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2017-2018 Federal Transit Administration (FTA) Formula Grants for Rural Area Program (Section 5311) Guidance and Application Instructions February 2017

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2017-2018 Federal Transit Administration (FTA)

Formula Grants for Rural Area Program (Section 5311)

Guidance and Application Instructions

February 2017

2017-2018 FTA Formula Grants for Rural Area Program (Section 5311) Guidance and Application Instructions February 2017

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TABLE OF CONTENTS Introduction ..................................................................................................................... 4 

Eligibility and Application Information .............................................................................. 4 

General Program Overview ............................................................................................. 5 

A. Transfers To Eligible Applicant- Certain Small Urbanized Area (SUZA) Recipients ONLY .............................................................................................................................. 5 

B. FTA Charter Service Regulations ............................................................................... 5 

C. FTA Incidental Use Requests ..................................................................................... 5 

D. Information Regarding Grant Agreements and Resolutions ....................................... 6 

General Program Requirements ..................................................................................... 6 

A. Transportation Services Open-to-the-Public ............................................................... 7 

B. Statewide Mass Transportation Operating Assistance (STOA) Program .................... 7 

C. Title VI Civil Rights Act Statement Notice/Posting ...................................................... 8 

D. Transportation Services for Individuals with Disabilities in Accordance with the Americans with Disabilities Act (ADA) ............................................................................. 8 

E. NYSDOT/FTA Purchasing/Procurement Procedures .................................................. 9 

F. Public Notice of Award ................................................................................................ 9 

G. Public Operators and Labor Unions for Special Section 5333(b) Warranty .............. 10 

H. Annual Reports and Audit Requirements .................................................................. 10 

I. Third-Party Contracts ................................................................................................. 11 

Application Evaluation Process ..................................................................................... 11 

Application Submission ................................................................................................. 12 

Application Instructions Overview ................................................................................. 17 

General Information ....................................................................................................... 17 

Completing Part I of the Application .............................................................................. 17 

SHEET 1 - Cover Page ................................................................................................. 18 

SHEET 2 - Operating Budget ........................................................................................ 18 

SHEET 2A - Indirect Cost Worksheet ............................................................................ 24 

SHEET 2B - Detailed Fare Information ......................................................................... 24 

SHEET 3 - Vehicle Request .......................................................................................... 24 

SHEET 3A - Other Capital ............................................................................................. 25 

SHEET 3B - Mobility Management Request ................................................................. 26 

SHEET 3C - In-Kind Match ........................................................................................... 26 

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SHEET 3D - ADPTAP (Appalachian Development Public Transportation Assistance Program) ....................................................................................................................... 26 

SHEET 4 - Current Fleet/Facility Inventory ................................................................... 27 

SHEET 5 - OA, ADP, & SES Apportionments ............................................................... 29 

SHEET 6 - Schedule & Route Guides ........................................................................... 29 

SHEET 7 - Supplemental Information ........................................................................... 30 

Completing Parts II and IIA of the Application ............................................................... 31 

PART A: Applicant Information ..................................................................................... 31 

PART B: Additional Operator Information (Using Part IIA) ............................................ 32 

PART C: Project Funding Request ............................................................................... 33 

PART D: Smart Growth Threshold Questions (for Capital Assistance Funding Requests Only) .............................................................................................................................. 34 

PART E: Coordination Efforts with Locally Developed, Coordinated Public Transit Human Services Transportation Plans .......................................................................... 34 

PART F: Public Participation and Coordination Requirements ...................................... 35 

PART G: Title VI Assurances/Disadvantaged Business Enterprise (DBE) Activities ..... 35 

PART H: Public Operators and Labor Unions for Special Section 5333(B) Warranty ... 36 

PART I: Service Changes ............................................................................................. 37 

PART J: Applicant Affirmations, Certifications, and Assurances ................................... 38 

PART K: FTA Certifications and Assurances, Attorney Affirmation .............................. 39 

PART L: Third-Party Affirmation, Certifications, and Assurances .................................. 40 

APPENDICES ............................................................................................................... 42 

Appendix A: Application Submission Checklist ............................................................. 42 

Appendix B: Public Notice Requirements, Process, and Example ................................ 45 

Appendix C: Local Resolution Example ........................................................................ 48 

Appendix D: Notary Form .............................................................................................. 49 

Appendix E: Third-Party Operating Assistance Agreement ........................................... 50 

Appendix F: NYSDOT Staff Contact Information ........................................................... 52 

2017-2018 FTA Formula Grants for Rural Area Program (Section 5311) Guidance and Application Instructions February 2017

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Introduction

The New York State Department of Transportation (NYSDOT) is seeking Applications for the Federal Transit Administration (FTA) Formula Grants for Rural Area Program (Section 5311). Approximately $32.4 million is available in Federal and State matching funds. This Program enhances access to health care, shopping, education, employment, public services, and recreation, and serves to foster economic growth for people in rural areas by:

Assisting in the maintenance, development, improvement, and use of public transportation systems in rural and small urban areas;

Encouraging and facilitating the coordination of programs and services to ensure the most efficient use of funds;

Assisting in the development and support of intercity bus transportation; and Providing for the participation of private transportation providers in rural transportation to

the maximum extent feasible. Funds may be used for capital and operating assistance for the purpose of supporting public transportation in rural areas, defined as those areas by the US Census with populations of less than 50,000.

Eligibility and Application Information

Only services primarily operating within the boundaries of New York State are eligible for funding. Eligible applicants include those entities that are either eligible for, or are a current recipient of, Statewide Mass Transportation Operating Assistance (STOA) through the New York State Department of Transportation (NYSDOT). Entities include: Counties; Cities; Intercity Bus Operators; Regional Transportation Authorities; or Federally-recognized Indian Tribal Governments.1

This Rural Program Guidance is intended to assist applicants to:

Make informed decisions about their eligibility to apply; Understand the program’s requirements, application evaluation process, available

funding, and required local funding commitments; and Learn about the availability of technical resources.

1 Indian Tribal Governments are also eligible to participate as direct recipients to FTA under the Tribal Transit Program (TTP), Section 5311 (j).

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Application information is available on NYSDOT's website at: https://www.dot.ny.gov/public-transportation/rural-programs/5311/application-material To be considered for funding, the Application must be electronically submitted by April 10, 2017 to [email protected].

General Program Overview

A. Transfers To Eligible Applicant- Certain Small Urbanized Area (SUZA) Recipients ONLY SUZA recipients eligible for this transfer include Broome, Chemung/Elmira, Tompkins, Ulster, Glens Falls, and Watertown. FTA Formula Grants for Rural Area Program (Section 5311) funds will continue to be initiated, and subsequently transferred, by NYSDOT to the urbanized area formula grants program account for SUZA recipients unless NYSDOT is otherwise notified in writing at the time of Application. Fund transfers are initiated by NYSDOT via letter to FTA. NYSDOT will notify each transit provider of the transfer process and the deadline for applying to FTA for funding.

B. FTA Charter Service Regulations FTA regulations provide for clear exemptions and exceptions for transit systems to provide charter service over and above regular schedules. A transit agency may provide charter service with federally funded equipment. However, agencies must follow the required process2 to ensure that any service was properly advertised and other providers were given ample opportunity to submit a proposal. To use an “Exemption“ or “Exception” category as stipulated in 49 CFR 604 an agency must obtain advance approval from NYSDOT. To obtain NYSDOT approval, a sub-recipient must complete and submit the Charter Service Application form “Request to Perform Charter Services with Federally Funded Equipment”.3 This service may or may not be eligible for STOA. Any charter activity must be reported to NYSDOT on the Quarterly Report Form found on the last page of the above form.

C. FTA Incidental Use Requests Incidental use is defined as authorized use of real property (and equipment) acquired with FTA funds for purposes of transit, but which also has limited non transit purposes due to transit operating circumstances. Such use must be compatible with the approved project purposes and

2 The FTA has a Charter Website https://www.transit.dot.gov/regulations-and-guidance/access/charter-bus-service/charter-bus-service. FTA’s Charter Bus Service Rule, which implements 49 U.S.C. 5323(d), protects private charter operators from unauthorized competition from FTA grant recipients. 3 To request approval, complete the “Request for Approval” section at the bottom of page one “Charter Service Application” located at: https://www.dot.ny.gov/public-transportation/rural-programs/5311/forms . See “Appendix A” of the Charter form for definitions and clarifications of “exemptions” and “exceptions”.

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must not interfere with intended public transportation uses of project assets, and must not in any way interfere with the grantee’s continuing control over the use of the property. To that end, any sub-recipient must inform NYSDOT in writing of its request to use FTA acquired property for a purpose other than transit, for NYSDOT’s submission to FTA. Requests for incidental use must contain the following detailed information:

1. Describe the incidental use (space used, purpose): 2. Is the incidental use by a public, private or not-for profit agency? Specify:_______ 3. Does the incidental use interfere with the project or public transportation operations?

Yes__ No__ If Yes, Explain: 4. How much does the incidental use cost (electric, heat, phones, maintenance,

depreciation, etc.) the transit system on an annual basis? 5. How much revenue does the incidental use generate for the transit system on an

annual basis? 6. Are the incidental use revenues used to support public transportation? Yes__ No__

Unless authorized in writing by FTA, incidental use of FTA funded facilities, buses or other equipment is prohibited. FTA will issue their determination of the request to the Applicant in writing upon completion of their review.

D. Information Regarding Grant Agreements and Resolutions Those systems that have existing multi-year "continuing" grant agreement for their FTA Formula Grants for Rural Area Program (Section 5311) operating assistance projects must adopt a new resolution and submit it as part of the Application. This resolution refers to the continuing agreement and authorizes the designated official to sign the current grant Application and progress the projects.

Include a resolution passed by the governing body of your municipality or authority authorizing a designated official to sign the grant Application and take any other steps necessary to advance the project. Use the language from the attached "Model Local Resolution” (Appendix C) for Federal Transit Administration (FTA) Formula Grants for Rural Area Program (Section 5311) Applications for Sponsors with Continuing Agreements." Note that the designated official named in the resolution must be the person to sign the Grant Application cover sheet. Obtain one certified copy of the resolution.

The signature of the designated official must be notarized. Use the attached notarization form (Appendix D) for this purpose. One original is required.

Return the certified resolution and the original notarization with your Application package if possible. Resolution must be received no later than 30 days after the application due date.

General Program Requirements

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Applicants must comply with all applicable local, State, and Federal laws and regulations, including those pertaining to public transportation. These include, but are not limited to:

FTA Certifications and Assurances; FTA Contract Requirements; and NYSDOT Rules and Regulations pursuant to the Transportation Law and Motor Vehicle

Law; a. Title 17 of the New York Codes, Rules and Regulations (NYCRR) as related to

STOA, the Public Transportation Safety Board, Traffic & Safety, and Operating Authority;

b. Title 15 of the NYCRR related to licensing as applicable; and c. Article 19A of the Vehicle and Traffic Law and vehicle registration requirements.

Additionally, Applicants must meet the following requirements:

A. Transportation Services Open-to-the-Public All FTA Formula Grants for Rural Area Program (Section 5311) assisted transportation services must be available to the general public at all times on a regular and continuing basis, and have publicly advertised and posted service hours, which means: No person may be denied access to a FTA Formula Grants for Rural Area Program

(Section 5311) funded service; All persons must be provided an equal opportunity to access services and programs; The availability of the service to the general public must be advertised on a regular and

frequent basis; The service must publicly post its hours of operation, availability to all, routes, reservation

system and fares; and The service may not be restricted or operated so as to discriminate against anyone on the

basis of race, color, creed, national origin, sex, age or disability. Service provided under contract to a social service agency will generally be considered public transportation, not charter service, if the service is under the control of the Applicant, is open door, and the Applicant can put any rider on the vehicle in addition to the agency’s clients.

B. Statewide Mass Transportation Operating Assistance (STOA) Program

In order to be eligible for the STOA program, the service must be open and marketed to the general public, charge a fare, and be provided with vehicles capable of carrying 15 or more passengers. An exception to use 8-14 passenger vehicles may be granted on a case-by-case basis. Only municipalities are eligible to receive STOA funds.

To initiate STOA, a letter of intent from the municipality is sent to the NYSDOT Public Transportation Bureau indicating sponsorship of public transportation services for STOA. This is followed by a signed 119R agreement between the municipality and the third-party operator, if the municipality is not providing the service directly.

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Revenue vehicle miles and individual passenger counts must be kept for STOA reporting purposes. Quarterly statistics must be reported to NYSDOT via the municipality by the 17th of January, April, July & October following the end of a quarter.

Operators receiving STOA must also maintain accounting books and records in accordance with NYSDOT's prescribed Uniform System of Accounts and file annual reports with the Department.

Part 975 of NYCRR details all STOA program requirements. NYSDOT’s website provides the STOA Rules and Regulations. Each Applicant is responsible for ensuring that the service provided, whether provided by the municipality itself or by a third party contractor, is in compliance with the STOA program.

C. Title VI Civil Rights Act Statement Notice/Posting A statement regarding the public’s rights under Title VI of the Civil Rights Act must be posted anywhere the public may frequent, including on vehicles and schedules, to ensure the public’s awareness of their rights. An example of a notice/posting is provided in the box below.

In addition, recipients are reminded of their obligations to comply with USDOT's DBE regulations when there are contracting opportunities using federal funds.

D. Transportation Services for Individuals with Disabilities in Accordance with the Americans with Disabilities Act (ADA) Recipients of federal funds should be familiar and comply with the criteria contained within the ADA4 pertaining to Transportation Services for Individuals with Disabilities. If you provide Fixed Route services, then you must provide Complimentary Paratransit to Fixed Route services (FR). Paratransit services can be limited to ¾ miles from the FR and at times when the FR services

4 For more information on meeting ADA requirements in public transportation service, download the “Demand and Paratransit Plan Guidance Document” at https://www.dot.ny.gov/divisions/policy-and-strategy/public-transportation/ada. Additional FTA guidance and ADA regulations are found at: http://www.fta.dot.gov/civilrights/12325.html

CIVIL RIGHTS STATEMENT

The (ENTER YOUR PROGRAM NAME HERE) is committed to providing non-discriminatory service to ensure that no person is excluded from participation in, or denied the benefits of, or be subjected to discrimination in the receipt of its services on the basis of race, color, or national origin as protected by Title VI of the Civil Rights Act of 1964 ("Title VI"). To request additional information about Title VI, or if you believe you have been subjected to discrimination and would like to submit a written complaint, you may contact: (ENTER YOUR SPECIFIC CONTACT INFORMATION HERE)

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are in operation and charge up to twice the normal fare. A copy of an approved Paratransit plan must be continuously on file with NYSDOT. As an alternative to operating FR and Paratransit services, recipients may operate Demand Response (DR) services, which can include Route Deviation (RD), Point Deviation (PD) or Dial-A-Ride (DAR) services. These types of services offer a hybrid demand service from a FR service to ALL riders regardless of ability to ride; there are no exceptions to this requirement. Deviation distances are defined for RD and PD services and all require a call in advance to arrange for pick up. Deviations on RD and PD service can charge up to twice the normal fare.

E. NYSDOT/FTA Purchasing/Procurement Procedures Applicants intending to purchase/procure transportation services or capital items must follow NYSDOT’s Procurement Policies and Procedures and Procurement Checklist. NYSDOT approvals must be received throughout the procurement process to ensure the project is eligible for FTA reimbursement. Advertising for competitive proposals for new or significantly expanded services, or equipment is required. Proposals (if any) from private, for profit companies to operate or provide services should be evaluated carefully, on a fully allocated cost basis. Applicants must respond to any proposals received. Failure to comply with procurement rules may result in loss of funding.

F. Public Notice of Award To the extent feasible, governmental agencies and nonprofit organizations receiving assistance from other Federal agencies for non-emergency transportation services must participate and coordinate with FTA recipients in the design and delivery of transportation services and be included in the planning for those services. This requirement must be taken into consideration when planning your service(s). FTA requires public transit systems funded under the FTA Formula Grants for Rural Area Program (Section 5311) to participate in their local planning process for coordinated public transit-human service transportation. To satisfy this requirement, the Applicant must publish their intent to apply for this funding and seek comments from the community of providers and the general public. To ensure that adequate time is allowed to address any public comments within the required timeframe, NYSDOT recommends that applicants issue the required Public Notice as soon as the maximum amount of federal funds being applied for is identified. To estimate the amount of funds to apply for, use the maximum federal operating apportionments provided and add the federal share of capital or other items contemplated in the Application. Estimates should be as accurate as possible. FTA requires that any Public Notice be equal to or greater than the actual Application amount. If the published federal amount is lower than the final Application request amount, re-issuance of the Public Notice will be required with the corrected amount listed. Within fifteen (15) calendar days, applicants must respond in writing to all substantive comments received from the public, private bus or taxi companies, public transportation operators or human service agencies. Substantive comments include those that request more information, service coordination or are submitting proposals for the service. A public hearing

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may be requested in response to the public notice. If a public hearing is held, a copy of the hearing record must be provided with the Application. Applicants must also respond to significant comments from the general public. Any requests for copies of project service descriptions from private bus and taxi companies must be filled promptly. In such cases, an additional fifteen calendar days from the date a private operator receives the project service description for a proposal to be received must be allowed. The Public Notice must be published before the Application due date. The Application requires proof of the published information by including the actual advertisement and the affidavit from the publishing agency that the information was published. Any comments on the Public Notice must be provided within 40 days after the Application due date. A sample Public Notice and the steps necessary to complete the Public Notice process are found in Appendix B.

G. Public Operators and Labor Unions for Special Section 5333(b) Warranty Section 5333(b) is the Labor Protection provision required under Federal law. Its purpose is to protect the employees of public transportation operators who may be affected by federally funded mass transportation projects. Section 5333(b) covers both "unionized" and "non-unionized" operators of public transportation services. The United States Department of Transportation (USDOT) and the United States Department of Labor (USDOL) have developed a Special Warranty and Model Agreement which establishes procedures designed to protect employees from being adversely affected by a project using federal mass transportation funds. Agreement to the terms and conditions of the 5333(b) Warranty and Model Agreement by the Applicant or a granting of a waiver of the 5333(b) requirements for the project by the USDOL is required before FTA Section 5311 Rural Program funds may be released for a project.

H. Annual Reports and Audit Requirements The Federal Single Audit covers all 5311 funds received by an agency for a given year including Operating and Capital funds. The Federal Single Audit5 must be submitted to: https://harvester.census.gov/facweb/. Additionally, an Annual Report is required for operating projects only. The Annual Report determines the actual costs of the FTA Formula Grants for Rural Area Program (Section 5311) operating budget and the amount eligible for federal reimbursement. The amounts shown in the Application budget should be the best estimates available at the time, but they are, nevertheless, only estimates. The actual amount of the FTA Formula Grants for Rural Area Program (Section 5311) funds to be received for an operating project may differ significantly from that shown in the Application, depending upon the results of the final audit. Applicants are advised that approval of an Application does not constitute a commitment by the State to pay the estimated amount of the FTA Formula Grants for Rural Area Program (Section 5311) funds shown in the Application.

5 For more information about Federal Single Audits, visit NYSDOT’s web page at: https://www.dot.ny.gov/main/business-center/audit/local-project-audits

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The Annual Report, certified by the Applicant’s Chief Financial Officer (CFO), must be submitted following the close of each fiscal year. This report will be sent to the Applicant on a separate schedule based on the Applicant’s reporting year cycle, and follows a similar format to the Application budget. Payment for the current fiscal year cannot be made until NYSDOT approval of the prior fiscal year’s Annual Report. Regional Transportation Authorities and other Urban systems required to file a “17-A” report have the option of completing the “Form G-1" Certification (included with the 17-A package) in place of the FTA Formula Grants for Rural Area Program (Section 5311) Annual Report. A copy of the certified Annual Report must also be forwarded to the auditor completing the required Federal Single Audit for a local government Applicant or an independent audit of any other Applicant.

I. Third-Party Contracts Eligible applicants that contract with private operators for service through a “purchase of service contract” are encouraged to use the model third-party contract and third-party lease and service contract for the FTA Formula Grants for Rural Area Program (Section 5311). The instructions and link to the document are found in Appendix E. If the Applicant has an existing boilerplate contract process it must include all of the provisions of the model contract in the agreement. Contracts involving the FTA Formula Grants for Rural Area Program (Section 5311) funds must be approved in writing by NYSDOT before the contract begins.

Application Evaluation Process Informational Sessions NYSDOT will be conducting informational sessions (webinars) for all eligible applicants interested in applying for funding under the 2017-2018 FTA Formula Grants for Rural Area Program (Section 5311). Pre-registration for these sessions will be required. In order to be considered for funding from this solicitation, all applicants must attend an Informational session (webinar). Pre-Application Review Process (Optional) In addition to the Informational Sessions, a pre-Application Review period will be made available to all interested applicants. This process allows applicants to get help directly with application questions. Email to the solicitation address at: [email protected] and your question will be assigned to a staff person for a direct and timely response. During the pre-application review process, questions will also be summarized and published through a weekly Frequently Asked Questions (FAQ’s) publication on the website. Participation in the pre-Application Review Process is optional. The pre-Application Process will close on March 20, 2017 and no further direct pre-application assistance will be offered. Questions may still be submitted through the email above after March 20, 2017 and will be answered in the weekly FAQ publication.

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Application Submission To ensure timely consideration for funding under this solicitation, it is the applicant’s responsibility to submit a complete and accurate application (Parts I, II and IIA (if applicable)), providing supporting documentation as needed. All Applications received by the deadline will be reviewed for eligibility and completeness. Only those Applications that are eligible, complete, and timely will be evaluated in this process using the criteria described below. Applications that are excluded from this solicitation review may be re-submitted at the time of the next solicitation. Evaluation Process In administering the Section 5311 program, the Department will give preference to public transportation projects that eliminate transportation barriers as well as improve mobility opportunities in rural areas; encourage and support increased coordination of public transportation services with other human service agency provided transportation services; and ensure a successful Intercity Bus program, which promotes the participation of private providers in both the development and provision of rural public transportation services. Using one Application, applicants may submit requests for funding for one or more of the following project types: Operating Assistance, Capital Vehicle, Capital Other, and Mobility Management. Evaluation Criteria Each project type will be scored separately in five equally weighted categories as described below. Each project type is eligible to receive a score of up to 100 points. Project types will be scored and ranked within these separate groups. To ensure timely consideration for funding under this solicitation, it is the applicant’s responsibility to submit a complete and accurate application (Parts I, II and IIA (if applicable), providing supporting documentation as needed. All Applications received by the deadline will be reviewed for eligibility and completeness. Only those Applications that are eligible, complete, and timely will be evaluated further. To assist applicants with providing a responsive Application, the following evaluation criteria should be considered by each applicant. Project Type: Operating Assistance Proposed Budget: (up to 20 points)

Demonstrated balanced budget Reasonableness of proposed budget Eligible for state and federal funding

Systems Efficiencies: (up to 20 points)

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Demonstrated current efficiencies implemented in the last 24 months (examples included by applicant)

Proposed improvements to existing efficiencies (proposed timeframe included) o Improvement to modal connections o Improvement to employers, medical, education and other trip destinations o Improvement to customer/trip generator locations o Improvement to overall safety o Improvement to employee benefit program

Reasonableness of current and proposed efficiencies and impact on operation Innovation and Enhancements: (up to 20 points)

Demonstrated recent innovations and enhancements instituted in the last 24 months and/or innovations and enhancements planned for the next 24 months (detailed description to be included in application by applicant).

Proposed project has unique characteristics, consideration of new approaches and/or use of innovative techniques to better serve the public, to solve a problem or issue, a look ahead at what the future may bring to the area or in the transit industry.

Inclusion of cost-effective solutions and/or creative/innovative ways to deliver the project/service.

Inclusion of means to complement Federal funding through new or improved partnerships/other fund sources/etc.

Reasonableness of recent and proposed innovations. Economic Impact/Community Benefits: (up to 20 points)

Demonstrated ways the project/service will benefit the community o Demographic which will benefit from the project/service.

Reasonableness of proposed community benefits. Demonstrated positive impact on the community’s economy

o Current negative impact that will be reversed, minimized, corrected. o Reasonableness of details describing project’s effect on area economy.

Inclusion of any possible negative economic impact on the community and how it will be addressed

Applicant’s Ability to Manage/Deliver the Project: (up to 20 points)

Reasonableness of project /service scope and schedule. If an existing project, reasonableness of applicant’s management of the program and

funding in the last five years (detailed description to be included in application by applicant). If project is new, reasonableness of past performance with a similar project(s) within the last five years (Applicant provides descriptive examples of how previous successful management of projects relates to the proposed project).

Compliance with all requirements of the program currently Historically complies with all requirements on a timely basis

Project Type: Capital Vehicle Proposed Budget: (up to 20 points)

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Reasonableness of proposed budget Complete request & reasonableness of need Eligible for federal funding and state match

Systems Efficiencies: (up to 20 points)

Demonstrated current efficiencies (examples included) Proposed improvements to existing efficiencies (proposed timeframe included)

o Improvement to modal connections o Improvement to overall safety

Reasonableness of current and proposed efficiencies Innovation and Enhancements: (up to 20 points)

Demonstrated recent innovations and enhancements instituted in the last 24 months and/or innovations and enhancements planned for the next 24 months (detailed description to be included in application by applicant).

Inclusion in the project of unique characteristics, consideration of new approaches and/or use of innovative techniques to better serve the public, to solve a problem or issue, a look ahead at what the future may bring to the area or in the transit industry.

Inclusion of cost-effective solutions and/or creative/innovative ways to deliver the project. Inclusion of means to complement Federal funding through new or improved

partnerships/other fund sources/etc. Inclusion of innovations planned for the next five to ten years. Reasonableness of recent and proposed innovations.

Economic Impact/Community Benefits: (up to 20 points)

Demonstrated ways the project will benefit the community o Demographic which will benefit from the project/service.

Reasonableness of proposed community benefits. Demonstrated positive impact on the community’s economy

o Current negative impact that will be reversed, minimized, corrected. o Reasonableness of details describing project’s effect on area economy.

Inclusion of any possible negative economic impact on the community and how it will be addressed

Applicant’s Ability to Manage/Deliver the Project: (up to 20 points)

Reasonableness of project scope and schedule. If an existing project, reasonableness of applicant’s management of the program and

funding in the last five years (detailed description to be included in application by applicant). If project is new, reasonableness of past performance with a similar project(s) within the last five years (Applicant provides descriptive examples of how previous successful management of projects relates to the proposed project).

Project Type: Capital Other Proposed Budget: (up to 20 points)

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Reasonableness of proposed budget Complete request & reasonableness of need Eligible for federal funding and state match

Systems Efficiencies: (up to 20 points)

Demonstrated current efficiencies (examples included) Proposed improvements to existing efficiencies (proposed timeframe included) Reasonableness of current and proposed efficiencies

Innovation and Enhancements: (up to 20 points)

Demonstrated recent innovations and enhancements instituted in the last 24 months and/or innovations and enhancements planned for the next 24 months (detailed description to be included in application by applicant).

Inclusion in the project of unique characteristics, consideration of new approaches and/or use of innovative techniques to better serve the public, to solve a problem or issue, a look ahead at what the future may bring to the area or in the transit industry.

Inclusion of cost-effective solutions and/or creative/innovative ways to deliver the project. Inclusion of means to complement Federal funding through new or improved

partnerships/other fund sources/etc. Inclusion of innovations planned for the next five to ten years. Reasonableness of recent and proposed innovations.

Economic Impact/Community Benefits: (up to 20 points)

Demonstrated ways the project will benefit the community o Demographic which will benefit from the project/service.

Reasonableness of proposed community benefits. Demonstrated positive impact on the community’s economy

o Current negative impact that will be reversed, minimized, corrected. o Reasonableness of details describing project’s effect on area economy.

Inclusion of any possible negative economic impact on the community and how it will be addressed

Applicant’s Ability to Manage/Deliver the Project: (up to 20 points)

Reasonableness of project scope and schedule If an existing project, reasonableness of applicant’s management of the program and

funding in the last five years (detailed description to be included in application by applicant). If project is new, reasonableness of past performance with a similar project(s) within the last five years (Applicant provides descriptive examples of how previous successful management of projects relates to the proposed project).

Project Type: Mobility Management Proposed Budget: (up to 20 points)

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Reasonableness of proposed budget Complete request & reasonableness of need Eligible for federal funding and state match

Systems Efficiencies: (up to 20 points)

Demonstrated current coordination efficiencies (examples included) Proposed improvements to existing coordination efficiencies (proposed timeframe

included) Reasonableness of current and proposed coordination efficiencies

Innovation and Enhancements: (up to 20 points)

Demonstrated recent innovations and enhancements instituted in the last 24 months and/or innovations and enhancements planned for the next 24 months (detailed description to be included in application by applicant).

Inclusion in the project of unique characteristics, consideration of new approaches and/or use of innovative techniques to better serve the public, to solve a problem or issue, a look ahead at what the future may bring to the area or in the transit industry.

Inclusion of cost-effective solutions and/or creative/innovative ways to deliver the project. Inclusion of means to complement Federal funding through new or improved

partnerships/other fund sources/etc. Inclusion of innovations planned for the next five to ten years. Reasonableness of recent and proposed innovations.

Economic Impact/Community Benefits: (up to 20 points)

Demonstrated ways the project will benefit the community o Demographic which will benefit from the project/service.

Reasonableness of proposed community benefits. Demonstrated positive impact on the community’s economy

o Current negative impact that will be reversed, minimized, corrected. o Reasonableness of details describing project’s effect on area economy.

Inclusion of any possible negative economic impact on the community and how it will be addressed

Applicant’s Ability to Manage/Deliver the Project: (up to 20 points)

Reasonableness of project scope and schedule If an existing project, reasonableness of applicant’s management of the program and

funding in the last five years (detailed description to be included in application by applicant). If project is new, reasonableness of past performance with a similar project(s) within the last five years (Applicant provides descriptive examples of how previous successful management of projects relates to the proposed project).

Project Award Responsive, eligible projects will be recommended for award based upon rank and scoring of project applications and subject to funding availability.

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Projects are recommended by NYSDOT for FTA approval through a grant application process in the Federal grants system. Applicants are notified in writing of project approvals and projects are then included in a master contract agreement or supplemental agreement. These agreements are subject to approval by the Office of the New York State Attorney General and the Office of the New York State Comptroller before project funding is available for reimbursement to awardees.

Application Instructions Overview

General Information Please review these instructions, and the Application in full prior to completing the Application. Completed Applications received by the deadline and in compliance with the established Application Evaluation Process section shall be evaluated with funding eligibility determined. If Application advances to award, the Application shall be used as the basis of the project scope in the contract. A successful Application is comprised of the following:

Operating project scheduled for completion within proposed time frame. Capital projects, including construction, scheduled for completion within 24 months

of contract award. Application parts are all inter-related - Applicants should ensure the parts complement

each other and do not offer conflicting information. The Application has three Parts:

Part I is an Excel spreadsheet that contains 12 (twelve) Sheets and four sub-forms for the actual operating budget. This portion of the Application collects detailed budget and operating information.

Part II is an Adobe pdf-fillable form used to collect data about the Applicant, Operators, summary budget information, and addresses questions related to program requirements.

Part IIA is intended for use only by applicants that have greater than 4 (four) Operators, or for those that need additional space to report Operator information.

Completing Part I of the Application Part I of the Application is an Excel workbook with multiple Worksheets (Sheets) as described below. Each Sheet requires the Applicant to provide information relative to budget requests for operating assistance, vehicles and other capital, mobility management and the Appalachian Development program. Part I of the Application is used to develop the FTA grant, contracts with awarded applicants, and to supply information for further program development. The Part I FTA Formula Grants for Rural Area Program (Section 5311) Application must be submitted electronically. In Part I, each Sheet has boxes that are shaded and color-coded as follows:

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WHITE boxes - Applicants are required to fill-in those boxes with all appropriate data. Enter Zero “0” in all boxes that do not require an entry to ensure the box was not accidently missed. RED boxes- Applicants are required to fill-in those boxes with all appropriate data. YELLOW boxes (subtotals) – Data is pre-populated and is formula-driven. Applicants do not need to make any entries. GREEN boxes (worksheet subtotals) – Data is pre-populated and is formula-driven. Applicants do not need to make any entries. Fields marked “OTHER” require a description of the resource. All pages must be completed.

SHEET 1 - Cover Page Enter the name of the Applicant, and all Operators. It is important to list the Applicant and all Operators on Sheet 1 to make sure that the names roll to the subsequent corresponding Operator Sheets. After Sheet 1A is complete, sign Sheet 1B. Scan a copy of this signature page and submit it electronically with the Application.

SHEET 2 - Operating Budget Sheet 2 is a roll up of Operator 1, 2, etc., and is locked and may not be modified. Operator 1, 2, 3, 4 – Operating Budgets Section 1 1 - This section fills in automatically from Sheet 1. 2 – Operating Expenses. Only eligible public mass transportation operating expenses can be included. The following categories of expenses are eligible for FTA Formula Grants for Rural Area Program (Section 5311) assistance, provided that auditable records are kept for each expense:

a. Transit Management Salaries and Wages, for which auditable project time records are maintained. These are personal service expenses (salaries and wages) of management personnel directly incurred in managing or supervising the transit operations. Salaries and wages for clerical or secretarial personnel may also be included. Indirect or overhead expenses (costs that are not direct costs of transit operations) should not be included here on line “a”, those expenses are addressed on line “q” see instructions below.

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b. Operating Personnel Salaries and Wages, for which auditable project time records are kept.

c. Vehicle Maintenance Salaries and Wages, for which auditable project time records are

kept.

d. Total Wages and Salaries (no entries required)

e. Fringe Benefits. Include fringe benefits for all personnel costs here

f. Total Salaries, Wages, and Fringe (no entries required)

g-k. Fuel & Lubricants, Parts and Repairs, Other Materials and Supplies, Transit Utilities and Leases, Vehicle and Other Insurance.

Auditable expenses in these categories for which cost records are maintained. Garage expenses that are incurred by or through the sharing of facilities or equipment (such as town garage expenses where the garage is used by transit system and non-transit system vehicles) should be pro-rated and reported here. If a pro-rating of such shared expenses is necessary, a separate statement must be attached to this budget that explains in detail the basis for the pro-rating. Clearly mark this and include as a digital attachment.

l. Purchase of Transportation Service Agreements/Contracts. The worksheet in Section 2,

item 1 should be completed for this category only if a third party operator is used under a purchase of service agreement or contract. If such contract expenses are included, a copy of the contract must be attached to this Project Budget that details the following:

The basis of selection of the operator; The term of the contract; A detailed calculation showing the basis for determining the contract cost.

m. Marketing, Advertising and Printing. These are auditable expenses for marketing and

advertising of the transit services and printing of schedules or special flyers. Expenses associated with enhancing a vehicle exterior are not eligible operating expenses and should be included in the capital request.

n. Other Contracted Services. These are auditable expenses that are necessary to run the

service but do not fall into the bus or facility category. These can include services for uniforms, cleaning, etc.

o. Audit Fee. These are auditable records that are for the explicit review of the mass

transportation financial records to produce an annual report or other information necessary to satisfy the sponsor’s financial reporting mechanisms. If the transit portion of the audit is pro-rated, this should be explained in a separate attachment.

p. Other Operating Expenses. These should be auditable and itemized and may include

such items as supplies, training, depreciation on property or equipment purchased without federal assistance; interest and other financial costs associated with borrowing

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to provide working capital for the payment of current operating expenses, etc. The worksheet on Section 2, item 2 should be completed for this item.

q. Indirect Expenses. Indirect expenses claimed (costs that are not direct costs of transit operations) must be submitted to your cognizant federal agency (CFA) with no findings on their part and detailed in an attached Cost Allocation Plan (CAP). The name of approving CFA is to be placed in its associated location on “Sheet 2A -Indirect Cost Worksheet” page of the spreadsheet. If Indirect Costs are claimed on Line 2q but not supported by a CAP, or approved by the CFA costs will be disallowed.

Ineligible expenses include: Depreciation of buildings, property or equipment purchased with government funds; provisions for income tax; charitable contributions or donations; interest expense on long-term borrowing or debt retirement; entertainment expenses; fines and penalties; contributions to capital reserve funds; and contra-expenses. Non-mass transportation expenses include services defined as ineligible for STOA, such as: exclusive airport services, special charter operations, exclusive school bus operations, transportation services provided by client agencies that are designed only to meet the specific needs of their clients, sightseeing services, deadheading, hotel contract services, van service, services to primarily serve gambling casinos or bingo parlors, services commonly known as “invalid coach service” or “ambulette” services or services on routes or trips not available to the general public. If the total transportation service includes ineligible expenses under the FTA Formula Grants for Rural Area Program (Section 5311), these expenses and income should be carried in separate accounts. If the operator does not maintain a separate accounting of such non-mass transportation expenses, then a statement must be attached to the project budget detailing how the eligible mass transportation expenses are segregated from the non-mass transportation expenses. 3 – Total Expenses This YELLOW box is formula driven and requires no entry. Percent Expenses for Supportive Employment Services (SES). If you have an allocation for SES funding, you are eligible to apply for it to help defer costs associated with meeting the newest employment related service in your area. Fill in the RED box with a percentage of your services that support employment trips and provide supplemental documentation in Sheet 7 to describe how you arrived at the percentage calculation. 4 – Revenues From Transit Services (STOA-Eligible)

a-b. Fare Paying Passengers & Fares Collected.

Include the number of boarding passengers who directly pay a fare and the total amount of revenue collected from those passengers. Revenues should include fares collected from any special reduced fares, discount fares, subscription fares, etc., provided that the

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passengers pay the fare themselves. Any money from on-board donations should be included as part of item 7b.

c-d. Third Party Passengers and Reimbursement

This GREEN box is formula driven and requires no entry. The worksheet on Section 2, item 3 should be completed for this item. When a reimbursement or contribution by a third party is made to the transportation operator for STOA eligible transportation, and the amount reimbursed is on an auditable per-passenger basis, the appropriate information should be shown here. Refer to the STOA rules and regulations for the definition of “Revenue Passenger.”

5 – Allowance for Profit Only public transportation services provided by private, for-profit operators, for which a fare is charged, may include amounts in this item. If an allowance for profit is included in a third-party purchase of service contract under item 2f, enter zero. 6 – Net Operating Deficit This calculation will be automatically generated, and is used in the calculation of the maximum FTA Formula Grants for Rural Area Program (Section 5311) amount payable. 7 – Other Subsidies and Revenues

a. Auxiliary Transit Revenues. These are revenues obtained directly from the operation of the transportation services exclusive of fares or special fares and which are used to cover the operating expenses of the service. Examples of auxiliary revenues are: baggage, package or mail revenues, income from advertising, and income from transit station and vehicle concessions and leases. Auditable records of such auxiliary revenues must be kept.

b. Voluntary Donations. These are revenues obtained from passengers over and above the

normal boarding fare. If Third-Party reimbursed riders claimed in 4c are also adding extra money in the farebox upon boarding, this revenue must be reported here to reflect the proper net operating deficit.

c. Contract Revenue. This is contracted subsidy or revenues received from agencies that

is not on a per-passenger reimbursement basis and not included in 4d. Generally, this would be an amount which is not directly tied to a specific number of passengers. SECTION 2, item 4 should be completed for this item.

d. STOA18-b. This line is used for the STOA for the project period that requires a matched

payment by the locality.

e. STOA Dedicated Tax Funds. This line is used for STOA funds not requiring match.

f-g. Local Funds Required To Match STOA 18-B. State law requires that local recipients of NYSTOA match a portion of the STOA payments. The amount shown must equal the amount in item 7.d. and the source of the funds (local government or third party

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operator) must be shown. The “Sources of Local Match” SECTION 3 (O) Operational Information should be completed for this item.

h-l. Other Revenue Sources. These items are for Federal, State, Local and Third Party

revenues which are used in this budget. It may include Section 5307, CST/TANF, JARC, RTAP, or other funds. The FTA Formula Grants for Rural Area Program (Section 5311) allocation is meant to help close the gap between the Net Operating Deficit, less any subsidies and revenues, including STOA and other revenues, which are available to the system. Any shortfall remaining between the total revenues/subsidies applied to the project and the FTA Formula Grants for Rural Area Program (Section 5311) allocation must be met by other sources in order to show that the public transit system can support the operational goals of the system and that the proper funds are applied to the project. Be aware that auditable records must be available for any local dollars committed here. SECTION 2, item 5 should be completed for these items.

m. This is electronic, therefore it will be automatically calculated. 8 – Unfunded Deficit

This entry will be automatically generated. This is calculated by subtracting Total Revenue and Subsidies (7.m.) from the Net Operating Deficit (6). Note that if the unfunded deficit for 2017 or 2018 is greater than the FTA Formula Grants for Rural Area Program (Section 5311) allocation, then additional revenue must be included to reduce the unfunded deficit to no more than the FTA Formula Grants for Rural Area Program (Section 5311) allocation. 9 – Preliminary Maximum Amount of 5311 Funds Payable This entry will be automatically generated. The FTA Formula Grants for Rural Area Program (Section 5311) allocation will be carried forward from the Formula Calculation box at the bottom of SECTION 2. Note that the allocation is the preliminary maximum amount payable. The final maximum amount of FTA Formula Grants for Rural Area Program (Section 5311) payable is the least of: a. 50% of the Net Operating Deficit; b. the 5311 allocation; or c. the unfunded deficit, as shown in the Formula Calculation box at the bottom of SECTION 2. The maximum payable may be less than the FTA Formula Grants for Rural Area Program (Section 5311) allocation due to higher revenues or lower expenses than anticipated or by overpayments from prior years. Prior year overpayments can be subtracted from the amount payable for the year or carried forward to the next year. 10 – Surplus/Deficit In the “ideal” budget, the unfunded deficit and the FTA Formula Grants for Rural Area Program (Section 5311) allocation are equal. If the unfunded deficit is greater than the allocation, then additional revenues must be included in Item 7 to show a balanced budget. If the unfunded deficit is less than the allocation, review the budget to ensure that all eligible expenses have been included and that all subsidies and revenues identified in item 7 are necessary to the project. The result of the latter situation where you are not eligible for all of the FTA Formula Grants for Rural Area Program (Section 5311) means that the next FTA Formula Grants for Rural Area Program (Section 5311) payment will subtract that amount.

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Section 2 1-6 All of the green filled boxes on page 1 are populated by filling in the white boxes in these areas. 7 – Formula Calculation for Maximum 5311 Funds. No entry is required. 8 – Maximum Amount of 5311 Funds Available 5311 Allocation Requested must be filled in Section 2, Line 170 of the spreadsheet. See Sheet 5 for FTA Formula Grants for Rural Area Program (Section 5311) Allocation. SES Apportionments, if applicable, are calculated based upon the information provided in line C23 of Section 1. Section 3 Fare Information - Space is provided for the breakdown of fares by type and by year. If you have changed your fare or intend to do so, provide additional information. Use “Other category for discounted fares or other passes. Method of Calculating Passenger and Miles - Indicate what methods are used to calculate passengers and miles for STOA and non-STOA eligible service. An Entry Must Be Made. Peak & Total Fleet Information - Space is provided for the breakdown of the fleet by type of service (see definitions on “Fleet Composition Sheet”). Ridership, Miles and Hours - Space is provided for the breakdown of each statistic by type of service (see definitions on “Fleet Composition Sheet”). Enter Number of Employees - (any employee directly involved in transit) - Space is provided here for reporting the number of employees directly involved in transit operations, including administrations, maintenance, and operations Safety Data - Space is provided here for required reporting of reportable Incidents, Fatalities, and Injuries. This is applicable only to Annual Reports submittals and should be collected by you over the course of each year.

Total Incidents (Fatality, Injury, or property damage $25,000 or greater for each occurrence) Definition: A collision, derailment, fire, hazardous material spill, act of nature (Act of God), evacuation or Other Safety Occurrence Not Otherwise Classified (OSONOC) occurring on transit-controlled property

Total Fatalities (Loss of Life for each occurrence). Definition: A death or suicide confirmed within 30 days of a reported incident. This does not include deaths in or on transit property that are a result of illness or other natural causes.

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Total Injuries (Requires immediate medical attention for each occurrence). Definition: Any physical damage or harm to persons as a result of an incident that requires immediate medical attention away from the scene.

SHEET 2A - Indirect Cost Worksheet If an agency wishes to claim indirect costs directly applicable to a transportation budget they may do so on this Sheet. Indirect costs, as defined in 2 CFR Part 225, are costs that are:

(1) Incurred for a common or joint purpose benefiting more than one cost objective; and

(2) Not readily assignable to the cost objectives specifically benefited, without effort disproportionate to the results achieved; and (3) Originating in the grantee department as well as those incurred by other departments in supplying goods, services, and facilities to the grantee department. Indirect costs are an eligible expense if all criteria have been met and a cognizant federal agency (or equivalent) has signed off.

See Sheet 2A for examples of indirect costs.

SHEET 2B - Detailed Fare Information The percentage of fare paying products will be automatically calculated based on the breakdown of product types and the numbers the Applicant provides.

SHEET 3 - Vehicle Request The Vehicle Request Sheet must be filled out completely as described in 2-Project budget below. Incidental use of FTA funded equipment is prohibited unless approved by FTA. See instructions on Pages 4-5 if you need to request approval for incidental use of FTA funded equipment. 1 – Heading. The heading includes the sponsor and operator(s) pre-populated from cover page, and instructions for completing the form. 2 – Project Budget This is a budget summary of the vehicles being requested in this Application. The Federal share of the project(s) will be 80%. Select from the drop down menus in each Vehicle Request Number row/cell the vehicle request description, service type, new or replacement, and procurement method. Fill in the quantity, cost per vehicle and VINs of vehicles being replaced in each row. The resulting project budget will self calculate as a result of prior entries and requires no action. The “Source of the Local Share” must be selected from the drop down menu.

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Vehicle estimated costs are provided on the Sheet for reference. The request should be based on vehicles needed in the next two years. The NYSDOT Section 5311 Equipment Disposition and Spare Vehicle Policy should be consulted for guidance on useful life and disposal of vehicles

SHEET 3A - Other Capital The capital budget must be filled out completely as described in 2-Project Budget and 3-Planning and Placement below. Attach additional documentation to support your application if you need additional space. 1 – Heading The heading includes the sponsor and operator(s) pre-populated from cover page, and instructions for completing the form. 2 – Project Budget This is a budget summary of the other capital being requested in this Application. The Federal share of the project(s) will be 80%. Use the table that begins with “Request 1” to make requests. Complete all cells in each Request. If the request is for replacement/rehabilitation provide the age/condition and if FTA funding was used to purchase the asset. Some cells are equipped with drop-down selections while others require text entry. The resulting project budget will self calculate as a result of prior entries and requires no action. The “Source of the Local Share” must be described in detail. This form also accommodates each type of other capital equipment being requested. The request should be based on other equipment needed during the next two years. 3 – Planning and Placement The planning and placement of items such as facilities, shelters, signs, equipment and other passenger amenities requires pre-planning and placement identification prior to approval. Use this section as both a reference and as a place to document your placement intentions. Below are suggested checklist items to consider pertaining to planning and/or placement of capital purchase requests. Review Zoning Policy and Procedures

Passenger Considerations/Amenities

Placement

Identified Transit Amenity Locations

Benches Placement Near Bus Stops/Roadway

Transit Route(s) Affected Vending Curb Clearance Residential, Commercial, Industrial Need

Fare Purchasing Machines Neighboring Property Owners

Peripheral Projects to be Assessed

Trash Receptacles Parking Restrictions (car & bike)

Development Plans Lighting Driveways/Signage

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Review Zoning Policy and Procedures

Passenger Considerations/Amenities

Placement

Design Criteria Landscaping Land Area and Construction Details

Construction Impacts/NEPA-SEQRA

Intelligent Transportation Systems (ITS)

Pedestrian Access

Traffic Safety Information Panels ADA Access-Safety and Security

Resolution of Conflicts Plan Maintenance and Responsibilities

Limited English Proficiency (LEP)

Project Point of Contact Person

Vandalism Control Kiosks, Receptacles, and Displays

SHEET 3B - Mobility Management Request The budget for mobility management projects must be filled out completely. This form is locked and may not be modified; many of the items are formula driven and require no entry. 1 – Heading The Heading includes the sponsor pre-populated from cover page, and instructions for completing the form. The contact information for the proposed mobility manager must be completed. Private not-for-profit agencies may partner with an eligible Applicant for a project. Mobility management projects must demonstrate coordination among multiple providers, agencies and user groups to recognize the value of shared services in order to receive funding. Projects can not serve the needs of only one agency, provider or population group. If you need additional space, you can use Sheet 7 in the spreadsheet or submit additional documents which are referenced in the description. 2 – Project Budget This is a budget summary of the mobility management expenses being requested in this Application. The Federal share of the project(s) will be 80%. Complete all cells as necessary; some cells are equipped with drop-down selections while others require text entry. The resulting project budget will self calculate as a result of prior entries and requires no action. The “Source of the Local Share” must be described in detail. If you are using an In-Kind match for your local share, then you must complete Sheet 3C.

SHEET 3C - In-Kind Match If you are not using In-Kind Match, fill in zero in the first line under Real or Approximate Value ($) of Contribution.

SHEET 3D - ADPTAP (Appalachian Development Public Transportation Assistance Program)

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Applicable to Allegany, Broome, Cattaraugus, Chautauqua, Chemung, Chenango, Cortland, Delaware, Otsego, Schoharie, Schuyler, Steuben, Tioga, and Tompkins counties in the Appalachian Region only. This program provides funding to States in the Appalachian Region of the United States. FTA apportions the funds for purposes eligible under the FTA Formula Grants for Rural Area Program (Section 5311). 1 – Eligible Projects ADTAP program funds may be used for capital projects, operating assistance, planning, job access reverse commute projects, and the acquisition of public transportation services, including service agreements with private providers of public transportation. Consistent with the objectives of the FTA Formula Grants for Rural Area Program (Section 5311); funds should enhance access to health care, shopping, education, employment, public services, and recreation. 2 – Local Share A 10% local match is required for Capital. The State will provide a 10% match for capital. The local match is 50% for Operating expenses. 3 – Basis of Apportionments. Apportionments are based on a proportional formula utilizing the Applicant’s rural area population. 4 – Funds Availability Appalachian Development Program funds are available for the fiscal year in which they are apportioned, plus two additional fiscal years.

SHEET 4 - Current Fleet/Facility Inventory This Sheet collects information needed for NYSDOT and NTD records and reporting.

Using the drop-down menu, select the vehicle type code. AO-An automobile is a passenger car up to and including station wagons in size. BU-A bus is a rubber-tired passenger vehicle powered by diesel, gasoline, battery or alternative fuel engines contained within the vehicle. Vehicles in this category do NOT include school buses or cutaways. This group DOES include minibuses such as a Sprinter. CU-A cutaway transit vehicle is built on a van or truck chassis by a second stage manufacturer. The chassis is purchased by the body builder, a framework is built for the body, and then the body is finished for a complete vehicle. For example, a truck chassis may be used as the base for a small transit bus.

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MV-Typical minivans are Dodge Caravans or Honda Odysseys. A minivan is a light duty vehicle having a typical seating capacity of up to seven passengers plus a driver. A minivan is smaller, lower and more streamlined than a full-sized van, but it is typically taller and has a higher floor than a passenger car. Minivans normally cannot accommodate standing passengers. BR-An over-the-road bus is a bus characterized by an elevated passenger deck located over a baggage compartment. SV-A sports utility vehicle is a high-performance four-wheel drive car built on a truck chassis. It is a passenger vehicle, which combines the towing capacity of a pickup truck with the passenger-carrying space of a minivan or station wagon. Most SUVs are designed with a roughly square cross-section, an engine compartment, a combined passenger and cargo compartment, and no dedicated trunk. Most mid-size and full-size SUVs have three rows of seats with a cargo area directly behind the last row of seats. Compact SUVs and mini SUVs may have five or fewer seats. VN-Typical vans are Ford E-series or Dodge Ram vans. A van is an enclosed vehicle having a typical seating capacity of 8 to 18 passengers and a driver. A van is typically taller and with a higher floor than a passenger car, such as a hatchback or station wagon. Vans normally cannot accommodate standing passengers.

Report the seating capacity of the vehicle.

This is the actual number of seats on-board the vehicle and generally is cited in the specification used in manufacturing the vehicle. When reporting the seating capacity, do not include the driver’s seat. If you have a modified vehicle with adjustable seats, report the maximum seating capacity of your vehicle at any given time.

Report the number of wheelchair positions on the vehicle. If zero, fill in zero.

The vehicle status drop-down Sheet is broken into various types as describes below.

Active Route Deviation: A type of transit service that operates as conventional fixed route bus service along a fixed alignment or path with scheduled time points at each terminal point and key intermediate locations. Route deviation service is different than conventional fixed route bus service in that the bus may deviate from the route alignment to service destinations within locally defined distance (e.g., 3/4 mile) off the route. Following an off route deviation, the bus must return to the point on the route it left. Active Demand Response: Demand Response (also called Paratransit or dial-a-ride) is comprised of vans or buses operating in response to calls from passengers or their agents to the transit operator, who then dispatches a vehicle to pick up the passengers and transport them to their destinations. Pick-ups must be generated no later than close of business the day prior to the ride. Active Commuter/Intercity: Regularly scheduled public service using an over-the-road bus that operates with limited stops between two urbanized areas or that connects rural areas to an urbanized area.

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Active Fixed Route: The term ''fixed route system'' means a system of providing designated public transportation on which a vehicle is operated along a prescribed route according to a fixed schedule. Note: If you provide fixed route service then you must also provide complementary Paratransit. See definition below. Active Complementary Paratransit: Transportation service required by the Americans with Disabilities Act (ADA) for individuals with disabilities who are unable to use fixed route transportation systems. This service must be comparable to the level of service provided to individuals without disabilities who use the fixed route system. The complementary services must be origin-to-destination service and offered at minimum of 3/4 mile off the fixed route. Spare: A spare is a vehicle that is occasionally used to provide service when regular fleet vehicles are not available due to such factors as maintenance, inspection, accident, etc.. Each system is allowed a spare factor of 20%. This factor is calculated by rounding up to the next whole number, e.g. if the spare factor is 1.2, then round up to 2. Pending Disposal: This vehicle has met its useful life and a request for disposal will or has been made but not granted as of yet. Disposed: Add all vehicles that have been disposed of in the last two years. This will be a check for our inventory.

SHEET 5 - OA, ADP, & SES Apportionments This is a table of each Applicant’s maximum FTA Formula Grants for Rural Area Program (Section 5311) operating assistance and NYSDOT staff contact. Operating Assistance (OA) is the standard FTA Formula Grants for Rural Area Program (Section 5311) assistance. The Appalachian Development Program (ADP) is available to 14 counties in the southern tier and can be used for Operating, Capital and Mobility Management. Supportive Employment Services (SES) is the operating assistance program dedicated to supporting work-related trips.

SHEET 6 - Schedule & Route Guides A complete digital/electronic set of schedules and route guides available for the system must be submitted with your Application. These files should be in GTFS (General Transit Feed Specification) format. Your system needs to have a method to produce GTFS in-house or work with the NYSDOT 511 contract vendor to ensure your schedules are up to date in 511. The published fares, the transfer policy, the hours of operation, and the policies for route deviation, demand responsive service should be clearly marked on the schedule. Annotate the schedule if only a portion of the service is rural.

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SHEET 7 - Supplemental Information Enter any additional information supporting your Application here as required. You may also attach additional electronic documents separately with your Application. Saving Application Save Application parts using the following naming convention that includes your Applicant Name and description. For example: “New York County 5311 App Part I 2017 2018” Attachments that support your application should use a similar format. For example: New York County 5311 Supplemental Info 2017 2018”

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CompletingPartsIIandIIAoftheApplication To open and/or start Part II or IIA of the Application, you must save a copy of the PDF-fillable form to your computer.

Applicants need Adobe Acrobat Standard or Pro, and Adobe Reader version 9 or higher (version 11 preferred) to maximize the functionality in the form. You can complete, print, save, and submit your work based on the software that you have. Please be sure to enable the form if necessary.

Web browsers such as Apple Safari, Google Chrome, and Mozilla may have their own non-Adobe PDF readers set as the default reader. To use one of these browsers, change the default PDF viewer setting to Adobe Reader. If Internet Explorer is used as the browser, no action is typically needed.

File size is limited to 20MB. If your submission is larger than 20 MB you will need to submit more than 1 email. Label your submissions “1 of __” etc.

Use the “Tab” key to navigate through the form to ensure questions are answered in the correct order. As responses to questions are provided, additional questions will be generated by the Application. Therefore, take care when answering questions to ensure the correct questions appear relative to your project/Application needs. Applicants must complete all required fields as they appear in the Application. Required fields are designated by a preceding asterisk (*).

PART A: Applicant Information This section contains information on how to navigate through Part II and IIA; and gives directions on how to complete these Parts of the Application. When you complete Part II and IIA, the forms can be electronically submitted.

1. Enter the number of Operators associated with the service that the Applicant is applying for. Hit Tab to move to the next question “Is the Applicant also an Operator?” Click on the appropriate radio button to respond to the question, then Tab to enter information in the next box- Applicant Name.

2. Enter the Applicant Name. This should be the legal name under which you operate. If

the Applicant is also an Operator, for the purposes of this Application, you are

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considered Operator 1. If your Operating Name is different than your Applicant Name complete the next box on the form:

If this does not apply to you, hit Tab to continue.

3. Select Applicant Entity Type from the drop down box on the right side of the page. Your selection here influences what questions appear in Part F.

Hit Tab to move to the Applicant Contact Information section.

4. Enter your contact information in the appropriate boxes. If your address is the same for business and contact, click on the check box to remove the second set of boxes. The Applicant must also enter ID’s for Grants Gateway, SFS, DUNS and Federal at the bottom of Part A.

PART B: Additional Operator Information (Using Part IIA) Part B collects contact information for one operator in addition to the Applicant. If there are more operators to report, complete and attach Part IIA “Additional Operator Information Page”.

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Part II and IIA function the same. Part IIA includes space for five (5) additional Operators. In addition to providing more space for Operator contact information, it also includes a second Part L for signatures of those Operators. Complete as many sheets as you need to accurately document your operators’ information.

PART C: Project Funding Request Check the box on the left side of the chart for each funding line requested. Using the Tab key, navigate through the Chart from left to right.

1. In the “Fiscal Year: FROM” and “Fiscal Year: TO” boxes, a drop down arrow will appear on the right side of the box. Click on that arrow to display a calendar. Use the arrows at the top of the calendar to move to the appropriate month and year, then click on the date to enter it in the box.

2. Using the budget information on Part I, Sheet 1 of the Excel spreadsheet, enter the “Estimated Project Costs” and “Federal Assistance Amounts”. Ensure the totals match between Application Part I and Part II.

3. If you apply for Capital Assistance (CA), a fourth checkbox “CA includes Mobility

Management” will appear. If the Application includes a mobility management project, check this box. If it does not, leave it blank. Your selection here will influence the questions to be answered in Part D and the signatures visible in Part L.

4. Complete the “Area Served” section. If you serve a portion of a county, provide a description of the areas served which should include the town, village or city names. If you serve an entire city or county, list the city or county name. If you need additional space, attach a separate document.

5. The “Total Req” is for your information only. No entry is required. It calculates the

amount of Federal Assistance requested based on your entries in the chart.

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PART D: Smart Growth Threshold Questions (for Capital Assistance Funding Requests Only) If Capital Assistance is requested, Question 1 will appear in Part D. If the response to this question is “Yes”, Questions 2-4 will appear. You must answer all of these questions. If the answer is “Yes” to any of these questions, you must complete the Smart Growth Screening Tool. To access this Screening Tool, click on the hyperlink. Please submit the Smart Growth Screening Tool form with the completed Application.

PART E: Coordination Efforts with Locally Developed, Coordinated Public Transit Human Services Transportation Plans

1. Question 1 requires a description of how the Applicant and/or transit operator participates in the local planning process and impact of coordination on budgets and community(ies).

2. Question 2 provides a drop-down to pick an option that best describes the Coordinated Plan’s status. If the Plan has been “Updated”, a date box will appear to provide the date of the most recent update. If “Other” is selected, you will be prompted to provide an explanation in the text box below.

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3. Question 3 requires a description of formal and/or informal coordination efforts in your

service area and impacts on budgets, efficiencies, and innovations planned or implemented.

Space is limited to the visible area. If you need additional space to describe your efforts, please attach a separate document with additional details to the Application submission.

PART F: Public Participation and Coordination Requirements

1. Based on your selection in the “Applicant Entity” box at the beginning of the form, you will see either the “Copy of Public Notice paid advertisements” or “Copy of Direct Notice” checkbox. Click on the checkbox to select it. If you have the most current Adobe software, by checking the box, you will be prompted to attach a file.

2. If you have received no comments in response to the public notice, check the “No” drop-

down box below and continue to Part G. If you check “Yes”, select the appropriate boxes below to indicate actions on addressing comments before proceeding to Part G.

All required documentation must be attached in the Application submittal package.

PART G: Title VI Assurances/Disadvantaged Business Enterprise (DBE) Activities Under Title VI of the Civil Rights Act of 1964 recipients of federal funds must provide information regarding lawsuits or complaints of discrimination.

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1. Check “Yes” or “No” in the drop-down boxes for Questions A and B as indicated. If “Yes” is selected, the text box below becomes available to provide a short explanation. If more space is needed, attach any description, status or summary as required.

2. Attach the Applicant’s Title VI Plan as requested in letter C.

PART H: Public Operators and Labor Unions for Special Section 5333(B) Warranty To complete this chart, enter information across the table, from left to right, using the Tab key to navigate.

The list should include both union and non-union Operators who will be receiving FTA Formula Grants for Rural Area Program (Section 5311) funds or are potentially eligible to apply for FTA Formula Grants for Rural Area Program (Section 5311) funds or that operate in the project service area or adjacent areas. This includes all private bus companies who pick up and discharge passengers within the service area as well as public municipal transit systems. Taxi companies should NOT be listed unless they provide shared-ride transportation on a regular and continuing basis; "shared-ride" taxi service means that no one individual can reserve the taxi for the entire trip and the fares for rides are shared among the passengers.

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Intercity bus operators (such as Greyhound MegaBus, Coach USA, or Trailways) that have stops within the service area must be listed. See Table A below for a list of intercity bus operators and unions that provide service in New York.

TABLE A: Intercity Bus Operators & Unions (For Reference Only)

Operator Union Adirondack Transit Lines, Inc. UTU

Birnie Bus Tours/Service 200 United

Butler Motor Transit, Inc.-Erie Division, a Coach USA Company

ATU

Bonanza Bus ATU

Chenango Valley Bus Lines, Inc. ATU

First Transit, Inc.(NCE) Teamsters

Fullington Auto Bus Company/Trailways No Union

Greyhound ATU

Lake Front Trailways No Union

Passenger Bus Corporation Teamsters

Peter Pan Bus Lines ATU

Pine Hill-Kingston Bus Corporation UTU

Shortline/Coach USA TWU

Megabus Production Workers Union

Address questions regarding intercity bus operators to the respective NYSDOT staff member listed in Appendix F.

PART I: Service Changes Provide information on service/route changes/efficiencies/innovations implemented in the last two years or being planned or proposed over the next two years. Checking “Yes” to any of the questions enables a text box for you to enter the requested information. If the answer is “No”, please explain how existing services meet the needs of the community(ies) and traveling public. Also, answer the question about fare changes, fare product and service linkages planned or proposed. If additional space is needed, attach a document to the Application submission.

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PART J: Applicant Affirmations, Certifications, and Assurances For the purpose of this Application, all applicants MUST check the box to indicate that you will comply with the following:

1. Required Certifications and Assurances for each Applicant 2. Lobbying 3. Procurement and Procurement Systems 4. Private Sector Protections 9. Transit Asset Management Plan, Public Transportation Safety Program, and State Safety Oversight Requirements 10. Alcohol and Controlled Substance Testing 16. Rural Areas and Appalachian Development Programs

The Applicant needs to read the Certifications and Assurances and determine if additional provisions apply based upon the projects the Applicant may be applying for. Select the appropriate categories from the list. To select more than one, use the Control or Shift keys and

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click on your choices. If you intend to comply with all of the additional provisions, check the second box.

By signing this Application, the Applicant is certifying and attesting that the Applicant has read and understands the current Certifications and Assurances and the Special Section 5333 (b) Warranty and agrees to comply with all requirements.

From the dropdown box, select whether the Applicant is authorized to sign as the Attorney. If the Applicant is authorized to sign for the Attorney, the Applicant must have documentation of such authorization on-file and available upon request by NYSDOT. Your choice will determine what information you see in Part K. Save Part II and IIA (as applicable) of the Application and email to other individuals that need to sign the Application as appropriate.

PART K: FTA Certifications and Assurances, Attorney Affirmation If, in Part J, you indicated that your Attorney would be signing the Application, your Attorney must complete this section. This section is blank if the Applicant signs as the Attorney in Part J.

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Save Part II and IIA (as applicable) of the Application and email to other individuals that need to sign the Application, as appropriate, or return to Applicant if no other signatures are required.

PART L: Third-Party Affirmation, Certifications, and Assurances

1. If the Applicant contracts with a Third-Party, an authorized official of the Third-Party Contractor must sign and complete where designated. Save Part II and IIA (as applicable) of the Application and email to other individuals that need to sign the Application, as appropriate, or return to Applicant if no other signatures are required. The Third-Party official is signing to certify and attest that the Third-Party has read and understands the current Certifications and Assurances and the Special Section 5333 (b) Warranty and agrees to comply with all requirements. Each Applicant and its Third-Party Contractor (if applicable) should each retain a copy of the Certifications and Assurances.

2. If the Application includes funding for continuing Mobility Management projects that will be provided by a Third-Party Contractor that is not included in the Application, the Mobility Manager must also sign this Application Affirmation.

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3. Once the Application is signed by all parties, the Applicant should save and print a copy of this form. To submit the Application, click on the submit button.

Save Application parts using the following naming convention that includes your Applicant Name and description. For example: “New York County 5311 App Part II 2017 2018” Attachments that support your application should use a similar format. For example: “New York County 5311 App 2017 2018 Title VI” or “New York County 5311 Public Notice 2017 2018” Once the submit button is clicked, an email will open with the Application as an attachment. You can attach additional documents at this time, including Part I. Keep in mind the overall size of the files as larger files (over 20MB) will be undeliverable. Consider zipping your files or sending them in multiple emails. After hitting the “Submit” button, please follow the instructions in the email to correctly name your submission. This completes Part II of the Application.

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APPENDICES Appendix A: Application Submission Checklist Use this checklist to assure all information necessary is included in your application submission. Application Part I: Excel Spreadsheet

□ Sheet 1 - Applicant, Operators & Project Summary

□ Sheet 2 - Operating Budget

□ Sheet 2A - Indirect Cost Worksheet (if applicable)

□ Sheet 2B – Detailed Fare Information

□ Sheet 3 – Vehicle Request

□ Sheet 3A – Other Capital Budget Application

o Independent Cost Estimates/Supporting Documentation

o Policy, Planning and Placement of Capital Purchase Requests

□ Sheet 3B – Mobility Management (if applicable)

□ Sheet 3C – In-Kind Match

□ Sheet 3D - ADPTAP (Appalachian Development Public Transportation Assistance

Program) (If applicable - Only 14 Counties are eligible – See Sheet 9)

□ Sheet 4 – Fleet Composition

□ Sheet 5 - 2017-2018 Apportionments for 5311 Operating, Appalachian Development

(ADPTAP) and Supportive Employment Services and NYSDOT System Specialists

(Informational Only)

□ Sheet 6 – Schedules & Route Guides (digital format)

□ Sheet 7 – Supplemental Information (as applicable)

□ Application Part II: PDF-fillable Form □ Parts A through L - Applicant Information & Certifications

□ Application Part IIA: PDF-fillable Form (if applicable)

□ Part IIA - Additional Operator Information Page

Application Deadline: April 10, 2017 - Electronically submit Parts I, II and IIA (as applicable)

(Excel & PDF forms) and supporting documentation to [email protected].

Applicants unable to complete the signatures electronically should submit a PDF scan of

signature pages at the time of Application.

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Save Application parts using the following naming convention that includes your Applicant Name and description. For example: “New York County 5311 App Part I 2017 2018”, “New York County 5311 App Part II 2017 2018”, “New York County 5311 App Title VI 2017 2018”.

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Appendix B: Public Notice Requirements, Process, and Example Action Municipal, Transportation Authority &

Federally Recognized Indian Nations Intercity Carriers with Direct Contracts with NYSDOT

Prepare Notice

Prepare a Public Notice for the project(s), using the attached sample notice as a guide to the format and language. Designate a contact person to receive and respond to comments on the project(s).

Prepare a Direct Notice for the project(s), using the attached sample notice as a guide to the format and language. NYSDOT recommends designation of the Intercity Bus Company CEO as contact person to receive comments on the project.

Notify Public

Publish the Public Notice as a paid advertisement (preferably at least 3" X 5" in size) in at least one newspaper of general circulation that has circulation coverage of the entire project service area. If a single newspaper does not cover the project area, the Notice must be published in a sufficient number of newspapers so that the entire project service area is covered. The cost of this advertising is an eligible Program expense and should be specified in the operating budget.

Mail copies of the Direct Notice to all human service agencies that provide or purchase government assisted transportation in, or adjacent to, the project service area, including County offices for the Aging, County Departments of Social Services, Senior Citizens’ organizations, community action agencies, Head Start, community workshops, Associations for Persons with Disabilities, Section 5310 operators, Coordinated plan committees, etc.

Mail an 8½ x 11 copy of the Public Notice to all private bus and taxi companies and public transportation operators in the project service area. Accompanying letters are not necessary.

Mail a copy of the Public Notice to all human service agencies that provide or purchase government assisted transportation in, or adjacent to, the project service area, including County offices for the Aging, County Departments of Social Services, Senior Citizens’ organizations, community action agencies, Head Start, community workshops, Associations for Persons with Disabilities, Section 5310 operators, Coordinated plan committees, etc.. To address outreach to minority and economically disadvantaged populations, follow the public outreach and language assistance plans, specified in your Title VI plan. Accompanying letters are not necessary

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Action Municipal, Transportation Authority & Federally Recognized Indian Nations

Intercity Carriers with Direct Contracts with NYSDOT

Assemble Documents for Application

Include the mailing list of operators and agencies to which you have mailed a copy of the Public Notice as part of your application. Group your listing into the following categories: 1) private bus and taxi operators; 2) public transportation operators; 3) human service agency operators; 4) coordinated planning participants; 5) and minority and economically disadvantaged populations.

Include the mailing list of operators and agencies to which you have mailed a copy of the Direct Notice as part of your application. Group your listing into the following categories: 1) private bus and taxi operators; 2) public transportation operators; 3) human service agency operators; 4) coordinated planning participants; and minority and economically disadvantaged populations.

Include a copy of the actual paid advertisment(s) in your application showing the publication name and the date. Retain the notarized affidavit of advertisement along with a copy of the advertisement for your project records

Include a copy of the actual Direct Notice.

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Example of FTA Formula Grants for Rural Area Program (Section 5311) Public Notice Public notice is hereby made that the [specify name of Applicant] is applying for federal financial assistance to provide public transportation service as follows: (specify the type of service (fixed-route, demand responsive, etc.), the project duration, and the general service area covered). Public notice is further made that the [specify name of Applicant] is also applying for federal financial assistance to purchase (describe what will be purchased) that will be used to provide public transportation service for (specify the type of service (e.g. fixed-route and/or demand responsive) and the general service area covered). The transportation service will be available to the general public during all hours of operation. The project is expected to be financed by FTA Section 5311 Rural Program public transportation funds, with additional funds to be provided from (specify each other expected program source of other federal, State or local funds for the project). The total federal share for operating and capital projects is expected to be $ ___________. Comments on the proposed project are invited from the general public, private bus and taxi companies, other public transportation providers and human service agencies. Interested parties may comment on the project or obtain more details about the project by writing to: (Name of Applicant’s Contact Person) (Address) (Telephone No. and Email) Human service agencies that receive assistance from other Federal agencies for non-emergency transportation services are encouraged to participate and coordinate with the provider in the planning, design and delivery of transportation services. Agencies may obtain copies of the service description and submit proposals for service coordination. Private bus and taxi operators may request copies of the project service description from the above named person and may submit comments on the service as described. If you wish to comment on any aspect of the proposed project, submit a proposal or a request for service coordination or request a public hearing on this project, you must make your interest known in writing within fifteen calendar days of the date of this publication and provide your comments within fifteen calendar days of your receipt of the project service description. Your requests and/or comments must be forwarded to the above person.

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Appendix C: Local Resolution Example RURAL PROGRAM FOR SPONSORS WITH CONTINUING AGREEMENTS Heading and Opening The Municipality or Transportation Authority should use its standard heading and standard opening for a resolution. Body of the Resolution Whereas, the (Municipality or authority name)is submitting a request for a grant of funds to the NYSDOT, pursuant to Section 5311, Title 49 United States Code, for a project(s) to provide public mass transportation service for (project description specifying general area and operator) for the (project years)fiscal years and has committed the local share; Whereas, the (Municipality or authority) and the State of New York have entered into a continuing agreement which authorizes the undertaking of the project(s) and reimbursement of the Federal and applicable State Shares; Resolved, that the (Title of designated official) is authorized to act on behalf of the (Municipality or authority) to sign the application and progress and complete the above named project(s). If Appropriate Whereas, the (Municipality or authority) is contracting with a third party subcontractor for the project(s) described above; Resolved, that the (Title of designated official) is authorized to sign any contracts or agreements between (Municipality or authority) and any third party subcontractor necessary to complete the public transportation project(s), subject to the approval of the municipality Attorney. Signatures The municipality should insert standard resolution signature information and signatures here and attach a Notarization Form

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Appendix D: Notary Form

NOTARIZATION FORM STATE OF NEW YORK COUNTY OF On this day of in the year before me personally

came _______ to me known, who, being by me duly

sworn did depose and say that s/he resides at

______________________________________________________; that s/he is the

______________________________________________________(Title) of the Municipal

Corporation described in and which executed the above instrument; that s/he knows the Seal of

said Municipal Corporation; that the Seal affixed to said instrument is such Corporate Seal;

that it was affixed by order of the Board of said Municipal Corporation pursuant to a resolution

which was duly adopted on _________ and to which a certified copy is attached and

made a part hereof; and that s/he signed his name thereto by like order.

Notary Public

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Appendix E: Third-Party Operating Assistance Agreement Instructions for completing Third-Party Operating Assistance Agreement: This agreement is to be used if an entity other than the recipient will provide the service in your application.

a) Enter the date, the name of the Municipality and the third-party operator (carrier) on the first page.

b) Prepare Part C -- Project Description, Term, Funding and Payment Procedures. This

should be a brief description of the service area, the funding and time period included in the most recent operating assistance application and a description of the municipal corporation’s procedure for paying the third-party operator.

c) Have the Third Party Agreement signed by the appropriate official of your municipality

and by the chief executive officer of the operator.

d) Email a signed copy to NYSDOT at: [email protected]

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Appendix F: NYSDOT Staff Contact Information