Okaloosa County BOCC — August 19, 2014 — FAA Grant Application_VPS Boarding Ramps — reading text

CONTRACT & LEASE INTERNAL COORDINATION SHEET Contract/Lease Number: Tracking Number:_ /0 55 - M4 Grant Funded: YESS NO Contractor/Lessee Name: Laat (py becca tear Purpose_ VQ me tage Date/Term: 1. Ext Greater THAN $50,000 Amount: 2's LJ GREATER THAN $25,000 Department: AP 3. LJ $25,000 OR LESS Dept. Monitor name aman /Yeree Document has been reviewed and includes any attachments or exhibits. Purchasing Review Date: K- 4- ff Pant uréhasing Director or Désignee Joanne Kublik Risk Management Review Approved as written: << NETS ik a Date: Go a! 43 == Risk Manager or designee ) Kae, Gedus Ln : a) aa County Attorney Review sont ved as writ ta 7 On” Date: B-W—\Y epi At torney Gregory T. Stewart Following Okaloosa County approval: Contracts & Grants Document has been received: Date: Contracts & Grants Manager OMB Approval No. 0348-0043 APPLICATION FOR 2. DATE SUBMITTED Applicant Identifier 8/1/2014 FEDERAL ASSISTANCE 1. TYPE OF 3. DATE RECEIVED BY STATE State Application Identifier SUBMISSION: Application Preapplication 1 Construction O Construction I Non-Construction 1 Non-Construction 4. DATE RECEIVED BY FEDERAL AGENCY Federal Identifier 5. APPLICANT INFORMATION Legal Name: Okaloosa County Board of County Commissioners DUNS 613277649 Organizational Unit: -Office of Contracts & Grants Address (give city, county, state, and zip code) 1804 Lewis Turner Blvd (Ste 206) Fort Walton Beach, FL 32547 Name and telephone number of the person to be contracted on matters involving this application (give area code) Marcella Eubanks(850)651-7200, Ext 4381 e-mail: grants@clerkofcourts.cc EMPLOYER IDENTIFICATION NUMBER (EIN): 7. TYPE OF APPLICANT: (enter appropriate letter in box) B [9] = [5] fo] fo] [o] [5] A. State H. Interdependent School District B. County |. State Controlled Institution of Higher Learning C. Municipal J. Private University , D. Township K. Indian Tribe 8. TYPE OF APPLICATION: E. Interstate L. Individual i N oO cannauat oO Revisi F. Intermunicipal M. Profit Organization lew ontinuation evision G. Special District N. Other (Specify) If Revision, enter appropriate letter(s) in box(es): B Decrease Award C_ Increase Duration Other (specify) A_ Increase Award D Decrease Duration 9. NAME OF FEDERAL AGENCY Federal Aviation Administration (FAA) 10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER 2 O;. 71 0 6 TITLE: Airport Improvement Program (AIP) 11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT: Replace obsolete Regional Boarding Ramps with Ground Level Passenger Loading Bridges at Gates A-1 and A-2 for 12. AREAS AFFECTED BY PROJECT (cities, counties, states, etc.): Okaloosa County Northwest Florida Regional Airport. 13. PROPOSED PROJECT 14. CONGRESSIONAL DISTRICTS OF Start Date Ending Date a. Applicant b. Project Dec 2014 Feb 2015 1st 1st 15. ESTIMATED FUNDING 16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 12372 PROCESS a. Federal $ 1.731.921 -00 a. YES, THIS PREAPPLICATION/APPLICATION WAS MADE AVAILABLE TO THE anne STATE EXECUTIVE ORDER 12372 PROCESS FOR REVIEW ON b. Applicant PFC $ 96,218 00 c. State $ 96,218 00 DATE: d. Local $ b. NO DX] PROGRAM IS NOT COVERED BY E. O. 12372 e. Other $ im OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW f. Program income $ 17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT? g. TOTAL $ 1,924,357 -90 CT] Yes _ If yes, attach an explanation 4] No 18. TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS APPLICATION ARE TRUE AND CORRECT, THE DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED a. Typed Name of Authorized Representative b. Title Charles K. Windes, Jr. Chairman, Okaloosa Board of County Commissioners c. Telephone number (850)651-7105 d. Signature of Authorized Representative e. Date Signed out Ss Taw A Ko Lorre on itions Not Usable Previous Authorized for Local Reproduction ““Btandard Form 424 (REV 4-88) Prescribed by OMB Circular A-102 U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION OMB NO. 80-RO184 PART Il PROJECT APPROVAL INFORMATION SECTION A Item 1 Does this assistance request require State, local, Name of Governing Body regional, or other priority rating? Priority L]Yes K]No Item 2. Does this assistance request require State, local Name of Agency or Board advisory, educational or health clearances? (Attach Documentation) []Yes K]No Item 3 Does this assistance request require clearinghouse review in accordance with OMB Circular A-95? (Attach Comments) []Yes K]No Item 4 Does this assistance request require State, local, Name of Approving Agency regional or other planning approval? Date LTYes K]No Check One: State im Item 5. Local O Is the proposed project covered by an approved Regional (C] comprehensive plan? L]Yes KXINo Location of plan Item 6. . . Will the assistance requested serve a Federal Name of Federal Installation Eglin Air Force Base installation? Federal Population benefiting from Project X]lYes LJNo Item 7 Will the assistance requested be on Federal land Name of Federal Installation Eglin Air Force Base or installation? Location of Federal Land Florida Lxlves LJNo Percent of Project 100% Item 8 Will the assistance requested have an impact or effect on the environment? LlYes X]No Number of: Item 9. Individuals Will the assistance requested cause the displacement of Families individuals, families, businesses, or farms? Ov PN Businesses es o Farms Item 10. Is there other related Federal assistance on this project previous, pending, or anticipated? L]Yes K]No FAA Form 5100-100 (6-73) SUPERSEDES FAA FORM 5100-10 PAGES 1 THRU 7 U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION Page 2 OMB NO. 80-RO184 PART II —- SECTION C The Sponsor hereby represents and certifies as follows: 1. Compatible Land Use. — The Sponsor has taken the following actions to assure compatible usage of land adjacent to or in the vicinity of the airport: N/A 2. Defaults. — The Sponsor is not in default on any obligation to the United States or any agency of the United States Government relative to the development, operation, or maintenance of any airport, except as stated herewith: N/A 3. Possible Disabilities. - There are no facts or circumstances (including the existence of effective or proposed leases, use agreements or other legal instruments affecting use of the Airport or the existence of pending litigation or other legal proceedings) which in reasonable probability might make it impossible for the Sponsor to carry out and complete the Project or carry out the provisions of Part V of this Application, either by limiting its legal or financial ability or otherwise, except as follows: N/A 4. Land. — (a) The sponsor holds the following property interest in the following areas of land* which are to be developed or used as part of or in connection with the Airport subject to the following exceptions, encumbrances, and adverse interests, all of which areas are identified on the aforementioned property map designated as Exhibit “A”: Land is on Eglin Air Force Base under a lease to Okaloosa County *State character of property interest in each area and list and identify for each all exceptions, encumbrances, and adverse interests of every kind and nature, including liens, easements, leases, etc. The separate areas of land need only be identified here by the area numbers shown on the property map. FAA Form 5100-100 (4-76) AAA Me U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION OMB NO. 80-RO184 PART II - SECTION C (Continued) The Sponsor further certifies that the above is based on a title examination by a qualified attorney or title company and that such attorney or title company has determined that the Sponsor holds the above property interests. (a)The Sponsor will acquire within a reasonable time, but in any event prior to the start of any construction work under the Project, the following property interest in the following areas of land* on which such construction work is to be performed, all of which areas are identified on the aforementioned property map designated as Exhibit “A”: N/A (c)The Sponsor will acquire within a reasonable time, and if feasible prior to the completion of all construction work under the Project, the following property interest in the following areas of land* which are to be developed or used as part of or in connection with the Airport as it will be upon completion of the Project, all of which areas are identified on the aforementioned property map designated as Exhibit “A”: N/A 5. Exclusive Rights. — There is no grant of an exclusive right for the conduct of any aeronautical activity at any airport owned or controlled by the Sponsor except as follows: None *State character of property interest in each area and list and identify for each all exceptions, encumbrances, and adverse interests of every kind and nature, including liens, easements, leases, etc. The separate areas of land need only be identified here by the area numbers shown on the property map. FAA Form 5100-100 (4-76) PAAMCEeT ate U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION OMB NO. 80-RO184 PART III- BUDGET INFORMATION - CONSTRUCTION SECTION A - GENERAL 1. Federal Domestic Assistance Catalog No. 2. Functional or Other Breakout. SECTION B - CALCULATION OF FEDERAL GRANT Cost Classification Use only for revisions Latest Approved Amount Adjustment + or(-) Total Amount Required Administration Expense 2,000 N Preliminary Expense Land, structures, right-of-way iN . Architectural engineering basic fees (Incl Const Mgt) 63,440 Other architectural engineering fees Project inspection fees Land development Relocation Expenses Relocation payments to individuals and businesses 10. Demolition and removal 11. Construction and project improvement 1,858,917 12. Equipment 13. Miscellaneous Pre-construction CM at Risk Phase | 14. Total (Lines 1 through 13) 1,924,357 15. Estimated Income (if applicable) 16. Net Project Amount (Line 14 minus 15) 17. Less: Ineligible Exclusions 18. Add: Contingencies 19. Total Project Amt. (Excluding Rehabilitation Grants) 20. Federal Share requested of Line 19 1,731,921 21. Add Rehabilitation Grants Requested (100 percent) 22. Total Federal grant requested (Lines 20 & 21) 1,731,921 23. Grantee share PFC 96,218 24. Other shares State of Florida 96,218 25. Total project (Lines 22, 23, & 24) 1,924,357 FAA Form 5100-100 (6-73) SUPERSEDES FAA FORM 5100-10 PAGES 1 THRU 7 U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION Page 4 OMB NO. 80-RO184 SECTION C - EXCLUSIONS Classification Ineligible for Participation Excluded from Contingency Provision 26 (1) _(2) a. $ $ b.. c. d. e. f. g- Totals SECTION D - PROPOSED METHOD OF FINANCING NON-FEDERAL SHARE 27. Grantee Share $ 96,218 a. Securities b. Mortgages c. Appropriations (By Applicant) d. Bonds e. Tax Levies f. Non Cash g .Other (Explain) Passenger Facility Charge (PFC) 96,218 h .TOTAL — Grantee share 96,218 28. Other Shares 96,218 a. State 96,218 b. Other c. Total Other Shares 96,218 29. TOTAL $ 192,436 SECTION E - REMARKS PART IV PROGRAM NARRATIVE (Attach - See Instructions) — FAA Form 5100-100 (6-73) SUPERSEDES FAA FORM 5100-10 PAGES 1 THRU 7 FAA AC 75-023 PART IV PROGRAM NARRATIVE PROJECT: Purchase and install two passenger loading bridges to replace obsolete Regional Boarding Ramps | AIRPORT: Northwest Florida Regional Airport 1. Objective: To provide safe and efficient passenger loading capability, replacing open (but covered) inferior ramps. 2. Benefits Anticipated: Protects passengers from elements and provides a safer entry onboard aircraft. Previous RBRs were prone to failure and possible serious falls. 3. Approach: (See approved Scope of Work in final Application) 4. Geographic Location: