Document
EERE 159 - Detailed Budget Justification
ICR 202401-0660-001 · OMB 0660-0054 · Object 138663302.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
|---|---|
| File Title | EERE 159 - Detailed Budget Justification |
| Author | Pat Saito |
| Last Modified By | Calc |
| File Modified | 2024-02-05 |
| File Created | 2026-09-21 |
| Conversion State | complete |
Extracted Text
State Digital Equity Capacity Grant Program
Specific Projects Application Form
This form will serve as a tool to capture specific project details for the State Digital Equity Capacity Grant Program application.
Applications from States must be received no later 11:59 p.m. ET on [DATE], 60 days after the issuance the NOFO. Applications from U.S. Territories
must be received no later 11:59 p.m. ET on July 31, 2024.
Per Section II.C.2. of the NOFO, any State or Territory applying for the program must submit an application that contains the information included in
this Application Form. States and Territories must submit all project details to NTIA via the NTIA Grants Portal within nine months of the award date.
The information collected will be subject to review and approval before the State or Territory may draw down funds to implement the project(s).
Applicants should enter into this form information pertaining to all projects the State or Territory intends to implement in this fiscal year's allocation.
Projects for which an applicant indicates they will subgrant funds will require additional details on the State or Territory's subgrantees.
If you have any further questions, or require technical assistance, please reach out to your assigned Federal Program Officer.
Click on the link below to view the specific projects application form.
Specific Projects
Applicant Level
Project Level
Project Level
State / Territory
Project
Project ID
Provide a unique ID for the project using
the following stucture where [XX] is two
digits, starting with 01:
[State or Territory Postal Code]-Capacity
Grant Project-[XX]
Write the postal
abbreviation for your State
or Territory (i.e., AL for
Alabama)
Example
AL
Birmingham Laptop
Distribution Program
AL-Capacity Grant Project-01
AL
Mental Health Online
Resource Portal
AL-Capacity Grant Project-02
AL
Library Computer Class
AL-Capacity Grant Project-03
Project Level
Project Level
Project Level
Primary Digital Equity
Outcome
Secondary Digital Equity
Outcome
Executive Summary
Select the secondary digital equity
outcome for the project
In 2-3 sentences, provide a brief
executive summary of the specific
activity or set of activities the project
intends to complete or implement,
where the project will be carried out,
and the expected beneficiaries of the
project.
Select the primary digital equity
outcome for the project
Civic and Social Engagement
Economic and Workforce
Development
Open-ended text
Health
Open-ended text
Economic and Workforce
Development
Open-ended text
Project Level
Project Level
Project Activities
Environmental and Historical Preservation (EHP)
List the specific activity or set of activities the project
intends to complete or implement
Does the project propose to install fixed equipment on
or in a building?
Open-ended text
No
Open-ended text
No
Open-ended text
No
Project Level
l and Historical Preservation (EHP)
If Yes, provide the location of the building and year of
original construction in the field directly below and
also upload the documentation required in the NTIA
Grants Portal for EHP.
Project Level
Build America Buy America
(BABA) Act
Is the project an “infrastructure project” (as
defined in 2 C.F.R. 184.3), and thus is subject
to and must abide by BABA?
No
Open-ended text
No
Open-ended text
No
Project Level
Project Level
Barriers to be Addressed
Measurable Objectives
List the barrier(s) to digital equity the
project will address
Individuals who live in
covered households (i.e.,
with an income no more
than 150 percent of the
federal poverty threshold)
List the measurable objectives to be pursued
Provide the estimated
and the data to be collected to demonstrate number of individuals to be
success in meeting these objectives, including
served for each covered
quantitative baseline data.
population.
Open-ended text
Open-ended text
10,000
Open-ended text
Open-ended text
10,000
Open-ended text
Open-ended text
10,000
Project Level
Covered Populations Served
Aging individuals
Incarcerated individuals
Veterans
Individuals with disabilities
Provide the estimated
Provide the estimated
Provide the estimated
Provide the estimated
number of individuals to be number of individuals to be number of individuals to be number of individuals to be
served for each covered
served for each covered
served for each covered
served for each covered
population.
population.
population.
population.
5,000
0
100
100
5,000
500
100
100
5,000
0
100
100
Project Level
ved
Individuals with a language
barrier
Individuals who are
members of a racial or
ethnic minority group
Individuals who primarily
reside in a rural area
Provide the estimated
Provide the estimated
Provide the estimated
number of individuals to be number of individuals to be number of individuals to be
served for each covered
served for each covered
served for each covered
population.
population.
population.
Geographies
List the specific geographies to be served (if
not State- or Territory-wide)
100
4,000
0 Open-ended text
100
4,000
1,000 Open-ended text
100
4,000
1,000 Open-ended text
Project Level
Project Level
Project Level
Alignment to DE Plan
Anticipated Outputs
Anticipated Start Date
Description of how the proposed project or activity will Provide estimates of the anticipated outputs
be evaluated to determine successful implementation of of the activity or project (For example, the
Insert the anticipated start date
the Digital Equity Plan of the State or Territory,
number of hours of training to be provided,
for this project
including specific references to the Digital Equity Plan
the number of curricula to be developed, or
and quantitative baseline data.
the number of devices to be provided).
Open-ended text
Open-ended text
9/1/2024
Open-ended text
Open-ended text
9/15/2024
Open-ended text
Open-ended text
10/1/2024
Project Level
Project Level
Project Level
Anticipated End Date
Project Duration
Funding Amount
Insert the anticipated end date
for this project
Do not enter or edit text below.
The project duration will auto-populate
based on the anticipated start and end
dates.
Insert the amount of funding that will be
used for this project
7/30/2025 0 years, 10 months, 29 days
$
150,000.00
7/15/2029 4 years, 10 months, 14 days
$
220,000.00
6/30/2029 4 years, 8 months, 29 days
$
90,000.00
Project Level
Subgrantee Level
Implemented Directly or via Subgrant?
Subgrantee Legal Name
Indicate whether the State or Territory will implement
If the project will be implemented through
the project directly or will subgrant funds to implement
a subgrant, insert the name of the entity
the project. (Note that additional details must be
that will implement the proposed project (if
provided in the following columns for projects
known at the time of application)
implemented through subgrants).
Subgrant
University of Alabama at
Birmingham
Directly by the State / Territory
Subgrant
Montgomery Library
Subgrantee Level
Subgrantee Level
Legal Identifiers of Subgrantee
Subgrantee Capacity
If the project will be implemented through
If the project will be implemented through If the project will be implemented through
a subgrant, describe the subgrantee's
a subgrant, insert the UEI of the subgrantee a subgrant, insert the EIN of the subgrantee capacity to manage the project for which it
will receive a subgrant
123456789101
123456789
Open-ended text
111098765432
987654321
Open-ended text
Subgrantee Level
Designation of Subgrantee as
WBE, MBE, Small Business
If the project will be implemented through
a subgrant, select if the subgrantee is a
women's business enterprise, minority
business enterprise, or small business
MBE
N/A
Specific Projects
Project Category
Economic and Workforce Development
Education
Health
Civic and Social Engagement
Delivery of Other Essential Services
Other
Implemented Directly or
through Subgrant?
Directly by the State / Territory
Subgrant
Designation of Subgrantee as
Installation of fixed
equipment?
WBE, MBE, Small Business
WBE
Yes
MBE
No
Small Business
N/A
*multi-select dropdown