Community Service Block Grant Program — 2020
CSBG Contract Documents for Off-Reservation Subcontractors

Agreement Proposal Documents:


Certification Lobbying STD FORM LLL Certification Regarding Lobbying/Disclosure of Lobbying Activities

Module 2 CSBG Eligible Entity Expenditures, Capacity, and Resources

Module 3 Community Level

Module 4 Individual and Family Level


Module 2

Module 3

Module 4
Instructions V2
Additional NPIs


Federal Funding Accountability and Transparency Act (FFATA) CSD 279 \
Contractors Certification Clauses CCC-04/2017 Contractors Certification Clauses Form
Contract Budget Forms

425 Budget Forms

425.S Contract Budget Summary Form and instructions

425.1.1 Budget Support—Personnel Costs and instructions

425.1.2 Budget Support—Non Personnel Costs and instructions

425.1.3 Other Agency Operating Funds and instructions

425.1.4 Budget Narrative and example

NCIDC 425 Budget Series
Justification for Contract Amendment/Modification Form NCIDC 425-B
Justification for Subcontract Amendment/Modification
Request for Pre-Approval Purchase/Lease CSD 558  
CSBG Closeout Package NCIDC 715 Series Closeout Interest Earned/Program Income and Equipment Inventory
Closeout/Equipment Inventory CSD 715 D Close-Out Equipment Inventory Schedule
Agency Staff and Board Roster CSD 188  
CSBG Monthly Expenditure Report NCIDC 425.ER  
CSBG Final Expenditure Report NCIDC 425.FER  
NCIDC Information Request Form NCIDC Advance Request Advance Request  
NCIDC CSBG Client Intake and Registration Client Intake and Registration  
CSD Self Assessment Tool Self Assessment Tool  
Sample Resolution Sample Resolution  

Federal Regulations Incorporated into this Agreement here

• Federal Regulation, 45 CFR Part 16 – Procedures of the Departmental Grant Appeals Board
• Federal Regulation, 45 CFR Part 30 – Claims Collection
• Federal Regulation, 45 CFR, Part 74 codification of OMB Circular A-11
• Federal Regulation, 45 CFR Part 76 – Debarment and Suspension from Eligibility for Financial Assistance (Nonprocurement)
• Federal Regulation, 45 CFR Part 80 - Nondiscrimination Under Programs Receiving Federal Assistance through the Department of Health and Human Services, Effectuation of Title VI of the Civil Rights Act of 1964
• Federal Regulation, 45 CFR Part 81 - Practice and Procedure for Hearings Under Part 80 of this Title
• Federal Regulation, 45 CFR Part 84 - Nondiscrimination on the Basis of Handicap in Programs and Activities Receiving Federal Financial Assistance
• Federal Regulation, 45 CFR Part 86 – Nondiscrimination on the Basis of Sex in Education Programs and Activities Receiving or Benefiting from Federal Financial Assistance
• Federal Regulation, 45 CFR Part 87 – Equal Treatment for Faith-Based Organizations
• Federal Regulation, 45 CFR Part 91 – Nondiscrimination on the Basis of Age in HHS Programs or Activities Receiving Federal Financial Assistance
• Federal Regulation, 45 CFR Part 93   – New Restrictions on Lobbying
• Federal Regulation, 45 CFR Part 96 – Block Grants
• Federal Regulation, 45 CFR Part 97 – Consolidation of Grants to the Insular Areas
• Federal Regulation, 45 CFR Part 100 – Intergovernmental Review of Department of Health and Human Services Programs and Activities