application 2021 transportation growth management grant
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2021 Transportation Growth Management Grant ApplicationInstructionsBe sure to download and review the 2021 Application Packet and 2021 Application Instructions before filling out this grant application.
You can save your progress and revisit this form at any time by clicking the "Save" button at the bottom of the page.
Applications must be received by July 30, 2021 at 11:59 p.m. (PDT)
Applicant informationInstructions: Complete this information for the applicant. Provide both a designated contact and an authorized representative (if different than the designated contact) for your entity.
Primary applicant jurisdictionCity of Mt. Angel
Mailing address5 North Garfield St., PO Box 960, Mt. Angel, Oregon 97362
Websitehttps://www.ci.mt-angel.or.us/
Contact person nameKevin Cronin
Contact person titleCity Manager
Contact phone(503) 845-9291
Contact [email protected]
Would you like to receive TGM news and updates?Yes
Authorized representative name, if different from the applicant contactKiel Jenkins
Authorized representative titleCity Contract Planner
Phone(503) 540-1616
List other participating local jurisdictions (if any)Participating local jurisdiction Providing match?
Project name and locationProject titleMt. Angel TSP Update
Project area: Using either of the two fields below, attach a map of the project area or describe the area your project is located in.
Option 1: Project area map Option 2: Project area descriptionCity of Mt. Angel Urban Growth Boundary, incorporating potential regional impacts.
ODOT region (1-5)Region 2
ODOT Region Map
Type of grantCategory 1: Transportation System Planning
Summary description of projectThe Mt. Angel TSP update project is part of a concerted effort to coordinate updates to the City’s long-range planning documents. The project, entitled “Mt. Angel Strong: Vision 2040,” includes the proposed TSP updated along with an updated HOA and EOA. The goal is to complete the planned HNA and EOA projects in 2022-23, allowing the City to use the HNA and EOA data and policy recommendations to ensure Mt. Angel’s transportation system is capable of supporting equitable and sustainable development over the 20 year planning period. The project will update the future streets plan, apply a “Main Street” approach to Hwy 214, identify needed infrastructure improvements and strategies to reduce GHG emissions, and incorporate needs of underserved populations in the TSP. The update will also incorporate policy recommendations and improvements identified during the SRTS action plan scheduled to reach completion in late 2021 to ensure increased bike and pedestrian access to schools and public parks.
Project cost table
TGM funds requested
Consultant$140,000.00
Local reimbursement$5,000.00
Total TGM funds requested$145,000.00
Local match Minimum Match (Calculated)$19,772.73
Match to be provided
Labor, supplies and services during project$9,772.73
Payment when Intergovernmental Agreement is signed$10,000.00
CertificationsCertificationsThis application was prepared by staff of the primary applicant or staff of one of the involved jurisdictions
Certifications checkboxBy checking this box, I certify that my organization listed above supports the proposed project, has the legal authority to pledge matching funds, and has the legal authority to apply for Transportation and Growth Management funds. I further certify that matching funds are available or will be available for the proposed project.
Eligibility requirements
Applications are reviewed on a pass/fail basis on each of the following three requirements.
Applications found to not meet each of these requirements will not be scored against the award criteria and will not be awarded a grant.
1. Clear transportation relationship
A proposed project must have a clear transportation relationship and produce transportation benefits. A project must entail analysis, evaluation and selection of alternatives, development of implementation actions, and public involvement that results in a long range transportation plan, land use plan, or other product that addresses a transportation problem, need, opportunity, or issue of local or regional importance.
Certification: Clear transportation relationshipBy checking this box, I certify that the project meets this eligibility criterion.
2. Adoption of products to meet project objectives
A proposed project must include preparation of an adoption-ready product or products that lead to a local policy decision and that directly address the project objectives, such as a transportation system plan, comprehensive plan amendment, land use plan, code amendment, implementation program, or intergovernmental agreement. Projects are expected to include adoption hearings (or equivalent) by the governing body or to prepare products which will be adopted as part of a larger project.
Certification: Adoption of products to meet project objectivesBy checking this box, I certify that the project meets this eligibility criterion.
3. Support of local officials
A proposed project must clearly demonstrate that local officials, both the primary applicant and any co-applicants, understand the purpose of the grant application and support the project objectives. A resolution of support, meeting minutes, or authorized letter from the governing body of all applicants (e.g. City Council, Board of Commissioners, or Transit Board) must be submitted with the application to meet this requirement.
Upload your resolution, minutes or authorized letter from governing body of applying jurisdiction(s) here:TGM Letter of Support 2021 - Don Fleck, Mayor.pdf
Award criteria
Criterion 1: Proposed project addresses a need and supports TGM objectives (up to 40 points)
The project clearly and effectively addresses a local or regional transportation or transportation-related land use issue, problem, need, or opportunity and will achieve one or more of the TGM objectives.
Response instructions are on page 8 of the 2021 Application Instructions.
Explain how your proposed project addresses a need and supports TGM objectivesIn addition to growth within the Mt. Angel UGB since the 1997 TSP update, regional growth, (including increased agriculture-related development and population growth of nearby cities such as Woodburn and Silverton) has and will continue to increase the burden on the city’s transportation system. City staff and elected officials recognize the need to ensure the TSP update process and policy recommendations are equitable, reflect the needs of Mt. Angel’s diverse population, and allow for sustainable, climate-resilient development.
TGM Objectives:1.1 1). The railroad running through the center of Mt. Angel has and will continue to provide a unique transportation and connectivity challenge due to its diagonal orientation and impact on street layout on the west side of the City. Currently, the physical road conditions at S Main Ave, W Church St, & Hwy 214 are a
significant barrier to all modes of transit and require specific analysis and solution. 2) Mt. Angel has an abundance of residential properties accessed by flag lots lacking the ability to provide future connectivity to existing and planned streets or support multi-modal transit options. One of the primary deliverables of the TSP update is to update the future streets plan to ensure connectivity and logical extension of existing and proposed streets, sidewalks, and bike paths throughout Mt. Angel. A “complete streets” approach will be applied as a lens to repair existing streets and plan for new facilities.3) The housing element of the comp plan identifies an “inefficient” land use pattern, specifically referencing large residential parcels that have been traditionally underutilized. As part of the HNA and TSP updates, the City will work to ensure the development code and future streets plan address the need to more efficiently utilize land within the City to maximize development potential within the existing UGB in concert with a separate grant request recently submitted (June 2021) to DLCD for housing assistance.4) Create an opportunity for dialogue with transportation partners, including Marion County, which operates two arterials in Mt Angel, and Cherriots, the region’s public transit provider, about an enhanced quality of service to meet the future needs.5) Apply a “Main Street” approach to OR Hwy 214 to prepare for and facilitate eventual improvements in anticipation of federal infrastructure funds and mandated ADA improvements.1.3 Mt. Angel has a wide range of residential development types that need to be served by the City’s transportation infrastructure. The proposed update to the plan will work to address walkable and safe access to and from underserved residential neighborhoods in need of street improvements and sidewalk installation. 1.4 Mt. Angel currently has public transportation access via the Cherriots 20X bus line. Cherriots will be represented on the TAC, helping to coordinate public transportation needs with anticipated residential development.2.2 The proposed update will look at ensuring easy pedestrian and bicycle access to public parks, schools, and business centers to give Mt. Angel residents have safe and convenient access to important amenities and public institutions, including an inventory of bike infrastructure.3.1 With the Bavarian district, Mt. Angel has a well-defined downtown core. The TSP update will work to connect residential districts with the downtown and incorporate both existing design standards within the Mt. Angel Development Code and the recommendations found within the 2014 Bavarian District downtown plan. 3.3 The TSP update will work in tandem with the City’s upcoming HOA and EOA updates to ensure recommended zone changes, Comprehensive Plan changes, and identified housing and employment land needs within the Mt. Angel Urban Growth Boundary are planned for and given adequate transportation infrastructure to connect future development to the downtown and Mt. Angel’s economic centers. 4.1 Mt. Angel has an existing infill development overlay zone with associated street development standards incentivizing infill development, thereby ensuring the maximum extent of urban growth within the existing community and minimizing the need for a future urban growth boundary expansion. To minimize infill development accessed by streets without the possibility of future connectivity, City staff intends the TSP update include a review of the standards to ensure infill development is completed in accordance with a detailed future streets plan. Currently, there are multiple deep flag lots with poor access and circulation.5.1 Objectives 1.3 and 5.3 of the 2011 Parks Master Plan identify the need to develop streets that yield themselves to bike and pedestrian use by ensuring existing and future streets have adequate space for bicyclists and pedestrians. The City also will incorporate the need to reduce GHG emissions into the updated TSP and associated development standards to address the intent of Governor Brown’s EO 20-04 at the macro level (planning for future transportation infrastructure) and the micro level (integrating provisions ensuring developments are not automotive-dependent). [GHG emphasis]
Criterion 2: Proposed project is timely and urgent (up to 25 points)
The application demonstrates timeliness and urgency. The project is needed now to:
address pressing local transportation and land use issues
make amendments to local plans or regulations necessitated by changes in federal regulations, state requirements or regional plans
make amendments to local plans or regulations necessitated by changes that were not anticipated in previous plans, including growth or lack of growth, changes in land-use patterns or changes in available funding
build on, complement or take a necessary step toward completing or implementing other high priority community initiatives, including Governor's Regional Solutions Team priority
resolve transportation or land use-related issues affecting the project readiness of local, regional or state transportation projects for which funding is expected to be obligated within the near future
Response instructions are on page 10 of the 2021 Application Instructions.
Explain how your proposed project is timely and urgentThe contemporary planning context is constantly changing and the 1997 TSP does not reflect Mt. Angel's current development goals, or address the needs created by annexations and new development in Mt. Angel over the past 24 years. Staff and elected officials intend the new TSP to update the city’s transportation system inventory, evaluate needed repairs and areas for improvement, identify methods for reducing GHG emissions, and coordinate with existing and anticipated local plans. The City recognizes the need to focus outreach on underserved communities throughout the update process, ensuring the TAC and CAC represents a diverse stakeholder base to produce policy recommendations that support the needs of the entirety of the Mt. Angel community.
Among the existing local projects to be included in the TSP update is the Mt. Angel SRTS (Safe Routes to School) program action plan. The SRTS program is an ongoing project started in 2020 and anticipated to reach completion in late 2021. The project is aimed at improving pedestrian and bike access from residential areas to schools. The project is divided into two phases: A consultant led, community-based identification of needed construction plan, followed by an on-the-ground process allowing the City and its consultant to determine future goals, evaluate the current system, and develop a detailed SRTS plan. It is crucial that the City incorporates any policy recommendations and needed improvements into the TSP, thus making the TSP update even more timely.
Mt. Angel is also targeting the development of a Main St. program to coordinate development along the Highway 214 corridor running through Mt. Angel, particularly within the downtown area. The TSP update will incorporate the need for a “Main Street” program and update policy goals and needs to work with ODOT to make Main St. more multi-modal and accessible. The project will also identify areas to be improved and target potential code and policy amendments needed to further the development of the Main Street corridor. Creating a distinct downtown accessible via multiple transportation options is key to encourage residents and tourists alike to visit and patronize Mt. Angel’s businesses and public spaces.
The city has begun the process of starting the “Mt. Angel Strong, Vision 2040” to develop a coordinated long-range plan based on a new economic opportunities analysis, housing needs analysis, and transportation systems plan to provide the policy basis for the upcoming 20 year planning period. The City has submitted an application for HB 2001 and 2003 housing funds to move forward with the development of an HNA and updated housing element. Coordinating these key policy documents will allow Mt. Angel to move forward with a cohesive and policy-driven land use and transportation plan. As part of major comprehensive plan updates, TSP updates are also required by OAR 660-012-0060 to ensure long range land use and transportation planning goals are in sync. Coordinating these plans will allow Mt. Angel to ensure recommended code changes and city-initiated zone changes adequately address the need to efficiently develop and serve land within city limits and UGB.
Criterion 3: Proposed project approach supports policy decision (up to 20 points)
The application demonstrates a clear approach to achieving the expected outcome and includes consideration for adoption. Where substantial coordination with other local, regional, and state planning efforts will need to occur, the mechanisms and responsibilities for the coordination are clear.
Response instructions are on page 11 of the 2021 Application Instructions.
Explain how your proposed project approach supports policy decisionThe TSP update portion of the Mt. Angel Strong: Vision 2040 plan will incorporate input from a variety of private and public stakeholders, including community organizations, faith-based groups, and representatives representing the City’s minority groups, senior population, and youth. Mt. Angel will work closely with the provided consultant, Marion County, ODOT, Cherriots representatives, SRTS representatives, and City Staff on a Technical Advisory Committee to ensure the needs and priorities of all relevant agencies are addressed in the TSP update. Specifically, City staff intends the project to coordinate public transit opportunities, provide an opportunity to collaborate with ODOT to ensure the downtown corridor is pedestrian and bike friendly, facilitate eventual infrastructure improvements, and incorporate the SRTS plan into the TSP.
The project will also include a Citizen Advisory Committee (CAC) comprised of local business owners, engaged residents, the Mt. Angel Chamber of Commerce, North Willamette Habitat for Humanity, and other public stakeholders as identified in Task 1C of the preliminary project timeline below. Staff will reach out to community groups, non-profits, and local church groups to ensure Mt. Angel’s Latinx population, senior citizens, and other underserved communities are included in the public engagement process. The CAC will ensure project deliverables developed by the TAC suit the needs of the Mt. Angel community and will provide important feedback from those with connections and roots in the community. The City intends that the CAC and TAC identify how policy decisions can help Mt. Angel develop a transportation system providing for safe and inexpensive transport for under-served populations to and from commercial and industrial areas within Mt. Angel and surrounding communities.
A key element of the TSP update is creating a walkable, pedestrian friendly downtown while reducing the reliance on automobile transport. In concert with the EOA and HNA updates, the TSP will incorporate methods for GHG reductions as identified in the OSTI GHG reductions toolkit including a focus on increasing bike-ped connectivity, identify needed code updates, and other strategies for small cities.
A detailed preliminary project schedule is shown below. Project tasks were outlined in accordance with the ODOT TSP update guidelines.
TASK DESCRIPTION
• 1- Project Outline 1A Kick-off meeting with consultant1B Develop equitable outreach plan1C Develop TAC/CAC Roster 1D Develop Stakeholder Database1E Create Project Schedule• 2- Existing Conditions, Future Conditions, Policy review, TAC/CAC Meeting #12A Review 1997 TSP, goals, policy framework, forecast future conditions based on a 20 year planning horizon, identify deficiencies in a future no-build scenario.2B Existing conditions inventory and analysis
2C Develop plan methodology and policy framework. Focus on increased options for bike/ped mobility, and public transit options, particularly for under-served communities. Develop goals to address the Oregon Sustainable Transportation Initiative via coordination with identified housing and economic needs.2D TAC Meeting #12E Draft TAC Memo #12F Schedule TAC and CAC Meeting #12G TAC Meeting #12H CAC Meeting #1• 3- Alternatives Development, TAC/CAC Meeting #23A Team meeting to review TAC/CAC Findings3B Open house and workshop3C Evaluate future systems conditions, potential funding mechanisms3D Draft TAC Memo #23F Schedule TAC and CAC Meeting #2. Provide online survey options and identify response mechanisms for those unable to attend in person.3G TAC Meeting #23H CAC Meeting #2• 4- Identification of Preferred Alternative, TAC/CAC Meeting #34A Team meeting to review TAC/CAC Findings4B Open house and workshop #24C Prepare preferred alternatives based on funding ability, TAC/CAC/Public feedback4D Draft TAC Memo #34E Schedule TAC and CAC Meeting #34F TAC Meeting #34G CAC Meeting #4• 5- Draft Updated TSP, ordinances5A Team meeting to review TAC/CAC Findings5B Schedule joint City Council / Planning Commission meeting #15C Joint City Council / Planning Commission meeting #15D Draft Updated TSP / ordinances5E Draft TAC Memo #45F Schedule joint TAC/CAC meeting5G Joint TAC/CAC Meeting• 6- Adoption6A Schedule joint City Council / Planning Commission #26B Joint City Council / Planning Commission meeting #26C Schedule PC/CC hearings, provide notice as needed6D Planning Commission hearing for TSP/ordinances6E City Council hearing TSP/ordinances6F Draft public outreach summary to document outreach to the transportation disadvantaged and Title XI communities.6G Draft final report
Criterion 4: Proposed project has community support (up to 5 points)
The application demonstrates that there is local support for project objectives, a commitment to participate, and a desire to implement the expected outcome.
Response instructions are on page 13 of the 2021 Application Instructions.
Upload letters of support from stakeholders hereLetter of support for transportation- Donna Bates- Mt. Angel Community Senior Center.pdf
Mt Angel Support for TGM 2021- Marion County PW.pdf
Suport letter Mt. Angel- Kari Johnsen- Habitat for Humanity.pdf
TGM Letter of Support - Shelley Otte - Littlest Angels Preschool.pdf
TGM Letter of Support 2021 - Don Fleck, Mayor.pdf
TGM Support Letter- Joshua Graves - CCS.pdf
Criterion 5: Proposed project sponsor is ready and capable (up to 10 points)
The application demonstrates that the local government is ready and able to begin the project within the TGM timetable and that there is local commitment and capability to manage and complete the project. The application demonstrates, if applicable, successful performance on previous TGM projects.
Response instructions are on page 14 of the 2021 Application Instructions.
Explain how proposed project sponsor is ready and capableThe City of Mt. Angel has allocated budget for staff time needed for work on the TSP update and staff are available to begin work as soon as the project work begins. While Mt. Angel has not received any TGM grants in the past ten years, the city has a new City Manager and contract planner capable of guiding the project from beginning to end. The City has a supportive City Council (see attached letter of support). With no elections scheduled until 2022, staff anticipate continuity and political support throughout the update process. The City also has GIS support and spatial data access via MWVCOG.
The project will be led by the provided consultant with assistance from City Manager Kevin Cronin and MWVCOG planner Kiel Jenkins. Kevin has over 25 years of public sector leadership and direct experience in project management, development review, long range planning, redevelopment, and economic development. For example, most recently, the City of Warrenton, with the assistance of a DLCD grant, adopted a HNA and missing middle codes to support new housing opportunities that went above and beyond state requirements and is a model for Oregon coastal communities. Kiel works as the City Planner for six cities in the Mid-Willamette Valley and has experience completing comprehensive plan and development code updates; downtown corridor master plans, and currently is the project manager for ongoing UGB Swap study and BLI/HNA projects. Kiel also has experience in the region with DLCD, having served as the urban planner and interim Mid-Willamette Valley regional representative from March to October of 2020.
Kevin and Kiel can provide expertise on the Mt. Angel’s comprehensive plan, development code, and TSP. They will also coordinate staff deliverables, aid in the formation of rosters for the TAC and CAC, and schedule community engagement events. Staff are committed to making sure Mt. Angel develops a TSP capable of supporting the long term housing needs and economic development goals while reflecting the priorities of the community.
If applicable, list local jurisdiction’s TGM projects within last 10 years and their status
If applicable, list local jurisdiction’s TGM projects within last 10 years and their status TGM File Project Title Status
Code
Required formsTitle VI: Racial & Ethnic Impact Statement formRacial-Ethnic-Impact-Statement_Mt Angel.pdf
Download the Racial & Ethnic Impact Statement form here
Today's date7/30/2021
If you encounter any issues with the submittal process, please contact:
Rachael LevasseurPlanning Section Web [email protected]
July 20, 2021
David Helton
City of Mt. Angel -Inc . Apri l 3, 1893-
5 N Garfield Street • P.O. Box 960 • Mt. Angel, OR 97362 Phone 503-845-9291 • Fax 503-845-6261
www.ci.mt-angel.or.us
Transportation & Growth Management Program
Oregon Department of Transportation Region 2
555 13th St NE
Salem, OR 97301
On behalf of the City of Mt. Angel I am pleased to write this letter of support for the City's grant
application for transportation planning assistance. Without the support of the TGM Program, the City is
not able to achieve its prosperity initiatives under the Mt. Angel Strong Road Map, which was endorsed
by the City Council in September 2020.
On June 7, 2021, the City Manager requested authorization for this grant application and the City
Council enthusiastically approved its submission. We are aware of the time and resources commitment
this grant request would entail, and are ready to fulfill that responsibility. We give our full support to the
grant application and look forward to working in collaboration with our agency partners and
community-based organizations on equitable and feasible transportation solutions that work for Mt.
Angel.
The City of Mt. Angel is convinced that investing in a transportation strategy will pay dividends to the
community with more housing and economic development opportunities that are sorely needed. This is
the second of many grant requests that will hopefully lay a foundation for an updated Comprehensive
Plan in 2021.
Thank you for your time and consideration and look forward to hearing from you soon.
Don Fleck, Mayor
cc: TGM Grant File
The City of Mt. Angel is an Equal Opportunity Employer and Provider.
Mt. Angel Community and Senior Center
• 195 E Charles St. Mount Angel OR 97362 Tel: (503)845-6998
July 22, 2021
David Helton Transportation & Growth Management Program Oregon Department of Transportation Region 2 555 13th St NE Salem, OR 97301
On behalf of the Mt Angel Community Senior Center, I am pleased to write this letter of support for the City of Mt. Angel’s grant application for transportation planning assistance. We are excited by the City’s renewed interest in long term planning for prosperity and want to contribute to this effort.
We give our full support to the grant application and look forward to working in collaboration with agency partners and community-based organizations on equitable and feasible transportation solutions that work for us and the Mt. Angel community.
We are convinced that making smart investments in transportation will help us provide better service to the community and encourage a healthy discussion on what works for Mt. Angel.
Thank you for your time and consideration and look forward to working with the City on this project.
Sincerely, Donna Bates, Director Mt Angel Community Senior Center 503-845-6998
5155 Silverton Road NE Salem, OR 97305-3802 www.co.marion.or.us/PW Printed on recycled paper Reduce – Reuse – Recycle - Recover
July 28, 2021 David Helton Transportation & Growth Management Program Oregon Department of Transportation Region 2 555 13th St NE Salem, OR 97301 I am pleased to write this letter of support for the City of Mt. Angel’s grant application for transportation planning assistance. We are excited by the City’s renewed interest in long term planning for prosperity and want to contribute to this effort. We give our full support to the grant application and look forward to working in collaboration with agency partners and community-based organizations on equitable and feasible transportation solutions that work for us and the Mt. Angel community. We are convinced that making smart investments in transportation will help us provide better service to the community and encourage a healthy discussion on what works for Mt. Angel. Thank you for your time and consideration and look forward to working with the City on this project. Sincerely,
Janelle Shanahan, PE Transportation Planner
PUBLIC WORKS
(503) 588-5036 BOARD OF COMMISSIONERS Kevin Cameron, Chair Danielle Bethell Colm Willis DIRECTOR Brian Nicholas, P.E. ADMINISTRATION BUILDING INSPECTION EMERGENCY MANAGEMENT ENGINEERING ENVIRONMENTAL SERVICES OPERATIONS PARKS PLANNING SURVEY
Marion County OREGON
July 26, 2021 David Helton Transportation & Growth Management Program Oregon Department of Transportation Region 2 555 13th St NE Salem, OR 97301 On behalf of the North Willamette Valley Habitat for Humanity I am pleased to write this letter of support for the City of Mt. Angel’s grant application for transportation planning assistance. We are excited by the City’s renewed interest in long term planning for prosperity and want to contribute to this effort. We give our full support to the grant application and look forward to working in collaboration with agency partners and community-based organizations on equitable and feasible transportation solutions that work for us and the Mt. Angel community. We are convinced that making smart investments in transportation will help us provide better service to the community and encourage a healthy discussion on what works for Mt. Angel. Thank you for your time and consideration and look forward to working with the City on this project. Sincerely,
Kari Johnsen Executive Director
July 28, 2021
%t(est �9e(s 9-lrescftoo( 620 Spruce Street * PO Box 87 4
Mt. Angel, OR 97362
503-845-6559
David Helton
Transportation & Growth Management Program
Oregon Department of Transportation Region 2
555 13th St NE
Salem, OR 97301
On behalf of the Littlest Angels Preschool I am pleased to write this letter of support for the City of Mt.
Angel's grant application for transportation planning assistance. We are excited by the City's renewed
interest in long term planning for prosperity and want to contribute to this effort.
We give our full support to the grant application and look forward to working in collaboration with
agency partners and community-based organizations on equitable and feasible transportation solutions
that work for us and the Mt. Angel community.
We are convinced that making smart investments in transportation will help us provide better service to
the community and encourage a healthy discussion on what works for Mt. Angel.
Thank you for your time and consideration, and I look forward to working with the City on this project.
Sincerely,
QkOu. Shelley R �:;;) � Teacher
RACIAL AND ETHNIC IMPACT STATEMENT This form is used for informational purposes only and must be included with the grant application.
Chapter 600 of the 2013 Oregon Laws require applicants to include with each grant application a racial and ethnic impact statement. The statement provides information as to the disproportionate or unique impact the proposed policies or programs may have on minority persons1 in the State of Oregon if the grant is awarded to a corporation or other legal entity other than natural persons.
1. The proposed grant project policies or programs could have a disproportionate or unique positive impact onthe following minority persons:
Indicate all that apply:
Women Asians or Pacific Islanders Persons with Disabilities American Indians African-Americans Alaskan Natives Hispanics
2. The proposed grant project policies or programs could have a disproportionate or unique negative impact onthe following minority persons:
Indicate all that apply:
Women Asians or Pacific Islanders Persons with Disabilities American Indians African-Americans Alaskan Natives Hispanics
3. The proposed grant project policies or programs will have no disproportionate or unique impact on minoritypersons.
If you checked numbers 1 or 2 above, please provide below the rationale for the existence of policies or programs having a disproportionate or unique impact on minority persons in this state. Further provide evidence of consultation with representative(s) of the affected minority persons.
By checking this box, I hereby certify the information contained on this Dated: form is true, complete, and accurate to the best of my knowledge.
Printed Name: Title:
Agency Name:
1 “Minority person” are defined in SB 463 (2013 Regular Session) as women, persons with disabilities (as defined in ORS 174.107), African Americans, Hispanics, Asians, or Pacific Islanders, American Indians and Alaskan Natives.