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Backup Documents 02/28/2023 Item #16D8 lb D8 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. 'tile completed routing slip cunt original documents are to he fortc;u'dcd to time Couch Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents mast he retched in the County Attorney Office no later than\londay preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines f l through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the exception of the Chairman's signature,draw a line through routinglincs#1 through#2,complete the checklist,and forward to the County Attorney Office. Route to Addressee(s) (List in routing order) Office Initials Date 1. Lisa N. Carr Community and Human LNC 2/21/2023 Services 2. County Attorney Office County Attorney Office n0 I Z'Z3I Z3 3. BCC Office Board of County �/ 1 /C/ Commissioners RL 6 i3( .3/2./2 4, Minutes and Records Clerk of Court's Office 9cjY 342,/?, c w, PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,may need to contact staff for additional or missing information. Name of Primary Staff Lisa N.Carr,Sr.Grant Coordinator, Phone Number 239-252-2339 Contact/Department Community and Human Services Agenda Date Item was December 13, 2022 Agenda Item Number 16.D.8 Approved by the BCC Type of Document ESG-RUSH Agreement Number of Original 2 Attached Documents Attached PO number or account number if document is n/a to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A" in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1, Does the document require the chairman's original signature? YES 2. Does the document need to be sent to another agency for additional signatures? If yes, LNC provide the Contact Information(Name;Agency; Address;Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be LNC signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's LNC Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the LNC document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's LNC signature and initials are required. 7. in most cases(some contracts are an exception),the original document and this routing slip LNC should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 12/13/2022 and all changes made during 0 n the meeting have been incorporated in the attached document. The County op 4.0:9001r403 Attorney's Office has reviewed the changes,if applicable. 6-00.1% 9. Initials of attorney verifying that the attached document is the version approved by the Wty3at®1 BCC,all changes directed by the BCC have been made, and the document is ready for the O p uieo al ea�aa�K®5 Chairman's signature. aQaillgt=. I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12 16u Instructions 1) Return one signed copy to: Lisa N. Car Grants Coordinator II Collier County Government I Community and Human Services 3339 E. Tamiami Trail,Bldg. H, Suite 211 Naples, FL 34112 I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9,03.04,Revised 1.26.05,Revised 2,24.05;Revised 11/30/12 tb u Funding Approval/Agreement U.S. Department of Housing and Urban Development Emergency Solutions Grants Program—RUSH Funding Office of Community Planning and Development 42 U.S.C. 11364a(c)(1) Assistance Listing Number 14.231 1.Recipient Name and Address 2.Unique Federal Award Identification Number:E-22-UW-12-0016 County of Collier 3.Tax Identification Number: 59-6000558 3299 Tamiami Trl E Ste 700 Naples,FL 34211-5749 4.Unique Entity Identifier: JWKJ KYRP LLU6 5. Previous Obligation(Enter"0"for initial RUSH allocation) $0 6.Amount of Funds Obligated or Deobligated by This Action(+or-) $861,716 7.Total Amount of Federal Funds Obligated $861,716 8.Total Required Match:$0 9.Total Amount of Federal Award(including Required Match):$861,716 10.Period of Performance and Budget Period Start Date/Federal Award 11.Period of Performance and Budget Period End Date(the Date(the date listed in Box 16 of the Agreement for the initial RUSH date that is 24 months after the date listed in Box 10) allocation)(mm/dd/yyyy) 2/14/2023 (mm/dd/yyyy) 2/13/2025 12.Type of Agreement(check applicable box) 13.Special Conditions and Requirements ® Initial Agreement(Purpose#1 —Initial RUSH allocation) ❑ Amendment(Purpose#2—Deobligation of funds) ❑ Not applicable ®Attached as Appendix A ❑ Amendment(Purpose#3—Obligation of additional funds) General Terms and Conditions: I. This Agreement is made and entered into by and between the U.S. Department of Housing and Urban Development (HUD) and the Recipient identified in Box 1 of this Grant Agreement, pursuant to the authority provided under 42 U.S.C. 11364a(c)(1). II. 42 U.S.C. 11364a(c)(1), the Recipient's Consolidated Plan submissions (including applicable amendments), and this Agreement, including any special conditions and requirements attached to this Agreement, constitute part of this Agreement. Ill. Subject to these general terms and conditions, HUD will make the funds as specified above ("RUSH funds") available to the Recipient upon execution of this Agreement by the Recipient and HUD. Pre-award costs may be paid with RUSH funds as provided in Appendix A. IV. Except as otherwise provided by this Agreement and applicable HUD waivers and suspensions of Emergency Solutions Grants (ESG) requirements, the Recipient must use RUSH funds in accordance with Section 103 and Subtitle B of Title IV of the McKinney-Vento Homeless Assistance Act (42 U.S.C. 11371 et seq.) and the ESG regulations at 24 CFR Part 576 (as now in effect and as may be amended from time to time). V. In the event of any conflict between 24 CFR part 576 and applicable Federal statutes, including 42 U.S.C. 11364a and section 100261 of the MAP-21 Act, the Federal statute will control. In the event of any conflict between Title IV of the McKinney-Vento Homeless Assistance Act and 42 U.S.C. 11364a, 42 U.S.C. 11364a will control. VI. The Recipient agrees to assume responsibility for environmental review, decision making, and action under 24 CFR Part 58, except where the Recipient is a state and distributes RUSH funds to a unit of general local government, the Recipient must require the unit of general local government to assume that responsibility and must comply with the state's responsibilities under 24 CFR 58.4. CAO 16DL VII. The Recipient must apply the following minimum criteria for purposes of determining eligibility for services or rental assistance provided with RUSH funds: Each individual or family must (1) be homeless or at-risk of homelessness; (2) have been residing in an area affected by a major disaster declared pursuant to the Robert T. Stafford Disaster Relief and Emergency Assistance Act (Stafford Act) on or after December 20, 2019 (e.g., an area covered by DR- 4673-FL, dated September 29, 2022); and (3) have needs that will not be served or fully met by the TSA Program (42 USC 5170b) and other existing Federal disaster relief programs (including both Federal and non-Federal cost share). An individual or family need not requalify as homeless or at risk of homelessness, if the individual or family was already determined to meet the ESG definition of homeless or at risk of homelessness and was receiving ESG assistance when the major disaster occurred. "Existing Federal disaster relief programs" shall be understood to mean Federal programs that provide assistance for the purpose of disaster relief and are permanently authorized as of the Federal Award Date (box 10). VIII. The Recipient must establish and maintain adequate procedures to prevent any duplication of benefits with RUSH funds as required by section 312 of the Stafford Act, as amended (42 U.S.C. 5155). IX. The Recipient agrees to comply with the applicable requirements at 2 CFR part 200, as may be amended from time to time. Where any previous or future amendments to 2 CFR part 200 replace or renumber sections of part 200 that are cited specifically in 24 CFR part 576, activities carried out after the effective date of the part 200 amendments will be governed by the part 200 requirements as replaced or renumbered by the part 200 amendments. X. RUSH funds are not subject to 24 CFR 576.201 or other match requirements. Program income may be treated by the Recipient as an addition to the Recipient's RUSH grant (or the subrecipient's subgrant, if the income is generated by the subrecipient's activities), provided that the program income is used in accordance with the purposes and conditions of that grant or subgrant. Otherwise, program income must be deducted from allowable costs as provided by 2 CFR 200.307(e)(1). The program income definition in 24 CFR 576.2 will apply, except that costs that are incidental to generating program income and not charged to the RUSH grant or subgrant may be deducted from gross income to determine program income, as allowed under 2 CFR 200.307(b). XI. The Recipient must complete the "Indirect Cost Rate Schedule" attached as Appendix B and return it to HUD with this Agreement. The Recipient must provide HUD with a revised schedule when any change is made to the rate(s) included in the schedule. The schedule and any revisions HUD receives from the Recipient will be incorporated into and made part of this Agreement, provided that each rate included satisfies the applicable requirements under 2 CFR part 200, including appendices. XII. The Recipient must comply with the Award Term in Appendix A to 2 CFR Part 25, "System for Award Management and Universal Identifier Requirements," and the Award Term in Appendix A to 2 CFR Part 170, "Reporting Subaward and Executive Compensation Information." If the Total Amount of Federal Award (Box 9) exceeds $500,000, the Recipient must also comply with Appendix XII to 2 CFR part 200—Award Term and Condition for Recipient Integrity and Performance Matters. XIII. Nothing in this Agreement shall be construed as creating or justifying any claim against the Federal government or the Recipient by any third party. XIV. Without the Recipient's execution of an amendment or other consent, HUD may amend this Agreement either to provide additional funds to the Recipient under 42 U.S.C. 11364a(c)(1) or to deobligate funds under this Agreement in accordance with applicable law. .�jr; t6DB XV. To make a change described in 24 CFR 576.2OO(b), the Recipient must amend its plan as provided by 24 CFR 576.2OO(b), except that the Recipient will not be required to comply with any consultation or citizen participation requirements with respect to the amount provided in the initial RUSH allocation, provided that the Recipient publishes its planned changes on the Internet at the appropriate Government web site or through other electronic media. 14. For the U.S.Department of HUD(Name,Title,and Contact Information of 15.Signature 16.Date(mm/dd/yyyy) Authorized Official) / ,� 2/14/2023 Lisa A.Johnson .L s&- CPD Director 17. For the Recipient(Name and Title of Authorized Official) 1 e 19. Date(mm/dd/yyyy) Rick LoCastro,Chairman l Z 12QZ3 Board of County Commissioners,Collier County,Florida 1 3 Funding Information(HUD Accounting Use Only): PAS Code:HGD Region:04 Program Code:HAED Appropriation:0192 Office: Miami Allotment:3 Appro Symbol:86X0192-12 A pr vei s • rm anal legal ATTEST CRYSTAL K. KINLEL, CLERK Derek D. Perry By s _ d ik) 0 -' Assistant County Attsrrt >y s'' :A!"‘ ., Deputy ,Clerk Atte.$t a$to,Chaintiali's stoniatare xy;, travel • Cs i6U8 Appendix A—Special Conditions and Requirements 1. In accordance with 24 CFR 5.110 and as provided in HUD's letter notifying Recipient of its first RUSH allocation, the same waivers HUD made available on October 3, 2022, with respect use of ESG funds in response to Hurricane Ian are made available for the same justifications and subject to the same conditions with respect to the RUSH funding allocated to the Recipient. For reference, see: www.hud.gov/sites/dfiles/CPD/documents/Signed-Hurricane-Ian-CPD-Waivers.pdf 2. In accordance with 2 CFR 200.458 and as stated in HUD's letter notifying Recipient of its initial RUSH allocation, HUD provided prior approval of pre-award costs, subject to the following conditions: i. The pre-award costs must satisfy all allowable criteria under 2 CFR 200.403, except that the pre-award costs may be incurred on any date between and including the date of HUD's letter notifying Recipient of its initial RUSH allocation and the date immediately preceding the start date of the period of performance/budget period for the grant. ii. The pre-award costs must be necessary for efficient and timely performance of eligible RUSH activities. iii. Before committing to use RUSH funds to reimburse each pre-award cost, the Recipient must either make a written determination that the pre-award cost is for an activity that is exempt from environmental review or categorically excluded and not subject to review under related environmental laws and authorities under 24 CFR part 58, or part 50 if applicable, or verify that the applicable environmental review has been completed and a Request for Release of Funds has been approved in accordance with 24 CFR part 58, if applicable. iv. Although the pre-award costs may consist of costs incurred by the Recipient or its subrecipient(s), the subrecipient must receive the Recipient's prior written approval before incurring any pre-award costs and that written approval must be consistent with all of HUD's conditions for prior approval of pre-award costs. v. The documentation supporting each pre-award cost reimbursed with RUSH funds must show compliance with each of these conditions for HUD's prior approval of pre-award costs. vi. The Recipient must assume the risk of all pre-award costs it incurs or approves before executing its RUSH grant agreement with HUD. HUD will not be required to reimburse pre- award costs if for any reason the Recipient does not receive a RUSH grant, if the grant is less than anticipated and inadequate to cover such costs, or if the pre-award costs do not meet the conditions listed above. 16Q8 Appendix B -- Indirect Cost Rate Schedule The Recipient shall attach a schedule of its indirect cost rate(s) in the format set forth below to the executed Agreement that is returned to HUD. The Recipient shall provide HUD with a revised schedule when any change is made to the rate(s) described in the schedule. The schedule and any revisions HUD receives from the Recipient shall be incorporated herein and made a part of this Agreement, provided that the rate(s) described comply with 2 CFR part 200, subpart E. Instructions: The Recipient must identify each agency or department of the Recipient that will carry out activities under the grant, the indirect cost rate applicable to each department/agency (including if the de minimis rate is used per 2 CFR§200.414(1)), and the type of direct cost base to which the rate will be applied(for example, Modified Total Direct Costs (MTDC)). Do not include indirect cost rates for subrecipients. Recipient Direct Department/Agency Indirect cost rate Cost Base .12 D � Funding Approval/Agreement U.S. Department of Housing and Urban Development Emergency Solutions Grants Program—RUSH Funding Office of Community Planning and Development 42 U.S.C. 11364a(c)(1) Assistance Listing Number 14.231 I.Recipient Name and Address 2.Unique Federal Award Identification Number:E-22-UW-12-0016 County of Collier 3299 Tamiami Trl E Ste 700 3.Tax Identification Number: 59-6000558 Naples,FL 34211-5749 4.Unique Entity Identifier: JWKJ KYRP LLU6 5.Previous Obligation(Enter"0"for initial RUSH allocation) $0 6.Amount of Funds Obligated or Deobligated by This Action(+or-) $861,716 7.Total Amount of Federal Funds Obligated $861,716 9.Total Required Match:$0 9.Total Amount of Federal Award(including Required Match):$861,716 10. Period of Performance and Budget Period Start Date/Federal Award 11.Period of Performance and Budget Period End Date(the Date(the date listed in Box 16 of the Agreement for the initial RUSH date that is 24 months after the date listed In Box 10) allocation)(mm/dd/yyyy) 2/14/2023 (mm/dd/yyyy) 2/13/2025 12.Type of Agreement(check applicable box) 13.Special Conditions and Requirements ® Initial Agreement(Purpose#1 —Initial RUSH allocation) ❑Amendment(Purpose#2—Deobligation of funds) Not applicable ®Attached as Appendix A ❑ Amendment(Purpose#3—Obligation of additional funds) General Terms and Conditions: I. This Agreement is made and entered into by and between the U.S. Department of Housing and Urban Development (HUD) and the Recipient identified in Box 1 of this Grant Agreement, pursuant to the authority provided under 42 U.S.C. 11364a(c)(1). II. 42 U.S.C. 11364a(c)(1), the Recipient's Consolidated Plan submissions (including applicable amendments), and this Agreement, including any special conditions and requirements attached to this Agreement, constitute part of this Agreement. III. Subject to these general terms and conditions, HUD will make the funds as specified above ("RUSH funds") available to the Recipient upon execution of this Agreement by the Recipient and HUD. Pre-award costs may be paid with RUSH funds as provided in Appendix A. IV. Except as otherwise provided by this Agreement and applicable HUD waivers and suspensions of Emergency Solutions Grants (ESG) requirements, the Recipient must use RUSH funds in accordance with Section 103 and Subtitle B of Title IV of the McKinney-Vento Homeless Assistance Act (42 U.S.C. 11371 et seq.) and the ESG regulations at 24 CFR Part 576 (as now in effect and as may be amended from time to time). V. In the event of any conflict between 24 CFR part 576 and applicable Federal statutes, including 42 U.S.C. 11364a and section 100261 of the MAP-21 Act, the Federal statute will control. In the event of any conflict between Title IV of the McKinney-Vento Homeless Assistance Act and 42 U.S.C. 11364a, 42 U.S.C. 11364a will control. VI. The Recipient agrees to assume responsibility for environmental review, decision making, and action under 24 CFR Part 58, except where the Recipient is a state and distributes RUSH funds to a unit of general local government, the Recipient must require the unit of general local government to assume that responsibility and must comply with the state's responsibilities under 24 CFR 58.4. 6D8 VII. The Recipient must apply the following minimum criteria for purposes of determining eligibility for services or rental assistance provided with RUSH funds: Each individual or family must (1) be homeless or at-risk of homelessness; (2) have been residing in an area affected by a major disaster declared pursuant to the Robert T. Stafford Disaster Relief and Emergency Assistance Act (Stafford Act) on or after December 20, 2019 (e.g., an area covered by DR- 4673-FL, dated September 29, 2022); and (3) have needs that will not be served or fully met by the TSA Program (42 USC 5170b) and other existing Federal disaster relief programs (including both Federal and non-Federal cost share). An individual or family need not requalify as homeless or at risk of homelessness, if the individual or family was already determined to meet the ESG definition of homeless or at risk of homelessness and was receiving ESG assistance when the major disaster occurred. "Existing Federal disaster relief programs" shall be understood to mean Federal programs that provide assistance for the purpose of disaster relief and are permanently authorized as of the Federal Award Date (box 10). VIII. The Recipient must establish and maintain adequate procedures to prevent any duplication of benefits with RUSH funds as required by section 312 of the Stafford Act, as amended (42 U.S.C. 5155). IX. The Recipient agrees to comply with the applicable requirements at 2 CFR part 200, as may be amended from time to time. Where any previous or future amendments to 2 CFR part 200 replace or renumber sections of part 200 that are cited specifically in 24 CFR part 576, activities carried out after the effective date of the part 200 amendments will be governed by the part 200 requirements as replaced or renumbered by the part 200 amendments. X. RUSH funds are not subject to 24 CFR 576.201 or other match requirements. Program income may be treated by the Recipient as an addition to the Recipient's RUSH grant (or the • subrecipient's subgrant, if the income is generated by the subrecipient's activities), provided that the program income is used in accordance with the purposes and conditions of that grant or subgrant. Otherwise, program income must be deducted from allowable costs as provided by 2 CFR 200.307(e)(1). The program income definition in 24 CFR 576.2 will apply, except that costs that are incidental to generating program income and not charged to the RUSH grant or subgrant may be deducted from gross income to determine program income, as allowed under 2 CFR 200.307(b). Xl. The Recipient must complete the "Indirect Cost Rate Schedule" attached as Appendix B and return it to HUD with this Agreement. The Recipient must provide HUD with a revised schedule when any change is made to the rate(s) included in the schedule. The schedule and any revisions HUD receives from the Recipient will be incorporated into and made part of this Agreement, provided that each rate included satisfies the applicable requirements under 2 CFR part 200, including appendices. XII. The Recipient must comply with the Award Term in Appendix A to 2 CFR Part 25, "System for Award Management and Universal Identifier Requirements," and the Award Term in Appendix A to 2 CFR Part 170, "Reporting Subaward and Executive Compensation Information." If the Total Amount of Federal Award (Box 9) exceeds $500,000, the Recipient must also comply with Appendix XII to 2 CFR part 200—Award Term and Condition for Recipient Integrity and Performance Matters. XIII. Nothing in this Agreement shall be construed as creating or justifying any claim against the Federal government or the Recipient by any third party. XIV. Without the Recipient's execution of an amendment or other consent, HUD may amend this Agreement either to provide additional funds to the Recipient under 42 U.S.C. 11364a(c)(1) or to deobligate funds under this Agreement in accordance with applicable law. 16D8 XV. To make a change described in 24 CFR 576.200(b), the Recipient must amend its plan as provided by 24 CFR 576.200(b), except that the Recipient will not be required to comply with any consultation or citizen participation requirements with respect to the amount provided in the initial RUSH allocation, provided that the Recipient publishes its planned changes on the Internet at the appropriate Government web site or through other electronic media. 14. For the U.S.Department of HUD(Name,Title,and Contact Information of 15.Signature 16.Date(mm/dd/yyyy) Authorized Official) 2/14/2023 Lisa A.Johnson GrL CPD Director 7� 17. For the Recipient(Name and Title of Authorized Official) 1 rtat 19.Date(mm/dd/yyyy) Rick LoCastro,Chairman Board of County Commissioners,Collier County,Florida 12 I l 3 202..3 1 I Funding Information(HUD Accounting Use Only): PAS Code:HGD Region:04 Program Code: HAED Appropriation:0192 Office:Miami Allotment:3 Appro Symbol:86X0192-12 A ! pr VP s o rm and legal' . f' 4TT. ST$ CRYSTAL f.. KINZEL, CLERK I ) ' ( I ' ', De-re 1 D. Perry I By s t L;s `} ' 1 WI. iA-1 Assistant County Attsrrt :,y .v..:..D :pl`ity Clerk Attest asfb'Ctiairman's signature only. bD Appendix A—Special Conditions and Requirements 1. In accordance with 24 CFR 5.110 and as provided in l lUD's letter notifying Recipient of its first RUSH allocation, the same waivers HUD made available on October 3, 2022, with respect use of' ESG funds in response to Hurricane Ian are made available for the same justifications and subject to the same conditions with respect to the RUSH funding allocated to the Recipient. For reference, see: www.hud.gov/sites/dfiles/CPD/documents/Signed-hurricane-lan-CPD-Waivers.pdf 2. In accordance with 2 CFR 200.458 and as stated in I lUD's letter notifying Recipient of its initial RUSH allocation, HUD provided prior approval of pre-award costs, subject to the following conditions: i. The pre-award costs must satisfy all allowable criteria under 2 CFR 200.403, except that the pre-award costs may be incurred on any date between and including the date of IIUD's letter notifying Recipient of its initial RUSH allocation and the date immediately preceding the start date of the period of performance/budget period for the grant. ii. The pre-award costs must be necessary for efficient and timely performance of eligible RUSH activities. iii. Before committing to use RUSH funds to reimburse each pre-award cost, the Recipient must either make a written determination that the pre-award cost is for an activity that is exempt from environmental review or categorically excluded and not subject to review under related environmental laws and authorities under 24 CFR part 58, or part 50 if applicable, or verify that the applicable environmental review has been completed and a Request for Release of Funds has been approved in accordance with 24 CFR part 58, if applicable. iv. Although the pre-award costs may consist of costs incurred by the Recipient or its subrecipient(s), the subrecipient must receive the Recipient's prior written approval before incurring any pre-award costs and that written approval must be consistent with all of l lUD's conditions for prior approval of pre-award costs. v. The documentation supporting each pre-award cost reimbursed with RUSH funds must show compliance with each of these conditions for HUD's prior approval of pre-award costs. vi. The Recipient must assume the risk of all pre-award costs it incurs or approves before executing its RUSH grant agreement with HUD. HUD will not be required to reimburse pre- award costs if for any reason the Recipient does not receive a RUSH grant, if the grant is less than anticipated and inadequate to cover such costs, or if the pre-award costs do not meet the conditions listed above. c"� 1608 Appendix B -- Indirect Cost Rate Schedule The Recipient shall attach a schedule of its indirect cost rate(s) in the format set forth below to the executed Agreement that is returned to HUD. The Recipient shall provide HUD with a revised schedule when any change is made to the rate(s) described in the schedule. The schedule and any revisions HUD receives from the Recipient shall be incorporated herein and made a part of this Agreement, provided that the rate(s) described comply with 2 CFR part 200, subpart E. Instructions: The Recipient must identO,each agency or department of the Recipient that will carry out activities under the grant, the indirect cost rate applicable to each department/agency (including if the de minimis rate is used per 2 CFR§200.4140), and the type of direct cost base to which the rate will be applied(for example, Modified Total Direct Costs (MTDC)). Do not include indirect cost rates for subrecipients. Recipient Direct Department/Agency Indirect cost rate Cost Base