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The form collects recipient identification details, type of organization, award and project contact information, and required business assurances. 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The use of the Pre-Award Information Sheet template is not required, but the data elements within the Pre-Award Information Sheet template are required.  \n\n| Recipient Name: |  | Award Number: |  |\n| --- | --- | --- | --- |\n| UEI: |  |  |  |\n| Business Officer: |  | BC Phone Number/Email: |  |\n| Project Investigator (PI): |  | PI Phone Number/Email: |  |\n\nA.  TYPE OF ORGANIZATION – Please indicate the type of organization of the Recipient by selecting one of the following:  \n☐ State Energy Office  \n☐ Indian Tribal Government  \nB.  BUSINESS ASSURANCES AND PAYMENT INFORMATION  \n1. DISCLOSURE OF POTENTIAL IMPROPRIETIES  \nBelow, please disclose if any of the following conditions exist. If the answer to any question (a) through (g) below is yes, provide a detailed explanation in an attachment to this form.  \na. Is the proposed Recipient, Subrecipient(s), or any of the Recipient’s or Subrecipient’s principals 1 under investigation for or charged with a covered offense2?  \n☐ Yes  \n☐ No  \nb. Has the proposed Recipient, Subrecipient(s), or any of the Recipient’s or Subrecipient’s principals been convicted of a covered offense in the last five years or had a civil judgment rendered against them for oneof those offenses in that time period?  \n☐ Yes  \n☐ No  \n1 For this form,“principal” means: (1) An officer, director, owner, partner, PI, or other person (as defined in 2 C.F.R. 180.95) within the Project Team with management or supervisory responsibilities related to this project and any resulting transaction; or (2) A consultant or other person, whether or not employed by the Recipient, Subrecipient, or their principals, or paid with Federal funds, who (a) is in a position to handle Federal funds,(b) is in a position to influence or control the use of those funds, or (c) occupies a technical or professional position capable of substantially influencing the development or outcome of an activity required to perform the transaction, including but not limited to, any Co-PIs.  \n2 For this form,“covered offenses” include: (1) Commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public or private agreement or transaction; (2) Violation of Federal or State antitrust statutes, including those proscribing price fixing between competitors, allocation of customers between competitors, and bid rigging; (3) Commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, receiving stolen property, making false claims, or obstruction of justice; or (4) Commission of any other offense indicating a lack of business integrity or business honesty that seriously and directly affects the Recipient’s present responsibility.  \nJuly 2023  \nc. Is the proposed Recipient, Subrecipient(s), or any of the Recipient’s or Subrecipient’s principals under investigation for potential violation of U.S. export control laws and regulations, or has the proposed Recipient, Subrecipient(s), or any of the Recipient’s or Subrecipient’s principals been convicted of any violations of U.S. export control laws and regulations?  \n☐ Yes  \n☐ No  \nd. Is the proposed Recipient or Subrecipient(s) under investigation for potential violations ofthe Drug-Free Workplace Act of 1988, or has the proposed Recipient or Subrecipient(s) been convicted of any violations of the Drug-Free Workplace Act of 1988?  \n☐ Yes  \n☐ No  \ne. Is the proposed Recipient, Subrecipient(s), or any of the Recipient’s or Subrecipient’s principals under investigation for research misconduct, or has the proposed Recipient, Subrecipient(s), or the","cbCaiuUuUWu7D1Lh","https://ap.wps.com/l/cbCaiuUuUWu7D1Lh","pdf",554720,"English","# Pre-Award Information Sheet\n# Recipient Identification\n## Type of Organization\n## Business Assurances and Payment Information\n### Disclosure of Potential Improprieties\n### Potential Conflicts of Interest","[{\"question\":\"What is the purpose of the Pre-Award Information Sheet?\",\"answer\":\"It documents information required to process SCEP financial assistance awards and collects the disclosures and assurances needed for pre-award review.\"},{\"question\":\"Who must provide and certify the information in the form?\",\"answer\":\"The proposed Recipient must provide the information on behalf of itself and all Subrecipients and certify it as accurate and complete.\"},{\"question\":\"What disclosures are required under business assurances?\",\"answer\":\"The form requires disclosures on potential improprieties (such as covered offenses, export control violations, Drug-Free Workplace Act issues, research misconduct, and suspension/debarment) and conflicts of interest, including financial and organizational conflicts.\"}]","Pre-Award Information Sheet - Home Energy Rebates | PDF"]