Form ED-915 PW EAA Infrastructure RLF Awards 2020

Economic Development Administration
GPRA Data Collection Form
Public Works, Economic Adjustment Infrastructure and Revolving Loan Fund Investments
Date___________________________________________________________________
Recipient Name

___________________________________________________________________

Full Address

___________________________________________________________________

Authorized Contact

___________________________________________________________________

Telephone

____________________________

Email (not optional)

___________________________________________________________________

Investment Program

Public Works ____

Project Number

___________________________________________________________________

Award Date

____________________________

Fax ______________________________

Economic Adjustment ____

Revolving Loan Fund ____

Close-out Date______________________
(if applicable)

Investment awarded during federal fiscal year: FY 20_____
Data in this report:
___ 3 years after investment award ____ 6 years after investment award ___ 9 years after investment award

Total Investment

CONSTRUCTION OR LOAN FUNDING
EDA Investment
Applicant Investment 1 Private Investment 2

$
$
$
$
(Note: Total Project should be the total of the other values in this section)

Other Federal
Investment
$

GRANT RECIPIENT COMPLETE THIS SECTION
RESULT OF EDA INVESTMENT
3 Years After Award 3

6 Years After Award 3

9 Years After Award 3

Private Investment Generated
Jobs Created
Jobs Retained
Total Jobs Created/Retained
1 (includes Local and State)
2 private investment associated with project construction, e.g. foundation grants
3 at the time of this report (see instructions)
OMB Approved ED-915
OMB Control Number 0610-0098
Expires: XX/XX/XXXX

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GPRA Data Collection Instructions
Public Works, and Economic Adjustment Infrastructure and Revolving Loan Fund Investments
EDA regional personnel will complete the following information prior to sending the form to the Investment Recipient. If there is not
sufficient space on the data collection form, you may use additional pages with the EDA project number, date of award, and reporting period
at the top of each page.
Recipient Name: Legal name of the Recipient.
Full Address: Physical address of the Recipient including city, state and zip. Include mailing address if different.
Authorized Contact: Person to contact regarding this report. Include the telephone number, if different from Recipient.
Telephone: Telephone number, including area code.
Fax: Facsimile number, including area code.
E-mail Address: Internet address of authorized contact using the following format, ([email protected]).
Investment Program: Check to indicate appropriate EDA investment program.
Project Number: as reflected on the CD-450 and/or CD-451 Notification of Grant Award
Award Date: DEC as reflected on the CD-450 and/or CD-451 Notification of Grant Award
Investment awarded: Identify federal fiscal year of award.
Data for this report: Check to identify the reporting period: three, six, or nine years after investment award date (DEC date in OPCS).
Construction or Loan Funding:
Total Project dollars: Total of EDA investment, applicant (local and state) dollars, private dollars, other federal dollars used in project
construction or loan fund capitalization.
EDA Investment: At time of award for this project number or most current value.
Applicant dollars: Include local and state funds. Local public sources such as city or county appropriations, general obligation/ revenue bond
issues, and economic development sales taxes. CDBG funds to entitlement cities are authorized for use as local shares. State sources are state
appropriations or CDBG funds to the state.
Private dollars: Private sector dollars invested in project construction or loan fund capitalization, including donations, foundation grants,
contributions from local financial institutions, and private donors.
Other Federal dollars: Federal sources, such as HUD, Agriculture, or Transportation funds not reported in Applicant dollars section.
Recipient Section Instructions
Private Investment Generated as a result of the EDA investment:
The incremental private sector investment made in addition to the initial construction investment, including investments in new plant and
equipment, other site improvements, etc. Do not report private sector contributions or loan fund capitalization which led to project
construction.
Direct Project Jobs:
Total Jobs: Total of jobs created and retained (i.e., people employed) at the time of this report.
Jobs Generally: Only permanent and direct jobs may be counted. Part-time jobs should be converted to full-time equivalents (sum the total
part-time hours worked per week and divide by the hourly work week for full-time employees, normally 35-40 hours).
Jobs Created: Private sector jobs created by businesses and other project beneficiaries as a result of the EDA project.
Jobs Retained: Private sector jobs retained as a result of the EDA project.
Direct Jobs: Include those created or retained by employers located at or near the project site or by firms that benefit directly from services
provided by the EDA-funded facility in order to locate, expand or operate in the project area. Recipients should report other direct or directly
-attributable jobs, including subsequent employers that locate or expand in the project area as a result of the project. For some projects (e.g.,
roads, water and sewer lines), direct jobs may include those created by firms that were not originally anticipated as part of the project;
however, these firms required the facility or service provided by the EDA project in order to locate or expand in the area. For more
information, please visit www.eda.gov
Record retention: Recipients must retain supporting performance documentation for a minimum of three years.
For RLF reporting: Actual Created Jobs are the result of and attributable to the RLF loan and have been verified by the borrower. Created
jobs may be credited if the jobs were created within five years of loan disbursement or, if construction is involved, within five years after
construction completion regardless of the status of the loan. A created job must be removed if the job fails to last 18 months. For loans paid in
full, borrowers may use the job data on file provided there is confidence in the reliability of the data. If there is a question on reliability, the
data should be verified by the next annual reporting period. Retained Jobs are existing jobs where it can be documented that without the RLF
assistance, the jobs would have been lost.
Special Provision for RLF Recapitalization: For GPRA purposes, private investment and jobs reported in years three, six and nine (3, 6
and 9) following award of an RLF recapitalization should be reported from the date of the recap, not from the date of the initial RLF award.
For example, if the RLF was initially awarded in 1995 and received a recapitalization award in 1999, only those jobs and private sector
investments dollars generated from 1999 to the end of the appropriate reporting period should be reported.
Agency Disclosure Notice: This information collection is authorized by OMB control #0610-0098. Public reporting burden for this collection of information is
estimated to average 8 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. Send comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to U.S. Department of Commerce, (Economic Development Administration, 1401 Constitution Ave NW, Washington, DC
20230.). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection
of information if it does not display a currently valid OMB control number.
OMB Approved ED-915

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