AppCoverPage.docx

This is an Application Cover Page for the Virginia RHTP (Rural Health Training Program) - Community Paramedicine initiative, a state-level funding opportunity administered by Virginia. The document serves as the required first page of a completed application package and establishes the framework for organizations to request funding for community paramedicine projects. Organizations must submit applications using the method specified on the RFA cover page, with all project details including the project title and total funding requested clearly identified on this cover page.

The application requires submission of comprehensive organizational information, including legal name, organization type (state agency, local government, tribal entity, nonprofit 501(c)(3), for-profit entity, institution of higher education, hospital/health system, or other), year established, number of employees, website, EIN, and Unique Entity Identifier (UEI) with SAM.gov registration status. The Authorized Organizational Representative must certify that all application information is accurate and complete, and that the organization accepts all Virginia RHTP subrecipient award conditions and will comply with 2 CFR Part 200, CMS RHTP Program Terms and Conditions, and all applicable federal and state requirements. The AOR certification includes the representative's full name, title, email, direct phone number, and signature with date.