Public Computer Centers Application

BROADBAND TECHNOLOGY OPPORTUNITIES PROGRAM

OMB Control No. 0660-0031

Public Computer Centers Application

Purpose: The following document outlines the current draft of Round 2 Public Computer Centers Application. This document sequentially outlines each question in the application as indicated in the Easygrants system.

Public Computer Centers Application

PRA Notice and Disclosure Statement prior to Acknowledgement Page

Section One: Acknowledgement

Before applying, applicants should fully read the Notice of Funds Availability (“NOFA”) and Grant Guidelines for Round 2 of BTOP funding. Among other things, applicants should be familiar with the following rules and requirements:

• If an applicant fails to submit a fully complete application, including all required supplemental materials, or fails to provide at a 20% cost share or request a waiver, the application will not be reviewed or considered for an award.

• Applicants must commit to substantially completing their project within two years after the issuance of the grant, and to finishing the project within three years.

• Applicants must successfully demonstrate that the project could not be implemented without federal grant assistance.

• Applicants may receive funding only for costs established in the NOFA as eligible costs for the appropriate project category.

• Applicants receiving awards will be subject to quarterly federal reporting requirements and other post-award regulations as specified in the NOFA.

• IMPORTANT NOTICE: Some of the elements in this application will be made publicly accessible through the application database available at http://www.broadbandusa.gov per Section VI. D. of the NOFA. As stated in the NOFA, those elements of the application that will be publicly displayed are: 1) the identity of the applicant and general applicant and project information; 2) an executive summary of the project; and 3) the federal grant request and cost match. Thus, NTIA will make the following information in the application publicly available: 1) the name and location of the applicant organization; 2) the name, phone number, and email address of the primary point of contact; 3) the project title and description; 4) the executive summary; 5) the total federal grant request and total match amount; and 6) the states in which the project will provide service.

Please check the box below to acknowledge that you have read the above notices as well as the applicable rules in the NOFA governing this program.

Section Two: Contact Information

Name and Contact Information of person to be contacted on matters involving this application.

Contact

• Name

• Prefix

• First

• Middle

• Last

• Suffix

• Title

• Phone/Fax

  • (Select if) Primary

  • Type

  • Phone Number

  • Extension

• Email

  • (Select if) Primary

  • Type

  • Email Address

Section Three: Additional Contacts

Applicant is required to add information of an additional person of contact.

Other Grant Projects Contact

• Name

  • Prefix

  • First

  • Middle

  • Last

  • Suffix

• Project Role

Applicant is required to select:

• Secondary POC

• Other Contact

• Phone

  • Extension

• Email (Business)

Section Four: Organization Information

Applicant is required to enter the DUNS number for the organization applying for the grant.

Organization Information

• DUNS Number (Lookup function)

• CCR Lookup Status

• DUNS Cage Number

• DUNS and CCR Lookup Status will populate the following:

  • Legal Business Name

  • Point of Contact (POC)

  • Alternate POC

  • Electronic Business POC

  • Alternate Electronic Business POC

*Applicant is required to confirm the information provided above*

Additional Organization Information: Applicant is required to identify the following:

• Type of organization: (Drop down menu of different types of organizations Applicant is required to select)

• State or State Agency

• County Government

• City or Township Government

• District of Columbia

• US Territory

• Indian Tribe

• Non-profit Corporation

• Non-profit Foundation

• Non-profit Institution

• Non-profit Association

• Is the organization a small business? (Drop Down Yes/No)

• Does the organization meet the definition of a socially and economically disadvantaged small business concern? (Drop Down Yes/No)

• National American Industry Classification System (NAICS) Code

Section Five: Authorization

Applicant is required to input the following information.

Authorized Organizational Representative

• AOR list

• First Lame

• Last Name

• Email

*Applicant is required to confirm the information listed above*

Section Six: Project Information

Applicant will be required to provide the following information:

Project Description

• Project Title

• Project Description

Other Applications

• Is this application being submitted in coordination with any other application being submitted during this round of funding, or with an application that received an award in the previous round of funding? (Yes/No)

• Please enter the EasyGrant ID and Project Title of any other applications that are being submitted in coordination with this one during this round of funding.

  • Easygrants ID

  • Project Title

• If YES, please explain any synergies and/or dependencies between this project and any other applications.

• (Essay) Describe how the projects are related, and detail any synergies created by the projects. Also note and dependencies this application may have on other applications and explain what contingency plans, if any, you have in the event the other project does not receive an award.

Individual Background Screening

• Is the Applicant exempt from the Department of Commerce requirements regarding individual background screening in connection with any award resulting from this application? (Select One)

• Yes, Applicant is exempt because it is an accredited college or university

• Yes, Applicant is exempt because it is a unit of a state or local government

• Yes, Applicant is exempt because it is an Economic Development District (EDD) designated by the Department of Commerce Economic Development Administration, has an EDD designation pending, or is a council of governments

• No, Applicant is subject to these requirements

• If the answer to the above question is “No,” please identify each key individual associated with the Applicant who would be required to complete Form CD-346, “Applicant for Funding Assistance,” in connection with any award resulting from this Application:

• Name

• Title

• Employer

Executive Summary, Project Purpose, and Benefits

• (Essay) Executive Summary of the proposed project: Please provide an Executive Summary of the Proposed Project. The Executive Summary should be a brief description of the Project, and address the following topics:

• Opportunity the proposed system seeks to address

• A general description of the proposed funded service areas (location, number of communities, etc.)

• Number of households and businesses passed

• Number of community anchor institutions, public safety entities, and critical community organizations passed and/or involved with project (e.g., health care, education, libraries, etc.)

• Proposed services and applications for the proposed funded service areas and users

• Approach to addressing the non-discrimination and interconnection obligations

• Type of broadband system that will be deployed (network type and technology standard)

• Qualifications of the applicant that demonstrate the ability to implement and operate a broadband infrastructure, and/or be a sustainable broadband service provider

• Overall infrastructure cost of the broadband system

• Overall expected subscriber projections for the project

• Number of jobs estimated to be created or saved as a result of this project

• (Essay) Description of BTOP Project Purpose: Describe the purpose of the project and how it supports the statutory objectives of the BTOP program (as set forth above). Please include information to support your assumptions relative to the following. [Two Page Limit]
  a) Project addresses compelling problem or presents an opportunity consistent with the BTOP statutory goals
  b) Project offers an effective solution to that problem or addresses the opportunity
  c) Proposed solution demonstrates broad significance and includes developments that can be replicated to improve future projects
  d) The extent to which the project would produce synergies with a BTOP project funded in Round 1, or an application for Round 2 in another project category (PCC or SBA)
  e) The extent to which the project addresses multiple statutory purposes

• (Essay) Recovery Act and Other Governmental Collaboration: Describe how your project will leverage Recovery Act or other federal or state developmental programs. Please identify the programs themselves and the dollar value associated with each. In addition, describe how the collaboration can lead to greater project efficiencies.

• (Essay) Public Availability: Will your facility be available to all members of the general public, or a specific population only? Please explain. If you charge membership dues or other fees for the population you are proposing to serve, please explain how these charges are consistent with the public interest.

• (Essay) Restrictions on Computer Use: If the use of your center(s) is restricted to certain purposes, please identify those and explain the reasons for the restrictions.

• (Essay) Technology Strategy: Describe the technology strategy for your Center: Explain the mechanics and operational details of your project and how your approach is an effective and appropriate means of creating sustainable adoption in your target population. Explain how your innovative solution(s) would be feasible in other situations.

• (Essay) Involvement of Community Colleges: Please describe any involvement of a community college in this application. In particular, if the project will create a public computer center in a community college, please discuss whether this will deliver substantive benefits to the community college’s core mission.

• Is Applicant seeking a waiver of the Buy American provision pursuant to section X.Q of the NOFA? (Yes/No)

  • (Essay) If YES, applicant is required to add additional information in the waiver document located in the “Uploads” section of the application, that will ask the following:

    • Specify the broadband equipment, facilities, or goods for which you are seeking a waiver. Also, provide statutory exemption upon which waiver request relies and rationale for receiving a waiver.

• Are you seeking a waiver of any requirement set forth in the NOFA that is not mandated by statute or applicable law? (Yes/No)

  • If YES, Applicant is required to add additional information in the waiver document located in the “Uploads” section of the application that will ask the following:

    • Explain the requirement and section of the NOFA that you are seeking relief from, the extraordinary circumstances presented, and why it is in the best interest of the federal government to grant your requested relief.

• Is Applicant delinquent on any federal debt? (Yes/No)

  • (Essay) If YES, please provide your justification for delinquency.

Section Seven: Partners

Applicant will be required to provide the following information:

Partners

• Are you partnering with any other key institutions, organizations, or other entities for this project? (Yes/No)

• If YES, a letter of commitment from all key partner(s) will be required. Upload all letters of commitment in the “Uploads” section of the application. If YES, please add your key partners below and provide the requested information.

  • Prefix

  • First

  • Middle

  • Last

  • Suffix

  • Title

  • Organization

  • Project Role

    • Contractor

    • Sub-recipient

    • Third party in-kind contributor

    • Other

  • Address 1

  • Address 2

  • Address 3

  • City

  • State/Province

  • Zip/Postal Code

  • Region

  • Country

  • Phone (Business)

  • Extension

  • E-mail (Business)

• Applicant is required to identify the type of organization for their partner: (Drop down menu of different types of organizations Applicant is required to select)

• State or State Agency

• County Government

• City or Township Government

• District of Columbia

• US Territory

• Indian Tribe

• Non-profit Corporation

• Non-profit Foundation

• Applicant is required to identify if their partner is:

  • Whether key partner(s) is a small business (Drop Down Yes/No)

  • Whether key partner(s) meets the definition of a socially and economically disadvantaged small business concern (Drop Down Yes/No)

Partners Description

• Please provide a description of the involvement of the partners listed above in the project.

(Essay) Project Partnerships: If applicable, describe the roles of the project partners, including any contributions to funding, planning, implementing, managing, or operating the proposed network. Please clarify any potential benefits that the partners will receive from the project (e.g., free or discounted access to dark fiber). Also discuss the project’s general approach to involving local communities in the project area. You will be asked to provide letters of commitment or support from key partners in the upload section.

Section Eight: Congressional Districts

Applicant will be required to provide the following information:

Congressional Districts

• Applicant Headquarters

• Project Service States (All 50 states available for selection)

• Project Service Areas (Pre-populated with Congressional Districts from states selected above)

• Will any portion of your proposed project serve federally recognized tribal entities? (Yes/No)

• Indicate each federally recognized tribal entity your proposed project will serve (List of Tribal Entities based on Project service areas selected above)

• Have you consulted with each of the federally recognized tribal entities identified above? (Yes/No)

Section Nine: Demographics

Applicant will be required to provide the following information:

Demographics

• Will your proposed project be specifically directed to serve vulnerable population groups? (Yes/No)

• If "Yes" which vulnerable population groups will your proposed project serve? Check as many as apply:

• Hispanic

• Black/African-American

• Asian

• Native American or Native Alaskan

• Native Hawaiian or Pacific Islander

• English as a Second Language (ESL)

• Disabled

• Low Income

• Unemployed

• Senior Citizen (55 and over)

• Youth

• Other- Applicant is required to explain “Other”

Applicant is required to answer the following essay questions, depending on their answers above:

• (Essay) Vulnerable Populations: Please describe the specific affirmative steps that your program will take to engage and serve each specified vulnerable population checked above.

• (Essay) Accessibility: Please describe the ways in which your center(s) will be accessible and welcoming to people with disabilities and which technologies will be used (i.e., software, adaptive technologies).

• (Essay) Other Languages: Please describe the multilingual training and outreach being offered and which languages it will be in.

Outreach

• (Essay) Outreach initiatives: Please describe your outreach strategy to ensure usage of services and equipment provided in your program proposal, and why you have chosen this strategy.

• How many total users do you expect to generate through the use of BTOP funds at your public computer center(s)?

Training and Education

Applicant is required to identify the following:

• (Essay) Peripherals and Equipment: Please describe the specific types of personal computing peripherals and/or broadband equipment do you intend [sic] to provide for each workstation.

• (Essay) Workstation Software: Please describe the type of software do you intend [sic] to provide on each workstation.

• (Essay) Training and Education programs: Please describe your primary training and educational programs, including curricula, student certification programs, and number of instructors and their qualifications. Explain how these programs respond to the needs within your community, and detail any lessons learned from prior experience.

• If you are providing educational or training programs, how many people in total will these programs reach on an annual basis?

• How many hours of training will be provided to each participant?

• How many Full Time Employee (FTE) instructors or facilitators will you employ for these courses?

• How many direct jobs will be created from this project?

• How many indirect jobs will be created from this project?

• How many jobs will be induced from this project?

Section Ten: Project Budget

Applicant will be required to provide the following information:

Project Budget: Applicant is required to provide the following information

1. Federal Grant Request

2. Total Match Amount

3. Total Budget

• Match Percentage

• (Essay) Projects Outside the Recommended Funding Range: If this total project budget is above or below the project size range recommended in the NOFA ($500,000-$15 million), please provide a reasoned explanation for this variance from the recommended range.

• (Essay) Sustainability: Demonstrate the sustainability of your project.

• Explain how your project will enable your centers to sustain themselves, providing ongoing services and maintaining community support beyond the scope of this grant.

Matching Funds

• Applicant is providing matching funds of at least 20% or more towards the total eligible project costs. (Yes/No, applying for a waiver)

  • If NO, Applicant will be required to supply additional information in the waiver document located in the “Uploads” section of the application, that will ask the following:

    • (Essay) Explain inability, based on financial need, to provide the required 20% share of the cost of the proposed project (see section V.C of the NOFA).

• (Essay) Describe Matching Contributions: Please provide a detailed account of all matching costs for this project. For cash matches provide: a) the name of the party providing the match, b) the funding amount (and percentage of the total budget it represents), c) the type of funding (e.g., grant match, equity, debt, internal, other), d) the use of the funding, and e) any key financing terms and conditions. For in-kind matches, provide: a) the name of the party providing the match, b) the match value (and percentage of the total budget it represents), c) the nature of the in-kind contribution, d) an explanation of how the contribution qualifies as an eligible cost under BTOP eligible cost rules, and e) if the contributor is not the applicant, a description of any benefits the contributor will derive from the project (e.g., free or discounted access to the network).

• (Essay) Unjust Enrichment: Please state whether this project is receiving, or if you have applied for, any Federal support for non-recurring costs in the area for which you are seeking an award. If so, please state how much and from which federal program.

• (Essay) Disclosure of federal and/or state funding sources: Please disclose the source and amount of other federal or state funding received or requested for activities or projects to which this project relates. Please specify all Universal Service Fund (USF) funding delineated by specific program.

Budget Narrative

• (Essay) Budget Narrative: Please provide a narrative that explains the project budget (as proposed on SF-424 A and/or SF-424 C) and spending plan (timeline) in sufficient detail for reviewers to determine whether the expenditures are necessary and appropriate to the solution you are proposing.

• (Essay) Budget Reasonableness: Concisely and convincingly explain why the unit price and total number of units required for this project are reasonable to deliver your proposed services in the designated proposed funded service areas. Provide any relevant data and summaries of your analysis (e.g., industry benchmarks around units required per household or institutions served, etc.)

• (Essay) Demonstration of Need: Please explain the reasons why the project would not have been implemented without federal assistance, and why the particular level of federal assistance requested is appropriate. The response should incorporate the data provided in the Net Present Value Analysis upload, and should include discussion of what discount rate is most appropriate to evaluate this project.

Funds to States and Territories

• Total U.S. Dollars

Section Eleven: Historical Financials

Applicant will be required to provide the following information:

Applicants are required to identify Historical Financials for 2007, 2008, and 2009 for the following categories:

• Revenue

• Expenditures

• Net Assets

• Change in Net Assets from Prior Year

• Bond Rating (if applicable)

Section Twelve: PCC Capacity

Applicant will be required to provide the following information:

Please provide estimates of the number of job-years created by this program. Refer to the Council of Economic Advisor’s guide to job creation estimates http://www.whitehouse.gov/administration/eop/cea/Estimate-of-job-creation for definitions and background. You may deviate from the guidance for job creation estimates provided therein if you have sound reason to believe that you can provide a more accurate estimate of job creation by another methodology.

• How many direct job-years will be created from this project?

• How many indirect jobs will be created from this project?

• How many jobs will be induced from this project?

• (Essay) Methodology: Please describe the methodology employed to produce the job-years estimates provided above. If you utilized the methodology suggested by the Council of Economic Advisors, please note that.

Community Anchor Institution

• Proposed # of Public Computer Centers: Applicant is required to identify the number of proposed Public Computer Centers for the following anchor institutions:

• Schools (k-12)

• Libraries

• Medical and Healthcare Providers

• Public Safety Entities

• Community Colleges

• Public Housing

• Other Institutions of Higher Education

• Other Community Support Organization

• Other Government Facilities

Total Community Anchor Institutions

Minority Serving Institutions

• Historically Black Colleges and Universities

• Tribal Colleges and Universities

• Alaska Native Serving Institutions

• Hispanic Serving Institutions

• Native Hawaiian Serving Institutions

Total Minority Serving Institutions

Weekly Usage Summary

Applicant is required to identify the following:

• Total Current # of Persons Served per 120-hour Business Week

• Total Proposed # of Persons Served per 120-hour Business Week

• Total Current # of Persons Served per 48-hour Weekend

• Total Proposed # of Persons Served per 48-hour Weekend

Broadband Workstation Summary

Applicant is required to identify the following:

• Number of Current Workstations proposed to be upgraded

• Total Current # of Broadband Workstations

• Total Proposed # of Broadband Workstations

• Average Current Facility Broadband Connection Speed per PCC Mbps

• Average Proposed Facility Broadband Connection Speed per PCC Mbps

Section Thirteen: Project Readiness

Applicant will be required to provide the following information:

Text Areas

• (Essay) Licenses and Regulatory Approvals: List any licenses or regulatory

approvals required to complete your project and indicate the status of each.

• If applicable, please list any local, state, or federal licenses and regulatory approvals required to complete your project, and indicate the status of each.

• (Essay) Organizational Readiness: Describe your organization's readiness to implement the project.

• Please describe key factors that demonstrate how your organization will be prepared to implement, operate, and sustain your project using federal funds. Include past experiences in managing projects of comparable size and complexity.

• (Essay) Project Timeline and Challenges: Provide a detailed implementation plan.

• Please provide a detailed implementation plan on a quarterly basis that shows the phases of the project and establishes key milestones. Include such activities as construction, staffing and hiring, resource development, staff training, equipment purchases, and installation. Also, include a description of key challenges or risks to the timely completion of the project, including any mitigation plans to address the risks.

Section Fourteen: Environmental Questionnaire

Applicant will be required to provide the following information:

• Does this PCC application have construction or ground disturbing activities? (Yes/No)

• If no, please answer the questions below. If yes, please do not answer the questions below and instead proceed to the next page to answer the expanded environmental questionnaire.

• Does the proposed action involve the procurement of materials? (Yes/No)

• If so, will the materials be installed, stored or operated in an existing building or structure? If yes, please click "Add" to include the list of equipment and peripherals to be procured.

• Does the proposed action involve procurement of electronic equipment? (Yes/No)

• If yes, will the equipment be disposed of in an environmentally sound manner at the end of its useful life?

• Does the proposed action involve construction, remodeling, or renovation? (Yes/No)

• If so, will these activities be limited to only minor interior renovations to a structure, facility, or installation? If yes, click "Add" to include a description of the proposed renovations with your project summary.

• Does the proposed action involve the production and/or distribution of informational materials, brochures, or newsletter? (Yes/No)

• Does the proposed action involve training, teaching, or meeting facilitation at an existing facility or structure? (Yes/No)

• If yes, click "Add" to explain.

• Does the proposed action involve ground or surface disturbance to accommodate new fiber optic cable? (Yes/No)

• If yes, please click "Add" to include a description of the extent of service upgrade, a list of the permits required, and linear footage of underground fiber optic cabling required.

• Does the proposed action involve an upgrade of broadband service to an existing facility or structure? (Yes/No)

• If yes, please include a description of the extent of service upgrade, a list of the permits required, and linear footage of underground fiber optic cabling required?

Section Fifteen: Environmental Questionnaire Part Two

Applicant will be required to provide the following information:

Applicant is required to answer the following essay questions:

• (Essay) Project Description: Describe all project-related construction activities, including, but not limited to building construction related to installing prefabricated buildings; internal modifications, or equipment additions to buildings or other structures (e.g., relocating interior walls or adding computer facilities); the construction and installation of buried cable; or installation of telecommunications transmission facilities including construction of new monopole towers, satellite dishes. Complete descriptions and locations must be provided for each site affected by project-related construction activities.

• (Essay) Property Changes: Describe and indicate the amount of property to be cleared, excavated, fended, or otherwise disturbed by the project. Describe the current land use and zoning for each project site affected by construction. Document whether the proposed project is located on public land owned or managed by the federal government. For information related to federal lands see the following website – http://www.geocommunicator.gov. This website provides cadastral survey and land management information and data from the National Integrated Land System specifically the distribution of the Public Land Survey System (PLSS), other survey-based data, and federal land boundaries.

• (Essay) Buildings: Describe buildings or other structure (i.e., transmission facilities), including dimensions, to be constructed or modified. For linear projects, state whether the project is to be located on or within previously disturbed public rights-of-way.

• (Essay) Wetlands: Describe and indicate whether wetlands are present on or near the project site(s) affected by construction (maps of wetlands may be obtained from the U.S. Fish and Wildlife Service’s National Wetland Inventory website: http://www.fws.gov/wetlands/ or from soil maps obtained from the USDA, Natural Resource Conservation Service’s website: http://websoilsurvey.nrcs.usda.gov/app/HomePage.htm).

• (Essay) Threatened and Endangered Species: Describe and indicate whether any project site(s) will directly or indirectly affect any threatened, endangered or candidate species or is within or near critical habitats. To document the analysis, applicants must provide species lists and appropriate specie accounts obtained from the U.S. Fish and Wildlife Service’s website: http://ecos.fws.gov/tess_public/ for each county affected by construction of the project.

• (Essay) Floodplains: Describe whether or not any facility(ies) or site(s) are located within a 100 or 500-year floodplain. Information related to floodplains and National Flood Insurance Maps may be obtained from the Federal Emergency Management Agency’s (FEMA) website: http://msc.fema.gov/webapp/wcs/stores/servlet/FemaWelcomeView?storeId=10001&catalogId=10001&langId=-1. If any project-related construction activities are within floodplains, a copy of the FEMA, “FIRMette” with construction activities depicted on the map must be included. For obtaining FIRMettes review the tutorial provided by FEMA.

• (Essay) Historic Properties and Cultural Resources: Describe any cultural resources, including historic properties, i.e., properties listed in or eligible for listing in the National Register of Historic Places, which are located in or within a one-mile radius of the project area and how they may be impacted by the project. Information related to historic properties can be obtained from the State Historic Preservation Office (SHPO) in your respective State – see the website of the National Conference of SHPO: http://www.ncshpo.org/find/index.htm. Applicants must indicate if any portion of the project is located on tribal lands, meaning lands within the exterior boundaries of any Indian reservation and all dependent Indian communities. Information regarding historic properties located on tribal lands may be obtained from the Tribal Historic Preservation Officer (THPO) or the tribe’s official representative for historic preservation. If provided, applicants should provide any information gathered about historic properties on tribal lands, including any correspondence with an Indian tribe. Applicants must gather information about the nature and location of historic properties from the SHPO. SHPOs should be asked the following questions: 1. Is the proposed project located on, within or adjacent to any properties listed in or eligible for listing in the National Register of Historic Places? Is the proposed project located on, within or adjacent to a National Historic Landmark? If the answer is yes, describe and indicate the geographic relationship between the project and property with maps. 2. Will the proposed project impact, use or alter a building or structure that was constructed more than 50 years ago? If so, describe the building/structure with a statement of its condition, including photographs, and document its age. 3. If provided, applicants should provide SHPO responses/information to these questions including any correspondence with the SHPO.

• (Essay) Coastal Areas: Determine whether or not the project is within the boundaries of a coastal zone management area (CZMA). For boundary related and contact information related to CZMA, see National Oceanic and Atmospheric Administration, Office of Ocean and Coastal Resource Management’s website: http://coastal management.noaa.gov/consistency/welcome.html

• (Essay) Brownfields: Determine whether the project is located within a brownfield site. Per 42 U.S.C. 9601, the term “brownfield site “ means real property, the expansion, redevelopment, or reuse of which may be complicated by the presence or potential presence of a hazardous substance, pollutant, or contaminant. Maps and locations of sites, facilities and properties that have been contaminated by hazardous materials and are being, or have been, cleaned up under EPA’s Superfund, RCRA and/or brownfields cleanup programs can be found at the following website: http://iaspub.epa.gov/Cleanups/.

Section Sixteen: Upload

Applicant will be required to provide the following information:

Upload Checklist

• Management Team Resumes and Organizational Chart (Required)

• Provide the resumes of the senior management team and project team members significant to the project's success. Please identify their years of experience and relevant expertise with projects of similar size, scope, and complexity. Please identify specific prior (or current) projects, dates, and outcomes that showcase the management team's track record as relevant to executing the project. In addition, provide an organizational chart that details the structure of your organization, including any parent, subsidiary, affiliate, or partner organizations.

• Government and Key Partnerships (Optional)

• Please submit documentation, such as letters of support or commitment, from each of the key partners in the project. The documentation should clearly describe the specific details of the partner’s participation. For example, if the partner is providing part of the project's cost matching contribution, the documentation should state the exact amount of the cash contribution, or describe, in detail, the nature of the in-kind contribution. If the partner is an Indian tribe or a socially and economically disadvantaged small business, as defined by Section 8(a) of the Small Business Act, 15 U.S.C. 637, the documentation should make note of this, and explain the basis for this claim.

• Historical Financial Statements (Required)

• Provide detailed organizational financial statements for the last two years: a) Income Statement; b) Balance Sheet; c) Statement of Cash Flows. If your organization was established less than two years ago, provide all available information. Note that, this response requires financial data for the organization as a whole—in contrast to the pro forma financial projections, which require project-specific financial information. A standard annual Income Statement, Balance Sheet, and Cash Flows based on generally accepted accounting principles (GAAP) are preferable. If your organization cannot readily produce this data in a standard format, you should explain why not, and provide comparable data, such as your most recent IRS Form 990 or annual audit, that provides as detailed a picture as possible of your financial history for a minimum of one year prior to your submission of this application. If appropriate, you may include Notes on Financial Statements that explain costs and revenues by major categories, and you may make note of any abnormal or one-time

• Public Center Detail (Required)

• Detailed Budget (Required)

• SPIN (Optional)

• Waivers – (Optional)

• BTOP Certifications (Required)

• SF 424 Budget (A or C) (Required)

• SF 424 B and D Assurances (Required)

• Supplemental Information (Optional)

Uploads

• Applicant required to pick “Upload” type and “Upload” the document

Section Seventeen: Review and Submit

Applicant is required to review and submit application.

View Full Submission

• Applicant can review the PDF

Validation Status

• Will indicate to Applicant whether each section is “complete” or “incomplete” in the application

27