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Project Scope/Cost Estimate Form <br />GRANTEE: PROJECT Name <br />Project scope (Describe the project in 30 words or less): <br />Project Scope Items - Q all that apply: <br />Install Renovate Replace Recreation Element <br />new existing existing <br />❑ ❑ ❑ Pool, aquatic center, splash pad <br />❑ <br />❑ <br />❑ <br />Trails or walking paths <br />❑ <br />❑ <br />❑ <br />Landscaping or irrigation <br />❑ <br />❑ <br />❑ <br />Group picnic, outdoor classrooms, other gathering spaces <br />❑ <br />❑ <br />❑ <br />Play equipment, outdoor fitness equipment <br />❑ <br />❑ <br />❑ <br />Sports fields, sports courts, court lighting <br />❑ <br />❑ <br />❑ <br />Community center, gym, other indoor facilities <br />❑ <br />❑ <br />❑ <br />Restroom, concession stand <br />❑ <br />❑ <br />❑ <br />Other: <br />❑ <br />❑ <br />❑ <br />Other: <br />❑ ❑ <br />❑ <br />Minor elements which support one or more of the recreation <br />_ <br />elements checked above: benches, lighting, parkin , signage, etc. <br />Total estimated cost for construction: <br />$ <br />_ <br />PRE -CONSTRUCTION (costs incurred prior to ground -breaking, such as design, <br />permits, bid packages, <br />CEQA); up to 25% of total GRANT amount. <br />$ <br />Total GRANT amount: <br />$ <br />The GRANTEE understands <br />that all elements listed on this form must be complete and open to the <br />public before the final <br />grant payment will be made. <br />AUTHORIZED REPRESENTATIVE Signature Date <br />Print Name and Title <br />The APPLICANT understands that this form will be used to establish ELIGIBLE COSTS, and that all of <br />the recreation features and support amenities listed on this form must be completed and open to <br />the public before the final PROJECT payment is processed as specified in the Final Payments <br />section of this guide. <br />13 <br />