Totals (d-5) + New or Revised Ensure that the Forecasted Cash Needs: 15. TOTAL equals to Budget Non-Federal Totals (f-5) SECTION A Budget Summary: 5.Totals Total (g). – The Total for 1st Year TOTAL in Section D does not equal to the Totals Total (Column 5, Row G) in Section A 19 SF424-A: Section E Budget Ensure that the project period years on the SF 424 block 17 – Estimates Of Federal Funds matches the provided budget periods in the SF 424 A. Enter data Needed For Balance of The project for the first budget period in Section D and enter future budget periods in Section E. Please refer to agency guidance if applicable. The number of budget years/periods does not match the span of the project Appendix C – Statement of Assurance As the authorized representative of [insert name of applicant organization] _________________________________________________, I assure SAMHSA that all participating service provider organizations listed in this application meet the experience requirement and applicable licensing, accreditation, and certification requirements. If this application is within the funding range for a grant award, we will provide the SAMHSA Government Project Officer (GPO) with the following documents. I understand that if this documentation is not received by the GPO within the specified timeframe, the application will be removed from consideration for an award and the funds will be provided to another applicant meeting these requirements. Official documentation that all mental health/substance use disorder treatment provider organizations participating in the project have been providing relevant services for a minimum of two years prior to the date of the application in the area(s) in which services are to be provided. Official documents must definitively establish that the organization has provided relevant services for the last two years; and Official documentation that all mental health/substance use disorder treatment provider organizations: 1) comply with all local (city, county) and state requirements for licensing, accreditation and certification; OR 2) official documentation from the appropriate agency of the applicable state, county, or
Totals (d-5) + New or Revised Budget Non-Federal Totals (f-5) The Total for 1st Year TOTAL in Section D does not equal to the Totals Total (Column 5, Row G) in Section A Ensure that the Forecasted Cash Needs: 15. TOTAL equals to SECTION A – Budget Summary: 5.Totals Total (g). 19 SF424-A: Section E – Budget Estimates Of Federal Funds Needed For Balance of The project The number of budget years/periods does not match the span of the project Ensure that the project period years on the SF 424 block 17 matches the provided budget periods in the SF 424 A. Enter data for the first budget period in Section D and enter future budget periods in Section E. Please refer to agency guidance if applicable. Appendix C – Statement of Assurance As the authorized representative of [insert name of applicant organization] _________________________________________________, I assure SAMHSA that all participating service provider organizations listed in this application meet the experience requirement and applicable licensing, accreditation, and certification requirements. If this application is within the funding range for a grant award, we will provide the SAMHSA Government Project Officer (GPO) with the following documents. I understand that if this documentation is not received by the GPO within the specified timeframe, the application will be removed from consideration for an award and the funds will be provided to another applicant meeting these requirements. Official documentation that all mental health/substance use disorder treatment provider organizations participating in the project have been providing relevant services for a minimum of two years prior to the date of the application in the area(s) in which services are to be provided. Official documents must definitively establish that the organization has provided relevant services for the last two years; and Official documentation that all mental health/substance use disorder treatment provider organizations: 1) comply with all local (city, county) and state requirements for licensing, accreditation and certification; OR 2) official documentation from the appropriate agency of the applicable state, county, or