Federal Fiscal Year 2020

Highway Safety Behavioral Community Event Grant Application

Department of Transportation Highway Safety Office

Behavioral Grants Program

5300 Bishop Blvd, Cheyenne, WY 82009

GOAL

The Wyoming Department of Transportation's Highway Safety Behavioral Grants Program goal is to reduce traffic crashes, deaths, injuries, and the associated economic losses in Wyoming through the coordinated efforts of traffic safety partners, state, and local law enforcement agencies.

PART 1

Applicant Contact Information

*Agency/Organization:

*DUNS Number (http://www.dnb.com/us):

* Wyoming Secretary of State Filing ID:

*Project Title:

*Mailing Address:

*City, State, Zip + 4:

* Required Fields

Information on completing this application and project resources are available on the Wyoming Department of Transportation website at: http://www.dot.state.wy.us/home/dot_safety/safety_grant_info.html.

Submit grant application to DOT-HSOGRANTS@WYO.GOV on or before March 18, 2019.

PART 2

List of Events in Application

Please list all events being applied for and the total cost for each event supported by the “Event Details Template”. If an event will be held more than once, please indicate the number of times the event will be held in parentheses following the event title. The total cost column should reflect the cost from the worksheet in the template multiplied by the number of times the event will be held. Ex. Battle of the Belts (3). Please see the following page for template instructions.

Title of Each Event	Total Cost	Local Match
Total	$0.00	$0.00

PART 3

Event Template Instructions and Definitions

To consider an event for funding, it must be accompanied by a completed “Event Details Template” posted with the grant application notice. Please save the document as the title of the event listed in Part 2 of the application and submit it as part of a completed application to the Highway Safety Office by March 18, 2019. The template should be used to approximate the costs associated with holding one event. If the event will be held multiple times over the grant funding year, please indicate the number of times it will be held in Part 2 “List of Events in the Application”. Acceptable event topics include occupant protection, distracted driving, impaired driving, and other traffic safety events supported by local data.

Problem Identification- This is asking for specific data that supports why the event should be held. Data sources may include, but are certainly not limited to, WYDOT’s Annual Report on Traffic Crashes, WASCOP Alcohol Factors, Wyoming Survey of Seatbelt Use, CDC reports, Fatality Analysis Reporting System (FARS data), information from the Wyoming Department of Health, and citation data if available. Applications that do not indicate the source of the data provided will be returned as incomplete.

Event Description- Describe the purpose of the event, where it will be held and why it is being held in that location, the target audience which should speak to the problem identification, potential reach, and how it will help Wyoming meet the Core Performance Measurers listed in the cover letter.

Objectives- What is the objective of executing the event?

Event Evaluation- Describe how you will evaluate the event as it relates to your objective. Evaluation should include who, what, when, where, why, and how of reaching your objective.

Position Title- Each position requesting time must list a position title.

Planning/Meeting Personnel Costs- List the approximate number of hours necessary to plan the event and take meetings in conjunction with the event.

Recruitment- Approximate number of hours that will be spent in the community getting people to help with the event.

Development of Content- Approximate number of hours that will be spent developing the educational content associated with the event.

Travel- Approximate number of hours that will be spent traveling in association with the event.

Set Up- Required time to set up the event.

Actual Event- Approximate number of hours that will be spent running and working the actual event.

Debrief- Approximate number of hours that will be spent letting partners and those involved in the event know how it went.

Reporting- Approximate number of hours that will be spent reporting back to the Highway Safety Office how the event went with the post event report used for event reimbursement.

Materials/Educational Materials- Educational materials are printed materials with traffic safety facts used as an educational tool at events. Other materials are non-educational purchases that are necessary for execution of the event.

Media- Please explain the media channel used and a note on how it relates directly back to the event.

Other/Misc Costs- Any costs that don’t fit a category given on the Proposed Cost Schedule for Events.

Please see the Grant Application Notice posted by the Highway Safety Office for an example on how to complete the Event Details Template. If there are any questions on the grant application process please contact the Highway Safety Office.

PART 4

FEDERAL GRANT MONIES

These questions relate to any Federal grant monies received for transit or safety activities.

(CFDA #20.600, 20.601, 20.607, etc.)

Yes No

Has the key (essential) personnel in the direct implementation and administration of the grant during the previous year remained the same? (Key personnel include the Grant Administrator, Accounting, Budget or Controller personnel) (2 CFR 200.331 (a) (6) (3)).
Has the organization as a whole remained unchanged during the previous year?
Has the accounting/financial system remained the same as last year? (There weren’t any upgrades or modifications to the system.) (2 CFR 200.331(a)(6)(3))
3a. If there were changes, please explain.
Does your entity receive Federal grant money directly from any Federal awarding agencies? FTA, NHTSA, etc. (These monies do not have any WYDOT involvement for applications, payments, etc.) (2 CFR 200.331(a)(6)(4))
Has a Federal agency monitored or inquired or been directly involved in the grant? (2 CFR 200.331(a)(6)(4))
5a. Has the Federal agency every performed a review or audit of the grant?
5b. If yes, did the Federal agency determine that there were no financial or compliance issues? If no, please provide a description of the financial and/or compliance issues written up by the Federal agency.
Does your entity have written procedures for procurement transactions? (2 CFR 200.318-323)

PART 5

Authorizing Official Information

The agency personnel contact information below must be completed

Project Administrator
Printed Name:
Title:
Telephone:
e-mail:
Authorizing Official for Agency/Organization
Printed Name:
Title:
Telephone:
e-mail:

By the submittal of this application for funding, I certify under penalty of law, based on information and belief formed after reasonable inquiry the statements and information contained in this application are true, accurate, and complete.

Please email the application along with all supporting documents to

DOT-HSOGRANTS@WYO.GOV.

If you have trouble emailing the application or have questions, please contact Stephanie Lucero @ 307-777-4198 or Karson James @ 307-777-4200.