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Home My WebLink About20091148RESOLUTION RE: APPROVE APPLICATION FOR FEDERAL TRANSIT ADMINISTRATION (FTA) GRANT ASSISTANCE FOR SECTIONS 5310 AND 5311 AND AUTHORIZE CHAIR TO SIGN - COLORADO DEPARTMENT OF TRANSPORTATION WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with an Application for Federal Transit Administration (FTA) Grant Assistance for Sections 5310 and 5311 from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Public Works, Transportation Unit, to the Colorado Department of Transportation, with terms and conditions being as stated in said application, and WHEREAS, after review, the Board deems it advisable to approve said application, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Application for Federal Transit Administration (FTA) Grant Assistance for Sections 5310 and 5311 from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Public Works, Transportation Unit, to the Colorado Department of Transportation be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said application. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 18th day of May, A.D., 2009. ATTEST: 44441t())///1 Weld County Clerk to the Boa BY•\ APP v 1(ilant y Clercto the Boarq County -Attorney Date of signature. OARDOF COU COMMISSIONERS LORADO F. Garcia, Chair co o (90 iii ( ( .A94r •ouglae Radem her, Pro -Tern • Sean P. Conway Jk�� arbarirkmeyer David E. Long 00 Pci 2009-1148 aclo) 7 k EG0060 April 2009 CDOT Grant Application for FTA Funding 2010-2011 CDOT APPLICATION for FTA GRANT ASSISTANCE Applications are due May 18, 2009, by 5:00 P.M. NO EXCEPTIONS! DEADLINE. By May 18, 2009, by 5:00 P.M.: Online Database Application Requirements, the Agency Profile, Capital Inventory, and Capital Equipment sections of the database must be completed and saved. Fillable-Form Application, the sections that deal with your 2010-2011 grant request must be emailed to Sylvia.labrucherie@dot.state.co.us. These are Microsoft Word Documents. Supporting Materials, signature pages, certificates, and assurances, which complete the application, must be postmarked or delivered. CDOT will not accept faxed or emailed copies of signature pages. All the certificates and assurances are the last section of the Application Instruction and Guidebook at www.dot.state.co.us/App transit/. For Postal Delivery: Sylvia Labrucherie, Transit Unit, DTD, Colorado Dept of Transportation, Shumate Building, 4201 E ARKANSAS AVE, DENVER CO 80222 For Delivery: Hand The easiest way to find the Shumate Building is to go to the north east side of the CDOT headquarters building. The Shumate Building is east of the Permit Office and north of the big radio tower. IMPORTANT NOTES! r You MUST complete or update your Agency Profile and Capital Inventory before submitting the ap- plication. Applications will not be reviewed until the Agency Profile and Capital Inventory (when ap- plicable) has been updated! Access the Agency Profile and Capital Inventory online at the Transit Unit website, www.dot.state.co.us/App_transit/. ce If you are making a capital request, it can only be done through the online database under "Capital Equipment Requests." This is true for all four grant programs. All requests must be completed and saved by the May 18th deadline, www.dot.state.co.us/App transit/. cri If you are a new applicant or are unsure if your proposed project is part of a regional transportation plan, contact John Valerio at 303-757-9769. If you are a human -service transportation provider and are unsure if your proposed Section 5310, 5316 (JARC), or 5317 (New Freedom) project is part of a local, coordinated human services -transportation plan, contact John Valerio at 303-757-9769. If you are applying for funds for a construction project, you must have National Environmental Policy Act (NEPA) documentation completed. Contact Ann Beauvais at 303-757-9767 for information. r If you are an INTERCITY BUS APPLICANT, complete Section A of the application. You must ALSO complete the document entitled "5311(0 Intercity Bus Application for New Projects," located on the Transit Unit's home page, www.dot.state.co.us/App transit/.. Colorado Department of Transportation Section A— Page 1 CDOT Grant Application for FTA Funding April 2009 PRE -SUBMITTAL REQUIREMENTS BEFORE YOUR APPLICATION IS REVIEWED, you must complete the Agency Profile and Capital Inventory on the Transit Unit website at http://wvvw.dot.state.co.us/App_transit/. If you are a new applicant (since 2005), contact Ann Beauvais at 303-757-9767 to receive a pass- word that enables you to create an Agency Profile. SUBMITTAL INFORMATION Read the Application Instructions and Guidebook! Keep it handy as you fill out the application. The Application Instructions and Guidebook is available online at http://www.dot.state.co.us/App transit/. It contains important information, including additional required documents, explanations and definitions, examples of eligible projects, worksheets, step- by-step instructions, sample resolutions, and contracts. Send in all the required attachments! We've included a checklist to help you make sure you've included everything that needs to be sent in. The application contains several sections that are listed below. You need to complete two or more sections, depending on the grant or grants you apply for. All applicants must complete Section A. Applicants for the individual grant programs must also fill out the following sections: lirligirdliinliMin APPLICATION FTA GRANT mali FTA GRANT TITLE FORMAT AND LOCATION a NAME OF SECTION WITHIN THE APPLICATION Agency Profile — — Agency Profile, Capital Inven- tory, Capital Request Online form through Transit Unit website A — - All Applicants 2010AppSectA-All.doc Fillable forms, MS Word documents. Obtain online through ReturTransn ite. via it emailwebo: Return to: Sylvia.labrucherie @dot.state.co.us B Sections 5310, 5311 Transportation for Elderly Persons and Persons with Disabilities; Rural and Small Urban Areas Evaluation Narrative for 5310 and 5311 Applicants PP 2010AppSectB-5310-11.doc C Section 5311 Rural and Small Urban Areas Proposed Scope of Work for 5311 Applicants 2010AppSectC-5311.doc D Section 5311(0 Intercity Bus Existing 5311(f) Applicants 2010AppSectD-ICB.doc E Section 5316 Job Access/Reverse Commute (JARC) 5316 Applicants 2010AppSectE-JARC.doc F Section 5317 New Freedom 5317 Applicants 2010AppSectF-NewFree.doc G Sections 5310, 5316, and 5317 Mobility Management 2010AppSectG-MoMgt.doc Section A— Page 2 Colorado Department of Transportation April 2009 CDOT Grant Application for FTA Funding SECTION APPLICATION A SECTION FOR ALL APPLICANTS Add a short title for your project. For example: "JARC Operating Funds for Fixed Route in Heritage County on Highway 88," "5310 Capital Funds to Purchase a Backup Camera System," "5317 Capital Funds for Mobility Manager for Hog Trails Transit," etc. (100 word maximum). Add a two or three sentence description of your project (250 word maximum). Al. Project Request Summary Project Name, 1st Grant Request. 5311 operating and admin finds for demand response service Brief Description of Proposed 1st Grant Request. Include Grant Project, Number. Weld County transit program Project Name, 2nd Grant Request. Brief Description of Proposed Project, 2nd Grant Request. Include Grant Number. Project Name, 3rd Grant Request. Brief Description of Proposed 3rd Grant Request. Include Grant Project, Number. Project Name, 4th Grant Request. Brief Description of Proposed 4th Include Grant Request. Grant Project, Number. A2. Proposed Subcontractors or Sub -Recipients Provide the name(s) of any subcontractors you will use for this project. 1. None 2. 3. 4. 5. 6. 7. 8. If you need to add more information to any of the questions in this application, or if any of the questions fail to "fill" properly, submit the information in a separate document when you email this application on or before May 18, 2009, by 5 P.M. Colorado Department of Transportation Section A— Page 3 CDOT Grant Application for FTA Funding April 2009 A3. FUNDING REQUEST SUMMARY These two tables summarize your funding request(s). Only Enter The FTA Amount You Are Requesting, table should fill in automatically. If it doesn't, submit information separately. Use whole dollars only. 2010 PROJECT FUNDING REQUESTS Grant Number 2010 OPERATING 2010 CAPITAL 2010 ADMIN OR PLANNING'"` 2010 TOTALS FTA MATCH TOTAL FTA MATCH TOTAL FTA MATCH TOTAL FTA MATCH TOTAL 5310 0 0 0 0 0 0 5311 107,000 107,000 214,000 0 0 0 50,000 12,500 62,500 157,000 119,500 276,500 5311(f) 0 0 0 0 0 0 0 0 0 0 0 0 5316 0 0 0 0 0 0 0 0 0 0 0 0 5317 0 0 0 0 0 0 0 0 0 Administrative expenses, but not planning expenses, are permitted under 5311. Planning but expenses, not administrative expenses, are permitted under 5316. 201 OJECT FUNDING REQUESTS Grant Number 2011 OPERATING 2011 CAPITAL 2011 ADMIN OR PLANNING" 2011 TOTALS FTA MATCH TOTAL FTA MATCH TOTAL FTA MATCH TOTAL FTA MATCH TOTAL 5310 0 0 0 0 0 5311 117,000 117,000 234,000 0 0 0 55,000 13,750 68,750 172,000 130,750 302,750 5311(f) 0 0 0 0 0 0 0 0 0 0 0 0 5316 0 0 0 0 0 0 0 0 0 0 0 0 5317 0 0 0 0 0 0 0 0 0 Administrative expenses, but not planning expenses, are permitted under 5311. Planning expenses, but not administrative expenses, are permitted under 5316. Section A- Page 4 Colorado Department of Transportation April 2009 CDOT Grant Application for FTA Funding A4. TRANSPORTATION COORDINATION A4.1. Resource Coordination- YES NO Do you broker service or provide service to another agency? If yes. describe it briefly. Non -emergency medicaid trip, AAA senior nutrition trips,HCBS -state medicaid ►� ❑ Do you share resources in any significant way with other agencies (e.g., maintenance/ me- chanics, vehicles, staff/drivers, facilities, mar- keting, insurance, fuel purchases, training, bi- lingual programs, etc.)? If yes, describe it/them briefly. Weld County does operate our own fuel site Both the City of Greeley and NECALG use the facilities when needed. .1 YES NO ❑ YES NO Have you realized any able savings in operating or as a result of your yes, describe it/them measurable or quantifi- costs directly through, coordination efforts? If briefly. When we are able to coordinate with other transit agencies there is time and operating saving, but we have not gone to the extreme of calculating thoses exact savings. fxl ❑ A4.2. Community Coordination Identify all the other transit providers in your service area. Include intercity bus, taxis, human service - transportation providers, etc., if any. Identify the trade union to which these providers belong, if any (e.g., Inde- pendent Driver Association of Teamsters, ACME, etc.). Transit Provider Trade Union 1 GET - Greeley Evans transit 2. Shamrock Taxi 3. CDSI 4. NE Co Assoc of Local Govt 5. Ft Collins transit 6. RTD 7. 8. 9. 10. 11. 12. 13. Briefly describe your efforts to coordinate transportation services with these providers. There is effort to coordinate pick up of people in the area when the other service providers are providing the same service in the area at the same time. For example when NECALG is coining into Longmont we can have them pick up in Fort Lupton for us. The same is true with CDSI and transport to adult day care. 14. Describe any barriers to coordination that you may have encountered with the providers listed in this section. The problem has always been the demand and canceled trips. When you are preparing to have a van full and you need to add or delete from that is makes the coordination diffucult to remain cost effective. Colorado Department of Transportation Section A— Page 5 CDOT Grant Application for FTA Funding April 2009 15. Describe your efforts to work with other organizations, agencies, businesses, and other appropriate community Transportation staff frequently will call doctors offices to see if they can reschedule appointments to interests in order to provide service (e.g., employers, medical centers, social service agencies, visitor services, activity centers, etc.). make the trip more cost effetive in the schedule we provide. We are trying to build a better network of transit providers to be able to coordinate trips in various parts of the county, again to become more cost effective. 16. Describe any other special efforts you have taken to During the past 18 months Weld County staff coordinate in a manner not yet described. investigated consolidation of our program with the City of Greely. A4.3. Human -Transportation Coordination -Services Important Note! You MUST answer the following questions about human service -transportation coordination if you are an applicant for Sections 5310, 5316 (JARC), and/or 5317 (New Freedom). YES NO Have you attended a human service- transportation coordination meeting within the last year? If you have. describe it briefly. County staff recently attending CASTA Spring meeting, and regular MPO meetings including the Weld county Transit Mobility Commission meetings ❑ 2. If yes, what, if anything, has your agency done since then? When? Regualr attendence 3. Describe your agency's efforts at local human service- transportation coordination planning. Staff members and elected officials attend local mobility meetings as weel as MPO meetings 4. If you have met with other agencies, providers, etc., to work on coordination activities, describe how success- ful your efforts have been so far. Yes. We worked with the Cityof Greeley, but were not successful in working out functional differences. 5. Regarding your coordinated planning efforts, what are the contact names, agencies, and phone numbers of the other primary agencies, groups, or individuals you are specifically working with? Brad Patterson, City of Greeley 397-8564 Joel Hammer, City of Greeley 397-8564 Various MPO Staff members 6. This project must be in CDOT's 2035 Regional Long Range Plans, even if broadly. Tell us how and where this project is plans. Statewide and it's described very described in the It meets the Human Service Transportation (Rural) cate- gory as stated in the March 2008 document. Section A— Page 6 Colorado Department of Transportation April 2009 CDOT Grant Application for FTA Funding SECTION B EVALUATION NARRATIVE for FTA SECTIONS 5310 AND 5311 BA. Justification of the Need for Service What is the eligibility criteria for who is eligible to ride your service? Transport services are for medicaid eligible individuales and rural area for seniors, disabled and general public. What is the purpose of the three most requested trips your clients request or require? Medical, adult day care, senior nutrition What is the need for transit service in your area? Elderly, disabled medical appointments Why does this need exist? How did you determine this? Weld County is a very large rural area and services in outlying area is very limited. Are you the lead transit provider in your area? If not, what is the rela- tionship of your project(s) to other transportation providers? Yes, in the rural area. City of Greeley does have a transit system to provide servies within the City limits. How many unduplicated clients do you serve annually (if applicable)? 3,500 Concerning the need for service, what other factors might be relevant in support of this application? The more moble we can keep the aging population the longer they will be able to remain in there own homes and maintain there independence. B.2. Justification of the Financial Need for Service Describe the economic conditions of the service area. What is the source of your information? Weld County is a diverse population with an annual 2008 average wage of $39,624. The Per Capital Income for Weld County in 2008 was $27,238. (Demographic Profile Upsatate Colorado, 2009) In the Agency Profile (online), you were asked to list sources of fund- ing. Explain why these funding sources are not sufficient to provide the project's services. The services that are programs, but medicaid especially when we have assisting the general rural for outside program, is adquate to maintain those does not reimbure the cost of providing transportation over 4,000 miles within the county to cover in public. Describe any of your funding sources that have decreased by more than ten percent over the last five years. Services were being provided for Head Start programs. Since there furling has been cut, we have stopped providing those services and therefore that funding has stopped. Describe your fare structure and/or suggested donation. Include the percentage of revenue from dona- tions or fares, if applicable. Weld County transit system does not charge fare. List the names of the other organi- zations you provide transportation for, if any. Tell us if they reimburse you for that transportation, the basis for that reimbursement, and how much the reimbursement is. HCBS, fixed amount by determination of Medicaid. NEMT, fixed amount determined by Medicaid. AAA senior transport, reimburse for actual use of services. TANF, reimburse actual use of services. Employment Services, reimburse for actual services. Head Start, meal transport reimburse for actual use of services. Describe any other reasons you have for needing funding. Cost for transport of general public is not covered though any other source of funding. Colorado Department of Transportation CDOT Grant Application for FTA Funding April 2009 B.3. Program Promotion (this section is required for 5311 applicants) Describe transit promote program it. how you promote and to whom your you Brochures Services, are buses, let with various doctors senior centers. offices, Health Department, Social Describe how agency vehicles marked. are All vehicle have the Weld County marking Weld County Transportation with the phone in addition they also have listed number. ►� YES Do the markings include the agency's name? ❑ NO YES Do the markings include the agency's logo? ❑ NO sI YES Do the markings include the agency's phone number? ❑ NO Section B— Page 2 Colorado Department of Transportation April 2009 CDOT Grant Application for FTA Funding B.4a Section 5310 PROJECT INFORMATION for CY 2010 ail These questions pertain to your proposed PROJECT, not your whole program. 4a.1. Section 5310 Project Information for Calendar Year 2010 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE What days of the week will this project operate? (e.g., M -F; M, TU, TH) What hours of the day will this project operate? (e.g., 8 AM -4:30 PM) What will be the average fare or donation? S $ $ Do you have a reservation schedule? // ❑ Yes ❑ No Do you broker trips? ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No If you broker more than 50 percent of 'our trips, do not include these trips in your agency's service information. Do you have seasonal fluctuations? I ❑ Yes ❑ No I ❑ Yes ❑ No 1 ❑ Yes ❑ No If you do have seasonal fluctuations, please describe them: Many of the cells in the three tables below should fill in automatically. If not, submit information separately. B4a.2. Section 5310 Administrative & Operating Expenses for CY 2010 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE TOTAL Total Operating Expenses S S $ $ 0 Total Administrative Expenses $ $ $ $ 0 Total Expenses of Administrative and (excluding capital) Operating $ 0 $ 0 $ o $ 0 B4a.3. Section 5310 Service Information for CY 2010 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE TOTAL Total Number of Passenger Trips 0 Total (excluding Number of Vehicles in Service spares and backups) 0 Total Number of Vehicle Service Miles 0 Total Number of Vehicle Service Hours 0 4a.4 Section 5310 Performance Information for Calendar Year 2010 ITEM TOTAL Cost per Mile _ $ Cost per Vehicle Service Hour $ Cost per Passenger Trip .. _ ._ _ _ __ . S Passenger Trip per Service Hour* Colorado Department of Transportation Section B— Page 3 CDOT Grant Application for FTA Funding April 2009 B.4b Subcontractor's 5310 Project Information for CY 2010 Copy this page if using more than one subcontractor. CONTRACTOR NAME NONE B4b.1. Section 5310 Subcontractor's Project Information for CY 2010 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE What days of the week will this project operate? (e.g., M -F; M, TU, TH) What hours of the day will this project operate? (e.g., 8 AM -4:30 PM) What will be the average fare or donation? $ $ $ Do you have a reservation schedule? G /��/ 4 ❑ Yes ❑ No Do you broker trips? ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No If'.i ou broker more than 50 percent ol.t our trips, do not include these trips in your agency's service information. Do you have seasonal fluctuations? ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No If you do have seasonal fluctuations, please describe them: Many of the cells in the three tables below should fill in automatically. If not, submit information separately. B4b.2. Subcontractor's Administrative & Operating Expenses for CY 2010 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE TOTAL Total Operating Expenses S $ S $ 0 Total Administrative Expenses S $ S $ 0 Total Expenses of Administrative and (excluding capital) Operating $ 0 $ 0 $ 0 $ 0 B4b.3. Subcontractor's Service Information for CY 2010 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE TOTAL Total Number of Passenger Trips U Total (excluding Number of Vehicles in Service spares and backups) 0 Total Number of Vehicle Service Miles 0 Total Number of Vehicle Service Hours 0 B4b.4 Subcontractor's Performance Information for CY 2010 ITEM TOTAL Cost per Mile_ Cost per Vehicle Service Hour _ _ _ $ Cost per Passenger Trip S Passenger Trip per Service Hour* $ Section B— Page 4 Colorado Department of Transportation April 2009 CDOT Grant Application for FTA Funding B.4c 5310 PROJECT INFORMATION for CY 2011 l hese questions pertain to your proposed PROJECT, not your whole program. B4c.1. Section 5310 Project 111. In ormation for Calendar Year 2011 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE What days of the week will this project operate? (e.g., M -F; M, TU, TH) What operate? hours of the day will this project (e.g., 8 AM -4:30 PM) What will be the average fare or donation? $ S $ Do you have a reservation schedule? ❑ Yes ❑ No ��l%��//%/�%��/%�� Do you broker trips? ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No If you broker more than 50 percent of your trips, do not include these trips in your agency's service information. Do you have seasonal fluctuations? I ❑ Yes ❑ No I ❑ Yes ❑ No 1 ❑ Yes ❑ No If you do have seasonal fluctuations, please describe them: Many of the cells in the three tables below should fill in automatically. If not, submit information separately. B4c.2. Section 5310 Administrative and Operating Expenses for CY 2011 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE TOTAL Total Operating Expenses $ S S $ 0 Total Administrative Expenses $ $ $ $ 0 Total of Administrative Expenses (excluding and Operating capital) $ 0 $ 0 $ 0 $ 0 4c.3. Section 5310 Service Information for CY 2011 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE TOTAL Total Number of Passenger Trips 0 Total Number of Vehicles in Service (excluding spares and backups) c) Total Number of Vehicle Service Miles 0 Total Number of Vehicle Service Hours 0 4c.4 Section 5310 Performance Information for CY 2011 ITEM TOTAL Cost per Mile S Cost per Vehicle Service Hour _. __ _ ..$ Cost per Passenger Trip _. S Passenger Trips per Service Hour* Colorado Department of Transportation Section B— Page 5 CDOT Grant Application for FTA Funding April 2009 B.4d Subcontractor's 5310 Project Information for CY 20114 Copy this page if using more than one subcontractor. CONTRACTOR NAME NONE B4d.1. Section 5310 Subcontractor's Project Information for CY 2011 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE What days of the week will this project operate? (e.g., M —F; M, TU, TH) What hours of the day will this project operate? (e.g., 8 AM -4:30 PM) What will be the average fare or donation? $ S $ Do you have a reservation schedule? re� %�� ❑ Yes ❑ No Do you broker trips? ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Ifyou broker more than 50 percent of your trips, do not include these trips in your agency's service information. Do you have seasonal fluctuations? ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No If you do have seasonal fluctuations, please describe them: Many of the cells in the three tables below should fill in automatically. If not, submit information separately. B4d.2. Subcontractor's Administrative & Op- rating Expenses for CY 2011 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE TOTAL Total Operating Expenses S $ S $ 0 Total Administrative Expenses $ S $ $ 0 Total of Administrative and Operating Expenses (excluding capital) $ 0 $ 0 $ 0 $ 0 B4d.3. Subcontractor's Service Information for CY 2011 ITEM DEMAND RESPONSE FIXED ROUTE TOTAL DEVIATED FIXED ROUTE Total Number of Passenger Trips 0 Total Number of Vehicles in Service (excluding spares and backups) tl Total Number of Vehicle Service Miles 0 Total Number of Vehicle Service Hours 0 B4d.4 Subcontractor's Performance Information for CY 2011 ITEM TOTAL Cost per Mile_ . S Cost per Vehicle Service Hour _ _ $ Cost per Passenger Trip _ _ $ Passenger Trips per Service Hour* _ _ _ _ $ Section B— Page 6 Colorado Department of Transportation April 2009 CDOT Grant Application for FTA Funding B.5a 5311 PROJECT INFORMATION for CY 2010 These questions pertain to your proposed PROJECT, not your whole program. B5a.1. Section 5311 Project Information for Calendar Year 2010 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE What days of the week will this project operate? (e.g., M —F; M, TU, TH) M -F What hours of the day will this project operate? (e.g., 8 AM -4:30 PM) 6:30 AM - 6:00 PM What will be the average fare or donation? $ 0.00 $ $ Do you have a reservation schedule? 7 r�� /! Yes ❑ No Do you broker trips? Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No *lfou broker more than 50 percent ofyour trips, do not include these trips in your agency's service information. Do you have seasonal fluctuations? ❑ Yes No ❑ Yes ❑ No ❑ Yes ❑ No If you do have seasonal fluctuations, please describe them: Many of the cells in the three tables below should fill in automatically. If not, submit information separately. B5a.2. Section 5311 Administrative & Operating Expenses for CY 2010 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE TOTAL Total Operating Expenses $ 214,000 $ S $ 214,000 Total Administrative Expenses $ 62,500 $ $ $ 62,500 Total of Administrative and Operating Expenses (excluding capital) $ 276.500 $ 0 $ 0 S 276,500 B5a.3. Section 5311 Service Information for CY 2010 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE TOTAL Total Number of Passenger Trips 13.000 13.000 Total Number of Vehicles in Service (excluding spares and backups) 18 18 Total Number of Vehicle Service Miles 79.000 79.000 Total Number of Vehicle Service Hours 5.553 5.553 B5a.4 Section 5311 Performance Information for CY 2010 ITEM TOTAL Cost per Mile _ $ 3.50 Cost per Vehicle Service Hour S 49.79 Cost per Passenger Trip _ _ _ _ $ 21.27 Passenger Trips per Service Hour* 2.34 Colorado Department of Transportation Section B- Page 7 CDOT Grant Application for FTA Funding April 2009 B.5b Subcontractor's 5311 Project Information for CY 2010 Copy this page for more than one subcontractor. CONTRACTOR NAME NONE B5b.1. Section 5311 Subcontractor's Project Information for CY 2010 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE What days of the week will this project operate? (e.g., M -F; M, TU, TH) What hours of the day will this project operate? (e.g., 8 AM -4:30 PM) What will be the average fare or donation? S S S Do you have a reservation schedule? ❑ Yes ❑ No /f��1��/% Do you broker trips? ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No *If you broker more than 50 percent of your trips, do not include these trips in your agency's service information. Do you have seasonal fluctuations? ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No If you do have seasonal fluctuations, please describe them: Many of the cells in the three tables below should till in automatically. If not, submit information separately. B5b.2. Subcontractor's Administrative & Operating Expenses for CY 2010 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE TOTAL Total Operating Expenses $ o S S $ 0 Total Administrative Expenses S $ S $ o Total Expenses of Administrative and Operating (excluding capital) $ o $ o $ 0 $ o B5b.3. Subcontractor's Service Information for CY 2010 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE TOTAL Total Number of Passenger Trips o Total spares Number of Vehicles in Service (excluding and backups) o Total Number of Vehicle Service Miles U Total Number of Vehicle Service Hours U B5b.4 Subcontractor's Performance Information for CY 2010 ITEM TOTAL Cost per Mile $ Cost per Vehicle Service Hour $ Cost per Passenger Trip _ _ . Passenger Trips per Service Hour Section B— Page 8 Colorado Department of Transportation April 2009 CDOT Grant Application for FTA Funding B.5c Section 5311 PROJECT INFORMATION for CY 2011 These questions pertain to your proposed project, not your whole program. B5c.1. Section 5311 Project Information for Calendar Year 2011 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE What days of the week will this project operate? (e.g., M -F; M, TU, TH) M -F What hours of (e.g., 8 AM -4:30 the day will this project operate? PM) 6:30 AM - 6:00 PM What will be the average fare or donation? $ 0.00 S S Do you have a reservation schedule? 4 Yes ❑ No/,./��%1�� Do you broker trips? Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No *Jf you broker more than 50 percent of your trips, do not include these trips in your agency's service information. Do you have seasonal fluctuations? ❑ Yes ►/ No ❑ Yes ❑ No ❑ Yes ❑ No If you do have seasonal fluctuations, please describe them: Many of the cells in the three tables below should fill in automatically. If not, submit information separately. B5c.2. Section 5311 Administrative & Operating Expenses for CY 2011 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE TOTAL Total Operating Expenses $ 234,000 $ $ $ 234,000 Total Administrative Expenses $ 68,750 $ $ $ 68,750 Total of Administrative Expenses (excluding and Operating capital) $ 302,750 $ 0 $ 0 $ 302,750 B5c.3. Section 5311 Service Information for CY 2011 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE TOTAL Total Number of Passenger Trips 14,500 14,500 Total Number of Vehicles in Service (excluding spares and backups) i 8 18 Total Number of Vehicle Service Miles 86M00 86,000 Total Number of Vehicle Service Hours 6,100 6,100 B5c.4 Section 5311 Performance Information for CY 2011 ITEM TOTAL Cost per Mile_ _ _ $ 3.52 Cost per Vehicle Service Hour S 49.63 Cost per Passenger Trip _ _ _ _ _. _ . $ 20.88 Passenger Trips per Service Hour* _ _ _ 2.38 Colorado Department of Transportation Section B— Page 9 CDOT Grant Application for FTA Funding April 2009 B.5d Subcontractor's 5311 Project Information for CY 2011 Copy this page for more than one subcontractor. CONTRACTOR NAME NONE B5d.1. Section 5311 Subcontractor's Project Information for CY 2011 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE What days of the week will operate? (e.g., M -F; M, TU, this project TH) What hours of the day will this project operate? (e.g., 8 AM -4:30 PM) What will be the average fare or donation? $ $ $ Do you have a reservation schedule? ❑ Yes ❑ No �/%�lA Do you broker trips? ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No *1f you broker more than 50 percent of your trips, do not include these trips in your agency's service in%rmation. Do you have seasonal fluctuations? ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No If you do have seasonal fluctuations, please describe them: Many of the cells in the three tables below should fill in automatically. If not, submit information separately. B5d.2. Subcontractor's Administrative & Operating Expenses for CY 2011 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE TOTAL Total Operating Expenses (2011) $ S S S 0 Total Administrative Expenses (2011) S $ $ k tO Total of Administrative and Operating Expenses (excluding capital) (2011) S 0 S 0 S 0 $ 0 B5d.3. Subcontractor's Service Information for CY 2011 ITEM DEMAND RESPONSE FIXED ROUTE DEVIATED FIXED ROUTE TOTAL Total Number of Passenger Trips (2011) 0 Total Number of Vehicles in Service (excluding spares and backups) (2011) 0 Total Number of Vehicle Service Miles (2011) 0 Total Number of Vehicle Service Hours (2011) 0 B5d.4 Subcontractor's Performance Information for CY 2011 ITEM TOTAL Cost per Mile _ $ Cost per Vehicle Service Hour . S Cost per Passenger Trip _ S Passenger Trips per Service Hour Section B— Page 10 Colorado Department of Transportation April 2009 CDOT Grant Application for FTA Funding SECTION C SECTION 5311 PROPOSED SCOPE OF WORK FOR 2010 C. 1. Section 5311 Project Funding Requests for Calendar Year 2010 In the table below, identify the federal funds requested, the required local match, and the total project costs. Enter only the FTA amount you are requesting, the remainder of the table should fill in automatically. If it fails to calculate properly, include the same information in a separate document. 2010 OPERATING 2010 CAPITAL 2010 ADMINSTRATION 2010 TOTALS FTA MATCH TOTAL FTA MATCH TOTAL FTA MATCH TOTAL FTA MATCH TOTAL 107,000 107,000 214,000 0 0 50,000 12,500 62,500 157,000 119,500 276,500 C.2. Section 5311 Sources of Match for CY 2010 Funding Requests The State of Colorado awards Section 5311 funding based on match ratios. For each funding category, tell us where this local match will come from and how much the match will be. If you have more than five sources of local match, add another page to your application that identifies the type of assistance (operating, administra- tive, or capital), the source of match, and the amount of that match. pera tang ss s ance. ource Of as a c " minimum 50%0 loca -`matte) 1. County General Fund $ 107,000 2. S 3. s 4. $ 5. C.2.2. r Capital Assistance: CY 2010 Source of Cash Match (minimum 20% local „,-- match) 1. $ 2. $ 3. $ 4. $ 5. $ C.2.3. Administrative L (minimum 20% Assistance: CY 2010 local match) Source of Cash Match 1. County General Fund $ 12,500 2. 3. $ 4. $ 5. $ Colorado Department of Transportation Section C— Page 1 CDOT Grant Application for FTA Funding April 2009 C. `.4. • psrat ng • assistance: - 0 0 ource of In -Kin • Match (minimum 50% local match) DONOR NAME ITEM DONATED PRODUCT OR SERVICE FAIR MARKET VALUE 1. ❑P ❑S $ How was fair market value determined? 2. ❑P ❑S $ How was fair market value determined? 3. $ ❑P ❑S How was fair market value determined? 4. ❑P ❑S S How was fair market value determined? 5. ❑P ❑S $ How was fair market value determined? .2.5. Administrative (minimum 20% local Assistance: match) CY 2010 Source of In -Kind Match DONOR NAME ITEM DONATED PRODUCT OR SERVICE FAIR MARKET VALUE 1. ❑P ❑S $ How was fair market value determined? `.1 L❑P ❑S $ How was fair market value determined? 3. P ❑ S s How was fair market value determined? 4. ❑P S s How was fair market value determined? 5. �5 ❑P ❑S How was fair market value determined? Section C— Page 2 Colorado Department of Transportation April 2009 CDOT Grant Application for FTA Funding C.3. Section 5311 Project Funding Requests for Calendar Year 2011 In the table below, identify the federal funds requested, the required local match, and the total project costs. Enter only the FTA amount you are requesting, the remainder of the table should fill in automatically. If it fails to calculate properly, include the same information in a separate document. 2011 OPERATING FTA 117,000 MATCH 117,000 TOTAL 234,000 2011 CAPITAL FTA MATCH 0 TOTAL 0 2011 ADMINSTRATION F- TA 55,000 MATCH 13,750 TOTAL 68,750 2011 TOTALS FTA 172,000 MATCH 130,750 TOTAL 302,750 C4. Section 5311 Sources of Match for CY 2011 Funding Requests The State of Colorado awards Section 5311 funding based on match ratios. For each funding category, tell us where this local match will come from and how much the match will be. If you have more than five sources of local match, add another page to your application that identifies the type of assistance (operating, administra- tive, or capital), the source of match, and the amount of that match. " ce: CY 20111 1. County General Fund $ 117,000 2. S 3. S 4. S 5. $ . ` �. r .. _ Deal mate 1. $ 2. 3. 4. s 5. 5 .4.3. ss n aurce o as atch SThAtirntch) 1. County General Fund $ 13,750 2. $ 3. $ 4. $ 5. $ Colorado Department of Transportation Section C— Page 3 CDOT Grant Application for FTA Funding April 2009 C.4.4. Operating Assistance: CY 2011 Source of In -Kind Match (minimum 50% local match) DONOR NAME ITEM DONATED PRODUCT OR SERVICE FAIR MARKET VALUE 1. s ❑P ❑S How was fair market value determined? 2. s ❑P ❑S How was fair market value determined? 3. $ ❑P ❑S How was fair market value determined? 4. $ ❑P ❑S How was fair market value determined? 5. ❑P ❑S $ How was fair market value determined? C.4.5. Administrative (minimum 20% local Assistance: match) CY 2011 Source of In -Kind Match DONOR NAME PRODUCT OR SERVICE FAIR MARKET VALUE ITEM DONATED 1. P S How was fair market value determined? 2. ❑P ❑S $ How was fair market value determined? 3. ❑P ❑S $ How was fair market value determined? 4. ❑P ❑S $ How was fair market value determined? 5 ❑P ❑S $ How was fair market value determined? Section C— Page 4 Colorado Department of Transportation April 2009 CDOT Grant Application for FTA Funding C.3. Description of Service Describe will fund. Skip this funding the Fixed Route Services this project Be specific! question if you're not requesting for a fixed route service. What is the specific Service Area, including towns, communities, etc., your proposed project will serve? How will you meet the ADA-specified comple- mentary paratransit requirements? Describe the Demand Responsive Services this project will fund, excluding ADA complementary paratransit service. Be specific! Skip this question if you're not requesting funding for a demand responsive service. Agency provides deviated fixed routes, modified fixed routes and door-to-door demand responsive transportation services to seniors, persons with disabilities, low income individuals for medical services, human services, and group activities. Non -medical transporting for Medicaid transportation has been in place for a number of years. We are the broker for Mediciad-Medical trips. Demand elderly proposed general responsive services and disabled. How will services will be available public? usually target you ensure for the the your Information is at a varity of location. Social Services has the information to refer individuals as well as the local agencies and doctors offices. What percentage of riders will be public? 5 What type do you of trips, client priorities, or conditions propose? The majority of the trips are for medical or senior related programs. Medical trip are always look at to make sure that the individuals can get to the care that in needed. The is every effort made to work with doctors and patients to make the trip as ecomonical as possible. Colorado Department of Transportation Section C— Page 5 CDOT Grant Application for FTA Funding April 2009 C.4. Service Area Population Refer to the Application For population figures, http://dola.colorado.gov/dlg/demog/pop Instructions and Guidebook visit the Colorado Department muni for specific of estimates.html instructions. Local Affairs, Demography Section: COMMUNITY NAME AREA - POPULATION from July 2005 census) IN SERVICE 1. Ault/Grover/Nunn/Pierce/Raymer 3,099 2. Tri Town Dacono/Firestone/Frederick 16,427 3. Hudson/Keenesburg/Kersey/Lochbuie 7,774 4. Mead/Milliken/Johnstown 8,306 5. Eaton/Severance 5,999 6. Hwy 85 Evans/Ft Lupton/Gilcrest/LaSalle/Plattevill 30,402 7. Unincorporated Weld County 45,532 8. 9. 10. Section C- Page 6 Colorado Department of Transportation FTA Grant Application Instructions April 2009 STANDARD ASSURANCES NAME OF APPLICANT Weld County Transportation hereby assures that it will comply with all applicable Federal statutes and regulations carrying out any project supported by an FTA grant or cooperative agreement. The Applicant agrees that it is under a continuing obligation to comply with the terms and condi- tions of the grant agreement or cooperative agreement issued for its project with FTA. The Applicant recognizes that federal laws, regulations, policies, and administrative practices may be modified from time to time and those modifications may affect project implementation. The Applicant understands that presidential executive orders and federal directives, including Federal policies and program guidance, may be issued concerning matters affecting the Appli- cant or its project. The Applicant agrees that the most recent federal requirements will apply to the project, unless FTA issues a written determination otherwise. AGENGY NAME Weld County Government PRINTED NAME (Chief Elected Official/ Board President/l.egal Representative) William R Garcia TITLE Chair, Board of County Commissioners SIGNATu RF�7,77 IAA i DATE May 14, 2009 2009-1148 Page 94 Colorado Department of Transportation April 2009 FTA Grant Application Instructions NONDISCRIMINATION ASSURANCE -CIVIL RIGHTS As required by 49 U.S.C. 5332 prohibiting discrimination on the basis of race, color, creed, na- tional origin, sex, or age, and prohibiting discrimination in employment or business opportunity, otherwise known as Title VT of the Civil Rights Act of 1964, as amended, 42 U.S.C. 2000d, and U.S. DOT regulations, "Nondiscrimination in Federally -Assisted Programs of the Department of Transportation Effectuation of Title VI of the Civil Rights Act," 49 CFR part 21 at 21.7. NAME OF APPLICANT Weld County Transportation assures that it will comply with all requirements imposed by or issued pursuant to the Civil Rights Act, so that no person in the United States, on the basis of race, color, national origin, creed, sex, or age will be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination in any program or activity (particularly in the level and quality of transportation services and transportation -related benefits) for which the Applicant receives Fed- eral assistance awarded by the FTA. The applicant will compile, maintain, and submit in a timely manner Title VI information re- quired by FTA and in compliance with the Department of Transportation's Title VI regulation, 49 CFR Part 21, The person or persons whose signature appears below are authorized to sign this assurance on behalf of the grant applicant or recipient. AGENGY NAME Weld County Government PRINTED NAME (Chief Elected Official/ Board President/Legal Representative) William R Garcia TITLE Chair, Board of County Commissioners SIGNATU/ _i7) / / J C. DATE May 14, 2009 Colorado Department of Transportation Page 95 FTA Grant Application Instructions April 2009 CIVIL RIGHTS LAWSUITS AND COMPLAINTS This form pertains to compliance with Title VI (Civil Rights) regulations governing the provision of public transportation services. Basic Requirement: No person shall, on the grounds of race, color, creed, national origin, sex, age, or disability, be excluded from participating in, denied the benefits of, or be subject to discrimination under any project, program, or activity funded in whole or in part through financial assistance under the Federal Transit Act, as amended. APPLICANT NAME Weld County Transportation ADDRESS 915 10th Street Greeley, CO 80631 PHONE (970) 356-4000 FAX (970) 352-9019 EMAIL wgarcia@co.weld.co.us PERIOD COVERED FEDERAL FISCAL YEAR 2009 Lawsuits and Complaints (Check all that apply) (Note: Complaints are formal, legal, written documents alleging discrimination filed with you or an appro- priate agency which has notified you of the complaint. Also, only civil rights lawsuits or complaints are reported with this form.) Z There have been no lawsuits filed against us for transit service during the period covered. ® There have been no complaints filed against us for transit service during the period covered There have been the following lawsuits or complaints filed against us during this period for transit service. The following information is attached (group lawsuits and complaint sepa- rately, by date of initiation): • date of the lawsuit or complaint • complainant's name and address • allegation summary • current status or disposition including the terms of any consent decree or agreement I, the undersigned, certify that the above and attached statements are truthful and complete to the best of my knowledge and that we comply with all rules and regulations related to the civil rights laws of the United States. AGENGY NAME Weld County Government PRINTED NAME (Chief Elected Official/ Board President/Legal Representative) William F Garcia TITLE Chair, Boar unty Commissioners SIGNAT R - (A DATE May 14, 2009 Page 96 Colorado Department of Transportation April 2009 FTA Grant Application Instructions CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS -PRIMARY COVERED TRANSACTIONS Complete if receiving singularly or combined more than $25,000 in FTA Section 5310, 5311, 5311(f), 5316, and 5317 funds. The potential grantee under this FTA project: NAME OF AGENCY Weld County Transportation certifies to the best of its knowledge and belief, that it and its principals: (a) are not presently debarred, suspended, proposed for debarment, declared ineligible, or volun- tarily excluded by any federal department or agency; (b) have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transac- tion or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement. theft, forgery, bribery falsification or destruction of records, making false statements, or receiving stolen property; (c) are not presently indicted for or other wise criminally or civilly charged by a governmental entity (federal. state, or local) with commission of any of the offenses enumerated in para- graph (b) of this certification; and have not within a three year period preceding this applica- tion/proposal had one or more public transactions (federal, state or local) terminated for cause or default; (d) have not within a three-year period preceding this application/proposal had one or more pub- lic transactions (federal, state, or local) terminated for cause or default. (If the applicant is unable to certify to any of the statements in this certification, such applicant shall attach an explanation to this certification). The potential grantee under this FTA project: NAME OF AGENCY Weld County Government Certifies or affirms the truthfulness and accuracy of the contents of the statements submitted on or with the certification and understand that the provisions of Title 49 CFR Part 29 and FTA C .2015.1 are applicable thereto. EXECUTED THIS DAY 14 MONTH May TITLE OF AUTHORIZED REPRESENTATIVE Chair, Board of County Commissioners SIG / ? D REPRESENTATIVE puy YEAR 2009 Colorado Department of Transportation Page 97 FTA Grant Application Instructions April 2009 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY, AND VOLUNTARY EXCLUSION -LOWER TIER COVERED TRANSACTIONS Complete if receiving singularly or combined more than $25,000 in FTA Section 5310, 5311, 5311(0, 5316, and 5317 funds. The potential grantee under this FTA project: NAME OF AGENCY Weld County Transportation certifies to the best of its knowledge and belief, that it and its prospective lower tier participants certify: (I) are not presently debarred, suspended, proposed for debarment, declared ineligible, or volun- tarily excluded from participation in this transaction by any federal department or agency; (2) if the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this certification. The potential grantee under this FTA project: NAME OF AGENCY Weld County Transportation Certifies or affirms the truthfulness and accuracy of the contents of the statements submitted on or with the certification and understand that the provisions of Title 49 CFR Part 29 and FTA C .201 5.1 are applicable thereto. EXECUTED THIS DAY 14 MONTH May TITLE OF AUTHORIZED REPRESENTATIVE Chair, Board of County Commissioners SIGNATU F RIZED REPRESENTATIVE YEAR 2009 Page 98 Colorado Department of Transportation April 2009 FTA Grant Application Instructions FTA SECTIONS 5310, 5311, 5316, 5317 APPLICATION FOR CDOT/FTA GRANT ASSISTANCE I hereby certify that as a person authorized to sign for: AGENCY NAME Weld County Transportation 1. The agency is a private non-profit organization incorporated in the State of Colorado, or a public op- erator of public transportation body which has undertaken the requisite certification process to be des- ignated as an eligible recipient of ETA funding. 2. The Applicant has the requisite fiscal, managerial, and legal capacity to carry out the project(s) de- scribed herein and to receive and disburse federal funds. 3. Some combination of federal, state, local and private funding sources has or will be committed by the applicant in a timely fashion to provide the required local share for the project(s) described herein. 4. The Applicant has, or will have by the time of delivery, sufficient funds to operate the vehicles and/or equipment purchased under this project, if applicable. 5. The transportation needs of elderly persons and persons with disabilities have or will be addressed by the Applicant. 6. The Applicant will implement policies and procedures to ensure compliance with the provisions of the Americans with Disabilities Act of 1990. 7. The Applicant will provide a fair and timely opportunity to private sector operators to participate in the project. 8. I have reviewed the FTA Sections 5310, 5311, 5316, 5317 Application for CDOT/FTA Grant Assis- tance and that all the information contained herein is true and correct to the best of my knowledge. PRINTED OR TYPED NAME OF AUTHORIZED REPRESENTATIVE William F. Garcia TITLE OF AUTHORIZED REPRESENTATIVE Chair, Board.gf-Founty Commissioners 1GTHORIZED REPRESENTATIVE DATE May 14, 2009 For additional specific information regarding the 2010/2011 FTA Sections 5310, 5311, 5316, 5317 Application for CDOT/FTA Grant Assistance please contact: NAME Barbara Connolly TITLE Controller PHONE (970) 356-4000 ext 4445 EMAIL ADDRESS bconnolly@co.weld.co.usW Colorado Department of Transportation Page 99 FTA Grant Application Instructions April 2009 49 USC & 5333(b) ASSURANCE SECTION 5311 (to include Intercity Bus) APPLICANTS ONLY LISTING OF ELIGIBLE SURFACE TRANSPORTATION PROVIDERS AND LABOR REPRESENTATION 1. APPLICANT NAME AND BRIEF DESCRIPTION OF PROJECT AND SERVICE AREA. Weld County Transit System is a demand response and modified demand response system providing specialized transportation to residents of Weld County, serving a wide spectrum of special groups of all ages and abilities. 2. OTHER SECTION 5311 RECIPIENTS WITHIN THE SERVICE AREA (WILL USUALLY BE BLANK). N/A 3. OTHER SURFACE PUBLIC TRANSPORTATION PROVIDERS WITHIN SERVICE AREA. The Bus (Greeley Transit System) Shamrock Taxi Cab Company NFRIVIPO - Smart Trips Rocky Mountain Shuttle 4. UNION REPRESENTATION OF EMPLOYEES IDENTIFIED IN 2 AND 3 IF ANY (LIST UNION AND PROVIDER). N/A WE, THE UNDERSIGNED REPRESENTING Weld County Government AND SUB -RECIPIENT (IF APPLICABLE) hereinafter referred to as the Applicant and Sub -recipient, respectively, have reviewed the "Spe- cial Section 13(c) Warranty for Application to the Small Urban and Rural Program" and certify to the Colorado Department of Transportation that we will comply with its provisions and that all its provisions will be incorporated into any contract between the Applicant and Sub -recipient which will expend funds received as a result of an application to the Colorado Department of Transportation under the Section 5311 Grant Program. SI ATUP T DATE May 14, 2009 TITLE OF APPLICANT Chair, Board of County Commissioners SIGNATURE OF SUBRECIPIENT DATE TITLE OF SUBRECIPIENT Not Applicable Page 100 Colorado Department of Transportation FTA Grant Application Instructions April 2009 PROGRAM SPECIFIC ASSURANCES The applicant's legally authorized representative must sign the signature block below identifying compli- ance with the applicable certifications and assurances. The assurances are delineated by program or type of assistance sought. This signed certification (along with the mandatory assurances) must be either sent or hand delivered to the Transit Unit in order to complete the 2010/2011 application for funding. FTA ASSURANCE APPLICABLE TO PROGRAM OR ASSISTANCE? Title of FTA Required Assurance 5310 5311 5316 5317 CAPITAL REQUESTS Lobbying Certification Iffl> $100,000 If> $100,000 lf> $100,000 If> $100,000 If> $100,000 Procurement Compliance (Capital Requests only) V V V V V Public Hearing (Capital Requests only) V V V V ✓ Acquisition of Rolling Stock (Pre -Award and Post Delivery Reviews —Capital Requests only) ✓ ✓ ✓ ✓ ✓ Bus Testing (Capital Requests only) ✓ V V V V Charter Service Agreement V School Transportation Agreement ✓ Demand Responsive Service (Demand Response Services Only) V V V V Alcohol Misuse and Prohibited Drug Use V Elderly Individuals & Individuals kith Disabili- ties Formula Program V Nonurbanized Area Formula Program V Job Access and Reverse Commute Formula Grant Program V New Freedom Program V We Certify and Assure that AGENCY NAME Weld County Transportation will comply with the applicable portions listed above. AGENGY NAME Weld County Government PRINTED NAME (Chief Elected Official/ Board President Legal Representative) William F Garcia TITLE Chair, Board of Co Couu++ss��ioners SIGNATURE ^�/ � C//f� DATE May 14, 2009 Page 102 Colorado Department of Transportation Esther Gesick From: Barb Connolly Sent: Friday, May 15, 2009 3:09 PM To: Esther Gesick Subject: CDOT Grant Attachments: SectC-5311.doc; SectA.doc; SectB-5310-5311.doc Esther, Here is the remainder of the grant application. The page numbers may not make sense as we are only required to file certain sections, but this is everything that is required with the exception of the on line profile. £&nSwta Connell* Barbara Connolly, CPA Controller Weld County 915 10th Street Greeley, CO 80631 (970) 356-4000 ext 4445 bconnolly(&,co.weld.co.us 1 Hello