FY21-Grants-for-Buses-and-Bus-Facilities-Supplemental-Form.pdf
PDF 751 KB Posted
- Attached to
- Fiscal Year 2021 Competitive Funding Opportunity; Grants for Buses and Bus Facilities Program
- Opportunity number
- FTA-2021-008-TPM-BUS
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Supplemental Form
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| 2021-20203.pdf |
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v1.0 Applicant and Proposal Profile Form - FY 2021 Buses and Bus Facilities Program Page of FY 2021 Grants for Buses and Bus Facilities 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:
Project Location:
Justice40 Population Impacted Justice40 Disadvantaged Community Served as Identified in the NOFO Actual or Estimated Annual Ridership Count Section II. Project Information About the Project (Descriptive title of this project) Project Type:
Nonattainment Area Is your project located in or will impact a maintenance or nonattainment area?
Environmental Justice Populations Is there an environmental justice population(s) located within the service area?
Racial Equity Does the project address racial equity as described in the NOFO (Section E.2)?
Does the project address racial equity as described in the NOFO (Section E.2)?
Barriers To Opportunity Does the project address barriers to opportunity as described in the NOFO (Section E.2)?
Does the project address barriers to opportunity as described in the NOFO (Section E.2)?
Justice40 Does the project support the Justice40 Initiative?
Does the project support the Justice40 Initiative?
Project Budget Description
QTY
Federal Amount Federal Match Amount Total Cost Other Federal Funds Other Total:
Does the project budget include funding for workforce development activities or training at the National Transit Institute (NTI)?
Matching Funds Information Project Scalability Is project scope scalable?
Project Timeline (Please be as specific as possible) Timeline Item Description Timeline Item Date Congressional Districts (Place of Performance) Congressional District Section III . Evaluation Criteria ***Address each of the evaluation criteria as described in the Notice of Funding Opportunity.*** Demonstration of Need Demonstration of Benefits Planning and Local/Regional Prioritization Local Financial Commitment Project Implementation Strategy Can this project be obligated within 12 months?
Technical, Legal, and Financial Capacity 9.0.0.2.20120627.2.874785
| CurrentPage: |
| PageCount: |
| btnValidate: |
| programCodeHidden: BUSFAC2021 |
| 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 Legal Name |
| FTA Recipient ID Number (30 characters): |
| lbl_hidden_txt_ftaRecipientIdNumber: FTA Recipient ID |
| Organization CEO (200 characters): |
| lbl_hidden_txt_orgCEO: Organization CEO |
| Applicant Eligibility - Designated recipient: |
| Applicant Eligibility - State: |
| Applicant Eligibility - Local governmental entity that operates fixed route bus service: |
| Applicant Eligibility - Tribe: |
| lbl_hidden_rbl_ApplicantEligibility: Applicant Eligbility |
| Project Location: Small Urbanized Area: 0 |
| lbl_hidden_cb_SmallUrban: Small Urbanized Area |
| Project Location: Large Urbanized Area: 0 |
| lbl_hidden_cb_LargeUrban: Large Urbanized Area |
| Rural: 0 |
| lbl_hidden_cb_Rural: Rural |
| lbl_hidden_cbl_ProjectLocation: Project Location |
| Description of services provided and areas served (4000 characters): |
| lbl_hidden_txt_descriptionOfAreaServed: Description of services provided and areas served |
| Justice40 Disadvantaged Community Served as Identified in the NOFO (100 characters): |
| lbl_hidden_gridItem_txt_piDesc: Justice40 Disadvantaged Community Served as Identified in the NOFO |
| Actual or Estimated Annual Ridership Count: |
| lbl_hidden_gridItem_num_AmountImpacted: Actual or Estimated Ridership Count |
| Remove Congressional District Item: |
| lbl_hidden_gridTable_populationImpactedRepeatable: Justice40 Population Impacted |
| Insert Project Timeline Item: |
| Project Title (200 characters): |
| lbl_hidden_txt_projectTitle: Project Title |
| Project Executive Summary (2000 characters): |
| lbl_hidden_txt_summaryOfReq: Project Executive Summary |
| Project Statement of Work (1000 characters): |
| lbl_hidden_txt_projectStatementOfWork: Project Statement of Work |
| Project Type - Bus Replacement: 0 |
| lbl_hidden_cb_Replacement: Bus Replacement |
| Project Type - Bus Rehabilitation: 0 |
| lbl_hidden_cb_Rehabilitation: Bus Rehabilitation |
| Project Type - Bus Expansion: 0 |
| lbl_hidden_cb_Expansion: Bus Expansion |
| Project Type - Bus Facility Replacement: 0 |
| lbl_hidden_cb_FacReplacement: Bus Facility Replacement |
| Project Type - Bus Facility rehabilitation: 0 |
| lbl_hidden_cb_FacRehabilitation: Bus Facility Rehabilitation |
| Project Type - Bus Facility Expansion: 0 |
| lbl_hidden_cb_FacExpansion: Bus Facility Expansion |
| Project Type - Bus Equipment: 0 |
| lbl_hidden_cb_Equipment: Bus Equipment |
| Project Type - Other: 0 |
| lbl_hidden_cb_Other: Other |
| lbl_hidden_cbl_ProjectType: Project Type |
| Applicant Type - If Other, Specify (200 characters): |
| lbl_hidden_txt_projTypeOther: If Other, specify |
| lbl_hidden_rbl_nonAttainment: Is your project located in or will impact a maintenance or nonattainment area? |
| Please list the maintenance or nonattainment area that the project will be located in or will impact and the National Ambient Air Quality Standards (NAAQS) pollutants addressed by the project: (500 characters): |
| lbl_hidden_txt_nonAttainmentArea: Please list the maintenance or nonattainment area that the project will be located in or will impact and the National Ambient Air Quality Standards (NAAQS) pollutants addressed by the project |
| lbl_hidden_rbl_envJustice: Is there an environmental justice population(s) located within the service area? |
| Describe the environmental justice population(s) and the anticipated benefits resulting from the project for those population(s): (500 characters): |
| lbl_hidden_txt_envJustice: Describe the environmental justice population(s) and the anticipated benefits resulting from the project for those population(s) |
| lbl_hidden_rbl_IsRacialEquity: Does the project address racial equity as described in the NOFO (Section E.2)? |
| If yes, please describe: (500 characters): |
| lbl_hidden_txt_racialEquity: If yes, please describe |
| lbl_hidden_rbl_IsBarriersOpp: Does the project address barriers to opportunity as described in the NOFO (Section E.2)? |
| If yes, please describe: (500 characters): |
| lbl_hidden_txt_barriers: If yes, please describe |
| lbl_hidden_rbl_IsJustice: Does the project support the Justice40 Initiative? |
| Describe how the project supports the Justice40 Initiative and the benefits provided: (1000 characters): |
| lbl_hidden_txt_justice: Describe how the project supports the Justice40 Initiative and the benefits provided |
| Describe the methodology used to determine the project meets the Justice40 Initiative: (1000 characters): |
| lbl_hidden_txt_justiceMethod: Describe the methodology used to determine the project meets the Justice40 Initiative |
| Item Description (100 characters): |
| lbl_hidden_gridItem_txt_Desc: Description |
| Quantity: |
| lbl_hidden_gridItem_num_Qty: Quantity |
| Federal Amount: |
| lbl_hidden_gridItem_num_FederalAmnt: Federal Amount |
| Federal Match Amount: |
| lbl_hidden_gridItem_num_LocalMatch: Federal Match Amount |
| Other Federal: |
| lbl_hidden_gridItem_num_OtherFederal: Other Federal Funds |
| Other: |
| lbl_hidden_gridItem_num_Other: Other |
| Total Cost: |
| lbl_hidden_gridItem_num_TotalCost: Total Cost |
| lbl_hidden_gridTable_budgetRepeatable: Project Budget |
| Insert Project Budget Item: |
| Grand Total - Federal Amount: |
| lbl_hidden_num_TotalFederalAmnt: Grand Total - Federal Amount |
| Grand Total - Federal Match Amount: |
| lbl_hidden_num_TotalLocalMatch: Grand Total - Federal Match Amount |
| Grand Total - Other Federal: |
| lbl_hidden_num_TotalOtherFederal: Grand Total - Other Federal Funds |
| Grand Total - Other: |
| lbl_hidden_num_TotalOther: Grand Total - Other |
| Grand Total - Total Cost: |
| lbl_hidden_num_TotalTotalCost: Grand Total - Total Cost |
| lbl_hidden_rbl_IsBudgetFunding: Is Project Scope scalable? |
| Matching Funds Amount: |
| lbl_hidden_num_matchingFunds: Matching Funds Amount |
| Source of Matching Funds (4000 characters): |
| lbl_hidden_txt_sourceMatchingFunds: Source of Matching Funds |
| Supporting Documentation of Local Match (4000 characters): |
| lbl_hidden_txt_supportingDocuments: Supporting Documentation of Local Match |
| lbl_hidden_rbl_IsScalable: Is Project Scope Scalable |
| If Yes, specify minimum Federal Funds necessary: |
| lbl_hidden_num_minFederalFunds: Specify minimum Federal Funds necessary |
| Provide explanation of scalability with specific references to the budget line items above (4000 characters): |
| lbl_hidden_txt_scalabilityExpl: Provide explanation of scalability with specific references to the budget line items above |
| Timeline Item Description (100 characters): |
| lbl_hidden_gridItem_txt_tlDesc: Timeline Item Description |
| Timeline Item Date (format MM/dd/YYYY): |
| lbl_hidden_gridItem_dateline_tlDate: Timeline Item Date |
| lbl_hidden_gridTable_timelineRepeatable: Project Timeline |
| Insert Project Timeline Item: |
| Congressional District: |
| lbl_hidden_gridItem_ddl_congressDist: Congressional District |
| lbl_hidden_gridTable_congressDistRepeatable: Congressional Districts |
| Insert Congressional District Item: |
| Demonstration of Need (4000 characters): |
| lbl_hidden_txt_demonstrationNeed: Demonstration of Need |
| Demonstration of Benefits (4000 characters): |
| lbl_hidden_txt_demonstrationBenefits: Demonstration of Benefits |
| Planning and Local/Regional Prioritization (4000 characters): |
| lbl_hidden_txt_planningLocalPrioritization: Planning and Local/Regional Prioritization |
| Local Financial Commitment (4000 characters): |
| lbl_hidden_txt_localFinancialCommitment: Local Financial Commitment |
| lbl_hidden_rbl_CanBeImplemented: Can this project be obligated within 12 months? |
| Project Implementation Strategy (4000 characters): |
| lbl_hidden_txt_projectImplementStrategy: Project Implementation Strategy |
| Technical, Legal, and Financial Capacity (4000 characters): |
| lbl_hidden_txt_techLegalFinanceCapacity: Technical, Legal, and Financial Capacity |
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