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HomeMy WebLinkAboutPerformance Report - PalmDesert - QTR4 2024 - UnsignedSAFE STREETS AND ROADS FOR ALL (SS4A) DISCRETIONARY GRANT PROGRAM Quarterly Performance Progress Report Page 1 of 3 Project Information NAME STATE SUBMISSION DATE AWARD NUMBER FHWA NAME OF GRANT RECIPIENT QUARTER NOFO FUNDING YEAR Project Overall Status Scope Schedule Budget Project Significant Activities and Issues (limited to 750 characters; to submit additional information, please attach it to the completed form with the award number and report year and quarter reporting): Action Items/Outstanding Issues (limited to 750 characters; to submit additional information, please attach it to the completed form with the award number and report year and quarter reporting): OMB CONTROL NUMBER: 2125-0675EXPIRATION DATE: 07/31/2027 SAFE STREETS AND ROADS FOR ALL (SS4A) DISCRETIONARY GRANT PROGRAM Quarterly Performance Progress Report Page 2 of 3 Action Plan Project Milestones Milestone Actual/Expected Date Planned Draft Action Plan Completion Date: Completion Date: Date: Submission Date: Supplemental Planning Activity Project Milestones Milestone Baseline Date (Grant Agreement) Latest Amended Date (If applicable) Actual/Expected Date Planned Draft Completion Date: Planned Completion Date: project/resulting deliveraPlanned Final Action PlanAdoption Date: Planned SS4A Final Report Submission Date: Demonstration Activity Project Milestones Milestone Baseline Date (Grant Agreement) Last Amended Date (If applicable) Actual/Expected Date Planned NEPA Completion Date: Planned Construction Start Date: Substantial Completion and Planned SS4A Final Report Submission Date: SAFE STREETS AND ROADS FOR ALL (SS4A) DISCRETIONARY GRANT PROGRAM Quarterly Performance Progress Report Page 3 of 3 Implementation (Construction) Project Milestones Milestone Actual/Expected Date Date: Date: Substantial Completion and Submission Date: Implementation (Non-Construction) Project Milestones Milestone Baseline Date (Grant Agreement) Latest Amended Date (If applicable) Actual/Expected Date Date: Date: Submission Date: Certification: By signing this report, I certify to the best of my knowledge and belief that the report is true, complete, and accurate, and the expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the terms and conditions of the Federal award. I am aware that any false, fictitious, or fraudulent information, or the omission of any material fact, may subject me to criminal, civil or administrative penalties for fraud, false statements, false claims or otherwise. (U.S. Code Title 18, Section 1001 and Title 31, Sections 3729-3730 and 3801-3812). Name of Authorized Certifying Official: Title of Authorized Certifying Official: Signature of Authorized Certifying Official: Telephone (Area code, number and extension): Email Address: FORM INSTRUCTIONS Paperwork Reduction Act Burden Statement A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collec�on of informa�on subject to the requirements of the Paperwork Reduc�on Act unless that collec�on of informa�on displays a currently valid OMB Control Number. The OMB Control Number for this informa�on collec�on is 2125-0675. Public repor�ng for this collec�on of informa�on is es�mated to be approximately 30 minutes per response, including the �me for reviewing instruc�ons, searching exis�ng data sources, gathering and maintaining the data needed, comple�ng and reviewing the collec�on of informa�on. Send comments regarding this burden es�mate or any other aspect of this collec�on of informa�on, including sugges�ons for reducing this burden to: Informa�on Collec�on Clearance Officer, Department of Transporta�on, Federal Highway Administra�on, 1200 New Jersey Ave SE, Washington, D.C. 20590. SAFE STREETS AND ROADS FOR ALL (SS4A) DISCRETIONARY GRANT PROGRAM PERFORMANCE PROGRESS REPORT Item Data Element Line Item Instructions PROJECT INFORMATION 1 Project Name Enter the project name associated with the award number. 2 State Enter the recipient State. 3 Federal Agency To Which Report Is Submitted FHWA will be pre-populated in this field. Submission Date Enter the date the report was submitted. 5 Award Number Enter the award number identified in the Grant Agreement. Name of Grant Recipient Enter name of the grant recipient. 7 Report Year and Quarter Enter the quarterly report year and quarter for the calendar 8 NOFO Funding Year In drop down menu, select the Fiscal Year (FY) year of funding and NOFO publication (e.g., first round = FY2022). PROJECT STATUS 9 Scope Enter any deviations from the scope, schedule and/or budget from what is in the grant agreement. 10 Schedule 11 Budget 12 Project Significant Activities and Issues This section should draw attention to, and track the progress of, highly significant or sensitive issues requiring action and direction in order to resolve. The Recipient should include administrative items and outstanding issues that could have a significant or adverse effect on the project’s scope, schedule, or budget. Status, responsible person(s), and due dates should be included for each action item/outstanding issue. Action items requiring action or direction should be included in the quarterly status meeting agenda. The action items/outstanding issues may be dropped from this section upon full implementation of the remedial action, and upon no further monitoring anticipated. 13 Action Items/Outstanding Issues PROJECT MILESTONES 14 Project Milestones Enter for each milestone the baseline date identified in the grant agreement, the latest amended date, and actual/expected completion date. CERTIFICATION 15 Name of Authorized Certifying Official Enter authorized official's name. 16 Title of Authorized Certifying Official Enter authorized official's title. 17 Signature of Authorized Certifying Official Original signature of the recipient's authorized official (e.g., digital signature or handwritten signature). 18 Telephone Enter authorized official's telephone. 19 Email Address Enter authorized official's email address.