Applications must be submitted by XX, 2024 by 5:00 pm EDT. Late applications will not be accepted.
This application site is for applicants wishing to submit a FY 2024 application for an Implementation grant. If you wish to apply for a Planning and Demonstration grant award, please visit: [Insert Link].
To assist in completing your application, please view the resources available at: https://www.transportation.gov/grants/ss4a/how-to-apply
Sign Up Instructions:
If you do not have a Valid Eval account, complete the dark blue Sign-up box below.
Once you have signed up and are logged into your account, the submission form fields below will be available for you to edit. Before starting to fill this form out, please take the time to ensure you have all the required information at hand and your final documents are ready for submission.
The Notice of Funding Opportunity (NOFO), with detailed instructions on how to prepare your proposal, is located at the right of this page. Additional templates and resources are also available there as well as on the SS4A program website.
Contact Information:
SS4A Program Website: https://www.transportation.gov/grants/SS4A
SS4A Email: ss4a@dot.gov
Telecommunications device for the deaf (TDD) is available at 202-366-3993.
[Insert Blue Valid Eval Sign-Up Box]
All fields are required, unless otherwise noted.
Primary applicant information should match what is indicated on the SF-424.
Entity/Community Name: [Form entry]
Entity/Community Type: [Drop down: County Government, City or Township Government, Metropolitan Planning Organization, Federally Recognized Tribal Government, Other Subdivision of a State (e.g., Special District, Local or State Educational District, or Transit Agency), Multijurisdictional Group of Entities]
Lead Applicant State: [Drop down from Federally-recognized Tribe, all states; DC, PR, American Samoa, Guam, Northern Mariana Islands, Virgin Islands]
Lead Applicant UEI: [Form entry]
If possible, please include two points of contact. While contractors are permitted to develop and submit application materials on behalf an applicant, the points of contact listed below must be staff of the applicant agency. In the event we need to contact you, we usually provide only a few business days to respond. Include individuals who will be responsive or put up away messages with other points of contact from (month) through (month) 2024.
Primary Contact First Name: [Form entry]
Primary Contact Last Name: [Form entry]
Primary Telephone number: [Form entry]
Primary Email: [Form entry]
Alternate Contact First Name: [Form entry]
Alternative Contact Last Name: [Form entry]
Alternate Telephone number: [Form entry]
Alternate Email: [Form entry]
Have you received, or is your jurisdiction covered by, previous year funding for an SS4A Action Plan or Implementation grant? [Radio button: No, Received previous year grant to develop or complete an Action Plan, Received previous year funding for supplemental planning activities, Jurisdiction included in a regional or multijurisdictional Action Plan effort that received previous year funding, Received previous year funding for an Implementation Grant]
Provide a weblink to the plan that serves as the Comprehensive Safety Action Plan or established plan(s) that are substantially similar. This may be attached as a supporting PDF document instead in the “Action Plan” file; if this is done, indicate “See Action Plan” in the box below:
[Form entry]
Does your application have additional applicants as part of a multijurisdictional group of eligible entities? [drop-down yes, no]
If yes, please provide an attachment (template online) listing all joint applicants and their population and safety data. All data entered below is based on the total population for the entire application area.
Total jurisdiction population is based on 2020 U.S. Census American Community Survey (ACS) data and includes the total population of all Census tracts where the applicant operates or performs their safety responsibilities. If the jurisdiction includes portions of Census tracts, please include the entire Census tract population here. The population values are available from the U.S. Census website directly or from the DOT Equitable Transportation Community Explorer (ETCE) tool. (For more information on how to use that tool, see [LINK]).
Total Jurisdiction Population: [Form entry-must be whole number]
Total Applicant Jurisdiction Applicant Census Tract(s): [Form entry]
The count of roadway fatalities from the most recent five years of data (2017-2021) in the jurisdiction based on DOT’s Fatality Analysis Reporting System (FARS) data, an alternative traffic fatality dataset, or a comparable data set with roadway fatality information. This should be a whole number. Cite the source, if using a dataset different from FARS, and provide a link to or attachment of the data.
Total Count Motor Vehicle-Involved Roadway Fatalities the most recent five years (either 2016-2020 or 2017-2021): [Form entry-must be whole number]
Alternative Fatality Data (upload documentation in artifacts if applicable): [Form entry-optional]
Fatality Rate per 100,000 persons: the fatality rate calculated using the 5-year annual average from the total count of fatalities from the most recent five years (2017-2021) based on FARS data, an alternative traffic fatality dataset, or a comparable data set with roadway fatality information, which is divided by the population of the applicant’s jurisdiction based on 2020 U.S. Census ACS population data. The rate should be normalized to per 100,000 persons.
Total Average Annual Fatality Rate (per 100,000 population: [allow one decimal point]
Project(s) Location Census Tract(s): [Form entry]
Identify the percent of population in underserved communities. The population in underserved communities should be a percentage obtained by dividing the population living in project-area Census tracts with an Underserved Community designation divided by the total population living in the project area. The population must be based on 2020 Census Data. You may use either the DOT Equitable Transportation Community Explorer tool OR the Climate and Economic Justice Screening Tool to identify disadvantaged communities. You must upload a screenshot of your results. Instructions are available at [LINK].
Please note which tool you are using to determine Underserved Community designation: [check box select only one]:
DOT Equitable Transportation Community Explorer
OMB Climate and Economic Justice Screening Tool
Tribal area – identified in NOFO as Underserved
U.S. territory – identified in NOFO as Underserved
Percent of Population in Underserved Communities in Project Area Census Tract(s): [Form entry]
Note: you will be required to attach project-level fatality and injury data to your application. Please see [LINK] for instructions and the crash data template to complete.
Enter a concise, descriptive title for the project. This should be the same title used in the SF-424 form and the application narrative. The title should be less than 15 words.
Project Title: [Form entry-max 150 characters]
Problem to be Solved with Project: provide a concise summary of the safety problem(s) this project will address. This should not exceed 2-3 sentences.
[Text Box]
Indicate applicant roadway safety responsibility (select all that apply):
[Check box 1: Ownership and/or maintenance responsibilities over a roadway network]
[Check box 2: Safety responsibilities that affect roadways]
[Check box 3: Have an agreement from the agency that has ownership and/or maintenance responsibilities for the roadway within the applicant’s jurisdiction]
Identify primary purpose of project (may only select one):
[Radio button: Infrastructure Strategies: Build physical transportation improvements; goal is to create safer facilities (e.g., constructing road diets, protected bike lanes, roundabouts); Behavioral Strategies: Focus on altering road user behavior and/or reinforcing roadway habits for all users (e.g., performing High Visibility Enforcement, safety outreach campaigns; Operational or Technology Strategies: Focus on enhancing the safety and efficacy of existing transportation infrastructure (e.g., enhancing emergency vehicle warning systems, updating signal phasing to protect turning movements or address conflict points at intersections]
This project will have significant benefit to the following groups (check all that apply):
[Check Box 1: Pedestrians]
[Check Box 2: Bicyclists]
[Check Box 3: Micromobility (e.g., scooters)]
[Check Box 4: Transit Users]
[Check Box 5: Commercial Motor Vehicles]
[Check Box 6: Automobiles]
[Check Box 7: Emergency Medical Services]
Other (please specify): [Form entry]
Major or Minor Construction: Major projects require acquisition of ROW, disturbances to the environment, utilities, and design which may take 3 to 5 years. Examples include: installation of turning lanes, roundabouts, or traffic signal installation. Minor projects have minimal environmental impacts/disturbances, have no ROW, minimal (to no) design, and completed within 18 months. Examples include: installation of pavement markings, signs, signal timings.
[Radio button: Major, Minor, Both, Project does not involve construction]
Does your project include any of the follow Demonstration or Other Supplemental Planning Activities: [Radio button- select all that apply:
Quick Build/Tactical Urbanism (e.g., paint, plastic bollards, etc.)
Demonstration/Pilot of Behavioral Program
Demonstration/Pilot of Operational Program
Demonstration/Pilot of technology to support safety planning and analysis
Road Safety Audits
MUTCD Experimentation (excluding roadway reconstruction)
Additional Analysis (e.g., speed or lighting studies)
Expanded Data Collection (e.g., targeted equity assessments)
Feasibility Study
Complementary Planning (e.g., Accessibility and Transition plans, Other]
Add elements to and/or update existing Comprehensive Safety Action Plan
For more information on what constitutes demonstration or supplemental planning activities, please visit: [Insert hyperlink once job aid is created]
Would you consider accepting funding for only demonstration activities and/or supplemental planning? Selecting yes will not impact the competitiveness of your application to receive funds to implement projects and strategies or your ability to apply for implementation funds in future rounds of the SS4A program. If you [Radio button: yes, no, n/a]
Information provided in this section should be consistent with the information provided in the 424-C attachment. Whole numbers are required for Federal share (no cents). The Federal share of the SS4A grant may not exceed 80% of the Total Eligible Costs. For guidance about how to calculate local share/match visit [insert link to new guidance document].
Total Federal share: [Form entry-whole number only]
Total Local share/Match: [Form entry that may include cents; must equal at least 20% of total project cost]
Total Project Cost: [Form entry]
Do you plan to use any other Federal funding (e.g., Title 23 funds) for this project? [form entry Yes/No]
If so, please list the other Federal funds you propose to use:
Allocate funding request amounts by State based on where the funds are expected to be spent. If the projects and strategies are located in only one State, put the full funding request amount.
Costs by State: [Form entry]
The total amount of funds to underserved communities is the amount of spent in Census tracts designated as Underserved Communities.
Total Federal Funds Allocated to Underserved Communities [Form entry-whole number only]
The following information should match what is in the Supplemental Estimated Budget Worksheet [insert link-need to create worksheet]. Total Project Cost is the sum of the Federal plus local share.
Supplemental Planning Activities (A) Federal Funding Request: [Form entry]
Supplemental Planning Activities (A) Total Project Costs: [Form entry]
Planning, Design, and Development Activities for Projects/Strategies (B) Federal Funding Request: [Form entry]
Planning, Design, and Development Activities for Projects/Strategies (B) Total Project Costs: [Form entry]
Carrying Out Projects and Strategies (C) Federal Funding Request: [Form entry]
Carrying Out Projects and Strategies (C) Total Project Costs: [Form entry]
Templates for each of these forms are located in the right hand-column. Applicants are required to use these templates, without modifications, in order for their application to be considered. When signatures are required as part of these templates, they must be signed by the applicant and not their contractors. When uploading documents, please ensure that the documents uploaded are not password protected.
SF 424 Application for Federal Assistance (required):
SF 424C Budget Information for Construction Programs (required)
SF 424D Assurances for Construction Programs (required)
SF-LLL Disclosure of Lobbying Activities (required)
Narrative (required)
Map (required)
Screenshot of DOT Equitable Transportation Community Explorer Tool or Climate and Economic Justice Screening Tool (required)
Self-Certification Eligibility Worksheet (required)
Action Plan (if applicable, required only if public links are not provided)
Supplemental Budget (required)
Information on joint applicants (if applicable)
Safety data (if using alternative to FARS)
Project location crash data template (required)
Letters of Support (if applicable)
Supporting materials (if applicable)
[Forms and templates available in right hand column: FY 2023 NOFO, What’s New for FY 2023 Job Aid, Implementation Application Checklist, SF-424, SF-424C, SF-424D, SF-LLL, Narrative Template, Self-Certification Eligibility Worksheet, Supplemental Estimated Budget Worksheet, Link to Justice 40 Tool]
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Lewis, Jazmyne (FHWA) |
| File Modified | 0000-00-00 |
| File Created | 2024-07-30 |