1. $3,000,000
    1. CONDITIONS FOR ACCEPTANCE
    2. TECHNICAL / FORMAT REQUIREMENTS
    3. NARRATIVE REQUIREMENTS
      1. I. Project Abstract
      2. III. School Improvement Initiatives
      3. IV. Professional Development, Resources, and Parental Involvement
      4. V. Program Implementation
      5. VI. Internal Collaboration
      6. VII. Fostering Collaboration with Districts
      7. VIII. Technical Assistance to Improve Student Performance
      8. IX. Collaboration with Other Agencies
      9. X. Responses to LEAs
      10. XI. Implementation, Review, and Monitoring
      11. XII. Budget
      12. XIII. Just Read, Florida!
      13. XIV. Technical Assistance/Professional Development in All Core Subject Areas
      14. XV. Dissemination of Information to Appropriate Populations
      15. XVI. Regions to be Targeted
      16. I. Project Abstract (0 points)
      17. III. School Improvement Initiatives (10 points)
      18. IV. Professional Development, Resources, and Parental Involvement (10 points)
      19. V. Program Implementation (10 points)
      20. VI. Internal Collaboration (5 points)
      21. VII. Fostering Collaboration with Districts (5 points)
      22. VIII. Technical Assistance to Improve Student Performance (15 points)
      23. IX. Collaboration with Other Agencies (5 points)
      24. X. Responses to LEAs (10 points)
      25. XI. Implementation, Review, and Monitoring (10 points)
      26. XII. Budget (5 points)
      27. XIII. Just Read, Florida! (5 points)
      28. XV. Dissemination of Information to Appropriate Populations (5 points)
      29. XVI. Regions to be Targeted (0 points)
    4. FISCAL REQUIREMENTS
    5. NOTICE OF INTENT TO APPLY
    6.  
    7. METHOD OF SELECTION
    8. IMPLEMENTATION REQUIREMENTS
    9. REPORTING OUTCOMES
  1. Title I Programs and Academic Intervention Services
    1. NCLB REGIONAL TECHNICAL ASSISTANCE CENTERS
  2. CERTIFICATION
  3. Instructions for Completion of DOE 100B
    1. District/Agency:
    2. ITEM MINIMUM REQUIREMENT TIMELINE
    3. Lisa C. Saavedra, Chief
    4. Lisa C. Saavedra, Chief
    5. District/Agency:
    6. FUNCTION ACTIVITY TIMELINE/ACTION ITEM
    7. FUNCTION ACTIVITY TIMELINE/ACTION ITEM
  4. FLORIDA DEPARTMENT OF EDUCATION Budget Description Form
      1. (1) FUNCTION
      2. (2) OBJECT
      3. (3) DESCRIPTION
      4. (4) AMOUNT
    1. DOE 103 A
    2. District/Agency:
    3. (1) FUNCTION
    4. (2) OBJECT
    5. (3) DESCRIPTION OF SERVICES
    6. INSTRUCTIONS FOR CAPITAL OUTLAY SCHEDULE
      1. A. 1) Eligible Applicant: 5) Telephone/SunCom:
      2. 6) FAX Number:
      3. 3) Contact Name: 7) E-mail:
      4. Goals Unit Cost
    7. product(s) to be delivered that will support the goals.
    8. Section A - Complete all information as requested.
    9. Section B - Complete information as requested. Columns (1), (2), (3), (3a), (4)
    10. NOTE:

FLORIDA DEPARTMENT OF EDUCATION
Request for Proposal (RFP) for Competitive Grants
Division/Office
Title
Specific Funding Authorities
Funding Purpose
Target Population
Eligible Applicants
Application Due Date
Delivery Address
Contact Persons
Total Funding Amount
Range of Awards
Budget Period
Additional Years of Funding
Funding Method
Local Match
K-12 Education/Student Achievement/Bureau of Student Assistance
NCLB Regional Technical Assistance Centers for 2004-05 Fiscal Year
No Child Left Behind Act of 2001, P. L. 107-110 - Title I, Title III and Title X-Homeless
[CFDA 84.010; 84.011; 84.365; and 84.196]
Funds will be provided on a competitive basis for technical assistance to local school
districts in each of the five regions. These funds will be used by the selected NCLB
Regional Technical Assistance Centers to assist Florida Department of Education
(FDOE) in school improvement, parental involvement, professional development,
scientifically-based research and continuous improvement activities to fully implement
the requirements of Title I, Title III and Title X-Homeless of The No Child Left Behind
Act of 2001. These Centers will assist schools in the greatest need of improvement,
with emphasis on those that did not make adequate yearly progress (AYP); support in
implementing NCLB requirements; provide technical assistance to district and school
personnel responsible for Title I, Title III, and Title X-Homeless program
implementation; and disseminate information on scientifically-based education
research.
District and school personnel, involved in Title I, Basic, Migrant, Neglected and
Delinquent, Title III, and Title X-Homeless Education programs.
School Districts, Consortia of School districts, colleges and universities, established
consortia, and not-for-profit organizations.
Due by
close of business
on
January 10, 2005
, to the Bureau of Grants Management.
This deadline refers to receipt by the Bureau and not a postmarked date.
NOTE
:
No
faxed or emailed copies will be accepted.
Bureau of Grants Management
Florida Department of Education
325 West Gaines Street
Turlington Building, Suite 344
Tallahassee, Florida 32399-0400
Phone: (850)245-0498
For technical support, please contact:
Lisa C. Saavedra, (850) 245-0414, lisa.saavedra@fldoe.org
$3,000,000
$350,000-$600,000, with the maximum award for a single Region of $600,000.00
Upon Receipt through September 30, 2005
Project period is for three (3) years. Budget is renewable for additional years of funding,
if the previous year’s deliverables are satisfactory and funds are available.
Reimbursement with Performance - Payment made upon submission of documented
allowable expenditures, plus documentation of completion of specified performance
objectives.
N/A
1

NCLB REGIONAL TECHNICAL ASSISTANCE CENTERS
?
FISCAL YEAR 2004-2005
?
GENERAL TERMS, ASSURANCES AND CONDITIONS FOR PARTICIPATION IN FEDERAL AND
STATE PROGRAMS
The Florida Department of Education (FDOE) has developed and implemented a document entitled,
General
Terms, Assurances and Conditions for Participation in Federal and State Programs
, to comply with:
?
34 CFR 76.301 of the Education Department General Administration Regulations (EDGAR) which requires
local educational agencies to submit a common assurance for participation in federal programs funded by the
U.S. Department of Education;
?
applicable regulations of other Federal agencies; and
?
state regulations and laws pertaining to the expenditure of state funds.
In order to receive funding, applicants must have on file with the FDOE, Office of the Comptroller, a signed
statement by the agency head certifying applicant adherence to these General Assurances for Participation in
State or Federal Programs. The complete text may be found at http://www.firn.edu/doe/comptroller/gbook.htm.
School Districts, Community Colleges, Universities and State Agencies: The certification of adherence filed with
the FDOE Comptroller’s Office shall remain in effect indefinitely unless a change occurs in federal or state law, or
there are other changes in circumstances affecting a term, assurance, or condition; and does not need to be
resubmitted with this proposal.
Private Colleges, Community-based Organizations, and Other Agencies: Applicants must submit with the
application the certification page signed by the agency head certifying applicant adherence to the general terms,
assurances, and conditions. Please note that private colleges, community-based organizations, and other non-
public agencies must also submit copies of the organization’s current budget, a list of its board of directors, and if
available, a copy of its most recent annual audit report prepared by an independent certified public accountant
licensed in this state. These items must be submitted prior to the issuance of a project award.
CONDITIONS FOR ACCEPTANCE
Proposals must be received in the Bureau of Grants Management by close of business on
January 10, 2005,
and
must include the following components. Proposals missing any of the requirements listed below will not be
reviewed for funding.
?
Applicants must clearly state which region (or regions) they are proposing to serve.
?
DOE 100B Project Application Form, with an original signature by the head of the organization submitting the
proposal. If the signature on the DOE 100B is other than the agency head, a letter must be attached from this
official, or the governing body, authorizing that individual to sign.
?
Section I: Assurances for NCLB Regional Technical Assistance Centers for 2004-05 Fiscal Year,
submitted
without modification.
?
Required budget forms:
DOE 103 Budget Description Form
DOE 103A Personnel Schedule
DOE 103B Professional And Technical Services Schedule
DOE 103C Capital Outlay Schedule
DOE 103D Travel Schedule
Performance-Based Deliverables and Invoice Schedule
2

Additional Requirements for All Private Entities:
?
General Terms, Assurances, and Conditions for Participation in Federal and State Programs certification page
with original signature of the agency head.
?
List of current Board of Directors and Articles of Incorporation
?
Copy of current operating budget
?
Copy of most recent external audit report
TECHNICAL / FORMAT REQUIREMENTS
?
One proposal with the original signature of the agency head in an ink other than black to distinguish it from the
copies. Abstract must clearly state which region (or regions) applicant intends to serve.
?
Four copies of the original proposal.
?
The DOE forms should indicate the correct TAPS tracking number in the upper right corner. These forms are
attached to the RFP and can be found in electronic format at the website,
http://www.firn.edu/doe/commhome/granhome.htm.
?
All applicants should use a 12-point font, 1” margins, and single-sided typed 8.5 X 11-inch sized pages.
?
The original and copies may be stapled, but no other binding will be acceptable.
NARRATIVE REQUIREMENTS
Applications should be assembled in the same order as described in this section.
I. Project Abstract
With a one-page limit, describe the essentials aspects of the project in relation to the purpose and priorities
identified in this RFP. Abstract must clearly state which region (or regions) applicant intends to serve.
II.
Instructions For Section 427 Of The General Education Provisions Act (GEPA) Requirement
Provide a description of the steps to be taken to ensure equitable access to and participation in this federally
assisted program for students, teachers, and other program beneficiaries with special needs. This description
should address the plan to overcome those barriers that are applicable to your circumstances. (Examples are
gender, race, national origin, color, disability, age, limited English proficiency, and other barriers.) The
requirements of this provision are not intended to duplicate the requirements of civil rights statutes, but rather are
intended to ensure that equity exists for all potential beneficiaries to fully participate and achieve high standards in
this project.
III.
School Improvement Initiatives
Describe the school improvement programs, procedures, and strategies that will be used with identified schools,
especially those that have a history of low-performance to improve student achievement. Describe how these
activities will be implemented in collaboration with the FDOE staff. Include strategies which will be used to ensure
collaboration with FDOE’s Assistance Plus and School Improvement Initiatives. Identify appropriate resources
available for schools and teachers to ensure the delivery of comprehensible instruction to LEP students. (Please
be specific by including dates of activities and supporting documentation. NOTE: All regional workshops,
meetings, and conferences must be planned in collaboration with and prior notification provided to the Bureau of
Student Assistance.)
IV.
Professional Development, Resources, and Parental Involvement
Describe effective methods and instructional strategies based on scientific research, to be used in supporting
professional development for school improvement in identified schools, especially those schools identified as low
achieving, as indicated by their failure to make Adequate Yearly Progress (AYP). Identify appropriate resources
3
?

available for schools/teachers to enhance their work with students with low achievement scores. Description must
include strategies to be used to assist schools and school districts in the meaningful engagement of parents and
the community in supporting student learning and school improvement. Include a description of strategies to meet
the needs of parents who are limited English proficient. (Please be specific by including projected dates of
activities and supporting documentation, and anticipated types and numbers of participants.)
V. Program Implementation
Describe the process and strategies for assisting the Bureau of Student Assistance in its efforts to provide technical
assistance to district personnel and identified school personnel with the implementation of projects and with
development and implementation of project amendments. Provide documentation as to how these activities will be
tied to FDOE’s goal of improving student achievement.
VI. Internal Collaboration
Describe the process for collaboration with staff in the Bureau of Student Assistance and staff in the Bureau of
School Improvement in assisting identified schools, specifically schools identified in need of improvement and
those that failed to make Adequate Yearly Progress (AYP). This description must include strategies to promote the
inclusion of measurable goals and objectives for incorporating the instructional needs of, and ensuring the equal
access for students who are economically disadvantaged, LEP, migrant, homeless and neglected/delinquent into
the School Improvement planning process; strategies to periodically review the progress of the school and identify
problems in the design and operation of the instructional program; and the process for making recommendations
for improvement to the school through staff in the Bureau of Student Assistance and staff in the Bureau of School
Improvement.
VII.
Fostering Collaboration with Districts
Describe the strategies that will be used to assist the Bureau of Student Assistance in promoting to all Florida’s
stakeholders, including non-English speakers whenever possible, the awareness and the implementation of
Florida’s Accountability Plan, the Just Read, Florida! Initiative and the Continuous Improvement Model, including
the 8 Step Instructional Model in an effort to assist identified schools in improving teaching and learning activities
that will result in increased student academic achievement.
VIII.
Technical Assistance to Improve Student Performance
Describe the technical assistance initiatives that will be provided in collaboration with the Bureau of Student
Assistance to schools identified as in need of improvement, as well as, schools that failed to make Adequate Yearly
Progress. Describe the support that will be provided to assist schools in increasing the number of educationally-
disadvantaged/economically-disadvantaged, migrant, homeless, and LEP students meeting Florida’s reading and
math targets and how these services will be coordinated with existing services being implemented through the
Bureau of Student Assistance and the Bureau of School Improvement. (Please be specific by including projected
dates of activities and supporting documentation, and anticipated types and numbers of participants). Describe the
strategies and activities which will be used to assist the Bureau of Student Assistance in the implementation of the
annual assessment of English Language Proficiency. Describe the ongoing support which will be provided to
districts prior to the administration of the annual assessment.
IX.
Collaboration with Other Agencies
Describe the strategies that will be used to collaborate with other service providers, including regional educational
entities, colleges and universities, private organizations, community-based organizations, and other providers, as
appropriate. Describe the procedures that will be used to meet the training requirements for teachers, school-
based administrators and guidance counselors.
X.
Responses to LEAs
Describe the strategies and activities to assist the Bureau of Student Assistance in the administration of Title I, III,
and Title X-Homeless Education Program to include, but not limited to assisting in the preparation of technical
assistance papers and other state guidance; assisting in the preparation and review of project applications and
amendments; responding to questions regarding program implementation; and participating in state committee
4
?

meetings. (NOTE: All regional workshops (two per year), meetings and conferences must be planned in
collaboration with the Bureau of Student Assistance.) Describe how you will ensure that interpretations, guidance,
and responses will be consistent statewide.
XI.
Implementation, Review, and Monitoring
Describe the strategies and activities to assist the Bureau of Student Assistance in monitoring the implementation
of federal and state programs. Monitoring will include program implementation, effectiveness, compliance, fidelity
to the approved application and appropriate identification of target students. Particular attention must be paid to
student eligibility requirements.
XII. Budget
Describe how you will ensure that funds are budgeted appropriately to support the intent of the Department; include
proposed expenditures and cost effective strategies. All applicants are required to provide documentation of the
capacity and fiscal soundness to perform and deliver the project deliverables within the specified timelines. Private,
not-for-profit agencies/entities must also provide copy of most recent external fiscal audit; documenting fiscal
soundness.
XIII.
Just Read, Florida!
The Technical Assistance Centers will assist the Bureau of Student Assistance in identifying, implementing, and
evaluating effective research-based reading initiatives through activities such as the following.
(1) Collaborating with providers of professional development for the Just Read, Florida! reading initiative.
(2) Conducting family literacy workshops for parents and other educational stakeholders.
(3) Disseminating information about effective reading instruction through networking, meetings, and workshops.
(4) Distribution of materials and access to a library of resources on reading programs based on scientific research.
(5) Assisting schools in collecting, interpreting and using data to monitor progress and evaluate the effectiveness of
reading programs.
XIV.
Technical Assistance/Professional Development in All Core Subject Areas
The Technical Assistance Centers will assist the Bureau of Student Assistance in ensuring that schools and school
districts receive technical assistance and professional development in the core academic areas, as defined by
NCLB.
XV.
Dissemination of Information to Appropriate Populations
The Technical Assistance Centers will, in collaboration with the Florida Department of Education, disseminate their
services to their member districts through newsletters, electronic and phone contacts, web site, oral and written
reports, and participation in local, statewide, and national meetings with other service providers and consumers.
XVI.
Regions to be Targeted
Applicant must clearly identify region or regions to be targeted; FDOE reserves the right to negotiate with
applicants if applications do not target all five regions.
5
?

SCORING CRITERIA:
A minimum score of 70 out of 100 total possible points (70%) is required for any project
to be funded.
I.
Project Abstract (0 points)
o
?
Proposal description of essential aspects is understandable, concise, and logical in relation to the project
purpose and priorities. Region (or regions) to be targeted is clearly stated.
6
?

II.
Section 427 Of The General Education Provisions Act (GEPA) Requirement (0 points)
o
?
Proposal has provided steps to ensure equitable access to and participation in this federally assisted
program for students, teachers, and other program beneficiaries with special needs are sufficient and
logical.
III.
School Improvement Initiatives (10 points)
o
?
Applicant’s school improvement programs, procedures, and strategies that will be used with identified
schools are comprehensive and attainable.
o
?
Applicant has described effective methods of ensuring that these activities will be implemented in
collaboration with the staff in the Department.
o
?
Identified appropriate resources available for schools and teachers to ensure the delivery of
?
comprehensible instruction to LEP students.
?
o
?
Applicant has included effective strategies to be used to ensure collaboration with FDOE’s Assistance
Plus and School Improvement.
o
?
Applicant has provided a realistic calendar of proposed activities.
IV.
Professional Development, Resources, and Parental Involvement (10 points)
o
?
Applicant has described a variety of methods and strategies to support professional development that are
based in scientific research and which have a proven record of effectiveness with the primary target
population.
o
?
Applicant has included appropriate resources for schools and teachers to enhance work with low
performing students.
o
?
Applicant has included strategies to assist in the meaningful participation of parents and the community.
o
?
Projected activities, dates, numbers, and types of participants are comprehensive and realistic.
V.
Program Implementation (10 points)
o
?
Applicant has described an effective process and strategies for assisting district and school personnel
with the implementation of projects and related activities.
o
?
Applicant has described an effective process and strategies for assisting district personnel with the
development and implementation of project amendments.
o
?
Applicant has tied these activities to improved student achievement.
VI.
Internal Collaboration (5 points)
o
?
Applicant has described effective methods of ensuring collaboration with staff in the Bureau of Student
Assistance and staff in the Bureau of School Improvement.
o
?
Applicant has proposed effective strategies to promote the inclusion of measurable objectives for
incorporating of Title I school wide components into the School Improvement planning process.
o
?
Applicant has included realistic plans to periodically review the progress of schools and identify problems
in the design and operation of the instructional program.
o
?
Applicant has included an effective process for making recommendations for improvement to schools
through the Bureau of Student Assistance and staff in the Bureau of School Improvement.
7
?

VII.
Fostering Collaboration with Districts (5 points)
o
?
Applicant has described the strategies being used to promote the awareness and the implementation of
the Florida Accountability Plan, the Just Read, Florida! Initiative and the Continuous Improvement Model,
including the 8 Step Instructional Model.
VIII.
Technical Assistance to Improve Student Performance (15 points)
o
?
Applicant has described the technical assistance and appropriate intervention that will be provided to
schools identified as in need of improvement, as well as schools that failed to make Adequate Yearly
Progress.
o
?
Applicant has described the support that will be provided to assist schools in increasing the number of
educationally-disadvantaged/economically-disadvantaged, migrant, homeless and other students
meeting Florida’s reading and math targets.
o
?
Applicant has described how these services will be coordinated with existing services being implemented
through the Bureau of Student Assistance and the Bureau of School Improvement.
o
?
Applicant has described the strategies and activities that will be used to assist the state in the
implementation of the annual assessment of English Language Proficiency.
o
?
Applicant has described the ongoing support that will be provided to districts prior to the administration of
the English Language Proficiency Assessment.
IX.
Collaboration with Other Agencies (5 points)
o
?
Applicant has described the strategies that will be used to collaborate with other service providers,
including regional educational entities, colleges and universities, private organizations, community-based
organizations, and other providers, as appropriate. This will include acting as staff to the NCLB
Oversight Committee to provide technical assistance to school personnel and District personnel that
utilizes effective instructional strategies and practices that are based on scientific research.
X.
Responses to LEAs (10 points)
o
?
Applicant has described the strategies and activities to assist the state in the administration of Title I to
include, but not limited to assisting in the preparation of technical assistance papers and other state
guidance; assisting in the preparation and review of project applications and amendments; responding to
questions regarding program implementation; and participating in state committee meetings.
o
?
Applicant has described a procedure that ensures that interpretations, guidance and responses will be
consistent statewide.
XI. Implementation, Review,
and Monitoring (10 points)
o
?
Applicant has described effective strategies and activities to assist the state in monitoring the
implementation of program.
o
?
Monitoring will include program implementation, effectiveness, compliance, fidelity to the approved
application and appropriate identification of target students. Particular attention must be paid to migrant
child count and eligibility.
XII.
Budget (5 points)
o
?
Funds are budgeted appropriately to support proposed activities.
o
?
Proposed expenditures demonstrate cost effective measures.
o
?
Budget line items and amounts are necessary and reasonable.
o
?
Evidence is provided to prove fiscal soundness
8

XIII.
Just Read, Florida! (5 points)
o
?
Proposal describes a sufficient plan for identifying, implementing, and evaluating effective research-
based reading initiatives for this project.
XIV.
Technical Assistance/Professional Development in All Core Subjects (5 points)
o
?
Applicants sufficiently describe how it will ensure that appropriate technical assistance and professional
development is provided in the core academic subjects.
o
?
Applicants indicated that particular emphasis will be placed on subject areas in need of improvement
.
XV.
Dissemination of Information to Appropriate Populations (5 points)
o
?
The applicant’s dissemination plan indicates that the project will use effective means to reach the
appropriate target populations and includes the necessary components for replication.
XVI.
Regions to be Targeted (0 points)
o
?
Applicants clearly identified region(s) to be targeted to schools and districts that have demonstrated the
most need for increasing student achievement levels.
FISCAL REQUIREMENTS
?
Purchases of equipment
are discouraged. However, should purchases be justified and approved in advance
by FDOE, all equipment shall become the property of FDOE upon completion of this project and each Center
shall be responsible for ensuring that the equipment is shipped to a location specified by FDOE within fifty (50)
days of termination of the project.
?
Indirect costs
shall only apply to federal projects. School districts are not required to develop an indirect cost
proposal, but if they fail to do so, they will not be allowed to recover any indirect costs. Agencies other than
school districts must furnish to the Comptroller’s Office a copy of their current negotiated indirect cost plan that
has been approved by the appropriate cognizant agency. Amounts from zero to the maximum negotiated rate
may be approved for a program or project by the FDOE Comptroller. State agencies, state universities, and
state community colleges must comply with Section 216.346, Florida Statutes, which states “in any contract
between state agencies, including any contract involving the Division of Colleges and Universities or the
Division of Community Colleges, the agency receiving the contract or grant moneys shall charge no more than
5 percent of the total cost of the contract or grant for overhead or indirect costs or any other costs not required
for the payment of direct costs.” Restrictions to the amount or percentage that can be charged to a project’s
administration which may include indirect costs will be specified in the approved project award notification or
amendment approval where applicable.
?
Payment by Reimbursement with Performance
requires that twenty-five percent of the amount of this project
will be paid upon approval of the proposal including the first deliverable (Initial Plan) and an invoice. Funds to
support the activities of this project will be transmitted upon the receipt and approval of specified deliverable
products and reports. Upon completion of acceptable activities, approval of reports described in Section II, and
receipt of invoice(s) by the FDOE, 25 percent of the amount of this project will be paid on January 31, 2005,
May 31, 2005, and September 30, 2005. An interim Budget Description Report should accompany the
quarterly invoice(s). A final Budget Description Report is due no later than November 20, 2005.
?
Invoices and accompanying disbursement reports
are to be submitted to
Bureau of Grants Management
Florida Department of Education
Turlington Building, Room 332
325 West Gaines Street
?
Tallahassee, Florida 32399-0400
?
?
Final Project Disbursement Report (DOE 399)
, must be completed and submitted to FDOE by all project
recipients no later than the date specified on the Project Award Notification (DOE 200).
9
?

NOTICE OF INTENT TO APPLY
The deadline date to notify the contact person of intent-to-apply is
January 3, 2005
. Send the notification to the
Bureau of Student Assistance via email to lisa.saavedra@fldoe.org, or via fax to (850) 245-0697, with the name of
the interested agency, contact name, and an e-mail address. Providing the intent-to-apply is not required for an
application to be considered, but assists the applicant by assuring receipt of answers to frequently asked questions
and competition updates. Conversely, eligible organizations which file an intent-to-apply are not required to apply.
METHOD OF ANSWERING FREQUENTLY ASKED QUESTIONS
Frequently asked questions, changes in dates, clarifications or addenda to the RFP will be conveyed via e-mail to
the email address and designated recipient provided in the Notice of Intent to Apply. The cut-off date for questions
to be answered is
January 3, 2005.
METHOD OF SELECTION
The Bureau of Student Assistance will be responsible for selecting a review committee for the NCLB Regional
Technical Assistance Centers. Department staff that have expertise in oversight of technical assistance will be
selected to review each application. Staff with previous experience in reading grants will be highly valued.
Committee members will be asked to commit to sufficient time and effort to performing a thorough review through
personal reading and group discussion of the application.
IMPLEMENTATION REQUIREMENTS
All funded projects and any amendments are subject to the procedures outlined in the Project Application and
Amendment Procedures for Federal an State Programs (Green Book) and the
General Assurances for Participation
in Federal and State Programs
. These procedures and documents can be accessed on-line at
http://www.firn.edu/doe/comptroller/gbook.htm.
REPORTING OUTCOMES
Funded applicants must provide quarterly reports, as required and described in
Section II: Required Timelines
and Deliverable Products and Reports
to
Lisa C. Saavedra, Chief
Bureau of Student Assistance
Florida Department of Education
Turlington Building, Room 314
325 West Gaines Street
Tallahassee, FL 32399-0400
10
?

ATTACHMENTS TO THE RFP
?
DOE 100B Project Application, with instructions
?
Section I:
Assurances for NCLB Technical Assistance Centers for 2004-05 Fiscal Year,
submitted without
modification.
?
Section II: Required Timelines And Deliverable Products and Reports
?
DOE 103 Budget Description Form, with instructions
?
DOE 103A Personnel Schedule, with instructions
?
DOE 103B Professional and Technical Services Schedule, with instructions
?
DOE 103C Capital Outlay Schedule, with instructions
?
DOE 103D Travel Schedule, with instructions
?
Bureau of Student Assistance/Title I Programs and Academic Intervention Regional Map
?
Performance-Based Deliverables and Invoice Schedule
?
General Assurances for Participation in Federal and State Programs Certification Page
11

Bureau of Student Assistance
?

Back to top


Title I Programs and Academic Intervention Services
Region 1
Region 4
Region 2
Region 3
Region 5
12
?

________________________________________________
FLORIDA DEPARTMENT OF EDUCATION
?
Project Application
?
TAPS Numbers
1.5A014 Title I, Part C
?
2.5A016 Title I, Part A
?
3.5A017 Title X
?
4.5A018 Title III
?
Please return to:
Florida Department of Education
Bureau of Grants Management
Room 344 Turlington Building
325 West Gaines Street
Tallahassee, Florida 32399-0400
Telephone: (850)245-0498
SunCom: 205-0498
A)
NCLB REGIONAL TECHNICAL
ASSISTANCE CENTERS
DOE USE ONLY
Date Received
B)
C)
)
C)
)
C)
(3)
)
D)
Total Funds Requested:
$
D)
Total Funds Requested:
$
D)
Total Funds Requested:
$
Total Approved Funds:
)
$
Total Approved Funds:
)
$
Total Approved Funds:
)
$

Back to top


CERTIFICATION
I, ______________________________________________, (
do hereby
assurances for this project.
expenditure of funds on this project.
of the project.
special project, where prohibited.
DOE 100B
Rev. 08/04
John Winn, Commissioner
E)
Name and Address of Eligible Applicant:
Applicant Contact Information
Contact Name:
Mailing Address:
Telephone Number:
E-mail Address:
Fax Number:
SunCom Number:
Program Name (1
Program Name (2
Program Name
Project Number:
(DOE Assigned
Project Number:
(DOE Assigned)
Project Number:
(DOE Assigned)
(DOE USE ONLY
(DOE USE ONLY
(DOE USE ONLY
Please Type Name)
certify that all facts, figures, and
representations made in this application are true, correct, and consistent with the statement of general assurances and specific programmatic
Furthermore, all applicable statutes, regulations, and procedures; administrative and programmatic
requirements; and procedures for fiscal control and maintenance of records will be implemented to ensure proper accountability for the
All records necessary to substantiate these requirements will be available for review by appropriate
state and federal staff. I further certify that all expenditures will be obligated on or after the effective date and prior to the termination date
Disbursements will be reported only as appropriate to this project, and will not be used for matching funds on this or any
Further, I understand that it is the responsibility of the agency head to obtain from its governing body the authorization for the submission
of this application.
Signature of Agency Head
13
?

Back to top


Instructions for Completion of DOE 100B
A.
?
Enter name and mailing address of eligible applicant. The applicant is the public or non-public
entity receiving funds to carry out the purpose of the project.
B.
?
Enter requested information for the applicant’s contact person. This is the person responsible
for responding to all questions regarding information included in this application.
C.
?
If not pre-printed, enter name of program(s) for which funds are requested in this project.
D.
?
Enter the total amount of funds requested for each program in this project.
E.
?
The original signature of the appropriate agency head is required.
The agency head is the
school district superintendent, university or community college president, state agency
commissioner or secretary, or the president/chairman of the Board for other eligible applicants.
?
Note:
Applications signed by officials other than the appropriate agency head identified
above must have a letter signed by the appropriate agency head, or documentation citing action
of the governing body delegating authority to the person to sign on behalf of said official.
Attach the letter or documentation to the DOE 100B when the application is submitted
14
?

FLORIDA DEPARTMENT OF EDUCATION
DIVISION OF STUDENT ACHIEVEMENT
NCLB REGIONAL TECHNICAL ASSISTANCE CENTERS
FISCAL YEAR 2004-2005
District/Agency:
SECTION I: ASSURANCES
THE PROJECT APPLICANT NAMED ABOVE AGREES TO THE FOLLOWING ASSURANCES.
program plans, and applications.
for, Federal funds paid to that agency under the program.
timelines with collaborative documentation.
1. Each Center will administer the program covered by the application in accordance with all applicable statutes, regulations,
2. Each Center will submit reports to the Florida Department of Education as may reasonably be necessary to enable the
Florida Department of Education to perform its duties and that the Center will maintain such records, and provide access to
those records, as the Florida Department of Education or its designee deem necessary to perform its duties.
3. Each Center will use fiscal control and sound accounting procedures that will ensure proper disbursement of, and accounting
4. All requirements for deliverable products and reports outlined in the state requirements will be met within the prescribed
Each Center representative will attend monthly meetings with the staff in the Bureau of Student Assistance and will ensure that all
activities and assistance to schools and school districts are planned in collaboration with this bureau. Centers will collaborate with
Bureau of School Improvement and other bureaus/offices as the Florida Department of Education may deem necessary to perform
its duties in meeting the needs of all identified schools and eligible children and youth.
15
?

NCLB REGIONAL TECHNICAL ASSISTANCE CENTERS
FISCAL YEAR 2004-2005
District/Agency:
SECTION II: REQUIRED TIMELINES AND DELIVERABLE PRODUCTS AND REPORTS
ITEM
MINIMUM REQUIREMENT
TIMELINE
1A. Technical Assistance Plan and training to
Plan must clearly identify service
Initial plan must be submitted with the
be provided to each school district in the
delivery plan which incorporates
application to:
Region during the 2004-2005 program year.
In the plan, emphasis must be placed on
Sections III - XIII described in project
narrative.
Lisa C. Saavedra, Chief
services to schools in greatest need of
Bureau of Student Assistance
improvement.
1B. A quarterly summary of training and
technical assistance, including school
improvement activities conducted in the
Region through this project.
Format for report shall be mutually
determined upon approval of the project.
Quarterly summaries are to be submitted
to:
Lisa C. Saavedra, Chief
Bureau of Student Assistance,
by the
following schedule:
February 28, 2005
May 31, 2005
September 30, 2005
1C. Coordination
Monthly meetings with the
Bureau of
Student Assistance
to coordinate
January, 2005 through August, 2005
activities of this project with school
improvement initiatives and other similar
technical assistance efforts.
16
?

NCLB REGIONAL TECHNICAL ASSISTANCE CENTERS
FISCAL YEAR 2004-2005
District/Agency:
SECTION II: REQUIRED TIMELINES AND DELIVERABLE PRODUCTS AND REPORTS
FUNCTION
ACTIVITY
TIMELINE/ACTION ITEM
2A. Identify, use and disseminate scientifically
research based instructional strategies and
Develop a list of scientifically research
based educational methods and
Distribute the list of scientifically research
based educational methods and instructional
educational practices identified as the most
effective with children in high poverty schools.
instructional strategies that have been
proven effective with low-achieving
strategies to FDOE for approval and then to
each member district and/or identified school
The list must also include strategies for building
children. The target population being
as appropriate.
capacity for parent/family involvement. Emphasis
students at or below Level 2 in Reading or
should be strategies and practices at the
Mathematics.
secondary level.
2B. Use available resources in the most effective way
to support school improvement in identified
schools, especially those identified for school
improvement and those that failed to make AYP.
Develop a list of strategies, activities, and
resources to ensure that low-achieving
children are held to the same high and
rigorous standards as all students. On
going participation in the DOE Continuous
Improvement Model initiative.
Distribute the list of strategies, activities, and
resources to FDOE for approval and then to
each member district and/or identified school
as appropriate.
2C. Assist school districts in the development and
implementation of their project applications, and
amendments, as well as, ensuring that school
improvement plans incorporate the inclusion of
measurable goals and objectives for incorporating
the instructional needs of the economically
disadvantaged, LEP, migrant, homeless and
neglected and delinquent students.
Develop a list of school districts that have
been provided with technical assistance in
the coordination with other programs and
services.
Include a list of school districts that have
received technical assistance from the
Center on a monthly summary to
Lisa
Saavedra, Chief, Bureau of Student
Assistance.
2D. Assist Title I School Support Teams and School
Improvement Teams in carrying out their
responsibilities to all schools funded by Title I, III
and X, especially schools identified or in danger of
being identified for school improvement based on
NCLB Act of 2001.
Develop a list of programs, activities, and
resources to assist low-achieving children
who are in danger of failing. Particularly
students scoring Level 2 or below on FCAT
Reading or Mathematics.
Distribute the list of programs, activities, and
resources available to assist low-achieving
children who are in danger of failing to FDOE
for approval and then to each member
district and/or identified school as
appropriate.
17
?

FUNCTION
ACTIVITY
TIMELINE/ACTION ITEM
3E. Describe the strategies being used to promote the
awareness and the implementation of the Florida
Accountability Plan, the Just Read Initiative and
the Continuous Improvement Model, including the
8 Step Instructional Model in an effort to assist
identified schools in improving teaching and
learning activities that will result in increased
student academic achievement.
Provide a copy of the Center’s formative and
summative evaluation to the DOE. Provide
list of any changes made to the Center’s
service delivery based on the information
garnered from districts’ needs assessments.
Plan must clearly identify service delivery plan
which incorporates Section III-XIII in project
narrative.
Distribute a copy of the Center’s formative
and summative evaluation to FDOE and to
each member district and/or identified
schools as appropriate.
3F. Provide technical assistance and appropriate
intervention to schools identified as being in
school improvement status and to assist them in
achieving adequate yearly progress (AYP).
Provide a list of collaborative efforts between
the Center and other service providers to
maximize the resources available to identified
schools.
Submit a list of the collaborative efforts that
have taken place between the Center and
other service providers with the purpose of
maximizing the resources. Submit as part of
quarterly report to:
Lisa Saavedra, Chief,
Bureau of Student Assistance
3G. Collaborate with other regional service providers
to maximize the resources available to identified
Develop a list of activities to be performed to
assist the Bureau of Student Assistance in the
Submit a list of the assistance delivered by
the Center to assist the Bureau of Student
schools, especially schools identified for school
improvement and those that failed to make AYP.
administration of the Title I, Parts A, C and D;
Title X, Education of Homeless Children and
Youth; and Title III and state ESOL activities.
Assistance in the administration of the Title I,
Parts A and D Programs, Title X, Education
of Homeless Children and Youth, and Title
III. Submit as part of quarterly report to:
Lisa Saavedra, Chief, Bureau of Student
Assistance
3H. Identify sufficient personnel and resources to carry
out required activities.
Provide a list of available resources, including
documented evidence of effectiveness and
anticipated amount of time/effort required for
Submit with initial application and include in
required quarterly reports.
effective implementation. Identify key
personnel responsible for each deliverable
and proposed activity described in response
to this Request for Application.
18
?

NCLB REGIONAL TECHNICAL ASSISTANCE CENTERS
TAPS Numbers
FISCAL YEAR 2004-2005
1. 5A014
2. 5A016
A)
3. 5A017
Name of Eligible Recipient:
4. 5A018
B)
Project Number:

Back to top


FLORIDA DEPARTMENT OF EDUCATION
Budget Description Form
Mark if funding is from _____ Title I-School Improvement, _____ Title I, Part C-Migrant, _____ Title X or _____ Title III
(1)
FUNCTION
(2)
OBJECT
(3)
DESCRIPTION
(4)
AMOUNT
C) TOTAL
$
DOE 103
Rev. 08/04
John Winn, Commissioner
19

Instructions
?
DOE 103 Budget Description Form
?
This form should be completed based on the required information as outlined in the Request for Proposal (RFP) or Request for
Application (RFA).
A.
Enter Name of Eligible Recipient.
B
.
Enter DOE assigned 13-digit project number, if available. If you have not been assigned a project number
for the project and period covered by this application, please leave this item blank.
COLUMN 1
?
SCHOOL DISTRICTS ONLY:
FUNCTION:
?
Use the four digit function codes as required in the Financial and Program Cost
Accounting and Reporting for Florida Schools Manual.
NOTE: If this column is shaded, it is not required for this application.
COLUMN 2
OBJECT:
?
SCHOOL DISTRICTS:
Use the three digit object codes as required in the Financial and Program Cost
Accounting and Reporting for Florida Schools Manual.
COMMUNITY COLLEGES:
Use the five digit object codes as required in the Accounting Manual for Florida’s Public
Community Colleges.
UNIVERSITIES AND STATE AGENCIES:
Use the six digit object codes as required in the Florida Accounting Information Resource
Manual.
OTHER AGENCIES:
Use the object codes as required in the agency’s expenditure chart of accounts.
COLUMN 3
?
ALL APPLICANTS:
DESCRIPTION:
?
Provide a specific description of the type of expenditures.
COLUMN 4
AMOUNT:
?
Provide the budget amount requested for each line item.
C. TOTAL -
Provide the total for Column (4) on the last page
.
20
?
District/Agency Page___of____

NCLB REGIONAL TECHNICAL ASSISTANCE CENTERS
FISCAL YEAR 2004-2005
PERSONNEL SCHEDULE
District/Agency:
(1)
FUNCTION
(2)
OBJECT
(3)
TYPE OF POSITION
(4)
FUNDED FTE
District/Agency Page
of
DOE 103 A
21

NCLB REGIONAL TECHNICAL ASSISTANCE CENTERS
FISCAL YEAR 2004-2005
INSTRUCTIONS FOR PERSONNEL SCHEDULE
District/Agency:
Record all position types including Other Personal Services for school district or other agency personnel employed on a regular or
temporary basis to be funded from the Title I project. School districts must use the required function and object numbers defined in
Financial and Program Cost Accounting and reporting for Florida Schools. Other agencies must use accounting numbers describing
these types of positions in the agency’s accounting system.
Other Personal Services is defined as compensation paid to persons, including substitute teachers not under written contract, who are
employed to provide temporary service to the school district or other agency.
(1)
?
For each position type described in column (2), record the appropriate function and object numbers. School
districts must use functions 5100 - 9100. Use the object numbers for salaries or Other Personal Services.
School districts must use objects 110-170 and 750 respectively as described in the Financial and Program
Cost Accounting and Reporting for Florida Schools (Red Book).
(2)
?
Enter a brief description of the type of position requested to be funded from this project. Each position type
must be listed as described in the Red Book or according to the district’s chart of accounts, if the district does
not use the Red Book salary object numbers. Additional information may be requested to justify the
relationship of a position as it relates to student achievement.
(1) Indicate the Full-Time Equivalent (FTE) number of positions to be funded. Determine FTE by dividing the
standard number of weekly work hours for the position into the actual work hours to be funded by the project.
District/Agency Page
?
of
DOE 103A
22

NCLB REGIONAL TECHNICAL ASSISTANCE CENTERS
FISCAL YEAR 2004-2005
PROFESSIONAL AND TECHNICAL SERVICES SCHEDULE
District/Agency:
On This Schedule, Record Only Disbursements for the Purchase of Professional and Technical Services
(1)
FUNCTION
(2)
OBJECT
(3)
DESCRIPTION OF SERVICES
District/Agency Page
of
23

NCLB REGIONAL TECHNICAL ASSISTANCE CENTERS
FISCAL YEAR 2004-2005
INSTRUCTIONS
PROFESSIONAL AND TECHNICAL SERVICES SCHEDULE
On this schedule, report only the purchase of professional and technical services. School district applicants must use the required
function and object codes described in the Financial and Program Cost Accounting and Reporting for Florida Schools Manual (Red
Book). Other agency applicants must use the object codes which describe this type of disbursement in the agency's accounting
system.
Professional and Technical Services are services rendered by personnel, who are not on the payroll of the district school board or
agency, and other services which the Board or agency may purchase. While a product may or may not result from the transaction,
the primary reason for the purchase is the service provided.
Column (1)
School district applicants only.
For the services described in Column (3), record the appropriate four digit function code for each professional
and technical service to be funded from this project. School districts must use functions 5100 – 9100.
Column (2)
Record the object code most appropriate to the services described in Column (3). Note: When the contract
with a consultant is for a single amount which covers both services and expenses (including travel), the total
contract amount should be recorded in the object for professional and technical services. When the contract
calls for a daily or fixed rate plus travel and per diem or expenses, or includes equipment purchases, these
amounts should be reported separately under the objects for professional and technical services, travel, and
equipment respectively. School districts must use object codes 310 – 390. All other agency applicants must
use the object codes as described in the agency’s expenditure chart of accounts.
Column (3)
Enter a specific description of each professional and technical service to be funded from this project.
24

NCLB REGIONAL TECHNICAL ASSISTANCE CENTERS
FISCAL YEAR 2004-2005
CAPITAL OUTLAY SCHEDULE
District/Agency:
(1)
FUNCTION
(2)
OBJECT
(3)
ITEM DESCRIPTION
District/Agency Page
of
DOE 103 C
25

NCLB REGIONAL TECHNICAL ASSISTANCE CENTERS
FISCAL YEAR 2004-2005
INSTRUCTIONS FOR CAPITAL OUTLAY SCHEDULE
On this schedule, report only proposed disbursements for capital outlay items. School district applicants must use the required function and
object codes described in the Financial and Program Cost Accounting and Reporting for Florida Schools Manual (Red Book). Other agency
applicants must use the object codes, which describe this type of disbursement in the agency’s accounting system.
Column (1) School district applicants only.
For the services described in Column (3), record the appropriate four-digit function code for each capital outlay item
requested. School districts use functions 5100 – 9100.
Column (2)
Record the appropriate object number for the capital outlay item requested in Column (3). School
districts must use object codes 610 - 692. All other agency applicants must use the object codes as
described in the agency’s expenditure chart of accounts.
Column (3)
List each capital outlay item requested to be funded from this project. Capital outlay items are to be listed by the
appropriate function and object codes.
26
?

NCLB REGIONAL TECHNICAL ASSISTANCE CENTERS
FISCAL YEAR 2004-2005
TRAVEL SCHEDULE
Program Name: ____________________________________________
Name of Eligible Applicant: ________________________________
(1)
FUNCTION
(2)
OBJECT
(3)
DESCRIPTION OF TYPE OF TRAVEL
District/Agency Page
of
DOE 103 D
27

NCLB REGIONAL TECHNICAL ASSISTANCE CENTERS
FISCAL YEAR 2004-2005
INSTRUCTIONS
TRAVEL SCHEDULE
On this schedule, report only proposed disbursements for travel. School district applicants must use the required function and object codes described
in the Financial and Program Cost Accounting and Reporting for Florida Schools Manual (Red Book). Other agency applicants must use the object
codes, which describe this type of disbursement in the agency’s accounting system.
NOTE:
Report travel for regular or temporary employees of the school district or agency to be funded by this project. Travel for consultants must be listed
on the Professional and Technical Services Schedule when it is not included in the contract. Travel and per diem charged to the project may not
exceed the rate prescribed by the district.
(1)
?
For the travel activity described in Column (3), record the appropriate four-digit function code. School districts use functions
5100 – 9100.
School district applicants only.
(2)
Record the appropriate object code for each travel activity requested in Column (3). School districts
must use object code 330. All other agency applicants must use the object code as described in the agency’s
expenditure chart of accounts.
(3)
?
Enter a brief description of each type of travel to be supported with funds from this project. List individual positions when travel
funds are being requested to perform necessary activities.
Do not list individual names.
Travel and per diem for project
personnel to participate in in-service training sessions or activities should be listed separately for each type of activity.
DOE 103 D
28

Performance-Based Deliverables and Invoice Schedule
Fiscal Year: 2004-2005
TAPS Number
A.
1) Eligible Applicant:
5) Telephone/SunCom:
2) Program Name:
No Child Left Behind Act of 2001, P. L. 107-110 - Title I, Title III and
Title X-Homeless [CFDA 84.010; 84.011; 84.365; and 84.196]
6) FAX Number:
3) Contact Name:
7) E-mail:
NCLB Regional Technical Assistance Centers for 2004-05 Fiscal Year
8) Project Number:
4) Title:
B.
(1)
(2)
(3)
(3a)
(4)
Goals
Unit Cost
(Please include a description of all the goals
goals achieved / outcomes /
products)
each goal
(Number
for each
goal
measured
Col. 3 divided
1.
Supplemental Instructional Services.
Create curriculum framework
alignments and hire teachers and staff
to assist in teaching the students of the
Front Porch communities; enable
communication between teachers and
statewide students.
THIS IS AN
EXAMPLE, DO NOT USE…….
Printed frameworks correlations; list of
teachers assigned to GED classes for
the Front Porch communities.
Documentation verifying 1-888
telephone number for students
throughout the state to contact teachers
and staff.
THIS IS AN EXAMPLE, DO
NOT USE……
$ 37,500
10
$ 3,7500
2.
Technological Hardware/Software
Acquisition; Create client tracking
system and obtain courseware
licenses.
THIS IS AN EXAMPLE, DO
NOT USE……
ESOL Foundation Course in FlashWave
and HTML formats with accompanying
correlations.
THIS IS AN EXAMPLE,
DO NOT USE……
$ 50,500
5
$ 10,100
3.
$
-
4.
Performance Measure / Objective
Evidence of Completion
Total Amount
Budgeted / Goal
measured in program application)
(Data showing
(List total amount for
measured)
(Automatically calculates)
by Col. 3a
29

Instructions for Completion of Performance-Based Deliverables and Invoice Schedule
1.
?
Enter the TAPS Number that corresponds with the TAPS Number on the appropriate DOE A or B Form.
2.
?
Applicants must complete Sections A, and B, of the Performance-Based Deliverables and Invoice Schedule. This report must clearly
delineate the specific area(s) that will be addressed, the measurable goal(s) that will be attained and the outcome(s) and/or
product(s) to be delivered that will support the goals.
Section A - Complete all information as requested.
1)
Enter name of eligible applicant.
2)
Enter the program name that corresponds to the Block A on the DOE 100 A or B form.
3 -
Enter requested information for the applicant's contact person. This is the person responsible for responding to all questions regarding
7)
information included in this application.
8)
Section B - Complete information as requested. Columns (1), (2), (3), (3a), (4)
NOTE:
down in order to view each line. Put your cursor on the row line under the number.
appear.
budgeted' has been established for each measure / goal addressed.
3.
unit cost.
4.
Award Notification.
5.
Project Number - Application purposes - Leave blank. Invoice Submission - enter the number located on the approved DOE 200 form.
The rows for the 'performance measures' and 'evidence of completion' will expand, however, be sure to spread the area by pulling the row
Hold down the left button and drag until all the words
The Unit Cost (B4) is calculated by dividing Column 3 by Column 3a, this column will automatically calculate once the 'total amount
Full payment is conditional upon meeting the performance requirements of the deliverable. Payments for partial performance will be based on
A Performance-Based Achievement Report is to be sent to the program office representative on or the dates indicated on the DOE 200 Project
The final DOE-399 is to be attached to the final invoice for payment and sent to the Office of Grants Management.
30
?

Florida Department of Education
General Assurances for Participation in Federal and State Progr
ams
Authority for Data Collection:
20 USC 1232e.
?
Planned Use of Data:
The requirements established in
United States Code Annotated,
?
Title 20, Education, Chapter
31, Subchapter III, Section 1232 (
e) stipulate that
[e]ach local
?
education agency which participat
es in an applicable program un
der which federal funds are
?
made available to such agency th
rough a State agency shall subm
it, to such an agency, a
?
general application containing t
he assurances set forth in subs
ection (b).
The application
?
shall cover the participation
by the local education agency in
all federal programs administered
?
by the U.S. Department of Education.
?
Instructions:
These general assurances will be in
effect for the duration of
participation in
?
federal and state programs until such time as the requirements
change. The superintendent or
?
other authorized officer must si
gn the certification and return
to the address below. Payment
?
for applications and contracts
cannot be made by this agency un
til the general application is
?
received. For further informati
on, contact the Florida Departme
nt of Education,
?
Comptroller
s Office at (850) 245-0401, Suncom 205-0401.
?
Certification:
?
I, the undersigned authorized offici
al for the named agency of
the State of Florida, hereby
?
apply for participation in f
ederally funded and state funded ed
ucation programs.
?
Typed Agency Name
Agency Number
Typed Name and Title of Authori
zed Official
(Agency Head)
I certify that the agency will adher
e to each of the assurances
contained in this set of General
Assurances for Participation
in Federal and State Programs.
Signature (must be original)
Date
Area Code / Telephone Number
Return original to:
Florida Department of Education
Comptroller’s Office, Room 944
Turlington
Building
325 West Gaines Street
Tallahassee, Florida 32399-0400
31
?

Back to top