dlt-checklist-fy-25.xlsx
XLSX spreadsheet 35 KB Posted
- Attached to
- Distance Learning and Telemedicine Grants
- Opportunity number
- RUS-25-01-DLT
About this file
This is a checklist document for the FY2025 Distance Learning and Telemedicine (DLT) grant program administered by the USDA Rural Utilities Service. The checklist outlines required application components including Standard Form 424, site worksheets, executive summary, scoring criteria documentation (rurality, economic need, special considerations, and need for services), matching requirements, scope of work, financial information, experience statement, telecommunications systems plan, compliance certifications, legal authority documentation, and environmental impact assessments.
The associated grant opportunity (RUS-25-01-DLT) provides financial assistance under CFDA 10.855 to support telecommunications-enabled distance learning and telemedicine services in rural areas. Eligible applicants include government entities, nonprofits, educational institutions, tribal governments, and businesses. The program funds telecommunications equipment and technology to increase rural access to education, training, and healthcare resources. Applications must include detailed technical plans, compliance certifications, and documentation of legal authority to contract with the federal government. Special attention is required for projects in flood plains or on tribal lands.
FY2025 DLT Application Checklist
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Other files
| File | Type | Posted |
|---|---|---|
| fy-25-dlt-app-guide.pdf | ||
| dlt-worksheets-fy-25.xlsx | XLSX spreadsheet | |
| fy-25-dlt nofo.pdf |
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DLT FY2025 Checklist
| FY2025 DLT- Application Checklist | |||
| Section | Description | Complete | Schedule |
| A | Completed Standard Form 424 | ||
| B | Site Worksheet | ||
| C | Executive Summary of the Project, including Publicly Releasable Project Description | ||
| D | Scoring Criteria Documentation | ||
| D-1 Rurality | |||
| D-2 Economic Need | |||
| D-3 Special Consideration | |||
| D-4 Need for Services and Benefits | |||
| E | Matching Requirements | ||
| F | Scope of Work | ||
| 1 - Specific Activities to be performed | |||
| 2 - Who will carry out activities | |||
| 3 - Timeframes for accomplishing objectives | |||
| 4 - Budget for all capital expenditures | |||
| G | Financial Information and Sustainability | ||
| H | Statement of Experience | ||
| I | Telecommunications Systems Plan | ||
| 1 - Capabilities & Description of Telecommunications Equipment | |||
| 2 - Complete Listing of all Telecommunications Equipment. | |||
| 3 - Description of the consultations with telecommunications carriers. | |||
| 4 - A diagram or map of the proposed system overlaid with a geographic map of the service area | |||
| 5- Sites (hub, hub/end-users, or end-users that will participate in the project and where equipment is located). Note: Any non-tribal applicant with end-user sites on tribal lands must include Tribal Consent (see Application Guide for additional details) | |||
| J | Compliance with Other Federal Statutes and Regulations | ||
| 1. Certificate Regarding Flood Hazard Area Precautions (check appropriate box below) | J-1 | ||
| The Project is not located in a 100-yr Flood Plain. No flood insurance is required. | |||
| The Project is located in a 100-yr Flood Plain. See attached statement regarding who is or will be providing the flood insurance. | |||
| 2. Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 Certification | J-2 | ||
| 3. Certificate Regarding Architectural Barriers | J-3 | ||
| 4. Non-Duplication of Services Certificate | J-4 | ||
| K | Evidence of Legal Existence and Authority to Contract with the Federal Government | ||
| 1. Evidence of Legal Existence | |||
| 2. SAM.gov registration with Financial Assistance General Certifications & Representations | |||
| L | Environmental Impact and Historic Preservation (indicate which document was provided) | ||
| Environmental Impact Survey - required for all projects except, those including broadband facilities | |||
| Environmental Questionnaire - required for all projects that include broadband facilities | |||
| M | Consultation with State Director for each state where there will be end-users |
By signing this certification, you are agreeing to the language in schedules J-1, J-2, J-3, and J-4, as shown in the application guide. If a box checked in Section J-1 above requires an attachment, the attachment is provided with this application. If you have any questions about your application, please contact RUS prior to submitting this application and certification.
Signature Date
Print Name and Title
Flood Insurance Attachment
Flood Insurance Attachment (Please explain below who is or will be providing flood insurance for any project sites which lie in the 100-yr. flood plain.):
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