HomeMy WebLinkAbout2021-470-E-OPT-FY 2022 Local ShareCertificate-Local share certification for fundingFY 2022 LOCAL SHARE CERTIFICATION FOR FUNDING
Orange County
(Legal Name of Applicant)
Requested Funding Amounts
Project Total Amount Local Share**
Administrative $ $ (20%)
5311 Operating (No State Match) $ $ (50%)
5310 Operating (No State Match) $ $ (50%)
5307 Operating $ 107,602 $ 53,801 (50%)
5307 Planning $ $ (20%)
Combined Capital $ $ (20%)
Mobility Management $ $ (50%)
5310 Capital Purchase of Service $ $ (20%)
__________________ $ $ (__%)
__________________ $ $ (__%)
__________________ $ $ (__%)
Funding programs covered are 5311, 5310, 5339 Bus and Bus Facilities, 5307 (Small fixed
route, regional, and consolidated urban-rural systems)
TOTAL $ 107,602 $ 53,801
Total Funding Requests Total Local Share
**NOTE: Applicants should be prepared for the entire Local Share amount in the event State
funding is not available.
The Local Share is available from the following sources:
Source of Funds Apply to Grant Amount
$
$
$
$
$
$
DocuSign Envelope ID: CCD372F9-6911-42FB-A25A-E93C95EECF4F
FY 2022 Local Share Certificate (page 2)
$
$
TOTAL $
** Fare box revenue is not an applicable source for local share funding
I, the undersigned representing (Legal Name of Applicant) Orange County do hereby certify to
the North Carolina Department of Transportation, that the required local funds for the FY2022
Community Transportation Program and 5307 Governors Apportionment will be available as of
July 1, 2021, which has a period of performance of July 1, 2021 – June 30, 2022.
_________________________________________
Signature of Authorized Official
Chair, Board of Orange County Commissioners
Type Name and Title of Authorized Official
Date
DocuSign Envelope ID: CCD372F9-6911-42FB-A25A-E93C95EECF4F
8/26/2021
FY 2022 LOCAL SHARE CERTIFICATION FOR FUNDING
Orange County
(Legal Name of Applicant)
Requested Funding Amounts
Project Total Amount Local Share**
Administrative $ $ (20%)
5311 Operating (No State Match) $ $ (50%)
5310 Operating (No State Match) $ $ (50%)
5307 Operating $ 223,804 $ 111,902 (50%)
5307 Planning $ $ (20%)
Combined Capital $ $ (20%)
Mobility Management $ $ (50%)
5310 Capital Purchase of Service $ $ (20%)
__________________ $ $ (__%)
__________________ $ $ (__%)
__________________ $ $ (__%)
Funding programs covered are 5311, 5310, 5339 Bus and Bus Facilities, 5307 (Small fixed
route, regional, and consolidated urban-rural systems)
TOTAL $ 223,804 $ 111,902
Total Funding Requests Total Local Share
**NOTE: Applicants should be prepared for the entire Local Share amount in the event State
funding is not available.
The Local Share is available from the following sources:
Source of Funds Apply to Grant Amount
$
$
$
$
$
$
DocuSign Envelope ID: CCD372F9-6911-42FB-A25A-E93C95EECF4F
FY 2022 Local Share Certificate (page 2)
$
$
TOTAL $
** Fare box revenue is not an applicable source for local share funding
I, the undersigned representing (Legal Name of Applicant) Orange County do hereby certify to
the North Carolina Department of Transportation, that the required local funds for the FY2022
Community Transportation Program and 5307 Governors Apportionment will be available as of
July 1, 2021, which has a period of performance of July 1, 2021 – June 30, 2022.
_________________________________________
Signature of Authorized Official
Chair, Board of Orange County Commissioners
Type Name and Title of Authorized Official
Date
DocuSign Envelope ID: CCD372F9-6911-42FB-A25A-E93C95EECF4F
8/26/2021
SECTION 5311, 5310, 5339, Combined Capital, 5307 or State Funds Call for Projects
TITLE VI PROGRAM REPORT
Legal Name of Applicant: Orange County
(Complete either Part A or Part B; and Part C)
Part A – No complaints or Lawsuits Filed
I certify that to the best of my knowledge, No complaints or lawsuits alleging discrimination have been filed against
Orange County Public Transportation (Transit System Name) during the period July 1, 2021 through June 30, 2022.
Signature of Authorized Official Date
Penny Rich, Chair, Board of Orange County Commissioners
Type Name and Title of Authorized Official
Part B – Complaints or Lawsuits Filed
I certify that to the best of my knowledge, the below described complaints or lawsuits alleging discrimination have been file d against Transit System Name)
during the period July 1, 2021 through June 30, 2022.
Complainant Name/Address/Telephone Number Date Description Status/Outcome
(Attach an additional page if required.)
Signature of Authorized Official Date
Type Name and Title of Authorized Official
Part C - Title VI Plan
Do you currently have a Title VI Plan: _____________________ Date of last plan update: ____________________________________
DocuSign Envelope ID: CCD372F9-6911-42FB-A25A-E93C95EECF4F
8/26/2021