Project No.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_![](media/image1.png){width="1.3055555555555556in"
height="0.7881944444444444in"}

# Project Amendment No. \_\_\_\_\_\_\_

**DUNS \# \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

## GRANT AMENDMENT FOR FISCAL YEAR 20\_\_

Between the Federal Motor Carrier Safety Administration and the *(State
Agency)*
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

This amendment shall be attached to and become a part of the referenced
grant agreement. This agreement is hereby revised for the purposes
described herein:

\[ \] increases

This amendment \[ \] decreases Federal Funding.

\[ \] does not change

The prior total cost of this MOTOR CARRIER SAFETY ASSISTANCE PROGRAM was
projected to be

\$\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_with a Federal share
not to exceed
\$\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

The revised total program cost is now projected to be:
\$\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

\[ \] increased

This Federal share is \[ \] decreased in amount of
\$[\_]{.underline}\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_[\_]{.underline}

\[ \] unchanged

providing for a revised total Federal share not to exceed
\$\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_[.]{.underline}

This amendment is for the purpose(s) of
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

All other terms and conditions of this grant remain unchanged.

This amendment is effective and expires on
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

  -------------------------- ----------------------------------------------------
                             

                             (Authorized Representative)

                             **Title:** **Date:\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

                             

                             **Federal Motor Carrier Safety Administration**

                             

                             (Authorized Representative)

                             **Title:**
                             [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}
                             **Date:**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
  -------------------------- ----------------------------------------------------

The collection of this information is authorized under the provisions of
P.L. 97-424; P.L. 99-570; 49 U.S.C. 31101-31104 and P.L. 105-178.

Public reporting for this collection of information is estimated to be
30 minutes per response, including the time for reviewing instructions
and completing and reviewing the collection of information. All
responses to this collection of information are mandatory, and will be
provided confidentiality to the extent allowed by law. Not withstanding
any other provision of law, no person is required to respond to nor
shall a person be subject to a penalty for failure to comply with a
collection of information subject to the requirements of the Paperwork
Reduction Act unless that collection of information displays a current
valid OMB Control Number. The valid OMB Control Number for this
information collection is 2126-0010. Send comments regarding this burden
estimate or any other aspect of this collection of information,
including suggestions for reducing this burden to: Information
Collection Clearance Officer, Federal Motor Carrier Safety
Administration, MC-MBI, U.S. Department of Transportation, Washington,
D.C. 20590.

FMCSA Form MCSAP-2A (Rev. 02/08) OMB 2126-0010 (Exp. 02/11)