Okaloosa County BOCC — August 19, 2014 — FAA Grant Application_Air Traffic Control Tower at DTS — reading text

CONTRACT & LEASE INTERNAL COORDINATION SHEET Contract/Lease Number: Tracking Number:_/25 3 —] Grant Funded: YES>< NO Contractor/Lessee Name: keen, Purpose Aur “Ta Ante mal yt Aol’ Tew. Date/Term: 1. kd GREATER THAN $50,000 Amount: 2. L] GREATER THAN $25,000 Department: _ {4/2 3. L] $25,000 or Less Dept. Monitor Name:{ ] bay INA Gory / 1h Or. Document has been reviewed and includes any attachments or exhibits. Purchasing Review Date: ¢- Al i VR * Purchasing Director or Designee Joanne Kublik Risk Management Review Approved as written: ty f ; ne Mey ee CS Date Risk Manager or designee Kacy Gacksin , \ County Attorney Review pio as written: s AAG Cay \ eco Date: % _ \- \Y Founty Attorney " Gregory T. Stewart J Following Okaloosa County approval: Contracts & Grants Document has been received: Date: Contracts & Grants Manager OMB Approval No. 0348-0043 APPLICATION FOR FEDERAL ASSISTANCE 2. DATE SUBMITTED Applicant Identifier August 1, 2014 DTS-14-1 1. TYPE OF SUBMISSION: Application KI Construction Preapplication O Construction 3. DATE RECEIVED BY STATE State Application Identifier 1 Non-Construction 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): HoO-GoOOOoOGBEA 8. TYPE OF APPLICATION: 4} New If Revision, enter appropriate letter(s) in box(es): CL Continuation O Revision B Decrease Award C Increase Duration Other (specify) A_ Increase Award D Decrease Duration 7. TYPE OF APPLICANT: (enter appropriate letter in box) B A. State H. Interdependent School District B. County |. State Controlled Institution of Higher Learning C. Municipal J. Private University D. Township K. Indian Tribe E. Interstate L. Individual F. Intermunicipal M. Profit Organization G. Special District N. Other (Specify) 9. NAME OF FEDERAL AGENCY Federal Aviation Administration (FAA) 10. CATALOG OF FEDERAL DOMESTIC 11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT: ASSISTANCE NUMBER 2 O;.]1 0 Design, Construct and Equip Air Traffic Control Tower and TITLE: Airport Improvement Program (AIP) Access Road for Destin Airport 12. AREAS AFFECTED BY PROJECT (cities, counties, states, etc.): Okaloosa County 13.. PROPOSED PROJECT 14. CONGRESSIONAL DISTRICTS OF Start Date Ending Date a. Applicant b. Project November November | Ist 1st 2014 2015 15. ESTIMATED FUNDING 16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 12372 PROCESS a. Federal $ 2.000.000 -00 a. YES, XX THIS PREAPPLICATION/APPLICATION WAS MADE AVAILABLE TO THE aided STATE EXECUTIVE ORDER 12372 PROCESS FOR REVIEW ON b. Applicant $ 597,356 00 c. State $ 1,486,682 -90 DATE: 12/19/2012 d. Local $ b. NO [-] PROGRAM IS NOT COVERED BY E. O. 12372 e. Other PFC $ 1,000,000 [_] OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW f. Program income $ 17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT? g. TOTAL $ 5,084,038 .00 | 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 County Board of Commissioners c. Telephone number (850)651-7105 d. Signature of Authorized Ld. Sa hi, wlooX& pvee e. Date Signed 56 i Previous Editions Not Usable Authorized for Local Reproduction Standard Form 424 (REV 4-88) Prescribed by OMB Circular A-102 U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION PART Il PROJECT APPROVAL INFORMATION SECTION A OMB NO. 80-RO184 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) L]Yes ]No Item 3 Does this assistance request require clearinghouse review in accordance with OMB Circular A-95? (Attach Comments)See EA/FONSI Submitted with Pre- Application. XlYes [-]No Item 4 Does this assistance request require State, local, Name of Approving Agency Okaloosa Walton regional or other planning approval? Transportation Planning Organization Xlves LINo Date Jul 2013 Check One: State im Item 5. Local O Is the proposed project covered by an approved Regional ([] comprehensive plan? L]Yes KINo Location of plan Item 6. Will the assistance requested serve a Federal Name of Federal Installation Eglin AFB installation? Federal Population benefiting from Project X]lYes LJNo Item 7 Will the assistance requested be on Federal land Name of Federal Installation or installation? Location of Federal Land L]Yes KXJNo Percent of Project Item 8 Will the assistance requested have an impact or effect on the environment? C]Yes K]No Number of: Item 9. Individuals Will the assistance requested cause the displacement of Families individuals, families, businesses, or farms? Cres EIN Businesses es ° Farms Item 10. Is there other related Federal assistance on this project previous, pending, or anticipated? LlYes KIJNo FAA Form 5100-100 (6-73) SUPERSEDES FAA FORM 5100-10 PAGES 1 THRU 7 Page 2 U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION 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: 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: 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”: Destin Airport (DTS) is owned by Sponsor—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) CANAG EN eats 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) ie AG Be oe U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION OMB NO. 80-RO184 PART III- BUDGET INFORMATION - CONSTRUCTION SECTION A - GENERAL . Federal Domestic Assistance Catalog No...............000.. Functional or Other Breakout..... 0.000.000.0000 eee eee eee SECTION B - CALCULATION OF FEDERAL GRANT Use only for revisions Cost Classification Latest Approved Adjustment Total Amount + or (-) Amount Required 1. Administration Expense $ $ 5,000 2. Preliminary Expense 3. Land, structures, right-of-way 4. Architectural engineering basic fees 424,203 5. Other architectural engineering fees 6. Project inspection fees 350,000 7. Land development 8. Relocation Expenses 9. Relocation payments to individuals and businesses 10. Demolition and removal 11. Construction and project improvement 4,304,835 12. Equipment 13. Miscellaneous Pre-construction CM at Risk Phase | 14. Total (Lines 1 through 13) 5,084,038 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) 5,084,038 20. Federal Share requested of Line 19 2,000,000 21. Add Rehabilitation Grants Requested (100 percent) 22. Total Federal grant requested (Lines 20 & 21) 2,000,000 23. Grantee share ($1M=PFC + 597,356 Apt Gen Fund) 1,597,356 24. Other shares State of Florida 1,486,682 25. Total project (Lines 22, 23, & 24) 5,084,038 FAA 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.. Cs d. e. f. g. Totals SECTION D - PROPOSED METHOD OF FINANCING NON-FEDERAL SHARE 27. Grantee Share $ 1,597,356 a. Securities b. Mortgages c. Appropriations (By Applicant) 597,356 d. Bonds e. Tax Levies f. Non Cash g .Other (Explain) Passenger Facility Charge (PFC) 1,000,000 h .TOTAL — Grantee share 1,597,356 28. Other Shares 1,486,682 a. State 1,486,682 b. Other c. Total Other Shares 1,1486,682 29. TOTAL $ 3,084,038 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: Design and Construct Air Traffic Control Tower | AIRPORT: Destin/Fort Walton Beach Airport 1. Objective: To provide safe and efficient control of aircraft in a high density area involving military and civilian aircraft. 2. Benefits Anticipated: Eliminate or significantly reduce incursions and potential or real accidents. 3. Approach: (See approved Scope of Work in final Application) Positive control of Destin