Brownfields in New England

Post-Award Forms & Reporting

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For your convenience, the forms below designated by an SFF are in a "screen-fillable" format. Using Adobe Acrobat in version 4.0 or higher, you can open the form and fill in the information right on the screen. You may then print out the information and include in your application or reporting packet.

Program-Specific Guidance Assessment Revolving Loan Fund Cleanup Job Training Targeted Brownfields Assessments State Assessment Showcase Communities

• Grant Management Documents
• Payment Requests
• Reporting
  • Quarterly Reports
  • MBE/WBE
  • Property Profile Form
  • ACRES
  • Federal Financial Report
• Closeout Process

Grants Management Documents

Grant Application/Amendment Forms

• SF-424 Application for Federal Assistance (PDF) (6 pp, 165K, SFF)
• SF-424A Budget Information (PDF) (5 pp, 161K, SFF) | Text Version (MS Word) (174K)
• Standard Form 424B Assurances – Non-Construction (PDF) (2 pp, 42K, SFF) | Text Version (MS Word) (55K)
• Standard Form LLL Disclosure of Lobbying Activities (PDF) (2 pp, 38K, SFF) | Text Version (MS Word) (52K)
• EPA Form 4700-4 Pre-award Compliance Certification (PDF) (2 pp, 27K)| Text Version (MS Word) (78K)
• Certification Regarding Lobbying (PDF) (1 pg, 19K, SFF) | Text Version (MS Word) (37K)
• Workplan Templates
  • Assessment Grant (PDF) (7 pp, 210K)| Text Version (MS Word) (128K)
  • Revolving Loan Fund Grant (PDF) (7 pp, 155K)| Text Version (MS Word) (105K)
  • Cleanup Grant (PDF) (4 pp, 181K)| Text Version (MS Word) (87K)
• Intergovernmental Review Contact List for states which require such review (ME, NH, and RI applicants).
• Additional forms may be found on the following web sites:
  • EPA Grants & Debarment
  • The White House - Office of the Management and Budget

Payment Requests

EPA 190-F-04-001 US EPA Payment Request (PDF) (1 pg, 40K, SFF)

Please fax your Payment Request to 702-798-2423.

Point of Contact for Region 1:
Colleen Garis (garis.colleen@epa.gov) at 702-798-2406
US Environmental Protection Agency
Las Vegas Finance Center
P.O. Box 98515
Las Vegas, NV 89193-8515

Reporting

Quarterly Reporting includes the following:

Report Grant Awarded Prior to 2008 Grant Awarded in or after 2008 Quarterly Report Quarterly * Property Profile Forms (If not using ACRES) Quarterly * MBE/WBE Report Quarterly * Semiannually **

* Periods ending March 31, June 30, September 30 & December 31
** Periods ending March 31 & September 30

Reports are due 30 days after the end of the reporting period.

Quarterly Reports

• Assessment Grant Quarterly Report Template (MS Word) (4 pp, 100K)
• Cleanup Grant Quarterly Report Template (MS Word) (4 pp, 49K)
• Revolving Loan Fund Program Report Template (MS Word) (4 pp, 98K)
• Job Training Grant Quarterly Report Template (MS Word) (7 pp, 89K)
• Job Training Reporting Form (PDF) (4 pp, 141K, SFF)

Please email or mail a copy of your quarterly reports and/or property profile forms to each person listed below:

Brownfields Data Manager (r1bf_forms@epa.gov) U.S. Environmental Protection Agency One Congress Street, Suite 1100 (Mail Code HIO) Boston, MA 02114-2023

Brownfields Data Manager (bf_forms@epa.gov) U.S. Environmental Protection Agency Ariel Rios Building (MS-5105) 1200 Pennsylvania Avenue, N.W. Washington, DC 20460

MBE/WBE Report

EPA Form 5700-52A Minority-Owned Business Enterprises / Women-Owned Business Enterprises Reports (MBE/WBE) (PDF) (5 pp, 50K)

Please email or mail a copy of your MBE/WBE reports to:

Valerie Bataille (bataille.valerie@epa.gov) Grants Management Office (MGM) USEPA, Region 1 – New England One Congress Street, Suite 1100 Boston, MA 02114-2023

Your Project Officer Office of Site Remediation & Restoration One Congress Street, Suite 1100 (Mail Code HBT) Boston, MA 02114-2023

Property Profile Form

The new Property Profile Form is available at: http://www.epa.gov/brownfields/pubs/rptforms.htm

ACRES

The Assessment, Cleanup and Redevelopment Exchange System (ACRES) is an online database for Brownfields Grantees to electronically submit data directly to EPA.

• Current Users – Login to ACRES via CDX
• New Users – If you are new to ACRES, you will need to register with the Central Data Exchange (CDX). Follow the steps in the Quick Reference Guide for Registering with CDX (PDF) (5 pp, 377K) to start using ACRES

Federal Financial Report

• SF425 Federal Financial Report (FFR) (Excel) (1 pg, 31K)
  As of Oct 1, 2009, this form replaces the SF269 and SF272
• Instructions on how to prepare the form (PDF) (5pp, 53K)

Closeout Process

Closeout reports are due no later than 90 days after the end of the cooperative agreement period of performance. The reports required for closeout are:

• Final Federal Financial Report
  • SF-425, Federal Financial Report (PDF) (1 pg, 42K) | Text Version (Excel) (1 pg, 58K)
  • Instructions for SF-425, Federal Financial Report (PDF) (5 pp, 53K)
• Final MBE/WBE Report
  • EPA Form 5700-52A Minority-Owned Business Enterprises / Women-Owned Business Enterprises Reports (MBE/WBE) (PDF) (5 pp, 50K)
• Final Technical Report
  The final technical report should be in the format of a Quarterly Report (See above for template) and summarize all activities performed during the grant period to include:
  • a final budget
  • a list of all sites assessed/cleaned up using grant funding
  • all activities performed using grant funding
    
    
• Final Lobbying Certification
  • EPA Form 5700-53 Lobbying and Litigation Certificate (PDF) (1 pg, 59K, SFF)

Please mail completed documents to:

U.S. Environmental Protection Agency Grants Management Office One Congress Street, Suite 1100 (Mail Code MGM) Boston, MA 02114-2023

Your Project Officer Office of Site Remediation & Restoration One Congress Street, Suite 1100 (Mail Code HBT) Boston, MA 02114-2023

The Final Federal Financial Report must also be emailed or faxed to:

Colleen Garis (garis.colleen@epa.gov)
Fax: 702-798-2423
Voice: 702-798-2406
US Environmental Protection Agency
Las Vegas Finance Center
P.O. Box 98515
Las Vegas, NV 89193-8515