FY22-LowNo-and-Buses-and-Bus-Facilities-Supplemental-Form.pdf
PDF 760 KB Posted
- Opportunity number
- FTA-2022-002-TPM-BUSC
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Supplemental Form
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| File | Type | Posted |
|---|---|---|
| FRN_2022-04621.pdf |
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v1.0 Page of Applicant and Proposal Form - FY 2022 Low or No Emission Grant Program and the Grants for Buses and Bus Facilities Competitive Program FY 2022 Low or No Emission Grant Program and the Grants for Buses and Bus Facilities Competitive Program Applicant and Proposal Profile Is this a resubmission due to an invalid/error message from FTA?
Is this application for:
(If applying to both programs, please check both boxes) Is this application for Note: If applying to both programs, applicants should enter information for both programs on this form but Must submit the application package including the Supplemental Form and attachments, to Each respective Opportunity ID on Grants.Gov for each program. That is, complete 1 form, but submit it to both programs in Grants.gov.
Is this application for Section I. Applicant Information (Name and Direct Phone Number) Applicant Eligibility:
Project Location:
Project Location Section II. Project Information About the Project (Descriptive title of this project) Propulsion Type:
Project Type:
Climate Change Environmental Justice Populations Is there an environmental justice population(s) located within the service area?
Racial Equity/Barriers to Opportunity Does the project address racial equity as described in the NOFO (Section E.2)?
Does the project address racial equity or barriers to opportunity (see NOFO Section E.2)?
Creating Good-Paying Jobs Zero-Emission Fleet Transition Plan - Workforce Involvement Justice40 Does the project support the Justice40 Initiative?
Does the project support the Justice40 Initiative?
Justice40 Population Impacted Justice40 Disadvantaged Community Served as Identified in the NOFO Section E.2 Actual or Estimated Annual Ridership Count Was this estimate generated using the Justice40 online mapping tool?
Was this estimate generated using the Justice40 online mapping tool?
Project Budget Description
QTY
Federal Amount Requested Local 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)?
For zero emission projects, is 5% of the project budget for workforce development training as outlined in the applicant's Zero-Emission Transition Plan?
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 (Project Location) Congressional District Partnership Provision Note: the partnership provision is only applicable to low or no emission projects that are applying to the Low-No Program or both the Low-No and Bus Program. Projects applying only to the Bus program are not eligible to use the partnership provision. See NOFO Section C(1).
Is this application a partnership between an eligible applicant and one or more partners?
Section III . Evaluation Criteria *** Address each of the evaluation criteria as described in the Notice of Funding Opportunity.*** Demonstration of Need Demonstration of Benefits Note: If applying to both programs, be sure to select "yes" and provide a response to both questions below.
Is this an application to the Low-No Program?
Is this a Low-No project?
Is this an application to the Buses and Bus Facilities Program?
Is this a Buses and Bus Facilities project?
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
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| PageCount: |
| ResetButton1: |
| btnValidate: |
| programCodeHidden: 2022LOWNOBUSFAC |
| programVersionHidden: 5 |
| 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 |
| Low-No (FTA-2022-001-TPM-LWNO): 0 |
| lbl_hidden_cb_app_lowno: Low-No (FTA-2022-001-TPM-LWNO) |
| lbl_hidden_cb_app_lowno_id: FTA-2022-001-TPM-LWNO |
| Buses and Bus Facilities (FTA-2022-002-TPM-BUSC): 0 |
| lbl_hidden_cb_app_busfac: Buses and Bus Facilities (FTA-2022-002-TPM-BUSC) |
| lbl_hidden_cb_app_busfac_id: FTA-2022-002-TPM-BUSC |
| lbl_hidden_cbl_ApplicationFor: Is this application for |
| 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 - Direct or designated recipient: |
| Applicant Eligibility - State: |
| Applicant Eligibility - Local Governmental Authority: |
| Applicant Eligibility - A Federally-recognized Indian Tribe: |
| lbl_hidden_rbl_applicantEligibility: Applicant Eligibility |
| Small Urbanized Area (50,000-199,999 people): 0 |
| lbl_hidden_cb_SmallUrban: Small Urbanized Area (50,000-199,999 people) |
| Large Urbanized Area (200,000+ people): 0 |
| lbl_hidden_cb_LargeUrban: Large Urbanized Area (200,000+ people) |
| Rural (less than 50,000 people): 0 |
| lbl_hidden_cb_Rural: Rural (less than 50,000 people) |
| 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 |
| 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 |
| lbl_hidden_cbl_propulsion: Propulsion Type |
| Propulsion - Battery electric: 0 |
| lbl_hidden_cb_batteryElectric: Battery electric |
| Propulsion- CNG: 0 |
| lbl_hidden_cb_CNG: CNG |
| Propulsion - Diesel: 0 |
| lbl_hidden_cb_diesel: Diesel |
| Propulsion- Diesel-electric hybrid: 0 |
| lbl_hidden_cb_dieselElec: Diesel-electric hybrid |
| Propulsion - Gasoline: 0 |
| lbl_hidden_cb_gasoline: Gasoline |
| Propulsion - Hydrogen fuel cell: 0 |
| lbl_hidden_cb_fuelCell: Hydrogen fuel cell |
| Propulsion - Other: 0 |
| lbl_hidden_cb_other: Other |
| Propulsion Type - If Other, Specify (200 characters): |
| lbl_hidden_txt_propTypeOther: If Other, specify |
| Project Type - Bus Replacement: 0 |
| lbl_hidden_cb_Replacement: Bus Replacement |
| Number of buses to be replaced: |
| lbl_hidden_num_Replacement: Number of buses to be replaced |
| Project Type - Bus Rehabilitation: 0 |
| lbl_hidden_cb_Rehabilitation: Bus Rehabilitation |
| Number of buses to be rehabilitated: |
| lbl_hidden_num_Rehabilitation: Number of buses to be rehabilitated |
| Project Type - Bus Expansion: 0 |
| lbl_hidden_cb_Expansion: Bus Expansion |
| Number of buses for service expansion: |
| lbl_hidden_num_Expansion: Number of buses for service 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 |
| Project Type - If Other, specify (200 characters): |
| lbl_hidden_txt_projTypeOther: If Other, specify |
| lbl_hidden_txt_climateChange: For Buses and Bus Facilities Projects, please describe the significant community benefits relating to the environment. See NOFO Section E.2 for additional guidance. |
| For Buses and Bus Facilities Projects, please describe the significant community benefits relating to the environment. See NOFO Section E.2 for additional guidance. (500 characters): |
| 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) (see NOFO Section E.2) (500 characters): |
| lbl_hidden_txt_envJustice: Describe the environmental justice population(s) and the anticipated benefits resulting from the project for those population(s) (see NOFO Section E.2) |
| lbl_hidden_rbl_IsRacialEquity: Does the project address racial equity or barriers to opportunity (see NOFO Section E.2)? |
| If yes, please describe: (500 characters): |
| lbl_hidden_txt_racialEquity: If yes, please describe |
| Applicants for facility projects, please describe how the project will support creating good paying jobs (see NOFO Section E.2) (500 characters): |
| lbl_hidden_txt_creatingGood: Applicants for facility projects, please describe how the project will support creating good paying jobs (see NOFO Section E.2): |
| For zero-emission projects, please explain how workforce representatives were included in the development of the workforce plan of the Zero-Emission Transition Plan and which of the three elements described in the NOFO Section E.2 were used to maintain job quality and avoid displacement of the existing workforce. (500 characters): |
| lbl_hidden_txt_zeroemission: For zero-emission projects, please explain how workforce representatives were included in the development of the workforce plan of the Zero-Emission Transition Plan and which of the three elements described in the NOFO Section E.2 were used to maintain job quality and avoid displacement of the existing workforce. |
| lbl_hidden_rbl_IsJustice: Does the project support the Justice40 Initiative? |
| Describe how the project supports the Justice40 Initiative and the benefits provided (see NOFO Section E.2) (1000 characters): |
| lbl_hidden_txt_justice: Describe how the project supports the Justice40 Initiative and the benefits provided (see NOFO Section E.2): |
| Describe the methodology used to determine the project meets the Justice40 Initiative (see NOFO Section E.2) (1000 characters): |
| lbl_hidden_txt_justiceMethod: Describe the methodology used to determine the project meets the Justice40 Initiative (see NOFO Section E.2): |
| Justice40 Disadvantaged Community Served as Identified in the NOFO Section E.2 (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: |
| What is the percentage of Disadvantaged Communities within the project area?: |
| lbl_hidden_num_percentDisadvComm: What is the percentage of Disadvantaged Communities within the project area? |
| lbl_hidden_rbl_IsOnlineMapping: Was this estimate generated using the Justice40 online mapping tool? |
| Item Description (100 characters): |
| lbl_hidden_gridItem_txt_Desc: Description |
| Quantity: |
| lbl_hidden_gridItem_num_Qty: Quantity |
| Federal Amount Requested: |
| lbl_hidden_gridItem_num_FederalAmnt: Federal Amount Requested |
| Local Match Amount: |
| lbl_hidden_gridItem_num_LocalMatch: Local 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 Requested: |
| lbl_hidden_num_TotalFederalAmnt: Grand Total - Federal Amount Requested |
| Grand Total - Local Match Amount: |
| lbl_hidden_num_TotalLocalMatch: Grand Total - Local 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: Does the project budget include funding for workforce development activities or training at the National Transit Institute (NTI)? |
| lbl_hidden_rbl_IsBudgetWorkforce: For zero emission projects, is 5% of the project budget for workforce development training as outlined in the applicant's Zero-Emission Transition Plan? |
| If no, please explain why the full 5% is not needed (1000 characters): |
| lbl_hidden_txt_budgetWorkforce: If no, please explain why the full 5% is not needed |
| 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_datetime_tlDate: Timeline Item Date |
| lbl_hidden_gridTable_timelineRepeatable: Project Timeline |
| Insert Project Timeline Item: |
| lbl_hidden_gridTable_congressDistRepeatable: Congressional Districts |
| Congressional District: |
| lbl_hidden_gridItem_ddl_congressDist: Congressional District |
| Insert Congressional District Item: |
| lbl_hidden_rbl_IsPartners: Is this application a partnership between an eligible applicant and one or more partners? |
| If yes, please list the partner(s) and describe their qualifications: (4000 characters): |
| lbl_hidden_txt_listPartners: List partner(s) and their qualifications |
| Demonstration of Need (4000 characters): |
| lbl_hidden_txt_demonstrationNeed: Demonstration of Need |
| lbl_hidden_rbl_IsLowno: Is this an application to the Low-No Program? |
| Please describe the benefits of the proposed project per the statutory requirements of the Low-No Program (see NOFO Section E(1)(b)(i)): (4000 characters): |
| lbl_hidden_txt_benefitsLowno: Please describe the benefits of the proposed project per the statutory requirements of the Low-No Program (see NOFO Section E(1)(b)(i)) |
| lbl_hidden_rbl_IsBusfac: Is this an application to the Buses and Bus Facilities Program? |
| Please describe the benefits of the proposed project per the statutory requirements of the Buses and Bus Facilities Program (see NOFO Section E(1)(b)(ii)): (4000 characters): |
| lbl_hidden_txt_benefitsBusfac: Please describe the benefits of the proposed project per the statutory requirements of the Buses and Bus Facilities Program (see NOFO Section E(1)(b)(ii)) |
| Planning and Local/Regional Prioritization (4000 characters): |
| lbl_hidden_txt_planningPrioritization: Planning and Local/Regional Prioritization |
| Local Financial Commitment (4000 characters): |
| lbl_hidden_txt_financialCommitment: Local Financial Commitment |
| lbl_hidden_rbl_CanBeImplemented: Can this project be obligated within 12 months? |
| Project Implementation Strategy (4000 characters): |
| lbl_hidden_txt_projectImplementation: Project Implementation Strategy |
| Technical, Legal, and Financial Capacity (4000 characters): |
| lbl_hidden_txt_technicalCapacity: Technical, Legal, and Financial Capacity |
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