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FISCAL YEAR 2013 APPLICATION
Arkansas State Highway and Transportation Department
Public Transportation Programs
Planning & Research Division
January 2012
SECTION 5316
Job Access and Reverse Commute Program
and
SECTION 5317
New Freedom Program
NOTICE OF NONDISCRIMINATION: The Arkansas State Highway and Transportation Department (Department) complies with all civil rights provisions of federal statutes and related authorities that prohibited discrimination in programs and activities receiving federal
financial assistance. Therefore, the Department does not discriminate on the basis of race, sex, color, age, national origin, religion or
disability, in the admission, access to and treatment in Department’s programs and activities, as well as the Department’s hiring or employment practices. Complaints of alleged discrimination and inquiries regarding the Department’s nondiscrimination policies may be
directed to Section Head - EEO/DBE (ADA/504/Title VI Coordinator), P. O. Box 2261, Little Rock, AR 72203, (501) 569-2298,
(Voice/TTY 711). This notice is available from the ADA/504/Title VI Coordinator in large print, on audiotape and in Braille. Free language assistance for Limited English Proficient individuals is available upon request.
TABLE OF CONTENTS
Application Form and Format
1. Project Type 1
2. Application Organization 1
3. Type of Applicant 2
4. Applicant’s Existing Transportation Services 3
5. Service Provided Through This Application 4
6. Local Coordination Plan 5
7. Financial Information 5
8. Estimated Project Budget 6
9. Transportation Management and Experience 7
10. Program Certifications and Assurances 8
Attachments
11. Supporting Documentation 12
12. Vehicle Inventory Form 14
13. Public Notice 15
14. Public or Private Operator’s Statement 16
15. Federal Assistance Form 424 17
PLEASE DO NOT COMPLETE THIS APPLICATION UNTIL YOU HAVE
COMPLETELY READ AND FOLLOWED THE INSTRUCTIONS IN THE
PROCEDURES MANUAL. All pages must be completed. Incomplete applications and
those lacking necessary supporting documents cannot be properly evaluated and therefore
cannot be considered. The original completed (original signatures in BLUE ink no
photocopies will be accepted) application must be received in the Public Transportation
Programs office no later than Wednesday March 7, 2012 4:00pm CDST.
i
ARKANSAS STATE HIGHWAY AND TRANSPORTATION DEPARTMENT
PUBLIC TRANSPORTATION PROGRAMS
Section 5316 - Job Access and Reverse Commute,
Section 5317 - New Freedom
** An Application Instructions Manual is Included in This Document Following Page 17**
FY 2013 Application Form
1. Project Type
Section 5316 - Job Access/Reverse Commute ____ Capital ____ Operating ____ Other
(Persons with Low Income)
Or
Section 5317 - New Freedom ____ Capital ____ Operating ____ Other
(Persons with Disability)
2. Application Organization
State Clearinghouse
Confirmation Number:
Legal Name of Agency:
Street Address:
Mailing Address:
City, State, Zip:
Agency Website:
Doing Business As:
Street Address:
Mailing Address:
City, State, Zip:
Executive Director: Telephone Number:
E-Mail Address: Fax Number:
Applicant Contact Person: Telephone Number:
E-Mail Address: Fax Number:
1
3. Type of Applicant (check one):
Public Entity (City, County) Public Transit Operator Private Non-Profit Agency
Private For Profit Agency
3a. Applicant been approved for federal assistance within last 3 years under any AHTD
administered transit program? (Circle all that apply)
Section 5310 Section 5311 Section 5316 Section 5317
3b. Geographical service area of applicant’s current transit operations:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
3c. Transportation service operates in any of the following urbanized areas?
(Check all that apply)
[ ] Fayetteville/Springdale [ ] Fort Smith [ ] Hot Springs [ ] Jonesboro
[ ] Little Rock/North Little Rock [ ] Pine Bluff [ ] Texarkana [ ] West Memphis
3d. All Section 5316 and Section 5317 Program Reporting and Expenditure forms are
computerized. It is important that these computer forms be used by approved applicants.
Are all staff persons proficient in Microsoft Word, Excel and Office? [ ] Yes [ ] No
If not, please explain how Program forms will be completed.
4. Applicant’s Existing Transportation Services
4a. List each service center and the passenger transportation information. Submit additional sheets if necessary.
Applicant Service Center
Location
Number
Vehicles used
to transport
clients
Number of
ADA
Accessible
Vehicles
Number of
Active
FTA
Vehicles
Avg. No.
Vehicle
Trips Per
Day
Avg. No.
Seats Per
Vehicle
Avg. No.
Clients
Participating
in Program
Avg. No.
Clients
Transported
Daily
Total Miles
Driven Per
Day
Applicant Service
Center
Service Area
Date Transportation
Service was started
at this center
Hours of
Operation
Days of
Service
Trip Purposes (i.e.
to Center, medical,
shop, employ, etc.
What Percentage is
Low-Income, Disabled,
Elderly, Other
(should total 100)
____LI ____D ____E ____O ____LI ____D ____E ____O
____LI ____D ____E ____O
____LI ____D ____E ____O
____LI ____D ____E ____O
____LI ____D ____E ____O
____LI ____D ____E ____O
____LI ____D ____E ____O
4b. Number of paid drivers: _____ Number of volunteers drivers: _________
4c. Type of Service: _____ Demand Response: _____ Fixed Route: _____ Both: _____
4d. Do you have a fare policy? [ ] No [ ] If yes, rate per trip _______________
4e. Do you provide service to non-agency clients? Yes [ ] No [ ]
4f. Does your agency’s policy allow non-agency persons to ride? Yes [ ] No [ ]
3
5. Describe Service To Be Provided Through This Application
5a. Location (List each service center and city/county): ____________________________________
_________________________________________ ______________________________________
_________________________________________ ______________________________________
5b. Estimated number of clients per day to be served with these funds? ___________________
5c. Estimated passenger trips per day? _______________________
5d. What percent of the daily trips are for: ______ Low-Income ______ Disabled ______ Other
5e. Identify trip purposes by percent (must equal 100 %).
Medical ___________ Personal/Shopping ___________ Education ___________
Employment ___________ Recreation/Social ___________ Child Care ___________
Nutrition __________ Other (Specify) ___________
5f. Number of days of the week operated? __________
5g. Number of hour’s vehicle will be utilized daily: __________
5h. Time(s) of day the vehicle will be utilized: __________
5i. Total miles driven per day: __________
5j. Is a vehicle being purchased as a: 1) Replacement 2) Expand Existing Routes or Hours 3) Establish New Service Areas/Clients, 4) Other (specify) _____________________________ If for Replacement, will the old vehicle remain in service? Yes No
5k. Describe your proposed project? Target groups, destinations, purpose, etc.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
5l. For Section 5316 Applicants. How many job sites will be serviced by this project? ________
5m. For Section 5317 Applicants. Was this service (route and same hours) available before August 10, 2005? Yes No
5n. For Section 5317 Applicants. How does this project differ from the service described in Question 4a? How does the proposed project meet the ―Beyond‖ ADA program requirements? (See Instructional Manual for explanation.)
_
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
4
6. Local Coordination Plan
6a. Title of Local Coordination Plan: _________________________________________________
6b. What strategy/project does this application address? Strategy Number ________; Page _______
6c. What specific coordination activities have you pursued this past year? (Other than plan development.)
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
______________________________________________________________________________
6d. List other Human-Service agencies providing transportation in your service area. (City or county
where this project will operate.)
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
_____________________________________________________________________________
7. Applicant Financial Information
7a. Is funding for your transportation services over the next four years:
[ ] Stable because of reliable federal or state recurring funding programs.
[ ] Reasonably secure, but some sources of funding are subject to variation and are not reliable.
[ ] Uncertain because all funding sources are not reliable.
7b. Report your agency’s information from the most current IRS Form 990: 20___
For the ________ calendar year, or tax year beginning ____________ and ending ______________
Organization Type (check only one) [ ] 501( c) _____ (insert no.) [ ] 4947(a)(1) [ ] 527
Gross Receipts $___________________
7c. Record Part 1 Data:
Direct Public Support $______________ Total revenue $_____________
Indirect Public Support $______________ Total expenses $_____________
Gov. Contribution (grants) $______________ Excess/deficit $_____________
Total (add 1a thru 1c) $______________ Net assets/fund balance $_____________
7d. Are transportation line items included in the annual budget for human service programs that
provide transportation services? Yes [ ] No [ ]
5
8. Estimated Project Budget 8a. What are the estimated annual costs for the proposed project? The Federal/Local match for
capital projects is 80/20. All other projects have a Federal/Local match of 50/50.
ITEM
CODE
ITEM DESCRIPTION
MATCH TOTAL
AMOUNT
FEDERAL
AMOUNT
LOCAL
AMOUNT
100 Computer Hardware 80/20
110 Computer Software 80/20
120 Vehicle (specify type) 80/20
130 Other (specify) 80/20
Total Capital Cost
200 Administrative Staff & Fringe 50/50
210 Drivers Salaries & Fringe 50/50
220 Other Personnel & Fringe 50/50
230 Audit 50/50
240 Insurance 50/50
250 Communication 50/50
260 Fuel and Oil 50/50
270 Maintenance & Repairs 50/50
290 Other (Specify) 50/50
Total Operating Costs
TOTAL FUNDS REQUESTED
(capital plus operating)
8b. List source of funds used for the required local match.
Federal, State, Local or Other Type of Funding Amount
8c. Specify Vehicle Type (See Appendix A of Instruction Manual). Section 5317 applicants must
request a lift-equipped vehicle to comply with the ADA!
Item No. _________ Vehicle Description ______________________________________
State Bid No. ____________________
8d. Vehicle justification.
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
6
9. Transportation Management and Experience 9a. List individual(s), phone number, fax number responsible for Performance Measurement Reports,
the Program Claim for Reimbursement, and the Fleet Preventative Maintenance report.
__________________________________________________________________________________
________________________________________________________________________________
9b. How many years has your organization been operating passenger transportation services? _______ 9c. When selecting drivers, does your organization (check all that apply):
[ ] Check driving records?
[ ] Require a physical exam?
[ ] Require a minimum age _______and maximum age _______?
[ ] Conduct pre-employment drug testing?
[ ] Have a drug and alcohol testing program?
9d. Does your organization require any of the following training courses (check all that apply):
[ ] First aid [ ] Defensive Driving
[ ] CPR [ ] Wheelchair Lift Operation
[ ] Drug and alcohol abuse awareness [ ] Child Passenger Safety
[ ] Driver sensitivity training [ ] Passenger assistance training
[ ] Vehicle emergency evacuation
9e. Describe in detail your agency passenger transportation safety program?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
____________________________________________________________________________
9f. What best describes your fleet preventative maintenance program:
[ ] Scheduled and documented maintenance program is being provided by a professional source.
[ ] An employee is assigned responsibility for ensuring each vehicle is properly maintained.
[ ] Drivers have primary responsibility for overseeing the maintenance of their vehicle.
[ ] None of the above.
Other_______________________________________________________________
9g. Describe in detail your fleet preventative maintenance program:
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
7
10. Program Certifications and Assurances
10a. Federal and State laws and regulations govern the operations of public transportation services. If
approved, an applicant must sign an annual certification and assurance form. This form ensures
compliance with applicable provisions of laws and regulations that may include the following:
American Disabilities Act
Commercial Drivers License Drug and Alcohol Testing
Lobbying Procurement Compliance
Public Providers of Public Transportation Public Hearing
Intergovernmental Review Acquisition and Lease of Capital Assets
Bus Testing Charter Service Agreement
School Transportation Agreement Demand Responsive Service
Interest and Other Financing Costs Intelligent Transportation Systems
Disadvantage Business Enterprise Program Labor Protection
49 U.S.C. Section 5316 Agreement or 49 U.S.C. Section 5317 Agreement
10b. An authorized officer on the board and the director, executive director, etc., (two different
original signatures) must date and sign this form for this application to be considered.
Certification of Information
I am an officer of the applicant organization herein and am authorized to make this certification.
I hereby certify on this day of ,
that the statements and other information contained in this application, including all attachments, are true and correct.
Further, I certify that the applicant organization has sufficient financial resources to assure payment of the required local
match for the project described in this application.
Authorized Officer on the Board :(Signature)
(Print Name)
(Position)
WITNESS:
Executive Director or CEO :(Signature)
(Print Name)
10c. Title VI Compliance - Title VI of the 1964 Civil Rights Act, Section 601, states:
―No person in the United States shall, on the grounds of race, color, or national origin,
be excluded from participation in, be denied the benefits of, or be subjected to
discrimination under any program or activity receiving Federal financial assistance.‖ Has your agency had any lawsuits or complaints alleging discrimination in service delivery or other
transit benefits filed against it in the past year? NO _____ YES _____
If yes, provide a concise description of the lawsuits or complaints alleging discrimination filed against
your agency, together with a statement of status or outcome of each such complaint or lawsuit.
8
Has your agency had any civil rights compliance review in NO _____ YES _____
the past three years?
If yes, provide a summary of all compliance review activities conducted in the last three years. The
summary should include the purpose or reason for the review, the name of the agency or organization
that performed the review, a summary of the findings and recommendations of the review, and a report
on the status and/or disposition of such findings and recommendations.
Executive Director or CEO :(Signature)________________________________________________
10d. Certification of Equal Access For Persons with Disabilities
To determine if your agency can provide equal access, please answer the following questions.
Total number of vehicles used to transport clients (all centers)? __________
Total number of vehicles ADA accessible? __________
How long would it take to provide a backup vehicle, if necessary? _____________
I hereby certify, that when viewed in its entirety, the passenger transportation program of
_______________________________________ provides disabled persons with access equal to that
afforded to any other persons in terms of the following criteria.
1) Response time;
2) Fares;
3) Geographic area of service;
4) Hours and days of service;
5) Restrictions based on trip purpose;
6) Availability of information and reservations capabilities;
7) Constraints on capacity or service availability; and
8) Public accommodations, including telephone and website services.
Certified by Executive Officer (Signature) _______________________________________________
10e. Certification of Vehicle Operation.
CERTIFICATION OF VEHICLE OPERATION
I, _________________________________________________, hereby certify that each active vehicle
(Executive Director’s Signature)
purchased with Federal Transit Administration funds are being used in accordance with Federal and
State program guidelines. Active vehicles are those for which reports are submitted to the AHTD.
Further, the vehicle is being utilized (in terms of ridership, mileage, etc.) as proposed in the agency’s
application and in accordance with the goals and objectives of transit local coordination efforts.
9
10f. Certification of Eligibility (for Public Entities only). This certifies that there are no nonprofit
organizations ready, willing and available in the area to provide service. Efforts to solicit service must
be documented and included with certification. Documentation shall include a list of all existing
transportation providers to whom letters were mailed.
LOCAL PUBLIC ENTITY ELGIBILITY
I, _______________________________________, the duly elected executive official of the
______________________________________ (Local Public Entity) hereby certify that no private
non-profit organizations in the proposed service area are readily available to provide transportation
services to elderly and disabled persons as outlined in this application.
Please complete and attach the Response Form to verify eligibility.
10
AVAILABILITY OF PRIVATE NON-PROFIT RESPONSE FORM Letters were sent on ____________ (date) to the following private non-profit organizations in
_______________________ (city/county). Indicate responses received and attach copies of responses or
correspondence.
NAME
ADDRESS
RESPONSE RECEIVED
11
11. Supporting Documentation (Include in the order indicated. Submitted documents are to be on 8 1/2” X 11”.)
Pre-Certified Private Non-Profit Applicants (These are agencies currently participating in a 5310, 5311, 5316 or 5317 Program with active vehicles and currently
submitting vehicle quarterly performance reports.)
a. Application with original signatures.
b. Amendments, if any, since last approved Articles of Incorporation.
c. Vehicle Inventory Form on page 14.
d. Public Notice - the actual newspaper clipping or a certified copy on page 15.
e. Public or Private Operator’s Statements on page 16.
f. State Clearinghouse confirmation receipt letter and Form 424. Form 424 located on page 17.
g. Latest completed financial audit, with all management letters on file.
New Applicants (These are agencies applying for the first time or agencies that previously participated in an AHTD Transit Program but
no longer have active vehicles requiring vehicle quarterly performance reports.)
a. Application with original signatures. Photocopy of application is not acceptable.
b. Listing of current Board of Directors with their positions, addresses and occupations.
c. Certificate of Incorporation issued by the Secretary of State with any amendments.
d. Articles of Incorporation with any amendments.
e. Letter of Tax Exempt Status from Internal Revenue Service.
f. Vehicle Inventory Form on page 14.
g. Public Notice - the actual newspaper clipping or a certified copy on page 15.
h. Public or Private Operator’s Statements on page 16.
h. State Clearinghouse confirmation receipt letter and Form 424. Form 424 located on page 17.
i. Latest completed financial audit, with all management letters on file.
j. Current or most recent, IRS Form 990 - Return of Organization Exempt from Income Tax. If
necessary, include the IRS approval Form 2758 where your agency filed for an extension.
k. Brochure or Flyer on your agency.
New and Pre-Certified Public Entities (New and Pre-Certified criteria same as above. Pre-certified Public Entities submit all items except b.)
a. Application with original signatures. Photocopy of application is not acceptable.
b. Listing of current Board of Directors with their positions, addresses and occupations.
c. Vehicle Inventory Form on page 14.
d. Public Notice - the actual newspaper clipping or a certified copy on page 15.
e. State Clearinghouse confirmation receipt letter and Form 424. Form 424 located on page 17.
12
(Page left intentionally blank)
13
ARKANSAS STATE HIGHWAY & TRANSPORTATION DEPARTMENT
FT No.
or Vehicle
No.
Type
Vehicle
Model Year
Last 5
Numbers of VIN
Physical Location
(Center Name and City)
Counties Served with
this Vehicle (List all Counties)
Seating Capacity (as listed on door)
ADA
ACCESSIBLE Lift/Ramp
Current
Condition
Current Mileage
Date Current Mileage Recorded _______________________
14
12. Public Notice
PUBLIC NOTICE
Public notice is hereby given this ________day of _______________, _______ that
the____________________________________of _________________________ has made
(name of organization) (location)
application for funds through 49 U.S.C. Section ____________ for public transportation services
These funds will be used primarily for the following purposes: ____________________
______________________________________________________________________________
_____________________________________________________________________________
Funds are considered essential to the efficient operation of this organization to provide public
transportation services to persons with low-income or persons with disabilities. There is no
intent to infringe upon, or compete with, existing public or private transit operators, including
Section 5307, urban public transit operators and Section 5311, rural public transit operators.
Any objection should be submitted in writing only to persons listed below. All comments will
become a part of this organization’s application and will be a matter of public record. All written
comments must be submitted within 30 days of the date of this notice. Any person wishing to
request a public hearing on the proposed project must submit a request in writing within 10 days
of the date of this notice to the persons listed below:
Name of Agency Chief Administrative Official
Title
Address
City, State, Zip Code
and to:
Mr. Don McMillen
Public Transportation Administrator
Public Transportation Programs
Arkansas State Highway and Transportation Department
P.O. Box 2261
Little Rock, AR 72203-2261
*** If requesting a non-ADA vehicle (without lift/ramp), include the following language in
your Public Notice ad: (Organization's Name) is requesting a vehicle that is not
compliant with the Americans with Disabilities Act. However, (Organization's Name)
does meet the "equivalency of service" requirements to the disabled community. ***
15
13. Public or Private Operator’s Statement
PUBLIC OR PRIVATE OPERATOR’S STATEMENT
Regarding Use of Federal Transit Funds
By a Private or Public Organization as a Part of the
FTA Section 5316 or Section 5317 Programs
The Federal Transit Administration (hereinafter called FTA) has established programs to help
private and public organizations provide for the special transportation of persons with low
income and persons with disabilities.
NOTICE IS HEREBY GIVEN that
_________________________________________________________________________
(Applicant Organization)
is applying to FTA through the Arkansas State Highway and Transportation Department for aid
in operating public transportation services in the following community/area:
Use of public transportation funds is considered essential in the provision of special
transportation needs in this area.
The ________________________________________________________________ of
(Transit Operation)
_________________________________________________ understands that the funds
(City and State)
being requested will be used for the special purpose of transporting primarily persons with low
incomes or persons with disabilities.
I, _______________________________________________________________ on behalf of
(Authorized Official)
_______________________________________________________________do hereby state
(Transit Operation)
that this agency has no objections to the use of Federal funds requested by this applicant.
16
APPLICATION FOR 2. DATE SUBMITTED Applicant Identifier
FEDERAL ASSISTANCE
1. TYPE OF SUBMISSION 3. DATE RECEIVED BY STATE State Application Identifier
Application Preapplication
Construction
4. DATE RECEIVED BY FEDERAL AGENCY Federal Identifier
Non-Construction X
5. APPLICANT INFORMATION
Legal Name: Organizational Unit:
Address (give city, county, state, & zip code) Name and telephone number of the person to be contacted on matters
involving this application (give area code):
6. EMPLOYER IDENTIFICATION NUMBER (EIN)
7. TYPE OF APPLICANT: (enter appropriate letter in box)
A. State H. Independent School District
B. County I. State Controlled Institution of Higher Learning
C. Municipal J. Private University
8. TYPE OF APPLICATION D. Township K. Indian Tribe
X New Construction Revision
E. Interstate L. Individual
F. Intermunicipal M. Profit Organization
G. Special District N, Other (Specify) _______________________
If Revision, enter appropriate letter(s) in boxes(s)
A. Increase Award B. Decrease Award C. Increase Duration 9. NAME OF FEDERAL AGENCY:
D. Decrease Duration E. Other (Specify) U.S. Department of Transportation Federal Transit Administration _____________________________________________
10. CATALOG OF FEDERAL DOMESTIC 11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT: ASSITANCE NUMBER:
Title:
12. AREAS AFFECTED BY PROJECT (cities, counties, states, etc.):
13. PROPOSED PROJECT 14. CONGRESSIONAL DISTRICTS OF: Start Date Ending Date a. Applicant b. Project
15. ESTIMATED FUNDING 16. IS APPLICANT SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 12372 PROCESS?
a. Federal $ - a. Yes This preapplication was made available to the State Executive Order 12372
b. Applicant $ - Process for Review on:
c. State $ - Date ________________________
d. Local $ - b. No Program is not covered by E.O. 12372
e. Other $ - or Program has not been selected by State for Review
f. Program Income $ - 17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEPT?
g. Total $ -
Yes If "yes", attach explanation No
18. TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS APPLICATION/PREAPPLICATION ARE TRUE AND CORRECT.
THE DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL
COMPLY WITH THE ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED.
a. Typed Name of Authorized Representative b. Title c. Telephone Number
d. Signature of Authorized Representative e. Date Signed
Catalog of Federal Assistance Numbers: Section 5309 - Discretionary Bus: 20-500 Section 5310 - Elderly and Disabled: 20-513
Section 5311 - Rural Public Transit: 20-509 Section 5316 - JARC: 20-516 Section 5317 - New Freedom: 20-521
17
FY 2013 APPLICATION
INSTRUCTIONS MANUAL
Arkansas State Highway and Transportation Department
Public Transportation Programs
Planning & Research Division
January 2012
SECTION 5316
Job Access and Reverse Commute
and
SECTION 5317
New Freedom Program
TABLE OF CONTENTS
General Application Information
Application Instructions, Overview and Eligible Criteria………………………... 1
Funding Limitation………………………..……………………………..…….… 2
Application Requirements and Process…………………………………………… 2
Statewide Metropolitan Planning Organizations………………………..……….. 3
Planning and Development Districts……..………………………..……………... 5
Protection of Public Transit Systems………………………………………..……. 6
Application Form Instructions
Section 1 – Project Type……………………………………….……………..… 8
Section 2 - Application Organization……………………..…………………..… 8
Section 3 – Type of Applicant………………………………….……………..… 8
Section 4 – Applicant Transportation Service………………………………….. 8
Section 5 – Service Provided Through This Application……………………..… 9
Section 6 – Local Coordination Plan……………………………………………. 10
Section 7 – Financial Information………………..……………………………... 11
Section 8 – Estimated Project Expenses………………………………………… 11
Section 9 - Transportation Management and Experience………………….……. 11
Section 10 – Program Certifications and Assurances…………………..……….. 12
Section 11 – Applicant’s Supporting Documentation…………….……………... 12
Section 12 – Vehicle Inventory.................................................................................12
Section 13 – Public Notice …………………………………………………..….. 12
Section 14 – Public or Private Operator’s Statement.…..……………………….. 13
Section 15 – Application for Federal Assistance Form 424 Instructions…...…… 13
What Happens Next………………………………………………………………. 14
Appendix A - Vehicles Type…………………………………………………………… 15
i
Application Instructions Manual for
Section 5316 – Job Access and Reverse Commute
and
Section 5317 – New Freedom
Federal Transit Assistance Grant Programs
APPLICATION DUE TO THE AHTD MARCH 7, 2012
APPLICATION DUE TO THE STATE CLEARINGHOUSE FEBRUARY 22, 2012
Application Instructions
The application for the Section 5316 (Job Access and Reverse Commute) and/or Section 5317 (New
Freedom) programs proceed this manual within this file. These instructions have been developed to
assist agencies in completing the application form and in complying with the program requirements.
Applicants should review the requirements carefully. Failure to comply with any requirement
may disqualify an applicant.
The information provided by the applicant is intended to justify the request for funding. The Program
Manager and the Intragency Review Committee use this information to evaluate and rank all proposed
projects. This information is also used to complete the State’s application to the Federal Transit
Administration.
Overview
The goal of these programs is to provide assistance in meeting the special transportation needs of
persons with low-income and persons with disabilities. The programs are designed to enhance other
Federal Transit Administration assistance programs by funding public transportation projects in all areas
(urbanized, small urban, and rural) of the State.
The federal share of eligible capital costs is not to exceed 80 percent of the net project cost and the local
share of eligible operating costs shall be no less than 20 percent of the net project cost. The Federal
share of eligible operating expenses is not to exceed 50 percent of the net project cost and the local share
of eligible operating costs shall be 50 percent of the net project cost. All of the local share must be
provided from sources other than Federal Department of Transportation funds.
Assistance provided to organizations through these programs is granted for the sole purpose of providing
necessary transportation services identified in your application. An organization must use the vehicle
primarily for the group of passengers identified in the application. Other passengers, including the
general public, may be transported on a ―space available‖ basis with the identified client group.
Eligible Criteria
There are three general categories of eligible applicants:
1. Private non-profit organizations determined by the Secretary of the Treasure to be an
organization described by 26 U.S.C. Section 501(c) which is exempt from taxation under 26
U.S.C. Section 501(a) or Section 101.
Page 1
2. State agencies or local governmental authorities.
3. Operators of public transportation services, including private operators of public transportation
services.
Funding Limitation
Applications will only be accepted from eligible legal entities operating in the State of Arkansas who
possess the experience, financial capacity and administrative ability to carry out the project or projects
for which the assistance is to support. Only one application will be accepted from each eligible legal
entity under each program. In other words, an applicant may submit a Section 5316 application and a
Section 5317 application.
The Department reserves the right to limit the number of applications accepted from sub-corporate
entities operating under or through a principle corporate entity. Further, the Department reserves the
right to limit or negotiate the amount of the request.
Funding is very limited under the Section 5317 program. The AHTD will give priority to applicants
requesting operating funds. Capital requests will be considered based on funding availability.
Application Requirements and Process
Before filling out the application, please read and follow specific instructions.
Important Note: State Clearinghouse confirmation receipt letter and Form 424 must be submitted with
the original application. The assigned number (AR – _________) must be placed on the application
(Section 2, Page 1).
Other confirmation letters (MPO & PDD) and State Clearinghouse Sign-off letter must be maintained in
the applicant’s file.
When the application has been completed, distribute copies as follows:
1. Submit one copy of the application (pages 1 thru 9 and page 17) to: State Clearinghouse, Office of
Budget, P.O. Box 3278, Little Rock, AR 72203, no later than Thursday, February 22, 2012.
Confirmation Letter and Form 424 must be included in original application to the AHTD.
2. Submit one copy of the application (pages 1 thru 9 and page 17) to the proper Metropolitan
Planning Organization (if you are a participating communities), see list beginning on page 3.
3. Submit one copy of the application (pages 1 thru 9 and page 17) to the proper Planning and
Development District; see list beginning on page 5.
4. Submit the original application (original signatures in BLUE ink only no photocopies will be
accepted) with all attachments to Public Transportation Programs, Arkansas State Highway and
Transportation Department, P.O. Box 2261, Little Rock, AR, 72203, no later than 4:00 p.m. on
Wednesday, March 7, 2012. The Public Transportation Programs is located in Room 109,
Planning & Research Building, 10324 Interstate 30, Little Rock, AR 72209. Enter the main lobby
(South Parking Lot) and request a visitor pass at the front desk.
5. Retain one complete copy for applicant’s file, along with confirmation letters.
6. Return Grant Award Notification Form to State Clearinghouse after project has been approved for
funding.
Page 2
The original application should be assembled in the appropriate format and it is mandatory that it be
completed with all required attachments. Read and answer all questions, incomplete applications and
those lacking necessary supporting documents cannot be properly evaluated; and, therefore, may not
be considered. Before the deadline, you may wish to contact Charles Brewer, Section 5316 Program
Manager at (501) 569-2478 or Steven Alexander, Section 5317 Program Manager at (501) 569-2561 to
request assistance with any questions or concerns you may have.
The Arkansas State Highway and Transportation Department will purchase all vehicles awarded to
successful applicants through the appropriate State procurement process according to our specifications.
Vehicles requested through the Section 5317 program must meet the Americans with Disabilities Act
requirements and be lift equipped.
Applications will be evaluated on a competitive basis and ranked according to the guidelines contained
in the AHTD State Management Plan: Section 5316 and Section 5317. The AHTD has included in this
year’s numerical rating system values for strategies listed in the local transit coordination plans.
Statewide Metropolitan Planning Organizations
Frontier Metropolitan Planning Organization Participating Communities
Tim Conklin, Study Director Alma, AR Arkhoma, OK
BI-State Transportation Study (BI-STATE) Barling, AR Bonanza, AR
P.O. Box 2067 Fort Smith, AR Greenwood, AR
1109 S. 16th St. Kibler, AR Lavaca, AR
Fort Smith, AR 72902 Moffett, OK Muldrow, OK
Pocola, OK Roland, OK
Phone: (479) 785-2651 Rudy, AR Spiro, OK
Fax: (479) 785-1964 Van Buren, AR Crawford County, AR
Email: [email protected] LeFlore County, OK Sebastian County, AR
Website: www.wapdd.org/bistate_index.html Sequoyah County, OK
Hot Springs Area Metropolitan Planning Organization Participating Communities
Dianne Morrison, Study Director City of Hot Springs
Hot Springs Area Transportation Study (HSATS) City of Mountain Pine
P.O. Box 700 Hot Springs Village
Hot Springs, AR 71902 Garland County
Hot Spring County
Phone: (501) 321-4804 Greater Hot Springs
Fax: (501) 321-6809 Chamber of Commerce
Email: [email protected]
Website: http://www.cityhs.net/business-transportation-planning.html
Jonesboro Metropolitan Planning Organization Participating Communities
Muhammad Amin Ulkarim, Study Director City of Jonesboro
Jonesboro Area Transportation Study (JATS) City of Brookland
P.O. Box 1845 City of Bono
Jonesboro, AR 72403-1845 City of Bay
Craighead County
Phone: (870) 933-4623
Fax: (870) 933-4619
Email: [email protected]
Website: www.jonesboro.org/MPO/mpo.htm
Page 3
Metroplan Participating Communities
Casey Covington, Study Director Alexander Austin
Central Arkansas Regional Transportation Study (CARTS) Benton Bryant
501 W. Markham - Suite B Cabot Cammack Village
Little Rock, AR 72201 Conway Haskell
Jacksonville Little Rock
Phone: (501) 372-3300 Maumelle Mayflower
Fax: (501) 372-8060 North Little Rock Shannon Hills
Email: [email protected] Sherwood Vilonia
Website: www.metroplan.org/ Ward Wooster
Wrightsville Faulkner County
Lonoke County Pulaski County
Saline County
Northwest Arkansas Regional Planning Commission Participating Communities
John McLarty, Study Director Bella Vista Benton County
NW Arkansas Regional Transportation Study (NARTS) Bentonville Bethel Heights
406 Shilo Cave Springs Centerton
Springdale, AR 72764 Elm Springs Fayetteville
Farmington Johnson
Phone: (479) 751-7125 Lowell Ozark Transit
Fax: (479) 751-7150 Razorback Transit Rogers
Email: [email protected] Springdale Tonitown
Website: www.nwarpc.com/ Washington County
Southeast Arkansas Regional Planning Commission Participating Communities
Jerre George, Executive Director Pine Bluff
Pine Bluff Area Transportation Study (PBATS) White Hall
1300 Ohio Jefferson County
Pine Bluff, AR 71611
Phone: (870) 534-4247
Fax: (870) 534-1555
Email: [email protected]
Website: http://www.searpc.com/
Texarkana Metropolitan Planning Organization Participating Communities
Brad McCaleb, Study Director Texarkana, TX
Texarkana Urban Transportation Study (TUTS) Texarkana, AR
P.O. Box 1967 Wake Village, TX
West 3rd & Texas Boulevard Nash, TX
Texarkana, TX 75504 Bowie County, TX
Miller County, AR
Phone: (903) 798-3927
Fax: (903) 798-3773
Email: [email protected]
Website: www.texarkanampo.org
Page 4 West Memphis Metropolitan Planning Organization Participating Communities
Eddie Brawley, Study Director West Memphis
West Memphis Area Transportation Study (WMATS) Marion
796 West Broadway Sunset
West Memphis, AR 72303 Crittenden County
Phone: (870) 735-8148
Fax: (870) 735-8158
Email: [email protected]
Website: mpo.midsouthcc.edu
Statewide Planning and Development Districts
Central Arkansas Planning & Development District (CAPDD) P.O. Box 300 115 Jefferson St. Lonoke, AR 72086 501-676-2721 FAX: 501-676-5020 Rodney Larsen, Executive Director Counties: Faulkner, Lonoke, Monroe, Prairie, Pulaski and Saline East Arkansas Planning & Development District (EAPDD) P.O. Box 1403 2905 King St. Jonesboro, AR 72403 72401 870-932-3957 FAX: 870-932-0135 Richard Spelic, Executive Director Counties: Clay, Craighead, Crittenden, Cross, Greene, Lawrence, Lee, Mississippi, Phillips, Poinsett,
Randolph and St. Francis Northwest Arkansas Economic Development District (NWAEDD) P.O. Box 190 818 Hwy. 62/65 N. Harrison, AR 72602-0190 870-741-5404 FAX: 870-741-1905 J. Michael Norton, Executive Director Counties: Baxter, Benton, Boone, Carroll, Madison, Marion, Newton, Searcy and Washington Southeast Arkansas Economic Development District (SEAEDD) P.O. Box 6806 8th & Walnut Sts. Pine Bluff, AR 71611 870-536-1971 FAX: 870-536-7718 Glenn Bell, Executive Director. Counties: Arkansas, Ashley, Bradley, Chicot, Cleveland, Desha, Drew, Grant, Jefferson and Lincoln Southwest Arkansas Planning and Development District (SWAPDD) P.O. Box 767 600 Bessie St. Magnolia, AR 71753 870-234-4030 FAX: 870-234-0135 Renee Dicus, Executive Director Counties: Calhoun, Columbia, Dallas, Hempstead, Howard, Lafayette, Little River, Miller, Nevada,
Ouachita, Sevier and Union West Central Arkansas Planning & Development District (WCAPDD) P.O. Box 21100 835 Central Avenue Suite 201 Hot Springs, AR 71903 71901 1-800-264-1001, 501-525-7577 FAX: 501-525-7677 Dwayne Pratt, Executive Director Counties: Clark, Conway, Garland, Hot Spring, Johnson, Montgomery, Perry, Pike, Pope and Yell
Page 5 Western Arkansas Planning & Development District (WAPDD) P.O. Box 2067 1109 South 16th St. Ft. Smith, AR 72901 72902 501-785-2651 FAX: 501-785-1964 John Guthrie, Executive Director Counties: Crawford, Franklin, Logan, Polk, Scott, and Sebastian White River Planning & Development District (WRPDD) P.O. Box 2396 Regional Services Center Batesville, AR 72503-2396 Hwy. 25 N., 72501 870-793-5233 FAX: 870-793-4035 Van Thomas, Executive Director Counties: Cleburne, Fulton, Independence, Izard, Jackson, Sharp, Stone, Van Buren, White, and
Woodruff Protection of Public Transit Systems
Federal aid is available to transportation providers from five major programs within the U.S. Department
of Transportation: Section 5307 for urbanized areas (Little Rock-North Little Rock, Fort Smith, Hot
Springs, Springdale, Pine Bluff, Fayetteville, and Texarkana); Section 5311 for non-urbanized areas; and
Sections 5310, 5316, and 5317 for either or both. If there is a known Section 5307 or Section 5311
transit system in the area, that system will be given priority to furnish transportation within their service
area insofar as they can or wish to do so.
SECTION 5307 SYSTEMS
Central Arkansas Transit Authority City of Fort Smith
901 Maple Street P.O. Box 1908
North Little Rock, AR 72114 Fort Smith, AR 72902
Executive Director – Betty Wineland Transit Director – Ken Savage
(501) 375-0024 (479) 494-7690
Hot Springs Intra-City Transit Jonesboro Economical Transportation
Municipal Bldg. - P.O. Box 700 P.O. Box 1845
Hot Springs, AR 71901 Jonesboro, AR 72403
Transit Manager – Bob Reddish Transportation Coordinator – Steve Ewart
(501) 321-2020 (870) 935-5387
Ozark Regional Transit Pine Bluff City Transit
2423 E. Robinson 2300 E. Harding
Springdale, AR 72764 Pine Bluff, AR 71601
Transit Director – Phil Pumphrey Transit Manager – Larry Reynolds
(479) 756-9109 (870) 534-5130
Razorback Transit Texarkana Urban Transit District
155 Razorback Road 818 Elm Street
Fayetteville, AR 72701 Texarkana, TX 75501
Director – Gary Smith General Manager – Vera Matthews
(479) 575-4400 (903) 794-0435
Page 6
SECTION 5311 SYSTEMS
Area Agency of Southeast Arkansas Black River Area Development Corporation
709 E. 8th Avenue 1403 Hospital Drive
Pine Bluff, AR 71611 Pocahontas, AR 72455
President/CEO – Betty Bradshaw Executive Director – Jim Jansen
(870) 543-3268 (870) 892-4547
Eureka Springs Transit Mid-Delta Community Services
137-A West Van Buren P.O. Box 745
Eureka Springs, AR 72632 Helena, AR 72342
Transit Director – Kenneth "Smitty" Smith Executive Director – Margaret Staub
(479) 253-9572 (870) 338-9004
North Arkansas Transportation Services Ozark Transit
P.O. Box 190 2423 E. Robinson
Harrison, AR 72601 Springdale, AR 72764
Transit Manager – Jo Anna Cartwright Transit Director – Phil Pumphrey
(870) 741-8008 (479) 756-9109
South Central Arkansas Transit
P.O. Box 580
Benton, AR 72018
Transit Manager – Cindy Dedman
(501) 332-6215
Page 7
Application Form Instructions
Section 1, Page 1 – Project Type
Check the category of funds (capital and / or operating) being requested beside either the Section 5316
or Section 5317 program. Section 2, Page 1 – Application Organization
Enter the assigned confirmation number from State Clearinghouse Letter of Receipt (AR -_____)
Legal Name of Agency: Identify the agency’s name exactly as it is filed with the Certificate from the
Articles of Incorporation. Public Bodies should refer to their creation documents. Do not abbreviate
your agency name.
Street Address: Indicate physical address of the legal name of agency.
Mailing Address: Indicate mailing address of the legal name of agency.
City, State, and Zip: Indicate information for legal agency.
Doing Business As: Identify the name, address, etc. of the agency utilizing vehicle, if applicable.
Executive Director: Identify the name, title if different than Executive Director, phone number, e-mail
address and fax number.
Applicant Contact Person: Identify the name, phone number, e-mail address and fax number if different
than Executive Director. An email address is desired as the AHTD strives to computerize the
application and reporting forms.
Please include your email addresses and agency website, if available.
Section 3, Page 2 – Type of Applicant Type of Applicant (check one): Public Entity, Private Non-Profit or Public Transit Operator.
3a. Federal funding received last year under the AHTD administered transit program?
Circle all appropriate programs.
3b & c. Transportation operates in urbanized area? Check appropriate bracket(s)
3d. All Section 5316 and Section 5317 Program Reporting and Expenditure forms are computerized. It
is important that these computer forms be used by approved applicants. Hand-written or penciled forms
will no longer be accepted. Check appropriate bracket(s) and explain as necessary.
Section 4, Page 3 – Applicant Existing Transportation Services
4a. Record separate information for two or more centers located in the same area. Example: Adult
and Children Programs. Count vehicle(s) used daily for passenger transportation; do not include back
Page 8
up vehicle(s). If a vehicle is utilized in more than one program, list the vehicle and the total miles driven
per day once under the primary program. Complete both tables. Incomplete data may result in
ineligible project.
Record the following information:
Name of center(s) and location(s),
Number of vehicles used to transport clients at Center(s),
Number of active (submit Quarterly Measurements Report) FTA vehicles used,
Average number of clients participating in the program,
Average number of clients transported daily in the vehicle(s),
What percentage is elderly, disabled, low-income or other (should total 100 percent),
What percentage is racial minority, and
Total miles driven per day with the vehicle(s).
Service Area (where will clients be transported?)
When was transportation service initiated? (month and year.)
What hours of the day will clients be transported? If they are transported in the morning and
then in the afternoon, this should be stated.
Number of days operated per week.
Trip purpose(s). Be specific.
4b. Record number of paid drivers and volunteer drivers.
4c. Identify service type. Demand Response (door to door, passenger calls for service), Fixed Route
(scheduled service regular route) or Both.
4d. If you have a fare policy, what is the rate?
4e. Do you provide service to individuals that do not attend your center? Record Yes or No.
Section 5, Page 4 – Describe Service to be Provided Through This Application
Service provided under the Section 5316 program must be for persons with low income seeking
employment or vocational training.
Service to be provided under the Section 5317 program must be new service (started after August 10,
2005) and go beyond transportation requirements under the Americans with Disabilities Act or ADA.
Funds may not be used to supplement existing service.
Answer each question describing the client services to be provided with the funds through this
application. Specifically
5n. The Federal Transit Administration (FTA) has issued additional guidance, dated October 6, 2008,
regarding eligible projects under the New Freedom program. New Freedom projects must meet two
program requirements: 1) New service or started after August 10, 2005 and 2) Go beyond ADA. The
FTA has identified typical projects that will meet these requirements for both fixed-route and demand
responsive providers.
Page 9
This list does not include all eligible projects, only the most typical ones. The proposed project must be
included in this list or adequately describe how the project meets both requirements.
1. Fixed Route Service
a. Expansion of service beyond the ¾ mile requirement.
b. Expansion of hours.
c. Incremental costs of providing same day service.
d. Incremental costs of making door-to-door service available.
e. Building an accessible path to a bus stop.
2. Demand Response Service
a. Expansion of service area beyond present area.
b. Expansion of hours beyond present times.
c. Expansion of trip purposes beyond present trips.
d. Acquisition of lifts, or modifying existing, with a larger capacity.
e. Installation of additional wheelchair securement locations on buses.
f. Purchasing vehicles to support new accessible taxi, ride sharing, vanpooling programs.
g. Administration expenses related to voucher programs.
h. Mobility Management projects.
i. Capacity issues due to number of inadequate seating, excessive trip lengths require
additional vehicles, number of vehicles on road at the same time needed for peak hours.
Section 6, Page 5 – Local Coordination Plan
There are several Public Transit/Human Service Local Coordination Plans developed for areas
throughout the State. Refer to the following list to determine which Plan covered your service area.
Your service area may be covered by more than one Plan. However, only one Plan should be identified.
To determine the appropriate strategy and Plan or obtain a copy of a Transit Local Coordination Plan
(TCP), please contact Steven Alexander, AHTD Public Transportation Section, at 501-569-2561.
1. Central Arkansas Transit Authority TCP – Pulaski County
2. Central Arkansas District TCP – Faulkner, Lonoke, Monroe, Prairie, Pulaski and Saline
3. East Arkansas District TCP – Clay, Craighead, Crittenden, Cross, Greene, Lawrence, Lee,
Mississippi, Phillips, Randolph and St. Francis
4. Faulkner County TCP – Faulkner
5. Garland County TCP - Garland
6. Greene County TCP – Greene
7. Jefferson County TCP - Jefferson
8. Jonesboro MPO TCP – Craighead
9. Northwest Arkansas RPC TCP – Benton and Washington
10. REACTS TCP - Baxter, Boone, Carroll, Madison, Marion, Newton, and Searcy
11. River Valley Transportation Providers TCP – Franklin, Logan, and Sebastian
12. Southeast Arkansas District TCP – Arkansas, Ashley, Bradley, Chicot, Cleveland, Desha, Drew,
Grant, Jefferson and Lincoln
13. Southwest Arkansas District TCP - Calhoun, Columbia, Dallas, Hempstead, Howard, Lafayette,
Little River, Miller, Nevada, Ouachita, Sevier and Union
Page 10
14. West Central Arkansas District TCP – Clark, Conway, Garland, Hot Spring, Johnson, Montgomery, Perry, Pike, Pope and Yell
15. Western Arkansas District TCP – Crawford, Franklin, Logan, Polk, Scott, and Sebastian
16. White River District TCP - Cleburne, Fulton, Independence, Izard, Jackson, Sharp, Stone, Van
Buren, White, and Woodruff
Section 7, Page 5– Financial Information
7a. Check the status of funding for your transportation services for the next four years.
7bc. Record the following information off your most current IRS Form 990.
7d. Are transportation line items included in the annual budget for human services programs?
Record Yes or No.
Section 8, Page 6 – Estimated Project Expenses
8a. The Section 5316 and Section 5317 programs allow both capital and operating funding
assistance. The budget table in the application contains typical expense items for transit
operations and therefore is provided as a guide. These items may or may not be completely
appropriate for your application. Only direct expenses are allowed under the programs (indirect
or overhead expenses are not allowed). Please complete all data for each appropriate item.
8b. Income Revenues: List all sources of transportation revenues and the amounts for each category
listed, complete actual data. This amount should equal the total local amount from the 8a table.
8c. Specify the Vehicle Item Number, Vehicle Description, and State Bid Number for the desired
vehicle. Attach a copy of the appropriate vehicle chart(s). The AHTD has estimated the costs of
the 2013 model vehicles and is reflected in the Base Price of each vehicle.
Any changes to the specified vehicle will require the applicant to justify the change, publish a new
Public Notice and sign a new Equal Access Certification form.
Section 5317 applicants must ―go beyond the ADA‖. Therefore, as a minimum, any vehicle purchased
under the Section 5317 Program must be lift-equipped.
8d. Provide a justification of why this vehicle is needed.
Section 9, Page 6 – Transportation Management and Experience
9a. Agencies are responsible for maintaining the interior and exterior of the vehicle in a clean
manner that reflects a quality transportation service. Record individual(s) responsible for
submitting Performance Reports, Financial Claims, and the Fleet Preventative Maintenance
Program. A copy of the AHTD Claim Form is included at the end of this package.
9b. Record number of years your organization has been transporting passengers.
Page 11
9c. Check all that apply when selecting drivers.
9d. Check all training courses your agency requires.
9e. Describe your agency’s passenger safety program.
9f. Check what best describes your fleet preventative maintenance program.
9g. Describe your agency’s preventative maintenance program.
Section 10, Page 8 – Program Certifications and Assurances
10a. Federal and State laws and regulations govern the operations of public transportation services.
Approved applicants must sign the Federal Transit Administration Standard Assurances form.
This form will be forwarded along with the grant award notice.
10b. Authorized representatives must date and sign Certification of Information.
10c. Executive Director or CEO must answer questions and sign Title VI Compliance.
10d. Certification of Equal Access For Persons with Disabilities must answer questions and sign.
10e. It is the intent of the AHTD to ensure that vehicles and operating funds are being used in
accordance with Federal and State program guidelines. The AHTD will review submitted
reports to evaluate actual vehicle utilization relative to the agency’s application and the goals and
objectives of transit local coordination efforts.
10f. Certification of Eligibility is for Public Entities only. The certification sheet must be signed.
The support documentation sheet must also be provided. This sheet verifies that local
transportation agencies have been contacted and cannot reasonably provide the service.
Section 11, Page 12 – Applicant’s Supporting Documentation
11. Provide required information depending upon the applicant’s status. Application is considered
incomplete with the omission of one document.
Section 12, Page 14 – Vehicle Inventory Form
Section 13, Page 15 – Public Notice Requirement
A current Public Notice must be given of your intent to submit this application for a federal assistance
grant. It must be published once as an official notice in a newspaper(s) of general circulation in the
service area.
Page 12
If requesting a non-ADA vehicle (without lift/ramp), include the following language in your Public
Notice ad: (Organization's Name) is requesting a vehicle that is not compliant with the Americans
with Disabilities Act. However, (Organization's Name) does meet the "equivalency of service"
requirements to the disabled community.
A certified copy of the Public Notice which was published in the newspaper and/OR the actual
newspaper article clipping must be submitted with your application. Photocopy is not acceptable.
Application is considered incomplete with the omission of this article.
Section 14, Page 16 – Public or Private Operator’s Statement
Identify existing public and private transportation providers in your service area.
Make sufficient copies of the Public or Private Operator’s Statement and request each of the
operators to certify that they have no objections to this application. If an operator refuses to sign or does
not return the form, indicate so on a duplicate form.
Public transportation providers are on pages 7 and 8. Private providers include taxicab companies.
If needed, review October 2011, Public Transportation Directory (www.arkansashighways.com and
click on Publications), or contact Steven Alexander.
Section 15, Page 17 - Application for Federal Assistance Form 424
This is a standard form used by applicants as a required facesheet for preapplications and applications
submitted for Federal assistance. It will be used by Federal agencies to obtain applicant certification
that States which have established a review and comment procedure in response to Executive Order
12372 and have selected the program to be included in their process, have been given an opportunity to
review the applicant’s submission.
Item: Entry:
1 Self-explanatory.
2 Date application submitted to the AHTD and applicant’s control number (if applicable).
3 State use only (if applicable).
4 If this application is to continue or revise an existing award, enter present Federal identifier
number. If for a new project, leave blank.
5 Legal name of applicant, name of primary organizational unit that will undertake the assistance
activity, complete address of the applicant, and name and telephone number of the person to
contact on matters related to this application.
6 Enter Employer Identification Number (EIN) as assigned by the Internal Revenue Service.
7 Enter the appropriate letter in the space provided.
8 Check appropriate box and enter appropriate letter(s) in the space(s) provided.
– ―New‖ means a new assistance award.
– ―Continuation‖ means an extension for an additional funding/budget period for a project with
a projected completion date.
– ―Revisions‖ means any change in the Federal Government’s financial obligation or contingent
liability from an existing obligation.
Page 13
9 Name of Federal agency from which assistance is being requested with this application
(completed info).
10 Use the Catalog of Federal Domestic Assistance number and title of the program under which
assistance is requested.
a. Section 5316 Job Access and Reverse Commute Program – 20.516
b. Section 5317 New Freedom Program – 20.521
11 Enter a brief description of the project – capital assistance, operating assistance.
12 List only the largest political entities affected (e.g., State, counties, cities).
13 Leave Blank.
14 List the applicant’s Congressional District and any District(s) affected by the program or project.
Marion Berry = 1 Vic Snyder = 2 John Boozman = 3 Mike Ross = 4
15 Use amounts from Project Budget (Application - Page 6).
16 Applicants should contact the State Single Point of Contact (SPOC) for Federal Executive Order
12372 to determine whether the application is subject to the State intergovernmental review
process. (a. yes, date submitted to State Clearing House).
17 This question applies to the applicant organization, not the person who signs as the authorized
representative. Categories of debt include delinquent audit disallowances, loans and taxes.
18 To be signed by the authorized representative of the applicant. A copy of the governing body’s
authorization for you to sign this application as official representative must be on file in the
applicant’s office. (Certain Federal agencies may require that this authorization be submitted as
part of the application.)
WHAT HAPPENS NEXT FOR THE APPLICANTS?
Applications are open—Applications for the Section 5316 and Section 5317 Grant Programs are
available by request or it can be downloaded at www.arkansashighways.com click on Publication.
Applications are submitted—Applications for the Section 5316 and Section 5317 Grant Programs are
due by 4:00 p.m., Wednesday, March 7, 2012. Applications received after that time may not be
considered for funding.
Applications are evaluated—All eligible applications will be evaluated on a competitive basis and
ranked according to an objective evaluation process.
Funds allocated—Federal funds are allocated, annually, to the States for the Section 5316 and Section
5317 Grant Programs through the Federal Transit Administration (FTA). Once the annual allocation is
received, the AHTD prepares a budget based on selection process.
Contract (Grants) forwarded to FTA—The AHTD assembles all recommended applications and their
costs into a single grant request and submits it to the AHTD Management and the FTA for approval.
The FTA must approve each grant before any expenses may be incurred or obligated.
Applicants are notified—Applicants are notified by letter as to the results of their application.
Contract agreements are executed—The AHTD and each applicant must execute a contract agreement
describing the terms and conditions of the grant.
Page 14
APPENDIX A - VEHICLE TYPES (Driver Included)
State Bid Estimated Base Item Vehicle Description Number Starting Cost*
Standard Vehicles without lift
1 Standard Minivan, 7 Passenger PT 10-0001 Ext #38 $25,063
2 Standard Van, 8 Passenger PT 10-0001 Ext #34 $22,358
3 Standard Van, 12 Passenger PT 10-0001 Ext #35 $25,537
4 (Executive top) Aisle Conversion Van, 13 Passenger PT 11-03 Item 1 $37,659
5 (High top) Conversion Van, 13 Passenger PT 11-04 Item 1 $46,428
6 Small Cutaway Bus, 14 Passenger PT 11-05 $45,223
ADA Accessible Vehicles
7 Minivan, Lowered Floor, w/Ramp 1/2 WC PT 11-01 $40,322
8 (Executive top) Aisle Conversion Van Rear Lift, 8/2 WC PT 11-03 Item 2 $40,720
9 (High top) Conversion Van, 9/1 WC PT 11-04 Item 2 $48,631
10 (High top) Conversion Van, 9/2 WC PT 11-04 Item 3 $49,273
11 Small Cutaway Bus, 11/1 WC PT 11-05 $47,773
12 Small Cutaway Bus, 9/2 WC PT 11-05 $48,343
Standard and ADA Accessible Buses (CDL Required)
13 Medium Cutaway Bus, 17 Pass. (gasoline engine) PT 11-06 Item 1 $47,792
14 Medium Cutaway Bus, 9/2 WC (gasoline engine) PT 11-06 Item 1 $50,108
15 Medium Cutaway Bus, 21 Pass. (gasoline engine) PT 11-06 Item 2 $51,600
16 Medium Cutaway Bus, 13/2 WC (gasoline engine) PT 11-06 Item 2 $53,781
17 Medium Cutaway Bus, 25 Pass. (gasoline engine) PT 10-06 Item 3 $54,348
18 Medium Cutaway Bus, 17/2 WC (gasoline engine) PT 10-06 Item 3 $56,529
Note: ADA accessible vehicles can seat additional individuals when wheelchair clients are not being transported. Example:
5/2 WC = 5 passenger and 2 wheelchair clients or
11/0 WC = 11 passenger and 0 wheelchair clients Note: Agencies are responsible for 20% of estimated base starting cost.
Page 15
Note: This is a sample picture for Item 1.
Item 1. 7-Passenger Standard Minivan
Item 1: 7-Passenger Standard Minivan Base Price: $25,063
(Agency’s 20% local match - $5,013)
Note: This is a sample picture for Item 2.
Item 2. 8-Passenger Standard Van
Item 2: 8-Passenger Standard Van Base Price: $22,358
(Agency’s 20% local match - $4,472)
Note: This is a sample picture for Item 3.
Item 3. 12-Passenger Standard Van
Item 3: 12-Passenger Standard Van Base Price: $25,537
(Agency’s 20% local match - $5,107)
Note: These are sample pictures for Items 4 and 8
.
Items 4, and 8. Aisle Conversion Van with Executive Top
Item 4: (Executive Top), 13-Passenger Van; Base Price: $37,659 (Agency’s 20% local match - $7,532)
Item 8: (Executive Top), 8/2 WC; Base Price: $40,720 (Agency’s 20% local match - $8,144)
Note: This is a sample picture for Items 5, 9 and 10.
Items 5, 9 and 10. Conversion Van with Transit High Top
Item 5: 13-Passenger Van, Base Price: $46,428 Item 9: 9/1 WC, Base Price: $48,631 (Agency’s 20% local match - $9,286) (Agency’s 20% local match - $9,726)
Item 10: 9/2 WC, Base Price $49,273 (Agency’s 20% local match - $9,855)
Note: These are sample pictures for Items 6, 11 and 12. Your vehicle will be solid white with no stripes or extra colors.
Items 6, 11 and 12. Small Cutaway Bus
Item 6: Small Cutaway 14-Passenger Bus Base Price: $45,223
(Agency’s 20% local match - $9,045)
Item 11: 11/1 WC Base Price: $47,773 Item 12: 9/2 WC Base Price: $48,343 (Agency’s 20% local match - $9,555) (Agency’s 20% local match - $9,669)
Note: This is a sample picture for Item 7.
Item 7.
Ramp Van
Item 7: 6/0 WC, 2/1 WC,1/2 WC Base Price: $40,322 (Agency’s 20% local match - $8,064)
Note: These are sample pictures of items 13 and 14. Your vehicle will be solid white with no stripes or extra colors.
Items 13 and 14. Medium Cutaway Bus
Item 13: 17-Passenger Bus Base Price: $47,792
(Agency’s 20% local match - $9,558)
Item 14: 9/2 WC Base Price: $50,108 (Agency’s 20% local match - $10,022)
Note: These are sample pictures of items 15 and 16. Your vehicle will be solid white with no stripes or extra colors.
Items 15 and 16. Medium Cutaway Bus
Item 15: 21-Passenger, Base Price: $51,600
(Agency’s 20% local match - $10,320)
Item 16: 13/2 WC, Base Price: $53,781 (Agency’s 20% local match - $10,756)
Note: These are sample pictures of items 17 and 18. Your vehicle will be solid white with no stripes or extra colors.
Items 17 and 18. Medium Cutaway Bus
Item 17: 25-Passenger, Base Price: $54,348 (Agency’s 20% local match - $10,870)
Item 18: 19/1 WC or 17/2 WC, Base Price: $56,529 (Agency’s 20% local match - $11,306)