Fillable Form 1.: The Flori da Senate Local Funding (The Florida Senate)

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Form 1.: The Flori da Senate Local Funding (The Florida Senate)

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The Form 1.: The Flori da Senate Local Funding (The Florida Senate) form is 6 pages long and contains:

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  • 10 check-boxes
  • 84 other fields

Country of origin: US
File type: PDF

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2.
3.
4.
5.
6.
7.
Total Project Cost for Fiscal Year 2021-2022 (including matching funds available for this project)
Type of Funding
Amount
Percentage
Federal
State (excluding the amount of this request)
Local
Other
Type of Funding
Amount
1.
Project Title
Senate Sponsor
Date of Request
Project/Program Description
Operations
Fixed Capital Outlay
Total State Funds Requested
Total State Funds Requested (from question #6)
Matching Funds
Total Project Costs for Fiscal Year 2021-2022
%
%
%
%
%
%
State Agency to receive requested funds
State Agency contacted?
Yes
No
The Flori
da Senate
Local Funding Initiative Request
Fiscal Year 2021-2022
Amount of the Nonrecurring Request for Fiscal Year 2021-2022
<Choose Agency>
0
Page 1 of 6
0
0
0
0
0
0
The Florida Senate
Local Funding Initiative Reque
st
Fiscal Year 2021-2022
8.
Fiscal Year
Amount
Vetoed
Recurring
Nonrecurring
Is future-year funding likely to be requested?
Yes
No
9.
Specific
Appropriation #
Has this project previously received state funding?
If yes, provide the most recent instance:
Yes
No
(yyyy-yy)
If yes, indicate nonrecurring amount per year.
a.
Describe the source of funding that can be used in lieu of state funding.
b.
10.
If yes, indicate the amount of funds received and what the funds were used for.
Has the entity requesting this project received any
federal assistance related to the COVID-19 pandemic?
NoYes
Page 2 of 6
Spending Category
Description
Amount
Executive Director/Project
Head Salary and Benefits
Other Salary and Benefits
Expense/Equipment/
Travel/Supplies/Other
Consultants/Contracted
Services/Study
Operational Costs:
Other
Salary and Benefits
Expense/Equipment/
Travel/Supplies/Other
Consultants/Contracted
Services/Study
Fixed Capital Construction/Major Renovation:
11.
Total State Funds Requested (must equal total from question #6)
Details on how the requested state funds will be expended
The Florida Senate
Local Funding Initiative Request
Fiscal Year 2021-2022
Administrative Costs:
Construction/Renovation/
Land/Planning
Engineering
0
Page 3 of 6
e.
What is the expected benefit or outcome of this project? What is the methodology by which this outcome will
be measured?
f.
What are the suggested penalties that the contracting agency may consider in addition to its standard
penalties for failing to meet deliverables or performance measures provided for in the contract?
c. What direct services will be provided to citizens by the appropriation project?
d.
Who is the target population served by this project? How many individuals are expected to be served?
12.
Program Performance
a.
What specific purpose or goal will be achieved by the funds requested?
b.
What activities and services will be provided to meet the intended purpose of these funds?
The Florida Senate
Local Funding Initiative Request
Fiscal Year 2021-2022
N/A is not considered a valid response.
N/A is not considered a valid response.
N/A is not considered a valid response.
N/A is not considered a valid response.
N/A is not considered a valid response.
N/A is not considered a valid response.
Page 4 of 6
The Florida Senate
Local Funding Initiative Request
Fiscal Year 2021-2022
16.
b.
Firm Name
c.
E-mail Address
d.
Phone Number
Ext.
15.
Recipient Contact Information
a.
Organization
b.
Municipality and County
c.
Organization Type
d.
First Name
e.
E-mail Address
f.
Phone Number
Last Name
14.
Requestor Contact Information
a.
First Name
b.
Organization
c.
E-mail Address
d.
Phone Number
Last Name
Ext.
For-profit Entity
Non-Profit 501(c) (3)
Non-Profit 501(c) (4)
Local Entity
University or College
Other (please specify)
13.
The owners of the facility to receive, directly or indirectly, any fixed capital outlay funding. Include
the relationship between the owners of the facility and the entity.
Lobbyist Contact Information
a.
Name
Page 5 of 6
19.
What is the status of construction?
20.
What percentage of the construction has been completed?
21.
What is the estimated completion date of construction?
The information provided will be posted to the Florida Senate website for public viewing if sponsored by a Senator.
18.
What is the population economic status?
Financially Disadvantaged Community (ch. 62-552, F.A.C.)
Financially Disadvantaged Municipality (ch. 62-552, F.A.C.)
Rural Area of Economic Concern
Rural Area of Opportunity (s. 288.0656, Florida Statutes)
N/A
Please complete the questions below for Water Projects only.
17.
Have you applied for alternative state funding?
Waste Water Revolving Loan
Drinking Water Revolving Loan
Small Community Wastewater Treatment Grant
Other (please specify)
N/A
The Florida Senate
Local Funding Initiative Request
Fiscal Year 2021-2022
Page 6 of 6
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Form 1.: The Flori da Senate Local Funding (The Florida Senate)

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Completed 27 January 2021

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