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Digital Imaging Program Fund
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Grant Request Form
Digital Imaging Program Fund Grant Request Form
Agency Information
Agency Name:
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Mailing Address:
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Email
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Division/Office:
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Phone:
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Agency Contact Person
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Project Description
1. Describe the digital imaging project.
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Describe the purpose and description of the project, benefit to the agency, scope of the project, size of the project, timeline for the project completion
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2. Is this project eligible for Federal funding (matching or otherwise?) If so, please describe.
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3. Provide a cost estimate of the project
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Please include a detailed cost breakdown of the vendor's service costs. Also, provide information identifying when fund disbursements are required to meet the vendor payment obligations.3. Cost estimate of the project. Please include a detailed cost breakdown of the vendor’s service costs. Also, provide information identifying when fund disbursements are required to meet vendor payment obligations. A written estimate from the State Use Vendor is required. Applications will not be accepted without a written estimate from the State Use Vendor. The following link provides contact information for the State Use Vendor. http://www.ksstateuse.org/content.asp?MerchantID=KSSTATE1&ContentID=AgencyBTCO
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4. Will the agency contract with the vendor to ensure the information will be delivered, handled, and stored in a secure manner in accordance with applicable Federal and State requirements?
Yes
No
If yes, please describe the security measures used by the vendor to ensure information security.
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If no, please describe the security measures the agency will utilize to ensure information security.
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5. Does the agency have alternative means of funding for digital imaging projects? If so, please describe.
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6. Please include any other information the agency feels is important in the funding decision.
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7. How does the agency plan to utilize the digitized documents?
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Please describe the methods of access (within agency and to public if applicable), agency use, and digital storage.
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