Welcome the Louisiana Highway Safety Commission FFY 2024 Application for funding.

Please note that if you use the "Save and Resume Later" link, you will need to copy and save the link that is provided by Formstack in the event that you do not receive an email from Formstack. Also, if you use the option, all file uploads and signatures will need to be resubmitted. Without this link, the data you have entered cannot be retrieved, and you will have to start filling out the form at the beginning.

If you have questions, please email LHSCadmin@la.gov or call 225-925-6991.

Thank you!

LHSC FFY 2024 PROPOSAL APPLICATION FORM

The following template shall be used for the completion of the full project proposal. The LHSC FFY 2024 Application Period is now open. Please visit the following link to access the full FFY 2024 Call for Proposals and Application Instructions which includes the Problem Identification: https://www.lahighwaysafety.org/grants/apply-for-a-grant/


Please complete ALL sections below.  Please consider the following before completing the project proposal:  


To Save and Resume, users must scroll to the bottom of the form to find the option.  Another important thing to note when using Save & Resume is that files uploaded to the form by the end users and signatures executed by the end user will NOT be saved to the form until the form is submitted to the database. Users should not upload files or sign the forms until they are ready to submit the project proposal.

APPLICANT INFORMATION

This is the agency that has authority to enter into a contract with the LHSC. The Contracting Agency information may be different from the Implementing Agency information.
Contracting Agency Address*
NOTE: Entering an incorrect Tax ID # could cause your project application to be rejected or delayed.
To get a DUNS number visit: https://www.dnb.com/duns-number.html All DUNS numbers must be registered and active with the System for Award Management (SAM).To verify that agency DUNS # is registered and active visit: https://sam.gov/SAM/ NOTE: Entering an incorrect DUNS # could cause your project application to be rejected or delayed.
Effective April 4, 2022, the federal government will stop using the DUNS Number and start using a new identifier, the Unique Entity ID (SAM), to identify businesses and organizations as unique. Like the DUNS Number, the UEI will be required to do business with the government (LHSC). • If you have an entity registration (even if your registration has expired), you already have a Unique Entity ID (SAM). You can find it by selecting the Entity Management widget in your Workspace on https://sam.gov/SAM/ or by signing in and searching entity information. • If you are a sub-awardee now or want to be one in the future, choose “Get Started” on the SAM homepage and “Get a UEI.” Do not choose “Register Entity.”
In order to contract with the LHSC, all applicants must register with the State of Louisiana and receive a State Vendor Number. Visit https://lagoverpvendor.doa.louisiana.gov/irj/portal/anonymous?guest_user=self_reg
All applicants must contact the Louisiana Department of Revenue (LDR) to receive a LDR #. All applicants can call Revenue at 1-855-307-3893 to get their number. NOTE: Entering an incorrect LDR # could cause your project application to be rejected or delayed.
This is the individual that is authorized to sign contracts on behalf of the Contracting Agency.
Correct email address of Authorizing Official is necessary for proper electronic routing of contract documents if selected for award.
Correct email address of Fiscal Officer is necessary for proper electronic routing of contract documents if selected for award.
This is the agency that will actually be conducting the project activities, i.e., Overtime enforcement, awareness and education, training, etc.
Implementing Agency Address *
Project Director's Name*
Address
Correct email address of Project Director is necessary for proper electronic routing of contract documents if selected for award.
(Please give details about your experience with the private sector, legal analysis, report writing and/or advocacy. ) (max 300 words)
(Please provide information on the number and the expertise of the staff involved. Please attach the CV or resume of the person who will be the focal point of the project and a link to your organization’s website.)
(Please mention any project(s)in the last 3 years which were funded, even partially.)

PROJECT INFORMATION

Project Start Date
Project End Date
Program Area*
CHECK ALL THAT APPLY
$
Please enter your proposed amount requested using only numbers - no commas are necessary
$
This may be different from the Grant amount requested if additional funding is secured. In this case, please provide evidence of the secured additional funding. Please enter your proposed amount requested using only numbers - no commas are necessary
$
List any income that could be generated from the proposed project.
Please indicate the specific target audience for the proposed project, i.e., young drivers ages 15-24, male pick-up truck drivers, etc.
Please indicate the location or service area of the proposed project; i.e., city, parish, region, statewide.
(No more than 200 words)

Description Area

Please provide data that justifies and identifies the cause and the targeted population of your proposed project.
Please define objectives that are specific, measurable, achievable, realistic, and time-bound. The project performance target should be written to coincide with the LHSC Statewide FY2023 Emphasis Area Performance Targets on pages 9-10 of the 2023 Call for Proposals and Application Instructions.
Identify the strategies (activities) used to achieve the objectives. The strategies should flow naturally from the problems and implement the objectives.
Describe the evaluation process for the proposed project. It also involves an analysis of the role project activities have played in the accomplishment of those performance targets and objectives.

BUDGET AND BUDGET NARRATIVE

Link to Budget Spreadsheet  Please use this link to access the LHSC Proposal Budget document.   The budget document will open as a Read-only file.  Please do NOT click the Edit Workbook button.  Instead select FILE, then you must choose SAVE AS from the drop down list and then choose DOWNLOAD A COPY to download the document to your computer.  Once you have downloaded and saved the document, you can enter your Budget Items and Budget Narrative. Please save and rename the file once you have completed your entries.


After completing and saving your budget document, you must return to the application and select CHOOSE FILE to upload it.  Please rename the file before you upload it.


You may have to click on the BACK arrow in your Internet Browser to return to your application and upload the budget document.


NOTE:  Enforcement projects please include your average overtime (OT) rate in the personnel services section and list the types of enforcement you are requesting; i.e., Impaired Driving OT, Occupant Protection OT, Bicycle/Pedestrian OT, Juvenile Underage Drinking Enforcement (JUDE) OT, Railroad OT, Speed OT, etc.


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Please fill in the attached Excel sheet.https://1drv.ms/x/s!AlbPThDggVvaghBdXlDU10Bamrov

ADDITIONAL DOCUMENTS

A copy of the Louisiana Secretary of State Office's Certificate of Registration from your organization
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All applicants must be in good standing with the Louisiana Secretary of State’s Office – https://coraweb.sos.la.gov/commercialsearch/commercialsearch.aspx
Additional information you would like to include with this proposal.
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Examples include: data charts, sample educational items, project curriculum, other justifications for project.
A copy of your organization’s audited financial statement from the most recent year.
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A CV or resume of the person who will be the focal point of the project
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SUBMISSION

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This email address is where the confirmation of your project proposal submission will be sent.
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