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Home My WebLink AboutGrant Application Book & Forms Neville. Elizabeth From: A list to provide information for grant applicants regarding LGMRIF grants. [SARAGRANTS@listserv.nysed.gov] on behalf of Geraldine Reed [GREED@MAIL.NYSED.GOV] Friday, November 03,2006435 PM SARAGRANTS@listserv.nysed.gov LGRMIF Grant Application Materials for 2007-2008 Sent: To: Subject: NEW YORK STATE ARCHIVES LOCAL GOVERNMENT RECORDS MANAGEMENT IMPROVEMENT FUND GRANT APPLICATION AND REFERENCE MATERIALS 2007-2008 Application Deadline - February 1, 2007 The New York State Archives' Grant Application and Reference Materials 2007-2008 are designed for local officials who wish to apply for a Local Government Records Management Improvement Fund (LGRMIF) grant. visit the State Archives Website at: http://www.archives.nysed.gov to view and download the complete application materials in PDF. The grant forms are also available as Word 2000 templates. If you do not have access to the website, you may order a photocopy of the LGRMIF competitive grants materials bye-mail at archgrants@mail.nysed.gov The Local Government Records Management Improvement Fund (LGRMIF) is a dedicated fund established to improve records management and archival administration in New York's local governments. It is comprised of the fees collected by county clerks and the New York City Register for the recording of selected documents, including deeds and mortgages, and for the assignment by county clerks of index numbers for certain court cases. The LGRMIF grant program is a competitive program. * Its primary purpose is to help local governments establish records management programs or develop new program components. * Local governments must assume primary responsibility for ongoing support of their programs. * The amount of grant funding available each year depends on the number of documents recorded and index numbers sold each year. * On average, between 500 and 700 local governments apply each year, and competition is typically quite rigorous. Types of Grants: * Individual Projects (a single local government) - may request up to $75,000. * Cooperative Projects (two or more local governments acting together) - may request up to $125,000. * Complex Projects (one local government addressing problems involving an exceptionally large quantity of records or a complicated records management problem) must request at least $75,001 but no more than $125,000. Each local government may submit a maximum of two applications (two individual applications, two cooperative applications, or one individual and one cooperative application-either as the lead applicant or as a member of the cooperative), but the applications must be submitted from separate departments in the government. Each application must be able to stand on its own as a viable project. Local governments applying for a complex grant are limited to one application. The Records Management Officer and the local government's chief administrative officer must sign the application. County clerks and the New York City Register may apply for one additional grant of up to 75,000 under the County Land Records Initiative, a subcategory of Active Records. A total of $1.5 million will be awarded for this initiative during the 2007-2008 grant year. The State Archives encourages local government officials to attend one of the many LGRMIF grant application information sessions held in all regions of the state beginning October 11 and continuing through the fall. In addition, the Archives' Regional Advisory Officers (RAOs) are available to provide technical advice to local governments. Applicants should 1 THE MORE GRANTS CHANGE, THE MORE THEY STAY THE SAME Geof Huth, Director Government Records Services New York State Archives Every year, the New York State Archives, 'Yith the help of our Local Government Records Advisory Council and many local government'folks, reviews its grants guidelines, working to improve them. Weare trying to ensure that our grants help local g3vfmments care for and manage their records, so our grants program has changed a little over each of the last sixteen years as we chase after that goal. This year, we'll see a few more changes than usual, changes we expect will make the grants process easier and better for everyone who applies. First, the deadline for the Local Government Records Management Improvement Fund grants will change back to the old deadline of the first working day in February. This means that the next deadline will be February 1,2007. This might seem like a small change, but a February 1st deadline allows for a more effective grants writing season. The December 1st deadline, which we have used recently, inconveniently forced people to finish their grant applications right after Thanksgiving each year. Unfortunately, the February 1st deadline may prove a bit inconvenient for those town clerks who are also tax collectors, but overall this will prove to be a good change. We have made a large number of changes to the required application forms. The most significant of these was the transfor- mation of the application narrative into a form (the LG-NA) that carefully lays out the information applicants need to include in every section of the narrative. Another new set of forms, the Budget Narratives, will require applicants to justify every expense in their grant budget. We have also included a new form that applicants must submit as part of their application: The Application Checklist (LG-CH) requires applicants to verify they are submitting a complete application. We are fairly certain that people won't forget this form, since applicants will now sign the application on this form, but watch out for this form. We expect these three changes will make it easier for applicants to write strong grant application narratives and to justify their requested expenses. In tandem with these additional forms, we will be eliminating many grant forms this year. Over the years, the Archives has developed a number of supplementary forms that collect specific information to reviewers evaluate applications. The form listing cooperating members of a grant has been appended to the Application Checklist. The Records Management Program Questionnaire disappeared, but essential information from that form has been added to the Application Narrative. The information in the old Pro- jects Previously Funded form is now covered in the Application Narrative. The Project Position Description and Indexing Project Information forms are no more. We hope these small changes will make applying for a Local Government Records Management Improvement Fund grant easier for all local government applicants. Other changes include the following: · Added "County Land Records Initiative" projects as a subcategory under Active Records. Only county clerks and the New York City Register are eligible to apply under this grant subcategory. · Eliminated the subcategory of "Inventory Streamlined." · Identified as priorities for funding any projects designed to inventory electronic records or to implement the recommen- dations resulting from an electronic records inventory. · Made "Microfilming" a separate grant category. · Raised the allowable amount for quality control testing of microfilm from $15 to $18 per every fourth roll of original microfilm. · Modified the grants review ranking criteria to correspond with the requirements for the application narrative. · Added the requirement that applicants must submit three quotes for remodeling projects where anyone vendor will receive more than $5,000. · Removed the cap of $5,000 on data conversion under the GIS subcategory. For more details on these changes, see the grants application booklet, released in October. If you are planning to apply for a grant next year, be sure to set up a meeting to discuss your application in detail with the Regional Advisory Officer who serves your region of the state. With the number of changes this year, it will be especially important that you confer with staff from the Archives about your application ahead of time. Good luck. Page 6 ~ new york state .\ archives . GRANTS ADl\.lINISTltATlON UNIT. 9:\81 Cultural Education Center. Albany, NY 12230. (518) 474-6926 LOCAL GOVERNMENT RECORDS MANAGEMENT IMPROVEMENT FUND Grant Application and Reference Materials 2007-2008 Application Deadline: Postmarked by February 1, 2007 The University of the State of New York The State Education Department www.nysed.gov Local Government Records Management Improvement Fund Grant Application and Reference Materials 2007-2008 September 2006 New York State Archives This publication is distributed by the New York State Archives. If you have any questions concern- ing its contents, please call (518) 474-6926, or send an e-mail to the State Archives at ARCHGRANTS@mail.nysed.gov New York State Archives web address: www.archives.nysed.gov THE UNIVERSITY OF THE STATE OF NEW YORK Regents of The University ROBERT M. BENNETT, Chancellor, B.A., M.S. ........................................................ Tonawanda ADELAIDE L. SANFORD, Vice Chancellor, B.A., MA, P.D. ..................................... Hollis SAUL B. COHEN, BA, MA, Ph.D. ........................................................................ New Rochelle JAMES C. DAWSON, A.A., B.A., M.S., Ph.D. ........................................................... Peru ANTHONY S. BOTTAR, BA, J.D. ............................................................................ North Syracuse MERRYL H. TISCH, BA, M.A. ................................................................................ New York GERALDINE D. CHAPEY, BA, MA, Ed.D. ............... .................................... Belle Harbor ARNOLD B. GARDNER, BA, LL.B. ........................................................................... Buffalo HARRY PHILLIPS, 3rd, B.A., M.S.F.S. ..................................................................... Hartsdale JOSEPH E. BOWMAN, JR., BA, M.L.S., M.A., M.Ed., Ed.D. ................................... Albany LORRAINE A. CORTES-VAzQUEZ, B.A., M.P.A. ........................................................ Bronx JAMES R. TALLON, JR., BA, MA .......................................................................... Binghamton MILTON L. COFIELD, B.S., M.BA, Ph.D. ................................................................ Rochester JOHN BRADEMAS, BA, Ph.D. ................................................................................ New York ROGER B. TILLES, BA, J.D. .................................................................................. Great Neck KAREN BROOKS HOPKINS, B.A., M.FA ......................................................................... Brooklyn President of The University and Commissioner of Education RICHARD P. MILLS Counsel and Deputy Commissioner for Legal Affairs KATHY A. AHERN Chief Operating Officer Deputy Commissioner for the Office of Management Services THERESA E. SA VO Deputy Commissioner for Cultural Education CAROLE F. HUXLEY Assistant Commissioner for New York State Archives CHRISTINE WARD Director of Operations KATHLEEN ROE Director, Government Records Services GEOFFREY A. HUTH The State Education Department does not discriminate on the basis of age, color, religion, creed, disabil- ity, marital status, veteran status, national origin, race, gender, genetic predisposition or carrier status, or sexual orientation in its educational programs, services, and activities. Portions of this publication can be made available in a variety offormats, including Braille, large print, or audio tape, upon request. Inquiries concerning this policy of non-discrimination should be directed to the State Education Department's Of- fice for Diversity, Ethics, and Access, Room 530, Education Building, Albany, NY 12234. Table of Contents I. General Information Introduction ........ ......... ..... ...... ..... ...... .... ............ ........... ............ ... .......... .... .....3 Summary of Changes for 2007-2008 ............................................................4 Timetable for 2007-2008 Grant Projects ....................................................... 5 Eligibility Requirements.. ...... ...... .......... .... .... .... ......... ....... .... ... ......... ....... .......5 Types of Grants.... ......... ...... ..... ...... .... ........ ............. ........... .... .... ... ......... ........ 6 II. Preparing an Application Getting Started. ...... ...... ........ ...... ........ ...... .... ........ ..... ...... .... .......... .... .... .... .......... .... 11 Parts of an Application .................................................................................12 III. Grants Project Categories Inventory and Planning ................................................................................19 Active Records. ......... .... ...... ..... ...... ..... .... .... ..... ....... ..... ...... ... ........... ......... ...22 Inactive Records. .... ........ ...... .... ....... ........ ... ...... ... .... ..... ...... .... ... ........ .... ......28 Microfilming. ......... ......... ...... ..... .......... ........ ......... .... ........ ..................... ........30 Historical Records. ..... .... ...... ..... ...... .... .... .... .... ......... ....................... .......... ...33 Educational Uses of Local Government Records......................................... 37 IV. Grants Review Review Process... ....... ........... ...... ...... ......... .... ............. ... ... ........ .......... ........43 Priorities for Funding ... ...... ..... ....... ..... ......... ..... ....... ........... ....... ........... ... .....43 Awards......................................................................................................... 43 Schedule of Payments.. ...... ..... ...... .... ..... .... ..... ........... ........... ....... ........ .......44 Project Administration ... ...... ................ ............. ..... ........ .............. ........ ......... 44 Appendices Grant Application Evaluation Form...............................................................4 7 Table of Cubic-Foot Equivalents...................................................................51 Records Management Publications Order Form...........................................53 Regional Advisory Offices. .... ... .... ..... .... ..... ..... .... ...... ...... ........... ..... ...... ........55 Map of Regional Offices ...............................................................................56 LGRMIF Forms A complete application packet is included at the back of the grants booklet. These forms can also be downloaded from the State Archives website (www.archives.nysed.gov) as either Word 2003 templates or PDF documents. In addition, you may contact your Regional Advisory Officer (RAO) to receive an application template via e-mail. Introduction The Local Government Records Management Improvement Fund Act (Chapter 78, Laws of 1989) established a dedicated fund to improve records management and ar- chival administration in New York's local governments. The Local Government Records Management Improvement Fund (LGRMIF) is comprised of the fees collected by county clerks and the New York City Register for the recording of selected documents, and for the assignment by county clerks of index numbers for certain court cases. The Act authorizes the Commissioner of Education to provide training and technical assis- tance, administer a grant program for local governments, and appoint a Local Govern- ment Records Advisory Council (LGRAC) to advise on the operation of the LGRMIF program. The purpose of LGRMIF grants is to help local governments establish records man- agement programs or develop new program components, not to support local govern- ment records management programs indefinitely. Local governments are expected to assume primary responsibility for ongoing support of their programs by providing the resources to manage their records on a continuing basis. This is consistent with the 1987 Local Government Records Law (Arts and Cultural Affairs Law 57-A), which re- quires most local governments to designate a Records Management Officer (RMO) and to develop a records management program. The LGRMIF grants program is competitive, awarding grants based on the merits of applications. The amount of grant funding available depends on the number of docu- ments recorded and index numbers assigned each year. This will vary with the state of the economy (as reflected in housing sales and thus the recording of deeds and mort- gages). On average, between 500 and 700 local governments apply each year. To in- crease their chances of funding, applicants should closely adhere to the application in- structions and address the relevant category requirements outlined in this booklet. The State Archives encourages local government officials to attend one of the many LGRMIF grant application workshops held in all regions of the state in the fall. In addi- tion, the Archives' Regional Advisory Officers (RAOs) are available to provide technical advice to local governments. Applicants should direct questions regarding applications to the RAOs or the State Archives' Grants Administration Unit in Albany at (518) 474- 6926. Additional information may be found on the Archives' website (www.archives.nysed.gov) under "Grants and Awards." 3 Summary of Changes for 2007-2008 The LGRMIF program has significantly changed for the 2007-2008 grant year because of new grants administration requirements issued by the State Education Department. This booklet has been revised to conform to the requirements, and the structure of the booklet has undergone a major revision in an effort to make it easier to use. As all changes cannot be listed here, it is important to read this booklet carefully. The follow- ing are some of the more significant changes we have implemented: . Changed deadline for applications to 1 February 2007. The 2007-2008 grant year will begin on 1 July 2007 and end on 30 June 2008. . Added the County Land Records Initiative as a subcategory under Active Records. Only county clerks and the New York City Register are eligible to apply under this grant subcategory. Requests in this subcategory may not exceed $75,000. . Eliminated the subcategory of Inventory Streamlined. . Identified projects to inventory electronic records and projects to implement the rec- ommendations resulting from an e-records inventory as priorities for funding. These projects will receive an additional five points in the numerical ranking of applica- tions. . Eliminated electronic records projects that enhance access to records as a priority for funding. . Eliminated Microfilming as a subcategory ofthe Inactive Records and Historical Re- cords categories. Microfilming is now a separate category. . Raised the allowable amount for quality control testing of microfilm from $15 to $18 per every fourth roll of original microfilm. . Added two new forms: Application Checklist (LG-CH) and Application Narrative (LG-NA). Instructions for completing the forms are included in these guidelines. . Eliminated the following forms: Local Governments Participating in Cooperative Ef- fort (LG-2), Records Management Program Questionnaire Form (LG-3), Projects Previously Funded by the LGRMIF (LG-4), Project Position Description Form (LG- 5), and Indexing Project Information Form (LG-8). . Added narrative sections to the budget forms. The applicant must use these sec- tions to justify all budget requests. 4 . Added the requirement that applicants must submit three quotes for remodeling projects where anyone vendor will receive more than $5,000. . Removed the cap of $5,000 on data conversion under the GIS subcategory. How- ever, if a government does not adequately demonstrate its ability to maintain data over time, reviewers may recommend funding no more than $5,000 for data con- version. Timetable for 2007-2008 Grants Projects 1 February 2007 Grant applications must be postmarked by this date. Anticipated date that notification letters will be mailed to all ap- plicants. Grants projects may start. All work on grants projects must be completed. 25 June 2007 1 July 2007 30 June 2008 31 July 2008 Final narrative and expenditure reports must be postmarked by this date. Eligibility Requirements Most local governments in New York State are required to have the following in place by the application deadline to apply for an LGRMIF grant: . Records Management Officer (RMO) appointed . Appropriate State Archives records retention and disposition schedule adopted The only exceptions to this are the City of New York and its five county clerks and five district attorneys, community school districts in New York City, housing authorities, and the Utica Transit Authority, all of which are not required to have RMOs or adopt State Archives records retention and disposition schedules. The State Education Department's (SED) Grants Finance Unit will not release grant funds to a local government that has failed to file the required fiscal reports or narrative reports for any SED grant (which includes LGRMIF grants). Public Benefit Corporations Public benefit corporations with local or regional jurisdiction are independent units of local government and are therefore eligible to apply for LGRMIF grants. 5 Community Colleges A community college sponsored by a single county may apply for grant funding only through its county's RMO and with the approval of the county's chief authorizing offi- cial. Fire Districts, Volunteer Fire Companies, Emergency Rescue Services, and Am- bulance Services Fire districts are eligible to apply for LGRMIF grants because they are local govern- ments. However, not-for-profit volunteer fire companies, ambulance services, and emergency rescue services are not local governments under the Local Government Records Law, and are therefore not eligible to apply for LGRMIF grants. For questions on eligibility, contact the Grants Administration Unit at (518) 474-6926. Types of Grants 1. Competitive Grants Applicants other than county clerks and the New York City Register Applicants other than county clerks and the New York City Register may submit a maximum of two applications involving individual or cooperative projects, but the applications must be submitted from separate departments. Each application must stand on its own as a viable project. . Individual Projects involve a single local government. The applicant may re- quest up to $75,000. . Cooperative Projects involve two or more local governments working together on one activity, with one government acting as the lead. Cooperative projects may apply for up to $125,000. The application must explain how the lead appli- cant will manage the project and how each of the participants will benefit. . Complex Projects involve one local government and must address an excep- tionally large quantity of records or a complicated records management prob- lem. Applicants other than county clerks and the New York City Register are limited to one complex grant application only. Local governments must request at least $75,001 but no more than $125,000 for complex grants. County clerks and the New York City Register 6 County clerks and the New York City Register are eligible for competitive grants as indicated above, and disaster recovery grants, as needed. In addition, county clerks and the New York City Register may apply for one additional grant of up to $75,000 under the County land Records Initiative, a subcategory of Ac- tive Records. A total of $1.5 million will be awarded for this initiative during the 2007-2008 grant year. County clerks and the New York City Register are eligible to apply for . up to three competitive grants, if the first two are for individual or cooperative projects or a combination of both . one complex grant and one County land Records Initiative grant . either of the first two plus one or more disaster recovery grants, as needed. For more information on the County land Records Initiative, see the subcategory description and requirements listed under the Active Records category. 2. Disaster Recovery Grants The lGRMIF program also offers up to $20,000 in support of disaster recovery projects. All local governments, except New York City municipal agencies, are eligi- ble to apply whenever a disaster involving records occurs. Disaster recovery grant applications must be submitted within thirty days of the disaster, unless ex- tenuating circumstances preclude this from occurring. If you experience a records disaster, contact your RAG immediately. If your RAG is not available, call the Records Advisory Services Unit in Albany at (518) 474- 6926. 7 Getting Started When preparing an LGRMIF grant application, carefully consider the nature, scope, and goals of the project you wish to undertake, as well as the process you intend to follow to complete the project. We recommend the following steps to start the appli- cation process. Understand the Purpose of the LGRMIF Grants Program LGRMIF grants are intended to implement a new records management initiative or to expand the capacity of an existing record keeping system. Conversely, LGRMIF grants are not intended to maintain a records management program or for maintenance pro- jects. Maintenance is defined as a project to redo a previously funded project or ad- dress records that have accumulated since the completion of a previous project. Soft- ware and hardware upgrades are generally considered examples of maintenance pro- jects. It is important to demonstrate in your application that you will support your re- cords management program once a project is completed and grant funding ends. Identify the Records Management Project or Problem There is no prescribed order for the process of establishing a records management program. Records inventory and planning is usually-but not necessarily-the first step, because an inventory provides information essential to the successful manage- ment offuture projects. It is your responsibility to determine which project takes priority, and then to justify this decision to the reviewers. If you need assistance with identifying where to start, contact your RAO. Collect Information About Your Needs Identify possible solutions to the problem, and decide which solution will be the most effective. If necessary, conduct a formal needs assessment to help you identify and prioritize your needs. Next, determine the grant category under which the proposed so- lution falls. Review the relevant category description to determine the eligible activities and requirements, and be especially sure that the application addresses each category requirement. Attend any workshops the State Archives offers that are relevant to your project. You may also request information from your RAO, but keep in mind that the RAO cannot review applications prior to submittal. Focus Your Project Propose a project that can be accomplished in a single year. Be sure the project has definite goals and a definite end point. You can frame a project as the first phase of a multi-year series of projects. However, because you may not be successful in obtaining 11 funds for subsequent years, you must demonstrate that each phase can stand on its own. Understand the Records Issues Prepare a well-organized application, showing definite goals and precise ways to achieve those goals. Demonstrate to the reviewers an understanding of basic records management concepts, especially those directly related to the proposed project. If your application involves implementing new technology, be sure to focus on the records is- sues. Reviewers generally do not recommend funding applications that focus on soft- ware and equipment purchases alone. Assemble the Grant Application Correctly Assemble your grant application in the order indicated on the Application Checklist. It is essential to submit a complete application. Parts of an Application Each of the parts of an application is described below and in the order in which they must appear in your application packet. Please note that your completed Application Narrative Form (LG-NA) is worth 70% of your application's score, and the Budget Code and Narrative forms are worth 30% of the score. Both your narrative and budget forms directly correspond to the reviewers' ranking criteria. (The Grant Application Evaluation Form in the appendix demonstrates how the narrative and budget forms relate to the ranking criteria; reviewers will com- plete one evaluation form for each application.) If you hire a grantwriter to prepare your application, be sure to review the application to make sure it addresses your unique situation adequately. You are ultimately responsi- ble for the quality of your application. Application Checklist (LG-CH) You must complete an Application Checklist and use it as your application cover sheet. Staff from the State Archives' Grants Administration Unit (GAU) will not forward your application for review if, on reviewing your Application Checklist, they determine you have not met the eligibility requirements, submitted all required forms, or certified your acceptance of the terms of the LGRMIF grants program. . Local Government Name. Name of the local government: e.g., Erie County, Town of Hempstead, Ulster BOCES. 12 . Eligibility Checklist. You must appoint a Records Management Officer and adopt the appropriate records retention schedule before the application deadline. See the relevant section in Part I, "General Information," of this grants booklet for a full ex- planation of eligibility requirements. . Forms and Other Materials Checklist. Assemble your application in the order in- dicated in the checklist. Place a check next to each item on the checklist to indicate that you have included it in your application packet. State Archives staff will review your application to verify your application is complete. . Certification and Approval. The Chief Administrative Officer or designee and the Records Management Officer (RMO) must sign the application and print or type their names and titles. The signatures verify that your government agrees to the conditions outlined in Appendix A and Appendix A-1 G (both of which you must in- clude with your application). The original copy ofthe application must be signed in blue ink; rubber-stamped signatures are not acceptable. Local governments not required to have an RMO should mark the RMO signature line "NtA." . Checklist for Participants in a Cooperative Project. Each participant in a coop- erative project must indicate their eligibility to apply for an LGRMIF grant. Each applicant must also indicate that they have included a letter of intent, a re- quirement of cooperative grant applications. Each letter must explain what the gov- ernment will do in the course of the project; how funds, personnel, facilities, and tasks will be shared; and what benefits will be gained. Each letter must be signed by the chief administrative officer of the participating government. Grant Project Application Form (LG-AP) . Application Type. Check only one. See the previous section of this booklet for in- formation on types of grants. . local Government. Name of the local government. . Department/Unit. Name of the specific department, agency, or unit that is applying for funds: e.g., Social Services, Town Clerk's Office, Police Department, Guidance Office, Personnel Office. . County. County where your central administrative office is located. . Chief Administrative Officer and Title. Name and title (e.g., superintendent, 13 mayor, county executive) of your chief administrative or authorizing officer. . Project Director and Title. Name and title of the person who will oversee the pro- ject. All projects must have a project director. Indicate whether the project director is also the RMO. . Project Category. Category and subcategory under which you are applying. Select only one category, and only one subcategory within that category. . Amount Requested. The grant request cannot exceed $75,000 for an individual project, $125,000 for a cooperative project, and $125,000 for a complex project. Projects under the County Lands Record Initiative subcategory cannot exceed $75,000. . Number of Grants Previously Received. Total number of LGRMIF grants you have received or participated in as a member of a cooperative project (including special initiatives). . Project Summary. Description of the proposed project, including its scope and ob- jectives. This summary provides grant reviewers with their first impression of each local government and its proposed project. Appendix A and Appendix A-1 G The State Education Department requires that a copy of Appendix A and Appendix A-1 G be included in each grant application, immediately following the Grant Project Appli- cation Form (LG-AP). Application Narrative Form (LG-NA) (maximum total of 70 points) The Application Narrative Form (LG-NA) is required for every grant application. A total of 70% of your application is evaluated according to information you provide in the ap- plication narrative. The point values listed below indicate the numerical weight the re- viewers assign to each of the parts of your application narrative during the grants re- view process. Address each of the issues listed on the form under each of the four sections of the narrative. Be as detailed as possible. Keep in mind that the application narrative directly corresponds to the criteria which reviewers will follow when ranking your application. The narrative consists of the following four sections: 14 I. Statement of the Problem (maximum 20 points) II. Intended Results (maximum 15 points) III. Plan of Work (maximum 20 points) IV. Local Government Support for Records Management (maximum 15 points) Each section has a series of issues which all applicants are required to address on the narrative form. Payee Information (PI) and Supplement These must be completed by all applicants so that the New York State Archives can either assign you a unique Payee Identification Number (also known as an agency code) for your local government, or verify the information we have on record. The State Education Department also needs this information to expedite electronic payments of grants funds. For instructions on completing the form, see the reverse side. Vendor Quote Form (LG-VQ). Detailed instructions for completing the LG-VQ are on the reverse side of the form. The form is required in the following cases: . In each instance where funds are requested for supplies and materials or equip- ment with a unit cost in excess of $5,000 . For purchased services, where the cost of a vendor's services, including consult- ant's services, exceeds $5,000 . Remodeling, where the cost of anyone activity exceeds $5,000 or where anyone vendor will receive over $5,000. If more than one contractor is used, this form must be completed for each. Imaging and Microfilming Project Information Form (LG-IM) If you are proposing to conduct a project involving either imaging, microfilming, or a combination of both, complete a separate copy of the LG-IM for each records series that will be the focus of the project. Detailed instructions for completing the LG-IM are on the reverse side of the form. For assistance in determining the number of images in the series, or on any other technical matter, consult State Archives Publication # 9, Producing High-Quality Microfilm. For projects that focus only on imaging or include an imaging component, see the State Archives' Imaging Production Guidelines, available on our website at www.archives.nysed.gov, and State Archives Publication #77, Managing Imaging and Micrographics Projects. 15 Other Materials Add whatever other materials are required for your specific project, such as needs as- sessments, archival and conservation vendor/consultant treatment proposals, floor plans, requests for quotations (RFQs), and consultant responses to RFQs. Budget Code and Narrative forms (maximum 30 points) The budget forms are required of all applicants. You do not need to include in your ap- plication those budget forms that do not apply to your project. Include in the project budget only those costs for which you are seeking funding; do not include your gov- ernment's contributions on the budget forms. Each budget code has the following components: . Budget Table. Enter all costs to be paid with grant funds for each relevant budget code. . Budget Narrative. Fully describe in this space how proposed expenditures are ap- propriate, reasonable, and necessary to support project goals and your records management program. Do not assume reviewers will automatically understand what may seem obvious to you. Reviewers are likely to recommend cutting budget requests that are not clearly and adequately explained. . Instructions (on reverse side of each budget page) . Lists of Eligible and Ineligible Expenditures (on reverse side of budget page) Budget Summary (FS-20) . The Budget Summary is required of all applicants. Transfer the total for each budget code to the table on the reverse side of the FS-20. Your Chief Administra- tive Officer must sign the form (in blue ink) in the lower left-hand corner to certify that the requested budget amounts are necessary and appropriate. Disregard the section on the form pertaining to indirect costs, because indirect costs are not eligi- ble in the LGRMIF grants program. 16 1. Inventory and Planning Governments conduct records inventories to find out what records they have, identify obsolete records, improve how they organize and control records, analyze records management needs, and develop a records management plan. Inventory and planning projects are the basis of other records management projects and can form the basis of a comprehensive records management program. For information on records inventory and planning, consult State Archives Publication #76, Inventory and Planning. Project Subcategories Some inventory and planning projects may involve activities that focus on the man- agement of inactive records. These include the identification and disposal of obsolete records, re-boxing records in standard storage cartons, developing or purchasing soft- ware to provide better records access, renovating or developing records storage areas, or purchasing appropriate steel shelving. If local governments request funding for any of these activities, they must also address the requirements for the appropriate Inactive Records subcategory (see the section in this booklet pertaining to the Inactive Records category). a) Records Inventory. You may conduct government-wide or focused inventories of active and inactive records. Subcategory Requirements . Explain how you will use inventory data to develop a needs assessment and a records management plan. The assessment and plan should explain short- and long-term needs, contain achievable goals, and address how you will attain those goals. Discuss who will develop the plan, which local government depart- ments or employees will be involved, and who will evaluate its progress and regularly update it. . Indicate, in cubic feet or bytes (if the inventory is of electronic records), the ap- proximate quantity of records you intend to inventory. Use the Table of Cubic- Foot Equivalents to estimate cubic footage. . Allow an inventory rate of one to two cubic feet per hour for paper records. Es- timate inventory rates for electronic records by conducting a test inventory of a single electronic recordkeeping system. . Use the records inventory forms and instructions in State Archives Publication #76, Inventory and Planning, to ensure the uniformity of information gathered 19 during the inventory. . If planning a partial inventory, specify which offices or government functions the grant project will cover and why. Criteria for selecting offices to be invent- toried include their importance; the quantity of their records; and their particular needs for access, security, confidentiality, and space. . If planning to re-inventory a set of records inventoried under a previous grant project, include compelling justification and explain how the local government will keep its inventory up to date in the future. . If submitting a cooperative application, indicate the order in which each par- ticipating local government's records will be inventoried and how the grant's re- sources will be shared. b) Records Survey and Program Planning. You can gain helpful information about your records from a professional survey without conducting a labor-intensive inven- tory. You may conduct surveys in-house or contract with a records management consultant. Subcategory Requirements . Indicate how you will develop a records management plan. Discuss who will develop the plan, which departments or employees will be involved, and who will evaluate progress and regularly update the plan. . Address the development of records management policies and procedures that will ensure a basic framework for an ongoing records management pro- gram. . Indicate, in cubic feet or bytes (if the inventory is of electronic records), the ap- proximate quantity of records you intend to survey. Use the Table of Cubic- Foot Equivalents to estimate the number of cubic feet. . If planning a partial survey, specify which offices or government functions the grant project will cover and why. Criteria for selecting offices to be inventoried include their importance; the quantity of their records; and their particular needs for access, security, confidentiality, and space. c) Office Retention Scheduling. Working from inventory data, interviews with office staff, and an appropriate State Archives records retention schedule, you may de- velop and implement retention schedules specific to the records and needs of indi- vidual departments. For information on office retention schedules, consult State 20 Archives Publication #41, Retention and Disposition of Records. Subcategory Requirements . Explain how you will ensure that each department or office will adopt and use its respective schedule. . Include a plan or list of interview questions for evaluating how individual de- partments or offices use their records. 21 2. Active Records Records management can have the greatest positive impact when applied to active re- cords. These are among the most important records because they are the most fre- quently used, cost the most to maintain, and are essential to the current management of government. Grants under this project category are for planning and implementing a new technology and enhancing capacity of an existing system. Funding is generally not recommended for maintenance, which includes system upgrades (unless the upgrade involves an in- crease in system capability), redoing a previously funded project, or addressing records that have accumulated since the completion of a previous project Requirements for Technology Implementation Projects . Records Management Focus. To be eligible for funding, your project must focus specifically on improving the management of records in your local government. Ad- dress how you will use technology to improve current records management and fu- ture records management needs such as the retention, security, and preservation of your electronic records. . Needs Assessment. There is no simple rule that determines when an applicant must conduct a needs assessment, but the more expensive and complex the solu- tion, the more likely a needs assessment is necessary. If a local government de- termines that a needs assessment is not necessary, it must explain why. Applica- tions for funding will fail if the reviewers believe a needs assessment was necessary but was not conducted. For information about how to prepare a needs assessment and when a needs assessment may not be necessary, contact your RAG or consult State Archives Publication #64, Conducting Needs Assessments for New Recordkeeping Systems. . Submission of Needs Assessment. Submit eight copies of the needs assess- ment or SPA upon which your technology implementation project is based, or ex- plain why a needs assessment was not necessary. Explain any inconsistencies be- tween the needs assessment and your proposed plan of work and purchases. . Detailed Consultant or Vendor Quotes. Provide eight copies of three complete, detailed quotes for each service that will cost over $5,000. The detailed quotes should clearly delineate individual project costs (travel, staff training, equipment in- stallation), hours for each service provided, and vendor qualifications. Lack of con- sistency between quotes, and lack of clarity or detail in quotes, will reduce a grant application's chances of funding. In addition, submit the required Vendor Quote 22 Form (LG-VQ) for each item over $5,000. · Requests for Quotes. Submit eight copies of the RFQ that outlined the standard requirements used to collect the quotes included in the grant application. You must indicate in the RFQ that you provided a copy of your needs assessment to all ven- dors as an attachment. A well-written RFQ should help ensure uniformity in the format of vendors' responses, so you can more easily compare the quality and cost of different proposals. · Maintenance of Technology. Your grant narrative must demonstrate that your lo- cal government clearly accepts the responsibility of maintaining any proposed tech- nology after the end ofthe grant period. Such maintenance would include software and hardware upgrades, annual maintenance agreements, and staff costs to run the system. . Source Code. Include a clause in any software development contract that requires the software code for customized software be placed in escrow. Also require the vendor to deliver software documentation that meets industry standards. Project Subcategories a) Files Management supports projects to reorganize paper or electronic files, im- plement file classification systems, develop written policies and procedures, and train staff. Subcategory Requirements · Describe the problems with the current filing system and the proposed changes to the system, including anticipated improvements in the speed and accuracy of retrieval. . Explain why you chose one files management solution over another. b) Disaster and Business Recovery Planning supports projects to develop, test, and implement disaster and business recovery plans and systems. Subcategory Requirements · Describe the components of the proposed disaster and business recovery plan, including any strategies for testing its viability. · Demonstrate that you will continue to update and test the business recovery plan after the end of the grant year. 23 . Justify, in terms of costs and the value of records involved, why you chose one disaster recovery strategy over others. . Explain, if applying to update a disaster plan funded under a previous LGRMIF project, why you could not update the plan during the normal course of busi- ness. c) Indexing and Access supports projects to index or improve access to any active records. Methods used to improve access include traditional manual indexing, im- plementing full-text-searching software, scanning and converting printed text to electronic text, or some combination of these. Funds are not available to support the maintenance of indexes, nor are they available to add new records to an exist- ing index. However, applicants may request funding to address a backlog of re- cords not addressed under a previous grant application. Subcategory Requirements . Demonstrate the need for improved access by indicating the number of times over a specified period you retrieved information from the records in question. . Indicate the date span of the records series you intend to index. For example, if proposing to index the last twenty-five years of your minutes, specify this in your application and provide the earliest and last date of the minutes. . Describe the chosen method for improving access: manual indexing, full-text searching, or a combination of solutions. If using prepackaged software, indicate the name and version (e.g., Access 2000, Minutes Manager). . Indicate the number of hours you will need to prepare for the indexing (staff training, developing master list). A sample master list of terms is available in State Archives Publication #78, Indexing Minutes. . If you are developing a database index, indicate the number of hours you esti- mate the indexing will take. The usual estimate for indexing minutes is seven pages per hour. The usual estimate for indexing birth, death, and marriage re- cords (and for similar types of objective indexing) is 4,000 keystrokes per hour. . Indicate the number of hours needed to develop your procedures manual. A sample procedures manual is available in State Archives Publication #78, Indexing Minutes. . Complete a separate Imaging and Microfilming Project Information Form (LG- 24 1M) for each records series involved in the project, if using imaging as part of your indexing solution. . Discuss how you propose to update and maintain the index over time. d) Imaging and Document Management supports needs assessment and implemen- tation projects for imaging and document management systems. Since the LGRMIF does not fund the maintenance of ongoing imaging programs, the imaging of new records in a series of records previously funded under an imaging grant is ineligible. However, applicants may request funding to address a backlog of records not ad- dressed under a previous grant application. Subcategory Requirements · Detail how you have determined that imaging is the best solution for managing the records involved. Address access issues, retention requirements, and costs. · Demonstrate your ability to implement and maintain an imaging system. For ex- ample, discuss your ability to budget for systems maintenance, store image files, protect file integrity, and migrate to the next platform. · Follow the State Archives' Imaging Production Guidelines (available on our website) regarding image specifications. See also Publication #77, Managing Imaging and Micrographics Projects, for information on aspects of project man- agement. · Complete a separate Imaging and Microfilming Project Information Form (LG- 1M) for each records series involved in the project. e) Geographic Information Systems (GIS) supports needs assessment and imple- mentation projects for GIS. Reviewers tend to limit funding for purchase of com- puters, software, and network infrastructure. Subcategory Requirements · Follow the GIS development process described in State Archives Publication #GIS03, Local Government GIS Development Guides. · When applying to implement a GIS or augment an existing GIS, submit eight copies of the needs assessment on which your project is based. · If you are implementing a GIS, follow the recommendations of your needs as- sessment in your grant application narrative, including timelines for equipment 25 purchases and application development. If your needs assessment is more than a few years old, explain why you believe its recommendations are still viable. If you do not adhere to your needs assessment completely, provide compelling justification for not doing so. . Fully explain why your government needs GIS and specific GIS applica- tions. . Explain how your government will maintain its GIS in the future with its own funds. . Demonstrate your government's ability to maintain data it acquires through data conversion. If you do not fully demonstrate this, reviewers may recommend funding no more than $5,000 for data conversion. For example, indicate the level of funding your government will dedicate to staffing, equipment, and ven- dor services in support of data maintenance, or indicate what percentage of data conversion will be paid with government funds. . If imaging is a component of your GIS project, complete a separate Imaging and Microfilming Project Information Form (LG-IM) for each records series involved in the project. f) eGovernment supports projects to enhance a government's ability to transact business over the Internet. Governments can apply to conduct a needs assessment for website development or enhancement, to provide online access to government records, or to develop electronic filing capability. Subcategory Requirements . Explain how the project will improve either access to, or the creation of, records. . Justify website development or enhancement projects in terms of significant improvements to records access or business applications. g) Records Systems supports needs assessments and implementation projects for any record keeping system not covered under another category. Such recordkeep- ing systems might include database management systems (for example, fire inci- dent reporting software), incident voice recording systems, and many others. Subcategory Requirement . Explain how the new system will improve the management of, and access to, records. Be specific about the types of records your project will address. 26 h) Business Process Analysis (BPA) supports the analysis and improvement of business processes that create or maintain records. A SPA project is a good choice for a government that has identified a record keeping problem but does not have a specific technological solution to that problem. Subcategory Requirements . Describe your current business process, including workflow, staff responsibili- ties, and costs. . Describe the problems you've identified with your current business process. . Ensure that any SPA addresses records management issues. i) County land Records Initiative supports efforts to improve electronic recordkeep- ing systems in county clerks' offices and the New York City Register. Only county clerks and the New York City Register are eligible to apply in this project subcate- gory. If you represent a county clerk's office or the New York City Register, you may apply to implement any electronic records project that falls under the Ac- tive Records category (except for GIS). Possible projects include, but are not lim- ited to: . developing a needs assessment for, and implementing, a new electronic re- cords system . increasing the capacity of an existing record keeping system . backfile conversion . developing services for the Web (e.g., e-filing) . migrating a legacy system to a current platform GIS projects are not eligible for funding under this initiative. Subcategory Requirements . Comply with any relevant Active Records subcategory requirements. For exam- ple, if you are proposing to scan a backlog of paper records, follow the subcate- gory requirements for Imaging and Document Management projects; if you are proposing to launch a new online service, follow the requirements for eGovern- ment projects. 27 3. Inactive Records This category encompasses projects to plan, develop, or improve the management of records during the inactive phase of their life cycle. Inactive records are records that are used infrequently but must be retained because their retention periods have not yet expired. Project Subcategories a) Planning and Design supports projects to conduct feasibility studies, develop plans for records storage, and develop an inactive records management program. This may include the services of architects or engineers to develop plans, drawings, and specifications for a proposed facility. Subcategory Requirements . Precisely state the inactive records issues that the project will consider. . Indicate the approximate cubic feet or bytes of records involved. b) Storage and Retrieval supports projects to enhance the storage and accessibility of inactive records. Projects may involve integrating records into an inactive stor- age area, purging obsolete records, renovating existing structures for inactive re- cords storage, developing retrieval methods, and formulating policies for managing inactive records. Subcategory Requirements . Indicate the number of cubic feet or bytes of records designated for storage. . Explain why you selected a particular site for records storage. . Identify the departments that will use the storage area and the controls that will ensure the security of the records. . Include floor plans, on 8 1/2" x 11" paper, of proposed storage areas. Draw the plan to scale, indicating all dimensions (length, width, and height) of the storage area. Include the proposed layout of shelving on this plan. . Indicate the number of cubic-foot boxes that will fit on each unit of shelving. . Indicate that the floor load capacity of the chosen site can support the weight of 28 the stored records. . Demonstrate that the proposed inactive records storage area is large enough to accommodate storage needs for several years, planning for at least 130% of the current cubic footage of volume. For example, if you have 100 cubic feet of re- cords to store, your plan should include room to store 130 cubic feet of records. Funds are not available to address a backlog of data entry or processing that has accumulated since the completion of a previous LGRMIF inactive records project. 29 4. Microfilming Microfilming is an appropriate technology for records that (1) have retention periods of fifteen years or more, (2) are vital records critical to the functioning of government, or (3) are so voluminous that significant storage space would be saved by filming. LGRMIF grants do not support the filming of new records in a series of records filmed under a previous LGRMIF grant. However, you may request funding to ad- dress a backlog of records not addressed in a previous grant project. Eligible ex- penses for microfilming include . Staff time to prepare records for filming, to index records, and to conduct frame- by-frame verification of microfilmed records. . Addressing the deterioration of acetate-based or nitrate microfilm, including the costs of assessing the problem, duplicating deteriorating film, and refilming or reformatting damaged records. . Microfilming, duplicating, and indexing, including costs associated with com- puter-output microfilm (COM) or computer-assisted retrieval (CAR). . Purchase of microfilm equipment, including microfilm storage cabinets, read- ers, reader-printers, reader-scanners, and microfilm cameras. Since replacing or upgrading old equipment is an example of maintenance, applicants must provide compelling justification for requests to purchase additional or replacement micro- film readers or cameras. Category Requirements Any project that will include microfilming must adhere to these requirements, re- gardless of grant project category: . Records being filmed. Explain why selected records are appropriate for micro- filming and list the benefits that will result from this microfilming project. Include an estimate of the volume of records that will be prepared for filming, as well as an estimate of the volume that will actually be filmed. . Number of images. Indicate the number of images to be filmed and discuss any special circumstances that affect the total number of images, such as cases where two or more documents will be filmed on a single frame of film. . Preparation of records. Indicate how you will prepare the records for filming. 30 Describe the individual tasks required for preparation (e.g., unfolding paper, re- moving staples, purging obsolete records and duplicates), and indicate the quantity of staff and time you will need to accomplish these tasks. The baseline rate for preparing records is 1,000 sheets per hour; more time may be required for older, worn records with many staples and clips. . LG-IM form. Complete a separate Imaging and Microfilming Project Information Form (LG-IM) for each records series involved in the project. . Ongoing support. Indicate how your government will support your microfilming program in the future. . Destruction of originals. Indicate whether original records will be destroyed af- ter microfilming. If not, justify this decision. . Itemize costs. Itemize all vendor costs, including the per-image filming rate, the cost per roll or fiche, and the cost for document preparation and image verifica- tion. If scanning is involved, be sure to break out costs for that service. . Estimate number of rolls. Include an estimate of the total number of rolls of original camera-negative microfilm and use copies that will be produced. Re- quest at least one use copy for each roll of original camera-negative film, unless some other format (such as digital images) will be used for access. . Digital images as use copies. If applicable, indicate why digital images were chosen as access copies over microfilm, and indicate how you plan to maintain access to those images in the future. If you are also requesting diazo microfilm use copies, you must justify the need for both film and digital copies. . Type of microfilm camera. Indicate the type of microfilm camera to be used (planetary, rotary, COM recorder) and justify why it was selected. Also justify the chosen microfilm format (16mm, 35mm). . Acetate problems. Describe the severity of an acetate microfilm problem (if applicable) by indicating the quantity of damaged film, the degree of degrada- tion, and the records series involved. . Adherence to guidelines. Indicate how you will adhere to microfilming guide- lines outlined in State Archives Publication #9, Producing High-Quality Microfilm, and #77, Managing Imaging and Micrographics Projects. Applicants proposing to microfilm court records must also adhere to all Unified Court System micro- film guidelines. 31 . Microfilm storage. Explain how camera-negative microfilm will be stored offsite under environmentally controlled conditions. . Quality control testing. Request $18 per roll for third-party testing of every fourth roll of original microfilm. This testing will verify adherence to State Ar- chives guidelines and local government specifications for density, resolution, targeting, and general quality. The Archives will provide successful applicants with specific guidelines and procedures for implementing this requirement. . Verification. Indicate that the microfilm images will be verified for legibility and assurance that they capture all of the information from the original records. Mi- crofilm must be 100% verified in order for records to be destroyed. The average verification rate is about 300 images per hour. . Readers. If requesting microfilm readers, reader-printers, or reader-scanners, indicate whether you have an operable microfilm reader of any kind. If you are requesting only digital use copies plus a reader, justify fully the need to pur- chase the reader. . In-house microfilming. If requesting funds to purchase microfilm cameras or processing equipment, demonstrate that establishing an in-house microfilming operation is more economical and efficient than outsourcing. . Detailed quotes. Provide eight copies of the complete detailed quotes and a Vendor Quote Form (LG-VQ) for microfilming services that exceed $5,000. The detailed quotes should clearly delineate individual project costs (preparing the records, filming, producing use copies). . Distributed access. If you cannot provide onsite access to the records, con- sider creating use copies to distribute to an institution that can provide regular access to the information. Grant funds may be used to produce these copies. 32 5. Historical Records Historical records, also known as archival records, are those records worthy of perma- nent preservation and special care because of the continuing importance of the infor- mation they contain. Historical records may exist in a variety of formats, including paper files, maps, photographs, videotapes, or computer files. These records are frequently identified on records retention and disposition schedules as having permanent reten- tion periods or potential historical importance. Project Subcategories a) Assessing Your Historical Records. Funds are available to hire consultants to assess the current status of archival activities, identify needs, develop plans, write policies and procedures, and recommend future activities. When developing a needs assessment project, refer to State Archives Publication #59, Archival Needs Assessment Guidelines and Template. b) Storage Facility Improvement. Funding is available to purchase and install intruder alarm systems, fire detection systems, fire suppression systems, water detectors, and environmental monitoring equipment for historical records storage facilities. Minor renovations and improvements to such facilities are also eligible. c) Improving Access. Funding is available for projects to hire archivists or catalogers to arrange, describe, and catalog records; to hire consultants to train staff and pro- vide advice on archival techniques; and to reproduce and distribute guides and other finding aids in paper or electronic format. Projects generally address historical records at the records series level, and must follow the standard practices de- scribed in the State Archives' manual, Guidelines for Arrangement and Description of Archives and Manuscripts. Funding will usually not be approved to support item- level description. Funds may also be used to improve access to historical records through digitiza- tion. If you propose to use digital technology, you must justify your project in terms of enhancing access to the records. Digitization is not a preservation solution. Funds are not available to address a backlog of data entry or processing that has built up after completion of a previous LGRMIF historical records project. Subcategory Requirements . Explain how you determined the time needed to process the records in- volved in the project. Full processing includes flat-filing, cleaning, arranging, 33 describing/cataloging, foldering, and boxing. Use the following as a guideline: o Completely unorganized collection-16 hours per cubic foot o Complicated series such as correspondence or subject files-8 hours per cubic foot o Fairly straightforward series that may need some work, such as case or job files or business records-4 hours per cubic foot o Well-organized series consisting primarily of bound volumes or volumi- nous series with uniform or repetitive information, such as invoices-2.5 cubic feet per week . Work with the State Archives to create series descriptions, catalog records, and collection guides in electronic format. All series descriptions and guides must be made available on a local website or through the State Archives' Historic Documents Inventory (HDI). For assistance, call the State Archives at (518) 474-6926. . For all projects involving document imaging, adhere to the Imaging and Document Management project requirements outlined under the Active Re- cords category. In addition, the plan of work must o indicate that the records have been arranged and described prior to any imaging activities. o explain the criteria used to choose what items to scan. d) Preservation. Preservation consists of general maintenance and other prac- tices that inhibit deterioration of records. Most records can be adequately pre- served with proper housing and storage or through reformatting. Eligible ex- penses for preservation include . Survey and analysis, by a professional conservator, of the preservation needs of historical records, and the development of a plan to address those needs. . Rehousing and basic processing activities, which may include the purchase of pH-neutral or alkaline (pH not less than 7.5), lignin-free storage supplies, including folders, boxes, records cartons, and paper to wrap volumes. 34 . Applying conservation treatments to return deteriorated or damaged items to stable and usable condition, or to prepare archival materials for du- plication. Restoration activities such as inpainting, leafcasting, replacing leather bindings, gold leafing, and tooling are not eligible for funding. Grant funds will be provided for conservation treatment only if the records have been or will be microfilmed, unless you demonstrate that the condition or small quantity of records precludes microfilming. Subcategory Requirements . Base requests for shelving, alkaline folders, and boxes on the volume of archival records involved in the project. . Demonstrate that by the end of the project you will house the historical records in a safe, secure environment with appropriate temperature and humidity controls. Also demonstrate that continued use of the records will not cause subsequent deterioration. . Justify the historical significance and intrinsic value of any records that must be preserved in their original form rather than on microfilm. . For each item to be conserved, submit vendor treatment proposals and estimated price quotes. Treatment proposals should describe specific tasks, proposed materials and techniques, estimated number of hours needed, and itemized costs for the project. e) Outreach and Public Programs. Outreach and public programs may include the use of historical local government records in informational brochures, local history publications, videos, exhibits, workshops, and lecture series. Proposals must indicate the intended audience for the program, the plan for distributing the materials produced, and the commitment of participating organizations or governments. General Category Requirements (as applicable): . Demonstrate that you have located and identified your historical records. Also demonstrate that you understand the difference between historical re- cords and publications, since funds cannot be used for published materials. . Provide a list of each records series involved in the project, including the cubic feet and condition. 35 . Demonstrate that your government has clear custody to the records involved. . Discuss policies and procedures relating to access, storage, and security of the historical records, unless these will be developed during the project. . Indicate that you will submit copies of any products, including brochures, collec- tion guides, and procedures manuals, to the State Archives and your RAO. 36 6. Educational Uses of Local Government Records You may propose projects to use local government records as teaching tools in the classroom and in the community. Projects may include teacher training workshops, de- velopment of curriculum materials, community walking tours, and local history bro- chures and exhibits. At the conclusion of an educational uses grant, you must demonstrate how the project helped address the State Education Department's learning standards, promoted the management of local government records, or increased public awareness of the educa- tional and historical value of these records. Also describe ongoing cooperation among local governments, teachers and students, and/or the general public. In addition, the State Archives encourages project participants to conduct workshops or information sessions for K-12, college, and community educational programs on the benefits of us- ing local government records. If you are considering an Educational Uses grant, direct your questions to either your RAO or Julie Daniels at (518) 474-6926. NOTE: Consider the Source: Historical Records in the Classroom, a State Archives publication, cannot be purchased with funds from this granting source. The average grant award for Educational Uses projects in the 2006-2007 grant year was $10,924. Activities Eligible for Support a) Teacher Training. Projects will develop programs to train teachers in the use of local government records as teaching tools in the classroom. You are encouraged to cooperate with university faculty and pre-service teachers. Strong preference will be given to projects that offer teachers in-service credit from individual school dis- tricts, or graduate credit from colleges and universities, rather than stipends for attend- ing training workshops. If you are requesting stipends, you must justify the amount ac- cording to relevant union contracts. The project should include the following participants: . Teachers/trainers who are skilled in using local government records in the classroom, who will instruct other teachers, and who will provide guidance dur- ing site visits 37 . Local government officials who will describe their respective local gov- ernments, their duties, types of records, and how to access those records . Participating teachers, generally fifteen to twenty teachers per one-week training session b) Brochures, Exhibits, and Walking Tours. Projects may include the develop- ment of educational brochures, exhibits, and walking tours that contribute to the public's understanding of records management and the educational value of lo- cal government records. Projects should include plans for product marketing and evaluation. It is suggested that projects be linked to K-12 education by re- lating to a particular curriculum or discipline, or through the development of learning activities that may be used with the brochure, exhibit, or walking tour. c) Document Teaching Packets and Accompanying Teachers' Guides. A document teaching packet is a collection of documents relating to a particular topic, accompanied by a teacher's guide, that provides historical background on the topic and suggests how to incorporate the documents into classroom in- struction. The teacher's guide can include items on how to use the documents with students, such as worksheets, constructed-response and document-based questions, suggested additional reading, resource lists, and bibliographies. d) Technology, Local Government Records, and Education. Projects can em- ploy multi-media technology that allows educators, students, and others to in- corporate local government records in the learning process. You may use grant funds to support the purchase of scanners, digital cameras, and com- puters if you appropriately justify the need for this equipment in your applica- tion. Requests for multiple pieces of equipment are discouraged. If you wish to purchase technology equipment with grant funds, show how the equipment: . directly relates to using local government records in the classroom . will continue to be used for educational uses of local government records or for records management after the completion of the grant cycle e) Other Projects. You may propose other types of educational uses projects if you can demonstrate a project's potential for long-term impact on both educa- tion and local government records management. 38 Category Requirements . Local Government Records. Demonstrate substantive use of local government records. You may use non-government records such as business, community or- ganization, and church records, as well as historical records from a local historical society and library, where such use meets an important informational need. . Objectives. Address how the proposed project will support the applicant's overall records management objectives and the State Education Department's learning standards. . Experience. Clearly demonstrate that grant participants have some knowledge or background in the use of local government records in education. This may include: o Experience conducting research at a local government and developing educa- tional materials based on that research. Demonstrate such experience by in- cluding a statement about the kinds of records used and how they were used, or a copy of a lesson plan or teaching packet based on local government records. o Participation in a workshop, such as "Primarily Teaching," offered by the National Archives and Records Administration. o Participation in a training workshop on how to use local government records in the classroom. o Intention to hire a consultant for the project who has expertise in teaching with local government records. . Letters of Support. If you intend to use records of local governments other than your own, you should involve these governments in the early stages of preparing the grant application. Submit a letter of support from each local government indicat- ing its intent to participate and outlining its responsibilities in the project. The letter should be sufficiently detailed so it is clear to reviewers that each local government understands its role. . Distribution Plan. Include a plan in the application narrative for the distribution of materials produced. Submit a copy of all reports, teaching materials, and packets produced with grant funds to the State Archives. Also distribute final products to all local governments whose records were used, local governments whose staffs participated in planning or training sessions, participating teachers, school district libraries of participating teachers, and appropriate community, educational, and research institutions. 39 Review Process State Archives staff in the Grants Administration Unit first review applications for eligi- bility and completeness. They will not send forward for further review those applications that do not meet the basic eligibility requirements, include all the required forms, or have the appropriate signatures. A local government is responsible for ensuring it meets eligibility requirements and for submitting a complete application. Review panels are created based on grant categories and subcategories. Outside ex- pert reviewers are assigned to panels to review grants in their area of expertise. Each reviewer evaluates approximately forty grant applications apiece and assigns each ap- plication a score based on information in the Application Narrative Form (LG-NA) and Budget Code and Narrative forms. The reviewers' ranking criteria are included in the appendix of this booklet. In May, reviewers convene as panels in Albany, deliberate in detail on the applications they have read, reconcile differences in conclusions from their preliminary reviews, as- sign each application a final score, rank each according to those scores, and make funding recommendations. These recommendations will be made in the order of rank- ing until available funds are depleted. In case of a tie, the application with the lower funding request will be given priority. The State Archives reserves the right to apply un- used funds from one panel to other panels. Priorities for Funding The following projects are priorities for funding in the 2007-2008 grant year. These projects will receive an extra 5 points each when scored. . Cooperative projects . First-time Inventory and Planning projects . Electronic records inventory projects or projects to implement recommendations resulting from an electronic records inventory Awards The Local Government Records Advisory Council (LGRAC) recommends which appli- cations to fund, based on reviewers' evaluations, and presents these recommendations to the Commissioner of Education, who makes the final decision on the awarding of grants. The New York State Division of the Budget releases funds necessary to make grant payments. 43 The State Archives will not release information regarding the status of an application until all applications have been reviewed and the Commissioner of Education has approved the proposed grant awards. Applicants who will not receive awards will be notified by mail as soon as possible. Suc- cessful applicants will be notified of awards by mail, usually in late June. Award decisions are final and are not subject to appeal. Schedule of Payments For approved applications, payments will be made as follows: 50% of the total upon a lo- cal government's acceptance of the award; up to 40% of additional funds based on esti- mates of funds needed to continue project work; and the final 1 0% at the end of the pro- ject, upon submission of satisfactory final reports on the completed work. Expenses incurred prior to the start of the grant year, 1 July 2007, cannot be paid using grant funds. Project Administration If awarded a grant, you must conduct projects in accordance with the proposed project budget, plan of work, and LGRMIF grant guidelines. In addition, you must follow your government's policies concerning wages, mileage and travel allowances, overtime com- pensation, and fringe benefits, as well as state rules pertaining to competitive bidding, safety regulations, and inventory control. Supporting or source documents are required for all grant-related transactions that involve the disbursement of grant funds. These documents include, but are not limited to, pur- chase orders, contracts, time and effort records, delivery receipts, vendors invoices, travel, and travel payment documents. These records must be kept for at least six years after the last payments was made. All records must be available for inspection by State Education Department officials or representatives. Each project must achieve results that substantially meet the objectives outlined in the application as approved. Grantees must submit final project performance reports that dis- cuss the project's accomplishments and progress toward intended results. Guidelines for final project reports may be found on the State Archives' website, www.archives.nysed.gov, or by contacting the Grants Adminstration Unit at (518) 474- 6926. State Archives staff will monitor each grant-funded project, and will make site visits during the course of projects to determine the rate and quality of progress. Some projects may be selected for more extensive review at the conclusion of the grant period. 44 Local Government Records Management Improvement Fund Grant Application Evaluation Form Applicant: Category: Sub-Category: Amount Requested: RECOMMENDATION: FUND~ MODIFY ~ DON'T FUND~ If the recommendation is to "Modify," the recommended funding level is: Region: $ Computation of Final Score TOTAL INITIAL SCORE: + 5 for cooperative projects + 5 for first-time Inventory and Planning projects + for electronic records inventory projects FINAL SCORE: Rating Guidelines I Score II Interpretation I QJI Outstanding I Applicant addresses the criterion with distinction LJ Good Applicant has provided a cogent and convincing response to the criterion ~I Adequate [ Applicant has addressed the criterion only competently CJ Fair Applicant may have addressed the criterion but is far from convincing, or the project is inherently weak in this regard 1 Poor Applicant has offered a few words in response to the crite- rion, but the words show little to no understanding of the issues ~ Unresponsive Applicant does not address the criterion directly or indirectly 47 Evaluation Criteria Criteria 5 4 3 2 1 0 1. Statement of the Problem [20 points] a. Describes the specific records management problem the project will address, and explains why the project is a high priority b. Identifies specific records that will be involved, and any previous grant-funded projects related to these records and this project. c. Provides qualitative descriptions and quantitative data about the problem d. Explains why funding from this grant program is essen- tial to accomplishing the project (For example, explains why funding is needed if funding was previously awarded for a similar project.) Score- Comments ---~ Criteria 5 4 3 2 1 0 2. Intended Results [15 points] a. Identifies each intended result (specific products, time and cost savings, or services), and describes the antici- pated benefits b. Explains how the project will address the records man- agement problem identified in the Statement of the Problem c. Describes in detail how the project will contribute to the development of a records management program Score= Comments 48 Criteria 5 4 3 2 1 0 3. Plan of Work [20 points] a. Explains why one solution was preferred over alterna- tives b. Provides a detailed outline of the proposed work activi- ties and a timetable showing when each phase of the project will be completed and demonstrating the pro- ject's goals are attainable by 30 June 2008 c. Explains who will be responsible for performing each project activity, including project management. Indicates the qualifications of key project staff (including consult- ants and vendors) in terms of education, training, and experience d. Addresses each of the requirements of the relevant pro- ject category and subcategory Score- Comments Criteria 5 4 3 2 1 0 4. Local Government Support [15 points] a. Identifies past contributions to records management b. Demonstrates contributions to this project c. Describes how this project and records management in general will be maintained over the long term Score- Comments 49 Criteria 5 4 3 2 1 0 Budget Narrative and Forms [30 points] X2 X2 X 2 X2 X2 a. Explains how the proposed expenditures will be used to support the project activities and contribute to the program goals b. Demonstrates costs are reasonable and necessary to support the project activities and goals c. Describes how the expenditures and activities will fur- ther the records management program Score- Comments Total initial score (carry over to top page): 50 Table of Cubic-Foot Equivalents FILE FOLDER CUBIC FT. RECORDS CTR. CONTAINERS CUBIC FT. DRAWERS Letter 1.5 10" x 12" x 15" - standard 1.0 Letter Lateral 2.0 .5" x 8"x 14" - tab 0.2 2.0 Legal 3.5" x 8" x 24" 0.4 6" x 6" x 36" - map 0.7 2.5 Legal Lateral 6" x 6" X 48" - map 1.0 4" x 4" x 48" - map 0.4 SHELF UNITS CUBIC FT. Letter, 36" long 2.4 Legal, 36" long 3.0 MAP OR PLAN CUBIC FT. MAP OR PLAN TUBES CUBIC FT. DRAWERS 2" x 26" x 38" flat 1.1 2" x 2" x 38" roll 0.1 2" x 38" x 50" flat 2.2 2" x 2" x 50" roll 0.1 4" x 26" x 38" flat 2.3 4" x 4" x 38" roll 0.3 4" x 38" x 50" flat 4.4 4" x 4" x 50" roll 0.5 OTHER SITUATIONS STEP 1: LENGTH x WIDTH x HEIGHT (IN INCHES) STEP 2: DIVIDE BY 1,728 = CUBIC FEET 51 new york state archives RECORDS MANAGEMENT PUBLICATIONS ORDER FORM There is no charge to New York State governments or agencies for any publication on this list. Others may receive one copy of any publication free of charge. There is a $2.00 charge for additional copies. Most of these publications are also available on our website at www.archives.nysed.gov Getling Started: 40. 44. 56. 57. 61. 76. OTR05 OTR06 OTR13 Fundamentals of Managing Local Government Archival Records Records Management Consultants Selected Bibliography on Historical Records Administration Government Records Services Brochure Seven Attributes of an Effective Records Management Program Inventory and Planning: The First Steps in Records Management Local Government Records Law (Article 57-A, Arts & Cultural Affairs Law)"' Part 185, 8NYCRR (Regulations of the Commissioner of Education) - for Local Governments" LGRMIF Grant Application and Reference Materials Sources of Archival Supplies and Archival Consultants. Part 188, 8NYCRR (Regulations of the Commissioner of Education) - for State Agencies" web only web only OTR30 Active Records: web only 78. web only 82. SGP02 Indexing Minutes Managing Records Disasters Guide to Efficient Filing Systems Disposition of Records: 6. Retention and Disposition of Library and Library System Records 41. Retention and Disposition of Records: How Long to Keep Records and How to Destroy Them SGS04 General Records Retention and Disposition Schedule for State Government Agencies Records Retention and Disposition Schedule for Local Governments (check appropriate schedule) _CO-2 for counties _MI-1 for miscellaneous governments _MU-1 for cities, towns, villages, and fire districts _EO-1 for school districts and BOCES Electronic Records: web only 58. eGovernment 62. Managing Records in E-Mail Systems 63. Guidelines for Choosing Records Management Software web only 64. Conducting Needs Assessments for New Recordkeeping Systems (revised 2003) GI503 Local Government GIS Development Guides (three-volume set) SGP10 Guidelines for the Legal Acceptance of Public Records in an Emerging Electronic Environment Historical Records: 31. Local Government Records Useful in Family History Research 36. Intrinsic Value of Local Government Archival Records 50. Appraisal of Local Government Records for Historical Value 54. Archives Week Action Guide (revised April 2000) 59. Archival Needs Assessment Guidelines and Template 60. Criteria for Selecting Records for Conservation Treatment 74. A Manual for Documentation Planning in New York State 81. Historical Records and the Local Government Historian 53 SP02 Guidelines for Arrangement and Description of Archives and Manuscripts: A Manual for Historical Records Programs in New York State Inactive Records: 42. 48. web only 49. 65. Guidelines for Off-Site Storage of Inactive Local Government Records Developing an Inactive Records Storage Facility Administration of Inactive Records Recommendations for Shelving for Inactive Records Storage Imaging and Micrographics: 9. Producing High-Quality Microfilm 11. introduction to Micrographics web only 15. Acetate Microfilm 20. Guideiines for Determining if a Stand-Alone Imaging System Is the Best Choice for You 21. Electronic Document Imaging and Optical Storage Systems for Local Governments: An Introduc- tion web only 22. Guidelines for Ensuring the Long-Term Accessibility and Usability of Records Stored as Digital Images 52. Computer-Output Microfilm (COM) 77. Managing Imaging and Micrographics Projects *For information on archival supplies and consultants, go to: http://wwvv.archives.nysed.govlalnysaservices/ns_mgr_cons _ vend.shtml **For information on laws and regulations related to records management, go to: http://www.archives.nysed.gov/ainysaservices/ns_mgUaws.shtml Indicate the number of publications you wish to receive and return this form to: New York State Archives www.archives.nysed.gov Room 9A47, CEC Albany, New York 12230 Name Title Organization Mailing Address Telephone Are you the designated RMO? Fax Number E-Mail Appointed within the last year? For further information, call (518) 474-6926 or e-mail: archpubs@mail.nysed.gov Aunust 7. 2006 54 NEW YORK STATE ARCHIVES GOVERNMENT RECORDS SERVICES Goof Butb, Director ghulh@mail.uysed.gov David Lowry, Manager, Records Advisory Services dlowry@mail.nysed.gov Ann Marie Przybyla, Manager, Records Service Development aprzybyl@mail.nysed.gov 9A47 Cultural Education Center, Albany, NY 12230 Phoue (518) 474-6926 Fax (518) 48CH923 REGION I New York State Archives 55 Hanson Place, Suite 724 Brooklyn, NY 11217 Phone (718) 9234300 or 9234301 Fax: (718) 923-4302 Brenda Parnes, RAO bpames@mail.nysed.gov Migdalia Torres, KS mtorres@mail.nyserl.gov REGION 3 Records Center Building 21, Suite 102 1220 Washington A venue Albany, NY 12226-2152 Phone (518) 485-6233 or 485-6235 Fax (518) 485-6236 Andrew Raymond, RAO araymond@mail.nyserl.gov Phyllis Darrah-Scheriff, KS pdarrahs@rnail.nysed.gov REGION 4 820 State Route 9 1401-C Northway Plaza Queensbury, NY 12804 Phone (518) 798-5717 or 798-5759 Fax (518) 798-6119 Denis Meadows, RAO dmeadows@mail.nyserl.gov Margaret Kahn, KS mkalm@mail.nysed.gov RAO - Regional Advisory Officer KS - Keyboard Specialist REGIONAL ADVISORY OFFICES REGION 5 Utica State Office Building 207 Genesee Street, Room 404 Ulica, NY 13501 Phone (315) 793-2780 or 793-2781 Fax (315) 793-2782 R. Kent Stuetz, RAO kstuetz@mail.nysed.gov Denise Russo, KS drusso@mail.nysed.gov REGION 6 Binghamton State Office Building 44 Hawley Street, Room 1604 Binghamton, NY 13901-4406 Phone (607) 721-8428 or 721-8429 Fax (607) 721-8431 Suzanne Etherington, RAO setherin@mail.nysed.gov Vacant, KS REGION 7 The Brookside School 220 Idlewood Road, Room 102 Rochester, NY 14618 Phone (585) 241-2827 or 241-2828 Fax (585) 241-2826 Gail A. Fischer, RAO gfischer@mail.nysed.gov JoAnne Ferris, KS jferris@mail.nysed.gov REGION 8 Mahoney State Office Building 65 Court Street, Room 313 Buffalo, NY 14202 Phone (716) 847-7903 or 847-7904 Fax (716) 847-7905 James M. Tammaro, RAO jtammaro@mail.nysed.gov Lynn A. Fleck, KS Ifleck@mail.nysed.gov REGION 9 301 Manchester Road Suite 200-A Poughkeepsie, NY 12603 Phone (845) 485-2633 or 485-2634 Fax (845) 485-2635 Linda Bull, RAO lbull@mail.nysed.gov ViDa Shah, KS vshah@mail.nysed.gov REGION 10 Suffolk State Office Building Room 2B-468 Veterans Memorial Highway Hauppauge, NY 11788-5501 Phone (631) 952-6864 or 952-6866 Fax (631) 952-6867 Lorraine Hill-Campbell, RAO Ihillcam@mail.nysed.gov Donna L. Deckelman, KS ddeckelm@mail.nysed.gov State Agency Advisory Officer 9A47 Cultural Education Center, Albany, NY 12230 Phone (518) 474-6926 55 Fax (518) 486-4923 ...... - 4 7 -- ....- - ()1 OJ ......... ~ .- - - ...- """"""'" -... - -- ~ 6 REGIONAL OFFICES NEW YORK STATE ARCHIVES GOVERNMENT RECORDS SERVICES I OFFICE LOCATIONS 1 BROOKLYN 3 ALBANY 4 QUEENSBURY 5 UTICA 6 BINGHAMTON 3 7 BRIGHTON 8 BUFFALO 9 POUGHKEEPSIE 10 HAUPPAUGE 9 1 Local Government Records Management Improvement Fund Application Checklist (LG-CH) Local Government Name: DO NOT WRITE IN THIS SPACE Log Number Date Received Records Management Officer (RMO) appointed? Dves D No DN/A Appropriate schedule adopted? DVes D No DN/A Year RMO was appointed: Year schedule was adopted: Please check off boxes in the first column to indicate that you have included all required forms. Assemble your application packet in the same order as the checklist below. Application Checklist (LG-CH) Grant Project Application (LG-AP) Appendix A and Appendix A-1 G Application Narrative Form (LG-NA) Payee Information Form (PI) and Supplement Project-Specific Forms and Materials Budget Code and Narrative Forms Budget Summary (FS-20) Applicant D D D D D D D D DO NOT WRITE IN THIS SPACE Archives Staff D D D D D D D D Certification and Approval The following signatures certify that the locai government agrees to the conditions outlined in Appendix A and Appendix A-1 G. I hereby certify that I am either the applicant's Chief Administrative Officer or the Records Management Officer (RMO), and that the information contained in this application is, to the best of our knowledge, complete and accurate. I further certify, to the best of my knowledge, that any ensuing program and activity will be conducted in accordance with all applicable state laws and regulations, application guidelines and instructions. and that the requested budget amounts are necessary for the implementation of this project. I understand that this application constitutes an offer and, if accepted by the New York State Education Department or renegotiated to acceptance, will form a binding agreement. I also understand that immediate written notice will be provided to the grants program office if at any time I learn that its certification was erroneous when submitted, or has become erroneous by reason of changed circumstances. CHIEF ADMINISTRATIVE OFFICER Signature (in blue ink) Type or print the name and title of the Chief Administrative Officer RECORDS MANAGEMENT OFFICER (RMO) Signature (in blue ink) Type or print the name and title of the Records Management Officer Date Date Telephone Number/Extension DO NOT WRITE IN THIS SPACE Reviewed by New York State Archives Date Form LG-CH 9/2006 Checklist for Participants in a Cooperative Project Instructions: Provide the name of each local government participating in the cooperative project. Indicate whether each local government has appointed an RMO and has adopted the appropriate schedule. Please indicate the year the schedule was adopted. Also, verify that you've included a letter of intent for each participating government. These two items are eligibility requirements that must be met by the lead local government and by EACH participant in the project BEFORE the grant application is submitted. For exceptions to this, see the section on Eligibility Requirements in Grant Application and Reference Materials. Attach copies of this form as needed to accommodate all participants. 1. Name of Cooperating Local Government: RMO appointed? o Ves o No o N/A Appropriate schedule(s) adopted? Letter of intent included? Year current RMO was appointed: o Ves ONo ON/A o Ves o No Year schedule was adopted: 2. Name of Cooperating Local Government: RMO appointed? o Ves o No ON/A Appropriate schedule( s) adopted? Letter of intent included? Year current RMO was appointed: OVes o No ON/A OVes o No Year schedule was adopted: 3. Name of Cooperating Local Government: RMO appointed? o Ves 0 No o N/A Appropriate schedule(s) adopted? Letter of intent included? Vear current RMO was appointed: OVes ONo o N/A DYes o No Year schedule was adopted: 4. Name of Cooperating Local Government: RMO appointed? o Ves o No o N/A Appropriate schedule(s) adopted? Letter of intent included? Year current RMO was appointed: OVes o No o N/A o Ves ONo Year schedule was adopted: Submit an original and eight (8) copies to: New York State Archives Grants Administration Unit 9A81 Cultural Education Center, Albany, NY 12230 New York State Archives Form LG-CH 9/2006 Local Government Records Management Improvement Fund DO NOT WRITE IN THIS SPACE Grant Project Application (LG-AP) Log Number Date Received 2007-2008 I Application Type (Check one): o Individual o Cooperative 0 Complex o Disaster Recovery A r I f ,ppllcant n ormation Local Government (Name) I Department/Unit (REQUIRED) T County Chief Administrative Officer (Last Name, First Name, Mr./Ms) Title Telephone Number/Extension I Fax Number 1 E-mail Address ( ) ( ) Address (Street, City, Zip Code) Project Director (Last Name, First Name, Mr./Ms) Is Project Director the RMO? DYes ONO Title Telephone Number/Extension I Fax Number I E-mail Address ( ) ( ) Address (Street, City, Zip Code) Check the a ro riate cate 0 o Records Inventory o Records Survey and Program Planning o Office Retention Scheduling o MICROFilMING (no subcategories) o ACTIVE 0 Files Management 0 Disaster/Business Recovery Planning Olndexing and Access RECORDS 0 Imaging and Document Management 0 Geographic Information Systems OeGovernment o Records Systems 0 Business Process Analysis 0 County land Records initiative o HISTORICAL 0 Assessing Your Historical Records RECORDS 0 Improving Access 0 Preservation o EDUCATIONAL USES (no sub-categories) Amount Requested: I $ .00 Project Summary (Complete in this box. Describe project. including scope. objectives. and description of records.) OFacility Improvement o Outreach and Public Programs Number of Grants Previously Received: New York State Archives Form LCi-AP 9/2006 Required for Federal and State Discretionary Grant Programs APPENDIX A STANDARD CLAUSES FOR NYS CONTRACTS The parties to the attached contract, license, lease, amendment or other agreement of any kind (hereinafter, "the contract" or "this contract") agree to be bound by the following clauses which are hereby made a part of the contract (the word "Contractor" herein refers to any party other than the State, whether a contractor, licenser, licensee, lessor, lessee or any other party): 1. EXECUTORY CLAUSE. In accordance with Section 41 of the State Finance Law, the State shall have no liability under this contract to the Contractor or to anyone else beyond funds appropriated and available for this contract. 2. NON-ASSIGNMENT CLAUSE. In accordance with Section 138 of the State Finance Law, this contract may not be assigned by the Contractor or its right, title or interest therein assigned, transferred, conveyed, sublet or otherwise disposed of without the previous consent, in writing, of the State and any attempts to assign the contract without the State's written consent are null and void. The Contractor may, however, assign its right to receive payment without the State's prior 'Written consent lUlless this contract concerns Certificates of Participation pursuant to Article 5-A of the State Finance Law. 3. COMPTROLLER'S APPROVAL. . Unless exempt by law or the Office of the State Comptroller's policy, in accordance with Section 112 of the State Finance Law (or, if this contract is with the State University or City University of New York, Section 355 or Section 6218 of the Education Law), if this contract exceeds $15,000 (or the minimum thresholds agreed to by the Office of the State Comptroller for certain S.U.N.Y. and CU.N.Y. contracts), or if this is an amendment for any amount to a contract which, as so amended, exceeds said statutory amount, or if, by this contract, the State agrees to give something other than money when the value or reasonably estimated value of such consideration exceeds $10,000, it shall not be valid, effective or binding upon the State until it has been approved by the State Comptroller and filed in his otlice. Comptroller's approval of contracts let by the Office of General Services is required when such contracts exceed $30,000 (State Finance Law Section 163.6.a). 4. WORKERS' COMPENSATION BENEFITS. Tn accordance with Section 142 of the State Finance Law, this contract shall be void and of no force and effect unless the Contractor shall provide and maintain coverage during the life of this contract for the benefit of such employees as are required to be covered by the provisions of the Workers' Compensation Law. 5. NON-DISCRIMINATION REOUIREMENTS. To the extent required by Article 15 of the Executive Law (also known as the Human Rights Law) and all other State and Federal statutory and constitutional non-discrimination provisions, the Contractor will not discriminate against any employee or applicant for employment because ofrace, creed, color, sex, national origin, sexual orientation, age, disability, genetic predisposition or carrier status, or marital status. Furthennore, in accordance with Section 220-e ofthe Labor Law, if this is a contract for the construction, alteration or repair of any public building or public work or for the manufacture, sale or distribution of materials, equipment or supplies, and to the extent that this contract shall be performed within the State of New York, Contractor agrees that neither it nor its subcontractors shall, by reason of race, creed, color, disability, sex, or national origin: (a) discriminate in hiring against any New York State citizen who is qualified and available to perform the work; or (b) discriminate against or intimidate any employee hired for the performance of work under this contract. If this is a building service contract as defmed in Section 230 of the Labor Law, then, in accordance with Section 239 thereof, Contractor agrees that neither it nor its subcontractors shall by reason of race, creed, color, national origin, age, sex or disability: (a) discriminate in hiring against any New York State citizen who is qualified and available to perform the work; or (b) discriminate against or intimidate any employee hired for the performance of work under this contract. Contractor is subject to fines of $50.00 per person per day for any violation of Section 220-e or Section 239 as well as possible temlination of this contract and forfeiture of all moneys due hereunder for a second or subsequent violation. 6. WAGE AND HOURS PROVISIONS. If this is a public work contract covered by Article & of the Labor Law or a building service contract covered by Article 9 thereof, neither Contractor's employees nor the employees of its subcontractors may be required or permitted to work more than the number of hours or days stated in said statutes, except as otherwise provided in the Labor Law and as set forth in prevailing wage and supplement schedules issued by the State Labor Department. Furthennore, Contractor and its subcontractors must pay at least the prevailing wage rate and payor provide the prevailing supplements, including the premium rates for overtime pay, as determined by the State Labor Department in accordance with the Labor Law. 7. NON-COLLUSIVE BIDDING CERTIFICA nON. In accordance 'vvith Section 139-d of the State Finance Law, if this contract was awarded based upon the submission of bids, Contractor warrants, under penalty of perjury, that its bid was arrived at independently and without collusion aimed at restricting competition. Contractor further warrants that. at the time Contractor submitted its bid, an authorized and responsible person executed and delivered to the Stale a non-collusive bidding certification on Contractor's behalf. 8. INTERNATIONAL BOYCOTT PROIIJBITION. Tn accordance with Section 220.f ofthe Labor Law and Section 139-h of the State Finance Law, if this contract exceeds $5.000, the Contractor agrees, as a material condition of the contract, that neither the Contractor nor any substanlially owned or affiliated person. finn. partnership or corporation has participated, is participating, or shall participate in an international boycott in violation of the federal Export Administration Act of 1979 (50 USC App. Sections 2401 et seq.) or regulations thereunder. If such Contractor, or any of the aforesaid affiliates of Contractor, is convicted or is othernise found to have violated said laws or regulations upon the final determination of the United States Commerce Department or any other appropriate agency of the United States subsequent to the contract's execution, such contract, amendment or modification thereto shall be rendered forfeit and void. The Contractor shall so notify the State Comptroller within five (5) business days of such conviction, determination or disposition of appeal (2NYCRR 105.4). 9. SET-OFF RIGHTS. The State shall have all of its common law, equitable and statutory rights of seto{)ff. These rights shall include. but not be limited to, the State's option to withhold for the purposes of seto{)ff any moneys due to the Contractor under this contract up to any amounts due and owing to the State with regard to this contract. any other contract with any State department or agency, including any contract for a term commencing prior to the term of this contract, plus any amounts due and owing to the State for any other reason including, without limitation, tax delinquencies, fee delinquencies or monetary penalties relative thereto. The State shall exercise its set-off rights in accordance with normal State practices including, in cases of seto{)ff pursuant to an audit, the finalization of such audit by the State agency, its representatives, or the State Comptroller. 10. RECORDS. The Contractor shall establish and maintain complete and accurate books, records, documents, accounts and other evidence directly pertinent to performance under this contract (hereinafter, collectively, "the Records"). The Records must be kept for the balance of the calendar year in which they were made and for six (6) additional years thereafter. The State Comptroller, the Attorney General and any other person or entity authorized to conduct an examination, as well as the agency or agencies involved in this contract, shall have access to the Records during nonnal business hours at an office of the Contractor within the State of New York or, ifno such office is available, at a mutually agreeable and reasonable venue within the State, for the term specified above for the purposes of inspection, auditing and copying. The State shall take reasonable steps to protect from public disclosure any of the Records which are exempt from disclosure under Section 87 of the Public Officers Law (the "Statute") provided that: (i) the Contractor shall timely inform an appropriate State official, in \.\Titing, that said records should not be disclosed; and Oi) said records shall be sufficiently identified; and (iii) designation of said records as exempt under the Statute is reasonable. Nothing contained herein shall diminish, or in any way adversely affect, the State's right to discovery in any pending or future litigation. II. IDENTIFYING INFORMATION AND PRIY ACY NOTIFICATION. (a) FEDERAL EMPLOYER IDENTIFICATION NUMBER and/or FEDERAL SOCIAL SECURITY NUMBER. All invoices or New York State standard vouchers submitted for payment for the sale of goods or services or the lease of real or personal property to a New York State agency must include the payee's identification number, i.e., the seller's or lessor's identification number. The number is either the payee's Federal employer identification number or Federal social security number, or both such nwnbers when the payee has both such numbers. Failure to include this number or numbers may delay payment. Where the payee does not have such number or numbers, the payee, on its invoice or New Yark State standard voucher, must give the reason or reasons why the payee does not have such number or numbers. (b) PRIVACY NOTIFICATION. (1) The authority to request the above personal information from a seller of goods or services or a lessor of real or personal property, and the authority to maintain such information, is found in Section 5 of the State Tax Law. Disclosure of this information by the seller or lessor to the State is mandatory. The principal purpose for which the information is collected is to enable the State to identifY individuals. businesses and others who have been delinquent in filing tax returns or may have understated their tax liabilities and to generally identifY persons affected by the taxes administered by the Commissioner of Taxation and Finance. The information will be used for tax administration purposes and for any other purpose authorized by law. (2) The personal information is requested by the purchasing unit of the agency contracting to purchase the goods or services or lease the real or personal property covered by this contract or lease. The information is maintained in New York State's Central Accounting System by the Director of Accounting Operations, Office of the State Comptroller, AESOB, Albany, New Yark 12236. 12. EOllAL EMPLOYMENT OPPORTlINITlES FOR MINORITIES AND WOMEN. In accnrdance with Section 312 of the Executive Law, if this contract is: (i) a written agreement or purchase order instmment, providing for a total expendihlre in excess of $25,000.00, whereby a contracting agency is committed to expend or does expend funds in return for labor, services, supplies, equipment, materials or any combination of the foregoing. to be performed for, or rendered or furnished to the contracting agency; or (ii) a written agreement in excess of $1 00,000.00 whereby a contracting agency is committed to expend or does expend funds for the acquisition, construction, demolition, replacement, major repair or renovation of real property and improvements thereon; or (iii) a vvritten agreement in excess of $100,000.00 """hereby the owner of a State assisted housing project is committed to expend or does expend funds for the acquisition, construction, demolition, replacement, major repair or renovation of real property and improvements thercon for such project, then: (a) The Contractor will not discriminate against employees or applicants for employment because ofrace, creed, color, national origin, sex, age, disability or marital status, and willlll1del1ake or continue existing programs of affirmative action to ensure that minority group members and women are afforded cqual employment opportunities without discrimination. Affirmative action shall mean recruitment, employment, job assignment, promotion, upgradings, demotion, transfer, layoff, or termination and rates of payor other forms of compensation; (b) at the request of the contracting agency, the Contractor shall request each employment agency, labor union, or authorized representative of workers with which it has a collective bargaining or other agreement or understanding, to furnish a written statement that such employment agency, labor union or representative will not discriminate on the basis of race, creed, color, national origin, sex, age, disability or marital status and that such union or representative ",ill atfmnatively cooperate in the implementation of the contractor's obligations herein; and (c) the Contractor shall state, in all solicitations or advertisements for employees, that, in the performance of the State contract, all qualified applicants will be afforded equal employment opportunities without discrimination because of race, creed, color, national origin, sex, age, disability or marital status. Contractor will include the provisions of "a", "b", and "c" above, in every subcontract over $25,000.00 for the construction, demolition, replacement, major repair, renovation, planning or design of real property and improvements thereon (the "Work") except where the Work is for the beneficial use of the Contractor. Section 312 does not apply to: (i) work, goods or services unrelated to this contract; or (ii) employment outside New York State; or (iii) banking services, insurance policies or the sale of securities. The State shall consider compliance by a contractor or subcontractor with the requirements of any federal law concerning equal employment opportunity which effectuates the purpose of this section. The contracting agency shall determine whether the imposition of the requirements of the provisions hereof duplicate or conflict with any such federal law and if such duplication or conflict exists, the contracting agency shall waive the applicability of Section 312 to the extent of such duplication or conflict. Contractor will comply with all duly promulgated and lawful rules and regulations of the Governor's Office of Minority and Women's Business Development pertaining hereto. 13. CONFLICTING TERMS. In the event of a contlict between the terms of the contract (including any and all attachments thereto and amendments thereoO and the terms of this Appendix A, the terms of this Appendix A shall control. 14. GOVERNING LAW. This contract shall be governed by the laws of the State of New York except where the Federal supremacy clause requires otherwise. 15. LATE PAYMENT. Timeliness of payment and any interest to be paid to Contractor for late payment shall be governed by Article Il-A of the State Finance Law to the extent required by law. 16. NO ARBITRATION. Disputes involving this contract, including the breach or alleged breach thereof, may not be submitted to binding arbitration (except where statutorily authorized), but must, instead, be heard in a court of competent jurisdiction of the State of New York. 17, SERVICE OF PROCESS. In addition to the methods of service allowed by the State Civil Practice Law & Rules ("CPLR"), Contractor hereby consents to service of process upon it by registered or certified mail, return receipt requested. Service hereunder shall be complete upon Contractor's actual receipt of process or upon the State's receipt of the return thereof by the United States Postal Service as refused or undeliverable. Contractor must promptly notify the State, in writing, of each and every change of address to which service of process can be made. Service by the State to the last known address shall be sufficient. Contractor will have thirty (30) calendar days after service hereunder is complete in which to respond. 18. PROIlIBlTION ON Pl1RCHASE OF TROPICAL HARDWOODS. The Contractor certifies and warrants that all wood products to be used under this contract award will be in accordance with, but not limited to, the specifications and provisions of State Finance Law ~165. (Use of Tropical Hardwoods) which prohibits purchase and use of tropical hardwoods, unless specifically exempted. by the State or any governmental agency or political subdivision or public benefit corporation. Qualifica- tion for an exemption under this law will be the responsibility of the contractor to establish to meet with the approval of the State. In addition, when any portion of this contract involving the use of woods, whether supply or installation, is to be performed by any subcontractor, the prime Contractor will indicate and certify in the submitted bid proposal that the subcontractor has been informed and is in compliance with specifications and provisions regarding use of tropical hardwoods as detailed in * 165 State Finance Law. Any such use must meet with the approval of the State; otherwise, the bid may not be considered responsive. Under bidder certifications, proof of qualification for exemption ""'ill be the responsibility of the Contractor to meet with the approval of the State. 19. MACBRIDE lAIR EMPLOYMENT PRINCIPLES, In accordance with the MacBride Fair Employment Principles (Chapter 807 of the Laws of 1992), the Contractor hereby stipulates that the Contractor either (a) has no business operations in Northern Ireland, or (b) shall take lawful steps in good faith to conduct any business operations in Northern Ireland in accordance with the MacBride Fair Employment Principles (as described in Section 165 of the New York State Finance Law), and shall pennit independent monitoring of compliance with such principles. 20. OMNIBUS PROCUREMENT ACT OF 1992. It is the policy of New York State to maximize opportunities for the participation of New York State business enterprises, including minority and women-owned business enterprises as bidders, subcontractors and suppliers on its procurement contracts. Information on the availability of New York State subcontractors and suppliers is available from: NYS Department of Economic Development Division for Small Business 30 South Pearl St - 71b Floor Albany, New York 12245 Telephone: 518-292-5220 A directory of certified minority and women..owned business enterprises is available from: NYS Department of Economic Development Division of Minority and Women's Business Development 30 South Pearl St - 2nd Floor Albany, New York 12245 http://www.empire.state.ny.us The Omnibus Procurement Act of 1992 requires that by signing this bid proposal or contract, as applicable, Contractors certify that whenever the total bid amount is greater than $1 million: (a) The Contractor has made reasonable efforts to encourage the participation of New York State Business Enterprises as suppliers and subcontractors, including certified minority and women-owned business enterprises, on this project, and has retained the documentation of these efforts to be provided upon request to the State; (b) The Contractor has complied with the Federal Equal Opportunity Act of 1972 (P.L. 92-261), as amended; (c) The Contractor agrees to make reasonable efforts to provide notification to New York State residents of employment opportunities on this project through listing any such positions with the Job Service Division of the New York State Department of Labor, or providing such notification in such manner as is consistent with existing collective bargaining contracts or agreements. The Contractor agrees to document these efforts and to provide said documentation to the State upon request; and (d) The Contractor acknowledges notice that the State may seek to obtain offset credits from foreign countries as a result ofthis contract and agrees to cooperate with the State in these efforts. 21. RECIPROCITY AND SANCTIONS PROVISIONS. Bidders are hereby notified that if their principal place of business is located in a country, nation, province, state or political subdivision that penalizes New York State vendors, and if the goods or services they offer will be substantially produced or performed outside New York State, the Omnibus Procurement Act 1994 and 2000 amendments (Chapter 684 and Chapter 383, respectively) require that they be denied contracts which they would otherwise obtain. NOTE: As of May 15, 2002, the list of discriminatory jurisdictions subject to this provision includes the states of South Carolina. Alaska. West Virginia, Wyoming, Louisiana and Hawaii. Contact NYS Department of Economic Development for a current list of jurisdictions subject to this provision. 22. PURCHASES OF APPAREL. In accordance with State Finance Law 162 (4-a), the State shall not purchase any apparel from any vendor unable or unwilling to certity that: (i) such apparel was manufactured in compliance with all applicable labor and occupational safety laws, including, but not limited to, child labor laws, wage and hours laws and workplace safety laws, and (ii) vendor will supply, with its bid (or, ifnot a bid situation, prior to or at the time of signing a contract with the State), if known, the names and addresses of each subcontractor and a list of all manufacturing plants to be utilized by the bidder. (Revised May 2003) APPENDIX A-I G General A. In the event that the Contractor shall receive, from any source whatsoever, sums the payment of which is in consideration for the same costs and services provided to the State, the monetary obligation of the State hereunder shall be reduced by an equivalent amount provided, however, that nothing contained herein shall require such reimbursement where additional similar services are provided and no duplicative payments are received. B. This agreement is subject to applicable Federal and State Laws and regulations and the policies and procedures stipulated in the NYS Education Department Fiscal Guidelines found at bttp;lOY"W..!]Y~e9~QYLe~t~/. Terminations A. The State may terminate this Agreement without cause by thirty (30) days prior written notice. In the event of such termination, the parties will adjust the accounts due and the Contractor will undertake no additional expenditures not already required. Upon any such termination, the parties shall endeavor in an orderly manner to wind down activities hereunder. Safeguards for Services and Confidentiality B. Any copyrightable work produced pursuant to said agreement shall be the sole and exclusive property ofthe New York State Education Department. The material prepared under the terms of this agreement by the Contractor shall be prepared by the Contractor in a form so that it will be ready for copyright in the name of the New York State Education Department. Should the Contractor use the services of consultants or other organizations or individuals who are not regular employees of the Contractor, the Contractor and such organization or individual shall, prior to the performance of any work pursuant to this agreement, enter into a written agreement, duly executed, which shall set forth the services to be provided by such organization or individual and the consideration therefor. Such agreement shall provide that any copyrightable work produced pursuant to said agreement shall be the sole and exclusive property of the New York State Education Department and that such work shall be prepared in a form ready for copyright by the New York State Education Department. A copy of such agreement shall be provided to the State. C. All reports of research, studies, publications, workshops, announcements, and other activities funded as a result of this proposal will acknowledge the support provided by the State of New York. D. This agreement cannot be modified, amended, or otherwise changed except by a written agreement signed by all parties to this contract. E. No failure to assert any rights or remedies available to the State under this agreement shall be considered a waiver of such right or remedy or any other right or remedy unless such waiver is contained in a writing signed by the party alleged to have waived its right or remedy. F. Expenses for travel, lodging, and subsistence shall be reimbursed in accordance with the policies stipulated in the afurementioned Fiscal guidelines. G. No fees shall be charged by the Contractor for training provided under this agreement. H. Nothing herein shall require the State to adopt the curriculum developed pursuant to this agreement. I. All inquiries, requests, and notifications regarding this agreement shall be directed to the Program Contact or Fiscal Contact shown on the Grant Award included as part of this agreement. 1. This agreement, including all appendices, is, upon signature of the parties and, when required the approval of the Attorney General and the State Comptroller, a legally enforceable contract. Therefore, a signature on behalf of the Contractor will bind the Contractor to all the terms and conditions stated therein. K. The parties to this agreement intend the foregoing writing to be the final, complete, and exclusive expression of all the terms oftheir agreement. Local Government Records Management Improvement Fund Application Narrative (LG-NA) Local Government Name Population Served Annual Operating Budget Total Number of Employees Full-time: Part-time: Please address each of the issues listed below. Be as detailed as possible. Keep in mind that the application narrative directly corresponds to the criteria which reviewers will follow when ranking your application. I. Statement of the Problem (maximum 20 points) a. Describe the specific records management problem the project will address. and explain why the project is a high priority. (5 points) b. Identify specific records series, government departments that will be involved, and any previous grant-funded projects relating to these records and this project. (5 points) c. Provide both qualitative descriptions of and quantitative data about the problem. (For example. support a request for an imaging project with a description of how you use the records and an estimate of the time you would save if the records were available and searchable on your personal computer.) (5 points) d. Explain why funding from this grant program is essential to accomplishing the project. (For example, explain why you need funding if you've previously received funding for a similar project.) (5 points) II. Intended Results (maximum 15 points) a. Identify each intended result (specific products, time and cost savings. or services). and describe the anticipated benefits. (5 points) b. Explain how the project will address the records management problem identified in the Statement of the Problem. (5 points) New York State Archives Fonn LG-NA 9/2006 c. Describe in detail how the project will contribute to the development of a records management program. (5 points) III. Plan of Work (maximum 20 points) a. Explain why one solution was preferred over alternatives. (For example, explain why you chose to scan rather than microfilm a records series, or justify conducting a consultant's survey rather than a comprehensive inventory.) (5 points) b. Provide a detailed outline of the proposed work activities and a timetable showing when each phase of the project will be completed and demonstrating the project's goals are attainable by 30 June 2008. (5 points) c. Explain who will be responsible for performing each project activity, including project management. Indicate the qualifications of key project staff (including consultants and vendors) in terms of education, training, and experience. (5 points) d. Address each of the requirements of the relevant project category and subcategory. (5 points) IV. Local Government Support for Records Management (maximum 15 points) It is important to demonstrate your commitment to records management. Types of support may include government funds, staffing, equipment, supplies, or the allocation of space. Provide specific budget amounts whenever possible. Include information only on the support your local government provided and will provide with its own funds. Projects completely funded by the LGRMIF do not constitute local support. LG-NA (Sept 2006) a. Identify your government's past contributions to records management. (5 points) b. Demonstrate contributions to this project. (5 points) c. Describe how this project and records management in general will be maintained over the long term. (5 points) New York Slate Archives Fonn LG-NA 9/2006 Local Govemment Records Management Improvement Fund Vendor Quote Form (LG-VQ) Please complete this form to provide evidence that you have contacted three vendors for price quotes. One or more of the quotes may be derived from State Contract Listing (www.ogs.state.ny.us/purchase). Photocopy the form if you must submit more than one Vendor Quote Form. Instructions for completing the form are on the reverse side. Vendor's Name and Address Description of Item State Contract Quoted or Service* Number Price 1. 2. 3. 'For services rendered, provide more detail in the Budget Category and Narrative fonm, Code 40. New York State Archives Fonn LG-VQ 9/2006 Instructions for Completing the Vendor Quote Form (LG-VQ)* Complete this form in the following cases: ~ When applying for funds to purchase equipment with a unit cost in excess of $5,000 ~ When applying for funds to purchase supplies and materials, including computer software, with a unit cost in excess of $5,000 ~ When applying for funds for purchased services where the cost of any single vendor's services, including a consultant's services, exceeds $5,000 ~ Remodeling, where the cost of anyone activity exceeds $5,000 or where anyone vendor will receive over $5,000. If more than one contractor is used, this form must be completed for each. Technology Implementation Project Proposals: Include eight copies of the complete, detailed quotes from the consultant or vendor for any service over $5,000. The detailed quotes must clearly delineate individual project costs (for example, travel, staff training, and equipment installation) and hours for each service provided. Also submit eight copies of the RFQ that outlined the requirements used to collect the detailed quotes. State Contract Purchases: If you are submitting a state contract quote, you must still submit three quotes in total for any purchase over $5,000. For more information on state contracts, contact Judy Gibbons, Non-State Agency Coordinator, Standards and Purchase Group, New York State Office of General Services, Corning Tower, 37th Floor, Albany, NY 12242; telephone (518) 474-6717. Preferred Vendors: Certain providers have "preferred source" status under the law. If using a preferred vendor to purchase supplies, equipment, or contracted services, indicate this on the Vendor Quote Form (LG-VQ). The legal status of preferred vendors varies from situation to situation. It is your responsibility to make sure the vendor cited as preferred actually has that status, and to indicate this in the budget narrative. Figures from preferred vendors may serve as one or more of the three quotes required for requested items over $5,000. Sole-Source Vendors: If there is only one vendor who can provide the required supplies, equipment, or contracted services, indicate this on the Vendor Quote Form (LG-VQ) and discuss in the budget narrative form your attempts to find additional vendors. A prior working relationship with a vendor (or consultant) does not, by itself, constitute justification for a sole-source contract. We encourage applicants to search for the best quality at the least expensive price. If you do not choose the lowest quote identified on this form, provide substantial justification for that decision in the budget narrative. It is not acceptable to use an averaged quote in the budget. 'Photocopy this form if you must submit more than one Vendor Quote Form (LG-VQ). Attach additional sheets if more space is necessary, but be brief and specific. New York State Archives Fonn LG- YQ 9/2006 Local Government Records Management Improvement Fund Imaging and Microfilming Project Information Form (LG-IM) LOCAL GOVERNMENT NAME ACTIVITIES (CHECK ALL THAT APPLY) IMAGING MICROFILMING D PAPER DOCUMENTS TO DIGITAL IMAGE D PAPER DOCUMENTS TO MICROFILM D MICROFILM IMAGES TO DIGITAL IMAGE D DIGITAL IMAGES TO MICROFILM D DIGITAL DOCUMENTS TO DIGITAL IMAGE RECORDS DESCRIPTION NAME OF RECORDS SERIES RETENTION PERIOD (YEARS) DATE RANGE OF RECORDS RECORDS SCHEDULE (NAME AND ITEM NUMBER) TOTAL NUMBER OF IMAGES Explain in the narrative any discrepancies between the number of images and the number of pages. MICROFILM Format of use copies: DOiazo or vesicular microfilm D Digital images Number of original rolls: 16mm 35mm Number of use rolls: 16mm 35mm TYPE OF FILE, D Closed (no additional records) D Open (additional expected) ANNUAL GROWTH' pages per year ARRANGEMENT, D Alphabetical D Numerical DChronological D Other (specify) CHARACTERISTICS ELECTRONIC DATA: D Digital images D Other electronic fonmats (such as word processing files) DOCUMENT SIZE, D Uniform D Varies Maximum size in inches: x Minimum size in inches: x PAPER TYPE, D Uniform D Varies D Bond D Tissue DCard D Other (specify) PAPER CONDITION, D Fragile % D Flat % D Rolled % D Foided % IMPRINT, DTyped D Handwritten D Pencil Dink D Other (specify) D Photostat PAPER COLOR DWhite % D Color % D Negative images % D Other: % FASTENERS, D Bound D Folders D Clips D Staples FREQUENCY OF FASTENERS, D Rare D Frequent D Always RETRIEVAL NUMBER OF REFERENCES, per DDay D Week D Month D Year REFERENCES NEEDING COPIES, % RETRIEVAL URGENCY: o Immediate D Within 1 day o Within 1 week ACCESS, D Public DStaff D Both REFERENCE COPY, D Microfilm D Paper D Electronic copy WORKPLAN PERSONNEL RESPONSIBILITIES (check all that apply) Vendor: D Microfilming D Scanning D Indexing or OCR cleanup/reformatting (include in RFQ) Grant-funded staff: D Microfilming D Scanning D Indexing or OCR c1eanuplreformatting WORK RATE FOR INHOUSE IMAGING/MICROFILMING PROJECT + + = Number of hours of Number of hours for Number of hours for Total hours preparation time image capture image verification Preparation time: Baseline rate is 1,000 sheets per hour; more time may be required for older, worn records with clips or staples Image capture: Baseline rate is 675 pages per hour; rate may vary depending on type of scanner and condition of records Image verification: Baseline rate is 300 pages per hour New York State Archives Form LG-IM 9/2006 Instructions for Completing Imaging and Microfilming Project Information Form COMPLETE ONE FORM FOR EACH SEPARATE SERIES YOU ARE IMAGING OR MICROFILMING Local Government Name: Enter the name of your local government. Activities: Check the activities you will carry out with this records series. Paper documents to digital image: Scanning of paper Microfilm documents to digital image: Scanning microfilm images Digital documents to digital image: Converting e-documents (like Word files) to digital images Paper documents to microfilm: Microfilming of paper Digital images to microfifm: Printing digital images directly to microfilm RECORDS DESCRIPTION Name of Records Series: Enter the title of the records series you intend to scan or microfilm (e.g., "Birth Records," "Payroll Records:' etc.). Retention Period (Years): Enter the retention period for the records series to be scanned or microfilmed (e.g., "6 years," "Permanent," etc.). Date Range of Records: Enter the earliest and latest years of the records series you intend to scan or microfilm. Records Schedule (Name and Item Number): Enter the records retention schedule name and item number (e.g., "MU-1,ltem1"). Total Number of Images: Enter the number of images to be scanned or microfilmed. For directions on how to estimate the number of images, see State Archives Publication #9, Producing High Quality Microfilm, p. 13- 14. If microfilming, note that the number of images on a roll may not equal the number of pages. Microfilm: If you are microfilming, enter format of your use copies (digital images or microfilm), the total number of camera (original) rolls, and the total number of duplicate (use) microfilm rolls, if applicable. Type of File: Check appropriate box. Annual Growth: Indicate the growth of the records series (whether paper or electronic) in number of pages per year. Arrangement: Check appropriate box to indicate the order in which the records are currently arranged. CHARACTERISTICS Electronic Data: Indicate whether the INITIAL RECORDS you will be imaging or scanning are digital images versus other electronic formats (such as word processing files or database reports). Document Size: Indicate whether the physical size of the paper documents or images (in the case of digital images) within the series is uniform or varies. Enter the maximum and minimum sizes of documents in inches. For electronic documents, assume the documents are 8W' X 11 ", unless the series has digital images of various sizes. Paper Type: For paper documents, indicate each type of paper present in the records series. Paper Condition: For paper documents, indicate the physical conditions of the records and the approximate percentages of documents in the series exhibiting those characteristics. Imprint: For paper documents, indicate each type of imprint present on any of the pages in the records series. Paper Color: For paper documents, indicate each of the colors of paper present in the records series and the approximate percentages of paper in the series with those colors. Fasteners: For paper documents, indicate the type of fasteners used to hold pages together. Frequency of Fasteners: Indicate how frequently documents in the records series are held together by fasteners. RETRIEVAL Number of References: Indicate the approximate rate at which users refer to information in this series. References Needing Copies: Enter the approximate percentage of references requests that require photocopying information in this series. Retrieval Urgency: Indicate the level of urgency with which the retrieval of records in this series is treated. Access: Indicate whether local government staff, the public, or both can retrieve records from this series. Reference Copy: Indicate the copy you INTEND TO USE to access this records series at the CONCLUSION of this project. WORKPLAN Personnel Responsibilities: Indicate whether the project will be done by a vendor and/or by granHunded staff. If a vendor will index the records, this activity should be included in the vendors' quotes. Work Rate for Inhouse Imaging/Microfilming Project: If applicable, indicate the hours of staff time you will need to prepare the records for imaging or filming (e.g., flattening paper, removing fasteners), hours you will need for image capture (Le., to actually scan or film the records), and hours for image verification to ensure the reformatted records are legible. Nl;:W York State ArchivesF Form LG-IM 9/2006 Local Government Records Management Improvement Fund Budget Narrative Form for Code 15 (BN-15) SALARIES FOR PROFESSIONAL STAFF Specific Position Titles Hours Rate of Proposed Worked Pav EXDenditure TOTAL iFS-20, Budaet Summarv Form) Yes No Will any of the above be paid with local government funds? 0 0 If so, for how many hours per week? Narrative: * Use only whole dollar amounts. If additional space is needed, please attach extra sheets. New York State Archives form BN-] 5 912006 Salaries for Professional Staff (Code 15) Table Provide the specific position title, number of hours needed, hourly rate of pay, and total project salary for each staff person you propose to pay with grant funds. Include only staff who will be professional employees of your local government in this budget code. Do not include consultants, per diem staff, or support staff. Narrative Explain in detail how these positions will support project activities and goals. Clearly outline the responsibilities of each position, describe the project-related activities, and demonstrate why the requested number of hours are needed. Eligible Expenditures Grant funding must be used only to pay staff involved with project-related activities. You may use grant funds to hire new staff or increase work hours of existing staff to carry out project-related work. If you are proposing to transfer existing staff to grant funds, justify the need and explain how these staff will be replaced in their former assignments using non-grant funds. Note to Town Applicants Refer to Sections 27 and 108 of the Town Law, which prescribe procedures for changes in the town clerk's salary. If the town clerk will direct or carry out the project with funds from the grant in addition to his or her regular duties, the application should clearly state that the clerk will perform these grant duties separately from and beyond his or her existing duties as town clerk or RMO. If the town receives a grant, the town board should adopt a resolution designating the clerk by an appropriate title (such as "project director") for the project work. The resolution should specify that the project duties will be performed separately from and beyond the person's responsibilities as town clerk or Records Management Officer. New York State Archives Form BN-15 9/2006 Local Government Records Management Improvement Fund Budget Narrative Form for Code 16 (BN-16) SALARIES FOR SUPPORT STAFF Specific Position Titles Hours Rate of Proposed Worked PaY Expenditure TOTAL (FS-2O, Budqet Summary Form) Yes No Will any of the above be paid with local government funds? D D If so, for how many hours per week? Narrative: * Use only whole dollar amounts. If additional space is needed, please attach extra sheets. New York State Archives Form BN-16 9/2006 Salaries for Support Staff (Code 16) Table Provide the specific position title, hours needed, hourly rate of pay, and total project salary for each support staff you intend to pay with grant funding. Include only those individuals who will be support staff of your government in this budget code. Do not include consultants, per diem staff, or professional staff. Narrative Justify in detail the need for these positions and explain how they will support project activities and goals. Clearly outline the responsibilities of the position and demonstrate why the requested number of hours are needed. Eligible Expenditures You may use grant funds to hire new staff or increase work hours of existing staff to carry out project-related work. If you propose to transfer existing staff to grant funding, justify the need and demonstrate that you will replace these staff in their former assignments using non-grant funds. Demonstrate that grant-funded salaries will be used only to support project-related activities. Note to Town Applicants Refer to Sections 27 and 108 of the Town Law, which prescribe procedures for changes in the town clerk's salary. If the town clerk will direct or carry out the project with funds from the grant in addition to his or her regular duties, the application should clearly state that the clerk will perform these grant duties separately from and beyond his or her existing duties as town clerk or RMO. If the town receives a grant, the town board should adopt a resolution designating the clerk by an appropriate title (such as "project director") for the project work. The resolution should specify that the project duties will be performed separately from and beyond the person's responsibilities as town clerk or Records Management Officer. New York State Archives Form BN-] 69/2006 Local Government Records Management Improvement Fund Budget Narrative Form for Code 20 (BN-20) EQUIPMENT Description of Item Quantit) Unit Proposed Cost EXDenditure TOTAL !transfer to FS-20, Budaet SummarY Form) Narrative: I New York Slale Archives Fonn BN-20 9/2006 * Use only whole dollar amounts. If additional space is needed, please attach extra sheets. Equipment (Code 20) Table Briefly describe the item to be purchased and specify quantity, unit cost, and proposed expenditure. Narrative Describe how this equipment will be used to support project activities and goals. Be sure to address how this equipment is important to records management needs. Demonstrate that such equipment is critical to the project and will be used on an ongoing basis after the grant to support records management. Other Required Forms A Vendor Quote Form (LG-VQ) must be completed for each proposed item with a unit cost over $5,000. Eligible Expenditures . Equipment with a unit cost of $5,000 or more. Budget equipment with a unit cost under $5,000 (steel shelving) under Code 45, Supplies and Materials. Ineligible Expenditures . Photocopiers . Office furniture New York State Archives Form BN-20 9/2006 Local Government Records Management Improvement Fund Budget Narrative Form for Code 30 (BN-30) MINOR REMODELING Description of Work to be .Performed Proposed EXDenditures TOTAL (transfer to FS-20, Budaet Summary Form) Narrative: * Use only whole dollar amounts. If additional space is needed, please attach extra sheets. New York State Archives Fonn BN-30 912006 Minor Remodeling (Code 30) Table Briefly describe and provide the cost of each proposed remodeling activity. Narrative Justify the need and describe the plan for the remodeling project. Explain how it will support the project goals outlined in the Application Narrative. Eligible Expenditures Any facility proposed for minor remodeling must be in existence before the grant application deadline. Activities eligible for funding under Minor Remodeling include, but are not limited to . feasibility studies and facility design . renovations to facilities to improve them for records storage, or to prepare them for the installation of eligible equipment (including labor and construction materials) . installation of fire detection and suppression systems and water detectors . purchase, modification, and installation of heating, ventilating, and air conditioning systems to control temperature and humidity . installation of walls, doors, locks, alarms, and other security systems to secure a records storage facility . minor modifications necessary to install microfilming or other project-related equipment . actions required to render the facility safe for occupancy and use by staff Ineligible Expenditures . Purchase or construction of facilities, or additions to existing structures . Construction of or repairs to the roof, exterior walls, or foundation of a building Other Required Forms . Applicants must complete a Vendor Quote Form (LG-VQ) for any single remodeling activity that exceeds $5,000 or for any request where anyone vendor will receive over $5,000. If one contactor is responsible for multiple activities, the quote from that contractor must provide a breakdown of costs by activity. . Include a floor plan of any records storage area that is the focus of a remodeling project. New York State Archives Form BN-30 9/2006 Local Government Records Management Improvement Fund Budget Narrative Form for Code 40 (BN-40) PURCHASED SERVICES Description ofltem Provider of Calculation of Proposed Services Cost Expenditure TOTAL (transfer to FS-20. Budget Summary Form) Narrative: * Use only whole dollar amounts. If additional space is needed, please attach extra sheets. New York Slale Archives Form BN-40 9/2006 Purchased Services (Code 40) Table Identify the type of service by general category (such as training, software installation, rentals), and provide the total expenditure for each. Indicate the number of days or hours a consultant will work, multiplied by a daily or hourly fee. List purchased services from a SOCES under Code 49. Narrative In the narrative, describe how the purchased services support project activities and goals. List the names of individual vendors or consultants, if applicable. Clearly explain and justify the consultant's role in and time spent on the project. If you have identified a consultant or vendor, provide information on their qualifications. Eligible Expenditures . Consultants to train staff, conduct studies, and recommend records management policies and procedures . Production of manuals, finding aids, teaching guides, or other publications directly related to the project . Other contractual services such as microfilming, imaging, paper recycling, and Internet services . Rental fees for the grant year for shredders and other equipment, temporary records storage space, and server space. Fees for renting space may be payable to commercial or other agencies but not to the applicant. . Tuition and registration fees for records management courses, workshops, and conferences as long as these courses are directly related to the proposed project (textbooks and other supplies should be requested under Code 45; travel costs should be requested under Code 46) Ineligible Expenditures . An employees of a local government may not serve as a consultant to that local government . Ongoing expenses, such as routine repairs, building maintenance, magazine subscriptions, membership fees, systems maintenance, and rental fees . Hiring a grantwriter Other Required Forms If the fee paid to consultants or vendors from grant funds exceeds $5,000, applicants must submit three quotes and complete a Vendor Quote Form (LG-VQ). The quotes must clearly delineate individual project costs (such as travel, staff training, and equipment installation) and hours for each service provided New York Slate Archives Form BN-40 9/2006 Local Government Records Management Improvement Fund Budget Narrative Form for Code 45 (BN-45) SUPPLIES AND MATERIALS AND EQUIPMENT LESS THAN $5,000 Description of Item Quantity Unit Cost Proposed Exoenditure TOTAL (transfer to FS-20, Budoet Summary Form) Narrative: * Use only whole dollar amounts. If additional space is needed, please attach extra sheets. New York Slate Archives Form BN-45 912006 Supplies and Materials (Code 45) Table Briefly describe each requested item and specify quantity, unit cost, and proposed expenditure. Request any equipment items with a unit cost of less than $5,000 and all computer software, regardless of the unit price, under this budget code. Narrative Describe how each of the supplies and materials itemized under this code will support project activities and goals. Eligible Expenditures . Supplies, such as shelving1, storage boxes2,records management software, alkaline supplies (folders and boxes), and equipment with a unit cost of less than $5,000 . Side-tab file folders for files management projects . All computer software, regardless of the unit price . Lateral open shelving with pull-down or flip-down locking doors . Fire-resistant file cabinets are also eligible Ineligible Expenditures . Standard file cabinets, including lateral file cabinets. . Office furniture . Office supplies, such as tape measures, calculators, marking pens, toner, printer paper, and file folders. . Wooden shelving of any kind, including shelving with particle board decking . Records center cartons other than standard cubic-foot boxes, unless the applicant provides sufficient justification for their purchase Other Required Forms . Applicants must submit three quotes and complete a Vendor Quote Form (LG-VQ) for computer software costing more than $5,000. . For shelving purchases, include a floor plan indicating the number of boxes you will store on each unit. 1 For information on appropriate shelving for records storage, consult State Archives Publication #65, Recommendations for Shelving for Inactive Records Storage. 2 Standard one-cubic-foot records storage cartons (10" x 12" x 15") may be purchased through the New York State Industries for the Disabled, 155 Washington Avenue, Suite 400, Albany, NY 12210; telephone (518)463-9706. Available in lots of twenty-five at $33.22/case (approximately $1.33/box). plus freight (approximately $8-$9 per case), for orders under $300. Grant funds will not be approved for cartons in excess of this price. New York Slate Archives Form BN-45 9/2006 Local Government Records Management Improvement Fund Budget Narrative Form for Code 46 (BN-46) TRAVEL EXPENSES Position of Purpose Calculation of Proposed Traveler Cost EXDenditure TOTALltransfer to FS-20, Budaet Summary Form) Narrative: * Use only whole dollar amounts. If additional space is needed, please attach extra sheets. New York State Archive!\ Form BN-46 9/2006 Travel Expenses (Code 46) Table Identify the purpose of travel, position of the person traveling, proposed mileage rate (if applicable), and total expenditure. Narrative Explain how the proposed travel will help achieve project goals as outlined in the application. Eligible Expenditures . Travel to State Archives workshops and to other educational opportunities directly related to the project (such as computer training or conferences) . Expenses for travel to a conference, including registration fees, lodging, meals, bus or train fares, and mileage reimbursement, if the conference relates directly to the project . Airfare, if you can clearly demonstrate that it is the most cost-efficient method of travel available . Mileage reimbursement for project staff who must travel in excess of their regular commute. Use your local government mileage rate or the current state rate of $0.445 per mile to estimate mileage. Ineligible Expenditures . Expenses associated with conferences and other events that do not relate directly to the proposed project New York Stale Archives Form BN-46 9/2006 Local Government Records Management Improvement Fund Budget Narrative Form for Code 49 (BN-49) PURCHASED SERVICES WITH BOCES Description of Services Name of BOCES Calculation of Proposed Cost Expenditure TOTAL (transfer to FS-20, BudQet Summary Form Narrative: I * Use only whole dollar amounts. If additional space is needed, please attach extra sheets. New York State Archives Form BN-49 912006 Purchased Services with BOCES (Code 49) Table Briefly describe the proposed services. Provide the name of the BOCES providing the service, calculation of cost, and total proposed expenditure. Narrative Describe how the purchased services with BOCES support project activities and goals. Eligible and Ineligible Expenditures See the list of eligible and ineligible expenditures under general purchased services (Code 40) New York Stale Archives Fonn BN-49 9/2006 Local Government Records Management Improvement Fund Budget Narrative Form for Code 80 (BN-80) EMPLOYEE BENEFITS Benefit Proposed Expenditure Social Security, Retirement (NYS Teachers, NYS Employees, Other), Health Insurance, Worker's Compensation, Unemployment Insurance, Other (Identify) TOTAL (transfer to FS-20 Budget Summary Form) Narrative: * Use only whole dollar amounts. If additional space is needed, please attach extra sheets. Ne\v York State Archives rorm BN-~m 9/2006 Employee Benefits (Code 80) Table Provide an itemized list of all benefits to be paid. Agencies may choose to calculate the proposed employee benefits using their agency's fringe benefits (FB) rate or itemizing the specific benefits. The FB Rate for project personnel must be the same as those used for other agency personnel. Narrative Justify the need for using grant funds to pay staff benefits. Fringe benefits should not exceed 35% of the cost of salaries requested unless you provide convincing justification for requests in excess of this limit. Eligible Expenditures . Employee benefits payable to professional staff and support staff identified in Code 15 and Code 16, respectively . Benefits equal to no more than 35% of the salaries for professional and support staff positions supported by grant funds . Benefits in excess of 35% that are adequately justified Ineligible Expenditures The amount of benefits in excess of 35% of salaries if you have not adequately justified that amount. New York Slate Archives Form BN-80 912006 The University ofthe State of New York THE STATE EDUCATION DEPARTMENT (see instructions for mailing address) PROPOSED BUDGET SUMMARY FOR A FEDERAL OR STATE PROJECT FS-20 (12/05) Grant Applicant Information Funding Source: Local Government Records Management Improvement Fund Report Prepared By: Name of Applicant: Mailing Address: Street , City State Zip Code Telephone #: ( ) County: E-Mail Address: Project Funding Dates: 7 / 1 / 2007 6 / 30 / 2008 Start End INSTRUCTIONS .:. Submit the original FS-20 Budget Summary and the required number of copies, along with the completed application, directly to the appropriate State Education Department office as indicated in the application instructions for the grant program for which you are applying. DO NOT submit this form to the Grants Finance Unit. .:. Please submit the FS-20 Budget Summary as a two--page form (not back-to-back on a single sheet). .:. Enter whole dollar amounts only. The amounts must agree with the budget category totals from each Budget Category and Narrative Form. .:. For changes in agency or payee address, contact the State Education Department office indicated on the application instructions for the grant program for which you are applying. .:. An approved copy of the FS-20 Budget Summary will be returned to the contact person noted above. A window envelope will be used; please make sure that the contact information is accurate. legible and confined to the address field. .:. For information on budgeting, including 2007-08 REVISED guidelines for equipment and supplies, refer to the Fiscal Guidelines for Federal and State-Aided Grants at www.oms.nysed.gov/cafe/. BUDGET SUMMARY FS-20 Page 2 CATEGORIES CODE PROJECT COSTS Professional Salaries 15 Support Staff Salaries 16 Purchased Services 40 Supplies and Materials 45 Travel Expenses 46 Employee Benefits 80 Indirect Cost (IC)' 90 (Amount from "C" below) BOCES Services 49 Minor Remodeling 30 Equipment 20 Grand Total 'A. Modified Direct Cost Base $ B. Approved Restricted IC Rate C. (A) x (B) = Indirect Cost (Be sure to put total in Code 90 above) % $ CHIEF ADMINISTRATOR'S CERTIFICATION 1 hereby certify that the requested budget amounts are necessary for the implementation of this project and that this agency is in compliance with applicable federal and state laws and regulations. / / Date Signature Name and Title of Chief Administrative Officer Finance: Log Approved WIto OJ ITIJJ IPTer#1 I OJ ITJJJ Contract # Agency Name: FOR DEPARTMENT USE ONLY Approved Funding Dates: From To Program Approval: Date: ----------------------------------------------------------------------------------------------- Fiscal Year First Pavment Line # Voucher # First Payment MIR Instructions for Completing Payee Information form (PI) and Payee Information form Supplement Payee Information Form (PI) . Section I: Institution Identifying Information Exact Legal Name of Agency. The official name of your local government. Contact PersonlTelephone Number. The name and phone number of the person who will be able to answer questions about this project, especially its budget. This will generally be either the RMO or the project director. Address. The State Education Department's Grants Finance Unit will use this information whenever it needs to contact a local government about its fiscal reporting. Federal Employer Identification Number (FEIN). Your Tax Identification Number. If you do not have a FEIN Number, please contact the IRS at 1-800-829-1040 for assistance. Municipality Code. Your Municipality Code, not your SED code. If you do not have a Municipality Code, please contact the New York State Comptroller's Office at (518) 474- 6975 for assistance. . Section II: Agency Profile Non-Profit Organization. Local governments are non-profit organizations. Non-Sectarian Organization. Local governments are non-sectarian organizations. . Section III: Charity Registration Number Status This section does not apply to LG.RMIF grants. . Section IV: Certification The chief administrative officer or designee must sign in blue ink. This must be the same person who signs the FS-20 (Budget Summary, page 2). Payee Information form Supplement for 2007-2008 . Answer the three requests for information on the lines provided NOTE: If any of the information provided here changes, please be sure to notify the Program Office to which your grant application was sent. .4 new york state If/" archives To: LGRMIF Grant Applicant FRO M: Grants Administration Unit R E : Payee Information (PI) form Supplement for 2007-2008 Payee Information form Supplement Please complete the information requested below, so that the New York State Archives can either assign you a unique Payee Identification Number (also known as an agency code) for your local government, or verify the information we have on record. 1. The school district in which your organization's main building or headquarters is physically located. 2. The physical address of your main building or headquarters. 3. The name of your parent organization (if applicable). Please include this supplement, along with your completed and signed Payee Information form, in your completed grant application packet. Assemble the application in the order on the Application Checklist Form (LG-CH). If you have any questions, please call the Grants Administration Unit at (518) 474-6926. PI (9/06) THE STATE EDUCATION DEPARTMENT I THE UNIVERSITY OF THE STATE OF NEW YORK I ALBANY, NY 12234 PAYEE INFORMATION In order to receive funds from the NYS Education Department, ALL SECTIONS of this form will need to be completed and returned with oriainal sianature to the Education Department program office as part of your grant application. Section I: Institution Identifying Information I Exact Legal Name of Agency I I Contact Person{Telephone Number K Business name, (if different from above) b- E: Payment/Fiscal Agent (if different from above) ~ c ." ... m ~ .. m it Address (number, street, and apt. or suite no.) to which checks will be mailed City, State, and ZIP code (+ 4 digits) or Foreign City, Country & Postal Code Federal Employer Identification Number (FEIN) of this agency is: D D - D D D D D D D * Provide FEIN of recipient agency regardless of payment/fiscal agent Municipality Code (if agency is a local government): D D D D D D D D D D D D Section II: Agency Profile 1. This agency is a (check one) 0 Non-Profit Organization 0 For Profit Organization 2. This agency is a (check one) 0 Sectarian Organization 0 Non-sectarian Organization 3. Is this agency chartered or incorporated by the New York State Board of Regents? (Check one) 0 Yes 0 No 4. Is any member of the Board of Directors an employee of the NYS Education Department? DYes, piease name 0 No Section III: Charity Registration Number Status (NON-PROFIT ORGANIZATIONS ONLY) Answer ONE of the four questions listed below. 1. The charity registration number (NOT a tax exempt or Federal ID number) of this organization is: 2. 0 This organization has applied for a charity registration number from the Department of State but has not as yet been notified of the authorized number granted. 3. 0 This organization is exempt from the requirement of registering with the Department of State as a charitable organization because it receives less than $25,000 in total from governmental agencies. 4. D This organization is exempt from the requirement of registering with the Department of State as a charitable organization pursuant to the Department of State Exemption Category indicated below (Please read attached Bulletin No. G-79 and the Summary of Exemption Categories and check ONE Exemption Category listed below, if applicable). D Exemption Category 1 D Exemption Category 5 D Exemption Category 2 D Exemption Category 6 D Exemption Category 3 D Exemption Category 7 D Exemption Category 4 D Exemption Category 8 Section IV: Certification I hereby certify that the information herewith provided is to the best of my knowledge both accurate and true. Chief Administrative Agency Official! Authorized Designee (Please Print) Signature - Chief Administrative Agency Official! Authorized Designee Date -----------------------------------.----------. SED USE ONLY: Deputy Area/Program Office Institution ID: CD ITIIJ I have reviewed the payee information contained herein and hereby approve this agency for payment. Deputy Area (Please Print) Program Office (Please Print) Program Manager (Please Print) Signature - Program Manager Date -----------------------------------------.----. SED USE ONLY: Grants Finance SED Agency Number/BEDS Code (if applicable): Institution Type: ITIIIJ Institution Subtype: CD ITIIJ ITIIIJ Interest Eligible: Dyes D no Reviewer: Date: