Va Form 40-0895-14 - Checklist Of Major Requirements For State Or Tribal Government Cemetery Construction Grants Page 2

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SECTION A - PREAPPLICATION PHASE (Deadline is April 1 each year for VA receipt) (Continued)
CHECK
NO.
REQUIREMENT
DATE
RECEIPT
22.
Updated Form SF 424, SF 424C, SF 424D
23.
Updated schedule when each of the remaining requirements will be met.
24.
VA Notification to Precede to Bid the Project to Applicant
NOTE: The following certifications from the authorized state or tribal government official must be submitted to VA as part of the
Preapplication Phase.
A. Compliance with VA Form 40-0895-2, Certification of Compliance with Provisions of the
25.
Davis-Bacon Act
B. Compliance with VA Form 40-0895-7, Certification Regarding Debarment, Suspension, and
26.
Other Responsibility Matters - Primary Covered Transactions (State or Tribal Government)
C. Compliance with VA Form 40-0895-8, Certification Regarding Drug-Free Workplace
27.
Requirements for Grantees other than individuals
28.
D. Compliance with VA Form 40-0895-9, Certification Regarding Lobbying
E. Compliance with VA Form 40-0895-15, Certification of Cemetery Maintained in Accordance
29.
With National Cemetery Administration Standards.
SECTION B - APPLICATION PHASE (Deadline is July 15 for that FY Grant Award)
30.
Advertisement for bids
31.
Bid tabulations
VA Form 40-0895-10, Certification of Compliance with Federal Requirements-State or
32.
Tribal Government Cemetery Construction Grant.
33.
Final application - SF 424, based on bids and consistent with SF 424C
34.
Revised budget page (SF 424C) based on bids
35.
Compliance with VA Form 40-0895-12, Certification Regarding Debarment, Suspension,
Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions (Contractor)
36.
Three (3) signed copies of the Memorandum of Agreement (VA Form 40-0895-11)
SECTION C - POST GRANT AWARD
Submit a written request to the Director, State Cemetery Grants Service (41E), requesting the
37.
Department of Veterans Affairs to schedule a final grant program review. Include the name and
telephone number of the local point of contact for the project.
Submit the project equipment list; (if there is no equipment involved in the grant, please make a
38.
statement to that effect in the request for a final grant program review.
Add the following statement to the SF 271, Outlay Report and Request for Reimbursement for
Construction Programs and add the statement to the HHS final reimbursement request.
39.
"IT IS HEREBY AGREED THAT THE MONETARY COMMITMENT OF THE FEDERAL
GOVERNMENT WILL HAVE BEEN MET AND THE PROJECT WILL BE CONSIDERED
TERMINATED UPON PAYMENT OF THIS VOUCHER."
40.
Compliance with the Single Audit Act requirements
41.
Final Master Plan (one copy for SCGP and one copy for state cemetery), if appropriate.
42.
As Built Drawings (one copy for SCGP and one copy for state cemetery)
Custody and Transfer Receipt Final Release of Claims Final Invoice - one copy for SCGP, if
43.
appropriate.
44.
Close out grant.
PAGE 2 OF 2
VA FORM
40-0895-14
DEC 2012

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