FY21-ARP-Additional-Assistance-Supplemental-Form.pdf
PDF 190 KB Posted
- Attached to
- American Rescue Plan (ARP) Additional Assistance
- Opportunity number
- FTA-2021-012-TPM-AAF
About this file
Supplemental Form
View the file
Other files
| File | Type | Posted |
|---|---|---|
| FRN_2021-19397.pdf | ||
| FY 2021 American Rescue Plan Additional Assistance Final NOFO.pdf |
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v1.0 Page of Applicant and Proposal Form - American Rescue Plan - Additional Assistance Funding American Rescue Plan - Additional Assistance Funding Applicant and Proposal Profile Is this a resubmission due to an invalid/error message from FTA?
Section I. Applicant Information (Name and Direct Phone Number) Applicant Eligibility:
Applicant Eligibility Project Location:
Project Location (if applicable) (if applicable) Section II. Project Information About the Project (Descriptive title of this project) Project Type (select all that apply):
Congressional Districts (Place of Performance) Congressional District Section III . Evaluation Criteria Are you using a starting date that is different from January 20, 2020?
Are you using a starting date that is different from January 20, 2020?
Does the project address racial equity as described in the NOFO (Section E.2)?
*** Address each of the evaluation criteria as described in the Notice of Funding Opportunity.*** Reduction in Farebox or Other Revenue Services Estimate of Need Demonstration of Expenditure of Cares Act Funding Project Spend Plan Project Proposed Milestones Timeline (Please be as specific as possible) Timeline Description Timeline Date Section IV. Requested Amount Project Budget 9.0.0.2.20120627.2.874785
| CurrentPage: |
| PageCount: |
| ResetButton1: |
| btnValidate: |
| programCodeHidden: ARPA2021 |
| programVersionHidden: 1.0 |
| Yes: |
| No: |
| lbl_hidden_rbl_Resubmission: Is this a resubmission due to an invalid/error message from FTA? |
| cFocus: |
| Grants.gov Tracking Number (13 characters): |
| lbl_hidden_txt_grantsNumber: Grants.gov Tracking Number |
| Organization Legal Name (200 characters): |
| lbl_hidden_txt_orgLegalName: Organization CEO |
| FTA Recipient ID Number (30 characters): |
| lbl_hidden_txt_ftaRecipientIdNumber: FTA Recipient Id |
| Organization CEO (200 characters): |
| lbl_hidden_txt_orgCEO: Organization CEO |
| Recipient of 5307 Funding: 0 |
| lbl_hidden_cb_Rec5307: Recipient of 5307 Funding |
| Recipient of 5311 Funding: 0 |
| lbl_hidden_cb_Rec5311: Recipient of 5311 Funding |
| lbl_hidden_cbl_Eligibility: Applicant Eligibility |
| Rural: 0 |
| lbl_hidden_cb_Rural: Rural |
| Small Urbanized Area: 0 |
| lbl_hidden_cb_SmallUrban: Small Urbanized Area |
| Large Urbanized Area: 0 |
| lbl_hidden_cb_LargeUrban: Large Urbanized Area |
| lbl_hidden_cbl_ProjectLocation: Project Location |
| lbl_hidden_txt_CensusBureau: Official census bureau urbanized area name |
| Official census bureau urbanized area name (200 characters): |
| lbl_hidden_txt_DesignatedRecipient: UZA’s designated recipient, if not the applicant |
| UZA’s designated recipient, if not the applicant (200 characters): |
| Project Title (200 characters): |
| lbl_hidden_txt_projectTitle: Project Title |
| Project Executive Summary (500 characters): |
| lbl_hidden_txt_summaryOfReq: Project Executive Summary |
| Project Statement of Work (1000 characters): |
| lbl_hidden_txt_projectStatementOfWork: Project Statement of Work |
| Operations: 0 |
| lbl_hidden_cb_Operations: Operations |
| Personnel: 0 |
| lbl_hidden_cb_Personnel: Personnel |
| Cleaning: 0 |
| lbl_hidden_cb_Cleaning: Cleaning |
| Debt Service Payments Incurred to Maintain Operations and Avoid Layoffs and Furloughs: 0 |
| lbl_hidden_cb_DebtService: Debt Service Payments incurred to Maintain Operations and Avoid Layoffs and Furloughs |
| Sanitization: 0 |
| lbl_hidden_cb_Sanitization: Sanitization |
| lbl_hidden_cbl_ProjectType: Project Type |
| Congressional District: |
| lbl_hidden_gridItem_ddl_congressDist: Congressional District |
| Remove Timeline Item: |
| lbl_hidden_gridTable_congressDistRepeatable: Congressional Districts |
| Insert Congressional District Item: |
| lbl_hidden_rbl_IsAlternateDate: Applicants can use a start date on or after January 20, 2020. Is the start date other than January 20, 2020? |
| lbl_hidden_datetime_AlternateDate: If yes, please specify that date here |
| If yes, please specify that date here (format MM/dd/YYYY): |
| Reduction in Farebox or Other Revenue Sources (4000 characters): |
| lbl_hidden_txt_EvalReductionFarebox: Reduction in Farebox or Other Revenue Sources |
| 2018 Farebox Revenue: |
| lbl_hidden_num_2018Farebox: 2018 Farebox Revenue |
| 2018 Non-Federal Revenue: |
| lbl_hidden_num_2018NonFedRev: 2018 Non-Federal Revenue |
| Fare revenues January 20, 2020 - September 30, 2020: |
| lbl_hidden_num_FareRevJanSept: Fare revenues January 20, 2020 - September 30, 2020 |
| Non-Federal revenues January 20, 2020 - September 30, 2020: |
| lbl_hidden_num_NonFedRevJanSept: Non-Federal revenues January 20, 2020 - September 30, 2020 |
| Fare revenues October 1, 2020 - September 30, 2021: |
| lbl_hidden_num_FareRevOctSept: Fare revenues October 1, 2020 - September 30, 2021 |
| Non-Federal revenues October 1, 2020 - September 30, 2021: |
| lbl_hidden_num_NonFedRevOctSept: Non-Federal revenues October 1, 2020 - September 30, 2021 |
| Anticipated Fare revenues October 1, 2021 - September 30, 2022: |
| lbl_hidden_num_AnticFareRevOctSept: Anticipated Fare revenues October 1, 2021 - September 30, 2022: |
| Anticipated Fare revenues October 1, 2021 - September 30, 2022: |
| lbl_hidden_num_AnticNonFedRevOctSept: Anticipated Non-Federal revenues October 1, 2021 - September 30, 2022 |
| Anticipated Fare revenues October 1, 2022 - September 30, 2023: |
| lbl_hidden_num_AnticFareRevOctSept2: Anticipated Fare revenues October 1, 2022 - September 30, 2023 |
| Anticipated Fare revenues October 1, 2022 - September 30, 2023: |
| lbl_hidden_num_AnticNonFedRevOctSept2: Anticipated Non-Federal revenues October 1, 2022 - September 30, 2023 |
| Estimate of Need (4000 characters): |
| lbl_hidden_txt_EvalEstimateNeed: Estimate of Need |
| 2018 Operating Expense Total: |
| lbl_hidden_num_2018OETotal: 2018 Operating Expense Total |
| Total CARES Act, CRRSAA, and ARP Funding Allocated to the Applicant: |
| lbl_hidden_num_TotalCARESAct: Total CARES Act, CRRSAA, and ARP Funding Allocated to the Applicant |
| Operating Expense January 20, 2020 - September 30, 2020: |
| lbl_hidden_num_OEJanSept: Operating Expense January 20, 2020 - September 30, 2020 |
| Federal Funding Used for Operating Expense January 20, 2020 - September 30, 2020: |
| lbl_hidden_num_FedFundingJanSept: Federal Funding Used for Operating Expense January 20, 2020 - September 30, 2020 |
| Operating Expense October 1, 2020 - September 30, 2021: |
| lbl_hidden_num_OEOctSept: Operating Expense October 1, 2020 - September 30, 2021 |
| Federal Funding Used for Operating Expense October 1, 2020 - September 30, 2021: |
| lbl_hidden_num_FedFundingOctSept: Federal Funding Used for Operating Expense October 1, 2020 - September 30, 2021 |
| Anticipated Operating Expense October 1, 2021 - September 30, 2022: |
| lbl_hidden_num_AnticOEOctSept: Anticipated Operating Expense October 1, 2021 - September 30, 2022 |
| Anticipated Federal Funding Used for Operating Expense October 1, 2021 - September 30, 2022: |
| lbl_hidden_num_AnticFedFundingOctSept: Anticipated Federal Funding Used for Operating Expense October 1, 2021 - September 30, 2022 |
| Anticipated Operating Expenses October 1, 2022 - September 30, 2023: |
| lbl_hidden_num_AnticOEOctSept2: Anticipated Operating Expenses October 1, 2022 - September 30, 2023 |
| Anticipated Federal Funding Used for Operating Expenses October 1, 2022 - September 30, 2023: |
| lbl_hidden_num_AnticFedFundingOctSept2: Anticipated Federal Funding Used for Operating Expenses October 1, 2022 - September 30, 2023 |
| Amount of CARES Act Funding Allocated to the Applicant: |
| lbl_hidden_num_AllocatedFunding: Amount of CARES Act Funding Allocated to the Applicant |
| Amount of CARES Act Funding Expended and Reimbursed by FTA at the Time of Submission: |
| lbl_hidden_num_ExpendedFunding: Amount of CARES Act Funding Expended and Reimbursed by FTA at the Time of Submission |
| Project Spend Plan (4000 characters): |
| lbl_hidden_txt_EvalProjectSpend: Project Spend Plan |
| Timeline Description (100 characters): |
| lbl_hidden_gridItem_txt_tlDesc: Timeline Description |
| Timeline Date (format MM/dd/YYYY): |
| lbl_hidden_gridItem_datetime_tlDate: Timeline Date |
| lbl_hidden_gridTable_timelineRepeatable: Project Timeline |
| Insert Project Timeline Item: |
| lbl_hidden_txt_additionalRequests: Explanation of Requests after September 30, 2023 |
| If applicable, for any requests after September 30, 2023 please provide an explanation and calculation. (4000 characters): |
| FY20 (Beginning with January 20th, 2020 through September 30, 2020): |
| lbl_hidden_num_BudgetFY20: FY20 (Beginning with January 20th, 2020 through September 30, 2020) |
| FY21 (October 1, 2020 through September 30, 2021): |
| lbl_hidden_num_BudgetFY21: FY21 (October 1, 2020 through September 30, 2021) |
| FY22 (October 1, 2021 through September 30, 2022): |
| lbl_hidden_num_BudgetFY22: FY22 (October 1, 2021 through September 30, 2022) |
| FY23 (October 1, 2022 through September 30, 2023): |
| lbl_hidden_num_BudgetFY23: FY23 (October 1, 2022 through September 30, 2023) |
| CARES Act, CRRSAA, and ARP Funding Allocated to the Applicant: |
| lbl_hidden_num_ExtraFunding: CARES Act, CRRSAA, and ARP Funding Allocated to the Applicant |
| Total: |
| lbl_hidden_num_TotalFederalAmnt: Grand Total - Federal Amount |
| 2018 Farebox Revenue: |
| lbl_hidden_num_TotalTotalCost: Grand Total - Total Cost |
File details come from the government source that posted it. Updated .