Energy Efficiency & Conservation Block Grant/LED Lighting Grant Application Package
GRANTS -GQV'"
Opportunity Title: Recovery Act Energy Efficiency and Conservation Block
Agency: {This elect nick grants apphcation4is intended to
9 National Energy Technology Laboratory
be usedfo apply for the specific Federal funding
Number: 81 opportun%tyreferenced
CFDA Description: Energy Efficiency Conservation Block Grant Program
gy y g ltpelf edera funding opportunity I isted is'not
Opportunity Number: DE- FOA- 0000013 the oppo t w you7want to,apply
Competition ID: close this application package by clickrngaon the
Gariceltiutton at the topof this screen Your
Opportunity Open Date: will theWneedrto locate ttie coerect Federal
03/26/2009
Opportunity Close Date: funding opportunity; download its�application
06/25/2009 a nd�then apply
Agency Contact: Sue Miltenberger
Specialist
E -mail: EECBG @netl.doe.gov
This opportunity is only open to organizations, applicants who are submitting grant applications on behalf of a company, state, local or
tribal government, academia, or other type of organization.
Application Filing Name: Carmel Street Department
Mandatory Documents Move Form to Mandatory Documents for Submission
Complete Application for Federal Assistance (SF -424)
Other Attachments Form
Prog"ct(Re t!) Lrocati� {'S!}
Move Form to
Delete
al Documents Move Form to Optional Documents for Submission
osure of Lobbying Activities (SF -LLL) Submission List
Move Form to
Delete
Instruction sir I
Enter a name for the application in the A lication Filing Name field.
PPl' PP 9
This application can be completed in its entirety offline; however, you will need to login to the Grants.gov website during the submission process.
You can save your application at any time by clicking the "Save" button at the top of your screen.
The "Save Submit" button will not be functional until all required data fields in the application are completed and you clicked on the "Check Package for Errors" button and
confirmed all data required data fields are completed.
2:„ Open and complete all of the documents listed in the "Mandatory Documents" box. Complete the SF -424 form first.
It is recommended that the SF -424 form be the first form completed for the application package. Data entered on the SF -424 will populate data fields in other mandatory and
optional forms and the user cannot enter data in these fields.
The forms listed in the "Mandatory Documents" box and "Optional Documents" may be predefined forms, such as SF -424, forms where a document needs to be attached,
such as the Project Narrative or a combination of both. "Mandatory Documents" are required for this application. "Optional Documents" can be used to provide additional
support for this application or may be required for specific types of grant activity. Reference the application package instructions for more information regarding "Optional
Documents
To open and complete a form, simply click on the form's name to select the item and then click on the button. This will move the document to the appropriate "Documents
for Submission" box and the form will be automatically added to your application package. To view the form, scroll down the screen or select the form name and click on the
"Open Form" button to begin completing the required data fields. To remove a form /document from the "Documents for Submission" box, click the document name to select it,
and then click the button. This will return the form /document to the "Mandatory Documents" or "Optional Documents" box.
All documents listed in the "Mandatory Documents" box must be moved to the "Mandatory Documents for Submission" box. When you open a required form, the fields which
must be completed are highlighted in yellow with a red border. Optional fields and completed fields are displayed in white. If you enter invalid or incomplete information in a
field, you will receive an error message.
4, Click the "Save Submit" button to submit your application to Grants.gov.
Once you have properly completed all required documents and attached any required or optional documentation, save the completed application by clicking on the "Save"
button.
Click on the "Check Package for Errors" button to ensure that you have completed all required data fields. Correct any errors or if none are found, save the application
package.
The "Save Submit" button will become active; click on the "Save Submit" button to begin the application submission process.
You will be taken to the applicant login page to enter your Grants.gov username and password. Follow all onscreen instructions for submission.
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OMB Number: 4040 -0004
Expiration Date: 01/31/2009
Application for Federal Assistance SF-424 Version 02
1. Type of Submission: *2. Type of Application: If Revision, select appropriate letter(s):
Preapplication New
1X1 Application Continuation Other (Specify)
Changed /Corrected Application Revision
3. Date Received: 4. Applicant Identifier:
Completed by Grants.gov upon submission.
5a. Federal Entity Identifier: 5b. Federal Award Identifier:
State Use Only:
6. Date Received by State: 7. State Application Identifier:
8. APPLICANT INFORMATION:
a. Legal Name: City of Carmel
b. Employer/Taxpayer Identification Number (EIN/TIN): c. Organizational DUNS:
35 6000972 0870333209111
d. Address:
Streetl: 3400 W. 131st St
Street2:
City: Westfield
County:
State: IN: Indiana
Province:
*Country: USA: UNITED STATES
*Zip Postal Code: 46074
e. Organizational Unit:
Department Name: Division Name:
Carmel Street Department
f. Name and contact information of person to be contacted on matters involving this application:
Prefix: M First Name: David
Middle Name:
Last Name: Huffman
Suffix:
Title: Street Commissioner
Organizational Affiliation:
'Telephone Number: 317 733 2001 Fax Number: 317 733 2005
'Email: dhuffman @carmel.in.gov
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OMB Number: 4040 -0004
Expiration Date: 01(31(2009
plication for Federal Assistance SF-424 Version 02
Type of Applicant 1: Select Applicant Type:
C: City or Township Government
Type of Applicant 2: Select Applicant Type:
Type of Applicant 3: Select Applicant Type:
Other (specify):
10. Name of Federal Agency:
National Energy Technology Laboratory
11. Catalog of Federal Domestic Assistance Number:
81.128
CFDA Title:
Energy Efficiency Conservation Block Grant Program
12. Funding Opportunity Number:
DE
Title:
covery Act Energy Efficiency and Conservation Block Grants Formula Grants
13. Competition Identification Number:
Title:
14. Areas Affected by Project (Cities, Counties, States, etc.):
City of Carmel in Hamilton County, Indiana
15. Descriptive Title of Applicant's Project:
Retro Refit Metal Halide street lights to LED Street Lights
=:ch supporting documents as specified in agency instructions.
I Add A4ta hmenls''' "A}tachrrients View ehrnents
II LL1I Att
OMB Number: 4040 -0004
Expiration Date: 01/31/2009
a -iii,oplication for Federal Assistance SF-424 Version 02
Rist
6. Congressional Districts Of:
a. Applicant IN 005 b. Program /Project IN -005
Attach an additional list of Program /Project Congressional Districts if needed.
Add Attachment' delete Attachment View Attachment f
17. Proposed Project:
a. Start Date: 06/10/2009 b. End Date: 12/10/2010
18. Estimated Funding
a. Federal 633, 000.00
b. Applicant 8,000.00
c. State 0.00
d. Local 0.00
e. Other 0.00
f. Program Income 0.00
*g. TOTAL 641,000.00
19. Is Application Subject to Review By State Under Executive Order 12372 Process?
El a. This application was made available to the State under the Executive Order 12372 Process for review on
a b. Program is subject to E.O. 12372 but has not been selected by the State for review.
c. Program is not covered by E.O. 12372.
20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes provide explanation.)
11 Yes No Explanation
21. *By signing this application, I certify (1) to the statements contained in the list of certifications and (2) that the statements
herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances and agree to
comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may
subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001)
I AGREE
The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency
specific instructions.
Authorized Representative:
Prefix: First Name: David
Middle Name:
Last Name: Huffman
Suffix:
Title: Street Commissioner
*Telephone Number: 317 733 2001 Fax Number: 317 733 2005
Email: dhuffman @carmel.in.gov
'gnature of Authorized Representative: Completed by Grants gov upon submission. Date Signed: Completed by Grants gov upon submission.
Authorized for Local Reproduction Standard Form 424 (Revised 10/2005)
Prescribed by OMB Circular A -102
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OMB Number: 4040 -0004
Expiration Date: 01/31/2009
Application for Federal Assistance SF-424 Version 02
a pplicant Federal Debt Delinquency Explanation
The following field should contain an explanation if the Applicant organization is delinquent on any Federal Debt. Maximum number of
characters that can be entered is 4,000. Try and avoid extra spaces and carriage returns to maximize the availability of space.
m
Other Attachment File(s)
Mandatory Other Attachment Filename: IN- CITY- CARMEL- Project Activity.pdf
I Add =ivvinndafory Other Attachment b elete Mandat AttaGirnent l I View Manda O th e r Attachmen
To add more "Other Attachment" attachments, please use the attachment buttons below.
I6Add` Optional Other'Attachment Delete Optioni3Other Attachment view `Op tonal Oth Attachment
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OMB Number: 4040 -0010
Expiration Date: 08/31/2011
Project/Performance Site Location(s)
I am submitting an application as an individual, and not on behalf of a company, state,
Project/Performance Site Primary Location local or tribal government, academia, or other type of organization.
Organization Name: City of Carmel
DUNS Number: 0870333209111
*Streetl: 3400 W.131st Street
Street2:
*City: Westfield County: Hamilton
*State: IN: Indiana
Province:
*Country: USA: UNITED STATES
ZIP Postal Code: 4 6074 8 2 6 7 Project/ Performance Site Congressional District: IN- 005
Project/Performance Site Location 1 C I am submitting an application as an individual, and not on behalf of a company, state,
local or tribal government, academia, or other type of organization.
Organization Name: City Of Carmel
DUNS Number: 0870333200000
*Streetl: One Civic Square
Street2:
Ow. City: Camel County:
State: IN: Indiana
Province:
*Country: USA: UNITED STATES
ZIP Postal Code: 46032 -2584 Project/ Performance Site Congressional District: IN- 005
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