2014 Rural (Non-Urbanized) Grant Application

FTA Section 5316 Job Access & Reverse Commute (JARC)

&

FTA Section 5317 New Freedom (NF)

State of Hawaii

Department of Transportation

Statewide Transportation Planning Office

200 Rodgers Boulevard

Honolulu, Hawaii 96819

2014 Rural (Non-Urbanized) Grant Application * FTA Section 5316 Job Access & Reverse Commute (JARC) & FTA Section 5317 New Freedom (NF)
Agency (Applicant) Name
Address
City County Zip
Contact Person
Phone	FAX	E-Mail Address
Applicant Name (print): Title (print) Signature: Date:

* Individual applications must be submitted for:

Non-Urbanized: JARC capital, JARC operating, NF capital and NF operating

I. PROGRAM OVERVIEW

A. SAFE, ACCOUNTABLE, FLEXIBLE, EFFICIENT TRANSPORTATION EQUITY ACT:

A LEGACY FOR USERS

On August 10, 2005, President George W. Bush signed into law the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users (SAFETEA-LU). The Job Access & Reverse Commute (JARC) and New Freedom (NF) Programs are authorized under the provisions set forth in SAFETEA-LU. These provisions authorize the U.S. Secretary of Transportation to apportion funds to each state as U.S. Department of Transportation Federal Transit Administration (FTA) grants. SAFETEA-LU also includes new planning requirements for the JARC and New Freedom Programs. Projects funded through these programs “must be derived from a locally developed, coordinated public transit-human services transportation plan”.

The Governor of Hawaii designates the Hawaii Department of Transportation (HDOT) as the recipient of Federal Transit Administration (FTA) Section 5316 JARC and 5317 New Freedom grants for the purpose of administering those funds in accordance with State and federal laws, rules and regulations. HDOT administers the Section 5316 JARC and Section 5317 New Freedom funds allocated to small urbanized areas (50,000 – 200,000 population) and non-urbanized areas (<50,000 population). Large urban area (> 200,000 population) JARC/New Freedom funds are administered by the City and County of Honolulu, Department of Transportation Services (DTS).

B. FTA Section 5316 JARC Program Goals

The JARC program goal is to improve access to transportation services to employment and employment-related activities for welfare recipients and eligible low-income individuals and to transport residents of urbanized areas and non-urbanized areas to suburban employment opportunities. Toward this goal, FTA provides financial assistance for transportation services planned, designed, and carried out to meet the transportation needs of eligible low-income individuals in all areas. Another goal is to implement coordination of Federally-assisted programs and services in order to make the most efficient use of federal resources.

JARC information at:

http://www.fta.dot.gov/grants/13093_3550.html

C. FTA SECTION 5317 NEW FREEDOM program Goals

The New Freedom program goal is to provide new public transportation services to overcome existing barriers facing Americans with disabilities seeking integration into the workforce and full participation into society. Lack of adequate transportation is a primary barrier to work for individuals with disabilities. New Freedom also seeks to expand the transportation mobility options available to persons with disabilities beyond requirements of the Americans with Disabilities Act of 1990 (42 U.S.C. 12101, et seq.). The definition of “new service” is any service or activity that was not implemented or operational before August 10, 2005.

New Freedom information at:

http://www.fta.dot.gov/grants/13093_3549.html

II. GRANT APPLICATION INFORMATION

Eligible Applicants

Eligible applicants include state or local governmental bodies, social services agencies, private and public transportation operators, and non-profit organizations.

Eligible Use of Program Funds

SAFETEA-LU requires that all JARC and New Freedom projects selected for funding must be derived from a locally developed Coordinated Public Transit-Human Services Transportation Plan (Coordinated Services Plan). The Coordinated Services Plan identifies existing services, needs, strategies and priorities for low-income individuals, individuals with disabilities and older adults. (Please see Page 8 Coordinated Services Plan Certification.)

Eligible Activities for JARC and NEW FREEDOM Projects

JARC/New Freedom capital and operating expenses are funded for the current year per project. Projects approved for multi-year funding require yearly application updates to ensure compliance with the original approved project scope. Multi-year funding may be granted to continue the advancement or expansion of the intended purpose of an approved grant. Funding commitments in the second and third year are not guaranteed, but will be granted pending the level of federal appropriations to the State of Hawaii. Eligible JARC projects include, but are not limited to:

JARC Operating Activities	JARC Capital Activities
Late night and weekend service Guaranteed ride home service Shuttle service Expanded fixed-route public transit routes Demand-responsive service Ridesharing and carpooling activities Voucher programs Implementing automated regional public transit and human services transportation information, scheduling and dispatch functions Subsidizing the costs associated with adding reverse commute bus, train, carpool van routes or service from urbanized areas and nonurbanized areas to suburban work areas Development and operation of “One-Stop” transportation call centers to coordinate transportation information on all travel modes and to manage eligibility requirements and arrangements for customers among supporting programs	Intelligent Transportation Systems (ITS) Acquisition of coordinated vehicle scheduling, dispatching and monitoring technologies Acquisition of Vehicles Development of Mobility Management Centers or facilities Acquisition of Geographic Information System (GIS) tools Acquisition of Global Positioning System (GPS) tools

New Freedom funds are available for capital and operating expenses to support new public transportation services beyond those required by the Americans with Disabilities Act of 1990 (ADA). The definition of “new service” is any service or activity that was not implemented or operational before August 10, 2005. New Freedom eligible activities include, but are not limited to:

NEW FREEDOM Operating Activities	NEW FREEDOM Capital Activities
Expansion of complementary paratransit service beyond the ¾ mile minimum requirements of ADA and defined as a “new” service Expansion of current hours of operations for ADA paratransit service beyond those provided on the fixed-route services; and defined as a “new” service Expansion of transit operations including driver pool to meet the demand of increased client and ridership Enhancement of the level of service by providing escorts or assisting riders through the door of their destinations Supporting the administration and expenses related to a new Voucher program for transportation services offered by human services providers Supporting new Volunteer driver and aide programs Supporting new mobility management and coordination programs among public transportation providers and other human services agencies providing transportation.	Acquisition of accessibility equipment (e.g. larger capacity lifts) designed to accommodate mobility aids that exceed dimensions and weight ratings established for common wheelchairs under the ADA and labor costs of aides to help drivers assist passengers with over-sized wheelchairs Installation of additional securement locations in public buses beyond what is required by ADA Purchasing accessible vehicles to support taxi, vanpooling, and/or ridesharing programs Building accessible path to a bus stop that is currently inaccessible Adding an elevator or ramp, detectable warnings or other accessibility improvements to a non-key station that are not otherwise required under the ADA Improving signage, or way-finding technology Implementation of other technologies that enhance accessibility for people with disabilities including Intelligent Transportation Systems (ITS). Mobility management activities

II. GRANT APPLICATION INFORMATION (cont.)

JARC/NF Performance Measures

Upon approval and receipt of FTA JARC and NF funds, applicants become responsible for satisfying program performance measures. HDOT reviews the applicant’s performance measures to validate the effectiveness of projects funded under FTA 5316 (JARC) and 5317 (New Freedom). The following performance measures are required to be submitted to HDOT on an annual basis.

JARC Program

Actual or estimated number of jobs that can be accessed as a result of geographic coverage of JARC projects implemented on the current reported year

Actual or estimated number of rides (as measured by one-way trips) provided as a result of the JARC projects implemented in the current reporting year

Estimated number of persons served by this project

NEW FREEDOM Program

Increase or enhancements related to geographic coverage, service quality and or service times that impact availability of transportation services for individuals with disabilities as a result of the New Freedom projects implemented in the current reporting year

Additions or changes to environmental infrastructure (e.g. transportation facilities, side walks, etc), technology, and vehicles that impact availabilities of transportation services as a result of the New Freedom projects implemented in the current reporting year

Actual or estimated number of rides (measured by one-way trips) provided for individuals with disabilities as a result of the New Freedom projects implemented in the current reporting year

Number of calls requesting information about the program

Number of service complaints or responses

Estimated number of persons served by this project

Buy America (Applicable to 5316 and 5317)
Buy America. 49 U.S.C. 5323(j) provides that, with exceptions, Federal funds may not be obligated for public transportation projects unless steel, iron, and manufactured products used in such projects are produced in the United States. JARC designated recipients and sub-recipients must conform with FTA regulations, 49 CFR part 661, and any amendments thereto. Buy America requirements apply to all purchases, including materials or supplies funded as operating costs, if the purchase exceeds the threshold for small purchases (currently $100,000). A manufacturer or supplier of steel, iron, or manufactured goods may be permitted to correct, after bid opening, an incomplete certification or a certification of noncompliance under certain circumstances if submission of the incorrect certification was the result of an inadvertent or clerical error. In addition, 49 U.S.C. 5323(j)(9) now allows a party adversely affected by an FTA action the right to seek review.

F. Cost Sharing/Match Requirement:

FTA will fund to a maximum of 80% of the total capital project cost, and to a maximum of 50% of the total project cost for operating assistance. HDOT is permitted to use and may retain 10% of the apportionment for administrative program costs, which includes planning and technical assistance.

The U.S. Department of Transportation (USDOT) program funds cannot be used as a source of local match for other FTA programs. Allowable sources for local match monies for JARC and/or New Freedom Programs operating assistance include dedicated tax revenues, private donations, revenue from human service contracts, and net income generated from advertising and concessions. Flexible matching share requirements allow coordination with other federal programs with transportation related functions such as Health and Human Services and Agriculture.

G.	Statewide Project Selection Process:

HDOT manages all JARC and New Freedom projects through a competitive selection process. All JARC and New Freedom projects will be judged according to the scoring criteria in order to determine the extent to which the proposed project meets the overall program goals and objectives of the program.

HDOT will establish an application review committee, which will be comprised of staff from non-applicant agencies, such as health and human services agencies, transit agencies and social services agencies, to review, score and rank the project applications.

III. APPLICATION CHECKLIST

Applicants should use this checklist to ensure that all documents and attachments are completed.

A. PROGRAM COMPLIANCE

Check if completed

COORDINATED PLAN CERTIFICATION
PRIVATE NON-PROFIT AGENCY INQUIRY & CERTIFICATION
GENERAL CERTIFICATIONS AND ASSURANCES
LABOR UNION INFORMATION
CIVIL RIGHTS
AGENCY PROFILE AND PROJECT DESCRIPTION
APPLICANT’S ANNUAL BUDGET

B. PROGRAM INFORMATION

Check if completed

PART 1.	JARC / NEW FREEDOM PROJECT SUMMARY
PART 2.	APPLICATION DEADLINE – Be aware of deadlines
PART 3.	PROJECT SCORING CRITERIA
PART 4.	PROJECT NARRATIVE
PART 5.	PROPOSED OPERATING BUDGET: 5316 JARC / 5317 NEW FREEDOM
PART 6.	PROPOSED CAPITAL BUDGET: 5316 JARC / 5317 NEW FREEDOM
PART 7.	OTHER TYPE OF CAPITAL ACQUISTIONS
PART 8.	MAINTENANCE PLAN (FOR VEHICLES, EQUIPMENTAND/OR FACILITY
A. PROGRAM COMPLIANCE

1. Coordinated Services Plan Certification

Reference: FTA C 9070.1F (JARC) Chapter V and FTA C 9045.1 (New Freedom) Chapter V pertaining to the requirements of a Coordinated Public Transit Human – Services Transportation Plan (Coordinated Services Plan) required of FTA 5310, 5316 and 5317 programs.

As part of the local coordinated planning process, the HDOT met in consultation with its neighbor island transit providers, local agencies, other State agencies, non-profit organizations and members of the public. The HDOT Coordinated Public Transit Human – Services Plan is intended to be an evolving plan that continues to identify, address and resolve service and transportation problems, gaps, overlaps and/or barriers under the FTA 5310 Elderly and Disabled, 5316 JARC, and 5317 New Freedom programs.

The most current Coordinated Public Transit Human – Services Plan (CSP) is located on the HDOT website at:

http://hidot.hawaii.gov/administration/files/2013/01/final-plan-hi-csp.pdf

Appendix D, page 149 of the CSP lists the Hawaii Statewide Transportation Goals and Objectives

The applicant is required to identify all Goals and Objectives listed in Appendix D of the CSP that pertains to their project.

List Goals and Objectives:

By completing and signing this certification, the applicant understands and agrees that the projects selected for funding under FTA Section 5316 (JARC) and 5317 (New Freedom) programs are “derived from a locally developed, coordinated public transit Human – Services transportation Plan” that was “developed through a process that includes representatives of public, private, and non-profit transportation and human services providers and participation by members of the public.”

____________________________	_____________

Applicant’s Authorized Signature	Date

2. Private Nonprofit Agency Status Inquiry and Certification

If you are claiming private non-profit status as an applicant for FTA Section 5316 or 5317 funding, you must provide official documentation verifying your organizations private non-profit status (e.g. State of Hawaii Department of Commerce and Consumer Affairs (DCCA) Certificate of Good Standing or Annual Report, or US Internal Revenue Service Tax Exemption).

Do not submit Articles of Incorporation, By-Laws or Tax status documentation.

Private Non-profits
Name of Non-profit Applicant:
State of Hawaii Articles of Incorporation No.:
Date of Incorporation:
Signature of applicant Certifying Active Status:

A. PROGRAM COMPLIANCE (cont.)

3. General Certifications and Assurances

The original of the “General Certifications and Assurances” should be signed and dated in black or blue ink. Use the legal name of your agency exactly as it appears on your Status Inquiry form. If you are a public entity, attach an authorizing resolution, designating a person authorized to sign on behalf of the agency, as an Appendix to the application.

Name of Applicant Agency:
Address:
Contact Person:	Work Phone:	Work Fax:

a.	The applicant assures that no person, on the grounds of race, color, creed, national origin, sex, age, or disability shall be excluded from participating in, or denied the benefits of, or be subject to discrimination under any project, program, or activity (particularly in the level and quality of transportation services and transportation-related benefits) for which the applicant receives Federal assistance funded by the Federal Transit Administration (FTA).

b.	The applicant assures that it shall not discriminate against any employee or applicant for employment because of race, color, creed, national origin, sex, age or disability and that it shall take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, color, creed, national origin, sex, or age.

c.	The applicant certifies that it will conduct any program or operate any facility that receives or benefits from Federal financial assistance administered by FTA in compliance with all applicable requirements imposed by or pursuant to 49 CFR Part 27, “Nondiscrimination on the Basis of Handicap in Programs and Activities Receiving or Benefiting from Federal Financial Assistance” and the Americans with Disabilities Act of 1990, as amended, at 49 CFR Parts 27, 37, & 38.

d.	The applicant assures that it will comply with the Federal statutes, regulations, executive orders, and administrative requirements, which relate to applications made to and grants received from FTA. The applicant acknowledges receipt and awareness of the list of such statutes, regulations, executive orders, and administrative requirements that is provided as references in FTA Circular 9045.1 “New Freedom Program Guidance and Application Instructions, dated May 1, 2007.”

e.	The applicant certifies that the contracting and procurement procedures that are in effect and will be used by the applicant for Section 5316 and 5317 equipment are in accordance and comply with the significant aspects of FTA Circular 4220.1, "Third Party Contracting Guidelines."

f.	The applicant certifies that any proposed project for the acquisition of or investment in rolling stock is in conformance with FTA rolling stock guidelines.

g.	The applicant certifies that it will comply with applicable provisions of 49 CFR Part 605 pertaining to school transportation operations which prohibits federally-funded equipment or facilities from being used to provide exclusive school bus service.

h.	The applicant certifies that it will comply with Government Code 41 U.S.C.701 et seq, and 49CFR, Part 32 in matters relating to providing a drug-free workplace.

i.	To the best of my knowledge and belief, the data in this application are true and correct, and I am authorized to sign these assurances and to file this application on behalf of the applicant.

Certifying Representative

Name (print):
Title (print)
Signature:	Date

A. PROGRAM COMPLIANCE (cont.)

4. LABOR UNION INFORMATION

The following information is required by FTA to ensure fair and equitable labor practices.

Name of Applicant:
Project Description:
Union Representation of Applicant’s Employees

Organization Name:
Contact Person:
Address:
Telephone:
(required) Email :

Other Surface	Union Representation of Employee
Public Transportation Providers	If Any
Organization: Contact Person: Address: Telephone: (required) Email:
Organization: Contact Person: Address: Telephone: (required) Email:
Organization: Contact Person: Address: Telephone: (required) Email:

A. PROGRAM COMPLIANCE (cont.

5. CIVIL RIGHTS COMPLIANCE

If you or your agency has any lawsuits or complaints that have been received or acted on in the last year based on Title VI of the Civil Rights Act or other relevant civil rights requirements describe here. Provide the status of lawsuits or an explanation of how complaints were resolved, including corrective actions taken.

(OR)

If NO lawsuits or complaints were received or acted on – certify below that, as a subrecipient of FTA funds, you agree and attest to the following statement:

THERE WERE NO LAWSUITS OR COMPLAINTS RECEIVED OR ACTED ON IN THE LAST YEAR RELATING TO TITLE VI OR OTHER RELEVANT CIVIL RIGHTS REQUIREMENTS.

Certifying Representative

Name (print):
Title (print)
Signature:	Date

A. PROGRAM COMPLIANCE (cont.)

6. APPLICANT PROFILE AND PROJECT DESCRIPTION

Briefly describe your agency’s purpose and the services it provides. Attach Supporting Documents (e.g., agency brochure).

Briefly describe each of your agency’s programs. Include client profile and number of clients served in each program

Briefly describe the current population and geographic area(s) that is served and the population and geographic area(s) that will be served by this project. Supporting documentation and an

8-1/2 x 11 map of the service area must be attached.

A. PROGRAM COMPLIANCE (cont.)

7. APPLICANT’S ANNUAL BUDGET

1. Transportation Program Annual Budget:

Estimated Income:
Passenger Revenue	$
Other Revenues	$
Total grants*, donations, subsidy from other agency funds	$
TOTAL INCOME	$
*Not including this grant request.
Estimated Expenses:
Wages, Salaries and Benefits (non-maintenance personnel)	$
Maintenance & Repair (include maintenance salaries)	$
Fuels	$
Casualty & Liability Insurance	$
Administrative & General Expense	$
Other Expenses (e.g., materials & supplies, taxes)	$
Contract Services (specify)__________________________	$
TOTAL EXPENSES	$

2. Applicant’s Funding Source(s):

AMOUNTS
SOURCE(S):	Prior Year (2010)	Current Year (2011)	Budget Year (2012)	Budget Year (2013)
a.	$	$	$	$
b.	$	$	$	$
c.	$	$	$	$
d.	$	$	$	$
TOTAL	$	$

B. PROGRAM INFORMATION

1. JARC/NEW FREEDOM PROJECT SUMMARY

A. Applicant Information:
Check all that applies Current 5316 Recipient Current 5317 Recipient Applying for other federal funds this year. Source(s): ________________
B. Type of Project (check one):	(Submit separate capital & operating applications.)
Capital Only (80% Fed/20% Local) Operating Only (50% Fed/50% Local)
C. Program (check one):
JARC Non-Urban (Rural) Project - FTA Section 5316 New Freedom Non-Urban (Rural) Project - FTA Section 5317
D. JARC/New Freedom Project Information:
Number of JARC welfare recipients:
Number of eligible JARC low-income persons:
Number of persons with disabilities:
E. Funding Request: (See Type of Project in Block “B” in computing Federal/Local Share)
Total Project Cost	$
FTA Share	$
Local Share	$
F. Identify Source(s) of Local Share.
$
$
$
$
$
$
Total Local Share	$

B. PROGRAM INFORMATION (cont.)

2. PROJECT SCORING CRITERIA

The Project Narrative will be ranked in accordance with the following Project Scoring Criteria. Scores will be calculated within a 0 – 10-point range per item, except items 3 and 8 of the Project Narrative, which carry a maximum value of 20 points. To receive the maximum points, each response must be complete and contain the required supporting documentation. Incomplete responses and/or a lack of supporting documentation will result in reduced scores.

JARC or New Freedom Program Goals and Objectives

Item 1. The applicant must be consistent in meeting the overall JARC or New Freedom Program Goals and objectives (see page 2 of this application). (10 point maximum).

Item 2. The applicant demonstrates how project activities directly address transportation gaps, overlaps, and/or barriers in service identified through the locally developed human services transportation planning process within their communities. (Applicant indicates the section/page number in the Coordinated Plan addressing the gaps and/or barriers). (10 point maximum.)

Operational/Implementation Plan

Item 3. The applicant provides a well-defined operations plan with defined routes, schedules, current/projected ridership, key personnel, and marketing strategies with supporting documentation for carrying out the project. For Capital and Mobility Management projects, the applicant provides an implementation plan that includes project tasks, timeframes, benchmarks, key milestones, key personnel, deliverables and estimated completion date with supporting documentation. Both the operations and implementation plans must identify key personnel assigned to this project and their qualifications, including resumes and certifications as supporting documentation. The applicant demonstrates their institutional capability to carry out the service delivery aspect of the project. (20 point maximum.)

Program Effectiveness and Performance Indicators

Item 4. The applicant identifies clear measurable outcome-based performance measures and indicators to track the effectiveness of the project (see page 5 JARC/New Freedom Performance Goals of the application). The applicant states the number of persons to be served, trip purpose(s), and the number of trips. Additional measurable units of service can also be used. The applicant describes the outcome (impact) that the project will have on low-income (JARC) or individuals with disabilities (New Freedom). (10 point maximum.)

Item 5. The applicant describes a process that details the ongoing monitoring and evaluation of the project or service, including methodologies and desired outcomes based upon the performance objectives identified in Question 4. (10 point maximum.)

Communication and Outreach

Item 6. Any Stakeholder list (list of any group or individual who is affected by or can affect the achievement of your organization’s objectives) should include, but not be limited to, Health and Human Services Agencies, public/private sector, non-profit agencies, transportation providers, and members of the public representing low-income (JARC) and individuals with disabilities (New Freedom). The applicant is evaluated based on their ability to coordinate with other community transportation and/or social service resources. (10 point maximum.)

E. Stakeholder Notification

Item 7. A stakeholder is defined as any group or individual who is affected by or can affect the achievement of your organization’s objectives. The applicant must keep stakeholders involved and informed of project activities throughout the project timeline. The applicant must describe how they would promote public awareness of the project. Three (3) letters of support from stakeholders must be attached to the grant application. (One of the three support letters may come from a client of the proposed project.) (10 point maximum.)

F. Project Budget

Item 8. The applicant must provide budget information as described on the form(s) supplied in the next Section. A complete listing of budgetary information will be necessary to receive the full 20-point value. Failure to provide all of the required information will result in 0 points for this question. The applicant must submit a clearly defined project budget, indicating anticipated project expenditures and revenues, including documentation of matching funds. (20 point maximum.)

B. PROGRAM INFORMATION (cont.)

3. PROJECT NARRATIVE

Complete the following Sections: Project Narrative, and Proposed Budget Information. Describe the project and proposed budget as concisely as possible. Refer to the Project Scoring Criteria beginning on page 17 for guidance on each of the questions. Each response will be reviewed and scored for clarity, completeness and accuracy.

Project Description

Briefly describe your project. For operating fund requests describe the program and how these funds will be used. Include proposed start and end dates. For capital funding requests, briefly describe your capital purchase and attach detailed specifications. For vehicle purchases attach vehicle specifications.

A. Project Goals and Objectives

Briefly describe how your proposed project is consistent with the goals and objectives of either the JARC or New Freedom grants programs, as listed in the program goals on Page 2 of this application. (10 point maximum)

Specify how your project addresses gaps, overlaps and/or barriers in service identified through your locally developed human services transportation planning process (coordinated services plan). (Indicate the section/page number in the coordinated services plan addressing the gaps, overlaps and/or barriers.) (10 point maximum.)

B.	Operational/Implementation Plan

For Operating projects, describe your operational plan that includes defined routes (may include a map of areas being served), schedules, current/projected ridership, key personnel, and marketing strategies. For Capital and Mobility Management projects, describe your implementation plan that includes project tasks, timeframes, benchmarks, key milestones, key personnel, deliverables and estimated start and completion date. Attach supporting documentation to substantiate this plan(s). (20 point maximum.)

C. Program Effectiveness and Performance Indicators

Identify the performance measures and indicators (See page 5 for JARC/New Freedom Performance Measures) to track the effectiveness of your proposed JARC/New Freedom project and provide: (10 point maximum)

The current (baseline) information.

The type of and number of persons you anticipate to be served

The number and purpose of trips (and other measurable units of service) the project will provide.

Include the desired outcome (impact) that the project will have on low-income (JARC) or individuals with disabilities

Based upon the performance objectives and outcomes identified in Item 4 above, describe your methodologies and procedures for ongoing monitoring and evaluation of the project or service. (10 point maximum.)

D. Communication and Outreach

List all stakeholders (any group or individual who is affected by or can affect the achievement of your organization’s objectives) who are or will be involved in the project. This list should include, but not be limited to, Health and Human Services Agencies, public/private sector, non-profit agencies, transportation providers, and members of the public representing low-income (JARC) and individuals with disabilities (New Freedom). Attach no more than three (3) letters of support from stakeholders to the grant application. (10 point maximum.)

Describe how you will promote public awareness of the project and how you will keep stakeholders involved and informed throughout the project. (10 point maximum.)

E. Project Budget

Provide a complete budget plan, showing revenues and expenditures in the format provided below. Estimate the proposed cost per trip (or other unit of service). Briefly describe efforts to ensure its cost-effectiveness. (20 point maximum.)

B. PROGRAM INFORMATION (cont.)

4. PROPOSED OPERATING BUDGET

5316 JARC or 5317 NEW FREEDOM

(1)	Total Operating Expenses (Itemize)
$
$
$
$
TOTAL OPERATING EXPENSES	$	$	(1)

(2))	Less Fare box and Other Revenue (For Public Operators Only)
$
$
$
$
TOTAL FAREBOX AND OTHER REVENUE APPLIED AGAINST ELIGIBLE EXPENSES	$	$	(2)

(3)	Less Ineligible Expenses (within operating expense) **
$
$
$
$
TOTAL INELIGIBLE EXPENSES	$	$	(3)

(4)	NET PROJECT COST (Line 1 – Line 2 – Line 3)	$	(4)

(5)	Local Share (Itemized by Source Type & Amount)
$
$
$
TOTAL LOCAL SHARE	$	$	(5)

(6)	FEDERAL SHARE*	$	(6)

(7)	BUDGET SUMMARY: Local Share + Federal Share = Total Project Cost
LOCAL SHARE: (50%)	$	(5)
FEDERAL SHARE: (50%)	+	$	(6)
TOTAL PROJECT COST:	=	$	(7)

** Examples of ineligible expense may include lobbying, depreciation, contributions, inter-department salary, etc.

B. PROGRAM INFORMATION (cont.)

5. PROPOSED CAPITAL BUDGET

5316 JARC or 5317 NEW FREEDOM

ITEM DESCRIPTION	COST
$
$
$
$
$
TOTAL PROJECT COST:	$

LOCAL SHARE (Itemize by Source Type & Amount)	AMOUNT
$
$
$
$
$
TOTAL LOCAL SHARE = Allowable Percentage (20%)	$
TOTAL FEDERAL SHARE= Allowable Percentage (80%)	$

B. PROGRAM INFORMATION (cont.)

6. OTHER TYPE OF CAPITAL ACQUISITIONS

Other type of “Capital Acquisitions” include equipment considered for and in support of a transit program or operation and may, for example, be transit related communication equipment (two-way radios, GPS, GIS), computer equipment including hardware and/or related software or any other auxiliary equipment (vehicle cameras). These purchase acquisitions typically will be used to support your transportation operation in proportion to the number of vehicles you operate in your transportation program. For procurement purposes, the applicant must obtain and submit three (3) estimates of equipment with this application. If equipment is to be sole sourced, written justification must be attached.

Describe the type of equipment you are interested in purchasing including the Make, Model and Year of the equipment and a cost estimate for each item.

Discuss how the requested equipment will be used to support the transit and transportation program, any expected improvements in service delivery or coordination, and any foreseeable reduction in the cost of providing service by using the equipment. If computer equipment is being requested for collecting and fleet tracking purposes, describe current method of collecting and tracking information.

B. PROGRAM INFORMATION (cont.)

7. MAINTENANCE PLAN

Enclose a copy of your maintenance plan for your vehicle(s), equipment and/or facilities to show evidence of your ability and commitment to maintain FTA-funded vehicles, equipment and facilities.

The maintenance plan may include a manufacturer’s warranty, manufacturer’s maintenance schedule, and/or may be plans developed and performed by personnel employed by the agency, or performed by any authorized service dealer that your agency utilizes.

The maintenance plan should contain at minimum: maintenance procedures or checklist, maintenance schedule, a list of the name, address and telephone number of any authorized service dealer(s) your agency utilizes.

Maintenance/repair records shall be retained and available for on-site inspection and other HDOT oversight.