Information and Education Grant (I&E) 2011- 2016
Request for Application (RFA) #11-10017

MO-10-0030 TPP

I&E 2011-2016 RFA # 11-10017 (PDF)Revised 01-07-2011

Appendices

Exhibits

Attachments

Appendices

Appendix 1 – Welfare and Institutions Codes:  I&E Program (Word)

Appendix 2 – Health and Safety Codes:  Sexual Health Education Accountability Act (Word)

Appendix 3 – Education Codes: California Comprehensive Sexual Health and HIV/AIDS Prevention Education Act (Word)

Appendix 4 – Certification of Compliance with the Sexual Health Education Accountability Act (Word)

Appendix 5 –  Teen Births in California: A Resource for Planning and Policy (PDF)

Appendix 6 – Needs Assessment Resources List (Word)

Appendix 7 – Logic Model Samples (Word)Revised 12-30-2010

Appendix 8 – Risk and Protective Factors  Resource (PDF)

Appendix 9 – School Agreement Form (Word)

Appendix 10 – I&E Project Interventions Criteria (Word)Revised 12-30-2010

Appendix 11 – Family PACT Integration Requirements for Intervention Activities (Word)

Appendix 12 – Project Plan Samples (Word)Revised 12-30-2010

Appendix 13 – Workplan Samples (Word)Revised 12-30-2010

Appendix 14 – Core Competencies for Adolescent Sexual and Reproductive Health (PDF)

Appendix 15 – Duty Statement Samples (Word)

Appendix 16 – Federal Financial Participation (FFP) User Guide (PDF)

Appendix 17 – Agency Information Form (Word)

Appendix 18 – CCC 307 - Certification (Word)

Appendix 19 – Darfur Contracting Act (Word)

Appendix 20 – Payee Data Record (STD 204) (Word)

Appendix 21 – Software and Hardware Requirements (Word)

Appendix 22 – Private Non Profit Corporation IRS Sample Letter (Word)

Appendix 23 – Glossary/Definitions (Word)

Appendix 24 – Application Technical Review Tool (Word)Revised 12-30-2010

Appendix 25 – Tips for Completing CCG RFA Packet (Word)

Appendix 26 – Budget Resource Document (Word)

Appendix 27 – Consultant/Subcontractor Guidelines (Word)

Appendix 28 – Application Intervention Summary Sample (Word)Posted 12-30-2010

Exhibits

Exhibit A1 – Standard Grant Agreement (CDPH 1229) (PDF)

Exhibit A – Scope of Work (FY 2011-2016) (PDF)

Exhibit B – Budget Detail and Payment Provisions (PDF)

Exhibit C – General Terms and Conditions (GTC 307) (PDF)View or download this exhibit at this Internet site: http://www.ols.dgs.ca.gov/Standard+Language/default.htm

Exhibit D(F) – Special Terms and Conditions (PDF)

Exhibit E – Additional Provisions (PDF)

Exhibit F – Contractor’s Release (PDF)

Exhibit G – Travel Reimbursement Information (PDF)

Exhibit H – Contract Equipment Purchased with CDPH Funds (CDPH 1203) (PDF)

Exhibit I – Inventory/Disposition of CDPH-Funded Equipment (CDPH 1204) (PDF)

Exhibit J – HIPAA Business Associate Addendum or UC HIPAA Business Associate Addendum (PDF, 1.3 MB)

Attachments

Attachment 1 – Application Checklist (Word)Revised 12-30-2010

Attachment 2 – Application Cover Page (Word)

Attachment 3 – Application Intervention Summary (Word)Revised 12-30-2010

Attachment 4 – Logic Models (Word)Revised 12-30-2010

Attachment 5 – Letter of Intent by Public Schools (Word)

Attachment 6 – Letter of Intent by Family PACT Provider  (Word)

Attachment 7 – Project Plan (Word)

Attachment 8 – Bidders’ Teleconference/Webinar Question Form (Word)

Attachment 9 – Bidders’ Teleconference/Webinar  Registration Form (Word)

Attachment 10 – Letter of Intent to Submit an Application (Word)

Attachment 11 – Self-Certification for I&E Collaboration with TPP Regional Network Form (Word)

Attachment 12 –Duty Statements (Word)

Attachment 13 – Applicant Budget Template (Excel)

Attachment 14 – Subcontractor Budget Template (Excel)

Attachment 15 – Subcontractor Summary (Word)