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APPLICATION FOR HIGHWAY SAFETY PROJECT REIMBURSEMENT GRANT <br />STATE OF HAWAII SAFE COMMUNITY PROGRAM — SAFE COMMUNITIES STAFF <br />PART I <br />FOR SCP -SCS USE ONLY <br />(Applicant to Complete) <br />G O CIAL OF AGENCY UNIT <br />Sign tare <br />Project Number: <br />Signature <br />1. APPLICANT (Name and Address) <br />Title: HPD Traffic Investigation <br />Hawaii Police Department , <br />Name <br />349 Kapiolani Street <br />Standard Area_Tiaffic Services <br />Hilo, Hawaii 96720 <br />Title <br />2. AGENCY UNIT (Name and Address) <br />Effective Date: 10-61-08 <br />Hawaii Police Department <br />Date <br />349 Kapiolani Street, Hilo, Hawaii 96720 <br />Federal Funds Obligated $18,570 <br />3. DURATION (Month, Day, Year) <br />A. Grant Period B. Project Period <br />FY Funds 09 Addendum _YES X NO <br />From: 10-01-08 From: 10-01-08 <br />Benefit of_ STATE X COUNTY <br />To: 09-30-09 To: 09-30-09 <br />4. LOCATION OF PROJECT <br />5a. TYPE OF APPLICATION [Check Appropriate Item(s)] <br />Hawaii Police Department <br />x Initial _ Revision _ Continuation <br />349 Kapiolani Street <br />Hilo, Hawaii 96720 <br />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 goal of this -project is to improve speed <br />and alcohol related fatal traffic investigations. <br />8. BUDGET Schedule B <br />8A. COST CATEGORY <br />Total <br />.-Grant Period <br />Expenditures Project Period <br />Prior Years <br />1 Personal Services <br />$12,570.00 <br />2 Consultant Services <br />$0 <br />3 Commodities <br />$6,00-0--.0-0 <br />4 Other Direct/Indirect Costs <br />$0 <br />TOTAL ESTIMATED COSTS Inc. Non -Fed. Share)_$18,570.00 <br />C. SPECIFY HOW NON-FEDERAL <br />8B. SOURCE OF FUNDS <br />(1) Federal (100 % of TOTAL) <br />$18,570.00 <br />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 />11. ACCEPTANCE OF CONDITIONS. It is understood and agreed by the undersigned that a reimbursement grant received as a result of this <br />application is subject to Public Law 89-564 (Highway Safety Act of 1966) and all administrative regulations governing grants established by the <br />U.S. Department of Transportation and the State of Hawaii. It is expressly agreed that this project constitutes an official part of the Hawaii <br />Highway Safety Program and that said applicant agency will meet the requirements as set forth herein, including accompanying schedules A,B,C <br />.e, n herein anll marte a nart of this annlicatinn. Autihnrization to nroceed with this Hiehwav Safety Proiect is requested. <br />11A. PR <br />JEC atZR2 <br />11B. AUT <br />G O CIAL OF AGENCY UNIT <br />Sign tare <br />Signature <br />Name <br />Paul K. Ferreira <br />Name <br />DIXIE Kmsu <br />Title <br />Acting Police Chief <br />Title <br />ACTING MAYOR <br />Date <br />SEP 2 4 7nng <br />Date <br />SEP 3 0 2008 <br />To be prepared by applicant, use separate sheets as required. EXHIBIT "A" Form HS 3-71 Rev. 04/07 <br />