The URL can be used to link to this page

Item C30M C ounty of f Monroe ELj » °o � BOARD OF COUNTY COMMISSIONERS /� � Mayor David Rice, District 4 Th e Florida Keys Mayor Pro Tem Sylvia J. Murphy, District 5 Danny L. Kolhage, District 1 George Neugent, District 2 Heather Carruthers, District 3 County Commission Meeting January 17, 2018 Agenda Item Number: C.30 Agenda Item Summary #3784 BULK ITEM: Yes DEPARTMENT: Social Services TIME APPROXIMATE: STAFF CONTACT: Sheryl Graham (305) 292 -4510 N/A AGENDA ITEM WORDING: Approval to apply for a Florida Department of Transportation (FDOT) FTA Section 5310 Program Federal Fiscal Year (43) 2018 Capital Assistance Grant for the purpose of purchasing a maximum of four (4) para transit vehicles to serve the transportation needs of the transportation disadvantaged, elderly, and persons with disabilities throughout Monroe County. ITEM BACKGROUND: The Florida Department of Transportation (FDOT) Section 5310 Grant is applied for on an annual basis by the Monroe County Social Services Transit department. This grant is intended to enhance mobility for seniors and persons with disabilities by providing funding for programs to serve the special needs of transit dependent populations beyond traditional public transportation and in accordance with the Americans with Disabilities Act (ADA). We are requesting a maximum of 4 vehicles for FFY 43 to replace our aging fleet. PREVIOUS RELEVANT BOCC ACTION: Approval granted by the BOCC on 01/18/2017 to apply for an FDOT FTA Section 5310 Program FFY 42 2017 Capital Assistance Grant for the purpose of purchasing 4 para- transit vehicles to serve the transportation disadvantaged population throughout Monroe County. CONTRACT /AGREEMENT CHANGES: Approval to apply for new grant year STAFF RECOMMENDATION: Approval DOCUMENTATION: 5310 Application 01 -02 -18 5310 Application Backup FINANCIAL IMPACT: Effective Date: 01/17/2018 Expiration Date: Total Dollar Value of Contract: 290,000.00 Total Cost to County: 29,000.00 Current Year Portion: Budgeted: Source of Funds: FDOT 5310 Grant Funds CPI: Indirect Costs: Estimated Ongoing Costs Not Included in above dollar amounts: Revenue Producing: N/A If yes, amount: Grant: Yes County Match: 10% cash match Insurance Required: Additional Details: 01/18/17 001 -61525 -SOCIAL SERVICE TRANSPORT 530641 $29,000.00 REVIEWED BY: Sheryl Graham Completed 12/29/2017 12:41 PM Pedro Mercado Completed 12/29/2017 12:54 PM Budget and Finance Completed 12/29/2017 1:08 PM Maria Slavik Completed 12/29/2017 1:34 PM Kathy Peters Completed 12/29/2017 3:18 PM Board of County Commissioners Pending 01/17/2018 9:00 AM App I FFY-is Purple-All Red- Capital Blue-Operating Fl a orida "e"artnient of Trnsp ortation P L V --T F ' 19 U.S.C. Section 5311, A Capital & Operating Assistance — FFY 2018 Step I of 3: Preliminary Application Formula Grants for the Enhanced Mobility of Seniors and Individuals with Disabilities CFDA 20.513 Legal Applicant Name: ElFirst Time Applicant ❑ Previous Applicant Project Type and Service Area of this Application (check all that apply) ❑ Large Urban Service Area ❑ Small Urban Service Area ❑ Rural Service Area Page I Of 37 Purple-All Tabie or C 0J - J tP r ,,+ S Fled- Cap0tal Blue- Opej atin TABLE OF CONTENTS PLEASE NOTE APPLICANT INFORMATION PRELIMINARY APPLICATION CHECKLIST PART 1 — APPLICANT ELIGIBILITY Eligibility Questionnaire Exhibit A: Cover Letter Exhibit B: Governing Board's Resolution Exhibit C: Coordinated Public Transit -Human Service Transportation Plan Exhibit D: CTC Agreement or Certification Exhibit E: Certification of Incorporation Exhibit F: Proof of Non- Profit Status Exhibit G: Local Clearinghouse Agency /RPC Cover Letter (only required forfacilities) Exhibit H: Public Hearing Notice PART it - FUNDING REQUEST Form A -1: Current System Description Form A -2: Fact Sheet Form B -:L: Proposed Project Description Form B -2: Financial Capacity — Proposed Budget for Transportation Program Form B -3: Breakdown of Transportation Costs Form C -z: Financial Capacity — Proposed Budget for Transportation Program Form C -2: Capital Request Form Form C -3: Current Vehicle and Transportation Equipment Inventory Form 2 3 4 5 6 6 7 8 9 io io to to 10 11 it 1 5 3.8 25 28 3 0 33 35 8 8 CU CL CD LO I- 0 C) LL co CD CD 8 CU CL CD LO r_ 0 L) d Page 2 of 37 rY'xG Urp?e- `ill Red- Cap ita! ? 3,a_ p ( OC3E'rat�r1g ;e a s e INJ - C o"e This grant application is color coded based on which type of award you are applying for. Forms and exhibits in purple must be completed for all applications. All k Forms and exhibits in red apply to capital applications, exclusively. Forms and exhibits in blu� appl to operating applications, exclusively. co 8 CU CL CD L0 0 C) 8 N CD CD 8 p r— p � sd CU CL CD LO E L) Page 3 of 37 �! eo ^ ,' o T, ., �r ie 3I c-.j- Capitai B -le- Opera , i c a n t n , ' f - 49 U.S.C. Section 5310, Formula Grants for the Enhanced Mobility of _ Seniors and Individuals with Disabilities: Agency (Applicant) Legal Name: GRA N�'A PLICA TIQ?N Physical Address (No P.O. Box): Applicant's County: If Applicant has offices in more than one county, list county where main office is located City: State: Zip + 4 Code: Congressional District: Federal Taxpayer ID Number: Applicant Fiscal period start and end dates: State Fiscal period from: Julys, 2oi8 to June30, 20-19 to Applicant's DUNS Number: Unique g -Digit number issued by Dun & Bradstreet. Maybe obtained free of charge at: http : / /fedgov.dnb. com /webform Project's Service Area: List the county or counties that will be served by the proposed project. Executive Director: =Grant ontact Person (if different than Executive Telephone: Telephone: Fax: E -mail Address: Current Vehicle Inventory: Vans Enter Number in Fleet Buses /Cutaw Fax: Email Address: Vans /Lifts Ys Other Sedans or Minivans N/A Authorizing Representative certifying to the information contained in this application is true and accurate. Signature (Authorizing Representative) [blue ink]: Printed Name: Title: Email Address: *Must attach a Resolution of Authority from your Board (original document) for the person signing all documents on behalf of your agency. See Exhibit B Page 4 of 37 F�ndaDepa��m��T�`apn�a�'on-s ,oap7'ica-/n"-'�+�� Purple-All Rea'[ap|1a/ B(ue'0penztinq L��| ��' ~ 4� N �- / �~ N � �l�� ~�� ~ °�� ' '.~ ~=^ � ° a��.��^�� Q ~ u � Each of the below items must be included with your Section S3:io Grant Application submittal in the same order [-7 ��[over Page (page z) FApp|icant|nfornnation PART |' APPLICANT ELIGIBILITY El Preliminary Application Checklist (this form) 01 E|igibi|ityOoestiunnaire F- 4' ExhibitA: Cove Letter Exhibit B: Governing Board's Resolution F� E � Exhibit[:[oordinatedPob|icTr ansit'HunnanServiceTransportati on P| an r �Exhibit D:[TC Agreement orCertification F Exhibit E: Certification nfIncorporation � F: Proof of Non-Profit Status Exhibit G: Local Clearinghouse Agency/RPC Cover Letter (only requiredforfacilities) Date received: F� Exhibit H: Public Hearing Notice PART ||' FUNDING REQUEST �'FV/rnA-z: Current System Description Form A-a: Fact Sheet Organization Chart Form B-1: Proposed Project Description F� Form B-2: Financial Capacity - Proposed Budget for Transportation Program F Proof Form B']: Breakdown of Transportation Costs Form C-i: Financial Capacity - Proposed Budget for Transportation Program El Proof of Local Match Form [a: Capital Request 0[onnp|eted Sample OrderFornn(s) Form [ '3: current Vehicle and Transportation Equipment Inventory � � CU CL CD � LO co CD CD CU CL CD � LO cu Page 5 Of 37 Puro'e-All J rUCANT 4 Eligibillity Questionnaire If you are a current grant sub - recipient and are not compliant with all FDOT and FTA Section "j-o requirements, then you will not be eligible to receive grant funds until compliance has been determined. You must be in compliance at time of grant award execution /joint participation agreement execution. If you are a current grant sub - recipient and have undergone a triennial review, complete the questions below: Note: This questionnaire does not apply to new sub - recipients and sub - recipients that have not yet been required by their respective FDOT District Office to complete a triennial review. For more information see FDOT's Triennial Review Process as part of the Etcrtp iyLaj o , ? t Ir ,° Page 6 of 37 .�i � PuTle- N a 0 Cap t Bjoe -& r'aten Exhibit : Cover Lette % . c - , +tom " ; � STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION GRANT APPLICATION ( Aaency Name) submits this Application for the Section 5310 Program Grant and agrees to comply with all assurances and exhibits attached hereto and by this reference made a part thereof, as itemized in the Checklist for Application Completeness. lAgency Name) further agrees, to the extent provided by law (in case of a government agency in accordance with Sections 129.07 and 768.28, Florida Statutes) to indemnify, defend and hold harmless FDOT and all of its officers, agents and employees from any claim, loss, damage, cost, charge, or expense arising out of the non- compliance by the Agency, its officers, agents or employees, with any of the assurances stated in this Application. This Application is submitted on this Date day of Month Year with an original resolution or certified copy of the original resolution authorizing Name & Title to sign this Application. Agency Name Signature [blue ink] Typed Name and Title of Authorized Representative Date Page 7 of 37 �(� �-z.� `Tr a. �: €�� a`c,r ��? Urole_AlE. Red- Capiial ( f'y �, Exhibit B: Governing Board's esolutJ0n ra �ncl 1 'i nZy C A RESOLUTION of the (Governing Board) authorizing the signing and submission of a grant application and supporting documents and assurances to the Florida Department of Transportation, the acceptance of a grant award from the Florida Department of Transportation, and the purchase of vehicles and /or equipment and /or expenditure of grant funds pursuant to a grant award. WHEREAS, MPR LJcanjt has the authority to apply for and accept grants and make purchases and /or expend funds pursuant to grant awards made by the Florida Department of Transportation as authorized by Chapter 341, Florida Statutes and /or by the Federal Transit Administration Act of 1964, as amended; NOW, THEREFORE, BE IT RESOLVED BY THE (Governing Board) FLORIDA: This resolution applies to the Federal Program under U.S.C. Section S310. The submission of a grant application(s), supporting documents, and assurances to the Florida Department of Transportation is approved. (Authorized Individual by Name and Title) is authorized to sign the application, accept a grant award, purchase vehicles /equipment and /or expend grant funds pursuant to a grant award, unless specifically rescinded. DULY PASSED AND ADOPTED THIS Date Year By Signature, Chairperson of the Board [blue ink] Typed Name and Title ATTEST: Seal Page 8 of 37 Dec'- Capiial B1f Ip- Operat,me, Exhibit C. Coordinated Public TranS ;t - L -� Ii Service Transportatior, Plan The projects selected for funding under the Section 5310 program must be included in a locally developed, coordinated public transit -human services transportation plan (Coordinated Plan) that was "developed through a process that includes representatives of public, private, and non - profit transportation and human services providers and participation by members of the public." Reference: FTA C 9070.1G, Enhanced Mobility of Seniors and Individuals with Disabilities Program Guidance and Application Instructions - Chapter V, Coordinated Planning Certification ( Agent Name) certifies and assures to the Florida Department of Transportation regarding its application for assistance under 49 U.S.C. 5310 that this grant request is included in a coordinated plan compliant with Federal Transit Administration Circular FTA C 9070.1G. (a) The name of this coordinated plan: (b; The agency that adopted this coordinated plan: (c) The date the coordinated plan was adopted: (d) Section and page in the coordinated plan that identifies the projector need your agency is fulfilling Signature [blue ink] Typed Name and Title of Authorized Representative Date Page 9 of 37 i:,..: cs_ � II 'J"Pl>_ P, Zed- Capital lue_Ooerarh � Exhibit D: CTC Agreement or Certification See Grant Application Instruction Manual for CTC Agreement requirements. Exhibit : Certification of Incorporation All first -time private non - profit applicants must include a copy of their certification of incorporation here. You may insert the certification as a PDF or print and attach the document to your final application. Exhibit : Proof of Non -roil Status All private non - profit applicants must include proof of non - profit status here. You may insert the proof of status as a PDF or print and attach the document to your final application. Exhibit G: Local Clearinghouse Agency /RPC Cover Letter (only required forfacilities) If grant application is for facilities, please include a copy of the cover letter submitted to the local clearinghouse agency or RPC. You may insert the letter as a PDF or print and attach the document to your final application. Exhibit D: Public Dearing Notice Attach a copy of the notice of public hearing and an affidavit of publication here. You may insert the notice as a PDF or print and attach the document to your final application. All interested parties within Counties Affected) are hereby advised that (Public Agency) is applying to the Florida Department of Transportation fora capital grant under Section 5310 of the Federal Transit Act of 1991, as amended, for the purchase of (Description of Equipment to be used for the provision of public transit services within jDefined Area of Operation) This notice is to provide an opportunity for a Public Hearing for this project. This public notice is to ensure that this project and the contemplated services will not duplicate current or proposed services provided by existing transit or paratransit operators in the area. This hearing will be conducted if and only if a written request for the hearing is received by (Specify due date) Requests for a hearing must be addressed to (Public Agency Name and Address) and a copy sent to (Name and Address of Appropriate FDOT District Office). All public notices must include the following language: Florida Law and Title VI of the Civil Rights Act of 1964 Prohibits Discrimination in Public accommodation on the basis of race, color, religion, sex, national origin, handicap, or of marital status. Persons believing they have been discriminated against on these conditions may file a complaint with the Florida Commission on Human Relations at 850- 488 -7082 or 800 - 34 2 -8 170 (voice messaging) Page io of 37 Purple -A" Red- Car,ital Blue-& p e s E n UN -" iNG r-orlT A- : Current S ys , .tern D escription (a) Please provide a brief general overview of the organization type (i.e., government authority, private non- profit, etc.) including its mission, program goals, and objectives (Maximum DOr) Xninrrlc\ (, ) Please proviae rntormation below: Organizational structure (attach an organizational chart at the end of this section) Total number of employees in the organization Total number of transportation- related employees in the organization ;cj Who is responsible for insurance, training, management, and administration of the agency's transportation programs? (Maximum loo words) Page 11 of 37 °o:' :.[�l'; � "`xi ✓ °�: o,'°.. r }�'( "C �. .. �['Y.xr I UrAtl a ill q B J peFaiung (d) How are the operations of the transportation program currently funded? What are the sources of the fund ing (e.g. stat e, local J fede ral, private foundations, fares, other program fees ?)? (Maximum zoo words) (e) How does your agency ensure that passengers are eligible recipients of 5310- funded transportation service? (Maximum zoo words) (f) To wha t exte nt does your agency serve minority populations? Is your agency minority - owned? (Maximum zoo words) Who drives the vehicles used for 5310- funded transportation services? I How many drivers do you have? Page 12 of 37 pb��ao^par��n�uf��n�nna�/op-s ��n//cauo�-�r�zn Purple-AU Ped- �--apitol B!'je-[)r,,F.rabny � Do your drivers have CDL certifications if required for the types of vehicles used? Page z3of37 r suvt,a;�:> "a �: .— A. p ,r.;'; _� `Y Ca31 =taI !�Je_operax.ir� (h) Fully explain your transportation program: Service hours, planned service, routes and trip types- Staffing—include plan for training on vehicle equipment such as wheelchair lifts, etc.; Records maintenance —who, what methods, use of databases, spreadsheets etc.; Vehicle maintenance —who, what, when and where. Which services are outsourced (e.g., oil changes)? Include a section on how vehicles are maintained without interruptions in service (refer to TOP if applicable); • System safety plan (refer to TOP if applicable), • Drug -free workplace (refer to TOP if applicable); and Data collection methods, including how data was collected to complete Form A -2. Note: If the applicant is a CTC, rplevaot rages of TDSP and AOR containing the above information may be provided. Please do riot attc ct ont re do rrt . ts. Page ic of 37 ;.1', App .EtzIio^�- Fora /I. -?5 Fac Z Sh s.� Red Capital Blue- operathl(� 2 Number of one -way trips (b) provided to seniors and individuals with disabilities PE YEA -i,* j Number of individual senior and (c) disabled clients (unduplicated) E ;`FA R. ----------------------------------------------------------------------------------------------- Total number of vehicles used ( d ) to provide service to seniors and individuals with disabilities AC TU 1 ,L. Page 3-5 of 37 Attachment: 5310 Application 01 - 2 -1 (F DOT 5310 Application 01 -17 -2018) kd) served by the agency RAH EA ", (for entire system).* Please include calculations. €�_ r a �'ur[)I ._ All Red- Ca Dual Total fleet vehicle miles traveled to provide service to seniors and individuals with disabilities :'F�: : . 7 Total number of square miles of service coverage. 3 Number of days that vehicles are in operation to provide service to seniors and individuals with disabilities A t .'e : PER Y - R. (f) (g) (h) Page if of 37 Attachment: 5310 Application 01 - 2 -1 (F DOT 5310 Application 01 -17 -2018) -- key to provide service to seniors and individuals with disabilities eligible for replacement ATlA:.. A'E AG...` E '. DAi . :io Number of hours of service ------------ - - - - FIE [Au. -� i Posted hours of normal -------------------------- operation agency provides M —F.• service to seniors and Saturday. Saturday.• individuals with disabilities Sunday: PER WE , (This does not Sunday. include non - scheduled TotaI (WEEK): Total (WEEK): emergency availability). *One -way passenger trip is the unit of service provided each time a passenger enters the vehicle, is transported, and then exits the vehicle. Each different destination would constitute a passenger trip. Page 17 of 37 Attachment: 5310 Application 01 - 2 -1 (F DOT 5310 Application 01 -17 -2018) r:;ri_ i� �- }:�3t�Y. °ri. ,3_�, _zx °;:� €�r; I}r�`� P, I :rp le- li Fled- Caoiial R r��,��t:�.� F orm B-1: Propsed Project Descriptio All Applicants , ,a) How will the grant funding be used? Check all that apply: Vehicle(s) -� Equipment Mobility Management Preventative Maintenance Operating 4 Red- Capita! Expansion LJ Replacement 7-1 Expansion Continuing Service (b) In which geographic area(s) will the requested grant funds be used to provide service? Urban (UZA) ElSmall Urban (SUZA) Rural Complete the service area percentages for the geographic areas where the requested grant funds will be used to provide service Example: If your agency makes 500 trips per year and 100 of those trips are urban then: 100 UZA trips 1500 total trips =.2 * 100 = 20% UZA service area UZA P SUZA Rural I Number of trips, revenue service hours, or revenue service ec° miles within specified by aeoaraohic area Total number of trips, revenue service hours, or revenue service miles q.aas Percentage of service within specified geographic gran %UZA service area %Small Urban service area o /oRural service area 8 8 CU 0 CL CD LO 0 co CD CD 8 8 r- 2 CU 2 CL CD LO r - 0 .a L) cu Page 3.8 of 37 - i tcl , E - OI prating Calculate the funding split for the geographic areas where the requested grant funds will be used to provide service. UZA SUZA -�T Rural Total amount requested v(�sltil =-, Percentage of service within specified E` uals Funding y geographic area split .) When invoicing for operating projects, you must use the above funding split on your invoice summary forms. Once you have determined the funding split between UZA, SUZA and Rural, you will need to calculate the match amount. N OTE: £3v'a "da 65 jtt: c r.c. c -7t UZA W .. .5 Federal & .5 Local $ $ SUZA .5 Federal & .5 Local $ $ Rural 5 Federal & .5 Lo cal $ $ Funding Split No"Z p3zed .5 Federal & .5 Local �; ; Federal Local r =. Assi.t2 ,.;E (80 Feder 7il 1 ';w S�t t2 aoc` UZA .8 Federal & .1 State & .1 Local $ $ $ SUZA .8 Federal & .1 State & ($ .1 Local $ $ Rural Y .8 Federal & .1 State & I 1 Local I $ I $ $ Funding MU't�?Iied .8 Federal & .1 State & Split by .1 Local IU a'Is j Federal TState Local Page 1 9 Of 3 7 p � Ur A Red- Ca p=tdi blue- Opet "a<tng (c) How will the grant funding improve your agency's transportation service? Provide detail. Will it be used to: Provide more hours of service? Expand service to a larger geographic area? Provide shorter headways? Provide more trips? Also, highlight the challenges or difficulties that your agency will overcome if awarded these funds. Page 20 of 37 m PorPlE. -P'll Pecs- Capita! SIB- !e- Operatinj (d) If this grant is not fully funded, can you still proceed with your transDortatinn nrnrnrm—? (e') New agencies only: Have you met with the CTC and, if so, how are you providing a service they cannot? Provide detailed information supporting this requirement. Page 21 of 37 >Uus I II«CU wiuHoui ine appropriate CTC coordination agreement may be rejected by FDOT. Grant awards will not be made without an appropriate coordination agreement. This coordination agreement must be enforced the entire time of grant (vehicle life or operating JPA expiration). 7 ri pti c� :, "ie f' :rir R r � #"_ a)�l"F"sl I\4i..- Ca 1.3f..I LJi..i Ca_fEiG<C�.�ry� Operating Requests cri,, (a) Please specify year of activity for operating assistance (typically current or immediate prior year). Capital Requests Only (a) If this capital request includes equipment, please describe the purpose of the request. () If you are requesting a vehicle that requires a driver with a CDL: * Who will drive the vehicle? O How will you ensure that your driver(s) maintain CDL certification? (C) If the requested vehicles or equipment will be used by a lessee or private operator under contract to the applicant agency, identify the proposed lessee /operator. ate Page 22 of 37 Include an equitable plan for distribution of vPhirlac „ Y + — Purple-A|| Red'C� Blue-(]peratinlg Preventive Maintenance Requests Only Note: Applicants apply for preventative maintenance costs must have a District-approved Preventative Maintenance (PK8) Plan and a cost allocation plan i[ maintenance activities are performed /n-bouse. (a) Please specify Period of Performance (should not exceed one 0.) year— must be for preceding or co//eocyear) (b) Please include a list of general PM activities to take place with the funding (c) Please list useful life for Page z3of37 F � P Red- Capitai Eh C8 0 cu CL CD Lo I 0 cl co N CD CD r_ 0 , Z3 cu CL CD Lo 4i r _ 0 E .a L) cu Page 2 4 Of 37 Pumle-Aii Red- Capital 13:ue-OperatLing Form B-2: Financial Capacitv—Pror)oqiat� School Bus Service Revenues ..~' ---' Freight Tariffs (4o4) --------�--- --^------� ----- .... ----------�-------_ rk .-,.-�--, . Interest Income (43-4) Contr Services ( 43p) Contributed Cash (43 1 ) Subsidy from Other Sectors of Operations (440) Total of Other Revenue $ Grand Total All Revenue s - ........... _ � T - CL CD � Ul) co CD CD CL CD � LO Page 25nf37 I CCII current Year Next year Page 26 Of 37 P Red- Capita; Blue-Opera�,Jnq E .� 'r. :(�✓a;;t"�8. -�. n, 'rat's, € - 0 . 'urpl - All ? , Cepita? ue- 01'eraunq Total Local Match — 50 %of Total Project cost $ Attach documentation of match funds directly after this page. Proof may consist of, but not be limited to: Transportation Disadvantaged (TD) allocation Written statements from county commissions, state agencies, city managers, mayors, town councils, organizations, accounting firms and financial institutions. Signature [blue ink] Typed Name and Title of Authorized Representative Date Page 27 of 37 Amount r d a 7 ^ >, :a�U P'i; ple -All Red- Capita ue -C per3rinc. Form B - 3: Breakdown of Transportation Casts Are you billing Direct Cost? EJ Yes D No If yes, skip Hourly Rate/ Per Trip Rate Calculation. uriy Rate CaICU13ti011 Note: If you elect to use this (hourly rate) calculation, du no complete the Per Trip Rate calculation section (6 —1o). , lat Transportation Cost Gross $ Transportation Total Revenues Cost [FTA Eligible ' ` ' [Revenue Used as FTA (> =c, •.,, a! Expense] Match Amount] 2. Hourl/ kate Net Transportation Cost [Calculated L) fed Service Hours Per Year above] y;) [(j)from Form A -2] � u s ' Tota` 'roj cL Cjst Net Transportation Cost Hourly Rate # of Vehicles (,MuItI li r; Service Hours Hourly � :1`��lt�itipii�� Rate [(d) from by) Per Year [(j) Form A -z] from Form A -2] ` [Calculated above] $ "e� Prc�e�t Cost Total Project Cost Passenger Fare Total Project Cost Revenue [Revenue [Calculated above]` Used as FTA Match ' Amount] Net Project Cost Your Section 5310 request is 50 of your net project cost. 4 �. .� Net Project Cost O iuit phed� Section 533.0 [Calculated above] icy} 5 0010 �i��l" Request Page 28 of 37 i "'Jrpk} -A€ Red- Capita! BlJE,-u�f.,erabrICA Per Trip R to Calculatior, ( -- ,o) NOTE If you elect to use this (per trip rate) calculation, J-0-got complete the Hourly Rate calculation section (i. — 5), 'a tetT,, ar,ssjort in Cc F n ss _ Total Revenues $ tion Cost in;s [Revenue Used as FTA Net Transportation [FTA Eligible Expense] Match Amount] Cost ate per n • V: t Project cost Passenger Fare Total Project Cost Revenue [Calculated above] J [Revenue Used as FTA '`" quais) Net Project Cost Match Amount] Your Section 5310 request is 50% of your net project cost. 5 � � Net Project Cost ' k- 1, 1 . it C [Calculated above] 1., , 50% /F ,,, Section 5310 Request Page 29 of 37 I Net Transportation ` Service Trips per i' "d� Cost [Calculated above] b ;d Year c �__� Rate per Trip p P [(b) from Form A -2] w $ # of vehicles lt i et�i ;i�fl..si�i Service Trips Rate per [(d) from Form per Year [(b) ('V'J!tip ,i Trip Total A -2] from Form A 2] '��' [Calculated ' use Project above] Cost • V: t Project cost Passenger Fare Total Project Cost Revenue [Calculated above] J [Revenue Used as FTA '`" quais) Net Project Cost Match Amount] Your Section 5310 request is 50% of your net project cost. 5 � � Net Project Cost ' k- 1, 1 . it C [Calculated above] 1., , 50% /F ,,, Section 5310 Request Page 29 of 37 For da F Purpl,�-Al! Red- cari Form C- Financial Capacity — Pr000spd Rj irqnof- FrN, C8 sd CL CD U I 0 Co N sd CD CD CL CD Lo r - 4) E .a L) m Page 3 Of 37 Fringe & Benefits (502) Services (503) Materials & Supplies (504) Vehicle Maintenance (504.01) Utilities (505) insurance (So6) Licenses & Taxes (507) Purchased Transit Service (5o8) Miscellaneous (509)* _ Leases & Rentals (512) Depreciation (513) Grand Total All Expenses s �•v� • G� IL I CCII Next year . ........___ ........... _...... .. ..... ._ ...._...... ._._............ Page 31 of 37 � Signature [blue ink] Typed Name and Title of Authorized Representative Date C8 C 0 cu L) CL CD U I 0 C) LL co C14 CD CD C 0 , Z3 cu CL CD LO 4i E .a L) cu Page 32 Of 37 Roq-!j,-� D 0:1,. c) F L PU All D,1 r,-:,-i ! � ,. v::� " .....x .. ✓ �ti.J;Yv .Ir_C' 1 �: ....F., E i.it �i 4. �J IE -�z 1 Red- CFP tal Blue- Gperat ;r ci Form C -z: Capital Request Form To identify vehicle type and estimate cost visit t _tP: /Ft' ip5flcndl All vehicle requests must be supported with a completed sample order form in order to generate a more accurate estimation of the vehicle cost. The order from can be obtained from 1. Select Desired Vehicle (Cutaway, Minibus etc.) 2. Choose Vendor (use drop down arrow next to vendor name to see information) 3. Select Order Packet 4. Complete Exhibit A (Order Form) The Auto and Light Truck contract can be found at . T;? #E t r ,� y . . a; Vehicle Request Subtotal s *Under Description /Vehicle Type, include the length and type vehicle, lift or ramp, number of seats and wheelchair positions. For example, 22' gasoline bus with lift, 12 ambulatory seats, and 2 wheelchair positions. Any bus options that are part of purchasing the bus itself should be part of the vehicle request and NOT separated out under equipment. Replacement Vehicles (R) Page 33 of 37 If the capital request includes replacement vehicles. Please list the vehicles in your current fleet that you are intending to replace with the vehicle from your vehicle request. Please list by order of Drinrity da Purple -,ill Rod- apiTal 1tle Oueratinrt Subtotal $ * List the number of items and provide a brief description (i.e. two -way radio or stereo radio, computer hardware /software, etc.) + Vehicle Subtotal Plus Equipment Subtotal o.8 Total Cost Multiplied by 8o% Page 34 of 37 Equals Total Cost g Equals Federal Request Form 424, Block z8 (a) If item requested is after - market, it is recommended to gather and retain at least two estimates for the equipment requested. Purchases must be approved at the local level and follnw tha r., r.• .,..,_, '. r3 Purple-All Red- Capita! End of Step 1: Preliminary Application 5310 Grant Application Revised on 15 September 2017 Revised by Jarrell Smith, 5310 Coordinator FDOT Public Transit Office 605 Suwannee Street (MS 26) Tallahassee, Florida 32399-0450 Work Phone 850-414-4045 Email. iarrell-smithLd)dot. state ,fl.us C8 CU CL CD L0 I-- 0 C) N CD CD r- CU CL CD LO r- 0 E .a L) (U Page 37 Of 37 49 U.S.C. Section 53 Capital & Operating Assistance — FFY 2018 Step 2 of 3.- Required Docur4in-nts for Award Formula Grants for the Enhanced Mobility of Seniors and Individuals with Disabilities CFDA 20.513 Legal Applicant Name: Note: Dear Applicant, You have successfully passed the first step in FDOT's 5310 grant application process! Based on the information provided in the preliminary application, you are eligible to receive an award. In order to be considered for a Notice of Grant Award (NOGA) and /or Joint Participation Agreement (JPA), you are required to submit the information outlined in the following pages. Page 3 of 3.1 CI P i _ C Pecs- CaPit:al EIJO- Cperat:m, Please No--c . e This grant application is color coded based on which type of award you are applying for. Forms and exhibits in purple must be completed for all applications. Forms and exhibits in red apply to capital applications, exclusively. Forms and exhibits in apply to operating applications, exclusively. Page 2 of 11 Purple-All able e ku g PLEASE NOTE REQUIRED DOCUMENT CHECKLIST Exhibit I: FDOT Certification and Assurances Exhibit J: Standard Lobbying Certification Exhibit K: Leasing Certification Exhibit L: Certification of Equivalent Service Form 424 Application for Federal Assistance Exhibit M: Federal Certifications and Assurances Exhibit N: Transportation Operating Procedure (TOP) Exhibit O: Title VI Plan Exhibit P: Protection of the Environment Exhibit Q: Triennial Review - CAP Closeout ed- pit.a# hue- zJ tc3CinL 2 4 5 7 9 10 10 10 10 10 10 co 8 CU CL CD LO 0 cl co CD CD 8 8 sd CU CL CD LO E L) cu Page 3 of 13 Ourr'e Red C,��Pital !3! erd R e Ll 0 L i St Each of the below items must be included with your Section 53:Lo Grant Application submittal in the same order as the checklist. Cover Page (page i) Required Document Checklist (this document) I Wzoageriall Exhibit 1: FDOT Certification and Assurances J Exhibit J: Standard Lobbying Certification Exhibit K: Leasing Certification Exhibit L: Certification of Equivalent Service L Form 4 Application for Federal Assistance L 7 Exhibit M: Federal Certifications and Assurances L_J Exhibit N: Transportation Operating Procedure (Applies to Section 53.1 o-only Applicants) [J Exhibit 0: Title VI Plan Exhibit P: Protection of the Environment (Required if the proposed project is for the construction of facilities) [] Exhibit Q: Triennial Review— CAP Closeout Page 4 Of 11 Pu ple -A. -` Capital BI a , E, M 4 a n a � ,-- -- ' Exhibit r FDOT Certification and A rar c--s (A enc Name I certifies and assures to the Florida Department of Transportation regarding its Application under U.S.C. Section 53 dated Date day of Month Year It shall adhere to all Certifications and Assurances made to the federal government in its Application. 2 It shall comply with Florida Statues: • Section 34 Administration and financing of public transit and intercity bus service programs and projects • Section 34 Transit Safety Standards; Inspections and System Safety Reviews 3 It shall comply with Florida Administrative Code (Does not apply to Section 5310 only recipients): • Rule Chapter 14 -73— Public Transportation • Rule Chapter 14 -9o— Equipment and Operational Safety Standards for Bus Transit Systems • Rule Chapter 1 4 - 90.0041— Medical Examination for Bus System Driver • Rule Chapter 4 - 2— Definitions 4 It shall comply with FDOT's: • Bus Transit System Safety Program Procedure No. 725 - 030-009 (Does not apply to Section 5310 only recipients) • Public Transit Substance Abuse Management Program Procedure No. 725- 030-035 • Transit Vehicle Inventory Management Procedure No. 725- 030-025 • Public Transportation Vehicle Leasing Procedure No. 725 - 030-001 • Guidelines for Acquiring Vehicles • Procurement Guidance for Transit Agencies Manual 5 It has the fiscal and managerial capability and legal authority to file the application. 6 Local matching funds will be available to purchase vehicles /equipment at the time an order is placed. 7 It will carry adequate insurance to maintain, repair, or replace project vehicles /equipment in the event of loss or damage due to an accident or casualty. S It will maintain project vehicles /equipment in good working order for the useful life of the vehicles /equipment. 9 It will return project vehicles /equipment to FDOT if, for any reason, they are no longer needed or used for the purpose intended. Page 5 of 3.3. I ur ;Ie -A Ned- Capital Bl =)e -CP r�auriy to It recognizes FDOT's authority to remove vehicles /equipment from its premises, at no cost to FDOT, if FDOT determines the vehicles /equipment are not used for the purpose intended, improperly maintained, uninsured, or operated unsafely. 3 -1 It will not enter into any lease of project vehicles /equipment or contract for transportation services with any third party without prior approval of FDOT. 1.2 It will notify FDOT within 2 4 iIco s of any accident or casualty involving project vehicles /equipment, and submit related reports as required by FDOT. 13 It will notify FDOT and request assistance if a vehicle would become unserviceable. 14 It will submit an annual financial audit report to FDOT (FDOTSingleAuditQa dot.state.fl.us), if required. 1.5 It will undergo a triennial review and inspection by FDOT to determine compliance with the baseline requirements. If found not in compliance, it must send a progress report to the local FDOT District office on a quarterly basis outlining the agency's progress towards compliance. Date Signature of Authorized Representative Typed Name and Title of Authorized Representative Page 6 of si at.e r Y xu Purple-All Red �CapitSl iu - 01)g�1r3t ;rq Exhibit !. Standard °_obbyig ic The undersigned (Contractor) certifies, to the best of his or her knowledge and belief, that: :L No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. 1 If any funds other than Federal appropriated funds have been paid or will be paid to any person for making lobbying contacts to an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form - -LLL, "Disclosure Form to Report Lobbying," (a copy the form can be obtained from Q!L -,, -, g :r =` _�� .�ir�, in accordance with its instructions [as amended by "Government wide Guidance for New Restrictions on Lobbying," 61 Fed. Reg. 1433 (1/39/96). Note: Language in paragraph (2) herein has been modified in accordance with Section 10 of the Lobbying Disclosure Act of 1995 (P.L. 104 -65, to be codified at 2 U.S.C. 1603, et seq.)] 3 The undersigned shall require that the language of this certification be included in the award documents for all sub - awards at all tiers (including subcontracts, sub - grants, and contracts under grants, loans, and cooperative agreements) and that all sub - recipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31, U.S.C. § 1352 (as amended by the Lobbying Disclosure Act of 1995). Any person who fails to file the required certification shall be subject to a civil penalty of not less than $so,000 and not more than $s00,000 for each such failure. I CS ' ; Pursuant to 31 U.S.C. g 3.352(c)(3)- (2)(A), a person who makes a prohibited expenditure or fails to file or amend a required certification or disclosure form shall be subject to a civil penalty of not less than $3-0,000 and not more than $300,00o for each such expenditure or failure. The (Contractor), certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition, the Contractor understands and agrees that the provisions of 31 U.S.C. A 3801, et seq., apply to this certification and disclosure, if any. Date Signature of Contractor's Authorized Official Typed Name and Title of Authorized Representative Page 7 of iz Exhibit K: Leasing Certification Memorandum for FTA 5310 Date: From: Signature Typed Name and Title ofAuthorized Representative Typed Agency Name To: Florida Department of Transportation, District Office Modal Development Office /Public Transit Subject: YEAR 2o18 GRANT APPLICATION TO THE FEDERAL TRANSIT ADMINISTRATION, OPERATING OR CAPITAL ASSISTANCE FOR ENHANCED MOBILITY OF SENIORS AND INDIVIDUALS WITH DISABILITIES PROGRAM, 49 UNITED STATES CODE SECTION 5310 Leasing: Will the Lftme o applicant icant a a 9e»_c_y) as applicant to the Federal Transit Administration Section 53 Program, lease the proposed vehicle(s) or equipment out to a third - party? O No 0 Yes If yes, specify to whom: NOTE: It is the responsibility of the applicant agency to ensure District approval of all lease agreements. Page 8 of 3.1 CERTIFICATION OF EQUIVALENT SERVICE (Agency Name) certifies that its demand responsive service offered to individuals with disabilities, including individuals who use wheelchairs, is equivalent to the level and quality of service offered to individuals without disabilities. Such service, when viewed in its entirety, is provided in the most integrated setting feasible and is equivalent with respect to: 1 Response time; 2 Fares; 3 Geographic service area; 4 Hours and days of service, 5 Restrictions on trip purpose; 6 Availability of information and reservation capability, and 7 Constraints on capacity or service availability. In accordance with r CFR Part 37, public entities operating demand responsive systems for the general public which receive financial assistance under 49 U.S.C. 533.o and 5313. of the Federal Transit Administration (FTA) funds must file this certification with the appropriate state program office before procuring any inaccessible vehicle. Such public entities not receiving FTA funds shall also file the certification with the appropriate state office program. Such public entities receiving FTA funds under any other section of the FTA Programs must file the certification with the appropriate FTA regional office. This certification is valid for no longer than one year from its date of filing. Non - public transportation systems that serve their own clients, such as social service agencies, are required to complete this form. Executed this Date day of Month Year Typed Name and Title of Authorized Representative Signature of Authorized Representative Page 9 of ii puj ple- I Red t a,rjit_l Blu Doerabnc Exhibit L: Certification of Equivalent Service CERTIFICATION OF EQUIVALENT SERVICE (Agency Name) certifies that its demand responsive service offered to individuals with disabilities, including individuals who use wheelchairs, is equivalent to the level and quality of service offered to individuals without disabilities. Such service, when viewed in its entirety, is provided in the most integrated setting feasible and is equivalent with respect to: 1 Response time; 2 Fares; 3 Geographic service area; 4 Hours and days of service, 5 Restrictions on trip purpose; 6 Availability of information and reservation capability, and 7 Constraints on capacity or service availability. In accordance with r CFR Part 37, public entities operating demand responsive systems for the general public which receive financial assistance under 49 U.S.C. 533.o and 5313. of the Federal Transit Administration (FTA) funds must file this certification with the appropriate state program office before procuring any inaccessible vehicle. Such public entities not receiving FTA funds shall also file the certification with the appropriate state office program. Such public entities receiving FTA funds under any other section of the FTA Programs must file the certification with the appropriate FTA regional office. This certification is valid for no longer than one year from its date of filing. Non - public transportation systems that serve their own clients, such as social service agencies, are required to complete this form. Executed this Date day of Month Year Typed Name and Title of Authorized Representative Signature of Authorized Representative Page 9 of ii Red- 1- apital 131s le- Ope - orm 424: Application for Federal Assistance Attach the completed Form 424 here. You may insert the completed form as a PDF or print and attach the form to your final application document. Exhibit : Federal aI and Ass ra�jC S Please attach Federal Certifications and Assurances signature page here. You may insert the signed certifications and assurances as a PDF or print and attach the form to your final application document. Exhibit N; Tragisportatio -i perati i Proce -ire (T P) (Applies to Section 5310 -only Applicants) Attach the agency's most recent TOP. See the FDOT State Management Plan for TOP requirements You may insert the TOP as a PDF or print and attach the document to your final application. Exhi il� 0. Title Vi ' ian If an applicant has not previously submitted their Title VI plan to the Department, a copy must be included here. You may insert the Title VI Plan as a PDF or print and attach the document to your final application. Exhibit P: Protection of the Environment Required if the proposed project is for the construction of facilities. Please see Grant Application Instruction Manual for details. Exhibit Ceti Triennial Pevievv - '4' P Ocse. -ic Required if the agency's latest Triennial Review included a Corrective Action Plan. Please submit a copy of the corrective action plan. Page to of 11 , -All Rai- ( l B#-l� End of Step 2: Required Documents for Award 5310 Grant Application Revised on 15 September 2017 Revised by: Jarrell Smith, 5310 Coordinator MOT Public Transit Office 605 Suwannee Street (MS 26) Tallahassee, Florida 32399 -0450 Work Phone: 850 Email jarrellsmith statefl us 8 CU CL CD 0 co CD CD 8 8 p r— p � sd CL CD LO r - 0 E L) Page is of ii County of Monroe The Florida ]Keys County Commission A January 18, 2017 Agenda Item Number: Agenda Item Sununary BOARD OF COUNTY COMMISSIONERS Mayor George Neugent, District 2 Mayor Pro Tern David Rice, District 4 Danny L. Kolhage, District 1 Heather Carruthers, District 3 Sylvia J. Murphy, District 5 Zeeting C.27 #2550 BULK ITEM: Yes DEPARTMENT: Social Services TIME APPROXIMATE: STAFF CONTACT: Sheryl Graham (305) 292 -4510 N/A AGENDA ITEM WORDING: Approval to apply for a Florida Department of Transportation (FDOT) FTA Section 5310 Program Federal Fiscal Year (42) 2017 Capital Assistance Grant for the purpose of purchasing four (4) para transit vehicles to serve the transportation needs of the transportation disadvantaged, elderly, and persons with disabilities throughout Monroe County. ITEM BACKGROUND: The Florida Department of Transportation (FDOT) Section 5310 Grant is applied for on an annual basis by the Monroe County Social Services Transit department. This grant is intended to enhance mobility for seniors and persons with disabilities by providing funding for programs to serve the special needs of transit dependent populations beyond traditional public transportation and in accordance with the Americans with Disabilities Act (ADA). We are requesting 4 vehicles for FFY 42 to replace our aging fleet. PREVIOUS RELEVANT BOCC ACTION: Approval granted by the BOCC on 01/20/2016 to apply for an FDOT FTA Section 5310 Program FFY 412016 Capital Assistance Grant for the purpose of purchasing 4 para- transit vehicles to serve the transportation disadvantaged population throughout Monroe County. CONTRACT /AGREEMENT CHANGES: Approval to apply for new grant year STAFF RECOMMENDATION: Approval DOCUMENTATION: FDOT 5310 Application Backup FDOT 5310 Application 12 -30 -16 FDOT 5310 Application part 2 12 -30 -16 FINANCIAL IMPACT: Effective Date: 01/18/2017 Expiration Date: Total Dollar Value of Contract: 290,000.00 Total Cost to County: 29,000.00 Current Year Portion: Budgeted: Source of Funds: FDOT 5310 Grant Funds CPI: Indirect Costs: Estimated Ongoing Costs Not Included in above dollar amounts: Revenue Producing: N/A If yes, amount: Grant: Yes County Match: 10% cash match Insurance Required: Additional Details: 01/18/17 001 -61525 -SOCIAL SERVICE TRANSPORT 530641 $29,000.00 REVIEWED BY: Sheryl Graham Completed 12/30/2016 1:03 PM Pedro Mercado Completed 12/30/2016 2:01 PM Budget and Finance Completed 12/30/2016 2:12 PM Maria Slavik Completed 12/30/2016 2:17 PM Kathy Peters Completed 12/30/2016 3:12 PM Board of County Commissioners Completed 01/18/2017 9:00 AM