2023 One Call Application Template.docx

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[Insert Your Organization Name Here] One Call Grant Application Template

Use this template to fill out the required text elements of your application as outlined in the Funding Opportunity Announcement Section D.

1. Complete page 2. This page must include your organization name and an authorized signature (this document can be converted to Adobe PDF and signed electronically if your organization has that capability, you can contact us if you need assistance.)

2. Applicant Eligibility responses are required. For any ‘no’ answer, provide a detailed explanation.

3. Project Requests by Priority are required.

a. If you are not requesting funding a priority you can delete those pages.

b. If you have multiple projects under a priority each one must be listed separately (copy/paste the entire template page).

4. Detailed Budget Narrative per project is required.

5. You must attach a signed/scanned copy of this document to your grants.gov forms package.

6. You must submit a signed copy of your application electronically through Grants.gov.

20222023 One Call Grant Application

The ____ {your organization name} __________hereby applies to the Department of Transportation for Federal funds appropriated for the support of Programs established under 49 U.S.C. Section 60134 et seq.

The State agency plans to carry out the Program, as described in the "Priority Project Requests". To accomplish the program, the state agency proposes to expend funds as set forth in the "One Call Grant Estimated Budget."

Authorized Signature:____________________________

Title:_____________________________________

Date:_____________________________________

Indicate the One Call Enforcement Authority for your State and/or Agency:

20222023 One Call Grant Applicant Eligibility

Changes to Section 6103 of the Pipeline Safety, Regulatory Certainty, and Job Creation Act of 2006, effective 01/03/2014, will affect States eligibility in applying for the One Call Grant. The State agency submitting the application is required to answer the following questions and provide data to clearly demonstrate compliance with these requirements. Failure to provide the requested information may void the application.

a) Does the State one-call notification program allow all underground facility operators, including all government operators, to participate as appropriate*? (list any pipeline exemptions) (Required – Yes or No, please provide a link to your state statute to support your answer)

b) Does the State one-call notification program allow all excavators, including all government and contract excavators, to participate as appropriate*? (Required – Yes or No, please provide a link to your state statute to support your answer)

c) Does the State one-call notification program provide for flexible and effective enforcement under State law? (Please provide citation to the state statute for enforcement and identify the enforcement authority.) (Required – Yes or No, please provide a link to your state statute to support your answer)

d) Does the State one-call notification program require that the one-call notification system requirements of the program are applicable without exemptions to municipalities, State agencies, or their contractors? (If you are currently determined to be ineligible by PHMSA based on this requirement, you do not qualify for this grant!) (Required – Yes or No, please provide a link to your state statute to support your answer)

e) Does the State one-call notification program provide for consideration of the gravity of the offense and risk to the public in determining appropriate enforcement? (Required – Yes or No, please provide a link to your state statute to support your answer)

f) Does the State one-call notification program provide for no cost underground facilities locate requests, excluding design, for all individuals planning excavation activities? (Required – Yes or No, please provide a link to your state statute to support your answer)

g) Does the State one-call notification program provide for voluntary participation of underground facilities owners or an activity of a type of excavator which have been determined by the State to be de minimis risk to public safety? (Required – Yes or No, please provide a link to your state statute to support your answer)

h) To the extent the State has determined it to be appropriate and necessary; has the State provided for administrative or civil penalties commensurate with the seriousness of a violation of the State one-call notification program by an excavator or facility owner? (Required – Yes or No, please provide a link to your state statute to support your answer)

Priority 1 Request:

1.1 Enter the title of this project: type or insert text here

1.2 Enter the Priority/SubCategory number from Appendix B: type or insert text here

1.4 Has this activity been performed previously? If yes, what were the results? Provide sufficient details about the effectiveness of this project in order to support the approval of this project for another year:

type or insert text here

1.5 What do you plan to do with the requested funds for this project? If you have entered costs under the "Other" budget category, you must explain those costs here:

type or insert text here

1.6 Estimated budget for this element:

1.7 Budget Description – Provide as detailed a description as possible of each of the “a” through “k” items budgeted above: type or insert text here Note:

· If you are purchasing items/supplies/other, then name what those things are, how many, and how much each item costs.

· If your budget estimate includes indirect costs, please attach a copy of your approved indirect cost rate agreement along with your proposal. If your entity does not have an approved indirect cost rate agreement, please include a statement to that effect in your budget request (per the de minimis cost rate in 2 CFR Part 200).

· If your budget includes personnel costs, please include a complete breakdown, including personnel title/position, hourly rate, and the number of hours expected to be spent by each personnel on the proposed project.

· If your proposal includes travel costs, please include adequate details on how the cost has been calculated including travel fare, hotel costs, per diem for each anticipated travel excursion, etc.

· If your proposal includes equipment costs, please include adequate details on how the cost has been calculated, including information on each specific equipment piece(s) required and their individual costs.

Detailed Supplies Listing if applicable:

Description, Quantity, Price per unit, total price

Priority 2 Request:

2.1 Enter the title of this project: type or insert text here

2.2 Enter the Priority/SubCategory number from Appendix B: type or insert text here

2.4 Has this activity been performed previously? If yes, what were the results? Provide sufficient details about the effectiveness of this project in order to support the approval of this project for another year: type or insert text here

2.5 What do you plan to do with the requested funds for this project? If you have entered costs under the "Other" budget category, you must explain those costs here: type or insert text here

2.6 Estimated budget for this element:

2.7 Budget Description – Provide as detailed a description as possible of each of the “a” through “k” items budgeted above: type or insert text here Note:

· If you are purchasing items/supplies/other, then name what those things are, how many, and how much each item costs.

· If your budget estimate includes indirect costs, please attach a copy of your approved indirect cost rate agreement along with your proposal. If your entity does not have an approved indirect cost rate agreement, please include a statement to that effect in your budget request (per the de minimis cost rate in 2 CFR Part 200).

· If your budget includes personnel costs, please include a complete breakdown, including personnel title/position, hourly rate, and the number of hours expected to be spent by each personnel on the proposed project.

· If your proposal includes travel costs, please include adequate details on how the cost has been calculated including travel fare, hotel costs, per diem for each anticipated travel excursion, etc.

· If your proposal includes equipment costs, please include adequate details on how the cost has been calculated, including information on each specific equipment piece(s) required and their individual costs.

Priority 3 Request:

3.1 Enter the title of this project: type or insert text here

3.2 Enter the Priority/SubCategory number from Appendix B: type or insert text here

3.4 Has this activity been performed previously? If yes, what were the results? Provide sufficient details about the effectiveness of this project in order to support the approval of this project for another year: type or insert text here

3.5 What do you plan to do with the requested funds for this project? If you have entered costs under the "Other" budget category, you must explain those costs here: type or insert text here

3.6 Estimated budget for this element:

3.7 Budget Description – Provide as detailed a description as possible of each of the “a” through “k” items budgeted above: type or insert text here Note:

· If you are purchasing items/supplies/other, then name what those things are, how many, and how much each item costs.

· If your budget estimate includes indirect costs, please attach a copy of your approved indirect cost rate agreement along with your proposal. If your entity does not have an approved indirect cost rate agreement, please include a statement to that effect in your budget request (per the de minimis cost rate in 2 CFR Part 200).

· If your budget includes personnel costs, please include a complete breakdown, including personnel title/position, hourly rate, and the number of hours expected to be spent by each personnel on the proposed project.

· If your proposal includes travel costs, please include adequate details on how the cost has been calculated including travel fare, hotel costs, per diem for each anticipated travel excursion, etc.

· If your proposal includes equipment costs, please include adequate details on how the cost has been calculated, including information on each specific equipment piece(s) required and their individual costs.

Total Budget Request:

Add up each priority item budget and insert the total for each category below

DIRECT COSTS

Personnel ..............................................................................................................................$ Fringe Benefits .....................................................................................................................$ Travel ...................................................................................................................................$ Equipment ............................................................................................................................$ Supplies ................................................................................................................................$ Contractual ...........................................................................................................................$ Other .....................................................................................................................................$ Total Direct ..........................................................................................................................$

INDIRECT COSTS

Indirect Charges ....................................................................................................................$

TOTAL COSTS FOR THIS REQUEST……………………………………………………$

Appendix B - One Call Grant Funding Priority List

The Priority List is not intended to be a restricted or all-inclusive list. Other projects with clear damage prevention benefits will be considered. The requestor must explain which priority level is appropriate and why. The project must clearly meet one or more of the criteria set forth in 49 USC § 6106.

Priority 1

1.1 Compliance Enforcement - Legal assistance with enforcement actions

1.2 Compliance Enforcement - Cost of enforcement and/or complaint investigations

1.3 Compliance Enforcement - Cost of enforcement actions (**NOTE: this does not include equipment**)

1.4 State agency collection and analysis of data - One Call center statistics

1.5 State agency collection and analysis of data - One Call center membership

1.6 State agency collection and analysis of data - Compliance/Noncompliance statistics

1.7 State agency collection and analysis of data - Causes of noncompliance

1.8 State agency collection and analysis of data - Frequency, cause, and consequences of dig-ins

1.9 State agency collection and analysis of data - Identification of problem areas or individuals

1.10 State agency collection and analysis of data - Incorporation of excavation damage data tools (such as DIRT, Virtual DIRT, etc.) into state monitoring and compliance program

1.11 State agency collection and analysis of data - Submission of state-collected excavation damage data to other data collection systems (such as DIRT and Virtual DIRT)

1.12 Legislation and Rulemaking - Obtaining input from affected interests

1.13 Legislation and Rulemaking - Assistance drafting language

1.14 Legislation and Rulemaking - Testimony before legislative/rulemaking bodies

1.15 Legislation and Rulemaking - Studies to identify legislative needs

1.16 Start-up costs for the state agency only - Mandated by new or amended law or rules

1.17 Start-up costs for the state agency only - Equipment Related to Start-up (Computer programming and software must be used exclusively for damage prevention activities. Computer upgrades for agency-wide activities are not eligible for funding.)

1.18 Start-up costs for the state agency only - Records Systems and databases

1.19 Start-up costs for the state agency only - Developing Procedures

1.20 Start-up costs for the state agency only - First-year information campaign on the new/changed law or rules (**A state cannot request grant funds to implement proposed legislation - the legislation must have already been enacted.**)

1.21 Other Priority 1

Priority 2

2.1 One Call Membership Initiatives for Operators - Initial Membership Fees

2.2 One Call Membership Initiatives for Operators - Fax Machines

2.3 One Call Membership Initiatives for Operators - Computer Equipment

2.4 One Call Membership Initiatives for Operators - Communication Improvements

2.5 One Call Membership Initiatives for Operators - E-mail Access

2.6 One Call Membership Initiatives for Operators - Dedicated Phone Line

2.7 One Call Membership Initiatives for Operators - Locating Equipment and training

2.8 Consolidation of Multiple One Call Centers (only costs incurred by the State agency) - State agency expense to encourage consolidation

2.9 Consolidation of Multiple One Call Centers (only costs incurred by the State agency) - One Call center consolidation expenses

2.10 Consolidation of Multiple One Call Centers (only costs incurred by the State agency) - First year awareness campaigns for new One Call center and/or phone number

2.11 Training of state inspection or enforcement personnel - Facility locating methods and technology

2.12 Training of state inspection or enforcement personnel - Provisions of state One Call law or regulations

2.13 Equipment to support on-going activities (Computer programming and software must be used exclusively for damage prevention activities. Computer upgrades for agency-wide activities are not eligible for funding.) (Computer programming and software. All requests for equipment will be requested under this priority beginning in 2014)

2.14 Location Capabilities - Development and/or conduct of training for locators

2.15 Location Capabilities - Field trials or demonstrations of new technology locating equipment

2.16 Efforts to encourage operators, excavators and others to contribute to data collection systems such as DIRT

2.17 Other Priority 2

Priority 3

3.1 Development and/or conduct of state-provided training programs for excavators (includes training DVDs)

3.2 Development and/or conduct of state-provided training programs for operators (includes training DVDs)

3.3 Development and/or distribution of educational items or materials (includes training DVDs)

3.4 Development and/or conduct of damage prevention awareness campaigns - Public Service Announcements

3.5 Development and/or conduct of damage prevention awareness campaigns - Informational Mailings

3.6 Development and/or conduct of damage prevention awareness campaigns – Advertisements

3.7 Development and/or conduct of damage prevention awareness campaigns - One Call center awareness and outreach

3.8 Development and/or conduct of damage prevention awareness campaigns - Booths/exhibits for damage prevention outreach

3.9 Development and/or conduct of damage prevention awareness campaigns - 811 awareness campaigns

3.10 Record retention and recording capabilities for One Call notification systems; and making the data available to the state.

3.11 Safe Digging Sweepstakes or One-Call Lottery initiatives

3.12 Enhanced White Lining (EWL) and Enhanced Positive Response (EPR) initiatives

3.13 Other Priority 3