TAG_Application_Narrative_Template.docx

Technical Assistance Grant (TAG) Project Narrative Template

Use this template to fill out the required text elements of your application as outlined in Section D.2 of the Notice of Funding Opportunity announcement.

1. Insert your organization name on page 2. Before submitting your full application package, print page 2 and have it signed by an authority in your organization; then scan that page to an Adobe pdf document to attach to the forms package.

2. You may copy/paste from another document or type directly into the space provided. Be sure to answer the questions starting on page 5.

FY 2017 Technical Assistance Grant Application

The ____{your organization name}__________ (organization) hereby applies to the Department of Transportation for Federal funds appropriated for the support of Programs established under 49 U.S.C. Section 60130 et seq.

The organization plans to carry out the Program as described in the "Project Abstract/Statement of Objectives". To accomplish the program, the organization proposes to expend funds as set forth in the "Technical Assistance Grant Estimated Budget".

Authorized Signature:____________________________

Title:_____________________________________

Date:_____________________________________

Project Abstract/Statement of Objectives

Please provide a clear and concise description of the work this grant will fund

{type or insert your Project Abstract here}

QUESTION 1

Describe the proposed project scope, goals and objectives that focus on areas where a pipeline failure could pose a significant risk to people or to unusually sensitive environmental areas (see definition in 49 CFR 195.6).

{type or insert your response here}

QUESTION 2

Describe the specific pipeline safety concerns the proposed project will address, including the range of risks that affected pipelines pose to the affected geographic area and the risks pipelines pose to the community.

{type or insert your response here}

QUESTION 3

Describe how the proposed project will foster open communication with affected pipeline operators and partnerships with other key members of the community to ensure project success.

{type or insert your response here}

QUESTION 4

Describe how the proposed project is designed to improve performance and safety over time and align with the challenges and strategies in pipeline safety, such as engineering, damage prevention, land use planning, education and outreach, emergency response, and/or community awareness.

{type or insert your response here}

QUESTION 5

Describe the specific project plan including resources, milestones, and estimated project costs that align with proposed project goals and objectives.

QUESTION 6

Describe how proposed project results and deliverables will be measured, evaluated and disseminated to affected stakeholders.

{type or insert your response here}

QUESTION 7

Describe how the proposed project provides the potential for learning or technology transfer to other groups and communities.

2016 State Damage Prevention Grant Page: 19