Regionally Coordinated Transportation Planning

Application for Funding

Regionally Coordinated Transportation Planning

FY 2016 & FY 2017

Template

Issued: February 17, 2015

Response Due: May 7, 2015

Texas Department of Transportation

Public Transportation Division

FORM A: Table of Contents and Checklist
Content / Check if Included in Application
Cover Letter Signed by Recipient’s Authorized Representative / 
Form A: Table of Contents and Checklist / 
Form B: Recipient Information / 
Form C: Contact Information / 
Form D: Federal and State Compliance Requirements
Form E: Obligation Certificate
Form F: Experience & Capacity
Form G: Stakeholder Engagement
Form H: Inventory of Transportation Resources, Comprehensive Needs Assessment, Gap Analysis & Identification of Inefficiencies / 
Form I: 5-Year Public Transit-Human Services Transportation Plan (including the elements in Table of Contents on pp. 10-12 of General Information & Instructions)
Form J: Quality Assurance
Form K: Leverage Other Resources
Form L: Workplan for FY 2016 (Sept. 1, 2015 through Aug. 31, 2016)
Form M: Workplan for FY 2017 (Sept. 1, 2016 through Dec. 31, 2016)
APPENDIX I: Letters of Commitment
APPENDIX II: Letters of Support
APPENDIX III: Budget Workbook
ADDITIONAL APPENDICES AS NEEDED
FORM B: Recipient Information
1. Legal Name of Agency:
2. Mailing Address Information (include mailing address, street, city, county, state and zip code):
3. Payee Identification (PIN) Number (14 digits)
4. Type of Agency
 Rural Transit District
 Urban Transit District
 Metropolitan Transit Authority
 Government Entity
 Other ______/ 5. Primary Contact for this Proposal
Name:
Title:
Phone:
Fax:
Email:
6. Financial Officer
Name:
Title:
Phone:
Fax:
E-mail: / 7. AuthorizedRepresentative
Name:
Title:
Phone:
Fax:
Email:
8. Counties served by the proposed activities:
FORM C: Contact Information
Primary Contact for Regionally Coordinated Transportation Planning
Name:
Title:
Organization:
Mailing Address:
Phone:
Fax:
Email:
Backup Contact for Regionally Coordinated Transportation Planning
Name:
Title:
Organization:
Mailing Address:
Phone:
Fax:
Email:
Billing Contact for Regionally Coordinated Transportation Planning
Name:
Title:
Organization:
Mailing Address:
Phone:
Fax:
Email:

FORM D:Federal and State Compliance Requirements

The following elements are required to be on file with the Texas Department of Transportation (TxDOT) before execution of a project grant agreement. If your agency has not sent to TxDOT a current copy of any item listed below, then send a current copy with this funding application.

  1. Recipients are required to have a current master grant agreement (MGA) with TxDOT.

Does your agency have a current MGA on file with TxDOT?:

  1. In accordance with Title 49 CFR Section 21.9(b) and 43 TAC 31.42, recipients are required to submit a Title VI Program or Plan to TxDOT.

Has your agency provided a current Title VI Programto TxDOT?

  1. In accordance with49 U.S.C. 5323(n), recipients are required to submit signed federal certifications and assurances to TxDOT.

Has your agency provided a signed FY 2015 certifications and assurances to TxDOT?

  1. In accordance with 43 TAC Chapter 31.39, recipients are required to have a current ethics certification.

Has your agency provided a current ethics policycertification to TxDOT?

  1. In accordance with OMB 68 Federal Register 38402 andOMB 68 Federal Register 55671 as amended by 79 Federal Register 75879,recipients are required to have a DUNS number for an application for Federal funds to be considered complete, must have an active DUNS numberat the time of the funding award and must keep this DUNS number in active status through the life of the contract.

Provide activeDUNS number:

Date DUNS number is due for update:

  1. In accordance with 49 CFR 21 and 43 TAC 31.42 a formal Equal Employment Opportunity (EEO) program is required of any applicant that employed 50 or more transit-related employees (including temporary, full-time or part-time employees) and received in excess of $1 million in capital or operating assistance or in excess of $250,000 in planning assistance in the previous Federal fiscal year.

Has your agency provided a current EEO program to TxDOT?: or N/A

  1. In accordance with the 43 TAC 31.44 agencies are required to have written procurement policies and procedures.

What was the effective date that your agency’s written procurement policies and procedures were approved?

  1. In accordance with the 49 CFR 18, a current (applicable to the fiscal year) indirect cost allocation plan is required to support the distribution of indirect costs related to the grant program, and must be approved by FTA or cognizant agency. Without an approval letter from the cognizant agency, indirect costs must be excluded from the reimbursement process.

Approved Indirect Cost Rate: % or N/A

Include as a separate attachment: 1) the Indirect Cost approval letter from the cognizant agency, which documents the approved percentage rate and applicable fiscal year and 2) Current Indirect Cost Allocation Plan with accompanying Certificate of Indirect Cost

  1. In accordance with the 43 TAC 31.48, agencies should be in compliance prior to issuance of funding.Provide a status update of any ongoing Improvement Action Plan(s) (IAP) with TxDOT or indicate if this is not applicable.
  1. Audit - Applicants of federal funding are required to comply with federal (OMB A-133) and/or state (State of Texas Single Audit Circular) requirements. Applicants should respond based on the previous fiscal year.

- If threshold expenditures of $500,000 or more have been met during the Transit Provider's previous fiscal year, the Transit Provider must submit a copy of the Single AuditReportand Management Letter (if applicable) to TxDOT's Audit Office, 125 East Eleventh Street, Austin, TX78701 or contact TxDOT’s Audit Office at

- If expenditures are less than $500,000 during the Transit Provider's previous fiscal year, the Transit Provider must submit a statementto TxDOT's Audit Office as follows: "We did not meet the $500,000 expenditure threshold or are a For-Profit agency and therefore, are not required to have a single audit performed for FY ______."

Has the agency expended $500,000 or more in transit or non-transit federal awards in the previous fiscal year?

Yes No

  1. If yes, were annual audits completed in accordance with OMB Circular A-133 and submitted to the TxDOT Audit Office?

Yes No

  1. If no, was a statement (e.g. letter) submitted to the TxDOT Audit Office as follows: "We did not meet the $500,000 expenditure threshold or are a For-Profit agency and therefore, are not required to have a single audit performed for FY _____."

Yes No

FORM E: Obligation Certificate

As an authorized official of

(Organization Name)

I certify to the following:

  1. The information presented in the application is true and accurate to the best of my knowledge.
  1. I have not intentionally made any misstatements or misrepresented the facts.
  1. The organization has the resources and technical capacity to support the proposed activities and/or project.
  1. The organization uses generally accepted accounting standards for its financial recordkeeping functions.
  1. The organization will participate in a continuous, comprehensive dialogue throughout the life of the project including but not limited to:

On-site monitoring by TxDOT personnel

Timely submission of required reports

Timely written notification of events that will affect the outcome of the project.

  1. The organization will comply with all applicable federal, state and local laws and regulations. This includes but is not limited to:

FTA Certification and Assurances

Master grant agreements

Project grant agreements

Applicable federal program circulars and similar federal and state guidance

  1. Applicant Affirmation: Compensation has not been received for participation in the preparation of the specifications for this call for projects.

Sign:

(Authorized Representative)

Printed/Typed Name:

Title:

Date:

FORMF: Experience & Capacity

Maximum: 1 page

Do not include the wording of each question, but do include the number of each question (such as 1.1, 1.2 and so on)

1.1Describe one specific, convincing example of how your agency effectively engaged stakeholders in a regional planning project, and why these efforts to engage were unquestionably successful.

1.2Describe one specific, convincing example of your agency leveraging funds (other than regionally coordinated transportation planning funds from TxDOT) to conduct regional transportation planning activities. List the other, leveraged funding source(s) and how your agency overcame any challenges to access these funds.

1.3Convincingly explain your agency’s capacity to begin proposed activities on Sept. 1, 2015 and manage proposed activities, provide necessary staff support and complete all activities and deliverables by Dec. 31, 2016. Specify whether work will be performed in-house (by your agency’s staff), through a partnership arrangement or using contracted services.

FORM G: Stakeholder Engagement

Maximum: 2 pages

Do not include the wording of each question, but do include the number of each question (such as 1.1, 1.2 and so on)

2.1 List the stakeholders and partners(including individuals with disabilities, individuals 65 and older and agencies that serve these priority populations) who participated in developing this funding application and clearly illustrate how these stakeholders and partners substantially contributed to the development of this funding application.

2.2Provide letters of commitment from representatives of each of the following groups indicating their firm commitment to actively participate in developing and approving this five-year public transit-human services transportation plan:

  • Representatives of public, private and non-profit transportation providers, including recipients of Section 5307 funds (small urban transportation providers), Section 5311 funds (rural transportation providers) and Sections 5310 (Enhanced Mobility of Seniors and Individuals with Disabilities);
  • Representatives of human services providers;
  • Representatives of metropolitan planning organizations (unless in a planning region with no MPO);
  • Individuals with disabilities;
  • Individuals 65 and older;
  • People with low incomes;
  • Veterans;
  • Workforce agencies
  • Advocates for children;
  • Other members of the public.

Note: Include letters of commitmentin an appendix. These letters do not count as part of the two-page maximum for Form G.

2.3Convincingly explain the process your agency will use to ensureactive, effective and regular participation ofindividuals with disabilities,individuals 65 and older and agencies that represent or serve these priority population in the development and approval of this five-year public transit-human services transportation plan and explain how your agency will document this ongoing participation.

2.4 Convincingly explainthe process your agency willuse to ensureactive, effectiveand regularparticipation of representatives of each of the other groups listed above in the development and approval of this five-year public transit-human services transportation plan and how your agency will document this ongoing participation.

FORM H:Inventory of Transportation Resources, Comprehensive Needs Assessment,Gap Analysis & Identification of Inefficiencies

Maximum: 2 pages

Do not include the wording of each question, but do include the number of each question (such as 1.1, 1.2 and so on)

Clearly and convincingly describe:

3.1Appropriate and effective steps that your agency will take to identify, document and assess:

  1. Transportation providers including public, private and non-profit transportation providers;
  2. Available transportation services;
  3. Inefficiencies, including overlaps and gaps in services, including services for priority populations listed above; and
  4. Underused equipment owned by public and private transportation providers; and

3.2Appropriate and effective methodologies that your agency will use to conduct a reliable comprehensive needs assessment and gap analysisto identify, documentand assess unmet transportation needs including gaps and overlaps in transportation services for:

  1. Individuals with disabilities
  2. Individuals 65 and older
  3. People with low incomes
  4. Individuals with limited English proficiency
  5. Children
  6. Veterans
  7. Workforce agencies
  8. Other members of the public

3.3How this inventory of transportation resources, comprehensive needs assessment and gap analysis will:

  1. Be consistent with and not duplicate resource inventories, needs assessments and gap analyses conducted by other metropolitan, regional and statewide planning processes; and
  2. Promote integration of services of programs funded by Federal Transit Administration, Federal Highway Administration, health and human services agencies, work force agencies, veterans’ agencies and others.

FORM I:5-Year Public Transit-Human Services Transportation Plan (including the elements in Table of Contents on pp. 10-12 of General Information & Instructions)

Maximum: 2 pages

Do not include the wording of each question, but do include the number of each question (such as 1.1, 1.2 and so on)

Clearly describespecific approaches and steps your agency will take to appropriately and effectively:

4.1Develop:

  1. Vision and mission statements;
  2. Goal(s) and objectives that are focused and strategic; and
  3. Strategies, activities and/or projects to address identified overlaps and gaps between current transportation services, as well as opportunities to improve efficiencies in transportation service delivery.

4.2Identify multiple financial and labor resources to be leveraged to help sustain this planning process and to “work this plan” following its completion in Dec. 2016.

4.3Prioritize objectives, strategies and/or projects to pursue (and upon which to base future funding requests), considering(a) anticipated availability of resources from multiple sources, (b) time, and (c) feasibility.

4.4Ensure that this plan will:

  1. Be consistent with other metropolitan, regional and statewide plans, and;
  2. Promote integration of services of programs funded by Federal transit Administration, Federal Highway Administration, the Department of Health and Human Services, other health and human services agencies, work force agencies, veterans’ agencies and others.

4.5Develop:

  1. Local performance measures to objectively evaluate progress and effectiveness in achieving the goal(s), objectives and priorities in your plan;
  2. A process for collecting, maintain and assessing data to evaluate these local performance measures, and;
  3. A process for collecting, maintain and assessing data to evaluate statewide performance measures.

FORM J:QUALITY ASSURANCE

Maximum: 1/2 page

Do not include the wording of each question, but do include the number of each question (such as 1.1, 1.2 and so on)

5.1Identify the individual who will manage the development of this plan and describe:

  1. How s/he will:
  2. ensure quality assurance measures;
  3. make certain all activities are completed on time and as part of an inclusive process that meaningfully engages other stakeholders; and
  4. His/her relevant experience.

5.2Describe how your agency will track activities identified in the updated coordinated plan and keep stakeholders informed of progress

FORM K:LEVERAGE OTHER RESOURCES

Maximum: 1 page

Do not include the wording of each question, but do include the number of each question (such as 1.1, 1.2 and so on)

6.1Identify funds other than regionally coordinated transportation planning funds from TxDOT that your agency will leverage to develop this 5-year public transit-human services transportation plan.

6.2Specify activities for which these other leveraged funds will be used.

1

FORM L: Workplan for FY 2016 (September 2015 – August 2016)

No page limit

Expand andrepeat rows and pages as needed

7.1 Complete a thorough and appropriate workplan using the template below to spell out: a) a goal, b) objectives for achieving this goal, c) activities to accomplish each objective, d) a lead and team responsible for each set of activities, e) a completion date for each activity, f)deliverables to complete, and g)a projected cost for developing each deliverable. This workplan shall correspond with the proposed activities described in Forms G -K.

Goal:(Sample: To prepare an updated, 5-year public transit-human services transportation plan for the period January 2017 through December 2021to ensure a network of transportation services to effectively and efficiently get people to where they need to go)
Objective / Activity / Lead & Team / Completion Date / Deliverable / Projected Cost to develop deliverable(s) under each objective
Objective 1: / Activity 1.1:
Activity 1.2:
Activity 1.3:
Activity 1.4:
Continue as needed / Identify lead & team per activity / Indicate completion date per activity / Deliverable 1: A report on the inventory of transportation resources.This report shall include (a) a description of the methodology used to conduct this inventory, (b) observations/findings/conclusions, (c) recommendations concerning the public transit – human services transportation plan, (d) appendices including data collection forms, assessment documents as applicable, minutes, sign-in sheets and documentation that stakeholders including individuals with disabilities, individuals 65 and older and persons with low incomes participated in the development and approval of this inventory and report.
Deliverable 2: A report on the comprehensive needs assessment and gap analysis. This report shall include (a) a description of the methodology used to conduct this needs assessment and gap analysis concerning the public’s transportation needs, (b) observations/findings/conclusions concerning unmet needs and inefficiencies such as overlaps and gaps in services, (c) a discussion of recommendations and implications concerning the public transit – human services transportation plan, (d) appendices including data collection forms, assessment documents, minutes, sign-in sheets and documentation that stakeholders including individuals with disabilities, individuals 65 and older and persons with low incomes participated in the development and approval of this comprehensive needs assessment, gap analysis and report.
Deliverable 3: A final updated, five-year public transit human-services transportation plan that includes all required elements. This deliverable also will include support documentation including minutes, sign-in sheets and other documentationthat stakeholders including individuals with disabilities, individuals 65 and older and persons with low incomes participated in the development and approval of this five-year plan and include the elements in the table of contents included in the Information and Instructions section of this funding application packet. / Deliverable 1
Projected Cost: $______
Indicate a projected cost for developing Deliverable 1. Provide calculations for how each cost figure was derived (either in this space or in an attached document that clearly identifies these calculations as corresponding to Deliverable 1).
Deliverable 2
Projected Cost: $______
Indicate a projected cost for developing Deliverable 2. Provide calculations for how each cost figure was derived (either in this space or in an attached document that clearly identifies these calculations as corresponding to Deliverable 2)
Deliverable 3
Projected Cost: $______
Indicate a projected cost for developing Deliverable 3. Provide calculations for how each cost figure was derived (either in this space or in an attached document that clearly identifies these calculations as corresponding to Deliverable 3)
FORM M: Workplan for FY 2017 (September 2016 – December 2016)

No page limit