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HomeMy WebLinkAboutAddendum - 1NOTICE OF AWARDU.S. Small Business Administration 2. Grant/Cooperative Agreement No.:1. AUTHORIZATION (Legislation/ Regulation) From Through (Mo./Day/Yr.)5. BUDGET PERIOD (Mo./Day/Yr.) From Through 6. FEDERAL CATALOG NO. 7. ADMINISTRATIVE CODES (Mo./Day/Yr.)4. PROJECT PERIOD (Mo./Day/Yr.) 3. RECIPIENT: (Name, Organizational Unit, Address) 8. TITLE OF PROJECT/PROGRAM (limit to 53 spaces) 9. AWARD AMOUNT Amount of SBA Financial Assistance 10.DIRECTOR OF PROJECT (Program or Center Director, Coordinator or Principal Investigator) 11.RECOMMENDED FUTURE SUPPORT (Subject to the availability offunds and satisfactory progress of the project) NAME BUDGET YEAR TOTAL DIRECT COST BUDGET YEAR TOTAL DIRECT COSTLastFirstInitial ADDRESS:a. b. Yes No(Other Terms & Conditions Attached) SBA Funds Only Total project costs including all other financial participation. FederalShare Non-FederalShare a. Personal Service b. Fringe Benefits c. Consultants d. Travel e. Equipment g. Contractual 14. THIS AWARD IS SUBJECT TO THE FOLLOWING COST PRINCIPLESAND OMB UNIFORM ADMINISTRATIVE REQUIREMENTS: 2 CFR Chapter 1, Chapter II, Part 200, et al, uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. Part 180 - OMB Guidelines to Agencies on government debarment and suspension (Non Procurement) In-KindNon-Federal Program Inc.Non-Federal i. TOTAL DIRECT COSTS j. Indirect cost (Rate). 13. REMARKS 12. Approved Budget (Excludes SBA Direct Assistance) f. Supplies h. Other k. OTHER APPL. COSTS l. TOTAL APPROVED BUDGET subject to adjustment in accordance with SBA policy 15. THIS AWARD IS SUBJECT TO THE TERMS AND CONDITIONS ON THE REVERSE SIDE 18.CONGRESSIONALDISTRICT NO. 16. CRS - EIN 17. COUNTY NAME 19a. CITY CODE b. COUNTY CODE c. STATE CODE d. PROGRAM CODE BUDGET CODE DOCUMENT NO.AMT. ACTION FIN. ASST.TYPE OF ORGANIZATION 20a.b.c.d. 21. AGENCY OFFICIAL (Signature, Name and Title)22. DATE ISSUED (Mo./Day/Yr.) 23. RECIPIENT OFFICIAL (Signature, Name and Title)24. DATE 2/16/2024 SBA FORM 1222 (4-15) Previous editions obsolete OMB Approval No.: 3245-0140 Expiration Date 7/31/2018 PURPOSE: This form is used to notify grant recipients of award reporting and record keeping requirements. Grantees are required to review and sign the form and return to SBA at the address: SBDC- SBA/OSBDC, 409 Third Street, SW 6th Floor, Washington, DC 20416All other SBA/OGM, 409 Third Street, 5th Floor, Washington, DC 20416 *Must meet all matching or cost participation requirements    PHUC NGUYEN Digitally signed by PHUC NGUYEN Date: 2023.12.13 07:55:17 -05'00' CAG-23-142, Adden #1-24 City of Renton Mayor Armondo Pavone Attest: Jason A. Seth, City Clerk SBA FORM 1222 (4-15) Previous editions obsolete Note: The estimated burden completing this form is 80 hours per response. You will not be required to respond to any collection of information unless it displays a currently valid OMB approval number. Comments on the burden should be sent to U.S. Small Business Administration, Chief, AIB, 409, 3rd St., S.W., Washigton, D.C. 20416 and Desk Office for Small Business Administration, Office of Management and Budget, New Executive Office Building, room 10202 Washington, D.C. 20503. OMB Approval (3245-0140). PLEASE DO NOT SEND FORMS TO OMB.