LowNo-2021-Supplemental-Form.pdf
PDF 194 KB Posted
- Opportunity number
- FTA-2021-001-LOWNO
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Supplemental Form
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| File | Type | Posted |
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| 2021-FRN.pdf |
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v1.0 Applicant and Proposal Profile Form - FY 2021 Low or No Emission Bus Program (5339(c)) Page of FY 2021 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:
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 located within the service area?
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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| 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_grants: Grants.gov Tracking Number |
| Organization Legal Name (50 characters): |
| lbl_hidden_txt_orgLegalName: Organization Legal Name |
| FTA Recipient Number (4 characters): |
| lbl_hidden_txt_ftaRecipientIdNumber: FTA Recipient ID Number |
| Organization Chief Executive Officer(50 characters): |
| lbl_hidden_txt_orgCEO: Organization Chief Executive Officer |
| Applicant Eligibility - Direct or designated recipient: |
| Applicant Eligibility - State: |
| Applicant Eligibility - Local: |
| Applicant Eligibility - A Federally-recognized Indian Tribe: |
| lbl_hidden_rbl_applicantEligibility: Applicant Eligibility |
| Project Location - Small Urbanized Area: |
| Project Location - Large Urbanized Area: |
| Project Location - Rural: |
| lbl_hidden_rbl_projectLocation: Project Location |
| Description of services provided and areas served (4000 characters): |
| lbl_hidden_txt_servicesProvided: Description of services provided and areas served |
| 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 (500 characters): |
| lbl_hidden_txt_projectStatementOfWork: Project Statement of Work |
| lbl_hidden_cbl_projectType: Project Type |
| lbl_hidden_cbl_projectType: Project Type |
| Propulsion - Battery electric: 0 |
| lbl_hidden_cb_batteryElectric: Battery Electric |
| Propulsion- Diesel-electric hybrid: 0 |
| lbl_hidden_cb_diesel: Diesel-electric hybrid |
| Propulsion- CNG: 0 |
| lbl_hidden_cb_CNG: CNG |
| Propulsion - Fuel cell: 0 |
| lbl_hidden_cb_fuelCell: 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 - Vehicle: 0 |
| lbl_hidden_cb_vehicle: Vehicle |
| Project Type - Facilities: 0 |
| lbl_hidden_cb_facilities: Facility |
| Project Type - Equipment: 0 |
| lbl_hidden_cb_equipment: Equipment |
| Project Type - Other: 0 |
| lbl_hidden_cb_projTypeOther: Other |
| Project Type - If Other, Specify (200 characters): |
| lbl_hidden_txt_projTypeOther: If other, specify |
| Yes: |
| No: |
| 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 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 and anticipated benefits to that population resulting from the project |
| lbl_hidden_gridTable_budgetRepeatable: Project Budget |
| 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 |
| Local Match: |
| lbl_hidden_gridItem_num_LocalMatch: Local Match |
| Other Federal Funds: |
| lbl_hidden_gridItem_num_OtherFederalFunds: Other Federal Funds |
| Other: |
| lbl_hidden_gridItem_num_Other: Other |
| Total Cost: |
| lbl_hidden_gridItem_num_TotalCost: Total Cost |
| Remove Congressional District Item: |
| Insert Project Budget Item: |
| Grand Total - Federal Amount: |
| lbl_hidden_num_TotalFederalAmnt: Grand Total - Federal Amount |
| Grand Total - Local Match: |
| lbl_hidden_num_TotalLocalMatch: Grand Total - Local Match |
| Grand Total - Federal Amount: |
| lbl_hidden_num_TotalOtherFederalFunds: Grand Total - Other Federal Funds |
| Grand Total - Federal Amount: |
| lbl_hidden_num_TotalOther: Grand Total - Other |
| Grand Total - Total Cost: |
| lbl_hidden_num_TotalTotalCost: Grand Total - Total Cost |
| 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: Minimum Federal Funds Necessary |
| Provide explanation of scalability with specific references to the budget line items above (4000 characters): |
| lbl_hidden_txt_scalabilityExpl: Explanation of Scalability |
| lbl_hidden_gridTable_timelineRepeatable: Project Timeline |
| Timeline Description (100 characters): |
| lbl_hidden_gridItem_txt_tlDesc: Timeline Description |
| Timeline Item Date (format MM/DD/YYYY): |
| lbl_hidden_gridItem_datetime_tlDate: Timeline Item Date |
| 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_listPartners: Is this application a partnership between an eligible applicant and one or more private sector 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 |
| 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 |
| 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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