<p> North Dakota Department of Emergency Services</p><p>FY 2011 Emergency Operations Center Grant Program</p><p>APPLICATION</p><p>Submission Deadline: June 10, 2011 Submit Application Electronically: [email protected]</p><p>1. CONTACT / GENERAL INFORMATION</p><p>Name of Agency/Jurisdiction: County: </p><p>Contact Person: Title: </p><p>Address: State: ND Zip Code: </p><p>Phone #: 701 Fax #: 701 Email Address: </p><p>Emergency Operations Center Name: </p><p>Investment Type: Construction Renovation</p><p>Total Cost of proposed EOC Project $ </p><p>75% Federal $ 25% Local Match $ </p><p>2. MATCH REQUIREMENT</p><p>Describe how the 25% match requirement will be met (max 800 characters): </p><p>3. OVERALL PURPOSE</p><p>Describe at a high level what will be implemented and accomplished by this project (max 1,800 characters) : </p><p>4. NEEDS ASSESSMENT</p><p>Certify that a facility assessment has been conducted (include date and who conducted the assessment) </p><p>Outline how the project will address the identified deficiencies or needs identified in the assessment. Address the impact of the project on the population/risk (max 1,800 characters) </p><p>5. INVESTMENT IMPACT</p><p>Describe how the project will mitigate needs and deficiencies outline in the needs assessment. Describe how the project will enhance emergency management capabilities, noting how the project will be accomplished in a cost effective manner (max 1,500 characters) </p><p>6. PRE-EXISTING PLANNING</p><p>Describe any pre-existing planning that has taken place relative to the deficiencies noted in the facility assessment, including architectural plans development; permits in place; explanation of proposed project including design criteria to address the identified hazards and threats. Describe hazard-resistance design guidance utilized as part of planning such as: FEMA 425/452 for identifying and mitigating manmade and terrorist threats; FEMA 361 and FEMA 543 for identifying and mitigating flood and wind hazards; FEMA 310 (ASCE31) and FEMA 356 for identifying and mitigating seismic hazards (max of 2,200 characters) </p><p>7. FUNDING PLAN</p><p>Provide details on how estimated costs were calculated (how did you come up with your total costs)</p><p>Description of cost & cost calculation Total Cost $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Total Project Cost $ Using the information in the above table, complete the Budget 424C form and submit with this application.</p><p>8. FUNDING SOURCES</p><p>Describe the sources of funding that will support implementation of the project. If no other funding resources are identified beyond the required cash match, provide rationale as to why the requested FY 2011 EOC Grant Program funding is sufficient (max 800 characters) </p><p>9. INVESTMENT CHALLENGES</p><p>List and identify potential challenges to effective implementation of the project over the period of performance. Provide a brief description of how each challenge will be addressed and mitigated, and indicate a probability of occurrence (high, medium or low). Be sure to address necessary steps and stages need to be successful, ID concerns or pitfalls, explain the areas of greatest challenge (max characters 2,000) </p><p>10. PROJECT MANAGEMENT </p><p>Explain how the management team members will organize and work together in order to successfully manage the project (max characters 2,000) </p><p>11. MILESTONES</p><p>Provide descriptions of up to 10 milestones that are critical to the success of the project. Milestones should be kept to high-level, major tasks that will need to occur. Be sure to identify the milestone start date and completion date (max characters 1,000) </p><p>ENVIRONMENTAL REVIEW</p><p>Remember, if your application is submitted and federally approved an environmental study must be completed, submitted and granted federal approval before any funds can be expended on the project.</p><p>Deadline</p><p>4:30 p.m. – June 10, 2011</p><p>Submit to:</p><p> [email protected]</p>