FY 2003
2014 Application
SECTION 5317
NEW FREEDOM
Capital Purchase
(Vehicles and Technology)
GRANT APPLICATION PACKET
Prepared by:
WV Department of Transportation
DIVISION OF PUBLIC TRANSIT
Building 5, Room 906
1900 Kanawha Boulevard, East
Charleston, WV 25305-0432
Phone: 304-558-0428
FAX: 304-558-0174
ATTENTION PLEASE!
Failure to submit this information on or before the application deadline April 1, 2013, 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.
IMPORTANT ANNOUNCEMENT
All drivers must be trained in
Passenger Service and Safety
(PASS)
or
Rider Sensitivity and Assistance Methods
(RSAM)
Driver training is required by the
Americans With Disabilities Act (ADA)
TABLE OF CONTENTS
Pages
I. General Information 6-20
II. Grant Application Packet 18
-Application Format 19
-Calendar for Section 5317 Application 20
-Application Checklist 21
-Letter of Intent 22-23
-Instructions for Application Title Page 24
-Title Page 25
-Instructions for Authorizing Resolution 26
-Authorizing Resolution 27-28
-Instructions for Verification Certification 29
-Verification Certification 30
-Instructions for Articles of Incorporation 31
-Instructions for Certifications 33
-Certifications 34-47
TABLE OF CONTENTS (continued)
Pages
III. Grant Application 48
-Questions 1- 34 49-61
IV. Appendices
(A) Appeals 62-63
(B) Glossary 64-69
(C) Criteria 70-71
D) Regional Planning and Development Councils and 72-77
Metropolitan Planning Organizations Addresses
(E) Attachments 78
SECTION I
GENERAL INFORMATION
GENERAL INFORMATION
The New Freedom formula grant program aims to provide additional tools to overcome existing barriers facing Americans with disabilities seeking integration into the work force and full participation in society. Lack of adequate transportation is a primary barrier to work for individuals with disabilities. The 2000 Census showed that only 60 percent of people between the ages of 16 and 64 with disabilities are employed. The New Freedom formula grant program seeks to reduce barriers to transportation services and expand the transportation mobility options available to people with disabilities beyond the requirements of the Americans with Disabilities Act (ADA) of 1990.
Funds are available for all areas, small urban, and rural; projects should address issues derived from a locally developed coordinated public transit-human services transportation plan.
For the purpose of the New Freedom Program, “new” service is any service or activity that was not operational before August 10, 2005 and did not have an identified funding source as of August 10, 2005, as evidenced by inclusion in the Transportation Improvement Plan (TIP) or the State Transportation Improvement Plan (STIP). New Public Transportation Services beyond the ADA.
GENERAL INFORMATION
for
Mobility Management
Mobility management projects may be funded to enhance transportation access for populations beyond those served by one agency or organization within a community. For example, a non-profit agency could receive funding to support the administrative cost of sharing services it provides to its own clientele with other individuals with disabilities and coordinate usage of vehicles with other non-profits, but not the operating cost of the service. Mobility management is intended to build coordination among existing public transportation providers and other transportation service providers with the result of expanding the availability of service.
ELIGIBLE APPLICANTS
PRIVATE - 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 unsure of your eligibility status and would like to request for approval to submit a Mobility Management Application, please contact the Division of Public Transit for guidance.
ELIGIBLE ACTIVITES
Mobility Management activities may include but not limited to:
▪ The promotion, enhancement and facilitation of access to transportation services, including the integration and coordination of services for the individuals with disabilities, older adults, and low-income individuals;
▪ Support for short term management activities to plan and implement coordinated services;
▪ Support of State and local coordination policy bodies and councils;
▪ The operation of transportation brokerages to coordinate providers, funding agencies and customers;
▪ The provision of coordinated services, including 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 trip planning activities for customers;
▪ The development and operation of one-stop transportation traveler call centers to coordinate transportation information on all travel modes and to manage eligibility requirements and arrangements for customers among supporting programs; and
▪ 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 (acquisitions of technology is also eligible as a standalone capital expense).
ELIGIBLE APPLICANTS
PRIVATE - 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.
OPERATORS 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 5317 Application, please contact the Division of Public Transit for guidance at (304) 558-0428.
ELIGIBLE ACTIVITES
New Freedom program funds must be used in projects designed to assist individuals with disabilities with accessing transportation services, including transportation to and from jobs and employment support services. For the purpose of the New Freedom Program, “new” service is any service or activity that was not operational before August 10, 2005 and did not have an identified funding source as of August 10, 2005, as evidenced by inclusion in the Transportation Improvement Plan (TIP) or the State Transportation Improvement Plan (STIP). All projects must be derived from a locally developed, coordinated public transit-human services transportation plan. Projects not included in a coordinated plan will not be eligible.
A. New Public Transportation “Services” Beyond the ADA. The following activities are examples of eligible projects meeting the definition of new public transportation:
▪ Enhancing public transportation services beyond minimum requirements of the ADA. Paratransit services can be eligible under New Freedom in several ways as long as the services provided meet the definition of “new.”
a) Acquisition of vehicles and equipment designed to accommodate mobility aids that exceed the dimensions and weight ratings established for common wheelchairs under the ADA and labor cost of aids to help drivers assist passengers with oversized wheelchairs. This would permit the acquisitions of larger lifts with a larger capacity, as well as modifications to lifts with a 600 lb design load, and the acquisition of heavier-duty vehicles for paratransit and/or demand-responsive service; and
▪ Making accessibility improvements to transit and intermodal stations not designated as key stations. Improvements for accessibility at existing transportation stations facilities that are not designed as key stations established under 40 CFR 37.47,37.51 or 37.53, and that are not required under 49 CFR 37.43 as part of an alteration or renovation to an existing station, so long as the projects are clearly intended to remove barriers that would otherwise have remained. New Freedom funds are eligible to be used for new accessibility enhancements that remove barriers to individuals with disabilities so they may access greater portions of public transportation systems, such as fixed-route bus service, commuter rail, light rail and rapid rail. This may include:
a) Building an accessible path to a bus stop that is currently inaccessible, including curb cuts, sidewalks, accessible pedestrian signals or other accessible features,
b) Adding an elevator or ramps, detectable warnings, or other accessibility improvements to a non-key station that are not otherwise required under the ADA,
c) Improving signage, or wayfinding technology, or
d) Implementation of other technology improvements that enhance accessibility for people with disabilities including Intelligent Transportation Systems (ITS)
B. New Public Transportation “Alternatives” Beyond the ADA. The following activities are examples and should not be considered an exhaustive list of projects that are eligible as new public transportation alternatives beyond the ADA under the New Freedom Program:
▪ Purchasing vehicles to support new accessible taxi, ride sharing, and/or vanpooling programs. New Freedom funds can be used to purchase and operate accessible vehicles for use in taxi, ridesharing and/or van pool programs provided that the vehicle 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 meeting the same requirements for lifts, ramps and securement systems specified in 49 CFR part 38, subpart B.
▪ See FTA Proposed Circular for the New Freedom Program Guidance and Application Instructions, August 30, 2006 for additional examples of “new” service.
TITLE AND OWNERSHIP OF VEHICLE
Title to and ownership of any vehicle, during its useful life, shall at all times remain with the Division. 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 SELECTION
Once 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 FTA.
DRUG AND ALCOHOL TESTING
Any 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 CDLs 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 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 558-2350.
Sections 5317 (New Freedom), 5316 (JARC), and 5310 are not subject to FTA drug and alcohol policies. Sections 5307 and 5311 recipients are subject to drug and alcohol testing.
CHARTER REGULATIONS
Section 5317 recipients may only provide charter services for “program purposes” which is defined in 49 C.F.R. part 604 as “transportation that serves the needs of either human service agencies or targeted populations (elderly individuals and /or individuals with disabilities). Your service only qualifies for the exemption contained in 49 C.F.R. 604.2(e) if the service is designed to serve the targeted populations (elderly individuals and individuals with disabilities).
PROCUREMENT
All vehicle and major capital purchases will be conducted by the Division of Public Transit. Upon successful grant, the DPT will issue procurement instructions for all other purchases.
RESTRICTIONS
No modifications are to be made on any equipment purchased with
Section 5317 funds without prior written approval from the Division of Public Transit.
Under no circumstances, is any equipment purchased with Section 5317
funds to be used as collateral in order to obtain a loan.
PROPERLY MAINTAINED VEHICLE
Approved 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 RECORDS
A Comprehensive Maintenance Record is to be maintained for each piece of equipment purchased with Section 5317 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 5317 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 PROCEDURES
Each 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/INCIDENT
Each 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 an 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.
INDEMNIFICATION
The 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 5317 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 5317 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 ACT
Approved 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.
CERTIFICATIONS
In this application packet your agency is signing various certifications. Agencies receiving assistance under the Section 5317 Program are required to abide by the signed certifications.
ON SITE MONITORING REVIEWS
Representatives 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 SUBMISSION
Applications 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 II
GRANT APPLICATION PACKET
APPLICATION FORMAT
This 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 5317 funding.
A checklist of items to be included in your application packet has been provided on Page 24.
As soon as possible, an applicant should copy or cc their Regional Planning and Development Council or Metropolitan Planning Organization with their 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.
Applications are due on or before 4:00 p.m., April 1, 2013 please submit one (1) original of your agency's application to the Division, at the following address:
Division of Public Transit
West Virginia Department of Transportation
Building 5, Room 906
1900 Kanawha Boulevard, East
Charleston, West Virginia 25305-0432
Phone: (304) 558-0428
APPLICATION CALENDAR FOR FY 2013 SECTION 5317 GRANT
This 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.
March 11, 2013 Notice of Funds Available /Applications available
April 1, 2013 Applications Due/Letter of Intent
April 1-5 Division reviews applications, appeals are resolved,
projects are selected for inclusion in the State
application to FTA.
April 15-19 Program of Projects /Application submitted to FTA
July 1, 2013 Contract year / projects begin
June 30, 2014 Contract year / projects end
APPLICATION 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 Funds
LETTER OF INTENT
A Letter of Intent will be required from all prospective Section 5317 applicants. These letters are due to the Division of Public Transit by April 1, 2013, 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 INTENT
TO BE TYPED ON YOUR AGENCY'S LETTERHEAD
Director
Division of Public Transit
Building 5, Room 906
1900 Kanawha Boulevard, East
Charleston, West Virginia 25305-0432
Dear Director:
The _____________________________________________ is hereby applying
(NAME OF AGENCY)
for Federal funding under the Section 5317 Program to …
(Describe Proposed Project)
It is my understanding that failure to submit the application on or before April 1, 2013, will mean that my organization may not be funded under the FY 2011 Section 5317 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 Organization
TITLE PAGE
Complete 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 PAGE
The_________________________________________________________
(Name of Your Agency)
located at____________________________________________________
(Street Address)
_______________________________________________________
(City) (State) (Zip)
is hereby applying for funding under the Section 5317 New Freedom Grant Program.
(((((((((((
Person(s) Completing Application:
____________________________________________________________
(Name) (Title) (Phone)
____________________________________________________________ (Name) (Title) (Phone)
AUTHORIZING RESOLUTION
On 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 blue ink.
AUTHORIZING RESOLUTION
C E R T I F I C A T E
I, _____________________________________, do hereby certify that I am the duly qualified and
Name of Certifying Officer
acting ____________________________ of the _____________________________________________
Title of Certifying Officer Name of Applicant
and as such, I am keeper of the seal, records and files of the __________________________________.
Name of Applicant
I 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 Vote
accordance and conformity with the _____________________________or________________________
By-Laws of the Applicant Statutes of the
______________________ (check one of the blanks) as made and provided, and that the following
State 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 Applicant
1. That an application be made to the West Virginia Department of Transportation, Division of
Public Transit, for a Federal grant under the Section 5317 Program to acquire funds to provide
__________________________________________________________________________________:
Brief Description of Project
2. That ________________________________ of the ________________________________________
Name of Authorized Individual Name of Applicant
is 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 Applicant
I 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
__________________________________________
Signature
SEAL
__________________________________________
Title
VERIFICATION CERTIFICATION
Sign the following verification using blue ink.
VERIFICATION CERTIFICATION
ASSURANCE OF AUTHORITY OF THE APPLICANT
AND ITS REPRESENTATIVE
For (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:
1) Execute and file the application for Federal assistance on behalf of the Applicant;
2) Execute and file the required certifications, assurances, and agreements on behalf of the Applicant binding the Applicant; and
3) Execute grant agreements and cooperative agreements with FTA on behalf of the Applicant.
Signature: ______________________________________________________
Date: ______________________________________________________
Name: ______________________________________________________
ARTICLES OF INCORPORATION
(Only applicable to Non-Profits)
Submit a copy (must be on 8½ 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 of March 14, 2011 will prevent your application from being considered for funding.
CERTIFICATIONS
Read and sign the following certifications using blue ink. Failure to sign these certifications will mean that your agency will not be considered for funding.
CERTIFICATIONS AND ASSURANCES REQUIRED FOR THE
SECTION 5317 – NEW FREEDOM PROGRAM
We 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 5317 financial assistance, the following assurances:
A. As required by 49 U.S.C. 5317(e)(1), which makes the requirements of 49 U.S.C. 5310 applicable to New Freedom grants to the extent the Federal Transit Administrator or his or her designee determines appropriate, by 49 U.S.C. 5310(d)(1), which makes the requirements of 49 U.S.C. 5307 applicable to Elderly Individuals and Individuals with Disabilities Formula Grants to the extent the Federal Transit Administrator or his or her designee determines appropriate, and by 49 U.S.C. 5307(d)(1), the Applicant for New Freedom Program assistance authorized under 49 U.S.C. 5317 certifies and ensures on behalf of itself and its subrecipients, if any, as follows:
1) 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;
2) 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;
3) In compliance with 49 U.S.C. 5307(d)(1)(C), the Applicant will adequately maintain the project equipment and facilities;
4) 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. 5317: (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;
5) 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. 5317(g), and if applicable by section 3012b(3) and (4) for the local share, and that those funds will be provided from approved non-Federal sources except as permitted by Federal law;
6) 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);
B. 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 and an area wide 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. 5317(f)(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;
C. In compliance with 49 U.S.C. 5317(f)(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;
D. 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; and
In compliance with 49 U.S.C. 5317(f)(3), the Applicant certifies that: (1) 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.
Signature:_________________________________________________
Date:_____________________________________________________
Title of
Authorized Official: __________________________________________________
GENERAL CERTIFICATIONS AND ASSURANCES
1. CERTIFICATION OF PROVISION OF NECESSARY LOCAL MATCHING FUNDS
I, ________________________________________,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 CERTIFICATION
The 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 USE
The ________________________________________________________ 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 semi-ambulatory 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 CERTIFICATION
I, ________________________________________________________ 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 CERTIFICATION
I, _______________________________________________________ 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 REGULATIONS
Name 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. INSPECTION
Name 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. COORDINATION
Name 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 COMPANIES
Name 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; and
B. 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 ACTS
Name 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 SERVICE
The ________________________________________________________
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
______________________________
Date
Assurance Concerning Nondiscrimination on the
Basis of Disability in Federally-Assisted Programs
and Activities Receiving or Benefiting from
Federal Financial Assistance
Implementing the Rehabilitation Act of 1973, as amended, and
the Americans With Disabilities Act of 1990
(Federal Transit Administration)
__________________________________________, (the "Recipient") AGREES THAT,
Name of Applicant
as 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 Applicant
BY: ______________________________________
Signature of Authorized Official
DRUG-FREE WORKPLACE ACT CERTIFICATION
FOR A PUBLIC OR PRIVATE ENTITY
1. 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 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
____________________________________________
Date
Federal Transit Administration
(FTA)
CIVIL RIGHTS ASSURANCE
The __________________________________________ HEREBY CERTIFIES THAT,
Name of Agency
as 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 subjected
to discrimination in the level and quality of transportation services and transit-related benefits.
2. The ______________________________________ will compile, maintain, and
Name of Agency
submit 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 Agency
public 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 OFFICIAL
TITLE VI REPORT
List 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 Transportation
Operations Agreement
Name 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
_______________________________________________________
Date
LOBBYING CERTIFICATION
Name 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
________________________________________________
Date
CERTIFICATION REGARDING DEBARMENT, SUSPENSION,
AND OTHER RESPONSIBILITY MATTERS
Name of Agency: _______________________________________________________
As required by U.S. DOT regulations on Governmentwide Debarment and Suspension (Nonprocurement) at 49 CFR 29.510:
1) The Applicant 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 voluntarily excluded from covered transactions 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) 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;
c) 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,
d) 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.
2) 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.
3) 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
________________________________________________
Date
SECTION III
GRANT APPLICATION
Complete the following application using the forms provided
5317 New Freedom/ Mobility Management
(Double click on the box and mark for the appropriate selection MS Word)
New Freedom Mobility Management/ Manager
Application Part 1: Applicant information
1) 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)
Private Non-Profit
Transit Authority
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)
Section 5311
Section 5310
Section 5309
Section 5307
Existing JARC recipient
Other FTA or federal programs
Please indicate:
Application Part 1: Applicant information
4) 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 Demographics
Please 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 Native
Black Hispanic Other
11) What is the percentage of the disabled population in your service area?
Application Part 3: Existing / Current Transportation Service
12) Describe the current transportation service(s) that your organization
provides:
13) List current inventory of vehicles in the table below (Please list each vehicle separately.)
|Type |Vehicle |Model |Current |Seating Capacity |Special Equipment |
| |Identification |Year |Mileage | |(Lift or Ramp) |
| |Number | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
Application Part 4: Project Description
25) Project Specific Programming (Please check the box or boxes for the program/s that you are seeking to fund)
New Freedom
Capital (80%20%)
Operating (50%/50%)
Mobility Management (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?
Yes
No
30) Describe 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 application
32) Factors- Resource Identification: Mark the appropriate box or boxes and fully describe the attributes that contribute to your program. Use additional space to detail your response.
New Freedom
Innovative Approaches- identify any innovative techniques and approaches that contribute to the proposed project.
Use of Employer-based Strategies-Describe any commitment by employer that will contribute to the success of the project.
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.
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 (New Freedom)
33) In this section you will be asked to provide the budget information associated with your project.
New Freedom Capital and or Mobility Management
Total Cost 20% Match* Federal Capital Cost@80%
$ $ $
*Indicate Source of Match___________________________________________________
Status of Match (Secured or unsecured) _______________________________________
New Freedom Operating
Total Cost 50% 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 you will be asked to provide the budget information associated with your project for one year.
“PROPOSED”
| | | | | | | | |
|NEW FREEDOM OPERATING BUDGET -1 Year |
| | | | | | | | |
| | | | |
|(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 Planning
|Capital funding is available through the Section 5317 program at an 80 percent Federal/20 percent local matching ratio. Projects eligible for|
|capital funding include: |
|Transit vehicles |
|Communications equipment |
|Bus stop shelters, with or without benches |
|Other capital needs |
|So 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-van |
|Low-floor mini-van |
|Converted van (Braun) |
|18-passenger cutaway |
|Champion-like vehicle |
|Pacer-like vehicle |
|ECII-like vehicle |
|GCII-like vehicle |
|Shop/support vehicle |
|Note 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 Year |Capital Items |
|FY2014 | |
|FY2014 | |
|FY2014 | |
|FY2014 | |
|FY2014 | |
|Please explain why this equipment is | |
|essential for the operation of your | |
|transit services? | |
APPENDIX-A
APPEALS
WVDPT Appeal Process
If 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:
Director
WV/DOT Division of Public Transit
Building 5, Room 906
1900 Kanawha Boulevard East
Charleston WV 25305-0432
A 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 Public Transit Director’s Office will review the appeal and provide a written response within ten (10) working days of receipt of the appeal.
APPENDIX -B
GLOSSARY OF TERMS
GLOSSARY OF TERMS
The 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 year.
Competitive 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: Dial-A-Ride is a term that has been applied to a variety of shared-ride 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 shared-ride taxi service in that they provide door-to-door service. However, most Dial-A-Ride 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 impairment; or is regarded as having such 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 Administration
Grantee: 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 5317.
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 one-way passenger trips, a round trip taken by the same individual should be counted as two passengers.
Private: Private means non-public, 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 non-profits 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-C
CRITERIA
|Applicant Information |Poorly |Somewhat |Significantly |Fully |
| |( ) |( ) |( ) |( ) |
|Clearly meets eligible criteria | | | | |
|Existing FTA /DPT recipient | | | | |
|Description of agency supports JARC or | | | | |
|New Freedom objectives | | | | |
|Service Area and Demographics |Poorly |Somewhat |Significantly |Fully |
| |( ) |( ) |( ) |( ) |
|Clearly defined service area | | | | |
|Local/regional poverty documented | | | | |
|Unemployment for the service area shown | | | | |
|Special needs population documented | | | | |
|Current Transportation |Poorly |Somewhat |Significantly |Fully |
|Operations and Capacity |( ) |( ) |( ) |( ) |
| | | | | |
|Demonstrated transportation provider | | | | |
|Adequate fleet or vehicles available | | | | |
|Transportation services for special needs | | | | |
|Has adequate staffing for program delivery | | | | |
|Addition resources/ other service providers | | | | |
|Identified | | | | |
|Vehicle maintenance plan | | | | |
|Project Description |Poorly |Somewhat |Significantly |Fully |
| |( ) |( ) |( ) |( ) |
|Project addresses objectives of JARC or New Freedom | | | | |
|Project utilizes resources and stakeholders | | | | |
|Identified through the coordination process | | | | |
|The 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. | | | | |
|Budget and Fiscal Management |Poorly |Somewhat |Significantly |Fully |
| |( ) |( ) |( ) |( ) |
|The 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 project | | | | |
| | | | | |
| | | | | |
|TOTAL FOR EACH COLUMN | | | | |
APPENDIX-D
REGIONAL PLANNING AND DEVELOPMENT COUNCILS AND
METROPOLITAN PLANNING ORGANIZATIONS ADDRESSES
`
WV REGIONAL PLANNING AND DEVELOPMENT COUNCILS
(revised 1/25/2012)
Region I Website:
McDowell, Mercer, Monroe, Raleigh, Summers, and Wyoming Counties
Region I Planning and Development Council
1439 East Main Street Phone: 304-431-7225
Suite 5 Fax: 304-431-7235
Princeton, WV 24740
Executive Director: David Cole davidcole@
Region II Website:
Cabell, Lincoln, Logan, Mason, Mingo and Wayne Counties
Region II Planning and Development Council
400 Third Street Phone: 304-529-3357
P O Box 939 Fax: 304-529-7229
Huntington, WV 25701
Executive Director: Michele Craig mcraig@
Senior Project Administrator: Kathy Elliott kkelliott@
Region III Website:
Boone, Clay, Kanawha, and Putnam Counties
BCKP Regional Intergovernmental Council
315 D Street Phone: 304-744-4258
South Charleston, WV 25303 Fax: 304-744-2534
Executive Director: Mark Felton markfelton@
Region IV Website: about.html
Fayette, Greenbrier, Nicholas, Pocahontas, and Webster Counties
Region IV Planning and Development Council
885 Broad Street Phone: 304-872-4970
Suite 100 Fax: 304-872-1012
Summersville, WV 26651
Executive Director: W.D. Smith (ext. 307) wdsmith@
Region V Website:
Calhoun, Jackson, Pleasants, Roane, Tyler, Wirt, and Wood Counties
Mid-Ohio Valley Regional Council
531 Market Street Phone: 304-422-4993
Parkersburg, WV 26101 Fax: 304-422-4998
Executive Director: James Mylott jim.mylott@
Region VI Website:
Doddridge, Harrison, Marion, Monongalia, Preston, and Taylor Counties
Region VI Planning and Development Council
34 Mountain Park Drive Phone: 304-366-5693
White Hall, WV 26554 Fax: 304-367-0804
Executive Director: James Hall jhall@
Assistant Director: Lea Wolfe leawolf@
Region VII Website:
Barbour, Braxton, Gilmer, Lewis, Randolph, Tucker, and Upshur Counties
Region VII Planning and Development Council
99 Edmiston Way Phone: 304-472-6564
Suite 225 Fax: 304-472-6590
Buckhannon, WV 26201
Executive Director: Rosemary Wagner rwagner@
Region VIII Website:
Grant, Hampshire, Hardy, Mineral, and Pendleton Counties
Region VIII Planning and Development Council
8 Grant County Industrial Park Phone: 304-257-2448
P O Box 849 or 304-257-1221
Petersburg, WV 26847 Fax: 304-257-4958
Executive Director: Terry Lively tlively@
Region IX Website:
Berkeley, Jefferson, and Morgan Counties
Eastern Panhandle Regional Planning and Development Council
400 West Stephen Street Phone: 304-263-1743
Suite 301 Fax: 304-263-7156
Martinsburg, WV 25401
Executive Director: Carol Goolsby cgoolsby@
Region X Website:
Serving Wheeling, Ohio and Marshall Co., WV; and Belmont Co., OH
Bel-O-Mar Regional Council and Interstate Planning Commission
105 Bridge Street Plaza Phone: 304-242-1800
P O Box 2086 Fax: 304-242-2437
Wheeling, WV 26003
Executive Director: William C. Phipps belomar@
Region XI Website: (reg. council tab)
Brooke and Hancock Counties
Brooke & Hancock Regional Council
124 North 4th Street Phone: 304-797-9666
Second Floor or 740-282-3685
Steubenville, OH 43952 Fax: 740-282-1821
Executive Director: John Brown jbrown@
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., OH
124 North 4th Street Phone: 304-797-9666
Second Floor or 740-282-3685
Steubenville, OH 43952 Fax: 740-282-1821
Executive 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., OH
105 Bridge Street Plaza Phone: 304-242-1800
P O Box 2086 Fax: 304-242-2437
Wheeling, WV 26003
Executive Director: William C. Phipps belomar@
KYOVA Interstate Planning Commission
wvs.state.wv.us/kyova/
Serving Huntington, WV; Ironton, Ohio (Cabell and Wayne Counties, WV; Lawrence County, Ohio)
400 Third Street (zip: 25701) Phone: 304-523-7434
P O Box 939 Fax: 304-529-7229
Huntington, WV 25712
Executive Director: Michele Craig mcraig@
Transportation Engineer: Saleem Salameh ssalameh@
Regional Intergovernmental Council
Serving Charleston Metropolitan Area (Kanawha and Putnam Counties)
315 D Street Phone: 304-744-4258
South Charleston, WV 25303 Fax: 304-744-2534
Executive Director: Mark Felton markfelton@
Wood-Washington-Wirt Interstate Planning Commission
Serving Parkersburg, WV, Marietta and Belpre, Ohio (Wood County, WV and Washington County, Ohio)
531 Market Street Phone: 304-422-4993
P O Box 247 Fax: 304-422-4998
Parkersburg, WV 26101
Transportation Director: Randy Durst (ext. 125) randy.durst@
Morgantown/Monongalia County Metropolitan Planning Organization
Serving the greater Morgantown area and Monongalia County
82 Hart Field Road, Suite 105 Phone: 304-291-9571
Morgantown, WV 26505 Fax: 304-291-9573
Executive Director: Bill Austin, AICP baustin@
Hagerstown/Eastern Panhandle Metropolitan Planning Organization
Serving the region of Berkeley and Jefferson Counties in WV, Franklin County in PA and Washington County, MD
33 West Washington Street Phone: 240-313-2080
Hagerstown, MD 21740 Fax: 240-313-2084
Director: Robert S. Gordon rgordon@
APPENDIX-E
ATTACHMENTS
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OVERALL TOTAL: _____________/100
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