Application Forms.pdf

Application checklist
A completed application checklist must accompany the grant application. Copy or remove this page,
then initial each item that has been attached to the application. Incomplete applications are ineligible
for funding. When submitting a hard copy, see the “How to apply” section for details.
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Application cover page
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Checklist
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Project description
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Project plans
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Reasonable public access and fees
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Range master plan
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Location map
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Public benefit information
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Budget worksheet
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Yes, project would still be completed if only partial funding was granted
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I certify that the range property owner has approved the proposed grant project.
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Insurance certificate
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Board resolution in support of the application
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Arizona GAO-W-9 form
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Control and tenure statement
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State Historical Preservation Office (SHPO) Certificate
Shooting Range Development Grant Application Packet
Page 12 of 19
X
X

Fill out and print this page and place it on the cover of your application.
Arizona Game and Fish Commission
Shooting Range Development Grants
Application cover page Please type or print
Department use only
Application #
Date received
Grant year
Organization name
Project title
Total project cost
$151,465.00
Maximum grant award is 50% of total
actual project cost.
Total Grant Amount
Requesting
$75,732.00
Brief description of the
project
Project start date
Project end date
Contact person for this
application
Mailing address
Telephone
Fax number
Email address
Shooting Range information
Name of range
Name of range manager
Phone Number
Email address of
Manager or contact
Mailing address of
range or general range
location
Legal description
Quarter
Section
Township
Range
I certify that the information contained in this grant application is accurate. If awarded a grant, our organization will
abide by the requirements of the Arizona Game and Fish Department. I acknowledge that failure to meet the
requirements of the grant program will result in the forfeiture of grant funds.
Signature of person who prepared the
application
Date
Printed name of individual above
Signature of the president of the applicant
organization
Date
Printed name of individual above
Shooting Range Development Grant Application Packet
Page 11 of 19
City of Buckeye
Rob Roach
530 E. Monroe Ave., Buckeye, AZ 85326
623-349-6165
rroach@buckeyeaz.gov
Rob Roach, Grant Program Manager
Joe Foss Shooting Complex
Joe Foss Shooting Complex Archery Courses
The City of Buckeye seeks to enhance and re-open 2 archery ranges at the Joe Foss 
Shooting Complex that have been non-operational for several years.
Upon AZGFD approval
September 2025
Not applicable
TBD
TBD
Current Operational Contact: Mark Bianco, mbianco@buckeyeaz.gov, 623-349-6614
530 E. Monroe Ave.
Buckeye, AZ 85326
1/15/25
1/15/25
Courtney Gomez, Grant Analyst
Parcel #401-90-011

AZGFD SHPO Consultation
This consultation is required by regulations implementing the State Preservation Act (A.R.S. § 41-861 through
42-864), effective July 24, 1982. It is understood that recipients of state funds are required to comply with this
law throughout the project period. The State Historic Preservation Act mandates that all State agencies consider
the potential of activities or projects to impact significant cultural resources. Each State agency is required to
consult with the State Historic Preservation Officer with regard to those activities or projects that may impact
cultural resources.
PROJECT TITLE
APPLICANT
Please answer the following questions which provide information on the potential of the project to impact
cultural resources:
Does the proposed project have the potential to disturb the surface and/or subsurface of the ground?
YES
NO
Are there any known prehistoric and/or historic archaeological sites within the project area that have the
potential to be disturbed by the proposed activity?
YES
NO
Are there any buildings or structures (including mines, bridges, dams, canals, etc.) which are 50 years or older
within the project area that have the potential to be disturbed by the proposed activity?
YES
NO
If you have answered “NO” to all of the above questions, please sign on the line below certifying that the
activity or project is in compliance (and will remain in compliance throughout the project period) with the State
Historic Preservation Act.
Authorized Signature/Date
Printed Name
Phone Number
If you have answered “YES” to any of the above questions you must complete the “SHPO Information Form”
and follow the directions on the back of this certification. Forward copies of all information requested to the
Arizona Game and Fish Department. All original copies should be submitted with the application to the
Arizona Game and Fish Department. DO NOT FORWARD THIS FORM TO SHPO!
Shooting Range Development Grant Application Packet
Page 16 of 19
City of Buckeye
X
X
X
Rob Roach, Grant Program Manager
623-349-6165
Joe Foss Shooting Complex Archery Courses

Identify the total project area acreage involved:
_Approximately 10 acres__________________________
Please comment on the condition of the current ground surface within the entire project boundary area (i.e., is
the ground in a natural undisturbed condition, or has it been bladed, paved, graded, etc.). Attach extra sheets if
more space is needed.
Has the project area been previously surveyed for cultural resources by a qualified Archaeologist?
          Unknown
If yes, the applicant must submit a copy of the Archaeologist’s 
report.
Identify the Landowner (Note: if a Federal Agency is involved, they must consult with SHPO pursuant to the
National Historic Preservation Act).
Project location: Maricopa County Assessors Parcel #401-90-011 (Township, Range, Section and quarter/
quarters)
Please provide a map identifying the location of the range and proposed project areas. Topo quad
maps and Google Earth images are both acceptable.
Shooting Range Development Grant Application Packet
Page 17 of 19
SHPO Information Sheet
If you answered yes to question #1 on the SHPO Consultation page, please attach a brief description of 
the proposed project and specifically identify any surface or subsurface impacts that are expected.        
- Not applicable.
_________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
All walking paths and shooting stations were previously created and graded. All other areas will remain in their 
natural undisturbed condition. 
Maricopa County

Budget Worksheet
Use this worksheet to develop a cost estimate. Additional categories may be used if needed.
Project Title:
Organization:
Estimated costs
Organization dollars
(Cash Dollars Dedicated
to the Project)
Value of donated
services and supplies
This column should
contain estimates of
all project costs.
Organization dollars and donated services and supplies
must equal 50% of the total project cost.
Planning/development
$_____0.00_____
$____0.00_____
$_____________
Equipment
$__21,600.00___
$__10,800.00___
$_____________
Construction
$__128,765.00__
$___64,383.00___
$_____________
Labor
$__0.00_______
$_0.00_________
$_____________
Supplies
$__1,100.00___
$__550.00_____
$_____________
Other
$___0.00_____
$___0.00______
$_____________
Total project cost
$_____________
Total organizational
dollars and donations
(Must Equal or Exceed 50% of
Total Project Cost)
$____________=
$_75,733.00_____ +
$______________
Grant Request
(Not to Exceed 50% of the Total
Project Costs)
$_____________
Please tell us if any other organizations are providing funding for this project.
Shooting Range Development Grant Application Packet
Page 18 of 19
City of Buckeye
75,732.00
75,733.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
151,465.00
- There are no other organizations providing funding for this project.
Joe Foss Shooting Complex Archery Courses

Board resolution in support of the grant application
Each application must include this resolution, signed by the president or similar governing group or officer, 
indicating that the application has the approval of the organization’s governing board. All resolution forms must 
be attested to by the organization’s secretary or officer and notarized.
Resolution of the City of Buckeye City Council
(organization’s governing body)
Resolution No: 83-24 Date: December 17, 2024
Approving the application to the Arizona Game and Fish Department for a Shooting Range 
Development Grant for project title: Joe Foss Shooting Complex Archery Courses. WHEREAS, the 
Arizona Game and Fish Commission under A.R.S.§17-231.4 has authorized the establishment of 
a Shooting Ranges Development Policy providing financial assistance for the development of 
shooting ranges for public purposes; and
WHEREAS, the Arizona Game and Fish Department has responsibility for the administration of the 
policy, including the necessary guidelines and procedures governing applications for funding 
assistance under the policy; and
WHEREAS, the application procedures require the applicant’s governing body to approve by 
resolution the submission of applications for shooting range assistance
NOW, THEREFORE, BE IT RESOLVED that this board hereby:
●
Approves the filing of an application for a shooting range development grant; and
●
Certifies that the project application is consistent and compatible with all adopted plans and 
programs for safe shooting range development; and
●
Agrees to comply with all procedures, guidelines and requirements of the Arizona Game and 
Fish Department as a part of the application process; and
●
Understands that the project scope and funding amount are subject to final approval by the 
Arizona Game and Fish Commission; and City of Buckeye (Name of project coordinator) is authorized to 
act on behalf of this organization by conducting negotiations, and by executing and submitting 
documents, including but not limited to, applications, agreements, amendments, and other 
documents which may be necessary for the completion of a shooting range development project. 
PASSED, ADOPTED AND APPROVED.
By signing below, I certify that I am the duly appointed and qualified Grant Program Manager (title of 
your office) of the City of Buckeye (name of your organization)and certify that the foregoing resolution is true, 
correct and was passed and adopted at a regular meeting of the board, held on December 17, 2024 (date of 
the meeting) at which a quorum was present.
Signature of office holder
Date
Printed name and title of individual
above
Notary’s seal and information
Shooting Range Development Grant Application Packet
Page 19 of 19
1/15/25
Rob Roach, Grant Program Manager