INDIAN NATIONS COUNCIL OF GOVERNMENTS
(INCOG)

Rural Economic Action Plan (REAP) Application

TRANSPORTATION -  FY2023

I. 	APPLICANT INFORMATION 

A.	Name:	      County:		 

B.	Address:			Phone:		 

				Email:_________________________

C.    Applicant’s Chief Elected Official: 								

D.	 Applicant's Contact Person (if other than chief elected official):

       Name:		 

       Address:			Phone:		 

      E-mail:   ______________________________

E.	Population (for City/Town/Unincorporated Area of County): 		 
		(Based on most recent Decennial Census information)

II.	PROJECT INFORMATION:

A.	Detailed Project Description (refer to the description in your engineering report or detailed budget for assistance): 	 
			 
B.	Project Location (attach map of target area):	 
			 
C.	Amount of Grant Request (REAP $): 	
	Total Project Cost (all sources of funding): ________________________________________
A.	Anticipated Project Start Date (Assume contract award Jan 2023, # of days after contract award): ______________________________________
E.	Total number of people benefiting from project* (ex. Traffic Count): 		 
*Actual number of Individuals benefiting from the project (might be different than the total population) 
F.	Detailed Project Budget (Form attached)
III.	REGIONAL OBJECTIVES (2 pts each)

A.	Does the project enhance economic development (ex. adds permanent jobs, brings in new business)?   qYes qNo If yes, please explain: 
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

B.	Does the project promote intergovernmental cooperation?  qYes qNo If yes, please explain:
_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

C.	Does it promote public health and safety? qYes qNo If yes, please explain:
_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

D.	Is the project included in regional or local plans such as a comprehensive plan, strategic plan, capital improvement (CIP) plan, hazard mitigation plan, or similar plans? qYes qNo 
If yes, please provide documentation and list the name of the plan.
________________________________________________________________________________________________________________________________________________________________
IV.	TRANSPORTATION PROJECT IMPACT (5 points each)

A.	Does it improve direct access to State Highway System? (explain):  	 

			 

B.	Does it provide direct access to an existing or planned employment center (ex. hospital, industrial park, commercial district)? Please describe and quantify to the extent possible:	

		 ________________________________________________________________________

		 ________________________________________________________________________

C.	Does it eliminate safety hazards? (please describe)    	

		 

V.	LOCAL EFFORT (not required, but up to 5 points are awarded for match)

A.	Narrative of local effort in the project/area (including Community/ County labor and equipment): 

________________________________________________________________________________________________________________________________________________________________

B.		Non-REAP Source*                                                   Non-REAP Funding Amount 

		 

	_______________________________________________________________________________

*Source may be local funds, other grant funds, volunteer labor (list # of hours at $10/hour) or donated materials (give actual or estimated worth). If the use of county crews and/or equipment is planned, please provide an estimate from the county.