OVR - Pennsylvania Department of Labor and Industry



COMMONWEALTH OF PENNSYLVANIA

DEPARTMENT OF LABOR AND INDUSTRY

OFFICE OF VOCATIONAL REHABILITATION

Grant Agreement

To Develop a Local Systems Change Project

Document Number

THIS GRANT AGREEMENT is made and entered into this day of , at Harrisburg, County of Dauphin, Commonwealth of Pennsylvania, by the Office of Vocational Rehabilitation, hereinafter called "OVR," and _______________ hereinafter called the "Grantee."

This project will be funded with federal Title VII, Part B funds and the required Pennsylvania State match. Pursuant to the federal regulations governing Independent Living Services, OVR may grant funds for certain purposes: specifically, 34 CFR  § 365.21 provides in pertinent part: In providing IL services as required under 704(E) of the ACT and 34 CFR § 364.43(b) a state may use funds provided under this part to provide directly or through grants or contracts, the following IL services**** (4) Individual and system advocacy.

OVR and the Grantee, intending to be legally bound, and in consideration of the acceptance of the terms and conditions contained in this grant and the award of a grant in the amount of $________, hereby agree as follows:

1. The Grantee, in consultation with OVR, will furnish all qualified personnel, facilities, materials, and perform all aspects of the grant project as hereinafter described in the Riders, attached hereto and made a part hereof as fully as if incorporated herein, as follows:

RIDER A, Specifications of Work to be Performed - Grantee Proposal

RIDER B, Terms and Conditions

RIDER C, Certification and Assurance Forms

RIDER D, Budget Information

2. The Grantee will comply with all applicable State and Federal laws, regulations, policies and guidelines, and furnish assurances and certifications of compliance as required herein.

In Witness whereof the parties hereto have affixed their signatures intending to be legally bound.

Office of Vocational Rehabilitation

Name of Agency

By:

Director Date OVR Executive Director Date

Approved As To Form And Legality:

Chief Counsel, Date Deputy General Counsel Date

Pa. Dept. of Labor & Industry Office of General Counsel

Attorney General Date

Office of Attorney General

Funding of this grant is contingent upon the availability of funds and approval of the grantor agency.

Approved:

Comptroller, Department Date

Subcontracting Agency Federal I.D. Number

or Social Security Number:

_____________ _________________________

Instructions for completing the Grant Agreement Form

1. Leave the Document Number line blank.

2. Leave the date and year lines blank.

3. Type the name of your agency on the third line of paragraph one.

4. Leave the amount of the grant line blank.

5. On the top of the second page, type the name of your Agency on the first line.

6. Authorized Individual signs the Grant Agreement Form on the line under the Agency name.

7. Type the Federal I.D. Number or the Social Security Number for the Grantee on the appropriate line in the middle of the second page.

A copy of this signed form will be provided once the document has received approval and all the required parties’ signatures.

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download