Mitigation Statement Of Interest For Projects : GovTrain Solutions, LLC

Statement of Interest (SOI)

Pre Disaster Mitigation Grant (PDM) FY 2020 and Flood Mitigation Assistance Grant (FMA) FY 2020

Please complete the form below detailing your intent to apply for Pre-Disaster Mitigation (PDM), and/or Flood Mitigation Assistance (FMA) funding, and a member of our grant staff will respond as soon as possible.

*Asterisk denotes a required field

Community/Organization Name*

(Eligible entities include: State Agencies, Federally Recognized Tribal organizations, Municipal/Local Governments, and certain Private Non-profits)

Title of Hazard Mitigation Activity*

(Your project name, i.e. Mountain Street Culvert Upgrade)

What are the Present and Future Hazard Conditions?*

(Describe the source of the hazards and risk to life, safety and improved property that you are trying to solve)

Brief Description of Scope of Work*

(What would you like this grant funding to accomplish? Please be sure to address the level of protection, any identified co-benefits, whether or not nature based solutions will be utilized, etc. Please also identify the anticipated permits that will be required.)

Project Type *

(Please select one.)

What is the current status of your local hazard mitigation plan? *

(please select one)

Is your proposed project identified in your local hazard mitigation plan?*

Yes No I don't know

Construction Projects
For non-construction projects such as local hazard mitigation plans, please skip to the Applicant Information Section

Approximate Project Address (If there is more than one address, please select one location for this SOI)*

Address Line 1

Address Line 2

City

State

ZIP Code

Have you experienced past (historic) damages at this site or is your project based on mitigating future (expected) damages?*

Past Damages Future Damages

Has a budget been formulated for the project?*

Yes No

If yes, what is the total cost estimate for the project?*

Please provide anticipated source of local (Non-Federal) cost share/match (25% minimum)*

Has the project received approval and support from the chief administrative official?*

Yes No I don't know

Has a schedule been formulated for the project?*

Yes No

If yes, please attach a draft schedule. No File Chosen

File uploads may not work on some mobile devices.

Please describe the likely detrimental impact, loss of essential services, damage to critical facilities, infrastructure and/or economic hardship if the project was not implemented.*

Describe/define your anticipated benefits (avoided losses) if the project is implemented.*

Has a Benefit Cost Analysis (BCA) been completed for the project?*

Yes No

(FEMA requires a DETAILED analysis using free software.)

Would you like staff assistance to help develop your BCA?*

Yes No

Have you reviewed the FEMA national priorities listed in the FEMA Notice of Funding Opportunity?*

Yes No

Applicant Information
This section is for general contact information.

Applicant Information (SOI Preparer)*

First Name

Last Name

Title

Email (SOI Preparer)*

Phone (SOI Preparer)*

Authorized Applicant Agent (Chief Elected or Appointed Official – This is the individual who will be required to sign formal grant application.)*

First Name

Last Name

Title

Email (Authorized Applicant)*

Address (Authorized Applicant)

Address Line 1

Address Line 2

City

State

ZIP Code

Phone (Authorized Applicant)*

Is there any other information you wish to include?*

Yes No

Additional Information

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Statement of Interest (SOI)

Pre Disaster Mitigation Grant (PDM) FY 2020 and Flood Mitigation Assistance Grant (FMA) FY 2020

Construction Projects For non-construction projects such as local hazard mitigation plans, please skip to the Applicant Information Section

Applicant Information This section is for general contact information.

Construction Projects
For non-construction projects such as local hazard mitigation plans, please skip to the Applicant Information Section

Applicant Information
This section is for general contact information.