REBUILD ILLINOIS DRAFT COMPETITIVE PUBLIC INFRASTRUCTURE PROGRAM APPLICATION MAY 27,2020 PRELIMINARY PACKAGE ALL MATERIALS DRAFT. APPLICATION SOME SECTIONS FOR PENDING OR STILL IN GOLF MILL STREETSCAPE, FESTIVAL PARK PREPARATION AS NOTED AND FLOOD RELIEF PROJECT Village of Niles 1000 Civic Center Drive Niles, Illinois 60714 June 30, 2020 VILLAGE OF NILES COMPETITIVE PUBLIC INFRASTRUCTURE PROGRAM APPLICATION Public Infrastructure Application Submission Checklist All applications will be screened for completeness. Applicants must complete and submit this checklist with the application. All pages of the application must be sequentially numbered. Use the right-hand column, labeled "Page Number" to indicate the page for each item. ____ Original grant application (indicate the "original" on the cover) ____ Two complete copies of the grant application PROJECT INFORMATION PAGE NUMBER ____ Completed Submission Checklist (This Page) ______2 ____ Letter of Transmittal from Chief Elected Official (pending) 3 ____ State of Illinois-DCEO Uniform Grant Application ______4 ____ Project Information ______8 ____ GATA Capital Budget _____10 ____ Engineer’s Cost Estimate _____14 ____ Project Location Map _____15 ____ FEMA Issued Floodplain Map _____18 ____ Project Summary _____19 ____ Minority Benefit/Affirmative Housing Statement _____(pending)21 ____ Job Creation Documentation ______23 ____ Project Readiness Summary ______24 DOCUMENTATION, CERTIFICATIONS, RESOLUTIONS ____ Signed Letters of Support Pending ____ Council Commitment of Funds (if applicable) Pending ____ Resident Participation/Public Hearings (if applicable) 7-day notice Pending Newspaper clipping & Publisher’s certification Pending Certified minutes Pending Attendance sheet(s) Pending ____ Local Government Certifications Pending ____ Mandatory Disclosures Pending ____ Conflict of Interest Disclosure Pending ____ Intergovernmental Cooperation Agreement, if applicable Not Applicable ATTACHMENTS ____ Current Infrastructure Condition Documentation Attached ____ Firm documentation of commitment from leveraging source(s) Pending ____ Copy of Construction Permit(s) Pending ____ Proof of Land Ownership (if applicable) Attached ____ Control of Right of Way/Easements (if applicable) Pending ____ Copy of water purchase or wastewater treatment agreement (if applicable) Not Applicable ____ Copy of Option to Purchase (if applicable) Not Applicable ____ Copy of Fair Housing Resolution Pending ____ W-9 Attached ____ SAM Registration (CAGE #) Attached ____ IRS Certification Letter Pending ____ Copy of Local Government Audit Attached 2 VILLAGE OF NILES COMPETITIVE PUBLIC INFRASTRUCTURE PROGRAM APPLICATION Letter of Transmittal (This item is still in preparation) 3 Uniform Application for State Grant Assistance Agency Completed Section 1. Type of Submission Pre-Application Application Changed / Corrected Application 2. Type of Application New Continuation (i.e. multiple year grant) Revision (modification to initial application) 3. Date/Time Received By State (Completed by State Agency upon Receipt of Application) 4. Name of Awarding State Agency 5. Catalog of State Financial Assistance (CSFA) Number 6. CSFA Title Catalog of Federal Domestic Assistance (CFDA) Not Applicable (No federal funding) 7. CFDA Number 8. CFDA Title 9. CFDA Number 10. CFDA Title Additional CFDA Number, if required Additional CFDA Title, if required Funding Opportunity Information 11. Funding Opportunity Number 12. Funding Opportunity Title 217.782.7500 Springfield | 312.814.7179 Chicago | www.illinois.gov/dceo Competition Identification Not Applicable 13. Competition Identification Number 14. Competition Identification Title Applicant Completed Section Applicant Information 15. Legal Name (Name used for DUNS registration and grantee pre-qualification) 16. Common Name (DBA) 17. Employer/Taxpayer identification number (EIN, TIN) 18. Organizational DUNS Number 19. SAM Cage Code 20. Business Address (Address 1) (Address 2) (City), (State), (zip - 4) Applicant's Organizational Unit 21. Department Name 22. Division Name Applicant's Name and Contact Information for Person to be Contacted for Program Matters involving this Application. 23. First Name 24. Last Name 25. Suffix 26. Title 27. Organizational Affiliation 28. Telephone Number 29. Fax Number 30. E-mail Address Applicant's Name and Contact Information for Person to be Contacted for Business/Administrative Office Matters involving the Application. 31. First Name 217.782.7500 Springfield | 312.817.7179 Chicago | www.illinois.gov/dceo 32. Last Name 33. Suffix 34. Title 35. Organizational Affiliation 36. Telephone Number 37. Fax Number 38. E-mail Address Areas Affected 39. Areas Affected by the Project (cities, counties, state-wide, add attachments e.g. maps) 40. Legislative and Congressional District of Applicant 41. Legislative and Congressional Districts or Program Project Applicant's Project 42. Description Title of Applicant's Project 43. Proposed Project Term Start Date End Date 44. Estimated Funding (Include all that apply) Amount Requested from the State Applicant Contribution (e.g., in kind, matching) Local Contribution Other Source of Contribution Program Income Total Amount 217.782.7500 Springfield | 312.814.7179 Chicago | www.illinois.gov/dceo Applicant Certification: 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 18, Section 1001) (*) The list of certification and assurances, or an internet site where you may obtain this list is contained in the Notice of Funding Opportunity. If a NOFO was not required for the award, the state agency will specify required assurances and certifications as an addendum to the application. I Agree Authorized Representative 45. First Name 46. Last Name 47. Suffix 48. Title 49. Telephone Number 50. Fax Number 51. E-mail Address 52. Signature of Authorized Representative 53. Date Signed 217.782.7500 Springfield | 312.814.7179 Chicago | www.illinois.gov/dceo VILLAGE OF NILES COMPETITIVE PUBLIC INFRASTRUCTURE PROGRAM APPLICATION APPLICANT PROJECT INFORMATION REBUILD ILLINOIS PUBLIC INFRASTRUCTURE Type of project? Flood relief project providing community amenities and such as a festival lawn, permeable pavement festival streetscape and destination festival park.__________________________________________ If this project is “on behalf of” another entity, what is the entity: ___________________________________________________________________________________________ I. PROJECT LOCATION ADDRESS: Street Address _9101 N Greenwood Ave______________________________________________________ (required) City _Niles___________________________ State IL________ Zip Code 60714___________________ The project location will be utilized to verify inclusion in an opportunity zone and/or DCEO underserved area. II. PROJECT BENEFIT INFORMATION Provide the total number of persons served based upon the Census: _29,803 (2010 Census)______________ CENSUS TRACT NUMBER(s) – Use additional sheet, if necessary. Is this project located in an Enterprise Zone? Yes No Is this project located in an Empowerment Area? Yes No Is this project located in a Tax Increment Financing District? Yes No What is the current unemployment rate of the County?_5.1%_______ (from IDES Non-Seasonally Adjusted, available at: https://www2.illinois.gov/ides/lmi/Pages/Local_Area_Unemployment_Statistics.aspx ) 8 VILLAGE OF NILES COMPETITIVE PUBLIC INFRASTRUCTURE PROGRAM APPLICATION III. APPLICATION WRITER CONTACT PERSON: TITLE: Tom Powers, P.E.____________________________ Village Engineer___________________________ ADDRESS AND PHONE NUMBER: Firm Name Village of Niles________________________________________________________ Street Address 1000 Civic Center Drive____________ P.O. Box_________________________ (required) (Only if no street address) City Niles _____________________________ State IL________ Zip Code 60714-3329_____ (include + 4) E-Mail [email protected] _______________________________________________________ (required) BUSINESS PHONE: (_847_)_588-9200____________ FAX PHONE: (_847_)_588-7950____________ FEDERAL EMPLOYER IDENTIFICATION NUMBER: 36-6006016_____________________________ (required) IV. PROJECT ENGINEER, if selected CONTACT PERSON: TITLE: Jeff Wickenkamp, P.E.___________________________ Vice President___________________________ ADDRESS AND PHONE NUMBER: Firm Name Hey and Associates, Inc.________________________________________________________ Street Address 8755 W. Higgins Rd, Suite 835____________ P.O. Box_________________________ (required) (Only if no street address) City Chicago_____________________________ State IL________ Zip Code 60631-4011___________ (include + 4) E-Mail [email protected] _______________________________________________________ (required) BUSINESS PHONE: (_773_)_693-9200____________ FAX PHONE: (_847 )_740-2888____________ FEDERAL EMPLOYER IDENTIFICATION NUMBER: 36-4183789_____________________________ 9 STATE OF ILLINOIS UNIFORM GRANT BUDGET TEMPLATE Commerce & Economic Opportunity Organization Name: Village of Niles DUNS# 20949178 NOFO # 92-1 CSFA Number: 420-75-2411 CSFA Description: Rebuild Illinois Fiscal Year: 2020 S E C T I O N A -- STATE