Assistance to Firefighters Grants Application Checklist

FEMA - AFG Application Checklist

Assistance to Firefighters Grants

Application Checklist

Completing this checklist will help you prepare your Assistance to Firefighters Grant

(AFG) application. Collecting this information beforehand will reduce the time and

energy needed to complete your application when the next grant cycle opens.

AFG Program Application Checklist Table 1: SAM.gov Profile

AFG Program Application Checklist Table 2: Applicant Characteristics

Applicant Characteristics

☐

Applicant type?

☐

Fire Department

☐ Nonaffiliated Emergency Medical Service (EMS)

☐

State Fire Training Academy (SFTA)

☐

Is this grant application a Regional request?

If yes, please list all eligible participating partners POC name(s), POC phone number(s), Employer Identification

Number for each partner.

Do you have a Memorandum of Understanding (MOU) with the participating partners? If yes, please upload the

MOU with your application.

Note: Community identification characteristic (e.g., Rural, Urban, Suburban) and the organizational status of the

host applicant (e.g., Career, Combination, Volunteer) will be entered and used for the Regional application,

SAM.gov Profile

☐

Is your System for Award Management (SAM) registration current?

☐

Yes

☐

What is the expiration date for your SAM registration?

☐

Do you know your Unique Entity Identifier (UEI) number issued by SAM?

☐

Has your E-Business point of contact in SAM established your organization in the FEMA

Grants Outcomes (FEMA GO) System?

☐

Have you registered in the FEMA GO System?

Search the SAM.gov website to confirm you UEI number matches your SAM.gov registration. You will also find

your expiration date through this search. Click here for help with FEMA GO registration.

AFG Program Application Checklist

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Applicant Characteristics

regardless of the composition of the participating partners. For additional information on Regional applications

and MOU requirements, please refer to the AFG Program Notice of Funding Opportunity.

☐

What kind of organization do you represent?

☐

All Paid/Career

☐ Volunteer

☐ Combination (Majority Career)

☐

Combination (Majority Volunteer)

☐

How many active firefighters does your department have who perform firefighting duties?

☐

How many of your active firefighters are trained to the level of Firefighter I or equivalent?

☐

Are you requesting training funds in this application to bring 100% of your firefighters into compliance with

National Fire Protection Association (NFPA) 1001?

☐ Which of the following standards does your organization

meet regarding physicals? If physicals are not required, do

not select any option.

☐

Meets NFPA or 1582 Standard

☐ Meets National Transportation Safety Board

(NSTB) or U.S. Department of Transportation (DOT)

standard

☐

How many members in your department are trained to the level of Emergency Medical Responder or

Emergency Medical Technician (EMT), Advanced EMT, or Paramedic?

☐

Does your department have a Community Paramedic program?

☐

How many stations are operated by your department?

☐

Does your organization protect critical infrastructure of the state?

☐

Do you currently report to the National Fire Incident Reporting System (NFIRS)? You will be required to report to

NFIRS for the entire period of the grant. If yes, make note of your Fire Department Identifier (FDID) number.

☐

Do you offer live fire training?

AFG Program Application Checklist Table 3: Operating Budget

Operating Budget

☐

What is your operating budget for the current and two previous fiscal years?

☐

What percentage of the declared operating budget is dedicated to personnel costs (salary, benefits, overtime

costs, etc.)?

☐

Does your department have any rainy-day reserves, emergency funds, or capital outlay? If yes, what is that

? f f

☐

The percentage of your budget derived from: (whole percentage)

Taxes

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Operating Budget

Bond issues

EMS billing

Grants

Donations

Fund drives

Fee for service

Other (please explain ‘Other’ portion of the budget)

Total percentage must equal 100%

Use the information above in your financial narrative. It is important that your application remain consistent

throughout. When breaking down the budget, be sure to account for all funding received.

(Budget breakdown should account for 100% of the budget.)

Financial Need Narrative

Describe your financial need and how consistent it is with AFG’s intent. Include details describing your

organization’s financial distress such as summarizing budget constraints, unsuccessful attempts to secure other

funding, and proving the financial distress is out of your control.

This section must be no more than 4,000 characters.

Click here for additional guidance in developing your narrative.

☐

Does your organization intend to apply for an Economic Hardship Waiver? Please

attach your request for a waiver to your application.

Guidance for requesting waivers can be found here:

https://www.fema.gov/sites/default/files/2020-

04/Eco_Hardship_Waiver_FPS_SAFER_AFG_IB_FINAL.pdf

☐

Cost Share

☐ Maintenance of effort

Other Funding Sources

☐

This fiscal year, are you receiving federal funding from any other grant program for

the same purpose for which you are applying for this grant?

☐

Yes

☐

This fiscal year, are you receiving federal funding from any other grant program

regardless of purpose?

☐

Yes

☐

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AFG Program Application Checklist Table 4: Applicant and Community Trends

Applicant and Community Trends

Injuries and fatalities

Most recent full

calendar year

e.g., 2023

Previous calendar

year e.g., 2022

A year before the

previous calendar

year e.g., 2021

☐

What is the total number of fire-related civilian

talities in your jurisdiction over the past thre

alendar years?

☐

What is the total number of fire-related civilian

juries in your jurisdiction over the past three calendar

years?

☐

What is the total number of line-of-duty member

juries in your jurisdiction over the past three calendar

years?

☐

What is the total number of members with self-

inflicted fatalities over the past three calendar years?

AFG Program Application Checklist Table 5: Vehicle Inventory

Vehicle Inventory

How many vehicles does your organization have in each of the type or class of vehicle listed below?

You must include vehicles that are leased or on long-term loan as well as any vehicles that have been ordered or

otherwise currently under contract for purchase or lease by your organization but not yet in your possession.

Front Line Vehicle: a vehicle that is fully equipped and ready to respond to emergency calls (first due, second due,

ready-reserve vehicle). Reserve Vehicle: a vehicle that is not fully equipped and not ready to respond. Do not list

vehicles that are permanently out of service.

Vehicle Inventory

List the number of:

Front Line

Reserve

Seated Positions

Engines or Pumpers

Ambulances

Tankers or Tenders

Aerial Apparatus

Brush/Quick Attack

Rescue Vehicles

Additional vehicles

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How many Advanced Life Support response

vehicles are in your fleet?

☐

Is your department facing a new risk, expanding service to a new area, or experiencing an increased call

volume? If yes, please explain.

AFG P

rogram Application Checklist Table 6: Community Description

Community Description

☐

Type of jurisdiction served

☐

What type of community does your organization serve?

☐

Urban

☐ Suburban

☐ Rural

☐

What is the square mileage of your first due response zone/jurisdiction

served?

☐

What percentage of your primary response area is protected by hydrants?

☐

What percentage of your primary response area is for the following:

Agriculture, wild land, open space, or undeveloped properties

Commercial/industrial

Residential

☐

What is the permanent resident population of first-due response area?

☐

Do you have a seasonal increase in population?

If yes, what is your seasonal increase in population (number of people)?

Community Description Narrative

Please describe your organization and/or community that you serve.

This section must be no more than 4,000 characters.

lick here for additional guidance in developing your narrative.

AFG P

rogram Application Checklist Table 7: Call Volume

Call Volume

Please provide the total number of incidents that your organization responded to for each year of the previous

three calendar year period. Include only those alarms which your organization was a primary responder and not

second due or giving mutual aid.

Call Volume

Note: Each incident must be counted only once regardless of the number of units or agencies that responded to

that incident (e.g., a vehicle fire with entrapment and injuries may be counted as a vehicle fire or a rescue call or

an EMS call, but not all three).

Summary

*How many responses per year by category? (Enter whole

number(s) only. If you have no calls for any of the categories,

enter 0)

Most recent

full calendar

year e.g.,

2023

calendar year

e.g., 2022

A year before

the previous

calendar year

e.g., 2021

NFIRS Series 100: Fire

NFIRS Series 200: Overpressure Rupture, Explosion, Overheat (No

Fire)

NFIRS Series 300: Rescue & Emergency Medical Service Incident

NFIRS Series 400: Hazardous Condition (No Fire)

NFIRS Series 500: Service Call

NFIRS Series 600: Good Intent Call

NFIRS Series 700: False Alarm & False Call

NFIRS Series 800: Severe Weather & Natural Disaster

NFIRS Series 900: Special Incident Type

Fire

* How many responses per year by category? (Enter whole

number(s) only. If you have no calls for any of the categories,

Enter 0)

Most recent

full calendar

year e.g.,

2023

calendar year

e.g., 2022

A year before

the previous

calendar year

e.g., 2021

Of the NFIRS Series 100 calls, how many are "Structure Fire"

(NFIRS Codes 111- 123)?

Of the NFIRS Series 100 calls, how many are "Vehicle Fire" (NFIRS

Codes 130-138)?

Of the NFIRS Series 100 calls, how many are "Vegetation Fire"

(NFIRS Codes 140- 143)?

What is the total acreage of all vegetation fires? Enter whole

numbers only. If you have no vegetation fires, enter 0.

Rescue and Emergency Medical Service Incidents

* How many responses per year by category? (Enter whole

number(s) only. If you have no calls for any of the categories,

Enter 0)

Most recent

full calendar

year e.g.,

2023

calendar year

e.g., 2022

A year before

the previous

calendar year

e.g., 2021

Of the NFIRS Series 300 calls, how many are "Motor Vehicle

Accidents" (NFIRS Codes 322-324)?

Of the NFIRS Series 300 calls, how many are "Extrications from

Vehicles" (NFIRS Code 352)?

Of the NFIRS Series 300 calls, how many are "Rescues"

(NFIRS Codes 300, 351, 353-381)?

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Call Volume

How many EMS-BLS Response Calls?

How many EMS-ALS Response Calls?

How many EMS-BLS Scheduled Transports?

How many EMS-ALS Scheduled Transports?

How many Community Paramedic Response Calls?

Mutual and Automatic Aid

* How many responses per year by category? (Enter whole

number(s) only. If you have no calls for any of the categories,

enter 0)

Most recent full

calendar year

e.g., 2023

calen

dar year

e.g., 2022

A year before

the

calendar year

e.g., 2021

How many times did your organization receive mutual aid?

How many times did your organization receive automatic aid?

How many times did your organization provide mutual aid?

How many times did your organization provide automatic aid?

Of the Mutual and Automatic Aid responses, how many were

structure fires?

AFG Program Application Checklist Table 8: Grant Request Details

Grant Request Details

☐

Are you requesting a Micro Grant? A Micro Grant is limited to

$50,000 in federal resources.

☐

Yes

☐

Add Activity to Request Details

☐

Equipment

☐

Modify Facilities

☐

Personal Protective Equipment (PPE)

☐

Training

☐

Wellness and Fitness

☐

Grant Writer Fee

☐

Vehicle Acquisition

Please note that Fire Department and nonaffiliated EMS applicants applying for Operations and Safety Activities

(Equipment, PPE, Modify Facilities, Wellness and Fitness, and Training) and that wish to apply for a vehicle must start

a separate application. The number of applications that can be submitted in the same application cycle is limited

based on the type of applicant/application selected. Please refer to the AFG funding notice for details.

FEMA-AFG Application Checklist

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AFG Program Application Checklist

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Grant Request Details

☐

Add Narratives to the Selected Activity

Note: each narrative section must be no more than 4,000

characters.

Click here for additional guidance in developing your narrative.

☐

Project Description and Budget Narrative

☐ Cost Benefit Narrative

☐ Statement of Effect on Operations Narrative

☐

Add Item(s) to Selected Activity

Select items based on Activity (add quantity, unit

price, budget class and description of item

requested). Please see examples of questions

below.

☐

Answer additional questions based on Activity/item selected

Additional questions vary based on the item and

activity selected. Please see examples of

questions below.

AFG Program Application Checklist: Examples of Additional Questions Based on Selected Activity

Additional Questions Table 1: Equipment Activity

Equipment Activity

1. Add Item to Equipment Activity

Add quantity, unit price, budget category and description of the item.

What is the purpose of this request?

☐

Obtain equipment to achieve minimum operational and

deployment standards for existing missions

☐ Replace noncompliant equipment to current standard

☐ Obtain equipment for new mission

☐

Upgrade technology to current standard

☐

Will the equipment being requested bring the organization into voluntary compliance

with a national standard? In your narrative statement, please explain how this

equipment will bring the organization into voluntary compliance.

☐

Yes

☐

At what level of service will this equipment be used if awarded this grant?

Select appropriate

option

☐

Is your department trained in the proper use of the equipment being requested?

☐

Yes

☐

Are you requesting funding to be trained for this item(s)? (Funding for requested

training should be requested as additional funding.)

☐

Yes

☐

If you are not requesting training funds through this application, will you obtain

training for this equipment through other sources?

☐

Yes

☐

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Additional Questions Table 2: Modify Facilities Activity

Modify Facilities Activity

1. Add Project to Modify Facilities Activity

Note: Additional Funding project must complement the Facility project. Do not select

Additional Funding only.

☐

Facility

☐ Additional Funding

Facility Identification

Does this facility have a fire alarm system?

☐

Yes

☐

Does this facility have a fire sprinkler system?

☐

Yes

☐

Does this facility have a diesel/smoke removal system?

☐

Yes

☐

When did the last major renovation to this facility occur? Please enter date built if no

renovations have occurred.

MM/DD/YYYY

2. Add Item to the selected Project

☐

Air Quality System(s)

☐ Generator(s) (fixed/primary/backup)

☐ Source Capture Exhaust System(s)

☐ Sprinkler System(s)

☐

Smoke/Carbon Monoxide/Alarm System(s)

☐

What is the square footage of the area that your modification will directly affect?

☐

Does the facility you wish to modify have a drive-through bay?

☐

Yes

☐

What is the age of the facility that is being modified?

☐

What type of facility will be modified?

☐

Station with sleeping quarters (to include

marine fire facilities)

☐ Station without sleeping quarters

☐ Training facilities

☐ Dispatch, administrative, maintenance,

storage

☐

What is the level of occupancy for the facility you wish to

modify?

Note: The occupancy is defined by the number of hours the

facility is used within a single 24-hour time period.

☐

Full-Time (24/7)

☐ Part-Time (daily, but not 24/7)

☐ Occasional

If requesting Source Capture Exhaust System:

☐ Will the installation of this unit upgrade, replace, or refurbish an existing system in

place?

☐

Yes

☐

AFG Program Application Checklist

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Additional Questions Table 3: PPE Activity

PPE Activity

1. Add Item to PPE

Add quantity, unit price, budget category, and description of the item

☐

What is the purpose of this request? ☐ Increase supply for new hires and/or existing firefighters

that do not have one set of turnout gear (PPE) or allocated

seated positions (Self-Contained Breathing Apparatus [SCBA]).

This includes replacing out of service PPE-Turnout Gear and

SCBA.

☐ Replace in-service or in-use damaged/unsafe/unrepairable

PPE/SCBA to meet current standard.

☐ Replace in-service/in-use/expired/noncompliant PPE/SCBA

to current standard.

☐ Replace PPE and SCBA to upgrade technology

Are you requesting for members that currently do not have above-mentioned item? (for

PPE only)

☐

Yes

☐

Is your department trained in the proper use of the PPE/SCBA being requested?

☐

Yes

☐

Are you requesting funding for training for this PPE/SCBA?

☐

Yes

☐

If you are not requesting training funds through this application, will you obtain training

for this PPE/SCBA through other sources?

☐

Yes

☐

How many of your on-duty active members currently have PPE that meets applicable

NFPA and Occupational Safety and Health Administration (OSHA) standards? Or how

many of your seated riding positions currently have compliant SCBA assigned to it?

☐

When requesting PPE (any PPE other than

SCBA), what are the ages of your PPE in years?

Years Old

# of items

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PPE Activity

25 or older

When requesting SCBA, to which edition(s) of the NFPA standard are your SCBA compliant?

Year

Current Inventory

Being Replaced

SCBA

Cylinder

SCBA

Cylinder

2018 Edition

2013 Edition

2007 Edition and older

Obsolete/non-compliant

Additional Questions Table 4: Training Activity

Training Activity

1. Add Project to the Training Activity

Provide a detailed description of the training program you selected.

Generally, this program can best be categorized

as:

☐

Training that is evaluated using national or state standards

☐

Training that does not result in certification

How many personnel will be trained by this program?

Generally, the training program provided under

this grant will:

☐

Bring your department into compliance with recommended

NFPA or other national standards

☐ Bring your department info compliance with mandates from

national, state, or local training requirements

☐ Address an identified risk for your department or

community

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Training Activity

Will this training enhance your ability to perform mutual aid?

☐

Yes

☐

Will this training include members from other fire departments and/or nonaffiliated

EMS organizations?

☐

Yes

☐

Will this training be:

☐

Instructor-led

☐ Self-directed/test-validated

☐

None of the above

2. Add Item to the selected Training Project

Enter quantity, unit price, budget category, and description

Additional Questions Table 5: Wellness and Fitness Activity

Wellness and Fitness Activity

1. Add Project to Wellness and Fitness Activity

Note: Applicants that have some of the Priority 1 programs in place must apply for funds to implement the

missing Priority 1 programs before applying for funds for any additional program or equipment within this activity.

Please refer to the AFG funding notice for additional information.

Does your organization

currently offer this

activity?

Will this program be

mandatory?

Will this program be

offered to all?

Initial Physical Exam

☐

Yes

☐ No

☐

Yes

☐ No

☐

Yes

☐ No

Job-Related Immunization Program

☐

Yes

☐ No

☐

Yes

☐ No

☐

Yes

☐ No

Periodic Physical Exam/Health Screening

☐

Yes

☐ No

☐

Yes

☐ No

☐

Yes

☐ No

Behavioral Health NFPA 1500 or

equivalent

☐

Yes

☐ No

☐

Yes

☐ No

☐

Yes

☐ No

Cancer Screening Program/Equipment

☐

Yes

☐ No

☐

Yes

☐ No

☐

Yes

☐ No

2. Add item to the selected Project

Enter quantity, unit price, budget class, and description

AFG Program Application Checklist

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Additional Questions Table 6: Vehicle Acquisition Activity

Vehicle Acquisition Activity

1. Add Item to Vehicle Acquisition

Enter quantity, unit price, budget class, and description

If applying for more than one vehicle, please select ‘Add item to vehicle acquisition’ again for separate narrative

sections and questions.

If Additional Funding for the vehicle acquisition is needed, please use ‘+Add cost’ link located above vehicle

description.

Please provide the model year, pumping capacity, and carrying capacity for each vehicle within your organization's

inventory. The list of vehicles will be prepopulated based on your inputs to the Applicant and Community

trends section of the application.

Vehicle Type or Class

Model Year (e.g., 2002)

Pumping

Capacity (GPM)

Carrying Capacity (gallons)

Add Item to Vehicle Acquisition Activity

Is the vehicle you propose to buy:

☐

Replacement of an existing apparatus

☐

New purchase

Do you have a driver-training program equivalent to national or NFPA standards?

☐

Yes

☐

Are you requesting funding for training specific to the vehicle acquisition?

☐

Yes

☐

If awarded, will you develop and/or enforce standard operating

policies/procedures that require: 1) all occupants to use seatbelts, 2) all drivers

of the recipient's apparatus must adhere to all traffic signs, signals, and state

traffic regulations?

☐

Yes

☐

Will this vehicle be used on Automatic and/or Mutual Aid?

☐

Automatic Aid

☐ Mutual Aid

☐ Both

☐

None

☐

How many vehicles of this type or class in your fleet were manufactured prior to 2002?

If applying for fire apparatus, was the vehicle you are requesting to replace built before the

applicable NFPA vehicle standard from 1992?

☐

Yes

☐ No