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<br /> <br /> <br /> <br /> APPLICATION FOR HIGHWAY SAFETY PROJECT REIMBURSEMENT GRANT <br /> STATE OF HAWAII SAFE COMMUNITY PROGRAM - SAFETY OFFICE <br /> <br /> FOR SCP-SO USE ONLY <br /> PART I <br /> (Applicant to complete) Project Number: OP05-05 (01-H-02) <br /> 1. APPLICANT (Name and Address) Title: HCPD Seat Belt <br /> Hawaii County Police Department <br /> 349 Kapiolani Street Standard Area Op <br /> Hilo, Hawaii 96720 <br /> 2. AGENCY UNIT (Name and Address) Effective Date: 10/l/04' <br /> Hawaii County Police Department <br /> 349 Kapiolani Street, Hilo, Hawaii 96720 Federal Funds obligated <br /> $ 60,000.00 <br /> 3. DURATION (Month, Day, Year) <br /> A. Grant Period B. Project Period FY Funds 05 Addendum_YES _X_ NO <br /> From: 10-01-04 From: 10-01-04 <br /> To: 09-30-05 To: 09-30-05 Benefit of STATE -X_ COUNTY <br /> j4. LOCATION OF PROJECT Sa. Type of Application (Check Appropriate Item(s) <br /> Hawaii County Police Department -Initial -Revision Continuation <br /> 349 Kapiolani Street <br /> Hilo, Hawaii 96720 5b. REIMBURSEMENT SCHEDULE DESIRED <br /> Monthly x Quarterly <br /> 6. PROJECT DESCRIPTION (Schedule A) <br /> 7. PROJECT OBJECTIVES AND TASKS SUMMARY FROM SCHEDULE A The project objectives are to <br /> reduce fatalities and injuries to front seat occupants, and rear seat occupants aged <br /> 17 and under, of motor vehicle collisions by increasing the usage rate of seat belts. <br /> 8. BUDGET (Schedule B) <br /> 8A. COST CATEGORY Total <br /> Expenditures <br /> Grant Period Prior Years Project Period <br /> (1) Personal Services $60,000.00 $226,911.00 $286,911.00 <br /> (2) Consultant Services $0 $0 $0 <br /> (3) Commodities $0 $3300.00 $3300.00 <br /> (4) Other Direct/Indirect Costs $0 $0 $0 <br /> TOTAL ESTIMATED COSTS (Inc. Non-Fed. Share) $60,000.00 $2301211.00 $290,211.00 <br /> 8B. SOURCE OF FUNDS C. SPECIFY HOW NON-FEDERAL <br /> (1) Federal (100 8 of TOTAL) $60,000.00 SHARE WILL BE PROVIDED <br /> (2) Applicant Age <br /> 9. MILESTONES (Schedule C) <br /> 10. AGREEMENT OF UNDERSTANDING AND COMPLIANCE (See Schedule D, attached) <br /> .1. ACCEPTANCE OF CONDITIONS. It is understood and agreed by the undersigned that a reimbursement grant received as a <br /> -esult of this application is subject to Public Law 89-564 (Highway Safety Act of 1966) and all administrative <br /> -egulations governing grants established by the U.S. Department of Transportation and the State of Hawaii. It is <br /> expressly agreed that this project constitutes an official part of the Hawaii Highway Safety Program and that said <br /> applicant agency will meet the requirements as set forth herein, including accompanying schedules A,B,C & D, which are <br /> ncorporated herein and made a part of this application. Authorization to proceed with this Highway Safety Project is <br /> 'equested. <br /> 11A. PROJ CT DIRECTOR 11B. AUTHORI NG OFFICIAL OF AGENCY UNIT <br /> Signature Signature <br /> Name R Name RY KIM <br /> Title ACTING POLIO H F Title MAYOR <br /> Rru C% -nn.. <br /> Date AUG Date <br /> 0 <br /> To be prepared by applicant, use separate sheets as required. Form HS 3-71 Rev. 7/14/00 <br />