Attachment A 2024 SRS Title Application Form (1).docx

Attachment A: Project Proposal SECURE RURAL SCHOOLS – Title II Project Submission Form

SECURE RURAL SCHOOLS AND COMMUNITY SELF DETERMINATION ACT OF 2000, Public Law 106-393 (16 U.S.C. 500) as amended by the "Infrastructure Investment and Jobs Act (Public Law 117-58).

Person Submitting Proposal:

Date:

E-mail :

Phone:

Organization Name:

Notice of Funding Opportunity Number.:

Notice of Funding Opportunity Title:

Recipient Project Title:

Estimated Period of Performance:

BLM Contact Name:

BLM Field and District Office:

County(ies) Project is Located:

Total Funding Request (SRS Title II)

1. Project Location (Attach project area map)

a. 4th Field Watershed Name and HUC #

b. Township

Range

Section(s)

Township

Range

Section(s)

Township

Range

Section(s)

Township

Range

Section(s)

Township

Range

Section(s)

No

If yes, specify:

2. Project Goals and Objectives

• Project title

• Statement of need

• Goals and objectives

• Public and program interest of the BLM

3. Project Description ] (recommended max. 30 lines.)

Describe the details of the project, the procedures to be used, how data will be collected, analyzed, and interpreted, etc. Proposals must have measurable outcomes.

• Activities

• Methods

• Timetable or milestones

• Information to support environmental compliance review requirements. (NOTE: Projects under wildlife management, the native plant program, threatened and endangered species habitat conservation - the narrative should provide enough detail so that reviewers are able to determine project compliance with Section 7 of the Endangered Species Act of 1973)

• Description of stakeholder coordination or involvement

• Required project monitoring and evaluation plan, including how you will measure project performance and assessment tools to be used

• Information on key project personnel

• Anticipated future funding needs

• Details and supporting documentation on the project location

• Other program or project-specific narrative requirements

No

If yes, then describe (recommended max. 10 lines)

5. How does proposed project meet purposes of the Legislation? (check all that apply)

Improves maintenance of existing infrastructure.

Implements stewardship objectives that enhance forest ecosystems.

Restores and improves land health and water quality.

6. Project Type (check one or more)

Road Maintenance

Trail Maintenance

Road Decommission/Obliteration

Trail Obliteration

Soil Productivity Improvement

Forest Ecosystem Health Improvement

Watershed Restoration & Maintenance

Fish Habitat Restoration

Control of Noxious Weeds

Wildlife Habitat Restoration

Reestablish Native Species

Other Infrastructure Maintenance or Obliteration

7. Measure of Project Accomplishments/Expected Outcomes

a. Total Acres

b. Total Miles

c. Number of Structures

d. No. Laborer Days

e. Estimated People Reached:

f. Other (specify)

8. Merchantable Material Contracting Pilots

No

9. Anticipated Project Costs

Item Federal Agency Appropriated Contribution

Total Available Funds

a. Field Work & Site Surveys

b. NEPA

c. ESA Consultation

d. Permit Acquisition

e. Project design & Engineering

f. Contract/Grant Preparation

g. Contract/Grant Administration

h. Contract/Grant Cost

i. Salaries

j. Materials & Supplies

k. Monitoring

l. Other

n. Indirect Costs

10. Is the Project Scalable?

a. Yes or No (Check one)

c. Explanation about the scaling of the project:

d. If seeking funding from multiple counties, what % of project funding from each county is being requested?

11. Proposed Method(s) of Accomplishment (check those that apply)

Contract

County Workforce

Volunteers

12. Estimated Completion Date

13. Identify Source(s) of Other Funding Identified in Table (Box 9, column C) Explain whether or not they are secured and clarify any other aspects that might be useful in evaluating the application.

14. BLM District Office jurisdiction of your project? Refer to map at https://blm-egis.maps.arcgis.com/apps/webappviewer/index.html?id=a446ec91307c45898cafe57a5f26982e

Check all that apply:

(Klamath Falls Field Office)

15. How will cooperative relationships between the people that use federal lands and the agencies that manage them be improved? List known partnerships or collaborative opportunities

16. How is this project in the best interest of the community?

17. How does project benefit O&C or Coos Bay Wagon Road or National Forest lands/resources? The project must show a benefit to O&C, Coos Bay Wagon Road or National Forest lands/resources to be considered for funding.

18. Target Species Benefited (if applicable)

19. Status of Project Planning

a. NEPA Complete?

Yes

No

b. If no, give estimated date of completion

No

Not Applicable

No

Not Applicable

No

Not Applicable

No

Not Applicable

No

Not Applicable

No

h. If you answered no to any of the questions above, please describe who will accomplish the work and when it will be complete:

NEPA=National Environment Policy Act, NOAA=National Oceanic and Atmospheric Administration, USFWS=United States Fish and Wildlife Service, DSL = Dept. of State Lands, ODFW = Oregon Department of Fish and Wildlife, COE = Army Corps of Engineers, SHPO = State Historic Preservation Officer

20. Monitoring Plan

a. What methods and measures of evaluation will be made to determine whether the proposed project meets or exceeds the desired ecological conditions?

Who is responsible for this monitoring item?

b. How will the project be evaluated to determine whether or not the proposed project contributes towards creating local employment and/or training opportunities, including summer youth jobs programs such as the Youth Conservation Corps?

Who is responsible for this monitoring item?

c. What methods and measures of evaluation will be established to determine how well the proposed project improves the use of, or added value to, any products removed from federal lands consistent with the purposes of this Act?

Who is responsible for this monitoring item?

d. Identify total funding needed to carry out specified monitoring tasks (Item k., Column D in Project Costs table)

What are the sources for funding?

21. What are the plans, analyses, legislation, or other supporting documents that support your application? (E.g., a watershed analysis, Oregon Plan for Salmon, Watershed Council plan, Resource Management Plan or another document that provides context within your group or agency)

22. Who are the other key people responsible for the success of this project? (list their names and titles)

List key project personnel and responsibilities, along with their contact information.

Describe the time to be dedicated to the project, how their experience and qualifications are appropriate to the success of the project.

List contractors, sub awards, consultants, if known, and their qualifications

23. Project location map(s) or photo(s):

At a minimum, the map should show the project location, roads, and streams; private versus BLM ownership; all maps should be printed on 8.5 x 11” paper. The photographs should show the project site or a representative portion of it. More than one photograph can be submitted, but they must all fit on an 8.5 x 11” page. It is recommended that Map(s) and photograph(s) are incorporated/attached to this application, rather than as separate documents.

All project proposals from nonfederal applicants MUST BE SUBMITTED through the Grants.gov portal and comply with all deadlines and requirements of the Secure Rural Schools, Title II Funding Opportunity Announcement. Internal BLM project must be submitted through SRS Title II SharePoint by the same due date.

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