Cycle 4 Lifeline Transportation Program (LTP) Application
Ü Please follow instruction in the call for projects memo, and
submit by 5 p.m., December 18, 2014 Ü
A. PROJECT SUMMARY
Project name:
Sponsor agency:
Brief Description of Project (about 50 words)
B. PROJECT ELIGIBILITY (Check all that apply, and fill in the blanks as applicable.)
See the Transportation Authority’s LTP page (www.sfcta.org/lifeline) for links to resources that correspond to the criteria below.
Eligible SponsorshipSponsor is an eligible direct recipient. / STA ☐ / Sec. 5307 (JARC)☐
Sponsor is an eligible sub-recipient and has partnered with an eligible direct recipient. / STA ☐ / Sec. 5307 (JARC)☐
Project Type
Capital / ☐
Operating / ☐ New ☐ Continuing
[For Sec. 5307 (JARC) applicants for operating projects]
This project is a “development” project that was not in service as of October 1, 2012, including projects that expand the service area or hours of operation for an existing service. ☐
This project is a “maintenance” project that received funding under the former Section 5316 JARC program. ☐
LTP Focus Areas / Area(s) name(s)
Community of Concern (CoC) / ☐
Low-income communities / ☐
Planning and Community Support
The project has clear and diverse community support as evidenced in:
(For all plans, specify the title and page number.)
Community-Based Transportation Plan (CBTP) / ☐
Other substantive local planning effort involving focused outreach to low-income populations / ☐
Regional welfare-to-work transportation plan / ☐
Coordinated Public Transit-Human Services Transportation Plan / ☐
Other documented assessment of need within CoCs / ☐
Letters of support (check if attached) / ☐
Public Use
The project is open to the general public or open to a segment of the general public defined by age, disability, or low income. ☐
Employment-related Use - Sec. 5307 (JARC) Eligibility
The project is designed to transport welfare recipients and eligible low income individuals to and from jobs and activities related to their employment. ☐
Local Match
LTP funding requested and percentage of budget STA Sec. 5307 (JARC) / $ | %
$ | %
Local match proposed and percentage of budget (funding source) / $ | %
Project Delivery
Sponsor will expend STA funds within 3 years of MTC’s programming date (scheduled April 2015) / ☐
Sponsor will expend Section 5307 (JARC) funds within 3 years of the FTA grant award / ☐
Civil Rights
Describe the applicant’s policy regarding Civil Rights (based on Title VI of the Civil Rights Act) and for ensuring that benefits of the project are distributed equitably among low-income and minority population groups in the project’s service area.
C. DEMOGRAPHIC INFORMATION
The following question is for administrative purposes only and is not a factor in determining which projects are selected to receive an award. Please refer to the US Census Bureau website: http://factfinder2.census.gov.
Does the proportion of minority people in the project’s service area exceed 58 percent (i.e., the regional average minority population)? [ ] Yes [ ] No
D. IMPLEMENTATION STRATEGY
Please demonstrate an ability to deliver the project on schedule, and describe any major issues that may delay the project, if any, and a strategy and timeline for resolving the issues.
1. For operating projects: Please provide below an operational plan for delivering service, including a project schedule. For fixed route services, attach route maps (see Section F: Attachments). Describe efforts to identify potential funding sources for sustaining the project beyond the grant period if needed.
2. For capital projects:
a. Please provide below an implementation plan, including start and end dates for all applicable phases: planning/conceptual engineering, environmental studies, design, right of way, construction (advertise and award), and/or procurement.
b. In the table below, please identify the responsible agency and funding plan for ongoing maintenance of the project, including but not limited to lighting and landscaping, and provide the following information for all involved agencies.
Phase / Agency / Brief Scope / Responsibility / Phase Lead? / Contractor Use?☐ / ☐
☐ / ☐
E. PERFORMANCE MEASURES
1. Please demonstrate below that the project is the most effective way to address the identified transportation need, and identify performance measures to track the project’s effectiveness.
Wherever applicable, at a minimum, performance measures should include documentation of units of service or facility provided with the funding (e.g. number of trips, service hours, workshops held, persons trained, car loans provided, bus shelters installed, etc.), cost per unit of service (e.g. cost per trip), and a quantitative summary of service delivery procedures employed for the project, as well as the number of low-income persons that will be served by this project per day, quarter, and/or year.
- Describe below a plan for ongoing monitoring and evaluation of the service or project, and steps to be taken if original goals are not achieved.
F. ATTACHMENTS
Please include the following required attachments, and other attachments as applicable.
1. Scope narrative that includes all of the following elements:a. project goals and benefits, specifically to meet the unmet transportation need, as identified in the relevant planning efforts
b. specific communities this project will serve, including pertinent demographic data
c. outreach to community members and coordination with other transportation or social service agencies – to-date and plans for future efforts; and
d. any innovative approaches. / ☐
2. Cost and funding detail (in the Excel template) / ☐
3. Maps (route maps required for fixed route projects), charts, drawings or other materials that are necessary to show the detail and context of the project / ☐
4. Letters of support from partner agencies and the public, as applicable / ☐
5. [For sponsors with previous LTP projects] List of previous LTP projects and status update, including project name, percent complete, and most recent service utilization rate. For projects not yet complete, provide the actual/anticipated allocation date for each LTP funding source, and the actual/anticipated completion date for each phase. For projects that are behind the originally proposed schedule, please provide an explanation as to the cause of delay, and what is being done to ensure that funds are not lost to the project and that the project is delivered in a timely fashion. Sponsor may refer to the Transportation Authority’s Portal if all of the required information is up-to-date. / ☐
G. CONTACT AND SIGNATURE
By signing the application, the signator affirms that: 1) the statements contained in the application are true and complete to the best of their knowledge; and 2) the applicant is prepared to comply with any and all laws, statutes, ordinances, rules, regulations or requirements of the federal, state, or local government, and any agency thereof, which are related to or in any manner affect the performance of the proposed project, including, but not limited to, Transportation Development Act (TDA) statutes and regulations, 49 U.S.C. Section 5307, FTA Circular C 9030.1E, the most current FTA Master Agreement, and the most current Certifications and Assurances for FTA Assistance Programs.
Sponsor Agency – Project Manager
Agency
DUNS number[1]
Name, title
Telephone Fax
Signature Date
Sponsor Agency – Grant Manager
Name, title
Telephone Fax
Signature Date
Other Partner Agencies
Agency Leads (name, title) Telephone Email
P:\Lifeline Program\2014 Lifeline Program\Call for Projects\LTP Cycle 4 Call - Att 4a-Application.docx Page 5 of 5
[1] Provide your organization’s nine-digit Dun & Bradstreet (D&B) Data Universal Numbering System (DUNS) number. To search for your agency’s DUNS number or to request a DUNS number via the internet, visit the D&B website: http://fedgov.dnb.com/webform. To request a DUNS number by phone, contact the D&B Government Customer Response Center at 1-866-705-5711. See Attachment 2 for more detail on this and other federal requirements.