FRA F 6180.135 HSIPR Program Application Form -- Track 1b--PE/NEPA

Track 1b - PE/NEPA OMB No. 2130-0583

Project Name:       Date of Submission:       Version Number:    

High Speed Intercity Passenger Rail (HSIPR) Program

Application Form

Track 1b–PE/NEPA

Welcome to the Track 1b – Preliminary Engineering (PE)/National Environmental Protection Act (NEPA) Application for the Federal Railroad Administration’s High Speed Intercity Passenger Rail (HSIPR) Program. Applicants for Track 1b-PE/NEPA are required to submit this Application Form and Supporting Materials (forms and documents) as outlined in Section G of this application as well as detailed in the HSIPR Guidance.

We appreciate your interest in the program and look forward to reviewing your application. If you have questions about the HSIPR program or this application, please contact us at [email protected].

Instructions:

• Please complete this document and provide any supporting documentation electronically.

• In the space provided at the top of each section, please indicate the project name, date of submission (mm/dd/yy) and the application version number. The distinct Track 1b project name should be less than 40 characters and follow the following format: State abbreviation-route or corridor name-project title (e.g., HI-Fast Corridor-Track Work IV).

• For each question, enter the appropriate information in the designated gray box. If a question is not applicable to your PE/NEPA Project, please indicate “N/A.”

• Narrative questions should be answered concisely in the space provided.

• Applicants must upload this completed application form and any supporting documentation to www.GrantSolutions.gov by August 24, 2009 at 11:59pm EDT.

• Fiscal Year (FY) refers to the Federal Government’s fiscal year (Oct. 1- Sept. 30).

• Please direct questions to: [email protected]

1. Point of Contact and Application Information

Application Point of Contact (POC) Name:      			POC Title:      
Street Address:      	City:      		State:      	Zip Code:      		Telephone Number:      
Fax:      			Email:      
Name of lead State or organization applying:      
Name(s) of additional States and/or organizations applying in this group (if applicable ):      
Is this PE/NEPA Project related to additional applications for HSIPR funding (under this track or other tracks)? Yes No Maybe
If “Yes” or “Maybe” provide the following information:
Other Program/Project Name	Lead Applicant	Track			Total HSIPR Funding Requested (if known)		Status of Application
     	     				$      
     	     				$      
     	     				$      
     	     				$      

Project Name:       Date of Submission:       Version Number:    

B. Project Overview

PE/NEPA Project Name:      
Indicate the activity(ies) for which you are applying: Preliminary Engineering (PE) NEPA site-specific
What are the anticipated start and end dates for this PE/NEPA Project? (mm/yyyy) Start Date:       End Date:      
PE/NEPA Project Narrative. Please limit response to 4,000 characters. Describe the PE/NEPA activities that would be completed with HSIPR Track 1 funding through this application. Include the design studies and the resulting project documents for PE activities.  For NEPA activities, address the technical and field studies that would be completed and documents that would be prepared, including: Project component studies PE/NEPA tasks / milestones Preparation of documents Describe the agency and public involvement approach including key activities and objectives (including permitting actions). Address the coordination plan with affected railroads and right-of-way owners.      
Status of Activities: In the following table, please indicate the status of planning studies/documentation supporting your planned investment. Indicate the status and key dates for each applicable activity as noted in Appendix 2 of the HSIPR Guidance.
	Select One of the Following:						Provide Dates for all activities:
	N/A	No study exists	Study Initiated			Study Completed	Actual or Anticipated Initiation Date (mm/yyyy)	Actual or Anticipated Completion Date (mm/yyyy)
Activities/Documents
Environmental Studies
Final NEPA Document (Categorical Exclusion (CE) documentation, Environmental Assessment (EA), or Environmental Impact Statement (EIS))							     	     
Historic and Cultural Resource Studies							     	     
Biological Surveys and Assessment							     	     
Wetlands Delineation and Hydrology Studies							     	     
Community Impact Assessment							     	     
Traffic Impact Studies							     	     
Air Emission Studies							     	     
Noise and Vibration Studies							     	     
Preliminary Engineering
Capital Cost Estimates							     	     
Travel Demand Forecasting							     	     
Operations Analysis							     	     
Operations & Maintenance Cost Estimates							     	     
System Safety Program Plan and Collision/derailment Hazard Analysis							     	     
Engineering Studies - specify in space below:      							     	     
Design Drawings							     	     
Project Management Plan							     	     
Other:      							     	     
Planned Investment. Please limit response to 4,000 characters. Provide an overview of the main features of the planned investment that is the subject of the PE/NEPA Project including a brief description of: The location of the planned investment, including name of rail line(s), State(s), and relevant jurisdiction(s) (upload map if applicable). Identification of existing service(s) that would benefit from the project, the cities/stations that would be served, and the state(s) where the service operates. How the planned investment was identified through a planning process and how it is consistent with an overall plan for developing High-Speed Rail/Intercity Passenger Rail service. How the project will fulfill a specific purpose and need in a cost-effective manner. The existing and planned intercity passenger rail service(s). The project’s independent utility. The specific improvements contemplated. Any use of railroad assets or rights-of-way, and potential use of public lands and property. Other rail services, such as commuter rail and freight rail that will make use of, or otherwise be affected by, the planned investment.      
Indicate the expected service objectives (check all that apply):
Additional Service Frequencies Service Quality Improvements Other (Please Describe):      				Improved On-Time performance on Existing Route Increased Average Speeds/Shorter Trip Times
Indicate the type of expected capital investments to be included in the planned investment (check all that apply):
Structures (bridges, tunnels, etc.) Track Rehabilitation Major Interlockings Station(s) Communication, Signaling and Control Rolling Stock Refurbishments				Rolling Stock Acquisition Support Facilities (Yards, Shops, Admin. Buildings) Grade Crossing Improvements Electric Traction Other (Please Describe):      
Total Cost of PE/NEPA Project: (Year of Expenditure (YOE) Dollars*) $       Of this amount, how much would come from the FRA HSIPR Program: (YOE Dollars)** $       Indicate the percentage of total cost to be covered by matching funds: %       * Year-of-Expenditure (YOE) dollars are inflated from the base year. Applicants should include their proposed inflation assumptions (and methodology, if applicable) in the supporting documentation ** This is the amount for which the applicant is applying.
Right-of-Way Owner(s): Provide the status of agreements with railroad(s) that own the right-of-way. If appropriate, “owner(s)” may also include operator(s) under track age rights or lease agreements. If more than two railroads, please detail in “Additional Information” in Section F of this application.
Railroad owner 1 (Name):					     
Status of railroad owner 1 (Click on the appropriate option from the dropdown menu shaded in gray):
Railroad owner 2 (Name):					     
Status of railroad owner 2 (Click on the appropriate option from the dropdown menu shaded in gray):
Intercity Passenger Rail Operator: If applicable, provide the status of agreement(s) with partner(s) that will operate the benefiting planned High-Speed Rail/Intercity Passenger Rail services after completion of the planned investment (e.g., Amtrak). Click on the appropriate option from the dropdown menu shaded in gray: Name of Operating Partner:       Status of Agreement:
Benefits to Other Types of Rail Service: If benefits to non-intercity passenger rail services are foreseen from the planned investment, please briefly describe those agreements and provide details on their status if applicable. Please limit response to 1,000 characters.      

Project Name:       Date of Submission:       Version Number:    

3. Eligibility Information

   
   

   1. Select applicant type, as defined in Appendix 1.1 of the HSIPR Guidance (check the appropriate box from the list):

   State

   Amtrak

   
   

   If one of the following, please append appropriate documentation as described in Section 4.3.1 of the HSIPR Guidance:

   Group of States

   Interstate Compact

   Public Agency established by one or more States

   Amtrak in cooperation with one or more States

   
   

4. Public Return on Investment

1. Transportation Project Benefits. Please limit response to 2,000 characters.

Describe the transportation benefits that are anticipated to result from the planned investment for which you are conducting PE/NEPA, including the extent to which the planned investment may be expected to:

• Lead to benefits for Intercity Passenger Rail including travel time reductions, increased frequencies, and enhanced service quality

• Address safety issues

• Address intercity passenger rail reliability issues

• Be integrated and complementary to the relevant comprehensive planning process (23 U.S.C. 135)

• Provide benefits to other modes of transportation, including benefits to Commuter Rail Services, Freight Rail Service, and Highway and Air Congestion Reduction and Delay or Avoidance of Planned Investments

     

2. Environmental Project Benefits Narrative. Please limit response to 1,000 characters.

Describe the intended contribution of the planned investment for which you are conducting PE/NEPA towards improved environmental quality, energy efficiency and reduction in the dependence on oil.

     

3. Livable Communities Project Benefits Narrative. Please limit response to 3,000 characters.

Describe the anticipated benefits of the planned investment for which you are conducting PE/NEPA for fostering and promoting Livable Communities, and include information on the following:

• Integration with existing high density, livable development (including relevant details on livable development (e.g., central business districts with walking and public transportation distribution networks with transit oriented development)).

• Development of intermodal stations with direct transfers to other transportation modes (both intercity passenger transport and local transit).

     

4. Economic Recovery Benefits. Please limit response to 2,000 characters.

Estimate the benefit that the PE/NEPA Project and the planned investment for which you are conducting PE/NEPA will make towards economic recovery and reinvestment, including information on the following:

• How both the PE/NEPA Project and the planned investment will result in the creation and preservation of jobs (including number of onsite and other direct jobs (on a 2080 work-hour per year, full-time equivalent basis). Include a timeline for the anticipated job creation, specifying which jobs would be created for the PE/NEPA studies and an estimate for the planned investment (consider the construction period and operating period).

• How the project represents an investment that will generate long-term economic benefits (including the timeline for achieving economic benefits) and describe, if applicable, how the project was identified as a solution to a wider economic challenge.

• If applicable, how the project will help to avoid reductions in State-provided essential services.

     

Project Name:       Date of Submission:       Version Number:    

3. Project Success Factors

Project Management Approach and Applicant Qualifications. Please limit response to 3,000 characters. Describe qualifications of the applicant and its key partners for undertaking the PE/NEPA Project, include the following information: Management Experience – provide relevant information on experience in managing rail programs and planning activities of a similar size and scope to the one proposed in this application. Provide an organizational chart (or equivalent) that outlines the roles played by key project team members in completing activities as well as information on the role of contract support, engineering support and program management. Financial Management Capacity and Capability– provide relevant information on capability to absorb potential planning project cost overruns. Risk Assessment – provide a preliminary assessment of uncertainties within the planning process and possible mitigation strategies (consider grantee risk, funding risk, schedule risk and stakeholder risk).      
Funding Sources: In the following table, please provide the requested information about your funding sources (if applicable)
Non FRA Funding Sources	New or Existing Funding Source?	Status of Funding1	Type of Funds	Dollar Amount (YOE $)	% of Total Project Cost	Describe any uploaded supporting documentation to help FRA verify funding source
     			     	     	     	     
     			     	     	     	     
     			     	     	     	     
     			     	     	     	     
Project Implementation Narrative. Please limit response to 1,000 characters. Provide a preliminary self-assessment of PE/NEPA Project uncertainties and mitigation strategies (consider grantee risk, funding risk, schedule risk and stakeholder risk). Describe any areas in which you could use technical assistance, best practices, advice or support from others, including FRA.      
Timeliness of Project Completion. Please limit response to 1,000 characters. Describe the extent to which the PE/NEPA Project will lead to future project and/or Service Development Program applications for Tracks 1 FD/Construction and Track 2 Programs.      

Project Name:       Date of Submission:       Version Number:    

3. Additional Information

1. Please provide any additional information, comments, or clarifications and indicate the section and question number that you are addressing (e.g., Section D, Question 3). This section is optional.

     

Project Name:       Date of Submission:       Version Number:    

3. Summary of Application Materials

Program Forms	Required	Optional	Reference	Description	Format
Application Form			HSIPR Guidance Section 4.3.3.3	This document to be submitted through GrantSolutions.	Form
Supporting Documentation	Required	Optional	Reference	Description	Format
Planned Investment map			Application Question B.6	Map of the Planned Investment location. Please upload into GrantSolutions.	None
Standard Forms	Required	Optional	Reference	Description	Format
SF 424: Application for Federal Assistance			HSIPR Guidance Section 4.3.3.3eference	Please submit through GrantSolutions	Form
SF 424A: Budget Information-Non Construction	For		HSIPR Guidance Section 4.3.3.3	Please submit through GrantSolutions	Form
SF 424B: Assurances-Non Construction			HSIPR Guidance Section 4.3.3.3	Please submit through GrantSolutions	Form
FRA Assurances Document			HSIPR Guidance Section 4.3.3.3	May be obtained from FRA’s website at http://www.fra.dot.gov/downloads/admin/assurancesandcertifications.pdf. The document should be signed by an authorized certifying official for the applicant. Submit through GrantSolutions.	Form

PRA  Public Protection Statement: Public reporting burden for this information collection is estimated to average 32 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  According to the Paperwork Reduction Act of 1995, a federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with, a collection of information unless it displays a currently valid OMB control number.  The valid OMB control number for this information collection is 2130-0583.

1 Reference Notes: The following categories and definitions are applied to funding sources:

Committed: Committed sources are programmed capital funds that have all the necessary approvals (e.g. legislative referendum) to be used to fund the proposed project without any additional action. These capital funds have been formally programmed in the State Rail Plan and/or any related local, regional, or state Capital Investment Program (CIP) or appropriation. Examples include dedicated or approved tax revenues, state capital grants that have been approved by all required legislative bodies, cash reserves that have been dedicated to the proposed project, and additional debt capacity that requires no further approvals and has been dedicated by the sponsoring agency to the proposed project.

Budgeted: This category is for funds that have been budgeted and/or programmed for use on the proposed project but remain uncommitted, i.e., the funds have not yet received statutory approval. Examples include debt financing in an agency-adopted CIP that has yet to be committed in their near future. Funds will be classified as budgeted where available funding cannot be committed until the grant is executed, or due to the local practices outside of the project sponsor's control (e.g., the project development schedule extends beyond the State Rail Program period).

Planned: This category is for funds that are identified and have a reasonable chance of being committed, but are neither committed nor budgeted. Examples include proposed sources that require a scheduled referendum, requests for state/local capital grants, and proposed debt financing that has not yet been adopted in the agency's CIP.

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