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New Century Construction/Renovation Grant Application, March 2008Application Deadline: Monday, May 5, 2008, 5:00 p.m. Please return original application plus six copies to: Linda Lord Application
Please type or print. Please write N/A for any items not applicable. Project Title ______________________________________ e.g. Expansion of Children’s Room; Expansion of Meeting Room; New Library Construction Project Replacing 100 year Old Building, Renovating Building to Improve Accessibility; etc. (Note: We are often asked to place grant information into a database and need a short, descriptive title in order to do this.) Please remember that a 1 to 1 local funding match is a legislative requirement of receiving this grant. E.G. If you are requesting the maximum grant of $50,000, you must have a $50,000 local match. 1. Name of Applicant Library _______________________________________________ 2. Address ______________________________________________________________ 3a. Name of Project Director ________________________________________________ 3b. Title of Project Director _________________________________________________ 4. Address (if different from No. 2 above) _____________________________________ ________________________________________________________________________ 5. Telephone number _______________________ Fax __________________________ 6. Email ________________________________________________________________ 7. Check one: Our library is a member of the ____ Central ____ Northern ____ Southern Maine Library District 8. Criteria: The Maine Library Commission has unanimously agreed to utilize the 2007 Maine Public Library Minimum standards, with the exception of the physical facility standards, as the criteria for judging applications. Libraries not meeting the physical facility standards must gear their grant applications to projects which would allow them to meet those standards. The Commission also agreed that grants are to be capped at $50,000 per applicant. Does this library meet the 2007 Maine Public Library Minimum standards set forth in Maine Public Library Standards 2007 with the exception of the facilities standards? ________ Yes _________ No If the response is no, your application will not be evaluated. The Maine Library Commission has set the other minimum public library standards as mandatory requirements for grant eligibility. If your grant application will help your library achieve a minimum facility standard, it will be accepted and rated. 9. Type of construction project (check one and include description): _____ New building (Brief description) _____ Renovation of existing building (Brief description) _____ Expansion of existing building (Brief description) 10. Do you have a program building statement? ______ yes ______ no If yes, please send one copy. 11. Name of your library building consultant _____________________________ Address _____________________________________________ Telephone number _____________________ 12. Have preliminary schematics been prepared? _____ yes (please send one copy) _____ no 13a. Name of Maine registered engineer associated with this project. _____________________________ Address ___________________________________ Telephone number ____________________________ 13b. Name of Maine registered architect associated with this project. _____________________________ Address ___________________________________ Telephone number ____________________________ 14. Earliest date construction can begin ________________________________ 15. Projected ending date of project __________________________________ 16. Date applicant last received a major construction grant ________________ Was the award from: _____ state _____ federal _____ or other (e.g. Stephen and Tabitha Foundation)? Amount of the award ____________________ 17. Population of town in which library is located _______________________ 18. Population of library’s legal service area ____________________________ 19. Please complete the following chart if any change will occur as a result of your project.
*See Maine Library Standards for staffing 20. Describe in detail how the proposed construction/renovation project will impact/improve your service to patrons? Budget Information Section A – Calculation of Proposed Project Budget
Section B - Proposed Method of Financing Project
* Please be prepared to verify this amount when reporting on your completed project. Section C – Budget Expenditures / Forecasting
Certification of ApplicationPossessing the legal authority to apply for a State Public Library Construction grant, we the undersigned members of the Public Library Board of Trustees of (Name of library) _______________________________ OR the governing body for the (Name of library) _____________________________________________ in (town/city) _________________________________________ certify that: a resolution, motion or similar action has been duly adopted or passed as an official act of the Board, authorizing the filing of the Application, and directing and authorizing the person identified as the Project Director on Page one (1) of the Application as the official representative of the Board to act in connection with the Application (and the proposed project, if funded), and to provide such additional information as may be required; and to the best of our knowledge and belief, all information in the Application is true and correct, and fiscal estimates are as accurate as they can be as of the date of this Application. Further, we agree to comply with all Assurances contained in the Application, and with all rules, regulations, policies, procedures, and requirements as they relate to the application, acceptance, and use of State funds for this State-assisted project, and that all State funds received for the project will be expended solely for the purpose for which granted, and any such funds not so expended, including funds lost or diverted to other purposes shall be returned to the Maine State Library for repayment to the State of Maine. Signature of governing body official (e.g. Chair of Board of Trustees or Town Manager)Name ________________________________________ Signature _____________________________________________ Date __________________ Title __________________________________________ _________________________________________________ Date ___________________ Person Authorized to receive New Century Construction FundsName and title ________________________________________________________________ Address _____________________________________________________________________ City/town ______________________________________ Zip __________________________ Telephone _________________________________ Fax ______________________________ Email __________________________________________________________________
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