Statement
of Assurances
2006-2007
Form P – Program Assurances Due: May 15, 2006
Directions: This form is to be signed by the applicant
agency and all significant partner agencies entering into direct collaboration
on the project. Use an additional copy
of the Assurances Form if the number of partners exceeds the space provided
below.
The
applicant partners agree:
1.
To conduct activities described herein in accordance with
applicable state and federal statutes and regulations, including those concerning
non-discrimination, prohibitions against lobbying, suspension, and disbarment,
the provision of a gun-free, drug-free and smoke-free work place, and access
for persons with disabilities.
2.
To use grant funds to supplement and, to the extent
possible, increase the level of funds that would have been made available for
the purposes described in the Request for Proposals. Grant funds will not be used to supplant services currently
provided using state or federal funds nor for construction.
3.
To participate in external evaluation of the project’s
effectiveness as determined by the Department of Education.
4.
The applicant assures that private non-profit schools have
been invited to participate in planning and implementing the activities of this
application when available and relevant to the Even Start Program.
5.
To keep such records and provide such information to the
Department of Education as reasonably may be required for fiscal audit and
program evaluation.
6.
To make all requests for budget revisions in writing
prior to actual use of funds.
7.
To notify the Department of Education of changes in
management staff and/or contact person.
8.
That all materials produced will include the following
statement: (This project) is supported
in part by a grant from federal and/or state funds administered by the Iowa
Department of Education.
9.
To comply with any/all expectations specifically identified
and/or described in this Request for Proposal and the federal guidance.
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Partner A
– Agency/Program Name: |
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Telephone: |
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Signature
of Head Administrator: |
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Title: |
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Date: |
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Partner B
– Agency/Program Name: |
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Telephone: |
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Signature
of Head Administrator: |
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Title: |
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Date: |
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Partner C
– Agency/Program Name: |
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Telephone: |
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Signature
of Head Administrator: |
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Title: |
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Date: |
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Partner D
– Agency/Program Name: |
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Telephone: |
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Signature
of Head Administrator: |
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Title: |
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Date: |