FY 2003 - West Virginia Department of Transportation
2013 Application SECTION 5316JOB ACCESS and REVERSE COMMUTE(JARC)GRANT APPLICATION PACKETPrepared by:WV Department of TransportationDIVISION OF PUBLIC TRANSITBuilding 5, Room 9061900 Kanawha Boulevard, EastCharleston, West Virginia 25305-0432Phone: 304-558-0428FAX: 304-558-0174ATTENTION PLEASE!Failure to submit this information on or before the application deadline March 12, 2012, will prevent your application from being considered for funding.Due to the pending reauthorization, if a project is funded under the current submitted application, an applicant / sub-grantee must re-submit the appropriate budgets, certifications, assurances and or any other documentation deemed necessary to qualify the project on a year to year basis.Subsequent funding for this project is contingent upon the funding levels from the Federal Transit Administration (FTA) and or the reauthorization of SAFETEA-LU. SYMBOL 168 \f "Symbol"SYMBOL 168 \f "Symbol"IMPORTANT ANNOUNCEMENTSYMBOL 168 \f "Symbol"SYMBOL 168 \f "Symbol"All drivers must be trained in Passenger Service and Safety(PASS)orRider Sensitivity and Assistance Methods(RSAM) Driver training is required by the Americans With Disabilities Act (ADA)TABLE OF CONTENTS Pages I. General Information 6-15 II. Grant Application Packet 16 Application Format 17 Calendar for Section 5316 Application 18 Application Checklist 19 Letter of Intent 20-21 -Instructions for Application Title Page 22 Title Page 23 -Instructions for Authorizing Resolution 24 -Authorizing Resolution 25-26 -Instructions for Verification Certification 27 Verification Certification 28 -Instructions for Articles of Incorporation 29 -Instructions for Certifications 31 Certifications 32-45 III. Grant Application 46 Questions 1 – 34 47- 59 TABLE OF CONTENTS continued PagesIV. Appendices 60-78 (A) Appeals 61 (B) Glossary 62-67 (C) Criteria 68-69Regional Planning and Development Councils and 71-75 Metropolitan Planning Organizations Addresses (E) Attachments 78 SECTION IGENERAL INFORMATIONGENERAL INFORMATIONThe Job Access and Reverse Commute (JARC) program is a formula-based program, which is intended to provide an equitable funding distribution to States and communities as well as stable and reliable funding in order to implement locally developed, coordinated public transit-human services transportation plans. The program was designed to provide maximum flexibility to communities in designing plans and projects to meet these needs in all areas—urbanized, small urban, and rural.The goal of JARC is to improve access to transportation services to employment and employment related activities for welfare recipients and eligible low-income individuals and to transport residents of urbanized areas and nonurbanized areas to suburban employment opportunities. Toward this goal, the Federal Transit Administration provides financial assistance for transportation services planned, designed, and carried out to meet the transportation needs of eligible low-income individuals, and of reverse commuters regardless of income. The program requires coordination of Federally-assisted programs and services in order to make the most efficient use of Federal resources.Eligible activities for JARC may include, but are not limited to:- Late-night and weekend service- Guaranteed ride home service- Shuttle service- Expanding fixed-route mass transit routes- Demand-responsive van service- Ridesharing and carpooling activitiesTypes of JARC funding with required match:-Capital (80% federal/ 20% local)-Operating (50% federal/ 50% local)-Planning (80% federal/ 20% local)ELIGIBLE APPLICANTSPRIVATE - non-public, to wit: bodies which are not municipalities or other political subdivisions of states; are not public agencies or instrumentalities of one or more states, are not Indian tribes (except private non-profits that are formed by Indian tribes); are not public corporations, boards or commissions established under the laws of any state; or are not subject to control by public authority, state or municipal.NON-PROFIT ORGANIZATION - a corporation or association determined by the Secretary of the Treasury to be an organization described by 26 U.S.C. Section 501(c), which is exempt from taxation under 26 U.S.C. Section 501 (a) or Section 101 or one which has been determined under state law to be non-profit and for which the designated state agency has received documentation certifying the status of the non-profit organization.OPERARTORS OF PUBLIC TRANSIT SERVICES, including private operators of transportation services. If you are not sure of your eligibility status and would like to request approval to submit a Section 5316 application, please contact the Division of Public Transit for guidance.ELIGIBLE ACTIVITESEligible projects may include, but are not limited to capital, planning and operating assistance to support activities such as:1)Late night and weekend service;Guaranteed ride home service;Shuttle service;Expanded fixed-route public transit routes;Demand responsive van service;Ridesharing and carpooling activities;Transit related aspects of bicycling (adding bicycle racks to vehicles to support individuals that bicycle a portion of their commute or providing bicycle storage at transit stations);Promotion and marketing efforts targeted to eligible program service, e.g., use of transit by workers with non-traditional work schedules, use of transit voucher programs by appropriate agencies for welfare recipients and other low-income individuals, the development of employer-provided transportation such as shuttles, ridesharing, or carpooling, the use of transit pass programs and benefits under Section 132 of the Internal Revenue Code of 1986;Supporting expenses related to voucher programs, e.g., provide vouchers to low-income individuals to purchase rides including: (1) mileage reimbursements as part of a volunteer driver program, (2) a taxi trip, or (3) trips provided by a human service agency. Transit passes for use on fixed route or Americans with Disabilities Act of 1990 (ADA) complementary paratransit service are not eligible. Vouchers are an expense which requires a 50/50 (federal/local) match.Acquiring Geographical Information Systems (GIS) tools;Implementing Intelligent Transportation Systems (ITS), including customer trip information technology;Integrating automated regional public transit and human service transportation information or scheduling and dispatch functions, orDeploying vehicle position-monitoring systems;Subsidizing the cost associated with adding reverse commute bus, train, carpool van routes or service from urbanized areas and non- urbanized areas to suburban work places;Facilitating the provision of public transportation services to suburban work places; andSupporting new mobility management and coordination programs among public transportation providers and other human service agencies providing transportation. Mobility management is an eligible capital cost. Mobility management techniques may enhance transportation access for populations beyond those served by one agency or organization within a community. Mobility management is intended to build coordination among existing public transportation providers and other transportation service providers with the result of expanding availability of service. Mobility management activities may include:(1) Promotion, enhancement and facilitation of access to transportation services, including the integration and coordination of services for individuals with disabilities, older adults, and low-income individuals; (2) Support for short-term management activities to plan and implement coordinated services; (3) Support of State and local coordination policy bodies and councils; (4) Operation of transportation brokerages to coordinate providers, funding, agencies and customers; (5) Provision of coordinated services, as well as employer-oriented Transportation Management Organizations’ and Human Service Organizations’ customer-oriented travel navigator systems and neighborhood travel coordination activities, such as coordinating individualized travel training and trip planning activities for customers; (6) Development and operation of one-stop transportation information on all travel modes to manage eligibility requirements and arrangements for customers among supporting programs; and (7) Operational planning for the acquisition of intelligent transportation technologies to help plan and operate coordinated systems inclusive of Geographic Information Systems (GIS) mapping, Global Positioning System technology, coordinated vehicle scheduling, dispatching and monitoring technologies as well as technologies to track cost and billing in a coordinated system and single smart customer payment systems (acquisition of technology is also eligible as a stand alone capital expense). Indirect cost/expenses can not exceed 10% of the grant.While promotion of transit pass programs is eligible for JARC funding, the actual purchase of the passes is not, as this does not meet the overall objective of adding to or increasing the capacity of transportation services to connect low-income individuals to employment and related services. TITLE AND OWNERSHIP OF VEHICLETitle to and ownership of any vehicle, during its useful life, shall at all times remain with the Division of Public Transit. The actual title will read as follows: WV Department of Transportation, Division of Public Transit c/o the approved agency. This helps to protect the Federal interest in the vehicle, as well as, keeps the agency from having to pay a 5% use tax on the original cost of the vehicle to the Division of Motor Vehicles (DMV). PROJECT SELECTIONOnce an agency has submitted their application to the Division of Public Transit, it is reviewed for completeness. The application is then scored based on need, transportation operations/service, service, capacity, coordination efforts, fiscal and managerial capabilities and the proposed operating plan. If an application has missing documentation, the agency is given an opportunity to submit the omitted documents with penalty points being deducted. Two points will be deducted from an agency’s application score for each piece of missing information. Any applications received after the grant application deadline are considered for funding ONLY after all other on-time requests have been met. The Division reserves the right not to score or consider late applications.The application scores are then ranked from highest to lowest and the agencies receiving the highest scores are included in the State's consolidated application submitted to the Federal Transit Administration (FTA). DRUG AND ALCOHOL TESTINGAny driver holding a CDL license could be required to submit to Drug and Alcohol Testing under the Omnibus Transportation Employee Testing Act of 1991. Tests will be composed of pre-employment, reasonable cause, post accident and random based on FMCSA’s regulations.Individuals who are required to possess CDL licenses by virtue of State or local law or by employer policy, but not by Federal regulation, are not subject to the provisions of these regulations.Any persons who operates a commercial motor vehicle less than 26,001 GVWR is not required to be tested for controlled substances and/or alcohol under these rules unless the vehicle is designed to transport sixteen (16) or more passengers including the driver or is required to be placarded for hazardous materials transportation under Federal law. For additional information, contact the Division of Motor Vehicles at 304-558-2350.Sections 5317 (New Freedom), 5316 (JARC), and 5310 (elderly and persons with disabilities) not subject to FTA drug and alcohol policies. Sections 5307 and 5311 recipients are subject to drug and alcohol testing.CHARTER REGULATIONS Charter regulations do not apply to recipients who only receive Sections 5310, 5316 and 5317 funding. PROCUREMENTAll vehicle and major capital purchases will be conducted by the Division. Upon successful grant, the Division will issue procurement instructions for all other purchases.RESTRICTIONSSYMBOL 117 \f "Wingdings"No modifications are to be made on any equipment purchased with Section 5316 funds without prior written approval from the Division.SYMBOL 117 \f "Wingdings"Under no circumstances, is any equipment purchased with Section 5316 funds to be used as collateral in order to obtain a loan.PROPERLY MAINTAINED VEHICLEApproved agencies shall be responsible for maintaining all equipment in the best working condition possible, allowing for normal wear and tear. An approved agency shall establish a preventative maintenance program that at least meets the manufacturer’s minimum requirements. The preventative maintenance program shall be utilized and maintained by the agency, in a file, on site, available for review by personnel from the Division of Public Transit or the Federal Transit Administration during periodic on site monitoring reviews. COMPREHENSIVE MAINTENANCE RECORDSA Comprehensive Maintenance Record is to be maintained for each piece of equipment purchased with Section 5316 funds. All preventative maintenance, as well as repairs, etc. shall be recorded on the Comprehensive Maintenance Record thereby providing a complete history of the equipment’s maintenance and repairs. Copies of invoices for preventative maintenance and repairs shall be maintained with the record. Completed records shall be maintained by the agency, in a file, on site, available for review by personnel from the Division of Public Transit or the Federal Transit Administration during periodic on site reviews. If an agency applies to replace a Section 5316 vehicle, the vehicle must have at least 80,000 miles at the time the application is submitted. Documentation of extraordinary repairs (i.e. engine or transmission replacement; water, oil or fuel pump replacements, etc.) are used as justification for seeking a replacement vehicle and this documentation must be submitted with the application. The Division of Public Transit does not consider replacement of tires, spark plugs, oil filters, air filters, fuel filters, lube jobs, oil changes, or other regularly scheduled maintenance items as a reason for replacing a vehicle.WRITTEN EMERGENCY PROCEDURESEach approved agency is to develop and implement written emergency procedures for use by vehicle operators in the event of a vehicle accident, breakdown or other emergency situation. The Division recommends the Safety Planning Information Directed to Effective Response (SPIDER) kit. REPORT OF ACCIDENT/INCIDENTEach approved agency is to immediately report to the Division of Public Transit when equipment is involved in an accident or an incident. The verbal report shall be followed by a written report that can be included on the Section 5316 Incident/Accident Form. Records are to be maintained in the agency’s files regarding all accidents or incidents for review by personnel from the Division of Public Transit or the Federal Transit Administration during periodic on site reviews.INDEMNIFICATIONThe approved agency shall indemnify, and hold harmless the State of West Virginia, the Division of Public Transit and its agents, servants and employees from any and all claims, suits, proceedings, losses, expenses, damages and liabilities, including, but not limited to attorney’s fees and court costs caused directly or indirectly by, or arising out of, agency’s use of the equipment purchased with Section 5316 funds. The State of West Virginia shall not be liable for any loss or damage to any cargo or other property, real or personal, left stored, loaded or transported in or upon the equipment funded with Section 5316 funds, at any time or any place, including, without limitation, while located at any garage or other premises operated by the recipient agency and under any circumstances whatsoever, whether or not due to negligence of the Division of Public Transit, and the recipient agency shall waive all claims against the Division of Public Transit by reason thereof and shall indemnify, defend and hold the State of West Virginia or the Division of Public Transit harmless from and against any and all claims, suits, actions or proceedings based upon or arising out of such loss or damage. COMPLIANCE WITH TITLE VI OF THE CIVIL RIGHTS ACTApproved agencies must comply with Title VI of the Civil Rights Act. Agencies can not discriminate on the grounds of race, color, creed, national origin, sex, age or disability. Clients can not be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program. Efforts are to be made to assure that the benefits of the agency’s programs are not systematically denied to minorities. Up to date Title VI notices and statutes are to be posted prominently in the agency’s workplaces. CERTIFICATIONSIn this application packet your agency is signing various certifications. Agencies receiving assistance under the Section 5316 Program are required to abide by the signed certificationsON SITE MONITORING REVIEWSRepresentatives from the Division of Public Transit and/or the Federal Transit Administration will periodically conduct on site reviews of approved applicants for the purpose of confirming the existence, condition and proper maintenance of funded equipment and that the recipient is in compliance with all rules and regulations and the grant contract governing this funding. LATE APPLICATION SUBMISSIONApplications that are received after 4:00 p.m. on March 12, 2012, will be considered for funding only after all other agencies’ on time requests have been met. The Division of Public Transit is NOT responsible for late, lost or misdirected mail. The Division reserves the right not to score or consider late applications. SECTION IIGRANT APPLICATION PACKETAPPLICATION FORMATThis application packet has been assembled in a very specific format which the Division of Public Transit hopes will reduce the amount of preparation time and aid in the fair evaluation of each application. Applications received by the Division that do not follow this format will be returned for revision to the submitting organization which may jeopardize your organization's Section 5316 funding.A checklist of items to be included in your application packet has been provided on Page 19. As soon as possible, an applicant should notify your Regional Planning and Development Council or Metropolitan Planning Organization with your intentions of applying for funding. (Planning organizations need ample time to review your application.) The application is available on the division’s webpage transportation.publictransit utilizing Microsoft word software. Todd Dorcas of the Division is available to answer any questions concerning this application packet and may be reached at (304) 558-0428.Pay particular attention to the Application Calendar provided on Page 18.On or before 4:00 p.m., March 12, 2012, please submit one (1) original of your agency's application to the Division, at the following address:Division of Public TransitWest Virginia Department of TransportationBuilding 5, Room 9061900 Kanawha Boulevard, EastCharleston, West Virginia 253050432 Phone: (304) 5580428CALENDAR FOR FY 2013 SECTION 5316 GRANT APPLICATIONThis calendar has been provided for use as a guide in planning the completion and submission of your application. Applicants should adhere to the dates as outlined in order to ensure proper completion and timely submission of their applications.January 31Applications availableFebruary 21Letters of Intent to be received by DPT and Regional Planning and Development Councils and Metropolitan Planning Organizations (See page 21)March 12Applications Due to the Division of Public TransitMarch 1323 Division reviews applications, appeals are resolved, projects are selected for inclusion in the State Consolidated Application to FTA. April Program of projects submitted to FTA July 1Contract year / projects beginJune 30, 2013Contract year / projects endAPPLICATION CHECKLIST______ Letter of Intent______ Title Page_____ Authorizing Resolution (SIGNED IN BLUE INK)______ Verification Certification (SIGNED IN BLUE INK)______ Articles of Incorporation (IRS Tax Exemption letter is not acceptable)______ Certifications (SIGNED IN BLUE INK)______ Questions 1 - 34______ Operating Budget of Project______ Notarized Proof of Necessary Local Matching and Operating FundsLETTER OF INTENTA Letter of Intent will be required from all prospective Section 5316 applicants. These letters are due to the Division of Public Transit by February 21, 2012, with a copy sent to your Local Planning and Development Council or Metropolitan Planning Organization. A sample of the Letter of Intent has been included on the following page. Letters of Intent must be typed on your agency's letterhead. LETTER OF INTENTTO BE TYPED ON YOUR AGENCY'S LETTERHEADDirectorDivision of Public TransitBuilding 5, Room 9061900 Kanawha Boulevard, EastCharleston, West Virginia 253050432Dear Director:The _____________________________________________ is hereby applying (NAME OF AGENCY)for Federal funding under the Section 5316 Program to …(Describe Proposed Project)It is my understanding that failure to submit the application on or before March 12, 2012, will mean that my organization may not be funded under the FY 2012 Section 5316 Program. All correspondence and questions may be directed to (name of contact person who has been designated to represent the applicant in this matter). He/she may be reached at (address, telephone, agency, fax number, email address). Very truly yours, (Name and address) cc: Local Planning & Development Council or Metropolitan Planning OrganizationTITLE PAGEComplete the following page by filling in the necessary blanks. It is not necessary to retype this page as this sheet will be the first page of your application. TITLE PAGEThe_________________________________________________________ (Name of Your Agency)located at____________________________________________________ (Street Address) _______________________________________________________(City)(State)(Zip)is hereby applying for funding under the Section 5316 Grant Program.Person(s) Completing Application:____________________________________________________________(Name)(Title)(Phone)____________________________________________________________(Name)(Title)(Phone)AUTHORIZING RESOLUTIONOn the following page is a statement authorizing you to file a grant application on behalf of your organization. Complete all blanks and place it directly after the cover page in your application. (Do not retype.) Sign the resolution using a blue pen.AUTHORIZING RESOLUTIONC E R T I F I C A T EI, _____________________________________, do hereby certify that I am the duly qualified and Name of Certifying Officeracting ____________________________ of the _____________________________________________ Title of Certifying Officer Name of Applicantand as such, I am keeper of the seal, records and files of the __________________________________. Name of ApplicantI do further certify that a regularly constituted meeting of the ___________________________________________________________________ of the Board of Directors, Executive Committee, etc. Name of Applicant_________________________________ held on the ___________ day of____________, _______,at which a quorum of all of the members were present and voting, a certain Resolution was _____________________ (or)________________________ (Check one of the blanks) adopted in full Unanimously By Majority Voteaccordance and conformity with the _____________________________or________________________ByLaws of the Applicant Statutes of the______________________ (check one of the blanks) as made and provided, and that the followingState of West Virginia is a complete and true copy of the pertinent provisions of said Resolution:"BE IT RESOLVED by the ______________________ of the __________________________________” Governing Body Name of Applicant1. That an application be made to the West Virginia Department of Transportation, Division of Public Transit, for a Federal grant under the Section 5316 Program to acquire funds to provide __________________________________________________________________________________:Brief Description of Project2. That ________________________________ of the ________________________________________ Name of Authorized IndividualName of Applicantis authorized to furnish such additional information as may reasonably be required by the Federal Transit Administration or the West Virginia Department of Transportation, Division of Public Transit, in connection with the aforesaid application for said grant.I further certify that the original of the complete said Resolution is on file in the records of the _______________________________________________________ in my custody.Name of ApplicantI do further certify that the foregoing Resolution remains in full force and effect and has not been rescinded, amended, or altered in any manner since the date of its adoption.IN WITNESS WHEREOF, I have affixed my official signature and the seal (if appropriate) of the ______________________________________________,this________day of ____________, _______. Name of Applicant __________________________________________ SignatureSEAL __________________________________________ Title VERIFICATION CERTIFICATIONSign the following verification using a blue pen. VERIFICATION CERTIFICATIONASSURANCE OF AUTHORITY OF THE APPLICANT AND ITS REPRESENTATIVEFor (Name of Applicant): _________________________________________________________The authorized representative of the Applicant who signs these certifications, assurances, and agreements affirms that both the Applicant and its representative has adequate authority under applicable state and local law and the Applicant’s by-laws or internal rules to:Execute and file the application for Federal assistance on behalf of the Applicant;Execute and file the required certifications, assurances, and agreements on behalf of the Applicant binding the Applicant; andExecute grant agreements and cooperative agreements with FTA on behalf of the Applicant.Signature: ______________________________________________________Date: ___________________________________________________________Name:__________________________________________________________ARTICLES OF INCORPORATIONSubmit a copy (must be on 8? x 11 size paper) of your organization's Articles of Incorporation. Note that a tax exempt statement from the IRS is not acceptable.The Articles of Incorporation should be inserted directly following the Verification Assurance when submitting your application. ATTENTION PLEASE!As you are aware, failure to submit this information on or before the application deadline March 14, 2011, will prevent your application from being considered for funding.CERTIFICATIONSRead and sign the following certifications using a blue pen. Failure to sign these certifications will mean that your agency will not be considered for funding. CERTIFICATIONS AND ASSURANCES REQUIRED FOR THE SECTION 5316 – JARC PROGRAMWe the governing body of ________________________________________________________In approving the submission of the attached application, certify that the APPLICANT has the legal authority and is willing to make as part of the contract between the West Virginia Department of Transportation, Division of Public Transit and the APPLICANT for Federal Transit Administration Section 5316 financial assistance, the following assurances:As required by 49 U.S.C. 5316(f)(1), which makes the requirements of 49 U.S.C. 5307 applicable to Job Access and Reverse Commute (JARC) formula grants, and 49 U.S.C. 5307(d)(1), the Applicant for JARC Formula Program assistance authorized under 49 U.S.C. 531 6, certifies on behalf of itself and its subrecipients, if any, as follows:In compliance with 49 U.S.C. 5307(d)(1)(A), the Applicant has or will have the legal, financial, and technical capacity to carry out its proposed program of projects, including safety and security aspects of that program; In compliance with 49 U.S.C. 5307(d)(1)(B), the Applicant has or will have satisfactory continuing control over the use of project equipment and facilities;In compliance with 49 U.S.C. 5307(d)(1)(C), the Applicant will adequately maintain the project equipment and facilities;In compliance with 49 U.S.C. 5307(d)(1)(D), the Applicant will ensure that elderly individuals and individuals with disabilities, or any person presenting a Medicare card issued to himself or herself pursuant to title II or title XVIII of the Social Security Act (42 U.S.C. 401 et seq. or 42 U.S.C. 1395 et seq.), will be charged for transportation during non-peak hours using or involving a facility or equipment of a project financed with Federal assistance authorized under 49 U.S.C. 5316 not more than fifty (50) percent of the peak hour fare;In compliance with 49 U.S.C. 5307(d)(1)(E), the Applicant, in carrying out a procurement financed with Federal assistance authorized under 49 U.S.C. 5316: (1) will use competitive procurement (as defined or approved by the Secretary), (2) will not use exclusionary or discriminatory specifications in its procurements, (3) will comply with applicable Buy America laws, and (4) will comply with the general provisions for FTA assistance of 49 U.S.C. 5323 and the third party procurement requirements of 49 U.S.C. 5325;In compliance with 49 U.S.C. 5307(d)(1)(F), the Applicant has complied with or will comply with the requirements of 49 U.S.C. 5307(c). Specifically, it: (1) has made available, or will make available, to the public information on the amounts available for the JARC Formula Grant Program, 49 U.S.C. 5316, and the projects it proposes to undertake; (2) has developed or will develop, in consultation with interested parties including private transportation providers, the proposed projects to be financed ; (3) has published or will publish a list of projects in a way that affected citizens, private transportation providers, and local elected officials have the opportunity to examine the proposed projects and submit comments on the proposed projects and the performance of the Applicant; (4) has provided or will provide an opportunity for a public hearing to obtain the views of citizens on the proposed projects; (5) has ensured or will ensure that the proposed projects provide for the coordination of transportation services assisted under 49 U.S.C. 5336 with transportation services assisted by another Federal Government source; (6) has considered or will consider the comments and views received, especially those of private transportation providers, in preparing its final list of projects; and (7) has made or will make the final list of projects available to the public;In compliance with 49 U.S.C. 5307(d)(1)(G), the Applicant has or will have available and will provide the amount of funds required by 49 U.S.C. 5316(g) for the local share, and that those funds will be provided from approved non-Federal sources except as permitted by Federal law;In compliance with 49 U.S.C. 5307(d)(1)(H), the Applicant will comply with: 49 U.S.C. 5301(a) (requirements for public transportation systems that maximize the safe, secure and efficient mobility of individuals, minimize environmental impacts, and minimize transportation-related fuel consumption and reliance on foreign oil); 49 U.S.C. 5301(d) (special efforts to design and provide public transportation for elderly individuals and individuals with disabilities); and 49 U.S.C. 5303 through 5306 (planning and private enterprise requirements); and In compliance with 49 U.S.C. 5307(d)(1)(I), the Applicant has a locally developed process to solicit and consider public comment before raising a fare or implementing a major reduction of public transportation;In compliance with 49 U.S.C. 5316(d), the Applicant certifies that (1) with respect to financial assistance authorized under 49 U.S.C. 5316(c)(1)(A), it will conduct in cooperation with the appropriate MPO an areawide solicitation for applications, and make awards on a competitive basis and (2) with respect to financial assistance authorized under 49 U.S.C. 5316(c)(1)(B) or 49 U.S.C. 5316(c)(1)(C), it will conduct a statewide solicitation for applications, and make awards on a competitive basis;In compliance with 49 U.S.C. 5316(f)(2), the Applicant certifies that any allocations to subrecipients of financial assistance authorized under 49 U.S.C. 5316 will be distributed on a fair and equitable basis;In compliance with 49 U.S.C. 5316(g)(2), the Applicant certifies that, before it transfers funds to a project funded under 49 U.S.C. 5336, that project will has been or will have been coordinated with private nonprofit providers of services; In compliance with 49 U.S.C. 5316(g)(3), the Applicant certifies that: (1) the projects it has selected or will select for assistance under that program were derived from a locally developed, coordinated public transit-human services transportation plan; and (2) the plan was developed through a process that included representatives of public, private, and nonprofit transportation and human services providers and participation by the public; andIn compliance with 49 U.S.C. 5316(c)(3), before the Applicant uses funding apportioned under 49 U.S.C. 5316(c)(1)(B) or (C) for projects serving an area other than that specified in 49 U.S.C. 5316(2)(B) or (C), the Applicant certifies that the chief executive officer of the State, or his or her designee will have certified to the Federal Transit Administrator, apart from these certifications herein, that all of the objectives of 49 U.S.C. 5316 are being met in the area from which such funding would be derived.Signature: _________________________________________________________ Date: _________________________________________________________ Title of Authorized Official: _________________________________________________________GENERAL CERTIFICATIONS AND ASSURANCES1. CERTIFICATION OF PROVISION OF NECESSARY LOCAL MATCHING FUNDSI, ________________________________________,hereby certify that the ____________________________________________;(Name)(Name of Agency)shall provide the total amount of local match from non-Federal sources required for the purchase of vehicle(s) within fifteen (15) days of receipt of written notification from the Division of Public Transit of the actual amount needed.It is my understanding that failure to comply with this stipulation will result in the Division of Public Transit's cancellation of the purchase order that is required in order to obtain my agency's vehicle(s) or communication equipment. I further understand that this cancellation will cause my agency to be delayed in the receipt of any vehicle(s) or communication equipment for approximately one (1) year.2. MAINTENANCE CERTIFICATIONThe Federal Transit Administration (FTA), realizing the potential problems of operability, safety, and reliability of the vehicle(s) if is not properly maintained, has instituted a requirement that all Section 5316 grantees must certify that a vehicle(s) or communication equipment purchased under the program will be maintained in accordance with the detailed maintenance and inspection schedules provided by the manufacturer. Failure to maintain vehicle(s) in accordance with their certification will preclude additional FTA assistance to that agency. I certify that I understand the FTA maintenance and inspection requirements and that _________________________________________________________ will comply. (Name of Agency)3. CIVIL RIGHTS _________________________________________________ hereby agrees that it will comply with the following requirements:(Name of Agency)(1) Nondiscrimination. In accordance with Title VI of the Civil Rights Act, as amended, 42 U.S.C. § 2000d, Section 303 of the Age Discrimination Act of 1975, as amended, 42 U.S.C. § 6102, Section 202 of the Americans With Disabilities Act of 1990, 42 U.S.C. § 12132, and Federal transit law at 49 U.S.C. § 5332, the RECIPIENT agrees that it will not discriminate against any employee or applicant for employment because of race, color, creed, national origin, sex, age, or disability. In addition, the RECIPIENT agrees to comply with applicable Federal implementing regulations and other implementing requirements FTA may issue.(2) Equal Employment Opportunity. The following equal employment opportunity requirements apply to this Project:(a) Race, Color, Creed, National Origin, Sex. In accordance with Title VII of the Civil Rights Act, as amended, 42 U.S.C. § 2000e, and Federal transit laws at 49 U.S.C. § 5332, the RECIPIENT agrees to comply with all applicable equal employment opportunity requirements of U.S. Department of Labor (U.S. DOL) regulations, “Office of Federal Agreement Compliance Programs, Equal Employment Opportunity, Department of Labor,” 41 C.F.R. Parts 60 et seq., (which implement Executive Order No. 11246, “Equal Employment Opportunity,” as amended by Executive Order No. 11375, “Amending Executive Order 11246 Relating to Equal Employment Opportunity, “ 42 U.S.C. § 2000e note), and with any applicable Federal statutes, executive orders, regulations, and Federal policies that may in the future affect construction activities undertaken in the course of the Project. The RECIPIENT agrees to take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, color, creed, national origin, sex, or age. Such action shall include, but not be limited to, the following: employment, upgrading, demotion or transfer, recruitment or recruitment advertising, layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. In addition, the RECIPIENT agrees to comply with any implementing requirements FTA may issue.(b) Sex. RECIPIENT agrees to comply with all applicable requirements of Title IX of the Education Amendments of 1972, as amended, 20 U.S.C. §§ 1681-1683, 1685-1688, with U.S. DOT regulations, “Nondiscrimination on the Basis of Sex in Education Programs or Activities Receiving Federal Financial Assistance,” 49 C.F.R. Part 25, and with any implementing directives that U.S.DOT or FTA may promulgate, which prohibit discrimination on the basis of sex.(c) Age. In accordance with the Age Discrimination Act of 1975, as amended, 42 U.S.C. §§ 6101 et seq. and implementing regulations, the RECIPIENT agrees to refrain from discrimination against present and prospective employees for reason of age. In addition, the RECIPIENT agrees to comply with any implementing requirements FTA may issue.(d) Disabilities. In accordance with Section 102 of the Americans With Disabilities Act, as amended, 42 U.S.C. § 12112, the RECIPIENT agrees that it will comply with the requirements of U.S. Equal Employment Opportunity Commission, “Regulations to Implement the Equal Employment Provisions of the Americans With Disabilities Act,” 29 C.F.R. Part 1630, pertaining to employment of persons with disabilities. In addition, the RECIPIENT agrees to comply with any implementing requirements FTA may issue.(3) RECIPIENT also agrees to include these requirements in each sub-agreement financed in whole or in part with Federal assistance provided by FTA, modified only if necessary to identify the affected parties.4. ENERGY CONSERVATION RECIPIENT agrees to comply with, and obtain the compliance of its subcontractors, with mandatory standards and policies relating to energy efficiency contained in applicable state energy conservation plans issued in compliance with the Energy Policy and Conservation Act, 42 U.S.C. §§ 6321 et seq.5. CERTIFICATION OF SPECIAL EFFORTS TO PROVIDE TRANSPORTATION THAT HANDICAPPED PERSONS CAN USEThe ________________________________________________________ hereby certifies that special efforts are being made in its(Name of Agency)service area to provide transportation that handicapped persons, including wheelchair users and semiambulatory persons can use. The transportation resulting from these special efforts is reasonable in comparison to the transportation provided to the general public and meets a significant fraction of the actual transportation needs of such persons within a reasonable time. 6. LITIGATION CERTIFICATIONI, ________________________________________________________ hereby certify that to the best of my knowledge there is no (Name)litigation pending or threatened which might affect the performance of this Project.7. FISCAL AND MANAGERIAL CAPABILITY CERTIFICATIONI, _______________________________________________________ hereby certify that, based on my experience with the (Name)______________________________________________________ and a review of the agency’s records, that the agency has the (Name of Agency)requisite fiscal and managerial capability to carry out this Project.8. APPLICATION OF FEDERAL, STATE AND LOCAL LAWS AND REGULATIONSName of Agency: __________________________________________________ hereby certifies that it will comply with changing federal, state and local requirements, the RECIPIENT shall note that federal, state and local requirements may change and the changed requirements will apply to this Project as required.Federal Regulation Changes - RECIPIENT shall at all times comply with all applicable FTA regulations, policies, procedures and directives, including without limitation those listed directly or by reference in the Master Agreement between the WV Department of Transportation, Division of Public Transit and FTA, as they may be amended or promulgated from time to time during the term of this Project. RECIPIENT's failure to so comply shall constitute a material breach of this Project.9. INSPECTIONName of Agency: _________________________________________________hereby certifies that it shall permit the Division, the Comptroller General of the United States and the Secretary of the United States Department of Transportation, or their authorized representatives, to inspect all vehicles, facilities and equipment used by the Agency as part of the Project to verify compliance with the requirements of the Program. All records of the transportation services rendered by the Agency, including maintenance records, records verifying usage of the vehicle, and all relevant Project records shall also be available for inspection. The Agency shall also permit the above named persons or agencies to audit the records and accounts of the Agency pertaining to the Project.10. COORDINATIONName of Authorizing Official: ___________________________________________________ hereby certifies that to the best of my knowledge the Name of Agency: _________________________________________________ has coordinated, to the maximum extent feasible, with other transportation providers and users, regardless of their funding source.11. EFFECTS ON PRIVATE MASS TRANSPORTATION COMPANIESName of Agency: __________________________________________________ as required by 49 U.S.C. 5323(a)(1)(C) or 5323 (a)(2)(B). the applicant certifies that before it acquires property or an interest in property of a private mass transportation company or operates mass transportation equipment or a facility in competition with or in addition to transportation service provided by an existing mass transportation company it has or will have:A.Provided for the participation of private mass transportation companies to the maximum extent feasible; andB.Paid or will pay just compensation under state or local law to a private mass transportation company for its franchises or property acquired.12. NO FEDERAL GOVERNMENT OBLIGATIONS TO THIRD PARTIES Name of Agency: __________________________________________________ acknowledges and agrees that, notwithstanding any concurrence by the Federal Government in or approval of the solicitation or award of the underlying Project, absent the express written consent by the Federal Government, the Federal Government is not a party to this Project and shall not be subject to any obligations or liabilities to the WV Division of Public Transit, RECIPIENT, or any other party (whether or not a party to the Project) pertaining to any matter resulting from the underlying Project.13. PROGRAM FRAUD AND FALSE OR FRAUDULENT STATEMENTS OR RELATED ACTSName of Authorizing Official:________________________________________________________ of the Name of Agency: ______________________________________________________ acknowledges that the provisions of the Program Fraud Civil Remedies Act of 1986, as amended, 31 U.S.C. §§ 3801 et seq. and U.S. DOT regulations, “Program Fraud Civil Remedies,” 49 C.F.R. Part 31, apply to its actions pertaining to this Project. Upon execution of the underlying Project, the RECIPIENT certifies or affirms the truthfulness and accuracy of any statement it has made, it makes, it may make, or causes to be made, pertaining to the underlying Project or the Federal Transit Administration (FTA) assisted Project for which the Project work is being performed. In addition to other penalties that may be applicable, the RECIPIENT further acknowledges that if it makes, or causes to be made, a false, fictitious, or fraudulent claim, statement, submission, or certification, the Federal Government reserves the right to impose the penalties of the Program Fraud Civil Remedies Act of 1986 on the RECIPIENT to the extent the Federal Government deems appropriate.I declare that the foregoing certifications are true and correct.Executed on ___________________________ at ________________________________________________.(Date)(City and State)_______________________________________________ (Signature of Official)_______________________________________________ (Title) CERTIFICATION OF EQUIVALENT SERVICEThe ________________________________________________________ Name of Agency certifies that its demand responsive service offered to individuals with disabilities, including individuals who use wheelchairs, is equivalent to the level and quality of service offered to individuals without disabilities. Such service, when viewed in its entirety, is provided in the most integrated setting feasible and is equivalent with respect to:(1) Response time;(2) Fares;(3) Geographic service area;(4) Hours and days of service;(5) Restrictions on trip purpose;(6) Availability of information and reservation capability; and(7) Constraints on capacity or service availability.In accordance with 49 CFR 37.27, public entities operating demand responsive systems for the general public which receive financial assistance under Sections 5310 or 5311 of the Federal Transit Act, as amended, must file this certification with the appropriate state program office before procuring any inaccessible vehicle. Such public entities not receiving Federal Transit Act funds shall also file the certification with the appropriate state program office. Such public entities receiving Federal Transit Act funds under any other Section of the Federal Transit Act must file the certification with the appropriate Federal Transit Administration regional office. This certification is valid for no longer than one year from its date of filing._________________________________________ Name & Title of Authorized Official_________________________________________Signature______________________________DateAssurance Concerning Nondiscrimination on theBasis of Disability in Federally-Assisted Programsand Activities Receiving or Benefiting fromFederal Financial AssistanceImplementing the Rehabilitation Act of 1973, as amended, andthe Americans With Disabilities Act of 1990(Federal Transit Administration)__________________________________________, (the "Recipient") AGREES THAT, Name of Applicantas a condition to the approval or extension of any Federal financial assistance from the Federal Transit Administration (FTA) to construct any facility, obtain any rolling stock or other equipment, undertake studies, conduct research or to participate in or obtain any benefit from any program administered by the FTA, no otherwise qualified person with a disability shall, solely by reason of his or her disability, be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination under any program or activity that receives or benefits from Federal financial assistance administered by the FTA or any entity within the United States Department of Transportation (DOT).Specifically, the Recipient GIVES ASSURANCE that it will conduct any program or operate any facility so assisted in compliance with all applicable requirements imposed by DOT regulations implementing the Rehabilitation Act of 1973, as amended, and the Americans With Disabilities Act of 1990 (any subsequent amendments thereto) set forth at 49 C.F.R. Parts 27, 37, and 38, as well as all applicable regulations and directives issued pursuant thereto by other Federal departments or agencies._________________________________________________________ Date Legal Name of ApplicantBY: _____________________________________ Signature of Authorized OfficialDRUG-FREE WORKPLACE ACT CERTIFICATIONFOR A PUBLIC OR PRIVATE ENTITY1. The ________________________________________________________________ Name of Applicant certifies that it will provide a drug-free workplace by:(a)Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the Applicant's workplace and specifying the actions that will be taken against employees for violation of such prohibition;(b)Establishing an ongoing drug-free awareness program to inform employees about--(1)The dangers of drug abuse in the workplace;(2)The Applicant's policy of maintaining a drug-free workplace;(3)Any available drug counseling, rehabilitation, and employee assistance programs; and,(4)The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace;(c)Making it a requirement that each employee to be engaged in the performance of the grant or cooperative agreement be given a copy of the statement required by paragraph (a);(d)Notifying the employee in the statement required by paragraph (a) that, as a condition of employment under the grant or cooperative agreement, the employee will--(1)Abide by the terms of the statement; and,(2)Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction;(e)Notifying the Federal agency in writing, within ten calendar days after receiving notice under subparagraph (d) (2) from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including position title, to every project officer or other designee on whose project activity the convicted employee was working, unless the Federal agency has designated a central point for the receipt of such notices. Notice shall include the identification number(s) of each affected grant or cooperative agreement.(f)Taking one of the following actions, within 30 calendar days of receiving notice under subparagraph (d) (2), with respect to any employee who is so convicted--(1)Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or(2)Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency;(g)Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (a), (b), (c), (d), (e), and (f).2. The Applicant's headquarters is located at the following address. The addresses of all workplaces maintained by the Applicant are provided on an accompanying list. Name of Applicant: Address: City: County: State: Zip Code:____________________________________________ Signature of Authorized Official____________________________________________ Title of Authorized Official____________________________________________ Name of Applicant____________________________________________ DateFederal Transit Administration(FTA)CIVIL RIGHTS ASSURANCEThe __________________________________________ HEREBY CERTIFIES THAT, Name of Agencyas a condition of receiving Federal financial assistance under the Federal Transit Administration (FTA) Transportation Act of 1964, as amended, it will ensure that:1.No person on the basis of race, color, or national origin will be subjectedto discrimination in the level and quality of transportation services and transit-related benefits.2.The ______________________________________ will compile, maintain, and Name of Agencysubmit in a timely manner Title VI information required by FTA Circular 4702.1 and in compliance with the Department of Transportation’s Title VI regulation, 49 C.F.R. Part 21.9.3.The ______________________________________ will make it known to the Name of Agencypublic that those person or persons alleging discrimination on the basis of race, color, or national origin as it relates to the provision of transportation services and transit-related benefits may file a complaint with the Federal Transit Administration and/or the U.S. Department of Transportation.The person or persons whose signature appears below are authorized to sign this assurance on behalf of the grant applicant or recipient._____________________________________DATE: __________________ NAME AND TITLE OF AUTHORIZED OFFICIAL_____________________________________ SIGNATURE OF AUTHORIZED OFFICIALTITLE VI REPORTList any active lawsuits or complaints naming the applicant which allege discrimination on the basis of race, color, or natural origin with respect to service or other transit benefits. The list should include: date the lawsuit or complaint was filed; a summary of the allegation; and the status of the lawsuit or complaint; including whether the parties to a lawsuit have entered into a consent decrees. If none, please state.A description of all pending applications for financial assistance and all financial assistance currently provided by other federal agencies. If none, please state.A summary of all civil rights compliance review activities conducted in the last three years. The summary should include: the purpose or reasons for the review; the name of the agency or organization that performed the review; a summary of the findings and recommendations of the review; and a report on the status and/or disposition of such findings and recommendations. If none, please state.School TransportationOperations AgreementName of Agency: _______________________________________________________A.As required by 49 U.S.C. 5323 (f) and FTA regulations, “School Bus Operations,” at 49 CFR 605.14, the Applicant agrees that it will:(1)Engage in school transportation operations in competition with private school transportation operators only to the extent permitted by an exception provided by 49 U.S.C. 5323(f), and implementing regulations, and(2)Comply with the requirements of 49 CFR Part 605 before providing any school transportation using equipment or facilities acquired with Federal assistance authorized by 49 U.S.C. Chapter 53 or Title 23 U.S.C. awarded by FTA for transportation projects.B.The Applicant understands that the requirements of 49 CFR Part 605 will apply to any school transportation it provides, the definitions of 49 CFR Part 605 apply to this school transportation agreement, and a violation of this agreement may require corrective measures and the imposition of penalties, including debarment from the receipt of further Federal assistance for transportation.____________________________________________ Name & Title of Authorized Official ____________________________________________ Signature____________________________________________ DateLOBBYING CERTIFICATIONName of Agency: _______________________________________________________A.As required by 31 U.S.C. 1352 and U.S. DOT regulations, “New Restrictions on Lobbying,” 49 CFR 20.110, the Applicant’s authorized representative certifies to the best of his or her knowledge and belief that for each application to FTA for Federal assistance exceeding $100,000:(1)No Federal appropriated funds have been or will be paid by or on behalf of the Applicant to any person to influence or attempt to influence an offi9cer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress , or an employee of a Member of Congress regarding the award of Federal assistance, or the extension, continuation, renewal, amendment, or modification of any Federal assistance agreement; and(2)If any funds other than Federal appropriated funds have been or will be paid to any person to influence or attempt to influence an officer or employee of any Federal agency, a member of Congress in connection with any application for Federal assistance, the Applicant ensures that it will complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying,” including information required by the instructions accompanying the form, which form may be amended to omit such information as authorized by 31 U.S.C. 1352.(3)The language of this certification shall be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, subagreements, contracts under grants, loans, and cooperative agreements). B.The Applicant understands that this certification is a material representation of fact upon which reliance is placed by the Federal Government and that submission of this certification is a prerequisite for providing Federal assistance for a transaction covered by 31 U.S.C. 1352. The Applicant also understands that any person who fails to file a required certification shall be subject to a civil penalty of not less than $ 10,000 and not more than $100,000 for each such failure._______________________________________ Name & Title of Authorized Official________________________________________ Signature____________________________________________DateCERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERSName of Agency: _______________________________________________________As required by U.S. DOT regulations on Governmentwide Debarment and Suspension (Nonprocurement) at 49 CFR 29.510:The Applicant certifies to the best of its knowledge and belief that it and its principals:Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency;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) transaction 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;Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, state or local) with commission of any of the offenses listed in paragraph (2) of this certification; and,Have not within a three-year period preceding this certification had one or more public transactions (Federal, state or local) terminated for cause or default.The Applicant also certifies that if, later, it becomes aware of any information contradicting the statements of paragraphs (a) through (d) above, it will promptly provide that information to the Division.If the Applicant is unable to certify to the statements within paragraphs (1) and (2) above, it shall indicate so on its Signature Page and provide a written explanation to the Division.____________________________________________ Name & Title of Authorized Official ____________________________________________ Signature_____________________________________________ DateSECTION IIIGRANT APPLICATIONComplete the following application using the forms provided. 5316 JARC (Job Access and Reverse Commute) (double click on the box for the appropriate selection-MSWord) Job Access and Reverse Commute (JARC)Application Part 1:Applicant information1) Name and type of applicant or agency requesting funding: (Please mark the box that corresponds to the type of agency that you are by double clicking on the box) FORMCHECKBOX Private Non-Profit FORMCHECKBOX Transit Authority FORMCHECKBOX Other / Private Operator of Public Transit (Specify_________________________________)2) Address: City/State/ Zip code:Telephone:Fax:Email:Website:3) Is your organization a recipient under any of the following programs?(Please mark the appropriate box or boxes) FORMCHECKBOX Section 5311 FORMCHECKBOX Section 5310 FORMCHECKBOX Section 5309 FORMCHECKBOX Section 5307 FORMCHECKBOX Existing JARC recipient FORMCHECKBOX Other FTA or federal programsPlease indicate:Application Part 1:Applicant information4) Are there any other federal or state funding sources utilized by your organization? If so, please list.5) Please provide a description of your agency. Include a mission statement if available. (Limit your response to 500 words and attach on a separate sheet as Attachment A in Appendix E.)Application Part 2:Service Area and DemographicsPlease cite the source and the year for your demographic data for questions six (6) through eleven (11).6) What is the geographic area served by your agency (County or counties, cities and towns)? Please submit a map or maps as Attachment B in Appendix E).7) Total population (number of persons) in your service area?8) What is the percentage of persons below poverty for your service area?9) What is the percentage of unemployment in your service area?10) What is the percentage of the minority population in your area for the following groups?Asian American Indian or Alaskan NativeBlackHispanicOther11) What is the percentage of the disabled population in your service area?Application Part 3: Existing / Current Transportation Service Describe the current transportation service(s) that your organization provides:Application Part 3:13) List the current inventory of vehicles in the table belowCURRENT VEHICLE INVENTORY(Please List Each Vehicle Separately and use as many sheets as needed)TypeVehicleIdentificationNumberModelYearCurrentMileageSeating CapacitySpecial Equipment(Lift or Ramp)Funding SourceForPurchaseSpare Vehicle(Yes/No)Application Part 3: Existing / Current Transportation Service (Continued)Does your organization have a written vehicle maintenance plan? FORMCHECKBOX Yes FORMCHECKBOX No15) If your organization does have a written vehicle maintenance plan, does it meet the manufacturer’s minimum requirements? FORMCHECKBOX Yes FORMCHECKBOX No (For questions 16-18, answer the questions that apply to your organization) 16) Description of service(s) currently provided to meet the needs of the elderly:17) Description of service(s) currently provided to meet the needs of the disabled:Description of efforts made to address the needs of low-income communities:Application Part 3: Existing Operation of your Agency (Staffing and Capacity)19) Indicate the hours and days of operation:Total full-time employees: 21) Number of full-time drivers:22) Other than drivers, please describe the position and duties of other full-time employees:23) Do you employ any part-time employees? If so, list them below with a brief description of their duties:24) Do you utilize volunteers? If so, how many and for what kinds of service or projects:Application Part 3: Existing Operation of your Agency (Continued)Please describe which vehicle(s) from the Current Vehicle Inventory table will be utilized for this project:Please Identify in the table below ALL other transportation providers (public and private) in the geographic area or areas that you propose to serve. Name and Address ofProviderContact Person&Phone NumberService AreaNumberOfVehiclesFrequency &Type of ServiceProvidedWheelchair Accessible(Yes/No)Application Part 4: Project Description Project Specific Programming (Please check the box or boxes for the program that you are seeking to fund) FORMCHECKBOX Job Access and Reverse Commute (JARC) FORMCHECKBOX Capital (80%20%) FORMCHECKBOX Operating (50%/50%) FORMCHECKBOX Planning (80%/20%)28) Project Name: 29) Does your project address any issues or areas derived from the most recent completed locally developed Coordinated Public Transit-Human Services Transportation Plan? FORMCHECKBOX Yes FORMCHECKBOX NoDescribe the project (Limit your response to 500 words and attach on a separate sheet as Attachment C in Appendix E.)31) Describe the consultation process with the public and the level of involvement of the community to be served (welfare recipients, low-income residents, persons with disabilities, etc) (Limit your response to 250 words and attach on a separate sheet as Attachment D in Appendix E.)Application Part 4: Project Description (Continued)Provide information identified below to support your applicationFactors- Resource Identification: Mark the appropriate box or boxes and fully describe the attributes that contribute to your program. Use additional space/ (paper) to detail your response if needed. FORMCHECKBOX Job Access and Reverse Commute (JARC) FORMCHECKBOX Innovative Approaches- identify any innovative techniques and approaches that contribute to the proposed project. FORMCHECKBOX Use of Employer-based Strategies-Describe any commitment by employer that will contribute to the success of the project. FORMCHECKBOX Linkages to Other Employment Support Services-Identify available employment support services that complement the transportation activities and are critical to ensuring that welfare recipients get and retain jobs. FORMCHECKBOX Other Strategies- Describe other locally-specific actions strategies and linkages, about which FTA/DOT should be aware, that were not captured in the preceding criteria.Application Part 5: Budget Federal and Local Match (JARC)33) In this section provide the budget information associated with your project.JARC Capital/PlanningTotal Cost20% Match*Federal Capital Cost@80%$$$*Indicate Source of Match___________________________________________________Status of Match (Secured or unsecured) _______________________________________JARC Operating Total Cost50% Match*Federal Operating Cost@50%$$$*Indicate Source of Match___________________________________________________Status of Match (Secured or unsecured) _______________________________________Application Part 5: Budget Federal and Local Match (JARC)34) In this section provide the budget information associated with your project.“PROPOSED”FY 2013 JARC OPERATING BUDGET (1) TOTAL OPERATING EXPENSES (Itemize)Salaries $ Manager? Drivers? Other?Fringe Benefits?Board Expenses?CDL Testing?Computer Supplies?Contracted Vehicle Maintenance Services?Contractual Services?Drug & Alcohol Testing Expenses?Fuel & Oil?Garage/Storage Costs?Hand Tools?Insurance (Transit Property, Vehicle Insurance & Other)?Marketing*?Office Equipment?Office Expenses?Office Maintenance?Physicals?Printing/Copying?Rent?Replacement Parts?Telecommunications?Travel?Uniform?Utilities?Miscellaneous(Specify Below)$ ?????????(1) TOTAL ANNUAL EXPENSES $ Capital PlanningCapital funding is available through the Section 5316 program at an 80 percent Federal/20 percent local matching ratio. Projects eligible for capital funding include:Transit vehiclesCommunications equipmentBus stop shelters, with or without benchesOther capital needsSo that we can better plan and budget your anticipated capital needs and/or requests, please complete the table below. For buses, identify the type as follows:Mini-vanLow-floor mini-vanConverted van (Braun)18-passenger cutawayChampion-like vehiclePacer-like vehicleECII-like vehicleGCII-like vehicleShop/support vehicleNote whether the bus will be for replacement or expansion. For replacement vehicles, include the VIN of the vehicle to be replaced. If requesting communication equipment, please also indicate if it is a replacement of older units or an addition.Please note that the Division may not have the resources to fund all capital requests. The Division may also decide to give priority to certain items, such as replacement vehicles, over other items like expansion vehicles.Fiscal YearCapital ItemsFY2013FY2013FY2013FY2013FY2013Please explain why this equipment is essential for the operation of your transit services?APPENDIX-AAPPEALSWVDPT Appeal ProcessIf an application is not funded based on committee recommendations, the applicant may appeal the outcome by using the following process: To Initiate the appeal process, the applicant must submit a written appeal to:DirectorWV DOT Division of Public TransitBuilding 5, Room 9061900 Kanawha Boulevard EastCharleston WV 25305-0432A letter of appeal from the applicant must clearly state the organization name, contact person, address, phone number, project description and grounds for appeal.A letter of appeal must be postmarked no later than fourteen (14) calendar days from the postmarked date of WV DOT, Division of Public Transit’s notice of the applicant’s funding status.The Division of Public Transit will review the appeal and provide a written response within ten (10) working days of receipt of the appeal.APPENDIX -BGLOSSARY OF TERMSGLOSSARY OF TERMSThe following definitions are provided as they relate to the FTA’s implementation of the JARC Program:Accessible Taxi: An accessible taxi is a vehicle that is used by a private provider of on-demand transportation service to the public that is regulated and licensed for such use by the municipality, county or other government entity. An accessible taxi is one which has the capacity to accommodate a passenger who uses a “common wheelchair” as defined under 49 CFR 37.3, at a minimum, while remaining in his/her personal mobility device inside the vehicle, and meets the same requirements for lifts, ramps, and securement systems specified in 49 CFR part 38, subpart B. Americans with Disabilities Act (ADA): Public Law 336 of the 101st Congress, enacted July 26, 1990. The ADA prohibits discrimination and ensures opportunity for persons with disabilities in employment, State and local government services, public accommodations, commercial facilities, and transportation.Capital Equipment: Is usually a tangible item that has a useful life of more than one petitive Selection Process: A process to choose which projects will be funded based on standard evaluation criteria applied to each project. Projects are not guaranteed funding year to year. As the Designated Recipient of FTA funds, the process is conducted by WVDOT/DPT for small urban and nonurbanized areas in the State of West Virginia. The projects selected must be derived from a Locally Developed, Coordinated Public Transit-Human Services Transportation Plan.DPT: The Division of Public Transit, West Virginia Department of Transportation (WVDOT) is the designated state agency to carry out the day-to-day administration of the JARC Program. Demand Responsive Service: Service which operates in response to calls from passengers to the transit operator. Vehicles are dispatched to pick up passengers and transport them to their destinations. The vehicles do not operate over a fixed route or on a fixed schedule. Routes change every day depending on the demand. Designated Recipient: In nonurbanized areas and urbanized areas with a population of less than 200,000, the recipient is the State agency designated by the Governor to receive and apportion amounts under JARC. In the State of West Virginia, the WVDOT/DPT is the designated recipient. Dial-A-Ride: DialARide is a term that has been applied to a variety of sharedride services operated by the private sector. These services utilize vans, small buses, or other vehicles larger than a taxi cab, but in many respects they resemble a sharedride taxi service in that they provide doortodoor service. However, most DialARide services do not pick up in response to hailing in the street.Disabled Person: Any individual who due to a physical or mental impairment is substantially limited in one or more of the major life activities; has a record of such an impairment; or is regarded as having such an impairment.Elderly Person: Any person at least 60 years of age.Eligible Subrecipients: For purposes of the WVDOT/DPT JARC Program, eligible subrecipients can be any local governmental authority, non-profit organization, or operator of public transportation services that receives a grant under the JARC program indirectly through a recipient. Fixed Route Service: Designated public transportation service in which a vehicle is operated along a prescribed route according to a fixed schedule.FTA: Federal Transit AdministrationGrantee: An eligible subrecipient, which submitted, and received approval of, a JARC application to the WVDOT/DPT. Human Service Transportation: Transportation services provided by or on behalf of a human service agency to provide access to agency services and/or to meet the basic, day-to-day mobility needs of transportation-disadvantaged populations, especially individuals with disabilities, older adults, and people with low incomes.Individual With a Disability: The term ‘individual with a disability’ means an individual who, because of illness, injury, age, congenital malfunction, or other incapacity or temporary or permanent disability (including an individual who is a wheelchair user or has semi-ambulatory capability), cannot use effectively, without special facilities, planning, or design, public transportation service or a public transportation facility. 49 U.S.C. 5302(a)(5). Locally Developed, Coordinated Public Transit-Human Services Transportation Plan: A locally developed plan that identifies the transportation needs of individuals with disabilities, older adults, and people with low incomes, provides strategies for meeting those local needs, and prioritizes transportation services for funding and implementation. The plan must include an area no smaller than a county. All JARC projects must be derived from these locally developed plans (Coordinated Plans). Local Funds or Local Share: Refers to the match for Section 5316. Local Intergovernmental Review: A process whereby all levels of government are notified of proposed projects involving Federal funds. It is intended to assure that conflicting projects or projects not in the best interest of the community are identified early in the planning phase. This review can be done by the regional planning and development council or metropolitan planning organization.Modified Fixed Route/ Demand Responsive: Vehicles that operate on a fixed route, but will detour from the route to pick up or drop off passengers. After the passenger is served, the vehicle will return to the fixed route.Mobility Management: Eligible capital expenses consisting of short-range planning and management activities and projects for improving coordination among public transportation and other transportation-service providers carried out by a grantee through an agreement entered into with a person, including a government entity, under Chapter 53 (other than Section 5309). Mobility management does not include operating public transportation services.Non-profit Organization: A corporation or association determined by the Secretary of the Treasury to be an organization describe by 26 U.S.C. 501(c) that is exempt from taxation under 26 U.S.C. 501(a) or one that has been determined under State law to be non-profit and for which the designated State agency has received documentation certifying the status of the non-profit organization.Nonurbanized Areas: A rural area with a population density of less than 500 people per square mile or small urban area with a population of less than 50,000 people. Operating Assistance: Financial assistance for transit operation (not capital expenditures) which originates at the local level.Operating Expenses: Any costs incurred while running the project, such as salaries, fuel, maintenance, insurance, training, etc.Paratransit: Comparable transportation service required by the ADA for individuals with disabilities who are unable to use fixed route transportation systems. Passengers: The number of oneway passenger trips, a round trip taken by the same individual should be counted as two passengers. Private: Private means nonpublic, to wit: bodies which are not municipalities or other political subdivision of States; are not public agencies or instrumentalities of one or more States, municipalities or political subdivision of States; are not Indian tribes (except private nonprofits that were formed by Indian tribes); are not public corporations, boards, or commissions established under the laws of any state; or are not subject to control by public authority, State or municipal.Pass-Through Recipient: An entity participating in a JARC project that would receive JARC funds through from an eligible subrecipient, which would be responsible for ensuring that the pass-through recipients complied with all State and Federal requirements required under the JARC Program. Program of Projects: A list of projects to be funded in a grant application submitted to FTA by a designated recipient. The program of projects lists the subrecipients and indicates whether they are private non-profit agencies, public bodies, or private providers of transportation service, and designates the areas served (including rural counties). In addition, the program of projects includes a brief description of the projects, total project cost, and Federal share for each project, and the amount of funds used for program administration from the 10% allowed. Route: A fixed path traversed by a transit vehicle in accordance with a predetermined schedule. Run: One transit vehicle trip in one direction from the beginning of a route to the end of it. When a transit vehicle makes a round trip on one route, it has completed two runs.Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users (SAFETEA-LU): The federal authorization bill that was signed into law in August 2005.Section 5311 Program: A federal transportation program that provides operating and capital assistance to agencies that provide public transportation services in the small urban and rural areas of the State. The Division of Public Transit is the State administering agency.Section 5316 or JARC: The Job Access and Reverse Commute Program as described in SAFETEA-LU. A federal transportation program that provides approved recipients funding to support the development and maintenance of job access or reverse commute projects designed to transport welfare recipients and eligible low income individuals to and from jobs and activities related to their employment. The Division of Public Transit is the State administering agency.Section 5311Recipient: Those agencies that receive Section 5311 funds.Section 5316 Recipient: Those agencies that receive Section 5316 funds.Section 5317 New Freedom Program: A federal transportation program that provides approved recipients with funding to provide new public transportation services and public transportation alternatives beyond those required by the Americans with Disabilities Act of 1990 that assist individuals with disabilities with transportation including transportation to and from jobs and employment support services. The Division of Public Transit is the State administering agency.Section 5317 Recipient: Those agencies that receive Section 5317 funds. Service Area: Geographic area over which the project is operating and the area whose population is served by the project including adjacent areas affected by it.Small Urbanized Areas: An area with a population between 50,000 and 200,000.Spare: Reserve vehicle to be used only when regular van(s) cannot be operated, (i.e., breakdown, emergency, etc.).State Transportation Improvement Program (STIP): A statewide document that includes all projects to be implemented within a four year period in an urbanized area with a population over 50,000. Subscription Bus: A transit service operating on specified schedules on fixed routes (although such routes can be modified), but not available to the general public.Transportation Improvement Program (TIP): A local approved short range transportation plan that reflects the program of publicly funded transportation improvements for the Metropolitan Planning Organization region.Urbanized Area (UZA): An area defined by the U.S. Census Bureau with a population of 50,000 or greater and a population density of at least 1,000 people per square mile in a central city and 500 per square mile in the surrounding area.Urban Transit Authorities: Those transit authorities operating in the urbanized areas of Charleston, Huntington, Martinsburg, Morgantown, Parkersburg, Weirton, and Wheeling.Welfare Recipient: An individual who has received assistance under a State or tribal program funded under Part A of Title IV of the Social Security Act at any time during the three-year period before the date on which the applicant applies for a grant under JARC.APPENDIX-CCRITERIAEvaluation CriteriaApplicant InformationClearly meets eligible criteriaExisting FTA /DPT recipient Description of agency supports JARC or New Freedom objectivesPoorly( )Somewhat( )Significantly( )Fully( )Service Area and DemographicsClearly defined service areaLocal/regional poverty documentedUnemployment for the service area shownSpecial needs population documentedPoorly( )Somewhat( )Significantly( )Fully( )Current TransportationOperations and Capacity Demonstrated transportation providerAdequate fleet or vehicles availableTransportation services for special needsHas adequate staffing for program deliveryAddition resources/ other service providers IdentifiedVehicle maintenance planPoorly( )Somewhat( )Significantly( )Fully( )Project DescriptionProject addresses objectives of JARC or New FreedomProject utilizes resources and stakeholders Identified through the coordination processThe applicant was an active participant in the coordinated plan.The project clearly identifies why the applicant is best suited to operate or provide the proposed service.Poorly( )Somewhat( )Significantly( )Fully( )Budget and Fiscal ManagementThe applicant has obtained local or other sources of funds for the project (Match).The project demonstrates reasonableness and detail of budget line items.The applicant has adequate staff to perform fiscal duties associated with the projectPoorly( )Somewhat( )Significantly( )Fully( )TOTAL FOR EACH COLUMNOVERALL TOTAL: ____________/100APPENDIX-DREGIONAL PLANNING AND DEVELOPMENT COUNCILS AND METROPOLITAN PLANNING ORGANIZATIONS ADDRESSES WV REGIONAL PLANNING AND DEVELOPMENT COUNCILS(revised 1/25/2012)Region IWebsite: McDowell, Mercer, Monroe, Raleigh, Summers, and Wyoming CountiesRegion I Planning and Development Council1439 East Main StreetPhone: 304-431-7225Suite 5Fax: 304-431-7235Princeton, WV 24740Executive Director: David Coledavidcole@ Region IIWebsite: Cabell, Lincoln, Logan, Mason, Mingo and Wayne CountiesRegion II Planning and Development Council720 4th Avenue (zip: 25701)Phone: 304-529-3357P O Box 939Fax: 304-529-7229Huntington, WV 25712Executive Director: Michele Craigmcraig@ Senior Project Administrator: Kathy Elliottkkelliott@ Region IIIWebsite: Boone, Clay, Kanawha, and Putnam CountiesBCKP Regional Intergovernmental Council315 D StreetPhone: 304-744-4258South Charleston, WV 25303Fax: 304-744-2534Executive Director: Mark Feltonmarkfelton@ Region IVWebsite: about.html Fayette, Greenbrier, Nicholas, Pocahontas, and Webster CountiesRegion IV Planning and Development Council885 Broad StreetPhone: 304-872-4970Suite 100Fax: 304-872-1012Summersville, WV 26651Executive Director: W.D. Smith (ext. 307)wdsmith@ Region VWebsite: Calhoun, Jackson, Pleasants, Roane, Tyler, Wirt, and Wood CountiesMid-Ohio Valley Regional Council531 Market StreetPhone: 304-422-4993Parkersburg, WV 26101Fax: 304-422-4998Executive Director: James Mylottjim.mylott@ Region VIWebsite: Doddridge, Harrison, Marion, Monongalia, Preston, and Taylor CountiesRegion VI Planning and Development Council34 Mountain Park DrivePhone: 304-366-5693White Hall, WV 26554Fax: 304-367-0804Executive Director: James Halljhall@ Assistant Director: Lea Wolfeleawolf@ Region VIIWebsite: Barbour, Braxton, Gilmer, Lewis, Randolph, Tucker, and Upshur CountiesRegion VII Planning and Development Council99 Edmiston WayPhone: 304-472-6564Suite 225Fax: 304-472-6590Buckhannon, WV 26201Executive Director: Rosemary Wagnerrwagner@ Region VIIIWebsite: Grant, Hampshire, Hardy, Mineral, and Pendleton CountiesRegion VIII Planning and Development Council8 Grant County Industrial ParkPhone: 304-257-2448P O Box 849or 304-257-1221Petersburg, WV 26847Fax: 304-257-4958Executive Director: Terry Livelytlively@ Region IXWebsite: Berkeley, Jefferson, and Morgan CountiesEastern Panhandle Regional Planning and Development Council400 West Stephen StreetPhone: 304-263-1743Suite 301Fax: 304-263-7156Martinsburg, WV 25401 Executive Director: Carol Goolsbycgoolsby@ Region XWebsite: Serving Wheeling, Ohio and Marshall Co., WV; and Belmont Co., OHBel-O-Mar Regional Council and Interstate Planning Commission105 Bridge Street PlazaPhone: 304-242-1800P O Box 2086Fax: 304-242-2437Wheeling, WV 26003Executive Director: William C. Phipps belomar@Region XIWebsite: (reg. council tab)Brooke and Hancock CountiesBrooke & Hancock Regional Council124 North 4th StreetPhone: 304-797-9666 Second Flooror 740-282-3685Steubenville, OH 43952Fax: 740-282-1821Executive Director: John Brownjbrown@ WV METROPOLITAN PLANNING ORGANIZATIONS(revised 1/25/2012)Brooke Hancock Jefferson Metropolitan Planning Commission Serving Steubenville, OH and Weirton, WV – Brooke and Hancock Co., WV and Jefferson Co., OH124 North 4th StreetPhone: 304-797-9666 Second Flooror 740-282-3685Steubenville, OH 43952Fax: 740-282-1821Executive Director:Dr. John Brown, AICP (ext. 203)jbrown@ Transportation Study Director: Michael Paprocki (ext. 209) mikepap@ Bel-O-Mar Regional Council and Interstate Planning Commission Serving Wheeling, Ohio and Marshall Co., WV; and Belmont Co., OH105 Bridge Street PlazaPhone: 304-242-1800P O Box 2086Fax: 304-242-2437Wheeling, WV 26003Executive Director: William C. Phipps belomar@ KYOVA Interstate Planning Commissionwvs.state.wv.us/kyova/ Serving Huntington, WV; Ironton, Ohio (Cabell and Wayne Counties, WV; Lawrence County, Ohio)720 Fourth Avenue (zip: 25701)Phone: 304-523-7434P O Box 939Fax: 304-529-7229Huntington, WV 25712Executive Director: Michele Craigmcraig@ Transportation Engineer: Saleem Salamehssalameh@ Regional Intergovernmental Council Serving Charleston Metropolitan Area (Kanawha and Putnam Counties)315 D StreetPhone: 304-744-4258South Charleston, WV 25303Fax: 304-744-2534Executive Director: Mark Feltonmarkfelton@Wood-Washington-Wirt Interstate Planning Commission Serving Parkersburg, WV, Marietta and Belpre, Ohio (Wood County, WV and Washington County, Ohio)531 Market StreetPhone: 304-422-4993P O Box 247Fax: 304-422-4998Parkersburg, WV 26101Transportation Director: Randy Durst (ext. 125)randy.durst@Morgantown/Monongalia County Metropolitan Planning Organization Serving the greater Morgantown area and Monongalia County82 Hart Field Road, Suite 105Phone: 304-291-9571Morgantown, WV 26505Fax: 304-291-9573Executive Director: Bill Austin, AICPbaustin@ Hagerstown/Eastern Panhandle Metropolitan Planning Organization Serving the region of Berkeley and Jefferson Counties in WV, Franklin County in PA and Washington County, MD33 West Washington StreetPhone: 240-313-2080Hagerstown, MD 21740Fax: 240-313-2084Director: Robert S. Gordonrgordon@ APPENDIX-EATTACHMENTS ................
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