Okaloosa County BOCC — February 4, 2014 — Pre-Applicaton for Passenger Bag Lifts on Loading Bridges — reading text

OMB Approval No. 0348-0043 2. DATE SUBMITTED APPLICATION FOR Applicant Identifier FEDERAL ASSISTANCE 1. TYPE OF 3, DATE RECEIVED BY STATE State Application Identifier SUBMISSION: Application Preapplication C1] Construction O) Construction 1 Non-Construction J] 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): 7. TYPE OF APPLICANT: (enter appropriate letter in box) B [5] [9] - [6] [] [o] fo] CJ [5] [3] A. State H. Interdependent School District B, County |. State Controlled Institution of Higher Learning C. Municipal J. Private University . D. Township K. Indian Tribe 8. TYPE OF APPLICATION: E. Interstate L. Individual & N oO Continuati oO R F. Intermunicipal M. Profit Organization lew ontinuation evision G. Special District N. Other (Specify) If Revision, enter appropriate letter(s) in box(es): A_ Increase Award B Decrease Award C_ Increase Duration D Decrease Duration Other (specify) 9. NAME OF FEDERAL AGENCY Federal Aviation Administration (FAA) 10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER 2 O}.]1 0 TITLE: Airport Improvement Program (AIP) 12, AREAS AFFECTED BY PROJECT (cities, counties, states, etc.): Okaloosa County 11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT: Purchase and install passenger bag lifts on Loading Bridges _| at Gates B-1, B-2 and B-3 for Northwest Florida Regional Airport. 13. PROPOSED PROJECT 14. CONGRESSIONAL DISTRICTS OF Start Date Ending Date a. Applicant b. Project August October 1st Ist 2014 2014 15. ESTIMATED FUNDING 16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 12372 PROCESS a. Federal $ 83.700 .00 a. YES, THIS PREAPPLICATION/APPLICATION WAS MADE AVAILABLE TO THE ? STATE EXECUTIVE ORDER 12372 PROCESS FOR REVIEW ON b. Applicant PFC $ 4,650 00 c. State $ 4,650.00 DATE: d. Local § 5. NO PROGRAM IS NOT COVERED BY E. O. 12372 e. Other $ CT] OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW f. Program income $ 17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT? g. TOTAL $ 93,000 -90 [1 yes if yes, attach an explanation X 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 c. Telephone number Charles K. Windes, Jr. Chairman, Okaloosa Board of County Commissioners (850)651-7105 e. Date Signed d. Signature of Authorized Representative Previous Editions Not Usable Standard Form 424 (REV 4-88) Prescribed by OMB Circular A-102 Authorized for Local Reproduction 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 L]Yes XINo item 2. Does this assistance request require State, local advisory, educational or health clearances? [lYes EXINo Name of Agency or Board (Attach Documentation) Item 3 Does this assistance request require clearinghouse review (Attach Comments) in accordance with OMB Circular A-95? Clyes EXINo Item 4 Does this assistance request require State, local, Name of Approving Agency regional or other planning approval? Date CTyes EXINo Check One: State C] Item 5. Local Cl ls the proposed project covered by an approved Regional C comprehensive plan? L]Yes [KINo 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 XlYes [No Item 7 Will the assistance requested be on Federal land or installation? Ex]lYes [_JNo Name of Federal Installation Eglin Air Force Base Location of Federal Land Florida Percent of Project 100% Item 8 Will the assistance requested have an impact or effect on the environment? []Yes BXINo Number of: ltem 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? [ves &XJNo Page 2 FAA Form 5100-100 (6-73) SUPERSEDES FAA FORM 5100-10 PAGES 1 THRU 7 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: 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) : FAAAC nage 38 OMB NO. 80-RO184 U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION 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”: (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 (4-76) FAA AC 81 50013 U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION OMB NO. 80-RO184 PART III- BUDGET INFORMATION - CONSTRUCTION SECTION A - GENERAL 1. Federal Domestic Assistance Catalog No....... 0... 0.002 20-106 2. Functional or Other Breakout... 0... eee ee ees SECTION B - CALCULATION OF FEDERAL GRANT Use only for revisions Cost Classification Latest Approved Adjustment Amount + or (-) Total Amount Required 1. Administration Expense $ $ 2. Preliminary Expense 3. Land, structures, right-of-way 4. Architectural engineering basic fees §. Other architectural engineering fees Project inspection fees Land development Relocation Expenses Oo} Cl; NT & 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 1 through 13) 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) 93,000 20. Federal Share requested of Line 19 83,700 21. Add Rehabilitation Grants Requested (100 percent) 22. Total Federal grant requested (Lines 20 & 21) 83,700 23. Grantee share PFC 4,650 24. Other shares 4,650 25. Total project (Lines 22, 23, & 24) 93,000 FAA Form 5100-100 (6-73) SUPERSEDES FAA FORM 5100-10 PAGES 1 THRU 7 Page 4 FEDERAL AVIATION ADMINISTRATION OMB NO. 80-RO184 U.S. DEPARTMENT OF TRANSPORTATION SECTION C - EXCLUSIONS Classification Ineligible for Excluded from Participation Contingency Provision 26 (1) (2) a. $ $ b.. Cc. d. e. f. g- Totals SECTION D - PROPOSED METHOD OF FINANCING NON-FEDERAL SHARE 27. Grantee Share $ 4,650 a. Securities b. Mortgages c. Appropriations (By Applicant) d. Bonds e. Tax Levies f. Non Cash ' g .Other (Explain) Passenger Facility Charge (PFC) = PFC 4,650 h .TOTAL ~ Grantee share 4,650 28. Other Shares 4,650 a. State 4,650 b. Other c. Total Other Shares 4,650 29. TOTAL $ 9,300 SECTION E - REMARKS PART IV PROGRAM NARRATIVE (Attach - See Instructions) FAA AC 75-023 PAGE 5 FAA Form 5100-100 (6-73) SUPERSEDES FAA FORM 5100-10 PAGES 1 THRU 7 PART IV PROGRAM NARRATIVE PROJECT: Purchase and Install Passenger Bag Lifts on Loading Bridges | AIRPORT: Northwest Florida Regional Airport 1. Objective: To match efficient handling of excess carryon luggage available on other passenger loading bridges at the airport 2. Benefits Anticipated: More efficient passenger loading and offloading of excess carry on luggage. _| 3. Approach: (See approved Scope of Work in final Application) Bags are inserted into a wheeled luggage bin that is lowered to the apron and rolled to the airplane cargo door. This minimizes the individual handling of bags in an efficient and safer manner 4. Geographic Location: See attached sketch Northwest Florida Regional Airport Terminal Area. 5. Justification for Force Account Work: (if applicable) N/A 6: Sponsor's Representative: (incl. address & tel. no.) Mr. Sunil Harman, A.A.E., IAP 1701 SR 85 North Eglin AFB, FL 32542 (850)651-7160 FAA ORLANDO AIRPORTS DISTRICT OFFICE - CATEGORICAL EXCLUSION FORM Airport: Northwest Florida Regional, Project Title: P LB Bag Lifts The Proposed Action is a Federal action subject to NEPA. List applicable paragraph number from FAA Order 5050.4B Chapter 1 paragraph 9g. . The Proposed Action is identified as one that can normally be Categorically Excluded. List applicable category from FAA Order 1050.1E paragraphs 307 through 312, 349 4 Attach a list of and clearly describe ALL components of the Proposed Action including