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Plan Subapplication
Table 1 Start a subapplication
Subapplicant Section
Entry Information /Options
Complete/Comments
Organization you are
applying for
Organization you are
applying to
Subapplication title
Subapplication type
Plan
Document control number
(optional)
Subapplicant Information
Table 2 Subapplicant Information
Subapplicant Section
Entry Information /Options
Complete/Comments
Name of federal agency
FEMA
Type of submission
▪ Pre-application
▪ Application
▪ Changed/Corrected
application
Type of Subapplicant
▪ State Government
▪ Local Government
▪ Indian Tribal Government
▪ Special Governmental District
▪ Private Non-Profit
▪ Other
Is Subapplication subject to
review by Executive Order
12372 Process?
▪ Yes
▪ No, program is not covered by
E.O. 12372
▪ No, program has not been
selected by state for review
If Yes, this
preapplication/application was
made available to the
Executive Order 12372
Process for review on: (MM-DD-
YYYY)
Plan Subapplication
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Subapplicant Section
Entry Information /Options
Complete/Comments
Is the Subapplicant delinquent
on any Federal debt?
▪ Yes
▪ No
If yes, please provide an
explanation:
Contact information
Table 3 Add a Subrecipient Authorized Representative (SAR)
Subapplicant Section
Entry Information
/Options
Complete/Comments
Title
Prefix (optional)
▪ Mr.
▪ Ms.
▪ Mrs.
▪ Dr.
First Name
Middle Initial
Last Name
Agency/Organization
Primary phone
Extension (optional)
Type
▪ Home
▪ Work
▪ Mobile
Secondary phone
Extension
Type
▪ Home
▪ Work
▪ Mobile
Optional phone
Fax number
Email
Address line 1
Plan Subapplication
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Subapplicant Section
Entry Information
/Options
Complete/Comments
Address line 2
City
State/territory
ZIP code
ZIP extension
Phone
Fax
Table 4 Add a Point(s) of Contact
Subapplicant Section
Entry Information
/Options
Complete/Comments
Title
Prefix (optional)
▪ Mr.
▪ Ms.
▪ Mrs.
▪ Dr.
▪ Hon.
▪ Exe.
First Name
Middle Initial (optional)
Last Name
Primary phone
Extension (optional)
Type
▪ Home
▪ Work
▪ Mobile
Secondary phone
Extension (optional)
Type
▪ Home
▪ Work
▪ Mobile
Optional phone
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Subapplicant Section
Entry Information
/Options
Complete/Comments
Fax number (optional)
Email
Address line 1
Address line 2 (optional)
City
State/territory
ZIP code
ZIP extension (optional)
Community
Please find the community(ies) that will benefit from this mitigation activity by clicking on the Find
Communities button. If needed, modify the Congressional District number for each community by
entering the updated number under the U.S. Congressional District column for that community.
NOTE: You should also notify your State NFIP coordinator so that the updated U.S. Congressional
District number can be updated in the Community Information System (CIS) database.
Table 5 Add Communities
(Complete this table for each benefitting community)
Subapplicant Section
Entry Information
/Options
Complete/Comments
State
Community name (optional)
County name (optional)
County code
CID number
CRS community
▪ Yes
▪ No
CRS rating
1-10
U.S. Congressional District
Plan Subapplication
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Subapplicant Section
Entry Information
/Options
Complete/Comments
Please provide any additional
comments (optional)
Attachments
Mitigation Plan
Please provide your plan information.
Table 6 Mitigation Plan Information
Subapplicant Section
Entry Information
/Options
Complete/Comments
Is the entity that will benefit
from the proposed activity
covered by a current
FEMA approved multi-hazard
mitigation plan in compliance
with 44 CFR Part 201?
▪ Yes
▪ No
If Yes, please provide plan
information:
Plan name
Plan type
▪ State Multi-hazard
Mitigation Plan
▪ Tribal Multi-hazard
Mitigation Plan
▪ Local Multi-hazard
Mitigation Plan
▪ Tribal (Local) Multi-
hazard Mitigation
Plan
▪ Local
Multijurisdictional
Multi-hazard
Mitigation Plan
▪ Tribal (Local)
Multijurisdictional
Multi-hazard
Mitigation Plan
Is this plan standard or
enhanced? (for Applicants only)
▪ Standard
▪ Enhanced
Plan Subapplication
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Subapplicant Section
Entry Information
/Options
Complete/Comments
Plan approval date (MM-DD-
YYYY)
Proposed activity description
(optional)
Please provide any additional
comments (optional).
Attachments
Scope of Work
The project Scope of Work (SOW) identifies the eligible activity, describes what will be accomplished
and explains how the mitigation activity will be implemented. The mitigation activity must be
described in sufficient detail to verify the cost estimate. All activities for which funding is requested
must be identified in the SOW prior to the close of the application period. FEMA has different
requirements for project, planning and management cost SOWs.
Table 7 Scope of Work
Subapplicant Section
Entry Information /Options
Complete/Comments
Subapplication title (include type
of activity and location)
Activities
Primary activity type
▪ New Plan
▪ Plan update
▪ Planning related activities
▪ Partnerships
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Subapplicant Section
Entry Information /Options
Complete/Comments
Primary sub-activity type
▪ State Multi-hazard Mitigation
Plan
▪ Tribal Multi-hazard Mitigation
Plan
▪ Local Multi-hazard Mitigation
Plan
▪ Tribal (Local) Multi-hazard
Mitigation Plan
▪ Local Multijurisdictional Multi-
hazard Mitigation Plan
▪ Tribal (Local) Multijurisdictional
Multi-hazard Mitigation Plan
▪ Tribal Flood Mitigation Plan
▪ Local Flood Mitigation Plan
▪ Tribal (Local) Flood Mitigation
Plan
▪ Other Plan
If Partnerships is selected as a
primary activity type, these
additional primary sub-activity
type options are available.
▪ Assess needs
▪ Conduct mitigation tabletop
exercises
▪ Create informational portal
▪ Develop partnership case
studies and best practices
▪ Hold forums
▪ Host meetings
▪ Host trainings or webinars
▪ Identify partnerships
opportunities
▪ Research potential partners
▪
Other
If Other Plans or Other are
selected as the primary sub-
activity type, please specify
Secondary activity type (optional)
(see Primary activity type list
above)
Secondary sub-activity type
(optional)
(see Primary sub-activity type lists
above)
If Other Plans or Other are
selected as the secondary sub-
activity type, please specify
Plan Subapplication
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Subapplicant Section
Entry Information /Options
Complete/Comments
Tertiary activity type (optional)
(see Primary activity type list
above)
Tertiary sub-activity type
(optional)
(see Primary sub-activity type lists
above)
If Other Plans or Other are
selected as the tertiary sub-
activity type, please specify
Geographic areas description
Hazard sources
Primary hazard source
▪ Biological incident
▪ Chemical incident
▪ Civil disturbance
▪ Cyber incident
▪ Dam/Levee break
▪ Disease
▪ Drought
▪ Earthquake
▪ Explosion
▪ Extreme temperature
▪ Fire
▪ Flooding
▪ Hostile action
▪ Infrastructure failure
▪ Landslide/Debris flow
▪ Nuclear explosion
▪ Radiological incident
▪ Severe Storm
▪ Solar event
▪ Space object
▪ Tornado
▪ Tropical cyclone
(Hurricane/Typhoon)
▪ Tsunami
▪ Uncategorized
▪ Volcano
▪
Winter storm
Secondary hazard source
(optional)
(see list above)
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Subapplicant Section
Entry Information /Options
Complete/Comments
If Uncategorized, please specify
Evaluation process description
Implementation process
description
Primary sources description
Staff and resources description
Additional comments (optional)
Attachments
Schedule
Specify the work schedule for the mitigation activities. Add tasks to the schedule. Please include all
tasks necessary to implement this mitigation activity; include descriptions and estimated time
frames.
Table 8 Add a Task
(complete this table for each task)
Subapplicant Section
Entry Information /Options
Complete/Comments
Task name
Task description
Start month (number)
Task duration (in months)
Plan Subapplication
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Table 9 Schedule
Subapplicant Section
Entry Information
/Options
Complete/Comments
Estimate the total duration of your
proposed activities (in months).
Proposed start date (MM/DD/YYYY)
Proposed end date (MM/DD/YYYY)
Budget
Budget cost estimate should directly link to your scope of work and work schedule. You must add at
least one item greater than $0 for your cost estimate. Once you have added item(s) for your cost
estimate, you may then add the item(s) for management cost (optional). FEMA will provide 100
percent federal funding for subrecipient management costs for BRIC program activities. As
necessary, please adjust your federal/non-federal cost shares and add the non-federal funding
source(s) you are planning to use for this project.
Cost estimate is the line item(s) budget to support the scope of work for the execution and
completion of the project. Be sure to include the cost associated with revisions/formal adoption.
Table 10 Add cost estimate budget items
Subapplicant Section
Entry Information /Options
Complete/Comments
Cost type:
Cost estimate
Add an item (complete
table for each cost item)
Name of cost item
Quantity
Plan Subapplication
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Subapplicant Section
Entry Information /Options
Complete/Comments
Unit of measure
▪ Acre
▪ Cubic foot
▪ Cubic yard
▪ Day
▪ Each
▪ Foot
▪ Hour
▪ Inch
▪ Linear foot
▪ Mile
▪ Million board feet
▪ Square foot
▪ Square yard
▪ Square foot per inch
▪ Ton
Unit price
$
Unit total
Budget class
▪ Construction
▪ Contractual
▪ Equipment
▪ Fringe benefits
▪ Indirect charges
▪ Other
▪ Personnel
▪ Supplies
▪ Travel
Pre-award
▪ Yes
▪ No
Cost estimate total
$
Management cost (optional) is the line item(s) to support the scope of work for the execution and
completion of the project. Be sure to include the cost associated with managing the
project/initiative/activity. The total amount of management costs cannot exceed 5% of the total
Cost estimate amount.
Table 11 Add management cost budget items
Subapplicant Section
Entry Information /Options
Complete/Comments
Cost type:
Management cost
Item
▪ Equipment
▪ Office Space Rental
▪ Other
▪ Salaries
Plan Subapplication
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Subapplicant Section
Entry Information /Options
Complete/Comments
▪ Supplies
▪ Travel
Quantity
Unit of measure
▪ Acre
▪ Cubic foot
▪ Cubic yard
▪ Day
▪ Each
▪ Foot
▪ Hour
▪ Inch
▪ Linear foot
▪ Mile
▪ Million board feet
▪ Square foot
▪ Square yard
▪ Square foot per inch
▪ Ton
Unit price
$
Unit total
Budget class
▪ Construction
▪ Contractual
▪ Equipment
▪ Fringe benefits
▪ Indirect charges
▪ Other
▪ Personnel
▪ Supplies
▪ Travel
Pre-award
▪ Yes
▪
No
Management cost total
$
Table 12 Grand total
(Cost estimate total + Management cost total)
Subapplicant Section
Entry Information /Options
Complete/Comments
Program income (optional)
$
Plan Subapplication
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Cost share
Cost share or matching means the portion of project costs not paid by federal funds.
Hazard mitigation assistance (HMA) funds may be used to pay up to 75% federal share of the eligible
activity costs. Small impoverished communities may be eligible for up to 90% federal share for
Building Resilient Infrastructure and Communities (BRIC) funding. Flood Mitigation Assistance (FMA)
and severe repetitive loss (SRL) properties may be eligible for up to 100% federal share. FEMA will
provide 100 percent federal funding for subrecipient management costs for BRIC program activities.
Repetitive loss (RL) properties may be eligible for up to 90% federal share.
Table 13 Proposed federal vs non-federal funding shares
Subapplicant Section
Entry Information /Options
Complete/Comments
Is this a small impoverished
community?
(See Appendix for definition)
This determines your
federal/non-federal share ratio.
▪ Yes
▪ No
If Yes
▪ Federal Share Percentage 90%
▪
Non-Federal Share Percentage
10%
Based on total budget cost
$
Proposed federal share
$
Proposed non-federal share
If No
▪ Federal Share Percentage 75%
▪
Non-Federal Share Percentage
25%
Based on total budget cost
$
Proposed federal share
$
Non-federal funding share is that portion of the total costs of the program provided by the non-
federal entity in the form of in-kind donations or cash match received from third parties or
contributed by the agency. In-kind contributions must be provided, and cash expended during the
project period along with federal funds to satisfy the matching requirements.
Plan Subapplication
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Table 14 Add funding source
(Complete this table for each funding source)
Subapplicant Section
Entry Information /Options
Complete/Comments
Funding source
Name of source agency
Funding amount
$
Percent non-federal share by
source
%
Funding type
▪ Administration
▪ Cash
▪ Consulting fees
▪ Engineering fees
▪ Equipment operation/rental
▪ Labor
▪ Other
▪ Program income
▪ Supplies
Date of availability
(MM/DD/YYYY)
Fund commitment letter date
(MM/DD/YYYY)
Total percent non-federal share
Please provide any addition
comments (optional)
Attachments
Evaluation
Table 15 Evaluation
Subapplicant Section
Entry Information /Options
Complete/Comments
Is the applicant participating in the
Community Rating System (CRS)? Located
at https://www.fema.gov/national-flood-
insurance-program-community-rating-
system
▪ Yes
▪ No
If Yes, what is their CRS rating?
1-10
Plan Subapplication
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Subapplicant Section
Entry Information /Options
Complete/Comments
Is the applicant a Cooperating Technical
Partner (CTP)? Located at
https://www.fema.gov/cooperating-
technical-partners-program
▪ Yes
▪ No
Was this created from a previous FEMA
HMA Advance assistance/Project scoping
award?
▪ Yes
▪ No
If yes, please provide the project identifier.
Has the recipient adopted building codes
consistent with the International Codes?
Located at
https://www.iccsafe.org/advocacy
▪ Yes
▪ No
If Yes, enter year of building code.
If Yes, please provide the building code.
Have the applicant's building codes been
assessed on the Building Code
Effectiveness Grading Schedule (BCEGS)?
Located at
http://www.isomitigation.com/bcegs
▪ Yes
▪ No
If Yes, what is their BCEGS rating?
1-10
Describe involvement of partners to
enhance the mitigation activity outcome.
Discuss how this planning activity benefits
your community and how the plan/data
will be used to promote resiliency.
Additional comments (optional)
Attachments
Assurances and Certifications
Applicants should refer to the regulations cited below to determine the certification to which they are
required to attest. Applicants should also review the instructions for certification included in the
regulations before completing this form.
Plan Subapplication
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Table 16 Lobbying
Subapplicant Section
Entry Information /Options
Complete/Comments
As required by section 1352, Title 31 of
the U.S. Code, and implemented at 44
CFR Part 18, for persons entering into a
grant or cooperating agreement over $
100,000, as defined at 44 CFR Part 18,
the applicant certifies that:
(a) No Federal appropriated funds have
been paid or will be paid, by or on behalf
of the undersigned, to any person for
influencing or attempting to influence an
officer or employee of any agency, a
Member of Congress, an officer or
employee of Congress, or an employee of
a Member of Congress in connection with
the making of any Federal grant, the
entering into of any cooperative
agreement, and the extension,
continuation, renewal, amendment, or
modification of any Federal grant or
cooperative agreement.
(b) If any other funds than Federal
appropriated funds have been paid or will
be paid to any other person for
influencing or attempting to influence an
officer or employee of any agency, a
member of Congress, an officer or an
employee of Congress, or employee of a
member of Congress in connection with
this Federal Grant or cooperative
agreement, the undersigned shall
complete and submit Stand Form-LLL,
"Disclosure of Lobbying Activities," in
accordance with its instructions.
(c) The undersigned shall require that the
language of this certification be included
in the award documents for all
subawards at all tiers (including
subgrants, contracts under grants and
cooperative agreements, and
subcontracts) and that all subrecipients
shall certify and disclose accordingly.
▪ Applicant will NOT use
federal appropriated funds
for lobbying purposes.
▪ Applicant will use non-
appropriated funds for
lobbying purposes. If so,
complete Standard Form
LLL “Disclosure of
Lobbying Activities” below.
Plan Subapplication
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Table 17 Standard Form-LLL "Disclosure of Lobbying Activities"
Subapplicant Section
Entry Information /Options
Complete/Comments
This form must be attached to
certification if non-appropriated
funds are to be used to influence
activities.
1. Type of federal action:
▪ Contract
▪ Cooperative agreement
▪ Grant
▪ Loan
▪ Loan guarantee
▪ Loan insurance
2. Status of federal action:
▪ Bid/offer/application
▪ Initial award
▪ Post award
3. Report Type:
▪ Initial filing
▪
Material change
4. Name and address of reporting
entity:
▪ Prime
▪ SubAwardee
If SubAwardee, enter tier, if
known: (optional)
Name
Street 1
Street 2 (optional)
City
State (optional)
Zip (optional)
Zip extension (optional)
Congressional district, if known:
(optional)
5. If SubAwardee, enter name and
address of prime below.
Name
Street 1
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Subapplicant Section
Entry Information /Options
Complete/Comments
Street 2 (optional)
City
State (optional)
Zip (optional)
Zip extension (optional)
Congressional district, if know:
(optional)
6. Federal department/agency:
7. Federal program
name/description:
CFDA number, if applicable:
(optional)
8. Federal action number, if
known: (optional)
9. Award amount, if known:
(optional)
$
10. Name and address of lobbying
registrant:
Prefix (optional)
▪ Dr.
▪ Miss
▪ Mr.
▪ Mrs.
▪ Ms.
▪ Rev.
First name
Middle name (optional)
Last name
Suffix (optional)
▪ Jr.
▪ MD
▪ PHD
▪ Sr.
Street 1
Plan Subapplication
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Subapplicant Section
Entry Information /Options
Complete/Comments
Street 2 (optional)
City
State (optional)
Zip (optional)
Zip extension (optional)
10b. Individual performing
services: (including address
if different from No. 10a)
Prefix (optional)
▪ Dr.
▪ Miss
▪ Mr.
▪ Mrs.
▪ Ms.
▪ Rev.
First name
Middle name (optional)
Last name
Suffix (optional)
▪ Jr.
▪ MD
▪ PHD
▪ Sr.
Street 1
Street 2 (optional)
City
State (optional)
Zip (optional)
Zip extension (optional)
Plan Subapplication
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Subapplicant Section
Entry Information /Options
Complete/Comments
11. Information requested
through this form is
authorized by title 31 U.S.C.
section 1352. This disclosure
of lobbying activities is a
material representation of fact
upon which reliance was
placed by the tier above when
the transaction was made or
entered into. This disclosure is
required pursuant to 31 U.S.C.
1352. This information will be
reported to the Congress
semi-annually and will be
available for public inspection.
Any person who fails to file the
required disclosure shall be
subject to a civil penalty of not
less than $10,000 and not
more than $100,000 for each
such failure.
Table 18 Drug-Free Workplace
(Grantee other than individuals)
Subapplicant Section
Entry Information /Options
Complete/Comments
As required by the Drug-Free
Workplace Act of 1988, and
implemented at 44 CFR Part 17,
Subpart F, for grantees, as defined at
44 CFR Part 17.615 and 17.620.
A. The applicant certifies that it will
continue to provide a drug-free
workplace by;
(a) Publishing a statement notifying
employees that the unlawful
manufacture, distribution,
dispensing, possession, or use of
a controlled substance is
prohibited in the grantee's
workplace and specifying the
actions that will be taken against
employees for violation of such
prohibition;
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Subapplicant Section
Entry Information /Options
Complete/Comments
(b) Establishing an on-going drug
free awareness program to
inform employees about
(1) The dangers of drug abuse in
the workplace;
(2) The grantee's policy of
maintaining a drug-free
workplace;
(3) Any available drug
counseling, rehabilitation,
and employee assistance
programs; and
(4) The penalties that may be
imposed upon employees for
drug abuse violations
occurring in the workplace.
(c) Making it a requirement that
each employee to be engaged in
the performance of the grant to
be given a copy of the statement
required by paragraph (a);
(d) Notifying the employee in the
statement required by paragraph
(a) that, as a condition of
employment under the grant, the
employee will-
(1) Abide by the term of the
statement; and
(2) Notify the employee in writing
of his or her conviction for a
violation of a criminal drug
statute occurring ion the
workplace no later than five
calendar days after such
convictions.
Plan Subapplication
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Subapplicant Section
Entry Information /Options
Complete/Comments
(e) Notifying the agency, in writing,
within 10 calendar days after
receiving notice under
subparagraph (d)(2) from an
employee or otherwise receiving
actual notice of such conviction.
Employers of convicted
employees must provide notice,
including position, title, to the
applicable FEMA awarding office,
i.e., regional office or FEMA
office.
(f) Taking one of the following
actions, within 30 calendar days
of receiving notice under
subparagraph (d)(2), with respect
to any employee who is
convicted-
(1) Taking appropriate
personnel action against
such an employee, up to
and including termination,
consistent with the
requirements of the
Rehabilitation act of 1973,
as amended; or
(2) Requiring such an employee
to participate satisfactorily
in a drug abuse assistance
or rehabilitation program
approved for such purposes
by a Federal, State, or local
health, law enforcement, or
other appropriate agency;(g)
Making a good faith effort to
continue to maintain a drug
free workplace through
implementation of
paragraphs (a), (b), (c), (d),
(e) and (f).
B. The grantee may insert in the
space provided below the site(s)
for the performance of work done
in connection with the specific
grant:
Plan Subapplication
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Subapplicant Section
Entry Information /Options
Complete/Comments
Place of performance (street address,
city, county, state, ZIP code) (optional)
There are workplaces on file that are
not identified.
Yes
