Tribal-Transit Supplemental Form-2019.pdf

190 KB Posted

Attached to
Public Transportation on Indian Reservations Program
Opportunity number
FTA-2019-004-TPM-TRTR
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Supplemental Form

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PKG00250844-instructions.docx DOCX document
FR-2019-09332.pdf PDF

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v1.0 SF424 Supplemental Form - Public Transportation On Indian Reservation Program (2019) Page of Applicant and Proposal Profile Tribal Transit Program (2019) Section I. Applicant Information Is this a resubmission due to an invalid/error message from FTA?

Applicant Eligibility:

Technical, Legal, and Financial Capacity

Note: Applicant should address all elements listed as part of the evaluation criteria in the Notice of Funding Opportunity (NOFO).

Note: Applicant should address all elements listed as part of the evaluation criteria in the Notice of Funding Opportunity (NOFO).

Note: Applicant should address all elements listed as part of the evaluation criteria in the Notice of Funding Opportunity (NOFO).

Section II. Evaluation Criteria (This section repeats per project) Eligibility Information (Descriptive title of this project) Project Purpose:

Project Type:

Planning and Local/Regional Prioritization Is the Project included in a local plan?

Note: Applicant should address all elements listed as part of the evaluation criteria in the Notice of Funding Opportunity (NOFO).

Project Can Be Implemented Within:

Project Can Be Obligated Within:

Note: Applicant should address all elements listed as part of the evaluation criteria in the Notice of Funding Opportunity (NOFO).

Demonstration of Benefits

Note: Applicant should address all elements listed as part of the evaluation criteria in the Notice of Funding Opportunity (NOFO).

Demonstration of Need

Note: Applicant should address all elements listed as part of the evaluation criteria in the Notice of Funding Opportunity (NOFO).

Financial Commitment and Operating Capacity

Note: Applicant should address all elements listed as part of the evaluation criteria in the Notice of Funding Opportunity (NOFO).

Annual Operating Budget

Note: Applicant should address all elements listed as part of the evaluation criteria in the Notice of Funding Opportunity (NOFO).

Planning Grant (if applicable)

Note: Applicant should address all elements listed as part of the evaluation criteria in the Notice of Funding Opportunity (NOFO).

Section III. Budget Information Project Budget Project Purpose Project Type Description

QTY

Federal Amount Local Match (10%) Total Cost Total:

Project Scalability Is Project scope scalable?

Matching Funds Information Are you applying for a Local Match Waiver?

If you are applying for a waiver, you must select "Yes" before you can proceed. By selecting "No" you will not be considered for a local match waiver.

Project Timeline Timeline Item Description Timeline Item Date Congressional District(s) (Place of Performance) Congressional District Congressional Representative 9.0.0.2.20120627.2.874785

CurrentPage:
PageCount:
btnValidate:
ResetButton1:
programCodeHidden: TribalTransit2018
programVersionHidden: 1.0
Yes:
No:
cFocus:
Grants.gov Tracking Number (13 characters):
Organization Legal Name (200 characters):
FTA Recipient ID Number (30 characters):
Applicant Eligibility - Alaska Native Village:
Applicant Eligibility - Federally Recognized Indian Tribe:
Description of current services provided (500 characters):
Description of current areas served (5000 characters):
Description of Technical Capacity to Implement Project (5000 characters):
Description of Legal Capacity to Implement Project (5000 characters):
Description of Financial Capacity to Implement Project (5000 characters):
btnAddProject:
Project Title (200 characters):
Project Executive Summary (8000 characters):
Project Purpose - Start-up/New Service (no existing service): 0
Project Purpose - Expansion: 0
Project Purpose - Replacement: 0
Project Purpose - Existing: 0
Project Type - Capital: 0
Project Type - Operating: 0
Project Type - Planning: 0
Project Type - Operating Selections:
Operating assistance justification for Indian Tribes (5000 characters):
N/A:
Planning and Local Prioritization Justification (5000 characters):
3 Months:
6 Months:
12 Months:
18 Months:
Project Readiness Justification (5000 characters):
Demonstration of Benefits (5000 characters):
Demonstration of Need (5000 characters):
Demonstration of Financial Commitment and Operating Capacity (5000 characters):
Tribe’s Annual Operating Budget (5000 characters):
Planning Studies Justification (5000 characters):
Project Purpose:
Project Type:
Item Description (100 characters):
Quantity:
Federal Amount:
Local Match:
Total Cost:
Remove Congressional District Item:
Insert Project Budget Item:
Grand Total - Federal Amount:
Grand Total - Local Match:
Grand Total - Total Cost:
If Yes, specify minimum Federal Funds necessary:
Provide explanation of scalability with specific references to the budget line items above (5000 characters):
Matching Funds Amount:
Source of Matching Funds (5000 characters):
Supporting Documentation of Local Match (5000 characters):
If Yes, add supporting documentation to demonstrate Local Match Financial Hardship. Why does tribe need a waiver for 10% local match? (5000 characters):
Timeline Item Description (100 characters):
Timeline Item Date (format MM/dd/YYYY):
Insert Project Timeline Item:
Summarize the time-line begining and ending the major tasks identified in the project budget (1000 characters):
Congressional District:
Congressional Representative:
Insert Congressional District Item:
btnRemoveProject:

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