REQUIRED FORMS CHECKLIST所需表格清单.docVIP

REQUIRED FORMS CHECKLIST “FOR DEVELOPMENT PROJECTS” To be eligible for funding consideration, each application must include all numbered items below and any supporting documents that are pertinent to the project. A detailed explanation of eligibility is provided for each item. All documents requiring the applicant’s signature must be signed by the agent authorized in the resolution to execute and submit documents on behalf of the applying entity. The authorized agent must submit a written list of any other persons who will be signing and submitting documents during the period of the project. DO NOT STAPLE OR BIND THE APPLICATION OR COPIES. CLIPPING IS SUFFICIENT. A. October FY 2013 Statewide OHV Program Certified Grant Application Form B. Applicant Resolution/Authority to Apply (versions for all applicants) C. Control Tenure Documents D. Americans with Disabilities Act (ADA) certification E. SHPO REVIEW FORM / SHPO Historic Property Inventory Form / SECTION 106 Documentation / NEPA (Environmental Determination Form) A “complete” application must include ONE (1) SET OF ORIGINALS of each item listed in A through E and SEVEN (7) SETS of items I through L and supporting documentation. ASP must receive complete applications by 5:00 p.m. on October 16, 2013 to be eligible for grant funding consideration. I. Project Scoring Criteria J. Estimated Project Cost Sheet / Scope Item Breakdown Sheets K. Four 4” x 6” Color Photographs (LANDSCAPE LAYOUT ONLY) L. Maps Plans  OCTOBER FY 2013 STATEWIDE OHV PROGRAM CERTIFIED GRANT APPLICATION FORM Project Sponsor Information 1. Project Sponsor Name 4. Third Party 2. Project Sponsor Address 5. Third Party Address 3. Project Contact: Name Title Telephone Fax E-mail 6. Third Party Contact: Name Title Telephone Fax E-mail Project Information 7. Project Title 8. Congressional District # 9. AZ Legislative District # 10. County 11. Brief Description of Project 12. Project Funding Amount Grant Request (_____%) Match Amo