Fillable Commonwealth of Massachusetts FY2020 Industrial Rail Access Program (IRAP) Application Form

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Commonwealth of Massachusetts FY2020 Industrial Rail Access Program (IRAP) Application Form

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The Commonwealth of Massachusetts FY2020 Industrial Rail Access Program (IRAP) Application Form form is 4 pages long and contains:

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  • 6 check-boxes
  • 119 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Commonwealth of Massachusetts

BROWSE COMMONWEALTH OF MASSACHUSETTS (MA) FORMS

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13
ATTACHMENT A.
FY2020 IRAP APPLICATION COVER SHEET
(Please type in text boxes provided below)
1. Name of Applicant:
2. Address of Applicant:
3. Nature of Applicants Business:
4. Contact Person:
5. Title:
Email: Phone:
6. Descriptive Name of Project:
7. Total project cost: Proposed Start Date:
Completion Date:
8. Funding Sources:
Amount: Percent of Project Cost:
IRAP Request:
Source of Private Sector Project Funding:
1.
2.
3.
9. Project location (limits):
10. Length:
( )
$
$ %
%
%
%
$
$
$
14
11. Railroad Milepost From: To:
12. Is Project fully designed by a qualified design firm? Yes: No:
13. Has Project received necessary environmental approvals? Yes: No:
14. Are there any right-of-way considerations that will need to be
addressed/resolved for this project to be constructed? Yes: No:
15. In the space provided below provide a brief project description (limit of 250
words) of the work that will be constructed under the proposed IRAP project.
The applicant certifies that the information provided in this application is true and
correct, and that the private sector matching funding commitments shown above are in
place and are not contingent upon any other project funding award that may be
anticipated or pending.
Signature: Title:
Name: Date:
(Please Type)
15
ATTACHMENT B.
Proposed Project Schedule and Estimated Timelines
IRAP Projects must be completed within 12 months from the MassDOT Notice to Proceed Date
Pre-Construction, Procurement and
Construction Activity Timelines
Start Date Responsible
Person/Entity
Estimated
Completion
Date
Instructions: complete the project schedule table to reflect the status of your project and
the remaining implementation tasks and work that will be completed under contract with
MassDOT. Insert additional rows as needed.
If the applicant has already completed pre-construction activities that can’t be funded
under the IRAP contract – any completed readiness activities such as design, permitting
and ROW work should be included along with the completion date to show MassDOT
that project implementation work has already begun, or is already completed – this
information is important from a project readiness stand point and is also evidence of the
applicant’s capacity to undertake and manage the project. The schedule should indicate
an understanding of the sequencing of activities and who will be responsible for
completion of various tasks and construction activities.
16
ATTACHMENT C.
Budget and Budget Narrative
Identified Project Costs/Major Expense
Components
IRAP
Amount
Private Sector
Funds
Total Project
Budget
Budget Narrative Notes:
Instructions: Complete the Budget table provided above inserting additional rows as
needed. Applicants are reminded that the maximum FY2020 MassDOT IRAP grant
contribution for a proposed project cannot exceed $500,000, nor can the MassDOT IRAP
funding requested represent more than 60 percent (60%) of the total project cost.
If the project is anticipated to be completed after the end of State Fiscal Year 2020 (June,
30, 2020) provide an estimated breakdown of costs planned in State Fiscal Year 2020
and those in future State Fiscal Years.
Use the space below the table to include a brief budget narrative to identify how
budgeted costs were determined (working estimates, preliminary quotes received or
based on prior experience) and indicate underlying budget assumptions and the basis for
identified costs (unit price X quantity for example) wherever possible.
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Commonwealth of Massachusetts FY2020 Industrial Rail Access Program (IRAP) Application Form

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Completed 12 May 2020

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