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

ASSURES that the “Special Section 5333 (b) Warranty for Application to the Small Urban and Rural Program” has been reviewed and certifies to the Florida Department of Transportation that it will comply with its provisions and all its provisions will be incorporated into any contract between the recipient and any sub-recipient which will expend funds received as a result of an application to the Florida Department of Transportation under the FTA Section 5311 Program. Dated _01/22/2013________________ _____DON R. AMUNDS, CHAIRMAN (Name and Title of Authorized Representative) _____________________________________ (Signature of Authorized Representative) Note: All applicants must complete the following form and submit it with the above Assurance. LISTING OF RECIPIENTS, OTHER ELIGIBLE SURFACE TRANSPORTATION PROVIDERS, AND LABOR ORGANIZATIONS REPRESENTING EMPLOYEES OF SUCH PROVIDERS, IF ANY (See Appendix for Example) 2 1 Site Project by Name, 3 4 Identify Recipients of Description, and Identify Other Eligible Identify Unions (and Transportation Provider (e.g. Recipient, Surface Transportation Providers) Representing Assistance Under this other Agency, or Providers (Type of Employees of Providers Grant. Contractor) Service) in Columns 1, 2, and 3 Okaloosa County Application for Section Tucker None Board of County 5311 funds for operating Transportation assistance for FY13 for Commissioners OCT to provide public transportation service to residents for rural areas of the county traveling within the rural area and/or to the adjacent urban area and return to rural domicile. 13  EXHIBIT K Coordinated Public Transit-Human Services Transportation Plan To be completed and signed by an individual authorized by the governing board of the applicant agency and submitted with the grant application. The Okaloosa County Board of County Commissioners certifies and assures to the Florida Department of Transportation in regard to its Application for Assistance under U.S.C. Section 5311 dated January 22, 2013: 1) This grant request is derived from a coordinated plan compliant with Federal Transit Administration Circular FTA C 9040.1F. 2) The name of this coordinated plan is provided below. Okaloosa County Transportation Disadvantaged Service Plan _________________________________________________________________________________ 3) The agency that adopted this coordinated plan is provided below. Okaloosa County Transportation Disadvantaged Local Coordinating Board _________________________________________________________________________________ 4) The date the coordinated plan was adopted is provided below. October 24, 2012 _________________________________________________________________________________ 5) The page number of the coordinated plan that this application supports. Page (25) _________________________________________________________________________________ 14