Fillable DUE DATE: March 13, 2020 Federal F iscal (Arizona)

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DUE DATE: March 13, 2020 Federal F iscal (Arizona)

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Federal F
iscal Year: 2021
DUE DATE: March 13, 2020
Agency:
Agency Name:
Address:
City, State, Zip:
Fax:
Phone:
Title & Name:
Address:
City, State,
Zip:
Phone:
Email:
Title & Name:
Address:
City, State,
Zip:
Phone:
Email:
Please attach a cover letter addressed
to the Director of the Governor’s Office of Highway Safety
on agency letterhead. This cover letter must be signed by a representative of your agency
authorized to commit your agency to conduct the grant should it be approved for funding.
Project Director:
Project Admin:
Financial Contact:
Governmental Unit:
(City, Town, County)
Governmental Name:
Mgr/Supvr Title & Name:
Address:
City, State, Zip:
Chief/Sheriff Title & Name:
Address:
City, State, Zip:
Phone:
Email:
Grant application decisions are reviewed and decided upon by GOHS and include consideration of the
following: analysis of crash data, need for the project, past performance with highway safety grants (if
applicable), and Federal funding availability. Please contact the Arizona Governor’s Office of Highway Safety
at (602) 255-3216 if you need assistance with this application.
SECTION A: Agency Application Information
ARIZONA GOVERNOR'S OFFICE OF HIGHWAY SAFETY
Grant Application for Law Enforcement Projects
PS - Pedestrian and Bicycle Safety
1 of 13
SECTIONB‐1:AgencyOverview–LAWENFORCEMENTPROJECTS
Fillintheinformationandstatisticsinthissectionforyourjurisdiction.
ProjectTitle:
ProjectDescription:(1or2paragraphs,briefoverview)
Number of sworn officers:
TotalPopulationinyour city/townorcounty:
TotalRoadMileage: Highway Local Total
CrashData:Includealldataforyourjurisdiction, notcrashesonlyworkedbyyouragency.
2018 2017 2016
TotalCrashes
TotalInjuryCrashes
TotalFatalCrashes
TotalPedestrian‐relatedCrashes
TotalPedestrian‐related SeriousInjuries
TotalPedestrian‐relatedFatalities
TotalBicycle‐relatedCrashes
TotalBicycle‐relatedSerious Injuries
TotalBicycle‐relatedFatalities
Thedataaboverepresents: County City/Town
ARIZONA GOVERNOR'S OFFICE OF HIGHWAY SAFETY
Grant Application for Law Enforcement Projects
PS - Pedestrian and Bicycle Safety
2 of 13
0
2019 2018 2017
Total Contacts (Traffic Stops)
Total Sober Designated Drivers Contacted
Total Know Your Limit Contacts
TOTAL DUI ARRESTS
Total DUI Aggravated
Total DUI Misdemeanor
Total DUI Extreme (.15 or Above)
Under 21 DUI Citations
Average BAC
Minor Consumption / Possession Citations
Total DUI Drug Arrests
30-Day Vehicle Impounds
Seat Belt Citations
Child Restraint Citations
Criminal Speed Citations
Reckless Driving Citations
Civil Speed Citations
Other Citations (except speed)
Other Arrests
Participating Officer/Deputies (Cumulative)
SECTION B-1: Agency Overview (Continued) – LAW ENFORCEMENT PROJECTS
Enforcement Data: Fill in the information and statistics below for your jurisdiction.
ARIZONA GOVERNOR'S OFFICE OF HIGHWAY SAFETY
Grant Application for Law Enforcement Projects
PS - Pedestrian and Bicycle Safety
3 of 13
SECTION B-2: Problem Identification
Provide a narrative of the highway safety problem in your community/jurisdiction. Describe the nature
and magnitude of the problem using valid, up-to-date statistical data. Identify which program area(s)
have the greatest need, (i.e., impaired driving, occupant protection, speeding and aggressive driving,
pedestrian safety, etc.). Indicate what is happening, when it is happening, where it is happening, and
the contributing factors.
ARIZONA GOVERNOR'S OFFICE OF HIGHWAY SAFETY
Grant Application for Law Enforcement Projects
PS - Pedestrian and Bicycle Safety
4 of 13
SECTIONC:GoalsandObjectives–PedestrianSafety
BasedonyourproblemidentificationstatedinSectionB‐2,fillintheblanksforeachagencyGoaland
ContractObjectiveoutlinedbelow.
AgencyGoals:
%fromincalendaryear
Todecreasefatalitiesinpedestriantraffic‐relatedfatalities
2019tobyDecember31,2021.
%from in
Todecreasethenumberofpedestriantraffic‐relatedseriousinjuries
calendaryear2019 to 
byDecember31,2021.
ContractObjective:
AdditionalContractObjectives:
Inadditiontotherequiredgoalsandobjectives,createtwoadditionalcontractobjectivesthat
yourAgencycanachievebytheendofFFY2021.
outreach/education bicycle a
nd pedestrian safety events each
Conduct/participate in
quarter during FFY 2021.
ARIZONA GOVERNOR'S OFFICE OF HIGHWAY SAFETY
Grant Application for Law Enforcement Projects
PS - Pedestrian and Bicycle Safety
5 of 13
SECTION D: Project Strategies and Activities (Method of Procedure)
In the spaces below, list or describe specific planned activities that your agency will perform in order to
achieve their project objectives on a quarterly basis. Activities should describe what will be done, who
will do it, and when it will take place. Objectives and subsequent activities in your project
should follow the SMART method:
S = Specific
M = Measurable
A = Action-Oriented
R = Realistic
T = Time-Framed
1st Quarter: 10/01/2020 - 12/31/2020
2nd Quarter: 01/01/2021 - 03/31/2021
Estimated 1st Quarter Expenditures:
Estimated 2nd Quarter Expenditures:
ARIZONA GOVERNOR'S OFFICE OF HIGHWAY SAFETY
Grant Application for Law Enforcement Projects
PS - Pedestrian and Bicycle Safety
6 of 13
SECTION D: Project Strategies and Activities (Continued)
3rd Quarter: 04/01/2021 - 06/30/2021
4th Quarter: 07/01/2021 - 09/30/2021
Estimated 3rd Quarter Expenditures:
Estimated 4th Quarter Expenditures:
ARIZONA GOVERNOR'S OFFICE OF HIGHWAY SAFETY
Grant Application for Law Enforcement Projects
PS - Pedestrian and Bicycle Safety
7 of 13
SECTION E: Detailed Project Budget
Please fill in the budget category that relates to your agency’s project proposal. Please note that GOHS
only grants overtime projects at a maximum employee related expense (ERE) rate of 40%.
Personnel Services
Description:
Personnel Services:
Employee Related
Expenses:
Description
Requested
Amount
Overtime
Amount
ERE
Amount
ERE %
Total:
ARIZONA GOVERNOR'S OFFICE OF HIGHWAY SAFETY
Grant Application for Law Enforcement Projects
PS - Pedestrian and Bicycle Safety
8 of 13
0.00%
0.00%
0.00%
0.00%
0.00%
Description:
Professional & Outside Services:
Total:
Professional & Outside Services
Description
Requested
Amount
Total:
ARIZONA GOVERNOR'S OFFICE OF HIGHWAY SAFETY
Grant Application for Law Enforcement Projects
PS - Pedestrian and Bicycle Safety
9 of 13
Description:
Travel:
Description Transport Lodging Per Diem Misc. Amount
Total:
Travel
In-state & Out-of-State
ARIZONA GOVERNOR'S OFFICE OF HIGHWAY SAFETY
Grant Application for Law Enforcement Projects
PS - Pedestrian and Bicycle Safety
10 of 13
Description
Quantity
Price
Per Unit
Tax
Shipping
Amount
Total:
Materials & Supplies
Description:
Materials & Supplies: Designated for items with a per unit cost less than $5,000.00.
ARIZONA GOVERNOR'S OFFICE OF HIGHWAY SAFETY
Grant Application for Law Enforcement Projects
PS - Pedestrian and Bicycle Safety
11 of 13
Description
Quantity
Price
Per U
nit
Tax
Shipping
Amount
Total:
Capital Outlay
Description:
Capital Outlay: Designated for any equipment with a per unit cost of $5,000.00 or more without accessories, tax, or
shipping. All other items should be placed in Materials & Supplies.
NOTE: It is the Agency's responsibility to confirm the equipment is Buy America compliant. A letter from the manufacturer
may be required.
ARIZONA GOVERNOR'S OFFICE OF HIGHWAY SAFETY
Grant Application for Law Enforcement Projects
PS - Pedestrian and Bicycle Safety
12 of 13
Description
Requested
Amount
Personnel Services
ERE:
Employee Related Expenses
Professional & Outside Services
Travel
Materials & Supplies
Capital Outlay
Total:
SECTION F: Additional Proposal Information
If there is any additional information that your agency would like to attach to their proposal, please
include a PDF attachment with your proposal. Additional information may include: pictures, invoice
estimates, City/Town/County resolutions, additional enforcement information, etc.
Total Estimated Costs
ARIZONA GOVERNOR'S OFFICE OF HIGHWAY SAFETY
Grant Application for Law Enforcement Projects
PS - Pedestrian and Bicycle Safety
13 of 13
$ 0
0.00%
$ 0
$ 0
$ 0
$ 0
$ 0
$ 0
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DUE DATE: March 13, 2020 Federal F iscal (Arizona)

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Completed 27 January 2021

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