Congressman Rodney Alexander
Louisiana's 5th District
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Picture of Louisiana
Picture of Louisiana
Picture of Louisiana

Appropriations Request Information Form

Congressman Rodney Alexander (LA05)

Please Note: Submission of this form does not ensure funding.

Please fill out this form as completely and accurately as possible.

  Point of contact email address:
1. The exact name, address, phone number, fax number and email of the potential grant recipient point of contact:
2. Very briefly describe the organization's main activities, and whether it is a public, private or non-profit entity:
3. What appropriation bill/subcommittee are you seeking funds from?
 

The 12 appropriations bills/subcommittees are:
 Agriculture, Rural Development, FDA
Commerce, Justice, Science
Defense
Energy and Water
Financial Services
Homeland Security
Interior and Environment
Labor, Health and Human Service, Education
Legislative Branch
Military Construction, VA
State, Foreign Operations
Transportation, HUD

4. What is the project name as it will be listed in the bill?
5. Provide a very brief summary of the activity or project for which the funding is requested: (The committee limits this to 100 characters.  Additional information can be added in question 11.)

(Maximum characters: 100)
You have characters left.
6. Are you requesting specific bill or report language? If so, what language are you requesting in what bill and/or report? If you don't know, please write "N/A.":
7. Please state the requested amount for FY09:
8. Does the potential grant recipient have matching funds or access to matching funds? If so, how much, what percentage, and from where?
9. Has the project received federal funds before? If so, then please state when funding was received and from where.
10. Indicate whether funding was received in the past four fiscal years. If so, what appropriation bill provided that funding? For example, "$100,000 Interior and Environment FY06 Appropriation Bill, STAG account." If not appropriations, please name the grant program:
11. Please include any background or additional information:


Please answer the following questions to the best of your ability:
12. For Agriculture, Rural Development and Food and Drug Administration requests: Which agency and account are you requesting funding from?
13.

For Defense requests:

Which account are you requesting funding from: RDT&E, Procurement, Personnel, O&M, Medical (excluding DHP), Reserve Equipment, National Guard Equipment, Counter Drugs or Other?

Which service are you requesting funding from: Army, Army reserve, Navy, Navy Reserve, Marine Corps, Marine Corps Reserve, Air Force, Air Force Reserve, Intelligence, Army Guard, Air National Guard or Defense-wide?

What is identification number for this request: R-1/PE#, P-1/Line#, TIARRA/JMIPP?
14.

For Energy and Water requests:

Which agency and account are you requesting funding from?

Is this a new project?

Description of Project's Statutory Authorization:

Please state FY05 through FY08 Funding, if applicable:

President's Budget Amount, if applicable:

Is bill/report language required?
15.

For Foreign Operations and Export Financing:

Which account or general provision are requesting funding from?

If proposal recommends funding for country, entity or organization, please select one of the following:
country or government entity within country/U.S. nonprofit organization/U.S. for profit organization/ foreign nonprofit organization/foreign for profit organization/U.S. government organization or entity/international organization/ U.S. college or university /foreign college or university:
16. For Homeland Security: Which agency and account are you requesting funding from?
17. For Interior and Environment:
Which agency and account are you requesting funding from?
If this is a STAG request, please answer the following questions:
 

Please note that there is a 45% cost share requirement for any portion of a project funded through an earmark. That means, for example, that a $1 million project would involve a maximum of $550,000 from the Federal government and the remaining $450,000 in cost sharing would be required prior to project initiation. Completion of this form is not a commitment to fund any specific project, nor is it a commitment to provide full Federal funding for 55% of any specific project.
 

Grantee Name:
 

Grantee City:
 

Grantee State:

 

Purpose: (specify both)

1) drinking water waste water storm water
2) new extension or renovation

 

Detailed Project Description:

 

Amount requested:
(cannot be greater than 55% of
the total project amount)

 

Federal share amount:

 

Local share amount:

 

Total population served by this project:

 

Total estimated cost of the project based on facilities plan or preliminary engineering report:

 

Amount received from past appropriations: (specify dollar amount per year)

 

Amount received from State Revolving Fund; i.e. Drinking Water SRF or Clean Water SRF:(specify dollar amount)

 

Amount received from Department of Agriculture, Rural Development program:(specify dollar amount)

 

This project is largely for economic development:

Yes No

 

This project is largely for projected growth:

Yes No

 

This project is largely for EPA compliance requirement:

Yes No

 

This project is largely for public health benefits:

Yes No

 

This project is largely for water quality improvements:

Yes No

 

This project is largely for EPA consent decree:

Yes No

 

Preliminary planning and engineering design is completed:

Yes No

 

The community has a financing plan certified by an authorized local official demonstrating how it will cover the 45% matching funds:

Yes No

 

Assuming you do not receive full Federal funding for 55% of the project, is there a financing plan, certified by an authorized local official, demonstrating how the remaining cost of the project will be covered:

Yes No

 

There is a completed facility plan, an approved capital improvement plan, or preliminary engineering report for the project that demonstrates it is cost-effective and that it will conform with NEPA requirements:

Yes No

 

The community has applied for project loan funding from the appropriate State Revolving Fund; i.e. Drinking Water SRF or Clean Water SRF:

Yes No

 

If the answer to the previous question is yes, was the project denied funding or did it fail to make a priority list for future funding under that program:

Yes No

 

The community has applied for funding from the Department of Agriculture, Rural Development program:

Yes No

 

If the answer to the previous question is yes, was the project denied funding or did it fail to make a priority list for future funding under that program:

Yes No

 
18.

For Transportation, Treasury, Housing and Urban Development:

Which agency and account are you requesting funding from?

How much of the request can be spent in FY09?

If this is a highway, transit, rail or aviation request, have you checked eligibility with FHWA, FTA, FRA or FAA?

If yes, did FHWA, FTA, FRA or FAA indicate the project is eligible under the account requested?

If this is a FHWA request, is the project considered by the State and/or regional transportation officials as critical to their needs?
If yes, please fax a letter of support from these officials to the Washington, D.C. office, Subject: Appropriations Request, Attn: Jack Thompson at (202)225-5639.