New Century Construction/Renovation Grant Application July 2006

Application Deadline: Friday, September 15, 2006 5:00 p.m.

Please return original application plus five copies to:

Linda Lord
Maine State Library
64 State House Station
Augusta, ME 04333

Application

• See related links in the right box for the application guide and the application. The application is available in Rich Text Format (rtf) for ease of competing in Word or similar program. Use the PDF for printing and filling out by hand. Use this HTML version (web) for a quick scan of contents and/or printing. To download" rtf" files, right click and save to your desktop or in a folder then open in Word or a similar program
• The PDF application version requires the free Adobe Reader.

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 ________________________________________________
(all communications will be sent to this person)

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 ______ non-member

8. Criteria: The Maine Library Commission has unanimously agreed to utilize the 2000 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 minimum library standards.rtf* set forth in Maine Public Library Standards 2000 with the exception of the facilities standards? ________ Yes _________ No *(To download" rtf" files, right click and save to your desktop or in a folder then open in Word or a similar program)

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. applicant last received a major construction grant ________________

Was the award from: _____ state _____ federal _____ or other (e.g. MBNA)? Amount of the award ____________________

17. Population of town in which library is located _______________________

18. Population of library’s legal service area ____________________________
(Check your annual report or call the library if not certain.)

19. Please complete the following chart if any change will occur as a result of your project.

Facility/Space Data	Existing	To be Gained as a Result of Proposed Project
Meetings rooms
Building –Square Footage
Hours open
Number of Full Time Equivalent Staff (FTE’s)*
Number of public computers

*per page 57 of the Maine Library Standards

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
(Round to Nearest Dollar)

Cost Classification	Amount Expended Within Past 36 Months, if any	Projected Expenditures	Total	Maine State Library USE ONLY
Acquisition of Site
Acquisition of Building
Site Development
Site Survey and Soil Investigation
Site Appraisal
Architect's Fees
Engineer's Fees
Special Consultant Fees (Describe work under "Remarks" below)
Legal Fees
Title Opinion
Advertisement of Bids
Duplication of Plans
Construction
Movable Equipment & Furniture
Works of Art (1% limit)
Audit Service
Other (Specify,e.g. fund raising)_____________________)
Other (Specify ______________________)
Grand Total
Architect's/Engineer's Estimate Per Square Foot Cost of Construction:  $_____________________________
Remarks:

 

Section B - Proposed Method of Financing Project

Contributions	Dollar Amount
1. Local Cash now available	$
2. Local Cash to be raised	$
3. Local Loan	$
4. Community Bonds	$
5. *Value of donated construction materials (do not include labor)	$
6. Total of Local Contributions #1-5 above	$
7. Amount requested in New Century funds (Should be equal to or less than #6 above)	$
8. Grand Total Cost of Project  (Add #6 & 7 above)	$

 

* Please be prepared to verify this amount when reporting on your completed project.

Section C – Budget Expenditures / Forecasting

Classification	Current Operating Budget	Budget for First Fiscal Year After Construction/Renovation
Salaries / Fringe
Salaries
Fringe Benefits
Sub-Total
Operating
Maintenance
Insurance
Utilities (including telephone)
Office & Program Supplies
Public Relations
Debt Retirement
Electronic Access Costs
Materials Collection
Other
Sub-Total
Capital Outlay
New Equipment (include major computer installations)
Furniture for new or expanded buildings
Payments & interest on loans & Bonds for construction of new buildings & buildings additions
Site acquisition costs
Other (Specify)
Sub-Total
Grand Total

Certification of Application

Possessing 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 ___________________
Library Director signature

Person Authorized to receive New Century Construction Funds

Name and title ________________________________________________________________

Address _____________________________________________________________________

City/town ______________________________________ Zip __________________________

Telephone _________________________________ Fax ______________________________

Email _______________________________________________________________________