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ARPA Project Request Form: Non-profits/ Outside Agencies

Non-Government/Non-Profit Project Application Form

Non-Government/Non-Profit Project Application Form

1.) Administrative Information:

C.) Primary Contact Person
C.) Primary Contact Person
First
Last
E.) Organization Address
E.) Organization Address
City
State/Province
Zip/Postal
H.) Person Signing Sub-recipient Contract
H.) Person Signing Sub-recipient Contract
First
Last

2.) Name of Proposed ARPA Project:

3.) Type of Project:

4.) Estimated Project Timeline:

*Note – Projects must be under contract by 12/31/24 and completed by 12/31/26.

5.) Please note project milestones:

(e.g. launch, end of phase I, etc.). If available, attach a scope of work and project schedule in the attachments section.
Maximum upload size: 516MB

6.) Project Description:

7.) Performance Measurement:

8.) Identify the Category for Eligible Use :

9.) Allowable Expenditures for American Rescue Plan Act (ARPA) Funds:

Select an expenditure category for the proposed project (choose only one).

10.) Please explain how the project qualifies under the expenditure category noted above:

11.) How does the proposed project relate to the COVID-19 pandemic and how will ARPA funding help address this need?

12.) How will this project benefit residents and/or businesses in the City of Lynn?

13.) What specific outcomes or accomplishments will this project receive?

14.) Project Cost:

15.) Are the project costs ready to be appropriated, or will they be phased?

(e.g., costs for planning then costs for execution).

16.) Are matching funds available from another source?

17.) Are there other funding opportunities available that may reduce the amount of ARPA funding needed?

(i.e. other state or federal grants or programs)

18.) Budget summary of activity, including all proposed and confirmed funding sources:

Maximum upload size: 516MB

19.) Will the proposed project incur any ongoing/recurring costs?

20.) Will this project result in savings for a City Department or Community beyond 2026?

21.) Will this project increase future revenues for the City of Lynn?

22.) Is additional staff required for the duration of the project?

(i.e. project management)

23.) Does the proposed project benefit residents disproportionately impacted by the COVID-19 pandemic?

(e.g., communities of color, people with disabilities, low-to-moderate income residents or elders)

24.) Does the proposed project reduce adverse climate impacts and/or promote environmental sustainability?

25.) Does the project benefit a neighborhood, region of the City, or the City as a whole?

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