low-no-supplemental-form-fy-2020.pdf
PDF 190 KB Posted
- Attached to
- Low or No Emission Program (Low-No Program)
- Opportunity number
- FTA-2020-005-LOWNO
- Issued by
-
Department of Transportation
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Supplemental Form
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Other files
| File | Type | Posted |
|---|---|---|
| PKG00257834-instructions.docx | DOCX document | |
| Low or No NOFO.pdf |
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v1.0 Applicant and Proposal Profile Form - FY 2020 Low or No Emission Bus Program (5339(c)) Page of FY 2020 Low or No Emission Bus Program (5339(c)) 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:
Section II. Project Information About the Project (Descriptive title of this project) Propulsion Type:
Departmental Objectives Opportunity Zone:
Project Type:
Project Budget Description
QTY
5339(c) Amount Other Federal Funds 5339(c) Local Match Total Cost Other Total:
Matching Funds Information Project Scalability Is project scope scalable?
Project Timeline Timeline Description Timeline Item Date Congressional Districts (Project Location) Congressional District Is this application a partnership between an eligible applicant and one or more private sector 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 Planning and Local/Regional Prioritization Local Financial Commitment Project Implementation Strategy Technical, Legal, and Financial Capacity 9.0.0.2.20120627.2.874785
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| programCodeHidden: SF-LOWNO-2020 |
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| Yes: |
| No: |
| cFocus: |
| Grants.gov Tracking Number (13 characters): |
| Organization Legal Name (50 characters): |
| FTA Recipient Number (4 characters): |
| Organization Chief Executive Officer(50 characters): |
| Applicant Eligibility - Direct or designated recipient: |
| Applicant Eligibility - State: |
| Applicant Eligibility - Local: |
| Applicant Eligibility - A Federally-recognized Indian Tribe: |
| Project Location - Small Urbanized Area: |
| Project Location - Large Urbanized Area: |
| Project Location - Rural: |
| Description of services provided and areas served (4000 characters): |
| Project Title (200 characters): |
| Project Executive Summary (2000 characters): |
| Project Statement of Work (500 characters): |
| Propulsion - Battery electric: 0 |
| Propulsion- Diesel-electric hybrid: 0 |
| Propulsion- CNG: 0 |
| Propulsion - Fuel cell: 0 |
| Propulsion- Other: 0 |
| Applicant Type - If Other, Specify (200 characters): |
| If applicable, describe how this application addresses one or more departmental objectives addressed in the NOFO (2000 characters): |
| Yes: |
| No: |
| txt_oppZoneName: |
| Describe how how the proposed project will impact the Opportunity Zone: (4000 characters): |
| Project Type - Vehicle: 0 |
| Project Type - Facilities: 0 |
| Project Type - Other: 0 |
| Project Type - Other: 0 |
| Applicant Type - If Other, Specify (200 characters): |
| Item Description (100 characters): |
| Quantity: |
| Federal Amount: |
| Other Federal Funds: |
| Local Match: |
| Other: |
| Total Cost: |
| Remove Congressional District Item: |
| Insert Project Budget Item: |
| Grand Total - Federal Amount: |
| Grand Total - Local Match: |
| Grand Total - Federal Amount: |
| Grand Total - Federal Amount: |
| Grand Total - Total Cost: |
| Matching Funds Amount: |
| Source of Matching Funds (4000 characters): |
| Supporting Documentation of Local Match (4000 characters): |
| If Yes, specify minimum Federal Funds necessary: |
| Provide explanation of scalability with specific references to the budget line items above (4000 characters): |
| Timeline Description (100 characters): |
| Timeline Item Date (format MM/dd/YYYY): |
| Insert Project Timeline Item: |
| Congressional District: |
| Insert Congressional District Item: |
| If yes, please list the partner(s) and describe their qualifications: (4000 characters): |
| Demonstration of Need (4000 characters): |
| Demonstration of Benefits (4000 characters): |
| Planning and Local/Regional Prioritization (4000 characters): |
| Local Financial Commitment (4000 characters): |
| Project Implementation Strategy (4000 characters): |
| Technical, Legal, and Financial Capacity (4000 characters): |
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