Okaloosa County BOCC — August 2, 2016 — 2016-17 Shirley Conroy Grant Application FINAL REVISED — reading text

Hotline at (800) 342-2762. Shirley Conroy Rural Area Capital Assistance Program Grant Application 9 Rev. 07/01/2016  PART II APPLICATION INSTRUCTIONS GENERAL INSTRUCTIONS Applications are due July 29, 2016. Final award decisions are scheduled to be approved at the Commission’s business meeting on September 9, 2016. Presented in this part are specific instructions on the preparation of the grant application forms. To be considered complete, the application should contain Exhibits A, B, C, D, E, and F as described in this manual. NOTE: It is the CTC's responsibility to complete and submit the grant application in its entirety in a timely manner. Local Coordinating Board review is required. Due to the timeliness of this application process, the Local Coordinating Board can review and approve the application after it is submitted to the CTD. The Local Coordinating Board Chair must certify, by signing Exhibit A of the grant application, that it has reviewed the grant application. A. Although specific instructions on the preparation of the grant application are provided, additional assistance may be obtained by contacting the Commission for the Transportation Disadvantaged, (850) 410-5700. B. Applicants must submit one original and five (5) copies of each proposal. Applications must include documentation supporting the cost of the project. For example, for cutaway vehicles, submit a copy of the Transit Research Inspections Procurement Services (TRIPS) order form identifying the specifications of the requested vehicle and the total cost. If purchasing other capital equipment, a copy of the quote(s) received identifying equipment details and total cost. The application prepared by each CTC must be securely stapled and submitted to the: Commission for the Transportation Disadvantaged 605 Suwannee Street, Mail Station 49 Tallahassee, Florida 32399-0450 Note: Binders are unnecessary and will be discarded in the processing of the grant. Shirley Conroy Rural Area Capital Assistance Program Grant Application 10 Rev. 07/01/2016 EXHIBIT A INSTRUCTIONS Except for the following notes, the applicant information form is self-explanatory. If questions arise, please contact the CTD. LEGAL NAME OF APPLICANT: The full legal name of the applicant's organization, not an individual. Applicant name and address must be registered in MyFloridaMarketplace. FEDERAL IDENTIFICATION NUMBER: The number used by all employers within the United States to identify their payroll and federal income tax. REMITTANCE ADDRESS: This should be the applicant's mailing address where all correspondence is sent, and will be the address on the grant agreement and the address to which your reimbursement checks will be sent. Changes of address must be registered in MyFloridaMarketPlace. If the physical location of the applicant is different from the mailing address, the applicant must notify the Commission of the applicant’s physical location of operations. PHONE NUMBER AND E-MAIL ADDRESS: To facilitate faster communications, the applicant should also include telephone, fax numbers and any e-mail addresses used by the applicant. LOCAL COORDINATING BOARD CERTIFICATION: Local Coordinating Board review is required. However, the review may be obtained after the grant application is submitted. The Local Coordinating Board Chair must certify, by signing Exhibit A, that the grant application has been reviewed by the LCB. EXHIBIT B INSTRUCTIONS I. PROJECT FUNDING A. Capital Equipment: Provide a detailed description and estimated cost of equipment to be purchased with grant funds to be utilized for rural area services. II. FUNDING PARTICIPATION A. Transportation Disadvantaged Trust Funds: Indicate the amount of funds requested of this grant for capital equipment. B. Cash Local Match: Indicate the percentage and dollar amount of the total contributions which the local sources are expected to contribute as a match to the grant funds. If applying for reduced match or a waiver of match as part of the REDI program, please state such here. C. Total Project Cost: Indicate the total proposed project cost. Shirley Conroy Rural Area Capital Assistance Program Grant Application 11 Rev. 07/01/2016 EXHIBIT C INSTRUCTIONS Scope: This is a competitive grant application. It is the responsibility of the applicant to ensure that each section provides sufficient information for the review committee to consider and award project funds accordingly. Include a description of how funds will be used for rural services or to enhance existing services for rural transportation. Applicants do not have to use the enclosed “Exhibit C” form, however, the format and order must be exactly the same as on the enclosed form. The following descriptions should be used to complete this grant application: Who - Describe who the equipment is going to serve. This could include demographic information that identifies the population that will be served in rural areas. Excerpts from the TDSP and data can be included to provide support in the area of demographics. This could also include the creation or development of services to address unmet needs in rural areas. Applicants may include letters of support. What - Include detailed descriptions of what type of equipment is needed to serve the rural areas. The subcommittee has requested that the equipment listed in the application be prioritized according to need. This should include whether the equipment is replacement equipment, equipment that is needed to enhance current equipment, or new equipment to expand services. If applying for a vehicle, specify the make and model of the vehicle and identify the accessories/equipment included on the vehicle. To ensure compliance with the competitive procurement requirements, we recommend purchasing from the State contract managed by the Florida Department of Transportation (http://www.tripsflorida.org/contracts.html) or the Florida Department of Management Services (http://www.dms.myflorida.com/business_operations/state_purchasing/state_contracts_and_agree ments). Both of these websites contain pricing information. Include a copy of the TRIPS order form or other quotes with your application indicating the various accessories to be included on the vehicle. This information will be used by the Subcommittee to document the award amount. If the application is for the replacement of a vehicle(s), indicate which vehicle(s) is being replaced on the vehicle and other transportation equipment inventory form. Where - Include information about where the equipment will be used. Maps, lists, and addresses can be used to provide detail on where the equipment will serve the needs in the rural areas. When - Address the time frame for implementation and describe the anticipated length of the project and demonstrate the immediate need for procurement of said equipment. How - Explain in detail how the equipment will be utilized in the rural areas. Applicants should also include what competitive procurement process will be completed to procure the equipment. Grant applicants must identify any other funding sources accessed for the purchase of equipment to ensure there is no duplication. CTCs should identify monies that have been awarded from FDOT or other funds designated for the acquisition of equipment. CTCs should also identify how local match will be funded and how other funds will be leveraged. If applying for reduced match or a waiver of match as part of the REDI program, please include request and justification here. Why - Include all information that would address why your agency is most deserving of the project funds and how the equipment will benefit all the Transportation Disadvantaged in the community. Justification could include, but is not be limited to, increase of number of trips provided in rural Shirley Conroy Rural Area Capital Assistance Program Grant Application 12 Rev. 07/01/2016 areas as a result of equipment purchased, service routes created in rural areas as a result of purchased equipment, improved accountability of funds expended due to the availability of equipment, cost savings or other efficiencies to be gained as a result of equipment purchased, and other innovative anticipated outcomes in the identified rural areas. Status of 2014/2015 and 2015/2016 Grants - Indicate capital equipment previously awarded through the Shirley Conroy Rural Area Capital Assistance Program Grant and the total dollar amount (if any) actually paid by the grant. If a grant was awarded, but the grant not charged, explain why the grant funds were not utilized as awarded. EXHIBIT D INSTRUCTIONS A resolution by the applicant's Board of Directors/County Commission authorizing an individual and/or position to sign this application and subsequent agreements, invoices, assurances, etc., must be completed. Exhibit D is a sample resolution for your consideration. It is not required that you use the sample resolution, as long as the same basic information is provided. The resolution must include original signatures and must be attested to and sealed (corporate or notary seal) by a corporate officer. Remember that the resolution can be good for an extended period of time or for multiple agreements if worded in such a fashion. EXHIBIT E INSTRUCTIONS The standard assurances form should be signed and dated by the person or position identified in the authorizing resolution. EXHIBIT F INSTRUCTIONS All grant applications must include a vehicle inventory form. The inventory must include all vehicles used to transport individuals, including existing fleet and additional vehicles that are currently on order, regardless of funding source. Shirley Conroy Rural Area Capital Assistance Program Grant Application 13 Rev. 07/01/2016  PART III APPLICATION FORMS EXHIBIT A Grant Application (Application Form) EXHIBIT B Grant Application (Proposed Project Funding) EXHIBIT C Grant Application (Scope) EXHIBIT D Grant Application (Sample Authorizing Resolution) EXHIBIT E Grant Application (Standard Assurances) EXHIBIT F Grant Application (Inventory) Shirley Conroy Rural Area Capital Assistance Program Grant Application 14 Rev. 07/01/2016  EXHIBIT A Commission for the Transportation Disadvantaged Grant Application Form for the Shirley Conroy Rural Area Capital Assistance Program Grant 1. DATE SUBMITTED: August 2nd, 2016 2. LEGAL NAME OF APPLICANT: Okaloosa County Board of County Commissioners 3. FEDERAL IDENTIFICATION NUMBER: 59-6000765 016 4. REMITTANCE ADDRESS: 302 N. Wilson Street, Suite 203 5. CITY AND STATE: Crestview, FL ZIP CODE: 32536 6. CONTACT PERSON FOR THIS GRANT: Marcella Eubanks 7. PHONE NUMBER (850) 689-5000 ext 4381