NYSDOT - 2009 Job Access and Reverse Commute & New Freedom Formula Application
STATE OF NEW YORK
Federal Transit Administration Formula Programs:
SECTION 5316 - JOB ACCESS and REVERSE COMMUTE (JARC)
SECTION 5317 - PROGRAM NEW FREEDOM (NF)
APPLICATION
Non-Urbanized Areas
Application Submission Deadline:
May 15, 2009 by 4pm
NEW YORK STATE DEPARTMENT OF TRANSPORTATION
Policy and Planning Division
Office of Integrated Modal Services
Public Transportation Bureau
- 11 -
NYSDOT - 2009 Job Access and Reverse Commute & New Freedom Application
TABLE OF CONTENTS
Application Checklist / Required Documents 3
Application Title Page 4
Project Information 5
Project Narrative 6
A. Project Need/Goals and Objectives 6
B. Implementation Plan 7
C. Project Budget 8
Form 1a – Operating Project Budget Summary 9
Form 1b – Capital 10
Form 1c - Mobility Management Summary 10
Form 3 – Detailed Expense Sheet 11
D. Coordination and Program Outreach 12
E. Program Effectiveness and Performance Indicators 13
Certification of Authorized Signature for JARC or NF Application 14
- 11 -
NYSDOT - 2009 Job Access and Reverse Commute & New Freedom Application
Application Checklist / Required Documents
Description List / Checkmark / Original / Copies / InstructionsOrganization Cover Sheet / 1 / 6 / Provide a cover letter on the official letter head of the agency applying for funding with signature of Executive/(CEO)
Completed Application Form / 1 / 6 / Complete all application criteria for each category.
Application - Certification Authorized Signature Page / 1 / 6 / The authorized signatory of the Executive/(CEO) to sign the agreement, with all FTA, NYSDOT regulations/laws
NYSDOT Supplied Detailed Project Budget / 1 / 6 / Provide a complete detailed budget, with a description of project costs for each line item, using budget forms provided.
Letters of Support from Agencies / 1 / 6 / Provide letters of support from agencies/stakeholders.
Map of Service Area:
[U.S. Census of County Area], showing low income, disabled, seniors / 1 / 6 / Provide Location Maps (preferably 8.5x11 inches). For route service, provide map of outlined bus route.
Adopted Coordinated Plan w/cited page / --- / 1 / Provide one (1) copy of the plan with the adopted resolution.
APPLICATION SUBMISSION DEADLINE:
May 15, 2009 by 4pm
Mail to:
Thomas M. Vaughan, Special Assistant
Public Transportation Bureau
New York Department of Transportation
50 Wolf Road – POD 5-4
Albany, NY 12232
- 11 -
NYSDOT - 2009 Job Access and Reverse Commute & New Freedom Application
Complete all information. If a section does not apply, enter N/A; do not leave segments blank.
APPLICATION TITLE PAGEAgency Name: (Full Legal Name)
Agency Type: (Please Check)
□ State or Local Government
□ Public Transportation Provider
□ Private non-profit (Please provide Department of Law Charities Registration Number)
Number: ______
□ Private Transportation Provider of Public Transportation Services
□ Federally Recognized Tribal Nations
Address:
City, State, Zip Code:
Authorized Signatory Name:
Email: Phone: Fax:
Manager of Project (If Different From Above):
Email: Phone: Fax:
Check All That Apply:
□ Current Section 5310 – Elderly Individuals & Individuals with Disabilities Program recipient
□ Current Section 5311 – Non-urbanized Area Formula Program recipient
□ Not Applicable
Formula Program (Check Only One):
□ Job Access and Reverse Commute (JARC) Project – Section 5316
□ New Freedom (NF) Project – Section 5317
Congressional District of Project Location:
List any known transit unions in the project area (JARC only projects): (Attach additional sheets if necessary)
- 11 -
NYSDOT - 2009 Job Access and Reverse Commute & New Freedom Application
PROJECT INFORMATIONProject Title:
Brief Summary of Project:
Project Beginning Date: Project Ending Date:
Project Cost Summary
Operating
(Fed 50%/Loc 50%) / Capital
(Fed 80%/Loc 20%) / Mobility Management
(Fed 80%/Loc 20%)
Select one program:
□ JARC □ New Freedom
Select one project type:
□ New Project
□ Continuation of existing project
□ Expansion of existing project / Federal Share / $ / $ / $
Local Share / $ / $ / $
Total / $ / $ / $
Continuation or Expansion of Project
Q1. Explain how the continuation or expansion of an existing project will benefit the target population of the JARC or NF program.
Q2. Briefly describe and give evidence of other demonstrated successes resulting from your prior year’s JARC/New Freedom project.
- 11 -
NYSDOT - 2009 Job Access and Reverse Commute & New Freedom Application
PROJECT NARRATIVE
Each of the following must be answered to ensure a qualifying project. Please do not delete any questions.
A. Project Need/Goals and Objectives (25 Points)
- Describe the target community this project will serve.
- Provide relevant demographic data and maps:
Population of non-urbanized project area served (<50,000):
Cite population data source:
JARC - number of low-income persons: and % of population
NF - number of disabled persons: and % of population
NF - number of frail senior persons: and % of population
County(ies) of area served:
Please provide a project area map with identifying pertinent data listed below:□ JARC – Employment sites, child-care facilities, affordable housing and low income areas.
□ New Freedom – Location of individuals with disabilities, senior housing, and day treatment centers, employment sites, independent living centers.
□ Operating Route – supply route map highlighted with an outline of the specific route.
3. What are the project’s goals and objectives?
4. Describe the unmet transportation need that the proposed project seeks to address in the coordinated plan and the relevant project planning effort that documents the need.
5. Estimate the number of people to be served, and/or the number of service units that will be provided.
6. Describe how project activities will mitigate the transportation need.
- Cite the eligible activity the project is applying for using the FTA eligible activities for JARC page 13 or New Freedom page 15.
- 11 -
NYSDOT - 2009 Job Access and Reverse Commute & New Freedom Application
B. Implementation Plan (25 Points)
1. List all key personnel assigned to this project.
List of Key Personnel
Title/Name / Position / Qualifications / Relevant ExperienceProject Manager /
Ms. or Mr. Mobility Manager / Mobility Manager / County Planner Mytown for 10 yrs. Prior experience of 5 yrs with Public Transit
2. Describe the agency’s ability to manage the project.
3. Describe the implementation plan for this project.
4. If requesting operating funds, please answer the following:
a. Hours of operation:
b. Late night/weekend operation:
5. If requesting mobility management funds, please answer the following:
a. Provide a job description, advertisements for position, salary if intending to hire a Mobility Manager.
b. Describe how the project will be marketed to serve the targeted population.
c. Who is the lead agency for the Mobility Management?
6. For capital projects, provide procurement method used by agency, and itemize products/services, product costs requested in a table attachment if necessary.
7. Key milestones and estimated completion date to be used in evaluating the project following the life of the project award.
Provide Milestone (s) / Estimated: Start Date - Completion Date8. Describe any proposed use of innovative approaches that will be employed for this project.
C. Project Budget (20 Points)
The project budget must list all expenditures and revenues. The following pages provide the required forms for a summary, and a detail budget to be used for this application submittal.
1. Provide a brief budget overview.
2. Estimate the proposed cost per trip (or other unit of service) and the methodology, display formulas used.
3. Describe efforts to ensure the project’s cost-effectiveness.
- 11 -
NYSDOT - 2009 Job Access and Reverse Commute & New Freedom Application
FORM 1a – OPERATING PROJECT BUDGET SUMMARY
(1) Total Operating Expenses (Itemize on Form 2)(1) Total / $
(2) Less fare box and other revenue
$
$
$
Subtotal / $ / (2) Total / $
(3) Net Project Costs (Line 1- Line 2 = Line 3) / (3) Total / $
(4) Fill out Line 4 if recipient of Section 5311 Funds
List 5311 funds received / $
List match funds for 5311 / $
Subtotal / $ / (4) Total / $
(5) Net Project Costs Less 5311 (Line 3 – Line 4 = Line 5)
If recipient does not receive 5311, Line 3 = Line 5 / (5) Total / $
(6) List non Federal share amount, including local, state, and other non-USDOT funds
$
$
$
$
$
Subtotal / $ / (6) Total / $
(7) Federal share (Line 5 – Line 6 = Line 7)
Eligible JARC and New Freedom award* / (7) Total / $
* Maximum JARC = $150,000, New Freedom = $100,000
Form 1b – Capital Project Budget Summary
(1) Total Capital Expenses, Itemize on Form 2 (Fed 80% / Local 20%)(1) Total / $
(2) List non Federal share amount, including local, state, and other non-USDOT funds
$
$
$
$
$
Subtotal / $ / (2) Total / $
(3) Federal share (Eligible JARC or New Freedom award)
(Line 1 – Line 2 = Line 3) / (3) Total / $
(1) Total Mobility Management Expenses, Itemize on Form 2 (Fed 80% / Local 20%)
(1) Total / $
(2) List non Federal share amount, including local, state, and other non-USDOT funds
$
$
$
$
$
Subtotal / $ / (2) Total / $
(3) Federal share (Eligible JARC or New Freedom award)
(Line 1 – Line 2 = Line 3) / (3) Total / $
Form 1c – Mobility Management Project Budget Summary
FORM 2 – DETAILED EXPENSE SHEET
Budget Item: All budget items with an *asterisk requires milestone information / Item Description/Purpose / Year 1Actual / Year 2
Estimated / Total Project Funding
Personnel (Salary):
Project Administration
Driver Salary
Fringe Benefit
*Consultant Services
*Lease/Rental Costs
*3rd Party Contract (Name of vendor)
Staff Travel
Staff Training
Insurance
Facility rental:
*Equipment
*Project Supplies & Material
*Computer Hardware
*Computer Software
Other Costs
Project Total
- 11 -
NYSDOT - 2009 Job Access and Reverse Commute & New Freedom Application
D. Coordination and Program Outreach (20 Points)
1. Describe how the project will be coordinated with public and/or private transportation and human service agencies serving low-income populations (JARC) or individuals with disabilities (NF).
2. Describe how project sponsor will continue to involve key stakeholders throughout the project life.
3. Describe efforts to market the project, and ways to promote public awareness of the program.
4. Letters of support from key stakeholders should be attached to the application.
§ Include a complete list of all project coordinating agencies and stakeholders, and their
role (s) in the project.
§ Complete TABLE 4 below:
TABLE 4 – COORDINATED PLAN REQUIRMENTSBrief Project Description / Identified Gaps / Identified Strategies / Cite page no. / Date/Lead Agency of Adoption of plan
- 11 -
NYSDOT - 2009 Job Access and Reverse Commute & New Freedom Application
E. Program Effectiveness and Performance Indicators (10 Points)
1. Demonstrate that the proposed project is the most appropriate match of service delivery to the need.
2. Identify performance measures to track the effectiveness of the service in meeting the identified goals.
3. Describe a plan for monitoring and evaluation of the service, and steps to be taken if original goals are not achieved.
4. What efforts are in place to continue this project beyond the project period if funding from JARC or NF was not available?
NYSDOT - 2009 Job Access and Reverse Commute & New Freedom Application
CERTIFICATION OF AUTHORIZED SIGNATURE FOR JARC or NF APPLICATION
The New York State Department of Transportation (NYSDOT), Section 5316 - Job Access and Reverse Commute, and Section 5317 - New Freedom formula application, as authorized below with signature, is material representation of fact upon which NYSDOT relied in awarding this formula and are incorporated by reference into the agreement.
The information in this application is public record. Therefore, applicants should not include information regarded as confidential.
By signing below the applicant affirms that he/she has read, understands and agrees to all of the FTA regulations and policies applicable to the project, regarding this application. To the best of his/her knowledge and belief, all information and data supplied in this application is true and correct.
The applicant agrees to all requirements set forth in the documents listed below:
· FTA FFY 2009 Master Agreement (Annual Document)
· FTA FFY 2009 Certifications and Assurances (Annual Document)
· FTA C 4220.1F Third Party Contracting Guidance
· FTA C 9050.1 Job Access and Reverse Commute
· FTA C 9045.1 New Freedom
· FTA C 5010.1D Grant Management Requirements
· USDOT Uniform Administrative Requirements for Formulas and Cooperative Agreements to State and Local Governments (49 CFR part 18) - OR -
· USDOT Uniform Administrative Requirements for Formulas and Cooperative Agreements with Institutions of Higher Education, Hospitals, and other Non-Profit Organizations,
(49 CFR part 19)
______
*Signature of the Authorized Applicant/Representative Date
______
Name (printed) of Authorized Applicant/Representative
______
Title of Authorized Applicant/Representative
______
Name of Organization
*Please use blue ink pen for signature.