COPS Application Attachment to SF-424-CHRP

Standard Application Forms

After logging in, the grantee will choose CHRP from the menu of options (attached below) and then the Eligibility section will pop up

Applicant Legal Name ORI

Welcome to the COPS Hiring Recovery Program (CHRP) Application

Please read the CHRP Application Guide carefully before completing the eligibility worksheet and starting your application.

CHRP Eligibility Worksheet

Please note that the answers to these questions will determine your eligibility for funding under this program. If you have any questions regarding your eligibility, a copy of this worksheet is available at www.cops.usdoj/??????. The COPS Office recommends that you review this information before moving forward with this worksheet. If you have questions regarding your eligibility after reviewing this information, please contact the COPS Office Response Center at 1.800.421.6770.

Note that if you are deemed ineligible at any point during your completion of the eligibility worksheet, the system will prevent you from accessing the remainder of the grant application.

1. Is your law enforcement agency a start-up agency?

Start-up agencies are not eligible for funding under this program. If you select yes, the system will prevent you from completing the rest of the grant application.

(Yes—ineligible)

(No—move to 2)

2. Is your agency applying for this grant as part of a consortium of agencies?

Agencies applying for funds as a consortium are not eligible for funding under this program. However, agencies within that consortium are encouraged to apply individually. If you select yes, the system will prevent you from completing the rest of the grant application.

(Yes—ineligible)

(No—move to 3)

3. Is your agency a tribal law enforcement agency?

(Yes- move to 3a)

(No – move to 4)

3a. Is your agency a Federally Recognized Tribe?

Only Federally Recognized Tribes are eligible to apply for funding under this grant program. If you select NO, the system will prevent you from completing the rest of the grant application.

(Yes – move to 4)

(No – ineligible)

4. Is your agency applying for funds under this grant to contract for law enforcement services?

(Yes——move to 4a)

(No—move to 5)

4a. Is your agency a Federally Recognized Tribe applying for funds under this grant to contract with the Bureau of Indian Affairs (BIA) for law enforcement services?

Only Federally Recognized Tribes that either have their own established law enforcement agency or plan to use the grant funds to pay for contract services with the BIA are eligible to apply for funding under this grant program. If you select No, the system will prevent you from completing the rest of the grant application.

(Yes—Move to 5)

(No—ineligible)

5. Does the law enforcement agency have primary law enforcement authority for the population served?

Only agencies that have primary law enforcement authority are eligible to apply for funding under this grant program. An agency with primary law enforcement authority is defined as the first responder to calls for service, and has ultimate and final responsibility for the prevention, detection, and/or investigation of crime within its jurisdiction. If you select no, the system will prevent you from completing the rest of the grant application.

(Yes—move to 6)

(No—ineligible)

6. Is your law enforcement agency a type other than a local, state, or tribal agency (e.g., Transit, School, University/College, Public Housing, Natural Resources, Parks, etc.)?

(Yes—move on to 6a)

(No—move on to 7)

6a. Does your agency have legislation that authorizes sworn law enforcement officers with full arrest authority and full police powers?

Agencies that do not have legislation that authorizes sworn law enforcement officers with full arrest authority and full police powers are not eligible for funding under this grant program. If you select no, the system will prevent you from completing the rest of the grant application.

(Yes—move on 7)

(No—ineligible)

7. Has your agency planned to retain all position(s) awarded under this grant program for at least one full local budget cycle following the conclusion of 36 months of grant funding?

Agencies that do not plan to retain all position(s) awarded under CHRP for at least one full local budget cycle are not eligible for funding under this grant program. If you select no, the system will prevent you from completing the rest of the grant application.

(Yes—questionnaire complete)

(No—ineligible)

Application for Federal Assistance SF-424 Version 02
*1. Type of Submission: Preapplication Application Changed/Corrected Application	*2. Type of Application New Continuation Revision			* If Revision, select appropriate letter(s)
				*Other (Specify)      
3. Date Received : 4. Applicant Identifier:            
5a. Federal Entity Identifier:      			*5b. Federal Award Identifier:      
State Use Only:
6. Date Received by State:      		7. State Application Identifier:      
8. APPLICANT INFORMATION:
*a. Legal Name:      
*b. Employer/Taxpayer Identification Number (EIN/TIN):      			*c. Organizational DUNS:      
d. Address:
*Street 1:      
Street 2:      
*City:      
County:      
*State:      
Province:      
*Country:      
*Zip / Postal Code      
e. Organizational Unit:
Department Name:      			Division Name:      
f. Name and contact information of person to be contacted on matters involving this application:
Prefix:       *First Name:      
Middle Name:      
*Last Name:      
Suffix:      
Title:      
Organizational Affiliation:
*Telephone Number:       Fax Number:      
*Email:      

Application for Federal Assistance SF-424 Version 02

*9. Type of Applicant 1: Select Applicant Type:

Type of Applicant 2: Select Applicant Type:

Type of Applicant 3: Select Applicant Type:

*Other (Specify)

     

*10 Name of Federal Agency:

     

11. Catalog of Federal Domestic Assistance Number:

     

CFDA Title:

     

*12 Funding Opportunity Number:

     

*Title:

     

13. Competition Identification Number:

     

Title:

     

14. Areas Affected by Project (Cities, Counties, States, etc.):

     

*15. Descriptive Title of Applicant’s Project:

     

Application for Federal Assistance SF-424 Version 02
16. Congressional Districts Of: *a. Applicant:       *b. Program/Project:      
17. Proposed Project: *a. Start Date:       *b. End Date:      
18. Estimated Funding ($):
*a. Federal *b. Applicant *c. State *d. Local *e. Other *f. Program Income *g. TOTAL	     
	     
	     
	     
	     
	     
*19. Is Application Subject to Review By State Under Executive Order 12372 Process? a. This application was made available to the State under the Executive Order 12372 Process for review on       b. Program is subject to E.O. 12372 but has not been selected by the State for review. c. Program is not covered by E. O. 12372
*20. Is the Applicant Delinquent On Any Federal Debt? (If “Yes”, provide explanation.) Yes No
21. *By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. (U. S. Code, Title 218, Section 1001) By clicking this box and typing my name below, I also certify that I have been legally and officially authorized by the appropriate governing body to submit this application and act on behalf of the grant applicant entity. I certify that I have read, understand, and agree, if awarded, to abide by all of the applicable grant compliance terms and conditions as outlined in the COPS Application Guide, the COPS Grant Owner’s Manual, assurances, certifications and all other applicable program regulations, laws, orders, or circulars. In addition, I certify that the information provided on this form and any attached forms is true and accurate to the best of my knowledge. I understand that false statements or claims made in connection with COPS programs may result in fines, imprisonment, debarment from participating in federal grants, cooperative agreements, or contracts, and/or any other remedy available by law to the federal government. ** I AGREE ** The certifications and assurances as well as grant terms and conditions can be reviewed at www.cops.usdoj/????.
Authorized Representative:
Prefix:       *First Name:       Middle Name:       *Last Name:       Suffix:      
*Title:      
*Telephone Number:      			Fax Number:      
* Email:      
*Signature (Typed Name) of Authorized Representative:      				*Date Signed:      

OMB Number: 4040-0004

Expiration Date: 01/31/2009

*Applicant Federal Debt Delinquency Explanation

The following should contain an explanation if the Applicant organization is delinquent of any Federal Debt.

     

Applicant Legal Name ORI

COPS Hiring Recovery Program (CHRP) Application

COPS Application Attachment to SF-424

The COPS Hiring Recovery Program (CHRP) is a competitive grant program that provides funding directly to law enforcement agencies having primary law enforcement authority to create and preserve jobs and to increase their community policing capacity and crime-prevention efforts. CHRP funding is available to hire full-time career law enforcement officers. There is no local matching requirement, but grant funding will be based on your agency’s current entry-level salaries and benefits for sworn officer positions. Any additional costs for higher salaries and benefits for positions hired under the CHRP grant must be paid for by the grantee agency.

In preparing your agency’s grant application, please be advised that grantees are prohibited from reducing state, local, or tribal funding for sworn officer positions as a direct result of applying for and/or receiving this CHRP grant. Instead, this program is intended to supplement the amount of state, local, or tribal funding that your agency would otherwise be able to budget for sworn officer positions.

In addition, at the conclusion of federal funding, grantees must retain all sworn officer positions awarded under the CHRP grant. The retained CHRP-funded positions should be added to your agency’s law enforcement budget with state and/or local funds, over and above the number of locally-funded sworn officer positions that would have existed in the absence of the grant.

To the extent possible, all data should come from a publicly verifiable source, and documentation may be requested by the COPS Office. This information will be used to evaluate your jurisdiction’s need for federal assistance to address its public safety needs and to preserve and create jobs.

SECTION 1: EXECUTIVE INFORMATION

Note: Listing individuals without ultimate programmatic and financial authority for the grant could delay the review of your application, or remove your application from consideration.

1. Applicant ORI Number: __ __ __ __ __ __ _

B. Applicant DUNS Number: __ __ __ __ __ __ __ __ __

A Data Universal Numbering System (DUNS) number is required.  A DUNS number is a unique nine-digit sequence recognized as the universal standard for identifying and keeping track of entities receiving federal funds.  For more information about how to obtain a DUNS number, please refer to the How to Apply section of the COPS Application Guide.

C. Central Contractor Registration (CCR)

All applicants are required to maintain current registrations in the Central Contractor Registration (CCR) database.  The CCR database is the repository for standard information about federal financial assistance applicants, recipients, and sub-recipients.  For more information about how to register with the CCR, please refer to the How to Apply section of the COPS Application Guide.  Please note that applicants must update or renew their CCR at least once per year to maintain an active status.

Does your agency have an active registration with the Central Contractor Registry?    Yes      No

If no, will your agency agree to have an active registration with the Central Contractor Registry before any COPS grant funding is awarded?    Yes      No

4. GNIS ID: __ __ __ __ __ __ __

Please enter your Geographic Names Information System (GNIS) Identification Number.

This is a unique ID assigned to all geographic entities by the U.S. Geological Survey. To look up your GNIS Feature ID, please go to the website: http://.geonames.usgs.gov/domestic/index.html. For more information about how to obtain a GNIS number, please refer to the How to Apply section of the CHRP Application Guide.

E. Law Enforcement Executive/Program Official Information:

For Law Enforcement Agencies: Enter the law enforcement executive’s name and contact information. This is the highest ranking law enforcement official within your jurisdiction (e.g., Chief of Police, Sheriff, or equivalent).

Title:

First Name: MI: Last Name: Suffix:

Agency Name:

Street Address 1:

Street Address 2:

City: State: Zip Code:

Telephone: Fax:

E-mail:

Type of Agency: (drop down selection- matches CMS list and GAD allowable types)

F. Government Executive/Financial Official Information:

For Government Agencies: Enter the government executive’s name and contact information. This is the highest ranking official within your jurisdiction (e.g., Mayor, City Administrator, Tribal Chairman, or equivalent).

Title:

First Name: MI: Last Name: Suffix:

Agency Name:

Street Address 1:

Street Address 2:

City: ____________________State: ________________Zip Code:

Telephone: Fax:

E-mail:

Type of Government Entity: (drop down selection- matches CMS list and GAD allowable types)

SECTION 2: GENERAL AGENCY INFORMATION

A. General Applicant Information

1. Cognizant Federal Agency: _______________________________________

Enter your jurisdiction’s Cognizant Federal Agency. A Cognizant Federal Agency, generally, is the federal agency from which your jurisdiction receives the most federal funding. Your Cognizant Federal Agency also may have been previously designated by the Office of Management and Budget.

2. Fiscal Year: _ _/_ _ /_ _ _ _ to _ _/_ _ /_ _ _ _ (mo/day/yr) Enter your jurisdiction’s fiscal year.

3. Jurisdictional population as of the 2000 U.S. Census: ________________

 Check here if the jurisdictional population is not represented by U.S. Census figures (e.g., colleges, special agencies, school police departments, etc.). (If checked, skip Question 4 and go to Question 5)

4. Enter the total jurisdictional population as of the 2007 Census Estimate. The Census Estimate can be looked up in the American FactFinder at http://FactFinder.census.gov.

5. If the jurisdictional population is not represented by U.S. Census figures, please indicate the size of the population in 2007: _________________________________

Please indicate the source of this estimate:_____________

(Question 5 is grayed out unless the checkbox in #3 above is checked)

6. Do officers have primary law enforcement authority for this entire jurisdictional population? [An agency with primary law enforcement authority is defined as the first responder to calls for service, and has ultimate and final responsibility for the prevention, detection, and/or investigation of crime within its jurisdiction.]

YES ____ NO _____

(If yes, skip to section B below)

1. If NO, what is the actual population for which your department has primary law enforcement authority? For example, your service population may be the 2007 Census Estimate minus the population of the incorporated towns and cities that have their own police departments within your geographic boundaries. ___________

B. Law Enforcement Agency Information

1. Enter the Current Fiscal Year Budgeted Sworn Force Strength:

Full-time:____________ Part-time:____________

The budgeted number of sworn officer positions is the number of sworn positions your agency has funded within its budget, including state, Bureau of Indian Affairs, and locally-funded vacancies. Do not include unfunded vacancies or unpaid/reserve officers.

2. Enter the Actual Sworn Force Strength as of the Date of This Application:

Full-time:____________ Part-time:____________

The actual number of sworn officer positions is the actual number of sworn positions employed by your agency as of the date of this application. Do not include funded but currently vacant positions or unpaid positions.

SECTION 3: CHRP PROGRAM REQUEST

Your agency may apply for COPS funds to use on or after the official grant award start date to hire new, additional officer positions (including filling existing unfunded vacancies) or rehire officers who have already been laid off, or are currently scheduled to be laid off on a future date, as a result of state, local or tribal budget reductions. Please base your application request on your agency’s current anticipated needs for funding in these primary categories. Please also be mindful of the initial three-year grant period and your agency’s ability to fill and retain the officer positions awarded, while following your agency’s established hiring policies and procedures.

As described in detail in the CHRP Application Guide, it is imperative that applicants understand that the COPS statute nonsupplanting requirement mandates that CHRP funds may be used only to supplement (increase) a grantee’s law enforcement budget for sworn officer positions and may not supplant (replace) state, local, or tribal funds that a grantee otherwise would have spent on officer positions if it had not received a CHRP award. This means that if your agency plans to:

1. Hire new officer positions (including filling existing officer vacancies that are no longer funded in your agency’s budget): It must hire these additional positions on or after the official grant award start date, above its current budgeted (funded) level of sworn officer positions, and otherwise comply with the nonsupplanting requirement as described in detail in the CHRP Application Guide and Grant Owner’s Manual;

2. Rehire officers who have already been laid off (at the time of application) as a result of state, local, or tribal budget cuts: It must rehire the officers on or after the official grant award start date, maintain documentation showing the date(s) that the positions were laid off and rehired, and otherwise comply with the nonsupplanting requirement as described in detail in the CHRP Application Guide and Grant Owner’s Manual;

3. Rehire officers who are (at the time of application) currently scheduled to be laid off on a future date as a result of state, local, or tribal budget cuts: It must continue to fund the officers with its own funds from the grant award start date until the date of the scheduled lay-off (for example, if the CHRP award start date is September 1 and the lay-off is scheduled for November 1, then the CHRP funds may not be used to fund the officers until November 1, the date of the scheduled lay-off), identify the number and date(s) of the scheduled lay-off(s) in this application [see below], maintain documentation showing the date(s) and reason(s) for the lay-off, and otherwise comply with the nonsupplanting requirement as described in detail in the CHRP Application Guide and Grant Owner’s Manual. [Please note that as long as your agency can document the date that the lay-off(s) would occur if the CHRP funds were not available, it may transfer the officers to the CHRP funding on or immediately after the date of the lay-off without formally completing the administrative steps associated with a lay-off for each individual officer.]

Documentation that may be used to prove that scheduled lay-offs are occurring for local economic reasons that are unrelated to the availability of CHRP grant funds may include (but are not limited to) council or departmental meeting minutes, memoranda, notices, or orders discussing the lay-offs; notices provided to the individual officers regarding the date(s) of the lay-offs; and/or budget documents ordering departmental and/or jurisdiction-wide budget cuts. These records must be maintained with your agency’s CHRP grant records during the grant period and for three years following the official closeout of the CHRP grant in the event of an audit, monitoring, or other evaluation of your grant compliance.

When completing the questions below, please base your responses on your agency’s current (at the time of application) needs for funding in the three hiring categories (new hires, rehires of previously laid off officers, and rehiring officers who are scheduled to be laid off on a specific future date). CHRP grant awards will be made for officer positions requested in each of these three categories and recipients of CHRP awards are required to use awarded funds for the specific categories awarded. If an applicant receives an award, and after receiving the awards needs to change the hiring categories, it must request a post-award grant modification to change the categories of hiring and receive prior approval before spending CHRP funding by calling the COPS Response Center at 1-800-421-6770.

How many CHRP sworn officer positions is your agency requesting (total)? _______

How many of the positions will be:

1. To hire new, additional officer positions (including to fill existing vacancies that are no longer funded in your agency’s budget)? ________________________

2. To rehire officers who have already been laid off (at the time of application) as a result of state, local, or tribal budget reductions? _______________________________________

3. To rehire officers who are (at the time of application) currently scheduled to be laid off on a specific future date as a result of state, local, or tribal budget reductions?

(# Positions)

_______ Date of the scheduled lay-off for these officers

If your agency has planned multiple future lay-off dates, please use the additional space below:

(# Positions)

_______ Date of the scheduled lay-off for these officers

(# Positions)

_______ Date of the scheduled lay-off for these officers

Special Reminder for Rehired Officers:

The CHRP program awards funding based on your agency’s entry-level salary and benefits package. Any additional (higher than entry-level) salary and benefits expenses for rehired officers must be paid by your agency.

Certification Regarding Future Lay-Offs:

If your agency plans to use CHRP funds to rehire officers who are currently scheduled to be laid off on a future date, please certify (by checking the appropriate boxes) to the following:

Certification:

 My agency has and will maintain documentation showing the date(s) of the scheduled lay-off(s) and demonstrating that the scheduled lay-off(s) is/are occurring for fiscal reasons that are unrelated to the availability or receipt of CHRP grant funds (as described above).

 My agency will use its own funds to continue funding these officers until the scheduled date(s) of the lay-off(s) and will use CHRP funds to rehire these officers only on or after the scheduled date of the lay-off(s).

 My agency recognizes that the CHRP program provides funding based on our entry-level salary and benefits package and that any additional costs for rehired officers beyond entry-level are our responsibility to pay with other sources of funding.

System Logic Note:

If b above is not null, then they must certify to the 3^rd checkbox only.

If c above is not null, then they must certify to all three checkboxes.

If b & c above is not null, then they must certify to all three checkboxes.

Failure to comply with the nonsupplanting and other COPS grant requirements may result in suspension or termination of grant funds, the repayment of grant funds, and/or other remedies available by law.

SECTION 4: NEED FOR FEDERAL ASSISTANCE

1) Enter your law enforcement agency’s total operating budget for the current AND previous two fiscal years.

CURRENT FISCAL YEAR (2009) $___________________

PREVIOUS FISCAL YEAR (2008) $___________________

PREVIOUS FISCAL YEAR (2007) $____________________

2) Enter the total jurisdictional (city, county, state, tribal) operating budget for the current AND previous two fiscal years.

CURRENT FISCAL YEAR (2009) $___________________

PREVIOUS FISCAL YEAR (2008) $___________________

PREVIOUS FISCAL YEAR (2007) $____________________

3) Enter the total jurisdictional (city, county, state, tribal) locally generated revenues for the current AND previous two fiscal years. Locally generated revenues may include locally generated property taxes, sales taxes and other taxes and revenue sources (for example, transportation taxes, transient lodging taxes, licensing fees, other non-property taxes and franchise taxes).

CURRENT FISCAL YEAR (2009) $___________________

PREVIOUS FISCAL YEAR (2008) $___________________

PREVIOUS FISCAL YEAR (2007) $____________________

4) Enter the total jurisdictional (city, county, state, tribal) general fund balance for the current and previous two fiscal years.

CURRENT FISCAL YEAR (2009) $___________________

PREVIOUS FISCAL YEAR (2008) $___________________

PREVIOUS FISCAL YEAR (2007) $____________________

5) Since January 1, 2008, what percentages of the following employees in your jurisdiction (city, county, state, tribal) have been reduced through lay-offs:

Civilian Law Enforcement Agency Personnel _____%

Sworn Law Enforcement Agency Personnel _____%

Other Government Agency Personnel _____%

6) Since January 1, 2008, what percentages of the following employees in your jurisdiction (city, county, state, tribal) have been reduced through furloughs that have lasted or are scheduled to last a minimum of forty hours over the course of a fiscal year:

Civilian Law Enforcement Agency Personnel _____%

Sworn Law Enforcement Agency Personnel _____%

Other Government Agency Personnel _____%

7) Since January 1, 2008 what percentages of the following employees in your jurisdiction (city, county, state, tribal) have been reduced due to official policies that limit your jurisdiction’s ability to fill vacancies (i.e., hiring freezes):

Civilian Law Enforcement Agency Personnel _____%

Sworn Law Enforcement Agency Personnel _____%

Other Government Agency Personnel _____%

8) The U.S. Census Bureau American Community Survey (ACS) provides multi-year poverty rate estimates for communities. For jurisdictions with a Census population greater than 20,000, please go to the U.S. Census Bureau’s American FactFinder (http://FactFinder.census.gov) to determine the percent of families in poverty in your jurisdiction based on the 2005-2007 ACS. For jurisdictions below 20,000 in population or not represented in the U.S. Census, please select the nearest best match for your jurisdiction (for example, the county in which your jurisdiction is located). Please see the CHRP Application Guide for additional information and help in using the American FactFinder.

Percent of families in poverty ________%

9) The Bureau of Labor Statistic’s’ Local Area Unemployment Statistics (LAUS) program provides monthly estimates of unemployment for communities. Please go to the Bureau of Labor Statistics’ LAUS website: (www.bls.gov/lau/data.htm) to find detailed instructions for looking up your local area’s unemployment rate. As with the previous question, it may be necessary to select the nearest best match to your jurisdiction (for example, a city of fewer than 25,000 people may report their county level rate). Please see the CHRP Application Guide for additional information and help in using the LAUS data.

Percentage unemployed for January 2009 _____%

Percentage unemployed for January 2008 ______ %

10) Indicate your jurisdiction’s estimated residential property foreclosure rate for calendar year 2008. This rate should be calculated as the total number of new default and auction foreclosure filings and new bank-owned foreclosures (REOs) in 2008 divided by the total number of residential households.

______%

______ Check here if the information necessary to calculate this rate is unavailable.

11) Indicate if your jurisdiction has experienced any of the following events since January 1, 2008:

_____Military base closure or realignment.

_____A declaration of natural or other major disaster or emergency has been made pursuant to the Robert T. Stafford Disaster Relief and Emergency Assistance Act. (42 U.S.C. 5121 et seq.)

_____A declaration as an economically or financially distressed area by the state in which the applicant is located.

_____Downgrading of the applicant’s bond rating by a major rating agency.

_____Has filed for or been declared bankrupt by a court of law.

_____Has been placed in receivership or its functional equivalent by the state or federal government.

System Note: They can select multiple items above.

12) Indicate if, since January 1, 2008, your jurisdiction has experienced an unplanned, non-recurring, capital outlay or unanticipated loss of revenue that has had a significant negative impact on your jurisdiction’s fiscal health.

Yes____ No____

12a) If YES, please express the cost of this event as a percentage of your total current operating budget ______% and please describe the event (please limit to 350 characters):

13) Using UCR crime definitions enter the actual number of incidents reported to your jurisdiction in calendar year 2008 for the following crime types:

Criminal Homicide: ­­­­­­­______________

Forcible Rape: ­­­­­­­______________

Robbery: ­­­­­­­______________

Aggravated Assault: ­­­­­­­______________

Burglary: ­­­­­­­______________

Larceny (except motor vehicle theft): ­­­­­­­______________

Motor Vehicle Theft: ­­­­­­­______________

*Note: If your agency currently reports to NIBRS, or does not report crime incident totals at all, please ensure that your data is converted to UCR Summary Data style. Please see the CHRP Application Guide or the FBI’s UCR Handbook (www.fbi.gov/ucr/handbook/ucrhandbook04.pdf) for more information.

System Note: Every field above is required. The field must be NUMERICAL and 0 or greater

SECTION 5: LAW ENFORCEMENT & COMMUNITY POLICING STRATEGY

Proposed Community Policing Plan

COPS grants must be used to initiate or enhance community policing activities. Please complete the following questions to describe the types of community policing activities that will result from CHRP funding. You may find more detailed information about community policing at the COPS Office web site http://www.cops.usdoj.gov/Default.asp?Item=36.

Community Partnerships

Community partnerships are on-going collaborative relationships between the law enforcement agency and the individuals and organizations they serve to both develop solutions to problems and increase trust in the police.

My agency:

P1) Regularly distributes relevant crime and disorder information to community members.

a) does not currently do, and has no plans to implement under this grant

b) does not currently do, and plans to initiate under this grant

c) currently does, and plans to continue doing under this grant

d) currently does, and plans to expand/enhance under this grant

P2) Routinely seeks input from the community to identify and prioritize neighborhood problems (e.g., through regularly scheduled community meetings, annual community surveys, etc.).

a) does not currently do, and has no plans to implement under this grant

b) does not currently do, and plans to initiate under this grant

c) currently does, and plans to continue doing under this grant

d) currently does, and plans to expand/enhance under this grant

P3) Regularly collaborates with other local government agencies that deliver public services.

a) does not currently do, and has no plans to implement under this grant

b) does not currently do, and plans to initiate under this grant

c) currently does, and plans to continue doing under this grant

d) currently does, and plans to expand/enhance under this grant

P4) Regularly collaborates with non-profit organizations and/or community groups.

a) does not currently do, and has no plans to implement under this grant

b) does not currently do, and plans to initiate under this grant

c) currently does, and plans to continue doing under this grant

d) currently does, and plans to expand/enhance under this grant

P5) Regularly collaborates with local businesses.

a) does not currently do, and has no plans to implement under this grant

b) does not currently do, and plans to initiate under this grant

c) currently does, and plans to continue doing under this grant

d) currently does, and plans to expand/enhance under this grant

P6) Regularly collaborates with informal neighborhood groups and resident associations.

a) does not currently do, and has no plans to implement under this grant

b) does not currently do, and plans to initiate under this grant

c) currently does, and plans to continue doing under this grant

d) currently does, and plans to expand/enhance under this grant

Problem Solving

Problem solving is an analytical process for systematically 1) identifying and prioritizing problems, 2) analyzing problems, 3) responding to problems, and 4) evaluating problem solving initiatives. Problem solving involves an agency-wide commitment to go beyond traditional police responses to crime to proactively address a multitude of problems that adversely affect quality of life.

My agency:

PS1) Routinely incorporates problem-solving principles into patrol work.

a) does not currently do, and has no plans to implement under this grant

b) does not currently do, and plans to initiate under this grant

c) currently does, and plans to continue doing under this grant

d) currently does, and plans to expand/enhance under this grant

PS2) Identifies and prioritizes crime and disorder problems through the routine examination of patterns and trends involving repeat victims, offenders, and locations.

a) does not currently do, and has no plans to implement under this grant

b) does not currently do, and plans to initiate under this grant

c) currently does, and plans to continue doing under this grant

d) currently does, and plans to expand/enhance under this grant

PS3) Routinely explores the underlying factors and conditions that contribute to crime and disorder problems.

a) does not currently do, and has no plans to implement under this grant

b) does not currently do, and plans to initiate under this grant

c) currently does, and plans to continue doing under this grant

d) currently does, and plans to expand/enhance under this grant

PS4) Systematically tailors responses to crime and disorder problems to address their underlying conditions.

a) does not currently do, and has no plans to implement under this grant

b) does not currently do, and plans to initiate under this grant

c) currently does, and plans to continue doing under this grant

d) currently does, and plans to expand/enhance under this grant

PS5) Regularly conducts assessments to determine the effectiveness of responses to crime and disorder problems.

a) does not currently do, and has no plans to implement under this grant

b) does not currently do, and plans to initiate under this grant

c) currently does, and plans to continue doing under this grant

d) currently does, and plans to expand/enhance under this grant

Organizational Transformation

Organizational transformation is the alignment of organizational management, structure, personnel and information systems to support community partnerships and proactive problem-solving efforts.

My agency:

OC1) Incorporates community policing principles into the agency’s mission statement and strategic plan.

a) does not currently do, and has no plans to implement under this grant

b) does not currently do, and plans to initiate under this grant

c) currently does, and plans to continue doing under this grant

d) currently does, and plans to expand/enhance under this grant

OC2) Practices community policing as an agency-wide effort involving all staff (i.e., not solely housed in a specialized unit).

a) does not currently do, and has no plans to implement under this grant

b) does not currently do, and plans to initiate under this grant

c) currently does, and plans to continue doing under this grant

d) currently does, and plans to expand/enhance under this grant

OC3) Incorporates problem-solving and partnership activities into personnel performance evaluations.

a) does not currently do, and has no plans to implement under this grant

b) does not currently do, and plans to initiate under this grant

c) currently does, and plans to continue doing under this grant

d) currently does, and plans to expand/enhance under this grant

Community Policing Plan Narrative (please limit to 2,000 words)

Please describe your agency’s implementation plan for this program (if awarded), with specific reference to each of the following elements of community policing: (a) community partnerships and support, including consultation with community groups, private agencies, and/or other public agencies; (b) related governmental and community initiatives that complement your agency’s proposed use of CHRP funding; and (c) organizational transformation – how your agency will use these funds, if awarded, to reorient its mission to community policing or enhance its involvement in and commitment to community policing. This narrative will not be scored for selection purposes but serves, along with the previous questions, as your agency’s community policing plan. Your organization may be audited or monitored to ensure that it is initiating or enhancing community policing in accordance with this plan. The COPS Office may also use this information to understand the needs of the field, and potentially provide for training, technical assistance, problem solving and community policing implementation tools.

If your organization receives this CHRP grant funding, these responses will be considered as your organization’s community policing plan. We understand that your community policing needs may change during the life of your CHRP grant (if awarded), and minor changes to this plan may be made without prior approval of the COPS Office. We also recognize that this plan may incorporate a broad range of possible community policing strategies and activities, and that your agency may implement particular community policing strategies from the plan on an as-needed basis throughout the life of the grant. If your agency’s community policing plan changes significantly, however, you must submit those changes in writing to the COPS Office for approval. Changes are “significant” if they deviate from the range of possible community policing activities identified and approved in this original community policing plan submitted with your application.

CP1) To what extent is there community support in your jurisdiction for implementing the proposed grant activities?

1. Minimal support

2. Moderate support

3. High level of support

CP2) If awarded, to what extent will the grant activities impact the other components of the criminal justice system in your jurisdiction?

1. Potentially increased burden

2. No change in burden

3. Potentially decreased burden

SECTION 6: CONTINUATION OF PROJECT AFTER FEDERAL FUNDING ENDS

Applicants must plan to retain all sworn officer positions awarded under the CHRP grant for a minimum of one full local budget cycle at the conclusion of 36 months of federal funding for each position. The retained CHRP-funded positions should be added to your agency’s law enforcement budget with state and/or local funds at the end of grant funding, over and above the number of locally-funded sworn officer positions that would have existed in the absence of the grant. At the time of grant application, applicants must affirm that they plan to retain the positions and identify the planned source(s) of retention funding. We understand that your agency’s source(s) of retention funding may change during the life of the grant. Your agency should maintain proper documentation of any changes in the event of an audit, monitoring or other evaluation of your grant compliance.

Has your agency planned to retain all additional sworn officer positions under this grant for a minimum of one full local budget cycle at the conclusion of 36 months of federal funding for each position? YES ___ NO___

(If YES, move on to next question)

(If NO, pop-up window should read: "Agencies that do not plan to retain all the positions awarded under this grant are ineligible to receive CHRP funding." The applicant will be asked again if they planned to retain and if they respond NO, they will be locked out of the application and will be asked to call the COPS Response Center. If applicant responds YES, they can move on to next question.)

Please identify the source(s) of funding that your agency plans to utilize to cover the costs of retention from the drop-down box listed below:

-General funds

-Raise bond/tax issue

-Asset forfeiture funds

-Private sources/donations

-Fundraising efforts

-Other (Please provide a brief description of the source(s) of funding not to exceed 75 words.)

(If they do not select one of the available funding source options or do fill in the text box they will not be able to proceed to the next step in the application process.)

Section 7: Budget Detail Worksheets

Instructions:

This worksheet will assist your agency in reporting your agency’s current entry-level salary and benefits costs and identifying your agency’s total three-year salary and benefits request per officer position. Please list the current entry-level base salary and fringe benefits rounded to the nearest whole dollar for one full-time sworn officer position within your agency. Do not include employee contributions.

Please complete the budget worksheet(s) based on your agency’s current annual first year entry-level salary and benefit package for your locally-funded officer positions. Please be advised that CHRP funding must only pay for entry-level salaries and benefits. Any additional costs incurred for higher than entry-level salaries and benefits for officers hired under the CHRP grant will be your agency’s responsibility.

Note: Part-time positions will not be funded.

Please refer to the CHRP Application Guide for additional information.

A. SWORN OFFICER POSITIONS

No Sworn Officer Positions Requested 

Instructions: Please complete the questions below based on your agency’s current first year entry-level salary and benefits package for your locally-funded officers. [You will be asked to project Year 2 and Year 3 increases below.]

Part 1: Full-Time Sworn Officer Information

A . Current First Year Entry-Level Base Salary for One Sworn Officer Position $_____ ___.00

Please calculate the fringe benefit costs below based on the first year entry-level benefits for one sworn officer position.

B . FRINGE BENEFITS: COST: % OF BASE: ADDITIONAL INFORMATION:

Social Security $______.00 % Exempt: □ Fixed Rate: □

Cannot exceed 6.2% of Total Base Salary. If less than 6.2%, exempt, or fixed rate, provide an explanation in “Sworn Officer Position Budget Summary.”

Medicare $ .00 % Exempt: □ Fixed Rate: □

Cannot exceed 1.45% of Total Base Salary. If less than 1.45%, exempt, or fixed rate, provide an explanation in the “Sworn Officer Position Budget Summary.”

Health Insurance $ .00 % Family Plan: □ Fixed Rate: □

Life Insurance	$ .00	%
Vacation	$ .00	%	Number of Hours Annually: _______
Sick Leave	$ .00	%	Number of Hours Annually: _______
Retirement	$ .00	%	Fixed Rate: □

Cannot exceed 20% of the Total Base Salary (unless a fixed rate). If a fixed rate, provide an explanation in the “Sworn Officer Position Budget Summary.”

Worker’s Compensation $ .00 % Exempt: □ Fixed Rate: □

Cannot exceed 10% of the Total Base Salary. If exempt or if it exceeds this rate, provide an explanation in the “Sworn Officer Position Budget Summary.”

Unemployment Insurance $ .00 % Exempt: □ Fixed Rate: □

Cannot exceed 5% of the Total Base Salary. If exempt or if it exceeds this rate, please provide an explanation in the “Sworn Officer Position Budget Summary.”

Other	$ .00	%	Describe:
Other	$ .00	%	Describe:
Other	$ .00	%	Describe:

Total Current First Year Entry-Level Benefits for One Sworn Officer Position = $ ____________

C . Total Year 1 Salary $ + Total Year 1 Benefits = $

Part A Part B

Based on the current first year entry-level salary and benefits package, please project Year 2 and Year 3 increases and use these figures to calculate the full three-year salary and benefits amounts per sworn officer position that you are requesting through the CHRP grant (for a detailed example of these calculations, please see the CHRP Application Guide).

Your agency must maintain records documenting how it calculated its Year 2 and Year 3 projections (and, accordingly, its total three-year salary and benefits amounts per officer position) in its CHRP grant records throughout the grant period and for three years following the official closeout of the COPS grant in the event of an audit, monitoring, or other evaluation of your grant compliance.

Year 2

Total Year 2 entry-level salary for one sworn officer position: __________

Total Year 2 entry-level benefits for one sworn officer position: _________

Year 3

Total Year 3 entry-level salary for one sworn officer position: __________

Total Year 3 entry-level benefits for one sworn officer position: _________

Total Three -Year Salary for one officer position: __________ X Number of Sworn Positions Requested ______________ = _______________ Total Three -Year Salary Project Cost

(calculated by the system)

Total Three- Year Benefits for one officer position: __________ X Number of Sworn Positions Requested ______________ = _______________ Total Three -Year Benefits Project Cost

(calculated by the system)

Total Three -Year Salary and Benefits for one Officer Position: __________ X Number of Sworn Positions Requested ______________ = _______________ Total Project Cost

(calculated by the system)

Part 2: Full-Time Sworn Officer Information

After completing Part 1 of this budget worksheet, answer the following questions. Be sure to answer EVERY question. Missing or erroneous information could delay the review of your agency’s request.

1. If your agency's second and/or third-year costs for salaries and/or fringe benefits increase after

the first year, check the reason(s) why in the space below:

 Cost of living adjustment (COLA)  Step raises  Change in benefit costs

 Other - please explain briefly:

2. If an explanation is required for any of the following categories, please provide in the space below:

1) Social Security: __________________________________________________________________

2) Medicare: _______________________________________________________________________

BUDGET SUMMARY

Note: System will calculate.

Budget Category		Category Total	Line #
A .	Sworn Officer Positions	$ . 00	1
Total Project Amount:		$ . 00
Total Federal Share Amount:)		$ . 00
	Contact Information for Budget Questions Please provide contact information of the financial official that the COPS Office may contact with questions related to your budget submission. Authorized Official's Typed Name: First Name Last Name Title Phone Email

Disclosure of Lobbying Activities

Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352.

Not Applicable 

1. Type of Federal Action:	2. Status of Federal Action: _____ bid/offer/application initial award post-award	3. Report Type: _____ initial filing material change For Material Change Only: Year:
contract grant cooperative agreement loan loan guarantee loan insurance
		Quarter: _______ Date of last report _______
4. Name and Address of Reporting Entity: ˆ Prime ˆ Subawardee Tier , if known:	5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional District (number), if known: _____
Congressional District (number), if known: _____
6. Federal Department/Agency:	7. Federal Program Name/Description: CFDA Number, if applicable:
8. Federal Action Number, if known:	Award Amount, if known: $
10. a. Name and Address of Lobbying Registrant (if individual, last name, first name, MI):	b. Individuals Performing Services (including address if different from No.1 0a) (last name, first name, MI):
Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.	Typed Name:
	Print Name:
	Title:
	Telephone No.:	Date: ______
Federal Use Only:	Authorized for Local Reproduction, Standard Form - LLL

By clicking this box and typing my name below, I certify that I have been legally and officially authorized by the appropriate governing body to submit this application and act on behalf of the grant applicant entity. I certify that I have read, understand, and agree, if awarded, to abide by all of the applicable grant compliance terms and conditions as outlined in the COPS Application Guide, the COPS Grant Owner’s Manual, assurances, certifications and all other applicable program regulations, laws, orders, or circulars. In addition, I certify that the information provided on this form and any attached forms is true and accurate to the best of my knowledge. I understand that false statements or claims made in connection with COPS programs may result in fines, imprisonment, debarment from participating in federal grants, cooperative agreements, or contracts, and/or any other remedy available by law to the federal government.

Please type your name here in place of your signature:

"COPS ONLINE NOTE: The only electronic signature submitted online with this application will be the individual registered with the user name and password that was entered during the COPS Online login process. However, the signatures of both the Law Enforcement Executive/Program Official and the Government Executive/Financial Official, as well as any applicable program partners' signatures, are REQUIRED for Sections 8, 9 and 11 of this application. Original, signed hard copies of the Certification of Review and Representation of Compliance with Requirements, Assurances and Certifications must be kept in the agency's files and furnished upon request."

By clicking this box, I have read and understand this requirement.

SUBMIT APPLICATION

Warning: Once you submit your application you will be unable to change any of your application information. Please ensure that you have reviewed all of your information before submitting your application to the COPS Office.

Paperwork Reduction Act Notice

The public reporting burden for this collection of information is estimated to be up to two hour per response, depending upon the COPS program being applied for, which includes time for reviewing instructions. Send comments regarding this burden estimate or any other aspects of the collection of this information, including suggestions for reducing this burden, to the Office of Community Oriented Policing Services, U.S. Department of Justice, 1100 Vermont Avenue, N.W., Washington, DC 20530; and to the Public Use Reports Project, Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503.

You are not required to respond to this collection of information unless it displays a valid OMB control number. The OMB control number for this application is 1103-0097 and the expiration date is 05/31/2011.