1. FLORIDA DEPARTMENT OF EDUCATION
    1. DELIVERABLES FORM
    2. APPLICANT INSTRUCTIONS: DELIVERABLES FORM
    3. TRAINING, TECHNICAL ASSISTANCE, AND DISSEMINATION FORM
    4. (1) Name of Activity and Brief Description
    5. (2) Quantity and Quality Standards for Acceptance (3) Method of Documentation
    6. (4) Critical Timelines
    7. APPLICANT INSTRUCTIONS: TRAINING, TECHNICAL ASSISTANCE, AND DISSEMINATION FORM
    8. Data Collection
    9. APPLICANT INSTRUCTIONS: STUDENT PERFORMANCE FORM
    10. APPLICANT INSTRUCTIONS: STUDENT PERFORMANCE FORM
    11. Student Performance (continued)
    12. FORMAL THIRD PARTY EVALUATION FORM
    13.  
  2. FLORIDA DEPARTMENT OF EDUCATION PROJECT APPLICATION
    1. TAPS Number 09C063
      1. DOE USE ONLY
      2. Total Approved Project:
      3. D) Applicant Contact Information
      4. CERTIFICATION
  3. Instructions for Completion of DOE 100A
      1. TAPS Number 09C063
      2. (1) FUNCTION
      3. (2) OBJECT
      4. (3) ACCOUNT TITLE AND NARRATIVE
      5. POSITION (5)
      6. AMOUNT
      7. Column 2

FLORIDA DEPARTMENT OF EDUCATION
Request for Application (RFA Discretionary)
Bureau / Office
Bureau of Instruction and Innovation, Office of Healthy Schools, Coordinated School Health
Program
Program Name
Tobacco Prevention and Intervention Teacher Training Continuation Project – Year II
Specific Funding Authority (ies)
State: Title XXXIV Alcoholic Beverages and Tobacco -Tobacco Products, section 561.025(2)
and 569.11(6), Florida Statues.
Funding Purpose/Priorities
Tobacco Prevention and Intervention Teacher Training Projects will be continued to support
public school districts to enhance teacher knowledge and skills needed to impact the use of
tobacco among youth by providing quality training for teachers to implement effective tobacco
prevention and intervention programs. Projects are to focus on tobacco prevention and/or
intervention, and may include other risk behavior content focusing on universal refusal skills
associated with tobacco and these other risk behaviors.
Continuation projects shall:
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develop a detailed work plan including goals, SMART (Specific, Measurable, Achievable,
Realistic and Time-phased) objectives, action steps, and evaluation strategies for the
continuation project;
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review the currently funded tobacco prevention and intervention teacher training project
to identify components that will be included in the continuation project;
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identify additional tobacco prevention and/or intervention curricula or programs requiring
teacher training;
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evaluate the results of additional training provided to teachers on tobacco prevention
and/or intervention curricula and/or programs; and
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assess student knowledge, identifying student gains in knowledge as a result of the
tobacco prevention and/or intervention curricula or programs taught by the trained
teacher.
Type of Award
Discretionary
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Total Funding Amount
Total funding amount is $150,000.
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A total of five awards at a maximum of $30,000 for each individual school district.
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Budget Period
July 1, 2008 through June 30, 2009
Program Performance Period
July 1, 2008 through June 30, 2009
Target Population
Instructional personnel who will implement tobacco education in Florida public schools
Eligible Applicant(s)
Gadsden, Lake, Palm Beach, Pasco, and St. Johns
Application Due Date
Proposals are due in the Office of Grants Management by the close of business on
May 21, 2008.
The due date refers to the date of receipt in Grants Management. For State programs,
the project effective date will be no earlier than the effective date of the legislative
appropriation, usually July 1. The ending date can be no later than June 30, of the
fiscal year unless otherwise specified in statute or proviso.
Contact Persons
Lynn Vinson, Office of Healthy Schools, 850/245-0480; Fax: 850/245-5116; E-mail:
Lynn.Vinson@fldoe.org
Dr. Antionette Meeks, Office of Healthy School, 850/245-0480; Fax: 850/245-5116; E-mail:
Antionette.Meeks@fldoe.org
Margaret White, Grants Management, 850/245-0496; Fax: 850/245-0737; E-mail:
Margaret.White@fldoe.org
Assurances
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The Department of Education has developed and implemented a document entitled,
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General Terms, Assurances and Conditions for Participation in Federal and State
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Programs, to comply with:
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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;
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applicable regulations of other Federal agencies; and
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State regulations and laws pertaining to the expenditure of state funds.
In order to receive funding, applicants must have on file with the Department of
Education, 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://fldoe.org/comptroller/doc/gbsectiond.doc.
School Districts, Community Colleges, Universities and State Agencies
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The certification of adherence filed with the Department of Education Comptroller’s
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Office shall remain in effect indefinitely unless a change occurs in federal or state law,
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or there are other changes in circumstances affecting a term, assurance, or condition;
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and does not need to be resubmitted with this application.
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Funding Method
Quarterly Advance to Public Entity - For quarterly advances of non-federal funding to
state agencies and LEAs made in accordance within the authority of the General
Appropriations Act. Expenditures must be documented and reported to DOE at the
end of the project period. If audited, the recipient must have expenditure detail
documentation supporting the requested advances.
Fiscal Requirements
Supporting documentation for expenditures is required for all funding methods.
Examples of such documentation include: invoices with check numbers verifying
payment, and/or bank statements; all or any of which must be available upon request.
Expenses
1.
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Allowable Expenses
: Project funds must be used for activities that directly support the
preparation, training, and engagement in public school tobacco education in grades K-12,
as well as the evaluation of this project. Allowable expenditures include professional
training fees, training supplies and materials, teacher stipends, substitute teachers,
tobacco curricula, evaluation and report preparation, and audiovisual and room rentals.
Note
: Funds may be used for substitute teachers only when classroom teachers attend
training during normal working hours. Stipends cannot be provided if substitute teachers
are used when classroom teachers attend training during normal working hours.
2.
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Unallowable Expenses:
Project funds may not be used for salaries of regular or
temporary school district employees, creation of positions or supplanting of existing
programs and funding, nonexpendable equipment or consumables such as computers,
DVD players, TVs, VCRs, or other electronic or telecommunications equipment, indirect
administrative costs, student training or transportation of students, food and beverages,
financial incentives for staff and students, non-educational products or gifts (such as t-
shirts), and materials not directly related to tobacco prevention and intervention.
Indirect
costs cannot be applied to this state funded project.
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All applicants must complete a DOE 101 and include the TAPS number in the space provided
on this form. Object code budget figures should be broken out in as much detail as possible.
Project Performance Accountability and Reporting Requirements
The Department’s program managers will track each project’s performance based on
the information provided in the Performance Expectation section, pages 7-16.
Please note that Performance Expectation forms must be completed and included as part of
the submitted proposal. The applicant must complete each of the following Performance
Expectations: Deliverables; Training, Technical Assistance, and Dissemination; Student
Performance; and Formal Third Party Evaluation. The Formal Third Party Evaluation is to be
used only if an evaluator is contracted for services.
NARRATIVE SECTION
Project Design-Narrative
Provide a brief summary of the proposed project with a minimum of two and a maximum
three paragraphs in length, limited to one page; and suitable for printing .
Project Design
: There is a 6-page maximum for the narrative. Forms, Performance
Expectations, attachments, and appendices are not included in this 6-page maximum. The
project narrative should be prepared using an 11-point font size, 1” margins, and single-sided
typed 8.5 x 11-inch sized pages.
The narrative must provide a detailed work plan of strategies and outcomes for the 2008-09
grant year specific to tobacco prevention and/or intervention teacher training. The work plan
must include the items listed below in the following order:
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Preliminary evaluation results report from the 2007-08 tobacco grant project
o
?
identification of how the evaluation results are directing plans for the continuation
project
o
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explanation of why 2008-09 grant programs/curricula trainings are being continued
o
?
justification and description of new tobacco prevention/intervention
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programs/curricula on which teachers will be trained
?
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Description of how the project will be implemented
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The application must include:
o
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list of goals and SMART objectives for the project
o
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description of how goals and objectives will be measured
o
?
identification of project activities used to carry out the goals and objectives
o
?
measure (quantitative and qualitative measures where appropriate) of the
effectiveness of all project components outcomes
o
?
identification of evaluation instruments and how data will be collected and
analyzed. Include impact of training on teachers, teacher follow-up, and the impact
on students receiving the program/curricula from these teachers
o
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indication of how program data will be used to plan for continuous improvement
?
List or chart of training programs including proposed training dates, number of training
days, number of training contact hours, target audience (e.g., 6
th
grade science teachers),
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number of attendees desired, and minimum number of targeted schools (e.g., 2
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elementary, 2-middle, 2-high, 2-alternative, 2-middle/high, 2-charter)
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Budget narrative
(No more than 10% of the requested budget may be used for
contracting with an evaluation professional for the purpose of evaluating your
project.)
Support for Reading/Strategic Imperatives
Describe how the proposed project will incorporate reading initiatives and one or more
of the Florida State Board of Education (SBE) strategic imperatives.
URL: http://www.fldoe.org/meetings/2005_01_18/StratPlanDetails.pdf
Dissemination/Marketing
Describe methods /strategies you will use to disseminate and market information
about the project to appropriate populations.
Reporting Outcomes
All reports and deliverables are to be sent to:
Lynn Vinson, Office of Healthy Schools
Florida Department of Education
325 W. Gaines Street, Suite 444
Tallahassee, FL 32399-0400
Reports to be submitted:
1.
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Interim Project Report – due
January 30, 2009.
This report will include information on
numbers of participants, program and/or curricula used, training session information,
assessment of training participants, and assessment of program and/or curricula
impact on students resulting from teacher training.
2.
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Final Project Report, to include a written evaluation report – due
August 7, 2009.
For Federal Programs - General Education Provisions Act (GEPA)
Provide a concise description of the process to ensure equitable access to, and participation
of students, teachers, and other program beneficiaries with special needs
.
For details refer to
URL:
http://www.ed.gov/fund/grant/apply/appforms/gepa427.pdf
Conditions for Acceptance
The requirements listed below must be met for applications to be considered for
review:
1) Application is received in DOE within the timeframe specified by the RFA
2) Application includes required forms: DOE 100A Project Application Form
and DOE 101 - Budget Narrative Form
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3) All required forms must have the assigned TAPS Number included on the
?
form
4) All required forms have original signatures by an authorized entity
5) Submit one (1) proposal with an original signature made in an ink color other
DOE 900D
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than black
6) Submit three (3) copies of the original proposal
7) Font Type / Size: 11 point
8) Margin Size: 1” – both side and top / bottom margins
9) Single / Spacing
10) Single -sided type pages
11) No Bound Copies
12) 8.5 x 11-inch sized pages
13) 6-page maximum for the narrative. Forms, Performance Expectations,
attachments, and appendices are not included in this 6-page maximum.
14) Application must be submitted to:
Office of Grants Management
Florida Department of Education
325 W. Gaines Street, Room 325
Tallahassee, Florida 32399-0400
NOTE: Applications signed by officials other than the appropriate agency head
identified above must have a letter signed by the 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 100A when the application
is submitted.
Method of Review
Proposals will be reviewed internally. Final recommendations for funding will be forwarded to
the Commissioner of Education for approval. Successful applicants will receive a Project
Award Notification (DOE 200).
Unsuccessful applicants will be notified, at a minimum,
electronically.
DOE 900D
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Project Performance Accountability Information, Instructions, and Forms
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NOTE:
The following pages are included in the RFA (DOE 900 D) template.
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The forms are to be completed by the applicant. Instructions follow each form. See additional
NOTE
at bottom of page.
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The Department of Education has developed a standardized format for applicants to use in preparing their proposals/applications for
discretionary funds. The intent of this process is to assure proper accountability for the use of federal and state funds. The Department has
implemented a web-based Grants Management System and the information provided about each funded project will be entered into this system.
The Department’s program managers will track each project’s performance based on the information provided in this section of the approved
project.
This information will:
9
 
Provide a centralized capability for retrieving information about various discretionary projects awarded by the Department.
9
 
Assist policy-makers and managers in monitoring discretionary funds and the impact they are having.
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Provide baseline information that can be used in assessing the alignment of funding to goals and strategic imperatives and in allocating
available funding to priority needs.
9
 
Facilitate effective project monitoring.
Types of project performance have been organized into four categories. These are:
9
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Deliverables:
Category Includes: Documents such as manuals, reports, videos, CD ROMs, training materials, brochures, and any other
tangible product to be developed by the project.
9
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Training, Technical Assistance, and Dissemination:
Category Includes: All training and technical assistance (TA) activities whether
provided onsite, through distance learning media, conferences, workshops, or other delivery strategies.
9
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Student Performance:
Category Includes: Any measure that is specific to student performance (e.g., test scores, attendance, behavior,
award of diplomas, certificates, etc. “Students” may include pre-k, K-12, and adult learners as well as parents.
9
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Service Delivery:
Category Includes: Delivery of intended services to target population (e.g., adult literacy services, child find services,
student evaluation services, etc.)
For each type of performance for which a project will be held accountable, the applicant must complete the information specified in the attached
forms. Use only those forms and types of performance applicable to the project. Instructions are provided for the completion of each form.
NOTE:
Selected project
s are required to obtain independent, formal, third-party evaluations. Other projects elect to obtain such evaluations. If
the proposal or application includes a required or optional third-party evaluation, a form and instructions for describing the proposal evaluation
are provided following the Project Performance Accountability pages.
DOE 900D
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DELIVERABLES FORM
Deliverables: Manuals, reports, videos, CD ROMs, training materials, brochures, and any other tangible product to be developed by the
project
(1) Name of Deliverable and Brief Description
(2) Standard(s) for Acceptance
(3) Due Date(s)
DOE 900D
Revised 03/07
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APPLICANT INSTRUCTIONS: DELIVERABLES FORM
Deliverables: Manuals, reports, videos, CD ROMs, training materials, brochures, and any other tangible product to be developed by the
project
(1) For each deliverable to be completed by the project, enter in Column (1), the name of the deliverable and provide a brief description. The
name should be identified from the following list. The description should indicate the purpose of the deliverable, including the target audience
and should indicate the type of content to be provided in the deliverable. For example, “Brochure for parents of retained students explaining
options for assistance.” Any required reports should also be included in this section.
Announcement
Brochure
CD Rom
Curriculum
Database
Database Analysis
Display
DVD
Evaluation Instrument
Guidelines
Instructional Materials
Lesson Plans
Manual
Needs Assessment
Newsletter
Policy Paper
Poster
Public Service Announcement
Report
Report Format
Screening Device
Software
Survey
Teacher’s Guides
Technical Assistance Paper
Training Materials – Handout
Training Materials – Presentation
PowerPoint)
Training Modules - Online
Video
Website
Workbook
Other
(2) For each deliverable identified in Column (1), specify all of the proposed standards that should be used to determine whether the deliverable
meets the expectations for the project. The standards should be selected from the following list and any additional detail appropriate to each
standard should be provided. For example, if one of the standards is “Meets technical specifications,” the descriptions should outline the
proposed technical standards.
ADA Compliant
Format Consistent with Content and
Review by DOE Staff
Appropriate for Duplication
Intended Audience
Review by Other Entity
Appropriately Organized
Grammatically Correct
Sufficient Copies Provided
Attractive
Includes Copyright and Funding Information
Translated into Appropriate Languages
Content Accurate
Meets technical specifications
User-Friendly
Content Complete
Peer Review
Other
Design and Content Appropriate to
Readability Level is Appropriate to
Intended
Audience
Audience
Provide in Column (3), the date when the deliverable will be complete. Interim dates for drafts, review, etc., should also be provided as
applicable.
DOE 900D
Revised 03/07
9

TRAINING, TECHNICAL ASSISTANCE, AND DISSEMINATION FORM
Training, Technical Assistance, and Dissemination: All training and technical assistance (TA) activities whether provided onsite,
through distance learning media, conferences, workshops, or other delivery strategies
(1) Name of Activity and Brief
Description
(2) Quantity and Quality
Standards for Acceptance
(3) Method of Documentation
(4) Critical
Timelines
DOE 900D
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APPLICANT INSTRUCTIONS: TRAINING, TECHNICAL ASSISTANCE, AND DISSEMINATION FORM
Training, Technical Assistance, and Dissemination: All training and technical assistance (TA) activities whether provided onsite,
through distance learning media, conferences, workshops, or other delivery strategies
(1) For each training, technical assistance or dissemination activity to be completed by the project, enter in Column (1), the name of the activity
and provide a brief description. The name should be identified from the following list. The description should indicate the purpose of the activity,
including the target audience and should indicate the type of content to be provided. For example, “Training for third grade teachers of reading in
use of multiple instructional strategies.”
Coaching
Distribution of Printed Material
On-Site Technical Assistance
Conference
Exhibits
Preservice Training
Coursework at Institutions of Higher
Follow-up to Training Activities
Seminars
Education
In-service Training
Telephone Technical Assistance
Dissemination though the Media
Mentoring
Workshop(s)
Dissemination Through Internet
One-On-One Training
Other
Distance Learning
Distribution of Media (Software, Videos, CD
ROMs,
etc.)
(2) For each activity identified in Column (1), specify all of the proposed standards that should be used to determine whether the activity meets
the expectations for the project. The standards should be selected from the following list and any additional detail appropriate to each standard
should be provided. For example, if one of the standards is “Participant Feedback Indicative of Usefulness,” the descriptions should outline how
participant feedback will be gathered and assessed.
Appropriately Organized
Design and Content Appropriate to
Grammatically Correct
Content Accurate
Intended Audience
Meets Technical Specifications
Content Complete
Use of Consultants
Participant Feedback Indicative of
Delivery Appropriate to Content and
Follow-up Data Indicative of Effectiveness
Usefulness
Audience
Format Consistent with Content and
Replicable
Intended Audience
User-Friendly
Other
(3) Provide in Column (3), the information/materials which will be provided (or otherwise available) to document the performance of the project.
Agreements
Analysis of Requests and Responses
Anecdotal Data
Contracts
Evaluation Summaries
List of Participants
NRS Report
Observation by DOE Staff
Participant Competency Evaluations
Participant Feedback Summaries
Peer Review
Purchase Orders
Self-Reporting
Sign-in Sheets
Travel Itineraries
Verification of Dissemination to Target
Audiences
Other
(4) Provide in Column (4), the critical timelines for completion of each activity taking into consideration announcements of training availability,
delivery of training, completion of follow-up, etc.
DOE 900D
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STUDENT PERFORMANCE FORM
Student Performance: Any measure that is specific to student performance; e.g., test scores, attendance, behavior, award of diplomas,
certificates, etc. Students may include pre-k, K-12, and adult learners
(1) Name of Performance and Brief
Description
(2) Method of Evaluating Performance
(3) Method of DOE Verification
(4) Timelines for
Data Collection
DOE 900D
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APPLICANT INSTRUCTIONS: STUDENT PERFORMANCE FORM
Student Performance: Any measure that is specific to student performance; e.g., test scores, attendance, behavior, award of diplomas,
certificates, etc. Students may include pre-k, K-12, and adult learners
(1) For each type of student performance to be impacted by the project, enter in Column (1), the name of the performance from the following list
and provide a brief description. The description should describe the student population and provide detail about the expected student
performance. For example, “Academic Achievement – Reading: Low-performing 3
rd
grade students in Smith Elementary School will increase by
1 level on the FCAT .”
Academic Achievement – Language Arts
Diploma
Participation in Assessment
Academic Achievement – Math
Enrollments
Participation in Least Restrictive
Academic Achievement – Reading
GED
Environment (LRE)
Academic Achievement – Science
High School Credential
Placements, Retention, Completions
Academic Achievement – Social Studies
Job Placement
(postsecondary JOBS)
Academic Achievement – Writing
Job Retention
Postsecondary Education Placement
Achievement – Arts
Improvement in Behavior
Postsecondary Education Completion
Achievement – Other
Increased Self-Sufficiency Through Use of
Program Completion
Achievement – Vocational Education
Technology
Promotion to Next Grade
Attendance
Literacy Completion Points
Satisfactory Completion of Coursework
Award of Certificate
Non-Traditional Enrollments
Secondary Credential
Career Advancement Retention
Occupational Completion Points
State-Adopted Assessment
Decrease in Disciplinary Actions
Parental Involvement in Education of
Workplace Readiness Completion
Decrease in Drop-out Rate
Dependent Children
Other
Decrease in Suspensions/Expulsions
Parental Involvement in Literacy Activities
of Dependent Children
(2) For each student identified in Column (1), specify all of the proposed standards from the following list that should be used to determine
whether the performance meets the expectations for the project. Any additional detail appropriate to each standard should be provided. For
example, if one of the standards is “Graduation Data,” the description should outline how the data will be gathered and what level of graduation
rate is expected.
Anecdotal Data
Graduation Data
Progress Monitoring
AYP Determination
Observation
Promotion Data
Disciplinary Referrals
Participation Records
School Grades
FCAT
Placement Data
Standardized Tests
GED Data
Portfolios
Suspension/Expulsion Data
Other
DOE 900D
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APPLICANT INSTRUCTIONS: STUDENT PERFORMANCE FORM
Student Performance (continued)
(3) Provide in Column 3, the information/materials which will be provided (or otherwise available) to document the performance of the project.
Agreements
Analysis of Requests and Responses
Anecdotal Data
Contracts
Evaluation Summaries
List of Participants
NRS Report
Observation by DOE Staff
Participant Competency Evaluations
Participant Feedback Summaries
Peer Review
Purchase Orders
Self-Reporting
Sign-in Sheets
Travel Itineraries
Verification of Dissemination to Target
Audiences
Other
(4) Provide in Column (4), the critical timelines for completion of each activity taking into consideration announcements of training availability,
delivery of training, completion of follow-up, etc.
DOE 900D
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FORMAL THIRD PARTY EVALUATION FORM
Formal Third-Party Evaluation: A formal evaluation conducted by a party not employed by the fiscal agent either under contract with
the project recipient or under the auspices of the DOE
(3) Date(s) Evaluation
(1) Scope of Evaluation and Brief Description
(2) Type of Entity Conducting Evaluation
to Be Conducted
DOE 900D
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FORMAL THIRD PARTY EVALUATION FORM
Formal Third-Party Evaluation: A formal evaluation conducted by a party not employed by the fiscal agent either under contract
with the project recipient or under the auspices of the DOE
If a formal third-party evaluation is required or proposed for this project the following information must be provided.
(1) In column (1), specify the scope of the evaluation using one or more of the descriptors provided below. Provide additional information
regarding the nature of the evaluation. For example, if the evaluation will cover only selected elements of the project, specify the elements
to be evaluated.
All Aspects of Project
Compliance Review
Formative Evaluation
Outcome Assessment
Process Review
Selected Elements of Project
Summative Evaluation
(2) In column (2) indicate the type of entity from the following list which will be conducting the third-party evaluation. Provide any additional
information which may be available about the entity to conduct the evaluation such as selection criteria or qualifications.
Board/Commission/Task Force
Governmental Agency
Institution of Higher Education
Consultant Firm
Independent Entity Selected by Project
Selected Peer Reviewers
DOE Funded Project
Individual Consultant
Other
(3) Provide in Column (3), the date(s) when the evaluation will be conducted including the date for completion of reports.
DOE 900D
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FLORIDA DEPARTMENT OF EDUCATION
PROJECT APPLICATION
TAPS Number
09C063
Please return to:
Florida Department of Education
Office of Grants Management
Room
Turlington Building
325 West Gaines Street
Tallahassee, Florida 32399-0400
Telephone: (850)
Suncom:
A) Program Name:
DOE USE ONLY
Date Received
B) Name and Address of Eligible Applicant:
Project Number (DOE Assigned)
C)
Total Funds Requested:
$
DOE USE ONLY
Total Approved Project:
$
D)
Applicant Contact Information
Contact Name:
Mailing Address:
Telephone Number:
SunCom Number:
Fax Number:
E-mail Address:
CERTIFICATION
I, ______________________________________________, (Please Type Name) do hereby 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 assurances for this project. 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 expenditure of funds on this project. 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 of the project. Disbursements will be reported only as appropriate to this project,
and will not be used for matching funds on this or any special project, where prohibited.
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.
E)
Signature of Agency Head
________________________________________________
DOE 100A
Revised 12/07
Page 17 of 20
Dr. Eric J. Smith, Commissioner

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Instructions for Completion of DOE 100A
A.
?
If not pre-printed, enter name of the program for which funds are requested.
B.
?
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.
C.
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Enter the total amount of funds requested for this project.
D.
?
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.
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 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 100A when the application is submitted.
DOE 100A
Revised 12/07
Page 18 of 20
Dr. Eric J. Smith, Commissioner

A)
Name of Eligible Recipient:
B)
TAPS Number
09C063
Project Number: (DOE USE ONLY)
FLORIDA DEPARTMENT OF EDUCATION
BUDGET NARRATIVE FORM
(1)
FUNCTION
(2)
OBJECT
(3)
ACCOUNT TITLE AND NARRATIVE
(4)
FTE
POSITION
(5)
AMOUNT
C) TOTAL
$
DOE 101
Revised 12/07
Page 19 of 20
Dr. Eric J. Smith, Commissioner

Instructions
?
Budget Narrative Form
?
This form should be completed based on the instructions outlined below, unless instructed otherwise in the Request for Proposal (RFP) or Request for
Application (RFA).
A.
Enter Name of Eligible Recipient.
B
.
(DOE USE ONLY)
COLUMN 1
FUNCTION:
SCHOOL DISTRICTS ONLY:
Use the four digit function codes as required in the Financial and Program Cost Accounting and Reporting for Florida Schools
Manual.
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 first three digits of the object codes listed in the Accounting Manual for Florida’s Public Community Colleges.
UNIVERSITIES AND STATE AGENCIES:
Use the first three digits of the object codes listed 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:
ACCOUNT TITLE:
Use the account title that applies to the object code listed in accordance with the agency's accounting system.
NARRATIVE:
Provide a detailed narrative for each object code listed. For example:
?
SALARIES
- describe the type(s) of positions requested. Use a separate line to describe each type of position.
?
OTHER PERSONAL SERVICES
– describe the type of service(s) and an estimated number of hours for each type of position. OPS is
defined as compensation paid to persons, including substitute teachers not under contract, who are employed to provide temporary
services to the program.
?
PROFESSIONAL/TECHNICAL SERVICES
- describe services rendered by personnel, other than agency personnel employees, who provide
specialized skills and knowledge.
?
CONTRACTUAL SERVICES AND/OR INTER-AGENCY AGREEMENTS
- provide the agency name and description of the service(s) to be rendered.
?
TRAVEL
- provide a description of each type of travel to be supported with project funds, such as conference(s), in district or out of
district, and out of state. Do not list individual names. List individual position(s) when travel funds are being requested to perform
necessary activities.
?
CAPITAL OUTLAY
- provide the type of items/equipment to be purchased with project funds.
?
INDIRECT COST
- provide the percentage rate being used. Use the current approved rate. (Reference the DOE Green Book for
additional guidance regarding indirect cost.)
COLUMN 4 – MUST BE COMPLETED FOR ALL SALARIES AND OTHER PERSONAL SERVICES.
FTE
- Indicate the Full Time Equivalent (FTE based on the standard workweek for the type of position) number of positions to be
funded. Determine FTE by dividing the standard number of weekly hours (e.g., 35 hours) for the type of position (e.g., teacher aide) into
the actual work hours to be funded by the project.
COLUMN 5
AMOUNT -
Provide the budget amount requested for each object code.
C.
?
TOTAL
-
Provide the total for Column (5) on the last page
.
Must be the same amount as requested on the DOE-100A or B.
DOE 101
Revised 12/07
Page 20 of 20
Dr. Eric J. Smith, Commissioner

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