APPENDIX A - ITD.docx

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Fiscal Year 2020 High Priority Program - Innovative Technology Deployment (HP-ITD)
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FM-MHP-20-002
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Updated version- Required Document Checklist

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APPENDIX A: Application Package Requirement Checklist

Below is a non-exhaustive list of documents necessary for a responsive grant application announcement. Please note that this list is intended to assist applicants in compiling their application. However, because the required documents may differ slightly based on the nature of the grant application, applicants should not rely solely on this checklist and must still read the entire NOFO to ensure that they have included all required documents.

FMCSA reserves the right to request additional documentation or information to confirm compliance with applicable laws.

Revised – this version replaces the Checklist included in the FY 2020 posted NOFO

Document Name
Document Description and Location Information
Submit in:
Brief Introduction
Include a description of the goal(s) of the application and the applicable program priority(s) met by the application’s projects.
Grants.gov
Problem Statement
A quantitative description of the identified problem. Include details on the data used to identify the problem and to establish the baseline.
Grants.gov
Performance Objective
A description of the applicant’s quantifiable goal related to the above problem statement.
Grants.gov
Program Activity Plan
A description of the activities the applicant believes will help mitigate the problem.
Grants.gov
Performance Measurement Plan
A description of how the applicant will measure progress towards the performance objective goal, such as quantifiable and measurable outputs.
Grants.gov
Monitoring and Reporting Plan
A description of the applicant’s method for ongoing monitoring of the progress of the project. This should include who will conduct the monitoring, the frequency with which it will be carried out, and how and to whom reports will be made.

Grants.gov

Budget Narrative
A budget narrative is a description, by budget category (object class) that details the costs necessary to complete the proposed projects.
Grants.gov
SF-424 Application for Federal Assistance
Required standard application form for all requests for Federal assistance. Form requests contact information for: 1) Lead Principal Investigator or Program Director (program/project manager) [enter in Box 8f]; and 2) Authorized Representative (AR) Official (authorized signer) [enter in AR section following Box 21]. Available in the Grants.gov application.

Grants.gov

SF-424A Budget Information for Non- Construction Programs
Required standard budget form for requests for Federal assistance. Available in the Grants.gov application package.
Grants.gov

SF-424B Assurances for Non-Construction Programs

Standard assurances form associated with accepting Federal assistance funds. This document indicates that the organization is in substantial compliance with various programs, regulations, and Federal laws for a non-construction program. Available in the Grants.gov application package.
Grants.gov
Grants.gov Lobbying Form
Required form that allows organizations to indicate that they do not engage in lobbying activities. Available in the Grants.gov application package.
Grants.gov
SF-LLL Disclosure of Lobbying Activities (if applicable)
Standard form to report their lobbying activities if applicable. Available in the Grants.gov application package.
Grants.gov
Key Contacts Form
Required form requests contact information for:

1) Additional Persons for the role of Authorized Representative Official (authorized signer);

2) Additional Persons for the role of Principal Investigator or Program Director (program/project manager); and 3) the lead role of Financial Official (Grants Manager).

NOTE: If more than one individual is designated in the same role, one individual must be identified as primary. Available in the Grants.gov application package.

Grants.gov

Attachment Form
Form used to submit supplemental attachments to support the grant application. Available in the Grants.gov application package.
Grants.gov

Indirect Cost Rate Agreement (If Indirect Costs are included in applicant budget)

Organization’s signed current approved indirect cost rate from the cognizant Federal agency or letter of request to cognizant agency for rate establishment or adjustment.
Grants.gov
ITD Program Plan / Top Level Design (PP/TLD) approval letter
To be eligible for an HP-ITD grant, the State shall have an approved Program Plan (PP/TLD) approved by the Secretary as outlined in FAST Act (Pub. L. No. 114-94).
Grants.gov

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