Okaloosa County BOCC — February 4, 2014 — Pre-application to Replace Boarding Ramps with Passenger Loading Bridges — reading text

OMB Approval No. 0348-0043 APPLICATION FOR 2. DATE SUBMITTED . Applicant Identifier FEDERAL ASSISTANCE 1. TYPEQF .- 3. DATE RECEIVED BY STATE Siate Application Identifier SUBMISSION: .. Application ‘ Preapplication . [J Construction _ 1 Construction 4, DATE RECEIVED BY FEDERAL AGENCY Federal ldentifier 1 Non-Construction Non-Construetion §. APPLICANT INFORMATION Legal Name: Okaloosa County Board of County Commissioners DUNS 613277649 Organizational Unit: -Office of Contracts & Grants Address (give cify, county, state, and zip code) 1804 Lewis Turner Blvd (Ste 206) Fort Walton Beach, FL 32547 Name and telaphone 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 fetter In box) B [5] [9] - [6] fo] [oj [J [7] [6] [5] A. State .H, Interdependent School District B. County |, State Controlled instttution of Higher Learning C. Municipal J. Private University ; D. Township K. Indian Tribe 8. TYPE OF APPLICATION: E, Interstate -L. IndWvidual F. intermunicipal M. Profit Organization & New QO Continuation CT Revision G. Special District N. Other (Specity) lf Revision, enter appropriate letter(s} In box(es): A Increase Award B Decrease Award D Decrease Duratlon Other (specify) I C Increase Duration 9, NAME OF FEDERAL AGENCY Federal Aviation Administration (FAA) 10. CATALOG OF FEDERAL DOMESTIC 11, DESCRIPTIVE TITLE OF APPLICANT'S PROJECT: ASSISTANCE NUMBER fo] 7 7 5 TITLE: Airport Improvement . Replace obsolete Regional Boarding Ramps with Ground ; eregramn {AIP) Level Passenger Loading Bridges at Gates A-1 and A-2 for 2. AREAS AFFECTED BY PROJECT (cities, counties, states, etc.}: Northwest Florida Regional Air port. Okaloosa County 13. PROPOSED PROJECT 14, CONGRESSIONAL DISTRICTS OF Start Date Ending Date a. Applicant b. Project May 2014 November | 1st Ist 2014 =. 15. ESTIMATED FUNDING 16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 12372 PROCESS a. Federal $ 1,260,000 00 a. YES, THIS PREAPPLICATION/APPLIGATION WAS MADE AVAILABLE TO THE “ STATE EXECUTIVE ORDER 12372 PROCESS FOR REVIEW ON b, Applicant PFC $ 70,000 00 ¢. State § 70,000 -09 "DATE: d, Local $ b NO PROGRAM IS NOT COVERED BY E, O, 12372 e. Other $ [] oR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW f= Program Income $ 17. 18 THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT? g. TOTAL $ 1,400,000 — -90 CJ Yes If yes, attach an explanation 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 Charles K. Windes, Jr. c. Telephone number b. Title Chairman, Okaloosa Board of County Commissioners (850)651-7105 e, Date Signed d. Signature of Authorized Representative Standard Form 424 (REV 4-88) Previous Editions Not Usable Authorized for Local Reproduction Prescribed by OMB Circular A-102 U.S. DEPARTMENT OF TRANSPORTATION OMB NO, 80-RO184 FEDERAL AVIATION ADMINISTRATION PART II PROJECT APPROVAL INFORMATION SECTION A Item 1 Does this assistance request require State, local, Name of Governing Body regional, or other priority rating? Priority ; Elves [XJNo [tem 2. Does this assistance request require State, local Name of Agency or Board advisory, educational or health clearances? {Attach Documentation) ClYes EJNo ltem 3 Does this assistance request require clearinghouse review (Attach Comments) in accordance with OMB Circular A-95? Clyes XJNo item 4 ; Does this assistance request require State, local, Name of Approving Agency regional or other planning approval? Date Llyes XNo Check One: State C] Item 5. Local in| Is the proposed project covered by an approved Regional [1 . comprehensive plan? [yes KXJNo 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 bdYes []No ltern 7 Will the assistance requested be on Federal land Name of Federal Installation Eqlin Air Force Base or installation? or, Location of Federal Land Florida ves LINo percent of Project 100% item 8 Will the assistance requested have an impact or effect on the environment? LlYes EJNo , Number of: item 9. Individuals Will the assistance requested cause the displacement of Familles individuals, families, businesses, or farms? Businesses — L]ves ExINo Farms ___. Item 10. Is there other related Federal assistance on this : project previous, pending, or anticipated? : [_]Yes BXJNo Page 2 FAA Form 6100-100 (6-73) SUPERSEDES FAA FORM 8100-10 PAGES 1 THRU 7 OMB NO, 80-RO184 U.S, DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION PART I - 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 Siates 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) EAA AC BI ooat OMB NO. 80-RO184 U,8. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION PART I— 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: N/A *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 (4-78) FAA AG aes, ae FEDERAL AVIATION ADMINISTRATION OMB NO. 80-RO184 U.S, DEPARTMENT OF TRANSPORTATION PART ill- BUDGET INFORMATION - CONSTRUCTION SECTION A ~- GENERAL 1. Federal Domestic Assistance Catalog No........... 06. cee ee 2. Functional or Other Breakout....... 0... c eee reece ensures SECTION B - CALCULATION OF FEDERAL GRANT Use only for revisions Latest Approved Adjustment Cost Classification Amount + or (+} Total Amount Required 4. Administration Expense Preliminary Expense Land, structures, right-of-way Architectural engineering basic fees Other architectural engineering fees Land development Relocation Expenses 2 3 4 5 8. Project inspection fees 7. 8 9 Relocation payments to individuals and businesses 10, Demolition and removal 11. Construction and project improvement 12, Equipment 13. Miscellaneous Pre-construction CM at Risk Phase | 14. Total (Lines 7 through 13) 15. Estimated Income (if applicable) 16, Net Project Amount (Line 14 minus 78) 17. Less: Ineligible Exclusions - 18. Add: Contingencies 19. Total Project Amt. (Excluding Rehabilitation Grants) 1,400,000 20. Federal Share requested of Line 19 1,260,000 21, Add Rehabilitation Grants Requested (100 percent) 1,260,000 22. Total Federal grant requested (Lines 20 & 21) 70,000 | 23, Grantee share PFC 24, Other shares State of Florida 70,000 25. Total project (Lines 22, 23, & 24) 1,400,000 Fad Form 5100-100 (6-73) SUPERSEDES FAA FORM 5100-10 PAGES 1 THRU 7 Page 4 U.S, DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION OMB NO, 80-RO184 SECTION C - EXCLUSIONS Classification Ineligible for Excluded from Participation 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 $ 70,000 a. Securities b. Mortgages c. Appropriations (By Applicant) d. Bonds e. Tax Levies f. Non Cash g .Other (Explain) Passenger Facility Charge (PFC) 70,000 h .TOTAL — Grantee share 70,000 28. Other Shares 70,000 a. State 70,000 b. Other c. Total Other Shares 70,000 29. TOTAL $ 140,000 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 PAGE § PARTIV —.. 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: See attached sketch 5. Justification for Force Account Work: (if applicable) N/A 6: Sponsor's Representative: (incl. address & tel. no.) } | 4 ‘ FAA ORLANDO AIRPORTS DISTRICT OFFICE - CATEGORICAL EXCLUSION FORM Airport: Northwest Florida Regional Project Title: Replace. RBRs The Proposed Action is a Federal action subject to NEPA, List applicable paragraph number from FAA Order 5050,4B Chapter | paragraph 9g. . The Proposed Action is identified as one that can normally be Categorically Excluded. List applicable category from FAA Order 1050.18 paragraphs 307 through 312, Attach a list of and clearly describe ALL components of the Proposed Action including all Connected Actions, Include a brief summary of existing conditions at the Proposed Action site. Attach a site map identifying the Proposed Action area on the