BIG Program Enrollment Grant Application
Please complete this application electronically and send it via email, with scanned attachments, to the BIG Program Grant Administrator at:
Grants@NYCBIG.info
Alternatively, this application may be completed electronically, printed, and mailed, with all attachments, to:
Brownfield Incentive Grant (BIG) Program
ATTN: Grant Administrator
c/o Brownfield Redevelopment Solutions, Inc.
739 Stokes Road, Units A & B
Medford, NJ 08055
General Project Eligibility Requirements
The property must be located in New York City.
The property must be enrolled in the NYC Voluntary Cleanup Program (NYC VCP).
The property must have an OER-approved Remedial Action Work Plan under the NYC VCP.
How to Apply for the Enrollment Grant:
Step 1: Identify the Applicant(s) and Project Contract(s)………………………………………………………………… Section A
Step 2: Property Description………………………………………………………………………………………………………….. Section B
Step 3: Identify the project type…………………………………………………………………………………………………….. Section C
Step 4: Eligibility for bonus awards…………………………………………………………………………………………………. Section D
Step 5: Grant Award limits……………………………………………………………………………………………………………… Section E
Step 6: Identify grant-eligible services……………………………………………………………………………………………. Section F
Step 7: Review insurance requirements…………………………………………………………………………………………. Section G
Step 8: Certify the application………………………………………………………………………………………………………... Section H
Step 9: Attach additional eligibility documentation if applicable…………………………………………………. Attachment 1
Step 10: Attach Project Questionnaire…………………………………………………………………………………………… Attachment 2
Step 11: Review Application Checklist……………………………………………………………………………………………. Section 1
Step 12: Submit Application and Attachments to BIG Program Grant Administrator……………….…….. Submit
This form is available for download at www.nyc.gov/big
Section A: Applicant Information
Identify the organization applying for this Enrollment Grant (the Applicant), and identify a representative of the
organization.
On the following page, you will be asked to list all organizations that have at least a 25% interest in the project subject to
this application, Co-Applicants, as well as points of contact within those organizations.
Grant Applicant Organization and Representative
If an environmental consultant or other representative, outside the Applicant Organization, is authorized to work directly
with the BIG Program Administrator to provide any additional information or materials necessary to complete the
application, provide the representative’s contact information below.
Authorized Representative (if applicable)
Organization Name
Street Address 1
First name
Middle Initial
Last name
Street Address 2
Job Title
City
State
Zip
Email
Website
Telephone
Fax
First name
Middle Initial
Last name
Job title
Telephone
Mobile
Fax
Email
Organization
Street Address
City
State
Zip
This form is available for download at www.nyc.gov/big
Section A - Page 1
Organization Name
First name
Middle Initial
Last nameStreet Address 1
Street Address 2
City State Zip
Website
Job Title
Email
Telephone
Fax
First name Middle Initial
Last name
Job title
Telephone Mobile Fax
Email
Organization
Street Address
City
State
Zip
Section A: Applicant Information (continued)
Please list all organizations that have at least a 25% interest in the project subject to this application (Co-Applicant), as
well as points of contact within those organizations. Attach additional pages, if necessary, available for download
at http://www.nyc.gov/html/oer/downloads/pdf/BIG/NYCBIG_addl_Pages_Applicant_Information.pdf
.
Co-Applicant Organization and Representative
Check box if Additional Co-Applicant Organization Information pages are attached
App
licant Eligibility Requirements for the BIG Program (check if true)
The Applicant is NOT subject to any pending action, order or agreement relating to the investigation or remediation of
contamination at a brownfield site as identified in section 43-1403(b) of the city Voluntary Cleanup Program (VCP) Rule.
The Applicant has submitted all required information on the outcome of all prior Projects that have received BIG
Program funds.
The Applicant has enrolled any property that previously received a BIG Pre-Enrollment Grant and was subsequently
developed in either a New York City or New York State remedial program.
Prior to this application, the Applicant has received BIG Program Grants for no more than one other brownfield
property in this fiscal year. (The City’s fiscal year runs from July 1 to June 30.)
The Applicant has enrolled property that received a BIG Pre-Enrollment Grant in this fiscal year in either a New York
City or New York State remedial program in this fiscal year.
The Applicant has site access and/or ownership of the property.
Organization Name
Street Address 1
First name
Middle Initial
Last name
Street Address 2
Job Title
City
State
Zip
Email
Website
Telephone
Fax
This form is available for download at www.nyc.gov/big
Section A - Page 2
Organization Name
First name
Middle Initial Last name
Job Title
Email
Telephone Fax
Street Address 1
Street Address 2
City State
Zip
Website
Section A: Applicant Information (continued)
Applicant Aliases
List names and locations of all aliases under which the Applicant Organization has done business in New York City.
Applicant Name
Applicant Alias Name
City, State
Co-App
licant Aliases
List names and locations of all aliases under which the Co-Applicant Organizations have done business in New York City.
Co-Applicant Name
Co-Applicant Alias Name
City, State
Section A – Page 3
This form is available for download at www.nyc.gov/big
Section B: Property Information
NYC Voluntary Cleanup and Grant Program Information
Provide the OER assigned numbers for this project:
NYC VCP Number(s) (if applicable required for Enrollment Grant applications)
BIG Program Grant Number(s) (if available)
E-Designation/Restricted Declaration Project Number(s)*
Date of VCP enrollment
OER Project Manager Name (if known)
Provide the approval date of the Remedial Action
Work Plan (RAWP (MM/DD/YYYY)
*required for E-Designation/Restricted Declaration applications and E-Designation/Restricted Declaration projects that have enrolled in the NYC VCP
Additional Environmental Information
Does the Project Site have any open NYS Department of Environmental YES NO UNKNOWN
Cons
ervation (DEC) Spill Numbers(s)?
If YES, provide the Spill Number(s):
Is
the Project Site, or a portion of the Project Site, subject to an NYS DEC Stipulation Agreement?
YES NO
Is the Project Site, or a portion of the Project Site, enrolled in the NYS BCP? YES NO
If the project is not supported by the New York city department of housing preservation and development or the New York city
housing development corporation for affordable and/or supportive housing, or by the New York city economic development
corporation for industrial or manufacturing, or substantially by the City for other projects; or the project is not a preferred
community development project and meets one of the following criteria, it may not be eligible for BIG Program funds.
Is the Project Site located in Manhattan at or south of 96
th
Street? YES NO
Is the Project Site larger than 100,000 square feet? YES NO
Project Name (should be the name used in the application for the NYC VCP)
Street Address 1
Street Address 2
Borough
Zip
Area (Square feet)
Section B – Page 4
This form is available for download at www.nyc.gov/big
Project Name (should be the name used in the application for the NYC VCP)
Street Address 1
Borough Zip
Area (Square feet)
Street Address 2
NYC VCP Number(s) (if applicable required for Enrollment Grant applications)
BIG Program Grant Number(s) (if available)
E-Designation/Restricted Declaration Project Number(s)*
OER Project Manager Name (if known)
Date of VCP enrollment
Provide the approval date of the Remedial Action
✔
✔
✔
✔
✔
Project Description
Briefly explain what will be built at the project site. The description provided here may be taken from the proposed use sections
of OER’s cleanup program documents. Additional details are reported in the Project Questionnaire (Attachment 2). Limit: 250
words.
Ta
x Lot Information
Block Lot Zoning Current Former Tentative
To Be
To Be
Partial Lot
Subdivided Merged
Section B – Page 5
This form is available for download at www.nyc.gov/big
Section C: Project Type
Is the project a Qualifying Brownfield or a Preferred Community Development Project?
The BIG Program makes larger grants to Preferred Community Development projects which include: Affordable Housing
Developments, Brownfield Opportunity Area (BOA) Compliant Developments, and Community Facility Developments.
Included required documentation in Attachment 3.
Check here if your Project is a Qualifying Brownfield Project.
(Use reimbursable allowance for the Qualifying Brownfield Project in Section F)
Check here if your Project is a Preferred Community Development Project and select the appropriate category below.
(Use reimbursable allowance for the Preferred Community Development Project in Section F)
Affordable Housing Development - a development where at least 20% of the housing units are affordable to families that
earn no more than eighty percent of the average median income of an area, as determined by the US Department of
Housing and Urban Development.
Required Documentation: Letter of interest from a federal, state, or local housing subsidy program.
BOA Compliant Development – a development located within an NYS Brownfield Opportunity Area (BOA) that is
consistent with the community development is consistent with plans established for the BOA. Must appear on BOA
organization letterhead and be signed by the Chief Executive Officer or an authorized representative.
Community Facility Development
Required Documentation: Description of the specific benefits the facility will provide the community including, but no limited
to, a community facility use pursuant to the NYC Zoning Resolution.
For Qualifying Brownfield Properties, an administrative fee applies which will be deducted from the total grant award. The fee
reimburses the BIG Program Grant Administrator for its services. For Preferred Community Development Projects the fee is not
deducted from the total grant award.
Section C – Page 6
This form is available for download at www.nyc.gov/big
Section D: Bonus Awards
Is the project eligible for a Bonus Award?
Include required documentation in Attachment 3
The Developer is a Not-for-profit Organization – Not-for-Profit Technical Assistance Grants are available only to Not-For-
Profit developers of Preferred Community Development Projects.
Required Documentation: Proof of organization’s Not-For-Profit status.
The project is a “Track One” Cleanup – This bonus is awarded to properties that satisfy the NYC VCP’s requirements for a
“Track One” unrestricted remediation. Track One awards will not be made until remediation is complete.
Required Documentation: OER confirmation of cleanup to Track One standards.
The project is a BOA Compliant Development and a Strategic Brownfield Property - This bonus is awarded to
properties located within a BOA that are eligible for an Enrollment Grant and that are recognized as a Strategic Property by
the local organization overseeing the BOA.
Required Documentation: Letter from the BOA grant recipient stating that the property is located within the identified BOA
and that the proposed redevelopment is consistent with plans established for the BOA. The letter must also state that the
BOA organization has recognized the property as a Strategic Property. Must appear on BOA organization letterhead and be
signed by the Chief Executive Officer or an authorized representative.
The project is located within the city’s Coastal Flood Zone and is eligible for a Climate Change Resilience Cleanup Bonus.
This bonus is awarded to properties in the city’s Coastal Zone that are remediated in the NYC VCP.
Required Documentation: OER confirmation of a completed cleanup at a property located in the City’s Coastal Flood Zone
Section D – Page 7
This form is available for download at www.nyc.gov/big
Section E: Grant Award Limit
This section establishes the maximum amount of a project’s Enrollment Grant. Keep this total in mind when filling out
Section F: Eligible and Services Checklist to ensure that you maximize your overall grant award without exceeding the
cap in any one grant category.
Qualifying Brownfield Projects:
• The Enrollment Grant Award, including Environmental Insurance and Cleanup Grants, is not to exceed $25,000.
• Within this limit, Pre-Development grants are capped at $5,000, and Pre-Development grants plus Environmental Investigation
grants are capped at $10,000.
• Any prior awards for the same project must be subtracted from the cap amount.
• Bonus grants will increase the $25,000 cap:
o Track One Cleanup Grants (add $10,000)
o BOA Strategic Property Grants (add $10,000)
o Coastal Flood Zone Cleanup Grants (add $10,000)
Preferred Community Development Projects:
• The Enrollment Grant Award, including Environmental Insurance and Cleanup Grants, is not to exceed $35,000, unless the
developer is a non-profit, in which case the grant is capped at $50,000.
• Within this limit, Pre-Development grants are capped $10,000, and Pre-Development grants plus Environmental Investigation
grants are capped at $25,000.
• Any prior awards for the same project must be subtracted from the cap amount.
• Bonus grants will increase the $35,000 cap:
o Not-for-Profit Technical Assistance Grants (add %5,000)
o Track One Cleanup Grants (add $10,000)
o BOA Strategic Property Grants (add $10,000)
o Coastal Flood Zone Cleanup Grants (add $10,000)
For a more detailed breakdown of the grant award limits
use the “Grant Award Calculator” which is available for download at:
https://www.nyc.gov/html/oer/downloads/pdf/BIG/NYCBIG_Enrollment_Award_Limit_Calculator.pdf
Section E - Page 8
This form is available for download at www.nyc/big
Section F: Eligible Activities and Services Checklist
List all BIG Program Qualified Vendors, as well as contractors and sub-contractors )e.g. excavation contractor, trucker
etc.), that have completed activities completed activities or services to be reimbursed. Use the identifier of each vendor in
the activity/service checklist below.
Select the eligible services and activities from the list below for which reimbursement is requested. Selection may be made by
checking the box in the left column for each of the listed items, indicating the number of units of each item and inserting the line
sub-total. A total of all costs must be entered on the last line of each section. Please do not use ditto marks when filling out this
form. In the event there is an error of the summation of the totals, the computation by the BIG Program Grant Administrator shall
govern. All work funded by the BIG Program must meet certain minimum performance standards. Deliverables required to provide
evidence of the completion of all activities and services funded by the BIG Program are summarized in blue text in the table below.
These deliverables must accompany all requests for reimbursement. For a complete description of required minimum performance
standards see the: "BIG Program Technical Specifications” document at http://www.nyc.gov/BIGapplications.
Identifier
Firm / Organization
A
B
C
D
E
Section F – Page 9
This form is available for download at www.nyc.gov.big
Select
Qualified
Vendor
(indicate by
identifier
from list
above)
Activity/Service Unit
Reimbursable
Allowance for
Qualifying
Brownfield
Project (See
Section C)
Reimbursable
Allowance for
Preferred
Community
Development
Project (See
Section C)
No. of
Units
Sub-Total
Other Services
Required Deliverables:
For
Site Survey: Copy of signed, certified and updated survey plan by New York State licensed Professional
Land Surveyor. For Community Outreach: Report of outreach activities from Certified Planner, Not-for-Profit
Service Provider, or QEP. For Phase I Environmental Site Assessment: Copy of Phase I ESA prepared in
conformance with ASTM Standard E1527-05.
Site survey
Day
$956
$1,275
$
Community outreach
Each
$956
$1,275
$
Phase I Environmental Site
Assessment
Each $1,594 $2,125 $
Total Reimbursement Request For Pre-Development Grant:
$
The reimbursement limit for a Pre-Development Grant is $5,000 for Qualifying Brownfield Projects and $10,000 for
Preferred Community Development Projects. If total request exceeds the limit, the reimbursement will equal the limit
minus applicable fees.
Select
Qualified
Vendor
(indicate by
identifier
from list
above)
Activity/Service Unit
Reimbursable
Allowance for
Qualifying
Brownfield
Project (See
Section C)
Reimbursable
Allowance for
Preferred
Community
Development
Project (See
Section C)
No. of
Units
Sub-Total
Pre-Development
Title insurance / Title search
Required Deliverable:
Copy of title insurance or title search report issued by title insurance/search company or professional
Full coverage
each
$765
$1,020
$
Limited coverage
each
$382.50
$510
$
Non-Insured reports
each
$255
$340
$
Project Feasibility Study
Required Deliverable:
Copy of Project Feasibility Study prepared by Certified Planner, Professional Engineer, QEP, or Not-for-Profit Service Provider.
Market analysis
Each
$765
$1,020
$
Concept plans
Each
$765
$1,020
$
Pro-forma financial
Each
$765
$1,020
$
Zoning analysis
Each
$765
$1,020
$
Legal due diligence review
Report
$300
$400
$
State BCP eligibility
consultation
Each $1,000 $1,333 $
Section F – Page 10
This form is available for download at www.nyc.gov.big
Section F – Page 11
This form is available for download at www.nyc.gov.big
Phase II / Site Characterization
Report
Eac h $1,275 $1,
700 $
Geophysi
cal survey report 1/2 Day $765 $1,020 $
Geophysical survey report Day $1,116 $1,488 $
Geophysical anomalles
investigation
(excavat
or/operator)
Day $606 $808 $
Soil bori
ng installation 1/2 Day $637.50 $850 $
Soil boring installation Day $956.25 $1,275 $
Soil sample collection field
screening
Day $510 $680 $
Monitoring w ell installation
(unconsolidated)
Well $1,593.75 $2,
125 $
Monitor
ing well installation
(bedrock)
Well $2,550 $3,
400 $
Dispos
al of drill cuttings and
transportation
Drum $79.50 $106 $
M
onitori
ng w ell survey Day $956.25 $1,275 $
Grant Project Reporting Eac h $318.75 $425 $
Groundwater
Copie
s of relevent reports and work plans, prepared by a QEP in accordance with acceptable environmental standards
Soil
Phase II / Remedial Investigation
Required Deliverables:
Copies of relevent reports and boring logs as applicable and prepared in accordance with acceptable environmental standards
Environmental Investigation
Work Plans and Reports
Required Deliverables:
Select
Qualified
Vendor
(indicate by
identifier
from list
above)
Activity/Service Unit
Reimbursable
Allowance for
Qualifying
Brownfield
Project (See
Section C)
Reimbursable
Allowance for
Preferred
Community
Development
Project (See
Section C)
No. of
Units
Sub Total
Groundwater (continued)
Temporary well-point
installation
Each $382.50 $510 $
Groundwater sample
collection/water level
measurement
Day $510 $680 $
Disposal of purge water and
transportation
Drum $51 $68 $
Aquifer Test
Each
$382.50
$510
$
Vapor
Vapor probe installation
Day
$956.25
$1,275
$
Vapor sample collection
Day
$510
$680
$
Ambient air sample collection
Day
$510
$680
$
Reports
Phase II/site characterization
report
Each $1,275 $1,700 $
Remedial investigation report
Each
$1,593.75
$2,125
$
Grant Project Reporting
Each
$318.75
$425
Total Reimbursement Request For Environmental Investigation Grant: The reimbursement limit for an Environmental
Investigation Grant is $10,000 for Qualifying Brownfield Projects and $25,000 for Preferred Community Development
Projects, inclusive or any Pre-Development Grant requests or awards. If total request exceeds the limit, the
reimbursement will equal the limit minus applicable fees.
$
Section F – Page 12
This form is available for download at www.nyc.gov.big
Section F – Page 13
This form is available for download at www.nyc.gov.big
Remedial Action Work Plan Eac h $5,000 $
Remedial Action Report Eac h $5,000 $
Remedial Investigation report and
remedial action w ork plan: Full
service
Eac h $30,000 $
Remedial Action Report: Full service Eac h $30,000 $
Site Management Plan Eac h $2,500 $
Grant Project Reporting Eac h $425 $
Field Oversight Half Day $400 $
Field Oversight Day $1,000 $
Environmental Insurance Premium $25,000/$30,000 $
Disposal - Soil, Hazardous Ton $102 $
Disposal - Soil, Non-Hazardous Ton $43 $
Waste characterization: ID-27 (TCLP
metals, TPH, PCBs, reactive CN & S,
ignitability, PH)
Sample $208 $
Manifests, Invoices, Weight Tickets and Copy of written documentation prepared and/or certified by QEP of relevant
disposal activities
Cleanup Grants
Work Plans and Reports
Required Deliverables:
Copies of relevant reports and work plans, prepared by a QEP in accordance with acceptable environmental standards
Soil Removal
Required Deliverables:
Select
Qualified
Vendor
(indicate by
identifier from
above list)
Activity/Service Unit
Reimbursable
Allowance
No. of
Units
Sub-Total
Soil Removal (continued)
Mobilization/demobilization -one
time allowable per site per
machine
Each $425 $
Loader/backhoe w/ operator
Day
$808
$
Small Trackhoe w/operator J
Deere 200LC or equivalent
Day $1,190 $
Large Trackhoe w/ operator (Cat
325 or equivalent
Day $1,445 $
Skid Steer Loader w/ operator
Day
$595
$
Dump Truck w/ operator (approx.
12 yd
3
)
Day $340 $
Dump Truck. Tandem - Triaxle w/
operator (25 yd
3
)
Day $765 $
Roll off Box (20 yd
3
)
Each
$510
$
Vacuum Truck w/ operator
Hour
$77
$
Post-excavation soil sample
collection
Day $680 $
Backfill
Required Deliverables:
Copies of written documentation prepared and/or certified by QEP of relevant backfill information
Recycled Concrete Aggregate
Ton
$13
$
Certified Clean Fill Material
Ton
$17
$
Top Soil
Cy
$21
$
Engineering Controls (Cap emplacement)
Required Deliverables:
Copies of written documentation prepared by QEP including quantity of material utilized
Clean fill/gravel
Ton
$17
$
Top Soil
Cy
$21
$
Asphalt (2 in. compacted asphalt
on 2 in. gravel base minimum
Sf $3.80 $
Cement paving 4 in. minimum
Sf
$4.25
$
Sub-slab depressurization system
passive
Sf $7.00 $
Sub-slab depressurization system
active
Sf $8.50 $
Vapor barrier/water proofing (up to
39 mil)
Sf $5.00 $
Vapor barrier (40 mil and greater
Sf
$6.00
$
Section F – Page 14
This form is available for download at www.nyc.gov.big
Section F – Page 15
This form is available for download at www.nyc.gov.big
Deed restriction preparation
Eac h $2,125 $
Priority Pollutant metals (13 metals) Sample $83 $
Total RCRA metals (8 metals) Sample $53 $
Target analyte list metals (23 metals) Sample $129 $
Target Compound List SVOC's Sample $204 $
Base neutrals Sample $115 $
Base neutrals + 10 or 15 Sample $128 $
Base neutrals/acid extractables
(semi-volatile organics)
Sample $204 $
Lab Analysis
Required Deliverables:
Copies of lab analysis reports
Metals (Soil/Water)
Organics (Soil/Water)
Institutional Controls
Required Deliverables:
Copy of declaration of covenants and restrictions, in draft or final form, prepared by an attorney
Select
Qualified
Vendor
(indicate by
identifier from
list
Activity/Service Unit
Reimbursable
Allowance
No. of
Units
Sub-Total
Lab Analysis (continued)
Organics (Soil/Water) (continued)
BTEX
Sample
$41
$
BTEX + MTBE + TBA
Sample
$41
$
Herbicides
Sample
$77
$
PAHs
Sample
$115
$
PCBs
Sample
$51
$
PCBs in oil
Sample
$41
$
Pesticides
Sample
$51
$
Volatiles
Sample
$68
$
Volatiles + 10 or 15
Sample
$77
$
Volatiles (drinking water)
Sample
$105
$
Volatiles (drinking water) +10 or 15
Sample
$115
$
Target compound list VOC's
Sample
$204
$
Target compound list (VO +10.
BNAE+20 Pest/PCB)
Sample $408 $
Organics (Air)
TO-15
Sample
$272
$
Group Tests
ID-27 (TCLP Metals, TPH, PCBs,
reactive CN & S, ignitability, pH)
Sample $208 $
Priority pollutants + 40 (VO+15,
BNAE+25, pest/PCB, 13 metals,
CN, phenol)
Sample $535 $
RCRA characteristics (reactive CN
& S, ignitability, corrosivity)
Sample $51 $
TCLP-Full (8 metals, VO, BNAE,
pesticides, herbicides)
Sample $509 $
Total Reimbursement for Cleanup Grant:
Select activities/services sufficient to meet grant award limit, including Track One Bonus Cleanup Grants and
BOA Strategic Property Bonus Grants. If the total reimbursement request exceeds the award limit, only the
amount up to the award limit will be reimbursed, minus applicable fees.
$
Section F – Page 16
This form is available for download at www.nyc.gov.big
Section G: Insurance Information
The purpose of this section is to describe in general the insurance requirements for the BIG Program.
Documentation of proof of insurance must be provided, when applicable, in order to complete the grant
application process. For more detailed information, please visit:
http://www.nyc.gov/html/oer/html/big/Insurance.shtml
Or contact:
Mark P. McIntyre
General Counsel, Mayor’s Office of Environmental Remediation
BIG Program Insurance Requirements
The BIG Program requires Qualified Vendors (QVs), contractors, and sub-contractors, to maintain insurance
that is adequate for the nature and scope of services that the QV will perform. The extent and type of
insurance required varies according to the type of work performed and the type of QV.
• For a cleanup, contractors hired to perform remedial work, and their sub-contractors, must carry
commercial general liability (CGL) coverage at $1,000,000 per occurrence and contractors pollution
liability (CPL) coverage of $1,000,000 per occurrence. In addition, these policies must list the City,
NYCEDC, and the Program Administrator as additional insureds.
• For the preparation of reports and documents, such as a Phase II Site Investigation Report, site
investigation, or a deed restriction, QVs, including architects, engineers, attorneys and qualified
environmental professionals, must carry professional liability insurance in the amount of $1,000,000 per
occurrence.
Whe
n applying for a Cleanup Grant that seeks reimbursement for the excavation and disposal of soil, the
applicant must identify the excavation contractor and trucking firm(s) that performed the active remediation and
produce Accord certificates evidencing that these entities are covered by CGL and CPL policies.
Insurance Requirements Fact Sheet:
http://www.nyc.gov/html/oer/downloads/pdf/BIG/NYCBIG_QV_Insurance_Fact_Sheet.pdf
Example of a Certificate of Insurance (COI):
http://www.nyc.gov/html/oer/downloads/pdf/BIG/BIG_COI_examples.pdf
Section G – Page 17
This form is available for download at www.nyc.gov.big
Section H: BIG Program Application Certification Form
Read the following statements and certify below that you have read, understand, and agree to all terms:
• The individual signing on behalf of the Applicant is fully authorized to do so and to certify as to the following on behalf of
the Applicant
• Applicant has read and is aware of the eligibility criteria, rules and regulations applicable to the BIG Program, and
determinations of the BIG Program Administrator and the New York City Office of Environmental Remediation.
• Applicant is eligible for the type of grant(s) applied for and is not debarred from receiving federal or New York City
funding.
• Applicant certifies that all statements and certifications made in this application are in all respects complete, accurate,
true and not misleading as of the date of this application, and shall remain so as of the date of the Grant Agreement, if
any. Should any material changes occur prior to entering into a Grant Agreement, Applicant shall submit a revised and
updated application.
• Applicant recognizes and acknowledges: (i) that Applicant will be required to enter into a Grant Agreement as a
condition of any grant that may be awarded; (ii) that grant monies, if awarded, may cover only a portion of the cost of
the project; and (iii) that the BIG Program Administrator is acting only as a conduit of City funds and not as a principal,
and that payment of grant monies, if awarded, will be forthcoming only when and if the grant monies are provided to the
BIG Program Administrator by the New York City Economic Development Corporation.
I certify that I have read, understand, and agree to all statements provided above.
Provide the following information for the Primary Grant Applicant and the Primary Contractor the Applicant Organization filling out this certification.
First Name Middle Initial Last Name Job Title
Telephone
Mobile
Fax
Email Date
Grant Applicant Organization from Section A Applicant Signature
Section H – Page 18
This form is available for download at www.nyc.gov.big
Section I: Enrollment Application Checklist
Required Attachments
Documentation of OER approval of Remedial Action Work Plan (RAWP).
Documentation demonstrating access or control of
Project
site.
Required documentation, if applying as a Preferred Community Development
Project.
Required documentation, if applying for Bonus
Grants.
Required documentation, if applying as a Not-for-Profit
organization.
Invoices on service provider letterhead for each activity/service for which reimbursement
is
requested as indicated in
the Eligible Activities and Services
Checklist.
Minimum Performance Standard Documentation for each activity/service for which reimbursement is requested as
indicated in the Eligible Activities and Services Checklist.
Completed BIG Program Project Questionnaire.
(
http://www.nyc.gov/html/oer/downloads/pdf/BIG/NYCBIG_Project_Questionnaire.pdf)
Insurance specimen for requested activities as applicable, per
Section G,
listing the City, the NYC Economic
Development Corporation (EDC), and BIG Program Grant Administrator as additionally insured. If you have any
questions regarding proof of insurance for your project, please contact Mark P. McIntyre, General Counsel, Mayor’s
Office of Environmental Remediation, at 212-788-3015 or
mmcintyre@cityhall.nyc.gov. The Applicant has an option of
submitting this item with this application or later upon execution of the Grant Agreement.
Signed Application certification (Section H), scanned and included with attachments.
Please complete electronically and send via email, with scanned required attachments, to the
BIG Program Administrator at: Grants@NYCBIG.info
Alternatively, this application may be completed electronically, printed, and mailed,
with all required attachments, to:
Brownfield Incentive Grant (BIG) Program
ATTN: Grant Administrator
c/o Brownfield Redevelopment Solutions, Inc.
739 Stokes Road, Units A & B
Medford, NJ 08055
Section I – Page 19
This form is available for download at www.nyc.gov.big
Attachment 1: (if applicable)
Preferred Community Development Documentation
Not-for-Profit Developer Documentation Bonus
Grant Documentation
Enrollment Grant Application (ver. 01JUN17)
Page 20
