Applicant Information Organization Provide the name of the applicant organization which will manage the project under contract with the TCEQ, if selected. Project Leader Enter the name of the primary contact person for the applicant organization. Title Enter the Project Leader’s title or position at the applicant organization. Federal ID No. Enter the organization’s federal ID number. E-mail Address Enter the e-mail address of the Project Leader. Mailing Address Enter the mailing address of the Project Leader. City Enter the city of the Project Leader’s mailing address. County Enter the county in which the Project Leader’s organization is located. State Enter the state of the Project Leader’s mailing address. Zip Code Enter the zip code of the Project Leader’s mailing address. Telephone No. Enter the telephone number of the Project Leader. Fax No. Enter the fax number of the Project Leader. Applicant Qualifications: Provide a brief description of the Applicant’s experience related to the activities in the proposed project, including planning, other state or federally funded work, and expertise in specific activities (technical, outreach, budgetary, and other). Please cite reports and other work products produced by the Applicant/Team. It is recommended that the Proposal Ranking Priorities Criteria D [identified in the FY 2014 Request for Grant Applications (RFGA)] be addressed here.
Fringe Benefits $ 0 Identify an overall rate that will not be exceeded for the contract. Travel $ 0 Identify the number of trips, reasons for and destination of trips, the number of travelers, and the estimate cost per trip. All travel costs must not exceed the . Supplies $ 0 Include only supplies which are needed to complete the proposed project. Equipment $ 0 Identify individual items with a unit acquisition cost of $5,000 or greater, along with the estimated cost of the item. Contractual $ 0 List each individual subcontract, cost of the contract, and itemize activities to be conducted under the contract. Construction $ 0 The construction category should only be used if construction activities are conducted in-house by the project lead organization. List major componens of the construction activities and the associate costs. Other $ 0 Costs may include such items as postage, printing, or stipends. Indirect $ 0 Costs calculated on the match portion must not exceed the cognizant/state single audit coordinating agency approved standard rate of the organization. State the rate and the base costs associated with the rate. Additionally, the organization may claim additional match through indirect costs waived for federal (TCEQ) reimbursement. This is done by calculating the difference between the standard indirect rate of the organization and the reduced rate of 15% for federal (TCEQ) costs. Under the Justification column, itemize the indirect costs for the match and the unrecovered indirect costs for the federal (TCEQ) portion separately. In-kind $ 0 In-kind contributions are services rendered at no charge by a third party (a party other than the applicant). Estimate a reasonable value for each in-kind service provided; the basis for estimating these values must be identified. In-kind services must be provided at the fair market value. In-kind costs are not reimbursable. Total $ 0 Identify the source of match to be utilized. The match source must be state or local funds that are not being counted towards other federal or state cost sharing requirements. Identify if program income costs are being utilized. Budget by Task Provide the estimated costs for each Task. Add and delete rows as necessary. Task # Title TCEQ Reimbursable Portion (Federal) Grantee Match Portion Total 1 Project Administration $ 0 $ 0 $ 0 2 Quality Assurance $ 0 $ 0 $ 0