Grant Program Application – Michigan Township Participating Plan

Risk Reduction Grant Application

Fields marked with * are required

Please Confirm the Following

I have read through the Grant Guidelines and I have a complete understanding of the grant program.

I have referred to the List of Grants, as these are indicative of Risk Reduction Projects the Par Plan members have implemented to reduce risk exposure.

Member Name of Applicant

Upload Dated Resolution (Please note meeting minutes will not be accepted).

Upload Bid from the Vendor(s) selected for the project.

UPLOAD ANY ADDITIONAL DOCUMENTS RELATED TO THE PROJECT.

Member Address

Member Telephone Number

Member Fax Number

Member Email Address

Member Current Population

Member MTPP Risk Control Field Representative (Find my Representative)

Member Risk Manager (Agent) (Find my Agent)

Member MTPP Zone Director (Find my Director)

Number of Continuous Years with MTPP

Project Title

Total Amount being Requested

Project Manager

Did you received a risk reduction grant in Cycle 18?

If so, have you completed it?

Yes No

Complete description of project: Include list of the items or services to be purchased and total cost of the project.

Members financial participation in project

Anticipated days to complete

Describe how this grant will specifically reduce risk and exposure

Describe measurable benefits of this project

I understand that I will receive a confirmation email within 72 hours of receipt. If I do not receive confirmation within 96 hours I will email mtpprrgp@tmhcc.com or call 248-371-3100 to ensure my application and supporting materials were received.