certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, United States Code. Any person who fails to file the required certification will be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Statement for Loan Guarantees and Loan Insurance “The undersigned states, to the best of his or her knowledge and belief, that: If any funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of

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Congress in connection with this commitment providing for the United States to insure or guarantee a loan, the undersigned must complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions. Submission of this statement is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required statement will be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.”

3. Prohibition on Assistance to Drug Traffickers for Covered Countries and Individuals (ADS 206) USAID reserves the right to terminate this Agreement, to demand a refund or take other appropriate measures if the Grantee is found to have been convicted of a narcotics offense or to have been engaged in drug trafficking as defined in 22 CFR Part 140. The undersigned must review USAID ADS 206 to determine if any certifications are required for Key Individuals or Covered Participants. If there are COVERED PARTICIPANTS: USAID reserves the right to terminate assistance to or take other appropriate measures with respect to, any participant approved by USAID who is found to have been convicted of a narcotics offense or to have been engaged in drug trafficking as defined in 22 CFR Part 140.

4. Certification Regarding Terrorist Financing, Implementing Executive Order 13224 By signing and submitting this application, the prospective recipient provides the certification set out below: 1. The Recipient, to the best of its current knowledge, did not provide, within the previous ten years, and will take all reasonable steps to ensure that it does not and will not knowingly provide, material support or resources to any individual or entity that commits, attempts to commit, advocates, facilitates, or participates in terrorist acts, or has committed, attempted to commit, facilitated, or participated in terrorist acts, as that term is defined in paragraph 3. The Certification in the preceding sentence will not be deemed applicable to material support or resources provided by the Recipient pursuant to an authorization contained in one or more applicable licenses issued by the U.S. Treasury’s Office of Foreign Assets Control (OFAC). 2. The following steps may enable the Recipient to comply with its obligations under paragraph 1:

a. Before providing any material support or resources to an individual or entity, the Recipient will verify that the individual or entity does not (i) appear on the master list of Specially Designated Nationals and

5

Blocked Persons, which is maintained by OFAC, or (ii) is not included in any supplementary information concerning prohibited individuals or entities that may be provided by USAID to the Recipient. b. Before providing any material support or resources to an individual or entity, the Recipient also will verify that the individual or entity has not been designated by the United Nations Security (UNSC) sanctions committee established under UNSC Resolution 1267 (1999) (the “1267 Committee”) [individuals and entities linked to the Taliban, Usama bin Laden, or the Al-Qaida Organization]. To determine whether there has been a published designation of an individual or entity by the 1267 Committee, the Recipient should refer to the consolidated list available online at the Committee’s Web site: http://www.un.org/Docs/sc/committees/1267/1267ListEng.htm. c. Before providing any material support or resources to an individual or entity, the Recipient will consider all information about that individual or entity of which it is aware and all public information that is reasonably available to it or of which it should be aware. d. The Recipient also will implement reasonable monitoring and oversight procedures to safeguard against assistance being diverted to support terrorist activity.

3. For purposes of this Certification -

a. “Material support and resources” means currency or monetary instruments or financial securities, financial services, lodging, training, expert advice or assistance, safehouses, false documentation or identification, communications equipment, facilities, weapons, lethal substances, explosives, personnel, transportation, and other physical assets, except medicine or religious materials.”

(i) “Training" means instruction or teaching designed to impart a specific skill, as opposed to general knowledge. (ii) “Expert advice or assistance" means advice or assistance derived from scientific, technical, or other specialized knowledge.

b. “Terrorist act” means -

(i) an act prohibited pursuant to one of the 12 United Nations Conventions and Protocols related to terrorism (see UN terrorism conventions Internet site: http://untreaty.un.org/English/Terrorism.asp); or

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(ii) an act of premeditated, politically motivated violence perpetrated against noncombatant targets by subnational groups or clandestine agents; or (iii) any other act intended to cause death or serious bodily injury to a civilian, or to any other person not taking an active part in hostilities in a situation of armed conflict, when the purpose of such act, by its nature or context, is to intimidate a population, or to compel a government or an international organization to do or to abstain from doing any act.

c. “Entity” means a partnership, association, corporation, or other organization, group or subgroup. d. References in this Certification to the provision of material support and resources must not be deemed to include the furnishing of USAID funds or USAID-financed commodities to the ultimate beneficiaries of USAID assistance, such as recipients of food, medical care, micro-enterprise loans, shelter, etc., unless the Recipient has reason to believe that one or more of these beneficiaries commits, attempts to commit, advocates, facilitates, or participates in terrorist acts, or has committed, attempted to commit, facilitated or participated in terrorist acts. e. The Recipient’s obligations under paragraph 1 are not applicable to the procurement of goods and/or services by the Recipient that are acquired in the ordinary course of business through contract or purchase, e.g., utilities, rents, office supplies, gasoline, etc., unless the Recipient has reason to believe that a vendor or supplier of such goods and services commits, attempts to commit, advocates, facilitates, or participates in terrorist acts, or has committed, attempted to commit, facilitated or participated in terrorist acts.

This Certification is an express term and condition of any agreement issued as a result of this application, and any violation of it will be grounds for unilateral termination of the agreement by USAID prior to the end of its term. 5. Certification Regarding Trafficking in Persons, Implementing Title XVII of the National Defense Authorization Act for Fiscal Year 2013 Note: This certification must be completed prior to receiving an award if the estimated value of services required to be performed under the award outside the United States exceeds $500,000. This certification must also be submitted annually to the Agreement Officer during the term of the award.

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By signing below, the applicant or recipient, as applicable, through its duly designated representative, after having conducted due diligence, hereby certifies the following:

1. The applicant/recipient has implemented a compliance plan to prevent the prohibited activities identified in section (a) of the Mandatory Provision “Trafficking in Persons” and is in compliance with that plan;

2. The application/recipient has implemented procedures to prevent any activities described in section (a) of the Mandatory Provision “Trafficking in Persons” and to monitor, detect, and terminate any contractor, subawardee, employee, or other agent of the applicant/recipient engaging in any activities described in such section; and

3. To the best of the representative’s knowledge, neither the applicant/recipient, nor any employee, contractor, or subawardee of the applicant/recipient, nor any agent of the applicant/recipient or of such a contractor or subawardee, is engaged in any of the activities described in section (a) the Mandatory Provision “Trafficking in Persons.”

6. Certification of Recipient By signing below the recipient provides certifications and assurances for (1) the Assurance of Compliance with Laws and Regulations Governing Non-Discrimination in Federally Assisted Programs, (2) the Certification Regarding Lobbying, (3) the Prohibition on Assistance to Drug Traffickers for Covered Countries and Individuals (ADS 206), (4) the Certification Regarding Terrorist Financing Implementing Executive Order 13224, and (5) the Certification Regarding Trafficking in Persons above. These certifications and assurances are given in consideration of and for the purpose of obtaining any and all Federal grants, loans, contracts, property, discounts, or other Federal financial assistance extended after the date hereof to the recipient by the Agency, including installment payments after such date on account of applications for Federal financial assistance which was approved before such date. The recipient recognizes and agrees that such Federal financial assistance will be extended in reliance on the representations and agreements made in these assurances, and that the United States will have the right to seek judicial enforcement of these assurances. These assurances are binding on the recipient, its successors, transferees, and assignees, and the person or persons whose signatures appear below are authorized to sign these assurances on behalf of the recipient. Request for Application or Annual Program Statement No. ___________________________

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Application No. ________________________________ Date of Application ________________________________ Name of Recipient ________________________________ Typed Name and Title ________________________________ Signature ________________________________ Date ________________________________

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Part II – Key Individual Certification Narcotics Offenses and Drug Trafficking

I hereby certify that within the last ten years: 1. I have not been convicted of a violation of, or a conspiracy to violate, any law or regulation of the United States or any other country concerning narcotic or psychotropic drugs or other controlled substances. 2. I am not and have not been an illicit trafficker in any such drug or controlled substance. 3. I am not and have not been a knowing assistor, abettor, conspirator, or colluder with others in the illicit trafficking in any such drug or substance. Signature: ____________________________ Date: ____________________________ Name: ____________________________ Title/Position: ____________________________ Organization: ____________________________ Address: ____________________________ ____________________________ Date of Birth: ____________________________ NOTICE: 1. You are required to sign this Certification under the provisions of 22 CFR Part 140, Prohibition on Assistance to Drug Traffickers. These regulations were issued by the Department of State and require that certain key individuals of organizations must sign this Certification. 2. If you make a false Certification you are subject to U.S. criminal prosecution under 18 U.S.C. 1001.

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Part III – Participant Certification Narcotics Offenses and Drug Trafficking

1. I hereby certify that within the last ten years: a. I have not been convicted of a violation of, or a conspiracy to violate, any law or regulation of the United States or any other country concerning narcotic or psychotropic drugs or other controlled substances. b. I am not and have not been an illicit trafficker in any such drug or controlled substance. c. I am not or have not been a knowing assistor, abettor, conspirator, or colluder with others in the illicit trafficking in any such drug or substance. 2. I understand that USAID may terminate my training if it is determined that I engaged in the above conduct during the last ten years or during my USAID training. Signature: ___________________________________ Name: ___________________________________ Date: ___________________________________ Address: ___________________________________ ___________________________________ Date of Birth: ___________________________________ NOTICE: 1. You are required to sign this Certification under the provisions of 22 CFR Part 140, Prohibition on Assistance to Drug Traffickers. These regulations were issued by the Department of State and require that certain participants must sign this Certification. 2. If you make a false Certification you are subject to U.S. criminal prosecution under 18 U.S.C. 1001.

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Part IV – Representation by Organization Regarding a Delinquent Tax Liability or a Felony Criminal Conviction

(a) As required by sections 744 and 745 of Division E of the Consolidated and

Further Continuing Appropriations Act, 2015 (Pub. L. 113-235), and similar provisions, if contained in subsequent appropriations acts, none of the funds made available by that Act may be used to enter into an assistance award with any organization that –

(1) “Was convicted of a felony criminal violation under any Federal law

within the preceding 24 months, where the awarding agency has direct knowledge of the conviction, unless the agency has considered, in accordance with its procedures, that this further action is not necessary to protect the interests of the Government”; or

(2) “Has any unpaid Federal tax liability that has been assessed for which

all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency has direct knowledge of the unpaid tax liability, unless the Federal agency has considered, in accordance with its procedures, that this further action is not necessary to protect the interests of the Government”.

It is USAID’s policy that no award may be made to any organization covered by (1) or (2) above, unless the M/OAA Compliance Division has made a determination that suspension or debarment is not necessary to protect the interests of the Government.

(b) Applicant Representation: (1) The Applicant represents that it is [ ] is not [ ] an organization that was

convicted of a felony criminal violation under a Federal law within the preceding 24 months.

(2) The Applicant represents that it is [ ] is not [ ] an organization that has any unpaid Federal tax liability that has been assessed for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability.

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Part V – Other Statements of Recipient

1. Authorized Individuals The recipient represents that the following persons are authorized to negotiate on its behalf with the Government and to bind the recipient in connection with this application or grant: Name Title Telephone No. Facsimile No. ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ 2. Taxpayer Identification Number (TIN) If the recipient is a U.S. organization, or a foreign organization which has income effectively connected with the conduct of activities in the U.S. or has an office or a place of business or a fiscal paying agent in the U.S., please indicate the recipient’s TIN: TIN: ________________________________ 3. Data Universal Numbering System (DUNS) Number (a) Unless otherwise specified in the solicitation using an applicable exemption, in the space provided at the end of this provision, the recipient should supply the Data Universal Numbering System (DUNS) number applicable to that name and address. Recipients should take care to report the number that identifies the recipient's name and address exactly as stated in the proposal. (b) The DUNS is a 9-digit number assigned by Dun and Bradstreet Information Services. If the recipient does not have a DUNS number, the recipient should call Dun and Bradstreet directly at 1-800-333-0505. A DUNS number will be provided immediately by telephone at no charge to the recipient. The recipient should be prepared to provide the following information: (1) Recipient’s name. (2) Recipient’s address. (3) Recipient's telephone number.

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(4) Line of business. (5) Chief executive officer/key manager. (6) Date the organization was started. (7) Number of people employed by the recipient. (8) Company affiliation. (c) Recipients located outside the United States may email Dun and Bradstreet at globalinfo@dbisma.com to obtain the location and phone number of the local Dun and Bradstreet Information Services office. The DUNS system is distinct from the Federal Taxpayer Identification Number (TIN) system. DUNS: ________________________________________ 4. Letter of Credit (LOC) Number If the recipient has an existing Letter of Credit (LOC) with USAID, please indicate the LOC number: LOC: _________________________________________

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5. Procurement Information (a) Applicability. This applies to the procurement of goods and services planned by the recipient (i.e., contracts, purchase orders, etc.) from a supplier of goods or services for the direct use or benefit of the recipient in conducting the program supported by the grant, and not to assistance provided by the recipient (i.e., a subgrant or subagreement) to a subgrantee or subrecipient in support of the subgrantee’s or subrecipient's program. Provision by the recipient of the requested information does not, in and of itself, constitute USAID approval. (b) Amount of Procurement. Please indicate the total estimated dollar amount of goods and services which the recipient plans to purchase under the grant: $__________________________ (c) Nonexpendable Property. If the recipient plans to purchase nonexpendable equipment which would require the approval of the Agreement Officer, indicate below (using a continuation page, as necessary) the types, quantities of each, and estimated unit costs. Nonexpendable equipment for which the Agreement Officer's approval to purchase is required is any article of nonexpendable tangible personal property charged directly to the grant, having a useful life of more than one year and an acquisition cost of $5,000 or more per unit. TYPE/DESCRIPTION (Generic) ____________________________ QUANTITY ____________________________ ESTIMATED UNIT COST ____________________________ (d) Source If the recipient plans to purchase any goods/commodities which are not in accordance with the Standard Provision “USAID Eligibility Rules for Procurement of Commodities and Services,” indicate below (using a continuation page, as necessary) the types and quantities of each, estimated unit costs of each, and probable source. “Source” means the country from which a commodity is shipped to the cooperating country or the cooperating country itself if the commodity is located in the cooperating country at the time of purchase. However, where a commodity is shipped from a free port or bonded warehouse in the form in which received, “source” means the country from which the commodity was shipped to the free port or bonded warehouse. Additionally, “available for purchase” includes “offered for sale at the time of purchase” if the commodity is listed in a vendor’s catalog or other statement of inventory, kept as part of the vendor’s customary business practices and regularly offered for sale, even if the commodities are not physically on the vendors’ shelves or even in the source country at the time of the order. In such cases, the recipient must document that the commodity was listed in the vendor’s catalog or other statement of inventory; that the vendor has a regular and customary business practice of selling the commodity through “just in time” or other similar inventory

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practices; and the recipient did not engage the vendor to list the commodity in its catalog or other statement of inventory just to fulfill the recipient’s request for the commodity. TYPE/DESCRIPTION _____________________________ QUANTITY _____________________________ ESTIMATED GOODS _____________________________ PROBABLE GOODS _____________________________ PROBABLE (Generic) _____________________________ UNIT COST _____________________________ SOURCE _____________________________ (e) Restricted Goods. If the recipient plans to purchase any restricted goods, indicate below (using a continuation page, as necessary) the types and quantities of each, estimated unit costs of each, intended use, and probable source. Restricted goods are Agricultural Commodities, Motor Vehicles, Pharmaceuticals, Pesticides, Used Equipment, U.S. Government-Owned Excess Property, and Fertilizer. TYPE/DESCRIPTION ______________________________ QUANTITY ______________________________ ESTIMATED ______________________________ PROBABLE ______________________________ INTENDED USE (Generic) ______________________________ UNIT COST ______________________________ SOURCE ______________________________ (f) Supplier Nationality. If the recipient plans to purchase any goods or services from suppliers of goods and services whose nationality is not in accordance with the Standard Provision “USAID Eligibility Rules for Procurement of Commodities and Services,” indicate below (using a continuation page, as necessary) the types and quantities of each good or service, estimated costs of each, probable nationality of each non-U.S. supplier of each good or service, and the rationale for purchasing from a non-U.S. supplier. TYPE/DESCRIPTION _____________________________ QUANTITY _____________________________ ESTIMATED _____________________________ PROBABLE SUPPLIER _____________________________ NATIONALITY _____________________________ RATIONALE (Generic) _____________________________ UNIT COST (Non-US Only) _____________________________ FOR NON-US _____________________________

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6. Past Performance References On a continuation page, please provide past performance information requested in the RFA. 7. Type of Organization The recipient, by checking the applicable box, represents that - (a) If the recipient is a U.S. entity, it operates as [ ] a corporation incorporated under the laws of the State of, [ ] an individual, [ ] a partnership, [ ] a nongovernmental nonprofit organization, [ ] a state or local governmental organization, [ ] a private college or university, [ ] a public college or university, [ ] an international organization, or [ ] a joint venture; or (b) If the recipient is a non-U.S. entity, it operates as [ ] a corporation organized under the laws of _____________________________ (country), [ ] an individual, [ ] a partnership, [ ] a nongovernmental nonprofit organization, [ ] a nongovernmental educational institution, [ ] a governmental organization, [ ] an international organization, or [ ] a joint venture. 8. Estimated Costs of Communications Products The following are the estimate(s) of the cost of each separate communications product (i.e., any printed material [other than non-color photocopy material], photographic services, or video production services) which is anticipated under the grant. Each estimate must include all the costs associated with preparation and execution of the product. Use a continuation page as necessary.

Part VI – Standard Provisions for Solicitations

1. Branding Strategy – Assistance (June 2012) a. Applicants recommended for an assistance award must submit and

negotiate a "Branding Strategy," describing how the program, project, or activity is named and positioned, and how it is promoted and communicated to beneficiaries and host country citizens.

b. The request for a Branding Strategy, by the Agreement Officer from the

applicant, confers no rights to the applicant and constitutes no USAID commitment to an award.

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c. Failure to submit and negotiate a Branding Strategy within the time frame specified by the Agreement Officer will make the applicant ineligible for an award.

d. The applicant must include all estimated costs associated with branding

and marking USAID programs, such as plaques, stickers, banners, press events, materials, and so forth, in the budget portion of the application. These costs are subject to the revision and negotiation with the Agreement Officer and will be incorporated into the Total Estimated Amount of the grant, cooperative agreement or other assistance instrument.

e. The Branding Strategy must include, at a minimum, all of the following:

(1) All estimated costs associated with branding and marking USAID programs, such as plaques, stickers, banners, press events, materials, and so forth.

(2) The intended name of the program, project, or activity.

(i) USAID requires the applicant to use the “USAID Identity,”

comprised of the USAID logo and brandmark, with the tagline “from the American people” as found on the USAID Web site at http://www.usaid.gov/branding, unless Section VI of the RFA or APS states that the USAID Administrator has approved the use of an additional or substitute logo, seal, or tagline.

(ii) USAID prefers local language translations of the phrase “made possible by (or with) the generous support of the American People” next to the USAID Identity when acknowledging contributions.

(iii) It is acceptable to cobrand the title with the USAID Identity and the applicant's identity.

(iv) If branding in the above manner is inappropriate or not possible, the applicant must explain how USAID's involvement will be showcased during publicity for the program or project.

(v) USAID prefers to fund projects that do not have a separate logo or identity that competes with the USAID Identity. If there is a plan to develop a separate logo to consistently identify this program, the applicant must attach a copy of the proposed logos. Section VI of the RFA or APS will state if an Administrator approved the use of an additional or substitute

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logo, seal, or tagline.

(3) The intended primary and secondary audiences for this project or program, including direct beneficiaries and any special target segments.

(4) Planned communication or program materials used to explain or

market the program to beneficiaries.

(i) Describe the main program message. (ii) Provide plans for training materials, posters, pamphlets,

public service announcement, billboards, Web sites, and so forth, as appropriate.

(iii) Provide any plans to announce and promote publicly this program or project to host country citizens, such as media releases, press conferences, public events, and so forth. Applicant must incorporate the USAID Identity and the message, “USAID is from the American People.”

(iv) Provide any additional ideas to increase awareness that the American people support this project or program.

(5) Information on any direct involvement from host-country

government or ministry, including any planned acknowledgement of the host-country government.

(6) Any other groups whose logo or identity the applicant will use on

program materials and related materials. Indicate if they are a donor or why they will be visibly acknowledged, and if they will receive the same prominence as USAID.

e. The Agreement Officer will review the Branding Strategy to ensure the

above information is adequately included and consistent with the stated objectives of the award, the applicant's cost data submissions, and the performance plan.

f. If the applicant receives an assistance award, the Branding Strategy will

be included in and made part of the resulting grant or cooperative agreement

(END OF PROVISION)

2. Marking Plan – Assistance (June 2012) a. Applicants recommended for an assistance award must submit and

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negotiate a “Marking Plan,” detailing the public communications, commodities, and program materials, and other items that will visibly bear the “USAID Identity,” which comprises of the USAID logo and brandmark, with the tagline “from the American people.” The USAID Identity is the official marking for the Agency, and is found on the USAID Web site at http://www.usaid.gov/branding. Section VI of the RFA or APS will state if an Administrator approved the use of an additional or substitute logo, seal, or tagline.

b. The request for a Marking Plan, by the Agreement Officer from the

applicant, confers no rights to the applicant and constitutes no USAID commitment to an award.

c. Failure to submit and negotiate a Marking Plan within the time frame

specified by the Agreement Officer will make the applicant ineligible for an award.

d. The applicant must include all estimated costs associated with branding

and marking USAID programs, such as plaques, stickers, banners, press events, materials, and so forth, in the budget portion of the application. These costs are subject to the revision and negotiation with the Agreement Officer and will be incorporated into the Total Estimated Amount of the grant, cooperative agreement or other assistance instrument.

e. The Marking Plan must include all of the following:

(1) A description of the public communications, commodities, and program materials that the applicant plans to produce and which will bear the USAID Identity as part of the award, including:

(i) Program, project, or activity sites funded by USAID,

including visible infrastructure projects or other sites physical in nature;

(ii) Technical assistance, studies, reports, papers, publications,

audio-visual productions, public service announcements, Web sites/Internet activities, promotional, informational, media, or communications products funded by USAID;

(iii) Commodities, equipment, supplies, and other materials

funded by USAID, including commodities or equipment provided under humanitarian assistance or disaster relief programs; and

(iv) It is acceptable to cobrand the title with the USAID Identity

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and the applicant's identity. (v) Events financed by USAID, such as training courses,

conferences, seminars, exhibitions, fairs, workshops, press conferences and other public activities. If the USAID Identity cannot be displayed, the recipient is encouraged to otherwise acknowledge USAID and the support of the American people.

(2) A table on the program deliverables with the following details:

(i) The program deliverables that the applicant plans to mark

with the USAID Identity; (ii) The type of marking and what materials the applicant will

use to mark the program deliverables; (iii) When in the performance period the applicant will mark the

program deliverables, and where the applicant will place the marking;

(iv) What program deliverables the applicant does not plan to

mark with the USAID Identity , and (v) The rationale for not marking program deliverables.

(3) Any requests for an exemption from USAID marking requirements,

and an explanation of why the exemption would apply. The applicant may request an exemption if USAID marking requirements would: (i) Compromise the intrinsic independence or neutrality of a

program or materials where independence or neutrality is an inherent aspect of the program and materials. The applicant must identify the USAID Development Objective, Interim Result, or program goal furthered by an appearance of neutrality, or state why an aspect of the award is presumptively neutral. Identify by category or deliverable item, examples of material for which an exemption is sought.

(ii) Diminish the credibility of audits, reports, analyses, studies,

or policy recommendations whose data or findings must be seen as independent. The applicant must explain why each particular deliverable must be seen as credible.

(iii) Undercut host-country government “ownership” of

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constitutions, laws, regulations, policies, studies, assessments, reports, publications, surveys or audits, public service announcements, or other communications. The applicant must explain why each particular item or product is better positioned as host-country government item or product.

(iv) Impair the functionality of an item. The applicant must

explain how marking the item or commodity would impair its functionality.

(v) Incur substantial costs or be impractical. The applicant must

explain why marking would not be cost beneficial or practical.

(vi) Offend local cultural or social norms, or be considered

inappropriate. The applicant must identify the relevant norm, and explain why marking would violate that norm or otherwise be inappropriate.

(vii) Conflict with international law. The applicant must identify

the applicable international law violated by the marking. f. The Agreement Officer will consider the Marking Plan's adequacy and

reasonableness and will approve or disapprove any exemption requests. The Marking Plan will be reviewed to ensure the above information is adequately included and consistent with the stated objectives of the award, the applicant's cost data submissions, and the performance plan.

g. If the applicant receives an assistance award, the Marking Plan, including

any approved exemptions, will be included in and made part of the resulting grant or cooperative agreement, and will apply for the term of the award unless provided otherwise.

(END OF PROVISION)

3. Conscience Clause Implementation (Assistance) – Solicitation Provision (February 2012) APPLICABILITY: This provision must be included in any new Request for Applications (RFA) or Annual Program Statement (APS) that intends to obligate FY04 or later funds made available for HIV/AIDS activities, regardless of the program account. Further guidance is found in AAPD 14-04, Section 2.D. CONSCIENCE CLAUSE IMPLEMENTATION (ASSISTANCE) – SOLICITATION

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PROVISION (February 2012) (a) An organization, including a faith-based organization, that is otherwise

eligible to receive funds under this agreement for HIV/AIDS prevention, treatment, or care—

1) Shall not be required, as a condition of receiving such assistance—

(i) to endorse or utilize a multisectoral or comprehensive

approach to combating HIV/AIDS; or (ii) to endorse, utilize, make a referral to, become integrated

with, or otherwise participate in any program or activity to which the organization has a religious or moral objection; and

2) Shall not be discriminated against in the solicitation or issuance of

grants, contracts, or cooperative agreements for refusing to meet any requirement described in paragraph (a)(1) above.

(b) An applicant who believes that this solicitation contains provisions or

requirements that would require it to endorse or use an approach or participate in an activity to which it has a religious or moral objection must so notify the cognizant Agreement Officer in accordance with the Mandatory Standard Provision titled “Notices” as soon as possible, and in any event not later than 15 calendar days before the deadline for submission of applications under this solicitation. The applicant must advise which activity(ies) it could not implement and the nature of the religious or moral objection.

(c) In responding to the solicitation, an applicant with a religious or moral

objection may compete for any funding opportunity as a prime partner, or as a leader or member of a consortium that comes together to compete for an award. Alternatively, such applicant may limit its application to those activities it can undertake and must indicate in its submission the activity(ies) it has excluded based on religious or moral objection. The offeror’s proposal will be evaluated based on the activities for which a proposal is submitted, and will not be evaluated favorably or unfavorably due to the absence of a proposal addressing the activity(ies) to which it objected and which it thus omitted. In addition to the notification in paragraph (b) above, the applicant must meet the submission date provided for in the solicitation.

(END OF PROVISION)

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4. Prohibition on Providing Federal Assistance to Entities that Require Certain Internal Confidentiality Agreements – Representation (April 2015) APPLICABILITY: This pre-award provision must be included in Section IV of all assistance solicitations. PROHIBITION ON PROVIDING FEDERAL ASSISTANCE TO ENTITIES THAT REQUIRE CERTAIN INTERNAL CONFIDENTIALITY AGREEMENTS – REPRESENTATION (APRIL 2015) (a) In accordance with section 743 of Division E, Title VII, of the Consolidated

and further Continuing Resolution Appropriations Act, 2015 (Pub. L. 113-235), Government agencies are not permitted to use funds appropriated (or otherwise made available) under that or any other Act for providing federal assistance to an entity that requires employees, subawardees or contractors of such entity seeking to report fraud, waste, or abuse to sign internal confidentiality agreements or statements prohibiting or otherwise restricting such employees, subawardees, or contractors from lawfully reporting such waste, fraud, or abuse to a designated investigative or law enforcement representative of a Federal department or agency authorized to receive such information.

(b) The prohibition in paragraph (a) of this provision does not contravene requirements applicable to Standard Form 312, Form 4414, or any other form issued by a Federal department or agency governing the nondisclosure of classified information.

(c) By submission of its application, the prospective recipient represents that it does not require employees, subawardees, or contractors of such entity seeking to report fraud, waste, or abuse to sign internal confidentiality agreements or statements prohibiting or otherwise restricting such employees, subawardees, or contractors from lawfully reporting such waste, fraud, or abuse to a designated investigative or law enforcement representative of a Federal department or agency authorized to receive such information.

(END OF PROVISION) 303mav_042116