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Grant Application, Budget, and Supplemental Application Narrative

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Grant Application, Budget, and Supplemental Application Narrative OMB Number: 4040-0004 Ex~Pira 1 r10 n oate : 0 4/3 1120 12 !Application for Federal Assistance SF-424 Version 02 *I. Type of Submission *2. Type of Application *If Revision, select appropriate letter(s): D Preapplication 0 New 0 Application 0 Continuation * Other (Specify) D Changed/Corrected Application [{] Revision *3. "Date Received: 4-. Application 1dentifier: Sa. 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: American Samoa Department of Homeland Security *b. Employer/Taxpayer Identification Number (EIN/TIN): *c. Organizational DUNS: 97-0000676 854994105 d. Address: *Streett: P.O. Box 4567 Street 2: *City: Paao Paao County: *State: .u.mencan ~amoa Province: Country: *Zip/ Postal Code: 96799-4567 e. Organizational Unit: Department Name: Division Name: f. Name and contact information of person to be contacted on matters involving this application: Prefix: First Name: Jacinta Mid le N am:: G. *Last Name: Brown Suffix: Title: Depu t y 0 1rec. t or Organizational Affiliation: *Telephone Number: Fax Number: *Email: OMB Number: 4040-0004 Expiration Dale: 04/31/20 12 Application for Federal Assistance SF-424 Version 02 9. Type of Applicant 1: Select Applicant Type: F. U.S. Territory or Possession Type of Applicant 2: Select Applicant Type: F. U.S. Territory or Possession ~p p licant i- Type of>Applicant3: Select Type: I___J F. U.S. Territory or Possession *Other (specify): * 10. Name of Federal Agency: National Telecommunication and Information Administration 11. Catalog of Federal Domestic Assistance Number: CFDA Title: 11.549 * 12. Funding Opportunity Number: 2013-NTIA-SLIGP-01 *Title: State and Local Implementation Grant Program. 13. Competition Identification Number: Title: 2013-NTIA-SLIGP-01 14. Areas Affected by Project (Cities, Counties, States, etc.): Territory of American Samoa * 15. Descriptive Title of Applicant's Project: American Samoa Wireless Public Safety Broadband Network. Attach supporting documents as specified in agency instructions. OMB Number: 4040-0004 Expiration Date: 04/3 1/2012 !Application for Federal Assistance SF-424 Version 02 16. Congressional Districts Of: *a. Applicant *b. Program/Project: 00-000 00-000 Attach an additional list ofProgram/Project Congressional Districts ifneeded. - -----=- - 17. Proposed Project: *a. Start Date: 7/15/2013 *b. End Date: 7/15/2016 18. Estimated Funding ($): *a. Federal $502,930.00 *b. Applicant $0.00 *c. State $0.00 *d. Local *e. Other $0.00 *f. Program Income $0.00 *g. TOTAL $502 930.00 *19. Is Application Subject to Review By State Under Executive Order 12372 Process? 0 a. This application was made available to the State under the Executive Order 12372 Process for review on Db. Program is subject to E.O. 12372 but has not been selected by the State for review. [2] c. Program is not covered by E.O. 12372 *20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes", provide explanation.) DYes [L]No ~ 1. *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 tenns ifl 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) [Z] **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: luniasolua Midd le N aneT. *Last Name: Savusa Suffix: *Title: Director *Telephone Number: 684-633-2827 Fax Number: 684-633-5111 *Email: [email protected] .I ) I *Signature of Authorized Re_pre s entativ e ~ B.-A_ ,.., Date Signed: (/I ~~ ADI _(, ~lil ' I ( BUDGET INFORMATION - Non-Construction Programs OMB Approval No. 0348-0044 SECTION A • BUDGET SUMMARY Grant Program Catalog of Federal Estimated Unobligated Funds New or Revised B1-1dget Function Domestic Assistance or Activity Number Federal Non-Federal Federal Non-Federal Total (a)_ (b) (c) (d) (e) (f) (g) $ $ $ $ ~ II $ 1. 0.00 2. 502,930.00 502,930.00 AS Wireless Publifi 11 .549 II 3. 1 0.00 1. 1 4. II 0.00· 5. Totals $ 0.00 $ 0.00 $ 502,930.00 $ 0.00 $ 502,930.00 SECTION B - BUDGET CATEGORIES ""'· Total 6. Object Class Categories GRANT PROGRAM, FUNCTION OR ACTIVITY I (1) Year 1 (2) Year 2 (3) Year 3 (4) Pre-Award I (5) $ $ $ $ $ a. Personnel 97,000.00 97,000.00 97,000.00 291,000.00 1111 b. Fringe Benefits 16,199.00 16,199.00 16,199.00 11 48,597.00 c. Travel 7,150.00 14,300.00 14,300.00 19,231.00 54,981.00 d. Equipment 0.00 0.00 0.00 u 0.00 e. Supplies 11,175.00 2,000.00 2,000.00 f II 15,175.00 f. Contractual 0.00 0.00 0.00 [I! 0.00 g. Construction 0.00 0.00 0.00 ~~ I 0.00 1 r h. Other 6,000.00 6,000.00 18,000.00 30,000.00 i. Total Direct Charges (surn of 6a-6h) 137,524.00 135,499.00 147,499.00 19,231.00 439,753.00 j. Indirect Charges 21,059.00 21,059.00 21,059.00 63,177.00 $ $ $ $ $ k. TOTALS (surn of6i and 6j) 158,583.00 156,558.00 168,558.00 19,231.00 502,930.00 I I 7. Program Income $ $ $ $ $ Authorized for Local Reproduction Standard Form 424A (Rev. 7-97) Previous Edition Usable Prescribed by OMB Circular A-102 m I 111 SECTION C - NON-FEDERALRESOURCES (a) Grant Program (b) Applicant (c) State (d) Other Sources (e) TOTALS 8. $ 0.00 $ 0.00 $ 0.00$ 0.00 9. 0.00 0.00 0.00 0.00 10. 0.00 0.00 0.00 0.00 11. N/A IJ I I 12. TOTAL (surn oflines 8-11) $ $ $ 0$ 0 SECTION D ~ FORECASTED CASH NEEDS Total for 1st Year 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter 13. Federal $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 14. Non-Federal 0.00 0.00 0.00 0.00 0.00 15. TOTAL (surn oflines 13 and 14) $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 SECTION E • BUDGET ESTIMATES OF FEDERAL FUNDS NEEDED:FOR BALANCE OFTHE PROJECT (a) Grant Program FUTURE FUNDING PERIODS (Years) (b) First (c) Second (d) Third (e) Fourth 16. N/A $ 0.00 $ 0.00 $ 0.00$ 0.00 17. N/A 0.00 0.00 0.00 0.00 18. N/A 0.00 0.00 0.00 0.00 19. N/A 0.00 0.00 0.00 0.00 20. TOTAL (surn oflines 16-19) $ 0.00 $ 0.00 $ 0.00 $ 0.00 SECTION F- OTHER BUDGET INFORMATION 21. Direct Charges: 122. Indirect Charges: l,ll 23. Remarks: I Authorized for Local Reproduction Standard Form 424A (Rev. 7-97) Page 2 State and Local Implementation Grant Program Application Supplemental Narrative American Samoa Department of Homeland Security American Samoa State and Local Implementation Grant Program Supplemental Narrative Contents 1. About American Samoa ................................................................................................................. 3 2. Critical infrastructure ...................................................................................................................... 6 3. Villages, counties & districts .......................................................................................................... 7 4. Public Safety Response Agencies ...................................................................................................... 9 5. Existing Public Safety Communications and Interoperability Infrastructure .......................... 9 6. Existing Governance ........................................................................................................................ 11 7. SLIGP Planning Project Proposal ................................................................................................ 15 (1) expand and improve the existing Territorial Interoperability Communications governance structure and develop staffing plans for the management and governing of the ASPSBN and for data collection activities as part of phase 2 after consultations with FirstNet, ............................... 16 (2) utilize the TECC to develop procedures to include traditional officials, private and government sector, and public representation in the planning of ASPSBN, .................................... 19 (3) develop an outreach campaign through TECC and its user group to educate the community and key stakeholders regarding the ASPSBN and the nationwide public safety broadband network and initiative, ............................................................................................................................. 20 (4) Utilize the TECC to develop policies on the use of the ASPSBN and to include interagency and entity memorandum of agreements with potential service providers selected by FirstNet and identify users of the ASPSBN .......................................................................................................... 20 (5) prepare a comprehensive Strategic and Operational Plan for the ASPSBN Plan as part of the American Samoa Statewide Communications Interoperability Plan (SCIP) that identifies the territories existing public safety needs and gaps in which the Nationwide Broadband Network and FirstNet can fill through the implementation of this technology and solution, as well as monitoring and demonstrating progress through development of milestones and goals to meet the needs identified in this plan. ............................................................................................................ 20 2 | Page American Samoa State and Local Implementation Grant Program Supplemental Narrative 1. About American Samoa Figure 1 American Samoa is a group of five volcanic islands
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