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Chester County Government

arpa@chesco.org

610-344-6000

American Rescue Plan Act Application

Applicant Information

Attach municipal plan

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Address

Attach bios of key staff

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Project Information

Project Location

Estimated Project Start Date

Date Picker

Estimated Project End Date

Date Picker

All award recipients must fall into one of the following six categories:

Services to Disproportionately Impacted Communities (Funds must be used to provide services to communities disproportionately impacted by the COVID-19 public health emergency.)

Infrastructure (Funds must be used to provide or improve water, sewer, or broadband infrastructure.)

Negative Economic Impact (Funds must be used to respond to negative economic impacts of the COVID-19 public health emergency, including to households and small businesses.)

Premium Pay (Funds must be used to provide premium pay to predetermined sectors as described in the Final Rule.)

Public Health Response (Funds must be used to respond to COVID-19 and the broader health impacts of COVID-19 and the COVID-19 public health emergency.)

Provision of Government Services (Funds must be used to provide government services. Government services generally include any service traditionally provided by a government, unless Treasury has stated otherwise.)

What type of problem will this project address?

The Premium Pay category requirements are as follows:

  1. Premium pay may be awarded to eligible workers up to $13 per hour.
  2. Premium pay may not exceed $25,000 for any single worker during the program.
  3. Eligible worker categories.
  4. Must perform “essential work” and teleworking is not permitted.
  5. Eligible worker is earning at or below 150 percent of their residing areas average annual wage.
  6. Eligible worker is not exempt from the FLSA overtime provisions.

Project Budget

Attach all federal, state, local, and/or private funding designated for this project. List source, dates, amounts requested, and amounts received. Also include potential funding that has been applied for but has not yet been awarded, donations, volunteers, matching funds, in-kind funds, etc. PLEASE ATTACH AS ONE DOCUMENT.

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Attach an overview of expenses including salaries, contracted services, materials, marketing, etc. PLEASE ATTACH AS ONE DOCUMENT.

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Project Outcomes and Reporting

Applicant's Auditing and Fiscal Controls

Contingency Plan

Attach letters of support if available

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Legal Considerations

Attach a detailed explanation of amount owed.

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Attach competitive quotes, proposals and/or bids.

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Grant Funding Agreement

If selected for an award, your organization will be required to sign a Grant Funding Agreement. Please review the sample agreement and confirm your organization would be willing and able to enter this agreement.

Sample Grant Funding Agreement

Grant Funding Agreement Acknowledgement

Affidavit

Certification: I hereby declare, pursuant to 18 Pa.C.S. § 4904, that the information contained in this application is true and correct based upon my personal knowledge, information, and belief. I further certify that the information provided in this application and the information provided in any and all supporting documents and forms is true and accurate in all material respects and that I am authorized to submit this application. I acknowledge that the County of Chester is relying on this application to determine eligibility for this grant and any false information contained herein may result in the repayment of the funds to the County of Chester and/or the United States Federal Government.

ARPA Regulations and Guidelines Agreement

Funding Source

Applicant Status

Disclosures

Audit Acknowledgement

The County of Chester provides equal grant opportunities to all applicants and prohibits discrimination and harassment of any type with regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, political affiliation, or any other characteristic protected by federal, state, or local laws. This policy prohibits any recipients of financial assistance under covered grants from the County of Chester from discrimination in any “project,” irrespective of the amount of financial assistance the recipient receives. The term “project” refers to all of the operations of a recipient, even if non-covered funds support a particular operation.

Right to Know Disclosure

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