STATE OF MISSISSIPPI
SMALL MUNICIPALITIES AND LIMITED POPULATION
COUNTIES GRANT PROGRAM (SMLPC)
2015
APPLICATION
Applicant:
COMMUNITY SERVICES DIVISION
MISSISSIPPI DEVELOPMENT AUTHORITY
501 North West Street ● Post Office Box 849 ● Jackson, Mississippi 39205-0849
Telephone (601) 359-3179
SMALL MUNICIPALITIES AND LIMITED POPULATION COUNTIES
GRANT APPLICATION
The Mississippi Small Municipalities and Limited Population Counties Grant Program, administered by the Mississippi
Development Authority (MDA), is designed for making grants to small municipalities and limited population counties or natural
gas districts (“Local Sponsors”) to finance projects to promote economic growth in the State of Mississippi (“State”). Funding
for the grants to Local Sponsors is derived from appropriations or funds otherwise made available by the State Legislature.
Maximum Grant Award: $150,000.00 per local sponsor
Eligibility: A small municipality or a limited population county must submit an application to MDA. An eligible municipality,
county and natural gas district are defined as follows: (Census Designated Place (CDP’s) on the official list are not eligible).
Small Municipality – means a municipality in the State of Mississippi with a population of ten thousand (10,000) or less
according to the most recent federal decennial census at the time the municipality submits its application to MDA under this
section. The term “small municipality” also includes a municipal historical hamlet as defined in Section 17-27-5 of the
Mississippi Code of 1972.
Limited Population County – means a county in the State of Mississippi with a population of thirty thousand (30,000) or less
according to the most recent federal decennial census at the time the county submits its application to MDA under this
section.
Natural Gas Districts – districts created by law and meeting the same requirements as small municipalities.
The application form for requesting FY 2015 funds provides a format for presenting proposed project information that can be
evaluated according to program requirements that are presented in the 2015 Small Municipalities and Limited Population
Counties Grant Guidelines. The application should be completed in the format provided with the appropriate appendices.
These instructions are designed to guide the application preparer through the 2015 application forms and should be followed
closely to ensure submittal of a complete application that presents the appropriate information.
Applications will be due by June 18, 2015, by 4:00 pm, MDA time;
Applicant must submit one (1) original application on or before the deadline. Applications that arrive after the deadline will not
be accepted. A municipality or county will be allowed to submit only one (1) application.
No electronic documents will be accepted. You will receive a letter to confirm MDA’s receipt of your application.
The complete application must be submitted in a Legal sized Dark Blue Classification Folder (2 dividers) and each
section bottom tabbed. DO NOT USE SHEET PROTECTORS OR NOTEBOOKS OF ANY KIND. All documentation must
have original signatures and original color pictures. This application should not be modified from its original format. Any
application that does not contain information sufficient to permit review will be not considered for funding.
Questions pertaining to the content of this application should be directed to Patricia Turner at (601) 359-9316. The 2015
application and 2015 guidelines are posted on the agency website: www.mississippi.org/csd.
On completion of the application, the signed original 2015 Small Municipalities and Limited Population Counties Grant
application form, complete with narrative requirements, budget sheet, and attachments must be submitted to:
Mailing Address:
Mississippi Development Authority
Community Services Division
Attn.: Patricia Turner
Post Office Box 849
Jackson, Mississippi 39205-0849
(601) 359-9316
Courier Delivery:
Mississippi Development Authority
Community Services Division
(FedEx UPS, etc.) Attn.: Patricia Turner
501 North West Street
Jackson, Mississippi 39201
(601) 359-9316
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SMALL MUNICIPALITIES AND LIMITED POPULATION COUNTIES GRANT
PROJECT OVERVIEW
APPLICANT INFORMATION
If the application was prepared by someone other than the
applicant, please complete the following:
Applicant:
Street Address
P. O. Box
Name
City/State/Zip
Agency
County
Street/P.O. Box
Chief Elected
City/State/Zip
Official Name
County
Title
Telephone
Email Address
Telefax
Telephone
Email Address
Telefax
Population (2010)
Applicant’s Fiscal Year Ending Date
Mississippi Senate District Number
Mississippi House District Number
Mississippi Congressional District Number
PROJECT DESCRIPTION
Priority #1: Economic development-related improvements to include water, sewer, street and drainage improvements
for the benefit of site development, industrial parks, business districts, tourism destinations, and projects
that improve the competitiveness of a community.
Priority #2: Downtown improvements to include: sidewalks, lighting, façade improvements, beautification
improvements (waste receptacles, stop signs, street signs, landscaping, awnings, etc.), and other
downtown improvements as approved by MDA.
Priority #3: Non-economic development related water, sewer, street and drainage improvements.
Priority #4: Purchase, construction or rehabilitation of public buildings to include: town halls, libraries, police stations,
fire stations, community centers, courthouses, other publicly owned buildings as approved by MDA.
(Please provide a detailed description of the project and narrative explaining how the specific improvements will relate to MDA
Priorities, together with supporting documentation.)
PROGRAM COST INFORMATION
Amount of SMLPC Funds Requested
Amount of Other Funds
Total Project Cost
$0.00
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CERTIFICATIONS
Chief Executive Officer's Certification
As part of the process of preparing this application for assistance through the State of Mississippi's Small
Municipalities and Limited Population Counties Grant Program (SMLPC), I certify to the best of my knowledge and
belief, the applicant has no outstanding serious audit or monitoring findings on previously funded SMLPC projects. All
data contained in this application is true and correct, and its submission has been duly authorized by the governing
body.
Signature, Chief Elected Official
Title (typed)
Name (typed)
Date
Office Telephone Number
Alternate Telephone Number
Application Preparer's Certification
To the best of my knowledge and belief, all data contained in this application is true and correct. Also, I certify that I
am not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from
participation in the Small Municipalities and Limited Population Counties Grant Program.
Signature, Application Preparer
Name (typed)
Company
Date
Office Telephone Number
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GENERAL PROJECT INFORMATION
1.
Project Description: Provide a detailed description of the project including justification of the project and the
impact of the project to the community. If you need additional space, please provide add a Project Description
tab to your application.
2.
Job Impact:
3.
Will the proposed project require the acquisition of real property or easements?
Yes
Number of
Existing Jobs
Number of jobs to be
created
Total
No
If yes, provide an explanation:
4.
Have the sources of funds listed on the “Budget Page” been approved for this project?
Yes
No
If yes, please provide a copy of the awards letter and insert the information into the table below. Matching
funds must be in place by the application due date which is June 18, 2015.
Please list all sources of funding to be used to fund this project. (Include SMLPC Request)
Source
Amount
TOTAL
Status of Commitment
$0.00
5.
Will the principal user of the facility supported with the SMLPC funds be a private company?
If yes, explain in detail:
6.
Expected date of project completion:
Yes
No
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7. Provide amounts of previous SMLPC grants awarded:
Year
Project
Amount
2001
2002
2003
2005
2006
2007
2008
2009
2010
2011
2013
2014
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ATTACHMENTS TO APPLICATION
This list is designed to aid the preparer in determining that all sections of this application have been
included and are attached to indicate that the application is complete. The application shall be submitted
with division tabs located at the bottom of the pages and division tabs labeled that describe the below
attachments:
A detailed description of the project and narrative explaining how the specific improvements will affect
MDA Priorities, economic development, together with supporting documentation. (Should include
pictures, newspaper articles, etc.)
Budget page
Proof of additional funding
Engineering report – the report should specify project activities, timetable for implementation, and a
cost estimate for each. Cost estimate must be submitted by an engineer or architect on their letterhead
as a signed original and stamped/seal
Executed copy of the Local Sponsor’s resolution of authorization to apply for SMLPC funds
Executed copy of the Local Sponsor’s resolution committing matching funds to the project
Timeline for implementation and completion of project
Legislative Support Letters
Other documents of need
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SMALL MUNICIPALITIES AND LIMITED POPULATION COUNTIES GRANT
Sample Budget Summary
Applicant:
Funding Year:
Grant Year:
Description
MDA
Contract: #
Other Funding Sources
Local Sponsor
Administration
Private Company
Other
Total
General Administration
$ 0.00
Application Prep.
$ 0.00
Subtotal (A)
Description
$0.00
MDA
SMLPC Activities
$0.00
$0.00
$ 0.00
Other Funding Sources
SMLPC
Local Sponsor
Private Company
Other
Total
Architectural/Engineering
$ 0.00
Contingency
$ 0.00
Construction of Public Building
$ 0.00
Renovation of Public Building
$ 0.00
Purchase of Public Building
$ 0.00
Downtown Improvements
$ 0.00
Street Improvements
$ 0.00
Other
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
Subtotal (B)
$0.00
$0.00
$0.00
$0.00
$ 0.00
Grand Total (A + B)
$0.00
$0.00
$0.00
$0.00
$ 0.00
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