Okaloosa County BOCC — December 4, 2012 — 5311 Op App FY13 — reading text

Middle Name: County: OKALOOSA Last Name: BAILEY State: FL Zip Code 32547 Suffix: Country: UNITED STATES OF AMERICA Email: bbailey@clerkofcourts.cc 6. EMPLOYER IDENTIFICATION NUMBER (EIN): Phone Number (give area code) (Replace these boxes with numerals) 59-6000765 (850)651-7200 X4381 Fax Number (give area code) (850)609-5029 8. TYPE OF APPLICATION: 7. TYPE OF APPLICANT: (See back of form for Application Types) New • Continuation •Revision If Revision, enter appropriate letter(s) in box(es) • • STATE (See back of form for description of letters.) Other (specify) Other (specify) 10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: 9. NAME OF FEDERAL AGENCY: 20-509 TITLE (Name of Program): Nonurbanized Area Formula Program FEDERAL TRANSIT AGENCY 11. DESCRIPTIVE TITLE OF APPLICANT’S PROJECT: 12. AREAS AFFECTED BY PROJECT (Cities, Counties, States, etc.): OPERATING ASSISTANCE IN SUPPORT OF PUBLIC OKALOOSA COUNTY TRANSPORTATION IN RURAL AREAS 13. PROPOSED PROJECT 14. CONGRESSIONAL DISTRICTS OF: Start Date: 07/01/2013 Ending Date: 09/30/2014 a. Applicant b. Project 1 1 15. ESTIMATED FUNDING: 16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 12372 PROCESS a. Federal $ 325,208 00 a . Yes. THIS PREAPPLICATION /APPLICATION WAS . MADE AVAILABLE TO THE STATE EXECUTIVE ORDER 12372 PROCESS FOR REVIEW ON: 01/15/13 b. Applicant $ 325,208 DATE: 00 . c. State $ b. No. • PROGRAM IS NOT COVERED BY E. O. 12372. 00 . d. Local $ • PROGRAM HAS NOT BEEN SELECTED BY STATE 00 . FOR REVIEW e. Other $ 17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL 00 . DEBT? f. Program Income $ • Yes. If “Yes” attach an explanation. 00 . No g. TOTAL $ 650,416 00 . 18. TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS APPLICATION/PREAPPLICATION 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. Authorized Representative Prefix: Mr. First Name: DON Middle Name: Robert Last Name: AMUNDS Suffix: b. Title: CHAIRMAN c. Telephone Number (give area code) (850) 651-7105 d. Signature of Authorized Representative: e. Date Signed: 01/22/2013 Previous Edition Usable. Authorized for Local Reproduction. Standard Form 424 (Rev.9-2003); Prescribed by OMB Circular A-102 8  All Applicants EXHIBIT A-1 FACT SHEET IF GRANT IS CURRENTLY AWARDED * 1. Number of one-way passenger trips. 55,186 55,500 PER YEAR 2. Number of individuals served 1,275 1,300 (unduplicated). PER YEAR 3. Number of vehicles used for this 11 11 service. ACTUAL 4. Number of ambulatory seats. 132 132 AVERAGE PER VEHICLE (Total Ambulatory seats divided by total number of fleet vehicles) 5. Number of wheelchair positions. 20 20 AVERAGE PER VEHICLE (Total wheelchair positions divided by total number of fleet vehicles) 6. Vehicle Miles traveled. 296,029 310,000 PER YEAR 7. Average vehicle hours in operation. 964 1,010 PER DAY 8. Normal vehicle hours in operation. 96 96 PER WEEK 9. Normal number of days in operation. 6 6 PER WEEK 9. Trip length (roundtrip). 5.36 5.59 AVERAGE • Estimates are acceptable. 9  APPLIES TO ALL APPLICANTS EXHIBIT E Single Audit Act One copy of Okaloosa County’s Comprehensive Annual Financial Report was submitted on March 16, 2012. There were no material weaknesses or reportable conditions noted in regard to the Single Audit. 10  APPLIES TO ALL APPLICANTS EXHIBIT F Federal Certifications and Assurances The last page (Appendix A) of the annual Federal Register Notice that applies to Federal Certifications and Assurances provides applicants with a single signature page on which an applicant and its attorney must certify compliance with the requirements of the various Federal Transit Administration grants or cooperative agreements. The Federal Register Notice is revised annually and is usually available around January 1 of each year. Applicants may obtain a copy of the current year document through the Internet at http://www.fta.dot.gov/funding/grants_financing_93.html (then, follow instructions on where to proceed.) If unable to access the form, applicants may contact their FDOT District Office for assistance. The appropriate signed Federal certification/assurance form must be included in the application when it is submitted to the FDOT District Office. GRANT WRITING TIP: All applicants must use the current year form and it must be the actual form from FTA. This form cannot be an edited version of a prior year’s form or a recreation of the form. The signature page for Federal Certifications and Assurances should be signed by an individual authorized by the applicant’s governing board to sign and submit applications, and its attorney. Blue ink is required as it distinguishes an original signature from a photocopied signature. Federal Certifications and Assurances Required of Each Applicant: • Authority of applicant and its representative • Standard Assurances • Debarment, Suspension, and other Responsibility Matters • Drug Free Workplace Certification • Intergovernmental Review Assurance • Federal Transit Administration Master Agreement • Nondiscrimination Assurance • Assurance of Nondiscrimination on the Basis of Disability Procurement Compliance. A. Applicants for Federal Assistance may signify compliance with the above certifications and assurances by placing an “X” at the top of Appendix A next to the statement that reads: “The Applicant agrees to comply with applicable requirements of Categories 01-24”. If an applicant chooses to do this, no additional notation is necessary, except for the signature on the reverse. . OR B. The applicant may signify compliance with certifications and assurances applicable only to the Section 5310 Program, specifically, Category XIII, by placing an “X” in Category 01, “Certifications and Assurances Required for Each Applicant” (to cover the above-noted items), as well as an “X” in Category 12 entitled “Alcohol Misuse and Prohibited Drug Use” and Category 18 “Nonurbanized Area Formula Program for States.” A description of the certifications required for the Section 5311 Formula Grants for Rural Areas Program is provided in the annual Federal Register Notice. 11  APPENDIX A FEDERAL FISCAL YEAR 2013 CERTIFICATIONS AND ASSURANCES FOR FEDERAL TRANSIT ADMINISTRATION ASSISTANCE PROGRAMS AS OF 1/14/2013 FY 2013 CERTIFICATIONS AND ASSURANCES NOT RELEASED BY FTA: From: Rudd, Kathy Sent: Monday, January 07, 2013 6:52 AM To: Rob Mahan; Sharon Kent; Heather Craft; Shawn Ward (ShawnW@santarosa.fl.gov); Kim Hansen; Kathy Balentine (gtran@fairpoint.net); Russell, Marilyn; Sharon Peeler (Speeler.jtrans@gmail.com) Cc: Strickland, Vanessa; Haley Fussell Subject: FW: 2013 FTA Federal Certifications and Assurances The 2013 Federal Certification and Assurance have not been posted, yet. We will send them out as soon as FTA releases them. You may go ahead and turn in your applications and complete the C/A later Thanks. Kathy Rudd FDOT D3 Transit Programs (850) 330-1549 kathy.rudd@dot.state.fl.us 1074 Hwy 90 Chipley, Fl 32428 12  APPLIES TO ALL APPLICANTS EXHIBIT I FTA Section 5333 (b) Assurance (Note: By signing the following assurance, the recipient of Section 5311 and/or 5311(f) assistance assures it will comply with the labor protection provisions of 49 U.S.C. 5333(b) by one of the following actions: (1) signing the Special Warranty for the Non-urbanized Area Program; (2) agreeing to alternative comparable arrangements approved by the Department of Labor (DOL); or (3) obtaining a waiver from the DOL.) The OKALOOSA COUNTY BOARD OF COUNTY COMMISSIONERS (hereinafter referred to as the “Recipient”) HEREBY