This notice contains collection-of-information requirements subject to the Paperwork Reduction Act. The use of Standard Forms 424, 424A, 424B, 424C, 424 D, and SF-LLL has been approved by the Office of Management and Budget (OMB) under the respective control numbers 0348-0043, 0348-0044, 0348-0040, 0348-0041, 0348-0042, and 0348-0046. Notwithstanding any other provision of law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with, a collection of information subject to the Paperwork Reduction Act, unless that collection displays a currently valid OMB control number. Public reporting burden for this collection of information is estimated to average 4 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send Comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Federal Highway Administration, 1200 New Jersey Avenue, SE., Washington, DC 20590.
Download a Word version of this application: imd2012appl.docx, 24 KB
Application: The application consists of both the Standard Form 424 and Project Narrative.
Standard Form 424 (SF-424): Application for Federal Assistance
Link to SF-424 - http://www.fhwa.dot.gov/discretionary/sf424.pdf
Project Narrative: Attachment to SF 424
The project narrative must respond to the application requirements outlined below. FHWA recommends that the project narrative be prepared with standard formatting preferences (e.g. a single-spaced document, using a standard 12-point font, such as Times New Roman, with 1-inch margins). An application must include information required for FHWA to assess each of the criteria specified in the Selection Criteria. These items are specifically referenced in the outline below.
The project narrative may not exceed 5 pages in length. Documentation supporting the assertions made in the narrative portion may also be provided, but should be limited to relevant information. FHWA recommends use of appropriately descriptive file names (e.g., "Project Narrative," "Maps," "IM Apportionment Obligation Plan," "Letters of Support," etc.) for all attachments. Those attachments must be submitted electronically in PDF format no larger than 2 megabytes. This additional information should be identified by the State and Project Title that matches the SF-424.
State: (This should match item #14 in the SF-424)
Descriptive Title of Applicant’s Project: (This should match item #15 on the SF-424)
Congressional District Information: (U.S. Congressional membership - not the State legislature)
Geographic Location: Provide a brief description of the project location:
Objectives and need for assistance:
Primary Scope of Work: (Select one of the following: A-F- details may be provided in item 2)
Provide a brief description of the proposed work: (Narrative)
Describe the project scope of work that is to be completed with the funding, and whether this is a complete project or part of a larger project. Only include work that would be eligible for IMD funding. Include a description of the transportation challenges that the project aims to address, and how the project will address these challenges.
Confirm the project is located on a statutorily eligible Interstate route (23 U.S.C. 118(c)(1)): (Y/N and cite under which statutory section the segment of Interstate was added to the system. http://www.fhwa.dot.gov/highwayhistory/data/page02.cfm)
The project must be located on Interstate routes eligible under title 23 U.S.C. section 118(c). Eligible routes may generally be found under the heading "Chargeable Mileage" on the table at http://www.fhwa.dot.gov/highwayhistory/data/page02.cfm. Describe how the proposed project meets the statutory eligibility requirements of 23 U.S.C. 118(c)(1). Cite under which statutory section the segment of Interstate was added to the system.
Application includes confirmation the State will obligate all apportioned FY 2012 IM program funds: (Y/N and provide demonstration of IM obligation plan – separate attachment is acceptable)
Demonstrate how the State will obligate all of its IM apportionments before the end of the fiscal year. Transferring IM funds in whole or in part to other fund categories does not constitute obligation of IM funds. Provide a separate attachment if necessary.
Under the provisions of 23 U.S.C. 118(c)(2), a State is eligible to receive an allocation of IMD funds, if it has obligated or demonstrates that it will obligate in the fiscal year all of its Interstate Maintenance (IM) funds apportioned under section 104(b)(4) of 23 U.S.C., other than an amount which, by itself, is insufficient to pay the Federal share of the cost of a project which has been submitted by the State for approval. Therefore, to be eligible to apply for FY 2012 IMD funds, a State must demonstrate how it will obligate all of its current unobligated balance of IM funds in FY 2012, without transferring these to another category. Since full year appropriations are not yet known, an estimate based on FY 2011 should be considered.
In 1992, FHWA established a policy that Interstate 4R discretionary funds would not be allocated to a State that had, in the preceding fiscal year, transferred either National Highway System (NHS) or Interstate Maintenance (IM) funds to the Surface Transportation Program (STP) apportionment. This policy was based on the significant Interstate System needs across the country and the congressional intent for IMD funds was to give priority consideration to high cost projects in States where available apportionments were insufficient to allow such projects to proceed on a timely basis. This policy is still appropriate and will be applied to FY 2012. Therefore, transfer of IM or NHS funds would not be allowable.
Will the funds be obligated within one year of the date the funds are made available and will the funds be applied to a ready-to-commence project? (Y/N and include estimated Obligation Date)
The State must be willing and able to obligate the IMD funds within 1 year of the date the funds are made available, and apply the funds to a ready-to-commence project.
In the case of construction work, will work begin 90 days after obligation of funds? (Y/N and include the Estimated Letting Date and Construction Start Date.)
In the case of construction work, the State must be willing and able to begin work within 90 days after obligation of funds.
Current Average Daily Traffic (ADT): (Provide current two-way ADT)
Provide the current 2-way average daily traffic (ADT). Statutory priority is given to high volume routes.
Percent Trucks: (%)
Statutory priority is given to high volume and high truck-volume routes.
Current and proposed number of lanes: (Total number of lanes both directions)
Provide the number of lanes before and after completion of the project. This and the ADT are used to gauge congestion on the route. The statutory priority is determined based on per-lane volume.
Amount of IMD funds requested: ($)
In accordance with 23 U.S.C. 120, the Federal share of the costs for most projects eligible under this program is 90 percent. However, the Federal share is 80 percent on projects, or the portion of projects, for work involving added single-occupancy vehicle lanes to increase capacity. The sliding scale provisions under 23 U.S.C. 120 also apply to the Federal share for these IMD projects.
Indicate the estimated future funding needs for the project, including anticipated requests for additional Federal funding and the items of work for which the funds are needed. For example, if the current request is for an initial phase of construction, funding needs for future construction should be included.
Total project cost: ($, amount must exceed $10 million in order to receive priority consideration)
Statutory priority is given to projects with a total project cost that exceeds $10 mill. Additional information concerning sources of funds should be provided in item # 13.
State ranking of application: (State priority _____ of _____ total applications)(2 max)
Funding for the IMD program is limited; therefore, the State’s top ranked projects will be given additional consideration. A maximum of two applications may be submitted per State.
Other funds leveraged / committed to the project and source of funds: ($ and source)
Because the annual requests for funding far exceed the available IMD funds, commitment of other funding sources to compliment the requested IMD funds is an important factor in project selection. Projects that leverage non-public funds will be given additional consideration. Include information about the commitment of funds, sources, and uses of all project funds, including Federal funds provided under other programs. Only indicate those amounts of funding that are firm and documented commitments. Do not include funding that was provided for previous projects or previous or future phases of work.
Explain how the funding will provide for expeditious completion of project: (Narrative)
Preference is given to requests that will expedite the completion of a viable project over requests for initial funding of a project that will require a long-term commitment of future Federal funding. For large-scale projects, consideration is given to the State's total funding plan to expedite the completion of the project. Projects that better demonstrate the need for assistance will be given additional consideration.
Will the applicant accept a lesser award and still meet the project milestones outlined in the application (Start Date and Completion Date)? (Y/N)
If yes, what is the minimum amount of IMD funding the applicant could accept and still meet the project milestones? ($, minimum IMD funds acceptable)
IMD funding is limited. If the applicant can accept less IMD funding and still meet the project milestones, the project will be given additional consideration.
Explain the transportation benefits of the project (improved highway safety and/or reduced congestion): (Narrative)
FHWA is particularly focusing on those projects with substantial benefits to either highway safety or congestion relief. Those projects that yield tangible transportation benefits will compete more favorably during project selection. Specifics, such as anticipated reductions in crash rates, etc. should be provided if available.
Explain if/how the project will provide for a State of Good Repair: (Narrative)
State of Good Repair is defined as improving the condition of existing transportation facilities and systems, with particular emphasis on projects that minimize lifecycle costs.