Fiscal Year 2025 Community Project Funding Request Form

Step 1 of 4

Failure to submit required information will result in an incomplete project request. Incomplete project requests will not be submitted to the Appropriations Committee for consideration for Community Project Funding (CPF).

Requestor Information

Name of Requesting Organization:

Legal name of the recipient organization that will receive the funding. Do not include abbreviations, acronyms, or use a “The” before the recipient’s name.

Type of Organization:

Upload Proof

Max. file size: 256 MB.

If funds are requested for a non-governmental entity, provide proof the recipient is a non-profit organization as described under section 501(c)(3) of the Internal Revenue Code of 1986. For-profit entities are not eligible.

Mailing Address

Street Address Address Line 2 City State ZIP Code

Website of Organization

Postal address of requesting organization (b) website address

Point of Contact for this Request (Name, Title, Phone Number, Email):

First Last Title

Phone

Evidence of community support for the project request.

Max. file size: 256 MB.

This may include links or digitalcopies of the following: a.(1) letters of support from elected community leaders, b.(2) press articles highlighting the need for the requested community projectfunding, c.(3) support from newspaper editorial boards, d.(4) projects listed in state intended use plans, community development plans, orother publicly available planning documents, e.(5) resolutions passed by city councils or boards, or f.(6) other compelling evidence of community support.

What are the benefits of this project and why is it a priority? a.NOTE: Benefits could include safety, environmental, economic, equity, mobility,etc. This description will not appear in the House report. b.EXAMPLE: These improvements will improve the health and safety of more than350 seniors that rely on services provided through the center for supplementalmeals and health services, as well as to meet requirements under the Americanswith Disabilities Act (ADA). As a result of a closure of a nearby communityservices facility within the County, improvements are necessary to address arecent increase in demand for elderly services and the need to expand the servicesavailable at this elderly services facility, which is in close proximity to theCounty’s largest elderly housing development.

Can the project obligate all appropriated funds within 12 months after enactment? If not, what would be the expected date of obligation? a. NOTE: Obligation occurs when a project sponsor signs a grant agreement with a federal agency.

Estimated start date

Estimated completion date

Does the project have other public (federal, state, local) and/or private funds committed to meet match or cost-share requirements for costs related to construction, operations, and maintenance? If so, what is the source and amount of those funds? b. Certain accounts have a non-federal match requirement.

If the project receives less than requested, can the project proceed without waiting for additional federal funding sources?