Go Human Community Hubs Application

2023 Go Human Community Hubs Application
Overview
The Southern California Association of Governments (SCAG) and Go Human announce the Call for Projects for the Go Human Community Hubs Program (Community Hubs Program). With support from the California Office of Traffic Safety, the Community Hubs Program provides grant funding to successful eligible applicants to implement traffic safety strategies by leveraging community gathering and resource sites.

In alignment with and furtherance of SCAG's Racial Equity Early Action Plan, the Community Hubs Program prioritizes outcomes for those most harmed by traffic injuries and fatalities, including without limitation Black, Indigenous and People of Color; disabled people; and frontline workers.

For fillable PDF application, follow this link.
Program Guidelines & FAQs
Applicants are invited to review the Community Hubs Program Guidelines and Frequently Asked Questions (FAQs). If applicants have additional questions, they may submit questions or request additional information by email with “Community Hubs Program” in the subject line to Stephen Patchan at spatchan@markthomas.com.
Application Submittal Instructions
Complete the following application pages and include all necessary attachments in your submittal.

If you have any questions pertaining to the application, email Stephen Patchan at spatchan@markthomas.com.

Applications are due by April 21, 2023 11:59 p.m. Any applications received after that time will not be considered.

Application Check List
Review the checklist to ensure eligibility and readiness to apply for the Community Hubs program.
Can you complete your project within the grant implementation period (May-August 31, 2023)? *
If not, consider reducing your scope.
Can your organization obtain the necessary permits to implement the proposed project within the project implementation period (ending in August 2023)?*
Is your Organization eligible for a Community Hubs Grant? *
If not, consider partnering with an eligible organization.
Are your costs allowed?*
To confirm eligible costs, refer to the Project Guidelines.
Can you provide the required insurance?*
To confirm insurance requirements regarding the project, refer to the Project Guidelines
If Awarded a Community Hubs grant, would your organization be able to provide and/or secure the following required components:
Submission of the Mid-Project Update, Final Report, and deliverables required by the Community Hubs Program? *
Lean more about the reporting requirements you will need to comply with if awarded in the Program Guidelines.
A Letter of Support from the local jurisdiction in which the project is being implemented?*
If you are proposing activities that utilize the facilities of another agency or organization, a Letter of Support from that agency or organization?*
A Unique Entity Identifier (UEI)? *
As provided by SAM.gov.
A W-9?*
A 501(c)3 incorporation letter (for nonprofits and community-based organizations) or business license (for social enterprises)? *

Scope of Work
This completed application will serve as the Scope of Work for your project, should it be selected for an award. SCAG may require Community Hubs Program Awardees (“Awardees”) to revise their Scope of Work prior to the implementation period. The implementation period for all projects shall begin no sooner than May/June 2023, pending finalization of the MOU. The project ends on August 31, 2023. The Scope of Work includes two tasks:

Task 1: Project Implementation (May/ June 2023 - August 31, 2023)

Awardee shall perform the activities, as approved by SCAG to implement traffic safety strategies by leveraging community gathering and resource sites.

Deliverables:

• Documentation of project implementation, including photos, videos, surveys, etc.

• Mid-Project status update (via phone or e-mail)

• Promotional Outreach Materials (including fliers, etc.)

Task 2: Final Report and Documentation (due September 8, 2023)

Awardee shall provide a short final report of the project that summarizes the implemented strategies, activities, outcomes, reach, impact, and photo documentation. SCAG shall provide a short Final Report template to streamline compilation.

Deliverables:

• Final Report

Applicant Information
Organization Name:*
Contact Name:*
Phone Number:*
Email: example@example.com*
Website:*
Social Media handles (Facebook, Instagram, Twitter, TikTok, LinkedIn):
Brief description of organization: Provide a short description of your organization including mission, goals, and demographics and communities served. *

100 words0/100
Organization Type:*

Community-Based OrganizationNon-Profit OrganizationSocial Enterprise
Has your agency been debarred or suspended (as listed on SAM.gov)?*
Does your organization have a fiscal sponsor?*
If yes, please identify the fiscal sponsor.
Have you worked with SCAG before or received funding from SCAG?*
Can you provide proof of the following required insurance and are you able to meet SCAG's insurance requirements? Refer to pages 5-7 of the Program Guidelines for Insurance Requirements. Note: Project Scope of Work may alter insurance requirements.*

General LiabilityAutomobile LiabilityWorkers CompensationProfessional Liability
If your organization is unable to meet specific requirements, please identify which requirements you are unable to comply with.
Applicants without insurance may be considered on a case-by-case basis.

Project Information
Project Name:*
Project City/ Jurisdiction:*
Project County:
Project Area: (Enter city, unincorporated area, neighborhood, or community):*
Total Funding Request:*
Not to exceed $40,000
Will your project require any of the following elements? Check all that apply.

Kit of Parts Technical AssistanceGo Human Co-branded AdsSpecial PermitsCity Council approvals

Problem Statement
Describe the communities your project will serve and how it will prioritize outcomes for those most harmed by traffic injuries and fatalities. (10 points)*

200 words0/200
What are the primary safety needs or issues this project will address? (10 points)*

200 words0/200

Proposed Project
Summarize the proposed traffic safety strategy. What actions will you take during the implementation period to address the stated traffic safety issues of the community described in the Problem Statement? (10 points)*

300 words0/300
What are the anticipated objectives and outcomes? How will your project track and evaluate outcomes and effectiveness? (10 points) *

300 words0/300
How many people do you anticipate reaching? *
(5 points)
Explain the steps you will take to reach this audience. How long does this proposed project strategically leverage or create a community network or gathering site (whether physical or virtual)? (15 points)*

350 words0/350

Qualifications
What are your qualifications to carry out this project? Please include your qualifications in relation to the experience in carrying out similar projects and the communities described in the Problem Statement. (10 points)*

200 words0/200
How do you plan to implement your project within the implementation period and within budget? (10 points)*

200 words0/200

Project Timeline
Please detail the key dates for project steps and actions. Include major milestones, including but not limited to, project start and end dates, securing permits, City Council approvals, Kit of Parts Safety Demonstration project dates (if applicable), events, messaging materials distribution dates, helmet distribution, etc.
Project Start:

MonthDayYear
Project implementation should begin mid-May, 2023.
Project End:

MonthDayYear
Project implemention shall end by August 31, 2023.
Secure Permits:

MonthDayYear
Date
City Council Approval:

MonthDayYear
Date
Kit of Parts Safety Demonstration Project Dates (if applicable):

MonthDayYear
Date
Events:

MonthDayYear
Date
Messaging Materials Distribution:

MonthDayYear
Date
Helmet Distribution:

MonthDayYear
Date
Other:
Other Date:

MonthDayYear
Date
Other:
Other Date:

MonthDayYear
Date

Project Budget
Using the budget template, please identify the labor costs to successfully complete your project. Upload the budget and supporting documentation as an attachment to this application.

Instructions

• Applicant Information. Fill out your organization information and project title.

• Job Titles and Hourly Rates. List the job titles of all staff that will work on your Go Human Community Hub project under “Direct Labor Classification(s).” List job titles and not names (e.g., Executive Director, Program Coordinator, Assistant, etc.). List the hourly rate for each staff under “Maximum Hourly Rate.” You must support the hourly rate with documentation that includes that hourly rate. Do not include overhead and fringe benefits costs to the hourly rate.

• Other Direct Costs. List the other direct costs under “Other Direct Costs”. Other direct costs include eligible hard costs such as printing, permit costs, bicycle helmets, equipment rentals. It may also include services, such as photography and videography. The costs should include cost per unit and quantity information in the Other Direct Cost Description line (e.g., Bike Lights $25/each for 60 units). Third-party contractors must be listed in Other Direct Costs and not Labor, and shall be limited to no more than $10,000. The other direct costs as well as third-party contractor costs must accompany sufficient documentations to substantiate the costs (e.g. a screenshot of the unit cost from widely recognized retailer website, a quote for the services and rentals) and are subject to SCAG’s procurement standards (documentation supporting the procurement process may be requested). For information on allowed and un-allowed costs, please refer to the Guidelines.

• Enter Number of Labor Hours. Fill out how many hours each job title will work, by task. The spreadsheet automatically calculates the cost.

Download Budget Template Here

Download Budget Guidance Here

Please upload Project Budget on next page.

Attachments
Please attach the required documentation. You may also include additional material that is necessary to complete other portions of your application.

Required attachments include:
Project Budget*

Cancelof
Budget Supporting Documentation*

Cancelof
Letter of Support from local jurisdiction or elected official from which the project will be implemented*

Cancelof
If applicable, Letter of Support from agency or organization providing facilities

Cancelof
Should be Empty:

2023 Go Human Community Hubs Application

Overview

Program Guidelines & FAQs

Application Submittal Instructions

Application Check List

Scope of Work

Applicant Information

Project Information

Problem Statement

Proposed Project

Qualifications

Project Timeline

Project Budget

Attachments