Fillable Grant Proposal Overview (City of Hampton)

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Grant Proposal Overview (City of Hampton)

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Rev. 5.3.2019
Grant Proposal Overview
*COMPLETED GRANT OVERVIEW PROPOSAL MUST BE ATTACHED TO THE GRANT ROUTING SHEET
BEFORE ROUTING IS INITIATED*
Grant Title: __________________________________________________________________________________
1. PRIMARY OR SUB-AWARD: Application will be submitted to: ☐ the agency that is the
primary source of funding (City = Primary Awardee); ☐ the agency that has received the
funds from another awarding agency (City = Sub-Awardee).
If the City is a Sub-Awardee, the agreement between the Primary Awardee and the agency to
which the City is making application must be attached to this Overview.
2. GRANT AWARD PERIOD: If awarded, funds are expected to be received: ☐ in the
current fiscal year only; ☐ in the current fiscal year and the future fiscal year(s) of
________________ or ☐ in the future fiscal year(s) of _________________________.
3. PREVIOUS APPLICATIONS:
(Not including the current application) This grant was previously
applied for during _________________________ fiscal year(s); and was previously awarded
during ____________________________ fiscal year(s).
If previously awarded, provide all prior agenda items numbers and dates of Council approval.
4. BACKGROUND/PURPOSE:
Rev. 5.3.2019
5. TYPE OF GRANT EXPECTED TO BE AWARDED:
☐ Cash Amount $ ____________________ ☐ Non-Cash (Describe): ________________
_________________________________________
_________________________________________
_________________________________________
6. FINANCIAL OBLIGATIONS:
a. Current Financial Obligations: This grant will ☐ will not ☐ require matching funds/contributions. If
so, please indicate in the space below the amount and whether the match is cash or in-kind, or
both.
☐ Required Match – CASH ☐ Required Match – IN KIND
Amount: Cash $ _______________ *Value of In-Kind $ _______________
* Description:
b. Future Financial Obligations: This proposal will ☐ will not ☐ incur commitments or financial
obligations for the City beyond the grant period. If it will, an authority memorandum from the City
Manager’s Office-Budget Division estimating future matching requirements and the time period must
be attached to this Overview.
c. Resource Obligations: This proposal will ☐ will not ☐ require special facilities, equipment and/or
services provided by the City. If it will, summarize arrangements in a separate memorandum and
attach to this Overview.
7. Sources of Grant and Matching Funds:
a. Source of Grant Funds (Please check all that apply.)
Federal $ ___________________ Federal Catalog No. ______________________________
Pass Through $ ___________________ Federal Grant No. _______________________________
State $ ___________________ State Grant No. ___________________________________
Foundation $ ___________________
Private $ ___________________
Please identify the funding source of your grant and any required or non-required matches.
• For Federal grants, please provide the Federal Catalog Number (CFDA) and the grant number.
• For State grants, the grant number must be supplied.
• All grant matches must be supplied by the submitting department,
unless they have historically
received a contribution/match from the City’s
Matching Funds Pool or a special arrangement has
been made with the City Manager's Office-Budget Division.
• If another City department, other than the submitting department, will be providing a funding or in
-
kind match, documentation to that effect must be submitted along with this grant packet.
Rev. 5.3.2019
b. Source of Matching Funds* (Please check all that apply.)
Department: ______________________________________________________________________________
Budget Line-Item: ______________________________________ Amount: _________________________
Budget Line-Item: ______________________________________ Amount: _________________________
Budget Line-Item: ______________________________________ Amount: _________________________
*If you are listing a department funding source other than your department, the Budget Division will need written
authorization of agreement to withdraw these funds.
8. Proposed Budget:
City Department-Match Other Match(es)
Grant Total
Cash
In-Kind
Cash
In-Kind
Personnel Svcs
Operating Exp.
Capital Outlay
Column Totals
Grand Total: ___________________________
9. Additional information that will be helpful to reviewers:
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Grant Proposal Overview (City of Hampton)

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Completed 3 August 2020

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