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APPLICATION FOR HIGHWAY SAFETY PROJECT REIMBURSEMENT GRANT <br /> STATE OF HAWAII SAFE COMMUNITY PROGRAM -SAFETY OFFICE <br /> FOR SCP-SO IISE ONLY <br /> PART I <br /> (Applicant to Complete) Project Number: OPOS-OS (02-H-01) <br /> 1. APPLICANT (Name and Address) Title: HCPD CIOT BASKETBALL TOURNAMENT <br /> Hawaii County Police Department <br /> 349 Kapiolani Street Standard Area OP <br /> Hilo, Hawaii 96720 <br /> 2. AGENCY UNIT (Name and Address) <br /> Hawaii County Police Department Effective Date: 10/1/04 <br /> 349 Kapiolani Street, Hilo, Hawaii 96720 Federal Funds Obli ated <br /> g 5 15,444.00 <br /> 3. DURATION (Month, Day, Year) <br /> A. Grant Period B. Project Period FY Funds OS Addendum_YES _~NO <br /> From: 10-01-04 From: 10-01-04 <br /> Benefit of STATE 7{ COUNTY <br /> To: 09-30-OS To: 09-30-OS <br /> 4. LOCATION OF PROJECT Sa. Type of Application (Check Appropriate Item(s) <br /> Hawaii County Police Department x Initial Revision Continuation <br /> 349 Kapiolani Street <br /> Hilo, Hawaii 96720 Sb. REIMBURSEMENT SCHHDIILE DESIRED <br /> Monthly x Quarterly <br /> 6. PROJECT DESCRIPTION (Schedule A) <br /> 7. PROJECT OBJECTIVES AND TASKS SDMMARY 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 improving awareness of state laws. <br /> 8. BUDGET (Schedule B) <br /> BA. COST CATEGORY Total <br /> Expenditures <br /> Grant Period Prior Years Project Period <br /> (1) Personal Services $3744.00 $7488.00 $11,232.00 <br /> (2) Consultant Services <br /> $o $0 $0 <br /> (3) commodities $7soo.oo $ls,ooo.oo S2z,soo.oo <br /> (4) Other Direct/Indirect Costs $1000.00 $2000.00 $3000.00 <br /> TOTAL ESTIMATED COSTS (Inc. Non-Fed. Share) $15,444.00 $30,888.00 $46,332.00 <br /> 8B. SOIIRCE OF FIINDS C. SPECIFY HOW NON-FEDERAL <br /> (1) Federal (100 & of TOTAL) $15,444.00 SHARE WILL SE PROVIDED <br /> (2) Applicant Age <br /> 9. MILHSTONES (Schedule C) <br /> 10. AGREEMENT OF UNDERSTANDING AND COMPLIANCE (See Schedule D, attached) <br /> 11. ACCHPTANCS OP CONDITIONS. It is understood and agreed by the undersigned that a reimbursement grant received as a <br /> result of this application is suhject to Public Law 89-564 (Highway Safety Act of 19661 and all administrative <br /> regulations 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 /> incorporated herein and made a part of this application. Authorization to proceed with this Highway Safety Project is <br /> <br /> requested. <br /> 11A. PROJEC DIRECTOR 118. AIITHO ING FFZCZAL OF AGENCY IINIT <br /> Signatur <br /> Signature <br /> Name HAR KUBO Narne HARRY KIM <br /> Title ACTING POLICE CHIEF Title MAYOR <br /> Date Date <br /> To be prepared by applicant, use separate sheets as required. Form HS 3-71 Rev. 7/14/00 <br /> <br />