CYWB Mini Grant Application

Guidelines and Instructions

Below is application form

Organization Name

Street Address, City, State and Zip

Tax ID Number

City of Bellevue Business License Number (if known)*

* Business license required in order to receive mini-grant reimbursement.

Contact Person

Title

Phone Number

Email

Project Lead (If different from contact person)

Title

Phone Number

Email

What is the primary business or activity at this location?

Does your organization currently have employee bike parking, transportation programs and/or supporting facilities/amenities, at this worksite?

If yes, please check all activities involved in your program:

Is the proposed mini-grant project a new employee transportation project/program, or an expansion of a current program element?

Project Title

What is the purpose of implementing the project? Provide background on why the project is important/beneficial or what need/gap it will fill. How will it boost participation in non-drive-alone commuting?

Project Description: Describe what will be implemented, including any parking management changes, campaigns, events, educational materials, incentives, and capital or project-specific software purchases.Capital purchase items may include items such as bike racks, way-finding signs for showers, lockers and bike facilities, carpool/vanpool program related items such as signage and hangtags and locker/shower facilities. Software may purchased if it is specifically for commute or parking management to reduce drive-alone commuting. Indicate whether the project is a component of a larger effort being undertaken by your organization for reducing drive-alone commute trips. If the project is a daily parking pricing project, describe here the detailed monthly and daily price comparison, in-and-out privileges (explanation required if not included), and which employees are eligible for daily parking,including count of those eligible. See page 4 in the "Rules" section in the PDF linked at the top of this form for eligibility requirements for daily parking projects.

How will this project impact drive-alone commuting at your worksite?

What is the project timeline or start/end date? (In order to receive reimbursement, all projects must be completed and an itemized invoice with original receipts, plus a project evaluation, must be submitted to the City of Bellevue by October 31 of the year following the year the application is submitted.

How will you ensure delivery of the project? Who will perform the work required to administer the project? If this person is no longer available to facilitate the project, who will ensure the project is completed?

Capital Costs

Incentives

Marketing materials

Other (Identify)

Total Project Cost

Total Grant amount requested

Please indicate any additional funds your organization will be contributing to this project

How many employees are located at your worksite? Please describe types of employees and number in each category type (full-time,part-time, permanent, temporary, etc.)

How many employees do you anticipate participating in the project? Please explain their involvement.

How will you invite/involve employee participants?

Please estimate how many new non-drive-alone commuters, or commute trips per month, that you expect as a result of the project. Include a description of your method for estimating.

Why/how do you anticipate this project will increase the number of employees/tenants using a non-drive-alone commute mode?

Please estimate how many project participants are likely to continue using non-drive-alone commute modes once the project has ended. (Note: On the Project Evaluation form, you will be asked to identify/estimate the number of employees/tenants switching from drive-alone to each non-drive-alone commute mode.)

Will your organization be willing to continue to the fund this project once mini-grant funding is fully expended? If not, what can you do to encourage the continuation of this project/program(if applicable)?

I understand this mini-grant operates on a reimbursement basis and that our organization will need to make expenditures and subsequently submit documentation to the City of Bellevue for reimbursement.