HomeMy WebLinkAboutS Grant North Carolina Community Transportation Program (CTP) Administrative Grant Application for FY 2004/2005t -(-8(03
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STATE OF 1~TORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY
GOVERNOR
December 8, 2003
MEMORANDUM
TO: Community Transportation Systems
FROM: Gayle Worley
Transportation Program Consultant
Community Transportation Section
SUBJECT: FY 2004 - 2005 State NCDOT Certifications and Assurances
LYNDO TIPPETT
SECRETARY
The revised list of Annual Certifications and Assurances for systems that will apply for
FY 2004 - 2005 State NCDOT funding is attached. It is important that each applicant be
familiar with all certification and assurance categories contained in this document since
they are a prerequisite to receiving Community Transportation Program (NCDOT) funds
administered by the department. The certifications and assurances include clarification
and reference sources that cite the specific authorizing legislation. This will be of use as
your attorney reviews the information.
It is the department's responsibility to ensure that subrecipients are in compliance with
applicable federal and state requirements. Please note that if it is determined that asub-
recipient is not in compliance or cannot comply with the requirements, financial
assistance will be withdrawn until the sub-recipient is in compliance with all applicable
certifications and assurances.
You will not be required to complete the Special Section 5333(b) Warranty required of
rural and small urban recipients that will be seeking federal funds. Please ensure that the
appropriate entity signs the State NCDOT certifications and assurances.
MAILING ADDRESS:
NC DEPARTMENT OF TRANSPORTATION
PUBLIC TRANSPORTATION DIVISION
1550 MAIL SERVICE CENTER
RALEIGH, NC 27699-1550
TELEPHONE: 919-733-4713
FAX: 919-733-1391
WWW. DOT. STATE. NC. US/TR.4NSIT/TR.4NSITNET/
LOCATION:
TRANSPORTATION BUILDING
1 SOUTH W ILMINGTON STREET
RALEIGH NC
Please mail the certifications and assurances, including the Attorney affirmation with
original signatures, to Faye McCullen at:
NC Department of Transportation
Public Transportation Division
ATTN: FAYE MCCULLEN
1550 Mail Service Center
Raleigh, NC 27699-1550
These items must be received by NCDOT no later than Friday, January 16, 2004
As always, if you require assistance or have any questions, please feel free to contact me
by telephone at (919) 733-4713 extension 237 or by email to ~worleYa~dot.state.nc.us.
Attachments
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State NCDOT Certifications and Assurances
STATE FISCAL YEAR 2004 COMMUNITY TRANSPORTATION PROGRAMS
STATE NCDOT CERTIFICATIONS AND ASSURANCES
Section 5311
In accordance with 49 U.S. C. 5323(n), the following certifications and assurances have been
compiled for North Carolina Community Transportation programs. North Carolina Department
of Transportation Public Transportation Division requires each subrecipients of state assistance
awarded by NCDOT to make all certifications and assurances as needed for all programs for
which the subrecipients intends to seek State assistance during State Fiscal Year 2004.
Number 01 through 14 in this document lists the fourteen (14) Categories of certifications and
assurances.
O1. REQUIRED OF EACH APPLICANT
Each subrecipient of State assistance awarded by NCDOT must provide all certifications and
assurances in this Category "Ol. " NC/DOT may not award any state assistance until the
Applicant provides these certifications and assurances by selecting Category "Ol. "
A. Authority of Applicant and Its Representative
The authorized representative of the Applicant and the attorney who sign these certifications,
assurances, and agreements affirm that both the Applicant and its authorized representative have
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 State 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 NCDOT for State assistance on
behalf of the Applicant.
B. Standard Assurances
The Applicant assures that it will comply with all applicable Federal statutes, regulations,
executive orders, FTA circulars, and other Federal requirements in carrying out any project
supported by an NCDOT grant or cooperative agreement. The Applicant agrees that it is under a
continuing obligation to comply with the terms and conditions of the grant agreement or
cooperative agreement issued for its approved project with NCDOT. The Applicant recognizes
that Federal and State modifications may affect project implementation. The Applicant agrees
that the most recent Federal and state requirements will apply to the project, unless NCDOT
issues a written determination otherwise.
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C. Debarment, Suspension, and Other Responsibility Matters for Primary Covered Transactions
Until new Federal Debarment and Suspension regulations are promulgated that discontinue the
current requirement for the Debarment and Suspension certification, U.S. DOT regulations
regarding Goverrunent_wide Debarment and Suspension (Non-procurement) at 49 CFR 29.510
require the following certification:
(1) The Applicant (Primary Participant) 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 (3) year period preceding this certification, 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 subparagraph (1)(b) of this certification; and
(d) Have not within athree-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 it later becomes aware of any information contradicting
the statements of paragraph (1) above, it will promptly provide that information to NCDOT.
(3) If the Applicant (Primary Participant) is unable to certify to all statements in paragraphs (1)
and (2) of this certification, it shall indicate so in its applications, or in the transmittal letter
or message accompanying its annual certifications and assurances, and provide a written
explanation to NCDOT.
D. Drug-Free Workplace Agreement
Until new U.S. DOT Drug-Free Workplace regulations that rescind the requirement for aDrug-
Free Workplace certification are promulgated, U.S. DOT regulations, "Drug-Free Workplace
Requirements (Grants)," 49 CFR part 29, at Subpart F, as amended by 41 U.S.C. 702, require as
follows: The Applicant agrees that it will provide adrug-free workplace by:
(1) Publishing a statement notifying its employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in its workplace and
specifying the actions that will be taken against its employees for violation of that
prohibition;
(2) Establishing an ongoing drug-free awareness program to inform its employees about:
(a) The dangers of drug abuse in the workplace;
(b) Its policy ofmaintaining adrug-free workplace;
(c) Any available drug counseling, rehabilitation, and employee assistance programs; and
(d) The penalties that maybe imposed upon its employees for drug abuse violations
occurring in the workplace;
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(3) Making it a requirement that each of its employees to be engaged in the performance or
implementation of the grant agreement or cooperative agreement be given a copy of the
statement required by paragraph (1) of this certification;
(4) Notifying each of its employees in the statement required by paragraph (1) of this
certification that, as a condition of employment financed with Federal assistance provided by
the grant agreement or cooperative agreement, the employee will be required to:
(a) Abide by the terms of the statement; and
(b) Notify the employer (Applicant) in writing of any conviction for a violation of a criminal
drug statute occurring in the workplace no later than five (5) calendar days after that
conviction;
(5) Notifying NCDOT in writing, within ten (10) calendar days after receiving notice required by
paragraph (4)(b) above from an employee or otherwise receiving actual notice of that
conviction; the Applicant, as employer of any convicted employee, must provide notice,
including position title, to every project officer or other designee on whose project activity
the convicted employee was working, and that notice shall include the identification
number(s) of each affected grant agreement or cooperative agreement;
(6) Taking one of the following actions within thirty (30) calendar days of receiving notice under
paragraph (4)(b) of this agreement with respect to any employee who is so convicted:
(a) Taking appropriate personnel action against that employee, up to and including
termination, consistent with the requirements of the Rehabilitation Act of 1973, as
amended; or
(b) Requiring that employee to participate satisfactorily in a drug abuse assistance or
rehabilitation program approved for such purposes by a Federal, state, or local health, law
enforcement, or other appropriate agency; and
(7) Making a good faith effort to continue to maintain adrug-free workplace through
implementation of paragraphs (1), (2), (3), (4), (5), and (6) of this agreement. The Applicant
agrees to maintain a list identifying its headquarters location and each workplace it maintains
in which project activities supported by NCDOT are conducted, and make that list readily
accessible to NCDOT.
E. Nondiscrimination Assurance
As required by 49 U.S.C. 5332 (which prohibits discrimination on the basis of race, color, creed,
national origin, sex, or age, and prohibits discrimination in employment or business opportunity),
Title VI of the Civil Rights Act of 1964, as amended, 42 U.S.C. 2000d, and U.S. DOT
regulations, "Nondiscrimination in Federally-Assisted Programs of the Department of
Transportation--Effectuation of Title VI of the Civil Rights Act," 49 CFR part 21 at 21.7, the
Applicant assures that it will comply with all requirements of 49 CFR part 21; FTA Circular
4702.1, "Title VI Program Guidelines for Federal Transit Administration Recipients," and other
applicable directives, 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 State assistance awarded by NCDOT.
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Specifically, during the period in which State assistance is extended to the project, or project
property is used for a purpose for which the State assistance is extended or for another purpose
involving the provision of similar services or benefits, or as long as the Applicant retains
ownership or possession of the project property, whichever is longer, the Applicant assures that:
(1) Each project will be conducted, property acquisitions will be undertaken, and project
facilities will be operated in accordance with all applicable requirements of 49 U.S.C. 5332
and 49 CFR part 21, and understands that this assurance extends to its entire facility and to
facilities operated in connection with the project.
(2) It will promptly take the necessary actions to effectuate this assurance, including notifying
the public that complaints of discrimination in the provision oftransportation-related services
or benefits maybe filed with U.S. DOT or NCDOT. Upon request by NCDOT, or U.S. DOT
the Applicant assures that it will submit the required information pertaining to its compliance
with these requirements.
(3) It will include in each sub-agreement, property transfer agreement, third party contract, third
party subcontract, or participation agreement adequate provisions to extend the requirements
of 49 U.S.C. 5332 and 49 CFR part 21 to other parties involved therein including any
subrecipient, transferee, third party contractor, third party subcontractor at any level,
successor in interest, or any other participant in the project.
(4) Should it transfer real property, structures, or improvements financed with State assistance
provided by NCDOT to another party, any deeds and instruments recording the transfer of
that property shall contain a covenant running with the land assuring nondiscrimination for
the period during which the property is used for a purpose for which State is extended or for
another purpose involving the provision of similar services or benefits.
(5) The United States has a right to seek judicial enforcement with regard to any matter arising
under the Act, regulations, and this assurance.
(6) It will make any changes in its 49 U.S.C. 5332 and Title VI implementing procedures as U.S.
DOT or NCDOT may request.
F. Assurance of Nondiscrimination on the Basis of Disability
As required by U.S. DOT regulations, "Nondiscrimination on the Basis of Handicap in Programs
and Activities Receiving or Benefiting from Federal Financial Assistance," at 49 CFR 27.9, the
Applicant assures that, as a condition to the approval or extension of any Federal assistance
awarded by 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 FTA, no otherwise qualified person with a disability shall be, solely by reason
of that disability, excluded from participation in, denied the benefits of, or otherwise subjected to
discrimination in any program or activity receiving or benefiting from State assistance by the
NCDOT or any entity within U.S. DOT. The Applicant assures that project implementation and
operations so assisted will comply with all applicable requirements of U.S. DOT regulations
implementing the Rehabilitation Act of 1973, as amended, 29 U.S.C. 794, et seq., and the
Americans with Disabilities Act of 1990, as amended, 42 U.S.C. 12101 et seq., and
implementing U.S. DOT regulations at 49 CFR parts 27, 37, and 38, and any applicable
regulations and directives issued by other Federal departments or agencies.
G. Procurement Compliance Certification
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The Applicant certifies that its procurements and procurement system will comply with all
applicable third party procurement requirements of Federal laws, executive orders, regulations,
and FTA directives (including FTA Circular 4220.1E, "Third Party Contracting Guidelines,"
including any revisions thereto) and other requirements FTA and NCDOT may issue and any
revisions thereto. The Applicant certifies that it will include in its contracts financed in whole or
in part with State assistance all clauses required by Federal laws, executive orders, or
regulations, and will ensure that each subrecipient and each contractor will also include in its
sub-agreements and its contracts financed in whole or in part with State assistance all applicable
clauses required by Federal laws, executive orders, or regulations.
H. Certifications and Assurances required by the U.S. Office of Management and Budget
(OMB) (SF-424B and SF-424D)
As required by OMB, the Applicant certifies that it:
(1) Has the legal authority to apply for State assistance and the institutional, managerial, and
financial capability (including funds sufficient to pay the non-Federal share of project cost)
to ensure proper planning, management, and completion of the project described in its
application;
(2) Will give North Carolina Department of Transportation through any authorized
representative, access to and the right to examine all records, books, papers, or documents
related to the award; and will establish a proper accounting system in accordance with
generally accepted accounting standards or agency directives;
(3) Will establish safeguards to prohibit employees from using their positions for a purpose that
constitutes or presents the appearance of personal or organizational conflict of interest or
personal gain;
(4) Will initiate and complete the work within the applicable project time periods following
receipt of notification by NCDOT;
(S) Will comply with all applicable Federal statutes relating to nondiscrimination including, but
not limited to:
(a) Title VI of the Civil Rights Act, 42 U.S.C. 2000d, which prohibits discrimination on the
basis of race, color, or national origin;
(b) Title IX of the Education Amendments of 1972, as amended, 20 U.S.C. 1681 through
1683, and 1685 through 1687, and U.S. DOT regulations, "Nondiscrimination on the
Basis of Sex in Education Programs or Activities Receiving Federal Financial
Assistance," 49 CFR part 25, which prohibit discrimination on the basis of sex;
(c) Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C. 794, which
prohibits discrimination on the basis of handicap;
(d) The Age Discrimination Act of 1975, as amended, 42 U.S.C. 6101 through 6107, which
prohibits discrimination on the basis of age;
(e) The Drug Abuse Office and Treatment Act of 1972, Pub. L. 92-255, March 21, 1972, and
amendments thereto, 21 U.S.C. 1174 et seq. relating to nondiscrimination on the basis of
drug abuse;
(f) The Comprehensive Alcohol Abuse and Alcoholism Prevention Act of 1970, Pub. L.
91-616, Dec. 31, 1970, and amendments thereto, 42 U.S.C. 4581 et seq. relating to
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nondiscrimination on the basis of alcohol abuse or alcoholism;
(g) The Public Health Service Act of 1912, as amended, 42 U.S.C. 290dd-3 and 290ee-3,
related to confidentiality of alcohol and drug abuse patient records;
(h) Title VIII of the Civil Rights Act, 42 U.S.C. 3601 et seq., relating to nondiscrimination in
the sale, rental, or financing of housing;
(i) Any other nondiscrimination provisions in the specific statutes under which State
assistance for the project maybe provided including, but not limited, to 49 U.S.C. 5332,
which prohibits discrimination on the basis of race, color, creed, national origin, sex, or
age, and prohibits discrimination in employment or business opportunity, and section
1101(b) of the Transportation Equity Act for the 21st Century, 23 U.S.C. 101 note, which
provides for participation of disadvantaged business enterprises in NCDOT programs;
and
(j) Any other nondiscrimination statute(s) that may apply to the project;
(6) Will comply with, or has complied with, the requirements of Titles II and III of the Uniform
Relocation Assistance and Real Property Acquisition Policies Act of 1970, as amended,
(Uniform Relocation Act) 42 U.S.C. 4601 et seq., which, among other things, provide for fair
and equitable treatment of persons displaced or whose property is acquired as a result of
State or federally assisted programs. These requirements apply to all interests in real
property acquired for project purposes regardless of Federal participation in any purchase.
As required by sections 210 and 305 of the Uniform Relocation Act, 42 U.S.C. 4630 and
4655, and U.S. DOT regulations, "Uniform Relocation Assistance and Real Property
Acquisition for Federal and Federally Assisted Programs," 49 CFR 24.4, the Applicant
assures that it has the requisite authority under applicable state and local law to comply with
the requirements of the Uniform Relocation Act, 42 U.S.C. 4601 et seq., and U.S. DOT
regulations, "Uniform Relocation Assistance and Real Property Acquisition for State and
Federally Assisted Programs," 49 CFR part 24, and will comply with or has complied with
that Act and those U.S. DOT implementing regulations, including but not limited to the
following:
(a) The Applicant will adequately inform each affected person of the benefits, policies, and
procedures provided for in 49 CFR part 24;
(b) The Applicant will provide fair and reasonable relocation payments and assistance as
required by 42 U.S.C. 4622, 4623, and 4624; 49 CFR part 24; and any applicable
NCDOT procedures, to or for families, individuals, partnerships, corporations, or
associations displaced as a result of any project financed with State assistance;
(c) The Applicant will provide relocation assistance programs offering the services described
in 42 U.S.C. 4625 to such displaced families, individuals, partnerships, corporations, or
associations in the manner provided in 49 CFR part 24 and State procedures;
(d) Within a reasonable time before displacement, the Applicant will make available
comparable replacement dwellings to displaced families and individuals as required by
42 U.S.C. 4625(c)(3);
(e) The Applicant will carry out the relocation process in such manner as to provide
displaced persons with uniform and consistent services, and will make available
replacement housing in the same range of choices with respect to such housing to all
displaced persons regardless of race, color, religion, or national origin;
(f) In acquiring real property, the Applicant will be guided to the greatest extent practicable
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under state law, by the real property acquisition policies of 42 U.S.C. 4651 and 4652;
(g) The Applicant will pay or reimburse property owners for necessary expenses as specified
in 42 U.S.C. 4653 and 4654, with the understanding that NCDOT will provide State
financial assistance for the Applicant's eligible costs of providing payments for those
expenses, as required by 42 U.S.C. 4631;
(h) The Applicant will execute such amendments to third party contracts and subagreements
financed with NCDOT assistance and execute, furnish, and be bound by such additional
documents as NCDOT may determine necessary to effectuate or implement the
assurances provided herein; and
(i) The Applicant agrees to make these assurances part of or incorporate them by reference
into any third party contract or subagreement, or any amendments thereto, relating to any
project financed by NCDOT involving relocation or land acquisition and provide in any
affected document that these relocation and land acquisition provisions shall supersede
any conflicting provisions;
(7) To the extent applicable, will comply with the Davis-Bacon Act, as amended, 40 U.S.C. 3141
et seq., the Copeland Act, as amended, 18 U.S.C. 874, and the Contract Work Hours and
Safety Standards Act, as amended, 40 U.S.C. 3701 et seq., regarding labor standards for State
and federally assisted subagreements;
(8) To the extent applicable, will comply with the flood insurance purchase requirements of
section 102(a) of the Flood Disaster Protection Act of 1973, as amended, 42 U.S.C. 4012a(a),
requiring recipients in a special flood hazard area to participate in the program and purchase
flood insurance if the total cost of insurable construction and acquisition is $10,000 or more;
(9) Will comply with the Lead-Based Paint Poisoning Prevention Act, 42 U.S.C. 4831(b), which
prohibits the use of lead-based paint in the construction or rehabilitation of residence
structures;
(10) Will not dispose of, modify the use of, or change the terms of the real property title or other
interest in the site and facilities on which a construction project supported with NCDOT
assistance takes place without permission and instructions from the awarding agency;
(11) Will record the State interest in the title of real property in accordance with NCDOT
directives and will include a covenant in the title of real property acquired in whole or in part
with State assistance funds to assure nondiscrimination during the useful life of the project;
(12) Will comply with Federal and State requirements concerning the drafting, review, and
approval of plans and specifications of any construction project supported with FTA and
NCDOT assistance. As required by U.S. DOT regulations, "Seismic Safety," 49 CFR
41.117(d), before accepting delivery of any building financed with FTA or NCDOT
assistance, it will obtain a certificate of compliance with the seismic design and construction
requirements of 49 CFR part 41;
(13) Will provide and maintain competent and adequate engineering supervision at the
construction site of any project supported with FTA and NCDOT assistance to ensure that the
complete work conforms with the approved plans and specifications, and will furnish
progress reports and such other information as maybe required by the state;
(14) Will comply with any applicable environmental standards that may be prescribed to
implement the following Federal laws and executive orders:
(a) Institution of environmental quality control measures under the National Environmental
Policy Act of 1969, as amended, 42 U.S.C. 4321 et seq. and Executive Order No.
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11514, as amended, 42 U.S.C. 4321 note;
(b) Notification of violating facilities pursuant to Executive Order No. 11738, 42 U.S.C.
7606 note;
(c) Protection of wetlands pursuant to Executive Order No. 11990, 42 U.S.C. 4321 note;
(d) Evaluation of flood hazards in floodplains in accordance with Executive Order 11988,
42 U.S.C. 4321 note;
(e) Assurance of project consistency with the approved state management program
developed pursuant to the requirements of the Coastal Zone Management Act of 1972,
as amended, 16 U.S.C. 1451 et seq.;
(f) Conformity of Federal actions to State (Clean Air) Implementation Plans under section
176(c) of the Clean Air Act of 1955, as amended, 42 U.S.C. 7401 et seq.;
(g) Protection of underground sources of drinking water under the Safe Drinking Water Act
of 1974, as amended, 42 U.S.C. 300h et seq.;
(h) Protection of endangered species under the Endangered Species Act of 1973, as
amended, 16 U.S.C. 1531 et seq.; and
(i) Environmental protections for Federal transportation programs, including, but not
limited to, protections for parks, recreation areas, or wildlife or waterfowl refuges of
national, state, or local significance or any land from a historic site of national, state, or
local significance to be used in a transportation project as required by 49 U.S.C. 303;
(j) Protection of the components of the national wild and scenic rivers systems, as required
under the Wild and Scenic Rivers Act of 1968, as amended, 16 U.S.C. 1271 et seq.; and
(k) Provision of assistance to NCDOT in complying with section 106 of the National
Historic Preservation Act of 1966, as amended, 16 U.S.C. 470f; the Archaeological and
Historic Preservation Act of 1974, as amended, 16 U.S.C. 469a-1 et seq.; and Executive
Order No. 11593 (identification and protection of historic properties), 16 U.S.C. 470
note;
(15) To the extent applicable, will comply with the requirements of the Hatch Act, 5 U.S.C. 1501
through 1508, and 7324 through 7326, which limit the political activities of state and local
agencies and their officers and employees whose primary employment activities are financed
in whole or part with State funds including a grant agreement, cooperative agreement, or
loan; except, in accordance with 23 U.S.C. 142(g), the Hatch Act does not apply to a
nonsupervisory employee of a transit system (or of any other agency or entity performing
related functions) receiving State assistance to whom that Act does not otherwise apply;
(16) Will comply with the National Research Act, Pub. L. 93-348, July 12, 1974, as amended, at
42 U.S.C. 289 et seq., and U.S. DOT regulations, "Protection of Human Subjects," 49 CFR
part 11, regarding the protection of human subjects involved in research, development, and
related activities supported by Federal assistance;
(17) Will comply with the Laboratory Animal Welfare Act of 1966, as amended, 7 U.S.C. 2131
et seq., and U.S. Department of Agriculture regulations, "Animal Welfare," 9 CFR
subchapter A, parts 1, 2, 3, and 4, pertaining to the care, handling, and treatment of warm
blooded animals held or used for research, teaching, or other activities supported by Federal
assistance;
(18) Will have performed the financial and compliance audits required by the Single Audit Act
Amendments of 1996, 31 U.S.C. 7501 et seq., OMB Circular No. A-133, "Audits of States,
Local Governments, and Non-Profit Organizations," Revised, and the most recent applicable
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OMB A-133 Compliance Supplement provisions for the Department of Transportation; and
(19) Will comply with all applicable requirements of all other Federal laws, executive orders,
regulations, and policies governing the project.
02. LOBBYING
An Applicant that submit or intends to submit an application to NCDOT for State assistance
exceeding $100, 000 must provide the following certification. NCDOT may not provide State
assistance for an application exceeding $100, 000 until the Applicant provides this certification
by selecting Category "02. "
A. As required by U.S. DOT regulations, "New Restrictions on Lobbying," at 49 CFR 20.110,
the Applicant's authorized representative certifies to the best of his or her knowledge and
belief that for each application for State assistance exceeding $100,000:
(1) No State 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 officer or employee of any Federal
agency, Member of Congress, officer or employee of Congress, or employee of a
Member of Congress about an award of Federal assistance, or the continuation, renewal,
extension, amendment, or modification of any Federal assistance agreement; and
(2) If any funds other than State 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, an officer or employee of Congress, or an employee of a Member
of Congress in connection with any application for Federal assistance, the Applicant
assures 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 maybe 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, and contracts under grants,
loans, and cooperative agreements).
(4) The language of this certification shall be included in the award documents for all
subawards at all tiers (including subcontracts, subgrants, and 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 and that submission of this certification is a prerequisite for
providing State 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.
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03. PRIVATE MASS TRANSPORTATION COMPANIES
A local government Applicant seeking State assistance authorized by 49 U. S. C. chapter 53 to
acquire the property or an interest in the property of a private mass transportation company or
to operate mass transportation equipment or facilities in competition with, or in addition to,
transportation service provided by an existing mass transportation company must provide the
following certification. NCDOT may not award State assistance for that type of project until the
Applicant provides this certification by selecting Category "03. "
As required by 49 U.S.C. 5323(a)(1), the Applicant certifies that before it acquires the property
or an interest in the property of a private mass transportation company or operates mass
transportation equipment or facilities in competition with, or in addition to, transportation service
provided by an existing mass transportation company, it has or will have:
A. Found that the assistance is essential to carrying out a program of projects as determined by
the plans and programs of the metropolitan planning organization;
B. Provided for the participation of private mass transportation companies to the maximum
extent feasible consistent with applicable State requirements and policies;
C. Paid just compensation under state or local law to a private mass transportation company for
its franchises or property acquired; and
D. Acknowledged that the assistance falls within the labor standards compliance requirements
of 49 U.S.C. 5333(a) and 5333(b).
04. PUBLIC HEARING
An Applicant seeking State assistance authorized by 49 U.S.C. chapter 53 for a capital project
that will substantially affect a community or a community's mass transportation service must
provide the following certification. NCDOT may not award State assistance for that type of
project until the Applicant provides this certification by selecting Category "04. "
As required by 49 U.S.C. 5323(b), the Applicant certifies that it has, or before submitting its
application, it will have:
A. Provided an adequate opportunity for a public hearing with adequate prior notice of the
proposed project published in a newspaper of general circulation in the geographic area to be
served;
B. Held that hearing and provided NCDOT a transcript or detailed report summarizing the
issues and responses, unless no one with a significant economic, social, or environmental
interest requests a hearing;
C. Considered the economic, social, and environmental effects of the proposed project; and
D. Determined that the proposed project is consistent with official plans for developing the
urban area.
10
• SFY 2005 Community Transportation Program
State NCDOT Certifications and Assurances
O5. ACQUISITION OF ROLLING STOCK
An Applicant seeking State assistance authorized by 49 U.S.C. chapter S3 to acquire any rolling
stock must provide the following certification. NCDOT may not award State assistance to
acquire such rolling stock until the Applicant provides this certification by selecting Category
"OS. "
As required by 49 U.S.C. 5323(m) and implementing NCDOT FTA regulations at 49 CFR 663.7,
the Applicant certifies that it will comply with the requirements of 49 CFR part 663 when
procuring revenue service rolling stock. Among other things, the Applicant agrees to conduct or
cause to be conducted the requisite pre-award and post-delivery reviews, and maintain on file the
certifications required by 49 CFR part 663, subparts B, C, and D.
06. BUS TESTING
An Applicant for State assistance appropriated or made available for 49 U.S.C. chapter 53 to
acquire any new bus model or any bus model with a new major change in configuration or
components must provide the following certification. NCDOT may not provide State assistance
for the acquisition of new buses until the Applicant provides this certification by selecting
Category "06. "
As required by FTA regulations, "Bus Testing," at 49 CFR 665.7, the Applicant certifies that
before it expends any State financial assistance to acquire the first bus of any new bus model or
any bus model with a new major change in configuration or components, or before authorizing
final acceptance of a new bus model, a newly configured bus model, or a bus model with a major
change in components (as described in 49 CFR part 665), the bus model:
A. Will have been tested at a bus testing facility approved by FTA; and
B. Will have received a copy of the test report prepared on the bus model.
07. CHARTER SERVICE AGREEMENT
An Applicant seeking State assistance authorized by 49 U.S.C. chapter S3 (except 49 U.S.C.
5310), or by Title 23, U.S.C. to acquire or operate any mass transportation equipment or
facilities must enter into the following Charter Service Agreement. NCDOT may not provide
State assistance authorized by 49 U.S.C. chapter S3 (except 49 U.S.C. 5310), or by Title 23,
U. S. C. for projects until the Applicant enters into this Charter Service Agreement by selecting
Category "07. "
A. As required by 49 U.S.C. 5323(d) and FTA regulations, "Charter Service," at 49 CFR 604.7,
the Applicant agrees that it and its recipients will:
(1) Provide charter service that uses equipment or facilities acquired with Federal or State
assistance authorized by 49 U.S.C. chapter 53 (except 49 U.S.C. 5310), or Title 23,
U.S.C., only to the extent that there are no private charter service operators willing and
able to provide the charter service that it or its recipients desire to provide, unless one or
11
' , SFY 2005 Community Transportation Program
State NCDOT Certifications and Assurances
more of the exceptions in 49 CFR 604.9 applies; and
(2) Comply with the requirements of 49 CFR part 604 before providing any charter service
using equipment or facilities acquired with Federal or State assistance authorized by 49
U.S.C. chapter 53 (except 49 U.S.C. 5310), or Title 23, U.S.C. for transportation projects.
B. As The Applicant understands that:
(1) The requirements of 49 CFR part 604 will apply to any charter service it provides,
(2) The definitions of 49 CFR part 604 apply to this Charter Service Agreement, and
(3) A violation of this Charter Service Agreement may require corrective measures and
imposition of penalties, including debarment from the receipt of further Federal and State
assistance for transportation.
08. SCHOOL TRANSPORTATION AGREEMENT
An Applicant seeking State assistance authorized by 49 U.S. C. chapter 53 or by Title 23, U.S. C.
to acquire or operate transportation facilities and equipment must enter into the following
School Transportation Agreement. NCDOT may not provide State assistance for such projects
until the Applicant enters into this agreement by selecting Category "08. "
A. As required by 49 U.S.C. 5323(f) and FTA and State regulations, "School Bus Operations,"
at 49 CFR 605.14, the Applicant agrees that it and all its recipients will:
(1) Engage in school transportation operations in competition with private school
transportation operators only to the extent permitted by 49 U.S.C. 5323(f), and Federal
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 and
authorized by 49 U.S.C. chapter 53 or Title 23 U.S.C. for transportation projects.
B. As The Applicant understands that:
(1) The requirements of 49 CFR part 605 will apply to any school transportation service it
provides,
(2) The definitions of 49 CFR part 605 apply to this school transportation agreement, and
(3) A violation of this School Transportation Agreement may require corrective measures
and imposition of penalties, including debarment from the receipt of further State
assistance for transportation.
12
. SFY 2005 Community Transportation Program
State NCDOT Certifications and Assurances
09. DEMAND RESPONSIVE SERVICE
An Applicant that operates demand responsive service and applies for State assistance
authorized for 49 U.S.C. chapter 53 to acquire non-rail mass transportation vehicles is required
to provide the following certification. NCDOT may not award State assistance authorized for 49
U.S.C. chapter 53 to an Applicant that operates demand responsive service to acquire non-rail
mass transportation vehicles until the Applicant provides this certification by selecting Category
"09. "
As required by U.S. DOT regulations, "Transportation Services for Individuals with Disabilities
(ADA)," at 49 CFR 37.77(d), the Applicant certifies that its demand responsive service offered
to persons with disabilities, including persons who use wheelchairs, is equivalent to the level and
quality of service offered to persons without disabilities. When the Applicant's service is viewed
in its entirety, the Applicant's service for persons with disabilities 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.
10. ALCOHOL MISUSE AND PROHIBITED DRUG USE
The Applicant is required to provide the following certification concerning its activities to
prevent alcohol misuse and prohibited drug use in its transit operations, NCDOT may not
provide State assistance to that Applicant until it provides this certification by selecting
Category "10. "
As required by FTA regulations, "Prevention of Alcohol Misuse and Prohibited Drug Use in
Transit Operations," at 49 CFR part 655, subpart I, the Applicant certifies that it has established
and implemented an alcohol misuse and anti-drug program, and has complied with or will
comply with all applicable requirements of FTA regulations, "Prevention of Alcohol Misuse and
Prohibited Drug Use in Transit Operations," 49 CFR part 655.
11. INTELLIGENT TRANSPORTATION SYSTEMS
An Applicant that submit or intends to submit an application to NCDOT for State assistance for
an Intelligent Transportation Systems (ITS) project, defined as any project that in whole or in
part finances the acquisition of technologies or systems of technologies that provide or
significantly contribute to the provision of one or more ITS user services as defined in the
"National ITS Architecture, "must provide the following assurance. NCDOT may not award
State assistance for an ITS project until the Applicant provides this assurance by selecting
Category "I1. "
13
SFY 2(105 Community Transportation Program
State NCDOT Certifications and Assurances
As used in this assurance, the term Intelligent Transportation Systems (ITS) project is defined to
include any project that in whole or in part finances the acquisition of technologies or systems of
technologies that provide or significantly contribute to the provision of one or more ITS user
services as defined in the "National ITS Architecture."
A. In accordance with section 5206(e) of TEA-21, 23 U.S.C. 502 note, the Applicant assures it
will comply with all applicable requirements of Section V (Regional ITS Architecture and
Section VI (Project Implementation) of FTA Notice, "FTA National ITS Architecture Policy
on Transit Projects," at 66 Fed. Reg. 1455 et seq., January 8, 2001, and other FTA
requirements that maybe issued in connection with any ITS project it undertakes financed
with Highway Trust Funds (including funds from the mass transit account) or funds made
available for the Intelligent Transportation Systems Program authorized by TEA-21, title V,
subtitle C, 23 U.S.C. 502 note.
B. With respect to any ITS project financed with Federal assistance derived from a source other
than Highway Trust Funds (including funds from the Mass Transit Account) or TEA-21, title
V, subtitle C, 23 U.S.C. 502 note, the Applicant assures that is will use its best efforts to
ensure that any ITS project it undertakes will not preclude interface with other intelligent
transportation systems in the Region.
12. URBANIZED AREA, JARC, AND CLEAN FUELS PROGRAMS
Each Applicant for Urbanized Area Formula Program assistance authorized by 49 U.S.C. 5307,
each Applicant for Job Access and Reverse Commute Program assistance authorized by section
3037 of the Transportation Equity Act for the 21St Century, 49 U.S. C. 5309 note, and each
Applicant for Clean Fuels Formula Program assistance authorized by 49 U.S. C. 5308 must
provide the following certifications. NCDOT may not award Federal assistance for those
programs until the Applicant provides these certifications and assurances by selecting Category
"12. " A state or other Applicant providing certifications and assurances that require the
compliance of its prospective subrecipients is expected to obtain sufficient documentation from
those subrecipients to assure the validity of its certifications and assurances.
Each Applicant that received Transit Enhancement funds authorized by 49 U.S. C. 5307(k)(1)
must list the projects carried out during that Federal fiscal year with those funds in its quarterly
report for the fourth quarter of the preceding Federal fiscal year. That list constitutes the report
of transit enhancement projects carried out during that fiscal year, which report is required to be
submitted as part of the Applicant's annual certifications and assurances, in accordance with 49
U.S. C. 5307(k)(3), and is therefore incorporated by reference and made part of the Applicant's
annual certifications and assurances. NCDOT may not award Urbanized Area Formula
Program assistance to any Applicant that has received Transit Enhancement funds authorized by
49 U.S. C. 5307(k)(1), unless that Applicant's quarterly report for the fourth quarter of the
preceding Federal fiscal year has been submitted to NCDOT and FTA and includes the requisite
list.
A. Certifications Required for the Urbanized Area Formula Program
(1) As required by 49 U.S.C. 5307(d)(1)(A) through (J), the Applicant certifies and assures as
14
SFY 2005 Community Transportation Program
State NCDOT Certifications and Assurances
follows:
(a) It has or will have the legal, financial, and technical capacity to carry out the proposed
program of projects;
(b) It has or will have satisfactory continuing control over the use of Project equipment and
facilities;
(c) It will adequately maintain the equipment and facilities;
(d) It will ensure that elderly and handicapped persons, or any person presenting a Medicare
card issued to himself or herself pursuant to title II or title XVIII of the Social Security
Act (42 U.S.C. 401 et seq. or 42 U.S.C. 1395 et seq.), will be charged for transportation
during non-peak hours using or involving a facility or equipment of a project financed
with Federal assistance authorized for 49 U.S.C. 5307, or for the Job Access and Reverse
Commute Program at section 3037 of the Transportation Equity Act for the 21St Century
(TEA-21), 49 U.S.C. 5309 note, not more than fifty (50) percent of the peak hour fare;
(e) In carrying out a procurement financed with Federal assistance authorized for the
Urbanized Area Formula Program, 49 U.S.C. 5307, or the Job Access and Reverse
Commute Program, section 3037 of TEA-21, 49 U.S.C. 5309 note, it: (1) will use
competitive procurement (as defined or approved by the Secretary and NCDOT ), (2) will
not use exclusionary or discriminatory specifications, and (3) will comply with applicable
Buy America laws;
(f) It has complied with or will comply with the requirements of 49 U.S.C. 5307(c).
Specifically, it: (1) has made available, or will make available, to the public information
on the amounts available for the Urbanized Area Formula Program, 49 U.S.C. 5307 and,
if applicable, the Job Access and Reverse Commute Grant Program, 49 U.S.C. 5309 note,
and the program of projects it proposes to undertake; (2) has developed or will develop,
in consultation with interested parties including private transportation providers, a
proposed program of projects for activities to be financed; (3) has published or will
publish a proposed program of projects in a way that affected citizens, private
transportation providers, and local elected officials have the opportunity to examine the
proposed program and submit comments on the proposed program and the performance
of the Applicant; (4) has provided or will provide an opportunity for a public hearing to
obtain the views of citizens on the proposed program of projects; (5) has ensured or will
ensure that the proposed program of projects provides for the coordination of
transportation services assisted under 49 U.S.C. 5336 with transportation services
assisted by another Federal Government source; (6) has considered or will consider the
comments and views received, especially those of private transportation providers, in
preparing its final program of proj ects; and (7) has made or will make the final program
of projects available to the public;
(g) It has or will have available and will provide the amount of funds required by 49 U.S.C.
5307(e) and applicable FTA policy (specifying Federal and local shares of project costs);
(h) It will comply with: 49 U.S.C. 5301(a) (requirements for transportation systems that
maximize mobility and minimize fuel consumption and air pollution); 49 U.S.C. 5301(d)
(requirements for transportation of the elderly and persons with disabilities); 49 U.S.C.
5303 through 5306 (planning requirements); and 49 U.S.C. 5301(d) (special efforts to
design and provide mass transportation for the elderly and persons with disabilities);
(i) It has a locally developed process to solicit and consider public comment before raising
15
SFY 2005 Community Transportation Program
State NCDOT Certifications and Assurances
fares or implementing a major reduction of transportation; and
(j) As required by 49 U.S.C. 5307(d)(1)(J), unless it has determined that it is not necessary
to expend one (1) percent of the amount of Federal assistance it receives for this fiscal
year apportioned in accordance with 49 U.S.C. 5336 for transit security projects, it will
expend at least one (1) percent of that assistance for transit security projects, including
increased lighting in or adjacent to a transit system (including bus stops, subway stations,
parking lots, and garages), increased camera surveillance of an area in or adjacent to that
system, emergency telephone line or lines to contact law enforcement or security
personnel in an area in or adjacent to that system, and any other project intended to
increase the security and safety of an existing or planned transit system.
(2) As required by 49 U.S.C. 5307(k)(3), if it has received Transit Enhancement funds
authorized by 49 U.S.C. 5307(k)(1), its quarterly report for the fourth quarter of the
preceding Federal fiscal year includes a list of the projects it has implemented during that
fiscal year using those funds, and that report is incorporated by reference and made part of its
certifications and assurances.
13. ADDITIONAL REGUIRMENTS FOR STATE FUNDED COMMUNITY
TRANSPORTATION PROGRAMS
An Applicant must sign annual NCDOT certifications and assurances as part of their Community
Transportation Program grant requests. NCDOT may not award State assistance to the
Applicant until the Applicant provides these certifications and assurances by selecting Category
"14. "
The certifies and assures that the following requirements and conditions will be fulfilled:
A. Applicant has or will have, by the time of delivery, sufficient funds to operate and maintain
the vehicles and equipment financed with State assistance awarded for its project;
B. Applicant has coordinated or will coordinate to the maximum extent feasible with other
transportation providers and users, including social service agencies authorized to purchase
transit service;
C. Applicant has complied or will comply with all applicable civil rights requirements;
D. Applicant has complied or will comply with applicable requirements of U.S. DOT
regulations regarding participation of disadvantaged business enterprises in U.S. DOT
programs;
E. Applicant has complied or will comply with Federal requirements regarding transportation of
elderly persons and persons with disabilities;
F. Applicant has complied or will comply with 49 CFR part 604 in the provision of any charter
service provided with equipment or facilities acquired with FTA assistance;
G. Applicant has complied or will comply with applicable provisions of 49 CFR part 605
pertaining to school transportation operations;
H. Viewing its demand responsive service to the general public in its entirety, the subrecipient
has complied or will comply with the requirement to provide demand responsive service to
persons with disabilities, including persons who use wheelchairs, meeting the standards of
16
SFY 205 Community Transportation Program
State NCDOT Certifications and Assurances
equivalent service set forth in 49 CFR 37.77(c), before purchasing non-accessible vehicles
for use in demand responsive service for the general public;
I. Applicant has established or will establish a procurement system, and has conducted or will
conduct its procurements in compliance with all applicable provisions of Federal laws,
executive orders, regulations, FTA Circular 4220.1 E, "Third Party Contracting
Requirements," as amended and revised, and other Federal requirements that maybe
applicable;
J. Applicant has complied or will comply with the requirement that its project provide for the
participation of private enterprise to the maximum extent feasible;
K. Applicant has paid or will pay just compensation under state or local law to each private
mass transportation company for its franchise or property acquired under the project;
L. Applicant has complied or will comply with all applicable lobbying requirements for each
application exceeding $100,000;
M. Applicant has complied or will comply with all applicable nonprocurement suspension and
debarment requirements;
N. Applicant has complied or will comply with all applicable bus testing requirements for new
bus models;
O. Applicant has complied or will comply with all applicable pre-award and post-delivery
review requirements;
P. Applicant has complied with or will comply with all assurances requires for prof ects
involving real property;
Q. Applicant has complied or will comply with applicable FTA and NCDOT Intelligent
Transportation Systems architecture requirements, to the extent required by FTA and
NCDOT;and
R. Applicant has complied or will comply with applicable prevention of alcohol misuse and
prohibited drug use program requirements, to the extent required by FTA and NCDOT.
14. North Carolina Department of Transportation Public Transportation Division
Vehicle Use
All vehicles purchased with State and/or Federal funds, including existing vehicles
and any vehicles purchased in the future, shall only be used for the provision of
public transportation services. Staff members shall not used any vehicles purchased
with State and/or Federal funds for other purposes including administrative.
Selection and Signature Page(s) follow.
17
• SFY 2005 Community Transportation Program
State NCDOT Certifications and Assurances
STATE FISCAL YEAR 2004 CERTIFICATIONS AND ASSURANCES FOR STATE
ADMINISTRATION ASSISTANCE PROGRAMS
Name of Applicant: County of Orange
The Applicant agrees to comply with applicable requirements of Categories Ol - 14.
(The Applicant may make this selection in lieu of individual selections below.)
OR
The Applicant agrees to comply with the applicable requirements of the following Categories it has selected:
Category Description
O1. Required of Each Applicant X_
02. Lobbying X_
03. Private Mass Transportation Companies X
04. Public Hearing X_
O5. Acquisition of Rolling Stock X_
06. Bus Testing X_
07. Charter Service Agreement X_
08. School Transportation Agreement X
09. Demand Responsive Service X
10. Alcohol Misuse and Prohibited Drug Use X_
11 Intelligent Transportation Systems X
12. Urbanized Area, JARC, and Clean Fuels Programs X
13. Additional Requirements for State Administration Assistance Programs X_
14 Prohibited use of FederaUState Funded Vehicles X_
(Both Certificates and Signature Pages must be appropriately completed and signed as
indicated.)
Applicant is unable to certify to the following certification and assurance:
Explanation:
18
SFY 2005 Community Transportation Program
State NCDOT Certifications and Assurances
STATE FISCAL YEAR 2004-2005 CERTIFICATIONS AND ASSURANCES
SIGNATURE PAGE
(Required of all Applicants for State/FTA assistance)
AFFIRMATION OF APPLICANT
Legal Name of Applicant: County of Orange.
Name of Authorized Representative:
Relationship of Authorized Representative:
BY SIGNING BELOW, on behalf of the Applicant, I declare that the Applicant has duly
authorized me to make these certifications and assurances and bind the Applicant's compliance.
Thus, the Applicant agrees to comply with all Federal statutes, regulations, executive orders, and
Federal requirements applicable to each application it makes to North Carolina Department of
Transportation (NCDOT) in State Fiscal Year 2004.
NCDOT intends that the certifications and assurances the Applicant selects on the other side of
this document, as representative of the certifications and assurances in Appendix A, should
apply, as required, to each project for which the Applicant seeks now, or may later, seek NCDOT
assistance during State Fiscal Year 2004.
The Applicant affirms the truthfulness and accuracy of the certifications and assurances it has
made in the statements submitted herein with this document and any other submission made to
FNCDOT, and acknowledges that the provisions of the Program Fraud Civil Remedies Act of
1986, 31 U.S.C. 3801 et seq., as implemented by U.S. DOT regulations, "Program Fraud Civil
Remedies," 49 CFR part 31 apply to any certification, assurance or submission made to NCDOT.
The criminal fraud provisions of 18 U.S.C. 1001 apply to any certification, assurance, or
submission made in connection with the Urbanized Area Formula Program, 49 U.S.C. 5307, and
may apply to any other certification, assurance, or submission made in connection with any other
program administered by NCDOT.
In signing this document, I declare under penalties of perjury that the foregoing certifications and
assurances, a other statements made by me on half of the Applicant are true and correct.
Signature
Date ~ ~/~_
Name [~Q.r~^
Authorized Renrese tive
19
• SFY 2005 Community Transportation Program
State NCDOT Certifications and Assurances
FIRMATION OF APPLI ANT'S ATTORNEY
SFY 2004-2 5 2004 COMMUNITY RANSPORTATION PROGRAM
For (Legal Name of Applic t): County of Or ge
As the undersigned Attorney r the above ed Applicant, I hereby affirm to the Applicant
that it has authority under state d local 1 to make and comply with the certifications and
assurances as indicated on the fo egoing ages. I further affirm that, in my opinion, the
certifications and assurances have een egally made and constitute legal and binding obligations
on the Applicant.
I further affirm to the Applicant
litigation pending or imminent t
assurances, or of the performanc
Signature
Date:
Name
Attorney for Applicant
the best of my knowledge, there is no legislation or
t adversely affect the validity of these certifications and
~roi ect.
Each Applicant for NCDOT/FTA financial assistance must provide an Affirmation of
Applicant's Attorney pertaining to the Applicant's legal capacity.
20
SFY 2005 Community Transportation Program
State NCDOT Certifications and Assurances
OPINION OF APPLICANT'S ATTORNEY
for ORANGE COUNTY, NORTH CAROLINA (Legal Name of Applicant)
SFY2004-2005 Community Transportation Program
As the undersigned legal counsel for the above named Applicant,
I hereby provide the following to the above named Applicant:
it is my opinion that the Applicant has authority under state
and local law to make and comply with the certifications and
assurances as indicated on the foregoing pages. It is further my
opinion that the certifications and assurances have been made
with proper legal authority and constitute legal and binding
obligations on the Applicant.
To the best of my knowledge, there is no legislation or
litigation pending or imminent that might adversely affect the
validity of these certifications and assurances, or of the
performance of the project.
Date: C zc3Q~ Geoffrey E. Gledhill
~ Name of Applicant's Attorney
ignat e
lsg:orangecounty\NCDOTopinionpage#3.doc
_ ~,~= ~ i /103
FY2004-2005 CT Application
FederaUState Certifications
TITLE VI CERTIFICATION
NON-DISCRIMINATION
FOR THE PERIOD JULY 1, 2002 -JUNE 30, 2003
Recipients of FTA funds must comply with Title VI of the 1964 Civil Rights Act, Section 601. Title VI states that "No person in the
United States shall, on the ground of race, color or national origin, be excluded from participation in, be denied the benefits of, or be
subjected to discrLm;nation under any program or activity receiving Federal financial assistance." As the direct recipient of the
Section 5311 funds, the Department of Transportation is required to periodically submit information to FTA that includes a
description of Title VI complaints that have been filed against the department and any subrecipient.
The legal applicant {subrecipient) must complete the Section 5311 Title VI Pro rg am Report. Please complete the attached form by
providing a concise description of any Title VI complaints or lawsuits alleging discrLm;nation in the service delivery area that have
been filed with the legal applicant during the period July 1, 2002 through June 30, 2003. Include a statement or outcome of each
complaint or lawsuit. The legal applicant is the agency that the depaztment enters into contract with, not the system name. However,
if any complaints have been alleged against the transportation system, they should be included in the form: The appropriate
certification should be completed indicating that information has been provided regazding all complaints received, and the form must
be si ng ed by the authorized official. If there have been no allegations or complaints, the legal applicant's authorized official should
complete the appropriate certification at the bottom of the form and sign where indicated.
Section II
Page 17 of 19
FY2004-2005 CTP Application
Federal /State Certifications
SECTION 5311 TITLE VI PROGRAM REPORT
July 1, 2002 -June 30, 2003
Legal Narne of Applicant (subrecipient):
The following Title VI complaints or lawsuits alleging discrimination have been filed with the applicant during the period July 1, 2002 through June 30, 2003:
Complainant Name/Address/Telephone Date Description Status/Outcome
Number
(Attach an additional page if required.)
I certify at to the best o y wledge, the above information describes all complaints or lawsuits alleging discrirination that have been filed against
during the period July 1, 2002 -June 30, 2003.
(Legal ame of Applicant)
I certify that to the best of my laiowledge, no complaints or lawsuits alleging discrimination have been filed against County of Orange during the period July 1, 2002 -June 30,
2003.
(Legal Name of Applicant)
r
Signature and Tit of Au or ed Official Date
Section II o
Page 19 of 19
FY2004-2005 CT Application
FederaUState Certifications
7
Community Transportation Program Application
Disadvantaged Business Enterprise (DBE)
All recipients and subrecipients of grant funds from the Federal Transit Administration (FTA) and%or
the State of North Carolina must participate in the Disadvantaged Business Enterprise (DBE)
program/Minority. Business Enterprises (MBE) program
The North Carolina Department of Transportation (NCDOT) must ensure that it and its subrecipients
provide DBEs the maximum opportunity to compete for purchases and be awarded contracts financed
in whole or in part with federal or state funds. NCDOT and subrecipients must not discriminate on the
basis of race, color, national origin, or sex in the award of contracts or when making purchases.
Systems that receive assistance in excess of $250,000 (exclusive of rolling stock) in a given Federal
fiscal year must prepare a DBE program, adopt for NCDOT review an annual DBE percentage
participation goal, and submit quarterly reports to NCDOT. All other systems are responsible for
executing the "DBE Good Faith Efforts Certification" enclosed with this application and for actually
carrying out good faith efforts on behalf of DBEs.
All systems may gain technical assistance by calling Les Twible at the Public Transportation Division
(PTD) of NCDOT at (919) 733-4713, ext. 278, or email ttwible(~dot.state.nc.us. Systems with annual
grant awards of less than $250,000 (exclusive of rolling stock) must complete and submit the enclosed
"DBE Good Faith Efforts Certification" with this application. Systems with annual grant awards of
more than $250,000 (exclusive of rolling stock) may also call Mr. Twible for reporting forms and
instructions.
Section II
Page 15 of 19
T
.._
FY2004-2005 CT Application
FederaUState Certifications
8
...DBE GOOD FAITH EFFORTS CERTIFICATION
This is to certify that in all purchase and contract selections County of Orange
(Applicant Name)
is committed to and shall make good faith efforts to purchase from and award contracts to Disadvantaged Business Enterprises
(DBEs).
Our good faith efforts will include the following items that are indicated by check mark(s):
X^ Write a letter to Certified DBEs in our service area to inform them of purchase or contract
opportunities;
X^ Document telephone calls, emails and correspondence made on behalf of DBEs;
^ Advertise on local TV Community Cable Network;
X^ Request purchase/contract price quotes/bids from DBEs;
X^ Look through newspapers for new businesses to determine DBE eligibility;
X^ Encourage interested eligible firms to become NCDOT certified. Firms should contact Bob
Mathes of the NCDOT Civil Rights Office at (919) 733-2300; and
X^ Consult NCDOT Certified DBE Directory. You may obtain a copy of this Directory either at
www.ncdot.orgJadrivnish'ation/civilri ts/dbedir/ or by contacting either Mr. Mathes or Mr. Tvvtble. A DBE company
will be listed in the DBE Directory for each work type or area of specialization that it performs.
^ Other efforts. Describe:
Documentation of all good faith efforts shall be retained for a period of five (5) years.
Title of Authorized Official: / ~ cR/K2~
SSA°~~
Signature of Authorized Official:
Typed Name of Authorized Official:
Date: ~(~l ~r`d j
Section II
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FY2004-2005 CT Application
FederaUState Certifications
Federal /State Certifications 6
Applicants must meet federal and state requirements prior to July 1, 2004. Applicants that do not meet federal
and state requirements are not eligible to incur expenses. The NCDOT will not award any financial assistance
until the applicant provides assurance of compliance and it has been determined that federal and state
requirements are met. For example, if an applicant does not meet federal and state requirements until August 1,
they will not be eligible to incur expenses for reimbursement until the North Carolina Board of Transportation
(NCBOT) approves the applicants request at their next regularly scheduled meeting. Requests for retroactive
funding to the effective date of compliance will be considered.
The required Certifications and Assurances, Attorney's Affirmation, and 5333(b) Labor
Warranty will be provided to you as soon as possible. We anticipate that updated
Certifications and Assurances will be available from the Federal Transit Authority (FTA)
during December 2003.
This section includes the required Disadvantaged Business Enterprise Certification, the
Title VI Certification of Non-Discrimination, and the Surface Provider List. These
forms in this section should be completed and returned with your completed
application by November 21, 2003.
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Page 14 of 19
_.
___ ____
FY2004-2005 CT Application
FederaUState Certifications
USE LOCAL LETTERHEAD STATIONARY
SAMPLE LOCAL SHARE CERTIFICATION FOR FUNDING
(.4LL APPLICANTS MUST PRESENT AND RETURN THIS SIGNED FORM FVITH.APPLICATIOIV) 5
I, the undersigned representing The County of Orange , do hereby
(Authorized Applicant/Subrecipient)
certify to the North Carolina Department of Transportation that the required local funds for the FY2005
Community Transportation Program are available.
__ _.
We are applying for the~following amounts:
Project Total Amount Local Share
Administrative /Emp Dev. $ 191.221 $ 28.638 (15%)
Capital (Vehicles & Other) $ 0 $ (10%)
Facility $ 0 $ (10%)
Technology $ 5200 $ 520 (10%)
TOTAL $ 196.421 $ 29,158
(Total of Projects) (Total Local Share)
The Local Share is available from the following sources:
Source of Funds Amount
Orange County General Funds $ 29,158
TOTAL
These funds will be available as of July 1, 2004 for the FY2005, which has a period of performance of July 1, 2004 -
June 30, 200. rA f
rV I
Signature of Applicant u orized Official
Title
dit ~ a re r' ~ ~ (~ (Lsa ~ nl
Printed NaYne
. ir1-~~63
Date
W
Section II
Page 13 of 19
__
FY2004-2005 CT Application
FederaUState Certifications
Subscribed and sworn to me (date) ~2~4o2wJf GL /~ o'L4G .3
4
rr f,. , n.,x~:,.
CuQ'7.~. - I/- D o~iQ ~ ~ O ~ /U ~ Seal
dress 2~2? ~
My commission expires (date)
*Note that the official authorized to submit the grant application, certifying official, and notary public should be three separate
individ//uals.
l~L~~ i~ 2 ~/~-~ O~
` ~ ~ C ~-~ 2?~'
Section II
Page 10 of 19
_ _ _ _ _ __
FY2004-2005 CT Application
FederaUState Certifications
C,4MMUNITY.TRANSPORTATION PROGRAM RESOLUTION 3
RESOLUTION
Applicant Seeking'Pernussion to Apply for Community Transportation Proeram Funding,
Enter Into Agreement With The North Cazolina Department Of Transportation
And to Provide the Necessary Assur s.
A motion was made by (Board Member's Name) ~-
and seconded by (Board Member's Name) '~s~~'""`~,
for the adoption of the following resolution, and upon ing put to a vote was duly dopted.
WHEREAS, Article 2B of Chaptex 136 of the North Carolina General Statutes and the Governor of North Carolina. have
designated the North Carolina Department of Transportation (NCDOT) as the agency responsible for administering federal
and state public transportation funds; and
WHEREAS, the North Carolina Department of Transportation will apply for a grant from the US
Department of Transportation, Federal Transit Administration and receives funds from the North Carolina General Assembly
to provide assistance for rural public transportation projects; and
WHEREAS, the purpose of these transportation funds is to provide grant monies to local agencies
for the provision of rural public transportation services consistent with the policy requirements for planning, community and
agency involvement, service design, service alternatives, training and conference participation, reporting and other
requirements (drug and alcohol testing policy and program, disadvantaged business enterprise program, and fully allocated
costs analysis);
WHEREAS, (Applicant's Name) ~ ~ hereby assures and certifies that it
will comply with the federal and state Statutes, re do ,executive orde ,Section 5333 (b) Warranty, and all
administrative requirements which relates to the applications made to and grants received from the Federal Transit
Administration, as well as the provisions of Section 1001 of Title 18, U. S. C. ~
NOW, THEREFORE, be it resolved that the (Authorized Official 's Title)* d"l ~ fJw~
U t
of (Name of Applicant's Governing Body)
is hereby authorized to submit a grant application for decal and sta funding, make th necessary assurances and
certifications and be empowered to enter into an agreement with the NCDOT to pmvide rural public transportation services.
I (Certifying Official's Name)* ~ t !(~-'C~~/' (~J, ~~,_ (Title) ~/l~{,rB.,t,t._
do hereby certify that the above is a true d correct copy of an excerpt from theminutes of a meeting of
the (Name of Applicant's Governing Board)
duly held on the ~ day of ~~v~+~. , 20~
~~`
Section R
Page 9 of 19
Signature of Certifying (pfficial