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Home My WebLink AboutC09-144 FTA/CDOT Grant App ECOTransit April 2009 FTA Grant Application Instructions ~i CERTIFICATES AND ASSURANCES FOR FTA/CDOT FY 2010-201 1 GRANT APPLICATIONS The certificates and assurances on the following pages in this section are required by the Depart- ment as part of a complete submission of your application for funding, As an applicant, you are ultimately responsible for your own compliance with federal laws, regu- lations, and directives if you are awarded federal funds; and if awarded FTA funds, you are also responsible for compliance with any third-party subcontractors participating in your project. / For reference only, the most current FTA Cer- tificationsand Assurances (FY2009) are avail- ablefor download on the Internet at http://www.fta.dot. Oy/flllld111 apply/grants_fi nancin8$30.htm1 or on paper upon request to the Department. / The Department has divided the assurance section into two parts: Mandatory Assurances and Program Specific Assurances. / Mandatory Assurances include those provided in the checklist below. Applicants will complete these certifications and have the legally author- izedrepresentative of their agency verify this certification. / Program Specific Assurances are managed by a checklist. Applicable assurances (Federal Fis- cal Year 2009) for this application process are designated by the Department. Applicants are to certify they will comply with the applicable assurances if awarded funding and have a 1e- gallyauthorized representative of their agency verify this certification. Please note: If you are awarded funding, the con- tractyour agency will sign will include clauses that will further legally bind your agency to the following certifications and assurances. NOTE: A link to IRS form VV-9 is on the Tran- sitUnit website. Mandatory Assurances Checklist The following certifications and assurances must be signed by the legally authorized representative of the applicant. DONE? MANDATORY ASSURANCES X Standard Federal Assurances X Nondiscrimination Assurance in accordance with the Civil Rights Act X Civil Rights Lawsuits and Complaints X Debarment, Suspension, and Other Exclusions X General Applicant Assurances x Listing of Eligible Surface Transportation Providers (Section 5311 (to include Intercity Bus) Applicants Only) Certification of Equivalent Service (Applications for non-accessible vehicles only) Colorado Department of Transportation Page 93 FTA Grant Application Instructions April 2009 STANDARD ASSURANCES NAME OF APPLICANT Eagle County Regional Transportation Authority hereby assures that it will comply with all applicable Federal statutes and regulations carrying out any. project supported by an FTA grant or cooperative agreement. The Applicant agrees that it is under a continuing obligation to comply with the terms and condi- tions ofthe grant agreement or cooperative agreement issued for its proj ect with FTA. The Applicant recognizes that federal laws, regulations, policies, and administrative practices may be modified from time to time and those modifications may affect project implementation. The Applicant understands that presidential executive orders and federal directives, including Federal policies and program guidance, may be issued concerning matters affecting the Appli- cant or its project. The Applicant agrees that the most recent federal requirements will apply to the project, unless FTA issues a written determination otherwise. AGENGY NAME Eagle County Regional Transportation Authority PRINTED NAME (Chief Elected Official/ Board President/Legal Representative) Jeff Shroll TITLE Chair, Board of Directors, Eagle County Regional Transportation Authority SIGNATURE DATE May 1, 2009 ~/~ Page 94 Colorado Department of Transportation April 2009 FTA Grant Application Instructions NONDISCRIMINATION ASSURANCE-CIVIL RIGHTS As required by 49 U.S.C. 5332 prohibiting discrimination on the basis of race, color, creed, na- tional origin, sex, or age, and prohibiting discrimination in employment or business opportunity, otherwise known as Title VI of the Civil Rights Act of 1964, as amended, 42 U.S.C. 20004, and U.S. DOT regulations, "Nondiscrimination inFederally-Assisted Programs of the Department of Transportation--Effectuation of Title VI of the Civil Rights Act," 49 CFR part 21 at 21.7. NAME OF APPLICANT Eagle County Regional Transportation Authority assures that it will comply with all requirements imposed by or issued pursuant to the Civil Rights Act, so that no person in the United States, on the basis of race, color, national origin, creed, sex, or age will be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination in any program or activity (particularly in the level and quality of transportation services and transportation-related benefits} for which the Applicant receives Fed- eral assistance awarded by the FTA. The applicant will compile, maintain, and submit in a timely manner Title VI information re- quired by FTA and in compliance with the Department of Transportation's .Title VI regulation, 49 CFR Part 21. The person or persons whose signature appears below are authorized to sign this assurance on behalf of the grant applicant or recipient. AGENGY NAME Eagle County Regional Transportation Authority PRINTED NAME (Chief Elected Official/ Board President/Legal Representative) Jeff Shroll TITLE Chair, Board of Directors, Eagle County Regional Transportation Authority SIGNATURE DATE May 1, 2009 ~: ~, ~., Colorado Department of Transportation Page 95 FTA Grant Application Instructions April 2009 CIVIL RIGHTS LAWSUITS AND COMPLAINTS This form pertains to compliance with Title VI (Civil Rights) regulations governing the provision of public transportation services. Basic Requirement: No person shall, on the grounds of race, color, creed, national origin, sex, age, or disability, be excluded from participating in, denied the benefits of, or be subj ect to discrimination under any proj ect, program, or activity funded in whole or in part through financial assistance under the Federal Transit Act, as amended. APPLICANT NAME Eagle County Regional Transportation Authority ADDRESS 3289 Cooley Mesa Road, Box 1070; Gypsum, CO 81637-1070 PHONE FAX 970-328-3520 970-328-3539 EMAIL PERIOD COVERED FEDERAL david.johnson@eaglecounty.us FISCAL YEAR 2009 Lawsuits and Complaints (Check all that apply) (Note: Complaints are formal, legal, written documents alleging discrimination filed with you or an appro- priate agency which has notified you of the complaint. Also, only civil rights lawsuits or complaints are reported with this form.} ® There have been no lawsuits filed against us for transit service during the period covered. ® There have been no complaints filed against us for transit service during the period covered ^ There have been the following lawsuits or complaints filed against us during this period for transit service. The following information is attached (group lawsuits and complaint sepa- rately, by date of initiation): • date of the lawsuit or complaint • complainant's name and address • allegation summary • current status or disposition including the terms of any consent decree or agreement I, the undersigned, certify that the above and attached statements are truthful and complete to the best of my knowledge and that we comply with all rules and regulations related to the civil rights laws of the United States. AGENGY NAME Ea le Count Re Tonal Trans ortation Authorit PRINTED NAME (Chief Elected Official/ Board President/Legal Representative) Jeff Shroll TITLE Chair, Board of Directors, Ea le Count Re Tonal Trans ortation Authorit SIGNATURE ~, ,~~ ~' f DATE May 1, 2009 Page 96 Colorado Department of Transportation April 2009 FTA Grant Application Instructions CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS -PRIMARY COVERED TRANSACTIONS Complete if receiving singularly or combined more than $25,000 in FTA Section 5310, 5311, 5311(f), 5316, and 5317 funds. The potential grantee under this FTA project: NAME OFAGENCY Eagle County Regional Transportation Authority certifies to the best of its knowledge and belief, that it and its principals: (a) are not presently debarred, suspended, proposed for debarment, declared ineligible, or volun- tarilyexcluded by any federal department or agency; (b) have not within athree-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transac- tion or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery falsification or destruction of records, making f alse statements, or receiving stolen. property; (c) are not presently indicted for or other wise criminally or civilly charged by a governmental entity (federal, state, or local) with commission of any of the offenses enumerated in para- graph (b) of this certification; and have not within a three year period preceding this applica- tion/proposal had one or more public transactions (federal, state or local) terminated for cause or default; (d) have not within athree-year period preceding this applicationlproposal had one or more pub- tic transactions (federal, state, or local) terminated for cause or default. (If the applicant is unable to certify to any of the statements in this certification, such applicant shall attach an explanation to this certification). The potential grantee under this FTA project: NAME OF AGENCY Eagle County Regional Transportation Authority Certifies or affirms the truthfulness and accuracy of the contents of the statements submitted on or with the certification and understand that the provisions of Title 49 CFR Part 29 and FTA C .2015.1 are applicable thereto. EXECUTED THIS DAY MONTH YEAR 1 Ma 2009 TITLE OF AUTHORIZED REPRESENTATIVE Ea le Count Attorne SIGNATURE OFAUTHORIZED REPRESENTATIVE ~...,_ Colorado Department of Transportation Page 97 FTA Grant Application Instructions April 2009 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY, AND VOLUNTARY EXCLUSION -LOWER TIER COVERED TRANSACTIONS Complete if receiving singularly or combined more than $25,000 in FTA Section 5310, 5311, 5311(f), 5316, and 5317 funds. The potential grantee under this FTA project: NAME OF AGENCY Eagle County Regional Transportation Authority certifies to the best of its knowledge and belief, that it and its prospective lower tier participants certify: (1) are not presently debarred, suspended, proposed for debarment, declared ineligible, or volun- tarilyexcluded from participation in this transaction by any federal department or agency; (2) if .the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this certification. The potential grantee under this FTA project: NAME OF AGENCY Eagle County Regional Transportation Authority Certifies or affirms the truthfulness and accuracy of the contents of the statements submitted on or with the certification and understand that the provisions of Title 49 CFR Part 29 and FTA C .2015.1 are applicable thereto. EXECUTED THIS DAY MONTH YEAR 1 Ma 2009 TITLE OF AUTHORIZED REPRESENTATIVE Ea le Count Attorne SIGNATURE OF A~ RIZED REP ENTATIVE / `_"' Page 98 Colorado Department of Transportation April 2009 FTA Grant Application Instructions FTA SECTIONS 5310, 5311, 5316, 5317 APPLICATION FOR CDOT/FTA GRANT ASSISTANCE I hereby certify that as a person authorized to sign for: AGENCY NAME Eagle County Regional Transportation Authority l . The agency is a private non-profit organization incorporated in the State of Colorado, or a public op- erator ofpublic transportation body which has undertaken the requisite certification process to be des- ignated as an eligible recipient of FTA funding. 2. The Applicant has the requisite fiscal, managerial, and legal capacity to carry out the project(s) de- scribedherein and to receive and disburse federal funds. 3. Some combination of federal, state, local and private funding sources has or will be committed by the applicant in a timely fashion to provide the required local share for the project(s) described herein. 4. The Applicant has, or will have by the time of delivery, sufficient funds to operate the vehicles and/or equipment purchased under this project, if applicable. 5. The transportation needs of elderly persons and persons with disabilities have or will be addressed by the Applicant. 6. The Applicant will implement policies and procedures to ensure compliance with the provisions of the Americans with Disabilities Act of 1990. 7. The Applicant will provide a fair and timely opportunity to private sector operators to participate in the project. 8. I have reviewed the FTA Sections 531 D, 5311, 5316, 5317 Application for CDOT/FTA Grant Assis- tance and that all the information .contained herein is true and correct to the best of my knowledge. PRINTED OR TYPED NAME OF AUTHORIZED REPRESENTATIVE Jeff Shroll TITLE OF AUTHORIZED REPRESENTATIVE Chair, Board of Directors, Eagle County Regional Transportation Authority SIGNATURE OF AUTHORIZED REPRESENTATIVE /J~~~`"Vlf/ l J~ DATE ~, May 1, 2009 For additional specific information regarding the 2010/2011 FTA Sections 5310, 5311, 5316, 5317 Appl ication for CDOT/FTA Grant Assistance please contact: NAME David Johnson TITLE PHONE Transit Planner 970-328-3524 EMAIL ADDRESS david. j ohnson@eaglecounty.us Colorado Department of Transportation Page 99 FTA Grant Application Instructions April 2009 49 USC & 5333(b) ASSURANCE SECTION 5311 (to include Intercity Bus) APPLICANTS ONLY LISTING OF ELIGIBLE SURFACE TRANSPORTATION PROVIDERS AND LABOR REPRESENTATION 1. APPLICANT NAME AND BRIEF DESCRIPTION OF PROJECT AND SERVICE AREA. Eagle County Regional Transportation Authority Vehicle Replacement Eagle and Lake Counties of Colorado 2.OTHER SECTION 5311 RECIPIENTS WITHIN THE SERVICE AREA (WILL USUALLY BE BLANK). 3.OTHER SURFACE PUBLIC TRANSPORTATION PROVIDERS WITHIN SERVICE AREA. Town of Avon Transit, Town of Vail Transit 4. UNION REPRESENTATION OF EMPLOYEES IDENTIFIED IN 2 AND 3 IF ANY (LIST UNION AND PROVIDER). WE, THE UNDERSIGNED REPRESENTING AND SUB-RECIPIENT (IF APPLICABLE) hereinafter referred to as the Applicant and Sub-recipient, respectively, have reviewed the "Spe- cial Section 13(c) Warranty for Application to the Small Urban and Rural Program" and certify to the Colorado Department of Transportation that we will comply with its provisions and that all its provisions will be incorporated into any contract between the Applicant and Sub-recipient which will expend funds received as a result of an application to the Colorado Department of Transportation under the Section 5311Grant Program. SIGNATURE OF APPLI NT ,6J DATE May 1, 2009 TITLE OF APPLICAN Chair, Board of Directors, Eagle County Regional Transportation Authority SIGNATURE OF SUBRECIPIENT DATE TITLE OF SUBRECIPIENT Page 100 Colorado Department of Transportation April 2009 FTA Grant Application Instructions CERTIFICATION OF EQUIVALENT SERVICE Only required for all agencies applying for non-accessible vehicles ~ APPLIES ONLY TO DEMAND-RESPONSIVE SYSTEMS If the applicant is applying for one or more vehicles that are not accessible to persons with dis- abilities, the agency must submit a Certification of Equivalent Service. Below are uidelines to assist an applicant in determining if its system is eligible to provide g equivalent service. Response Time: An a enc shall establish a policy which provides the same response time to all requests for g Y service. Response time is defined as the amount of time between the request for service and the delivery of service. An a enc shall have sufficient e ui ment to ensure .compliance with this policy. Subcontracted g Y q p accessible service is not acceptable unless equivalent response time can be demonstrated. Fares: There shall be no premium fare charged for persons with disabilities including those persons requiring a lift for vehicle access. Geograph is Area: All ersons shall be eli ible for trans ortation within the established geographic service area of p g p the agency. Hours and Days of Service: All passengers shall be afforded service during the established hours and days of service. Restriction on Trip Purpose: No person shall be denied, service for trip purposes which are provided to other passengers. Constraints on Capacity or Service Availability: Vehicle wheelchair carrying capacity shall not be constrained by a failure to provide an adequate number of wheelchair positions where demand is evident. Lifts, ramps, and other transfer and securement devices must accommodate all types of mobility devices in common use (specifically including electric wheelchairs and three-wheel scooters). Availability of .Information and Reservation Capability: The applicant shall have available a telecommunications device for the deaf (TDD) or compara- ble two-way communications system. Any proposed comparable system must be described with the f ling of the certification. Colorado Department of Transportation Page 101 ! ° ' ~ FTA Grant Application Instructions April 2009 PROGRAM SPECIFIC ASSURANCES The applicant's legally authorized representative must sign the signature block below identifying compli- ance with the applicable certifications and assurances: The assurances are delineated by program or type of assistance sought. This signed certification (along with the mandatory assurances) must be either sent or hand delivered to the Transit. Unit in order to complete the 2010/2011 application for funding. FTA ASSURANCE APPLICABLE TO PROGRAM OR ASSISTANCE? Title of FTA Required Assurance 5310 5311 5316 5317 CAPIESTS REQU Lobbying Certification If> $100,000 If> $100,000 If> $100,000 ~ If> $100,000 If> $100,000 Procurement Compliance (Capital Requests only) / / / / / Public Hearing (Capital Requests only) / / / / / Acquisition of Rolling Stock (Pre-Award and Post Delivery Reviews-Capital Requests only) / / / / / Bus Testing (Capital Requests only) / / / / / Charter Service Agreement / School Transportation Agreement / Demand Responsive Service (Demand Response Services Only) ~/ / / / Alcohol Misuse and Prohibited Drug Use / Elderly Individuals & Individuals with Disabili- ties Formula Program / Nonurbanized Area Formula Program / Job Access and Reverse Commute Formula Grant Program / New Freedom Program / We Certify and Assure that AGENCY NAME Eagle County Regional Transportation Authority will comply with the applicable portions listed above. AGENGY NAME Ea le County Regional Trans ortation Authority PRINTED NAME (Chief Elected OfficiaU Board President/Legal Representative) Jeff Shrol! TITLE Chair, ECO Transit Board of Directors SIGNATURE ~ F~~ ,~ ;,, DATE May 1, 2009 ~; ~` ~, Page 102 Colorado Department of Transportation