Allowability Request

This form should be attached to an official allowability request letter from the State Administrative Agency (SAA) on state letterhead, sent to the Grant Programs Directorate (GPD) for review. Please respond to all questions on this form for your request to be considered. This form is intended to be completed electronically.

Section I: Background Information

Date of request:	Click here to enter a date

State:	California

Grantee Name:	Click here to enter text.

Grant Number:	Click here to enter text.

Fiscal Year:	Choose a fiscal year

Grant Program:	Choose a grant program

Item requested:	Click here to enter text.

Intended Use of Item:	Click here to enter text.

Core Capabilities

☐ Planning

☐ Public Information and Warning

☐ Operational Coordination

☐ Forensics and Attribution

☐ Intelligence and Information Sharing

☐ Interdiction and Disruption

☐ Screening, Search, and Detection

☐ Access Control and Identity Verification

☐ Cybersecurity

☐ Physical Protective Measures

☐ Risk Management for Protection Programs and Activities

☐ Supply Chain Integrity and Security

☐ Community Resilience

☐ Long-term Vulnerability Reduction

☐ Risk and Disaster Resilience Assessment

☐ Threats and Hazard Identification

☐ Critical Transportation

☐ Environmental Response/Health and Safety

☐ Fatality Management Services

☐ Infrastructure Systems

☐ Mass Care Services

☐ Mass Search and Rescue Operations

☐ On-scene Security and Protection

☐ Operational Communications

☐ Public and Private Services and Resources

☐ Public Health and Medical Services

☐ Situational Assessment

☐ Economic Recovery

☐ Health and Social Services

☐ Housing

☐ Natural and Cultural Resources

Cost Category:	Organization

Applicable AEL Category:

☐ N/A

☐ Personal Protective Equipment

☐ Explosive Device Mitigation and Remediation Equipment

☐ CBRNE Operational and Search and Rescue Equipment

☐ Information Technology

☐ Cyber Security Enhancement Equipment

☐ Interoperable Communications Equipment

☐ Detection

☐ Decontamination

☐ Medical

☐ Power

☐ CBRNE Reference Materials

☐ CBRNE Incident Response Vehicles

☐ Terrorism Incident Prevention Equipment

☐ Physical Security Enhancement Equipment

☐ Inspection and Screen Systems

☐ Agricultural Terrorism Prevention, Response, and Mitigation Equipment

☐ CBRNE Prevention and Response Watercraft

☐ CBRNE Aviation Equipment

☐ CBRNE Logistical Support Equipment

☐ Intervention Equipment

☐ Other Click here to enter text.

Section II: Justification of Requested Item

Please answer the following questions. As the requesting party, it is the grantee’s responsibility to provide a rationale of why an item not referenced in the applicable grant guidance or listed on the AEL should be allowable.

Please provide the number and exact text of the summary section of the Investment you are basing this request on. How does the requested item support the investment?

What goals and objectives from your State Homeland Security Strategy (SHSS) and/or Urban Area Security Strategy (UASS) does this request support? Please provide goal and objective numbers and exact text, and describe how this request supports them.

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How does this request support the intent and requirements of the grant program in question per the applicable guidance? How is it reasonable, allocable, and allowable?

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Please provide a budget breakdown for the item requested.

Anticipated Expenditures (by Allowable Cost Category)	Cost
Planning: Click here to enter text.	Click here to enter text.
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Total Planning Costs	Click here to enter text.
Organization: Provide OT funds for 4 personnel	Click here to enter text.
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Total Organization Costs	Click here to enter text.
Equipment: Click here to enter text.	Click here to enter text.
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Total Equipment Costs	Click here to enter text.
Training: Click here to enter text.	Click here to enter text.
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Total Training Costs	Click here to enter text.
Exercises: Click here to enter text.	Click here to enter text.
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Total Exercise Costs	Click here to enter text.
M&A: Click here to enter text.	Click here to enter text.
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Total M&A Costs	Click here to enter text.
Total Cost:	Click here to enter text.

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Provide a link to the vendor/equipment website, if applicable.

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If there is a similar item listen on the AEL, please explain why it cannot be used. If not applicable, please type “N/A.”

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Please provide any additional information that further justifies why this item is necessary to meet the desired outcomes of this grant program.

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