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<br />INSTRUCTIONS: <br /> <br />a. Press F1 for help for each field. <br />b. Navigate through the form by using the TAB key or the mouse to highlight and enter data in each field. <br />c. All Questions in RED are required. <br />d. Documents attached must be in version WORD 97 or above or WORDPERFECT 6.0 or above. <br /> <br />(R8-PA-5/1/2004) <br /> <br />-------------------------------------------------------------------------------------------- <br />-------------------------------------------------------------------------------------------- <br /> <br />I. <br /> <br />Item name: c:J <br /> <br />(i.e, Design & Engineering, lumber, etc.) <br /> <br />Unity QT: c:JUnit of Measure: ..... <br /> <br />Unit Cost: c:J <br /> <br />Cost Estimate: c:J <br /> <br />J. <br /> <br />Item name: c:J <br /> <br />(i.e, Design & Engineering, lumber, etc.) <br /> <br />Unity QT: c:J Unit of Measure: ..... <br /> <br />Unit Cost: c:J <br /> <br />Cost Estimate: c:J <br /> <br />ENTER TOTAL PROJECT COST ESTIMATE: >lETIQ] <br /> <br />SPECIFY COST BREAKDOWN: <br /> <br />ESTIMATED TOTAL COST <br /> <br />$~ <br />$~ <br />$ 18.1281 <br />$21 <br />~ <br /> <br />APPLICANT SHARE <br />STATE SHARE <br />FEDERAL SHARE (MAX 75% OF ELIGIBLE COSTS) <br />OTHER NON-FEDERAL <br /> <br />IS THIS PROJECT PART OF THE INITIA TIVE (5% or 10%) <br /> <br />YES [g] <br /> <br />NO D <br /> <br />19 <br />