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FY2005-2006 CT Application <br />Subscribed and worn to me d to ` \\o~N P I S! I/~~~'' FederaUState Certifications <br />_~ O• ~•F , <br />NOTARY ~ <br />Notary Pub is = * * * : <br />`/ /t/ G Seal O~;• PUBLIC <br />Address ~y • U~ <br />My comrission expires (date) ~ ~~1'C' • , , • . •' .2'~~~ <br />i~~ijl COUN~`y1~O\ <br />HUMAN SERVICE AGENCY TRANSPORTATION ~~gf~~~TION <br />RESOLUTION <br />Applicant Seeking Permission to Apply for Human Service Transportation Funding, <br />Enter Into Agreement With The North Carolina Department Of Transportation <br />And to Provide The Necessary Assurances. <br />A motion was made by (Board Member's Name) <br />and seconded by (Board Member's Name) <br />for the adoption of the following resolution, and upon being put to a vote was duly adopted. <br />WHEREAS, Article 2B of Chapter 136 of the North Carolina General Statutes and the Governor of North Cazolina have <br />designated the North Cazolina Department of Transportation (NCDOT) as the agency responsible for administering federal <br />and state public transportation funds; and <br />WHEREAS, the North Cazolina Department of Transportation receives funds from the North Cazolina General Assembly to <br />provide assistance for rural public transportation projects; and <br />WHEREAS, the purpose of these transportation funds is to provide grant monies to local agencies <br />for the provision of rural public transportation services; <br />WHEREAS, (Applicant's Name) hereby assures and certifies that it <br />will comply with the, federal and state Statutes, regulations, executive orders, and all administrative requirements related to <br />the applications made to and grants received from the North Carolina Department of Transportation; <br />NOW, THEREFORE, be it resolved that the (Authorized OfjFcial's Title)* <br />of (Name ofApplicant's Governing Body) <br />is hereby authorized to submit a grant application for state funding, make the necessary assurances and certifications and be <br />empowered m enter into an agreement with the NCDOT to provide rural public transportation services. <br />I (Certifying Official's Name)* (Title) <br />do hereby certify that the above is a true and correct copy of an excerpt from the minutes of a meeting of <br />the (Name ofApplicant's Governing <br />duly held on the ~ day of , 20_ <br />Signature of Certifying O~Scial <br />*Note that the oj~cial authorlZed to submlf the grant appllcatlon, certifying o~cia[, and notary public should be three separate <br />indfviduals <br />Subscribed and sworn to me (date) <br />Section II <br />Notary Public * <br />Seal <br />My commission expires (date) <br />FY2005-2006 C7' Application <br />FederaUState Certifications <br />USE LOCAL LETTERHEAD STATIONARY <br />LOCAL SHARE CERTIFICATION FOR FUNDING <br />(ALL APPLICANTS MUST PRESENT AND RETURN THIS SIGNED FORM WITH APPLICATION) <br />I, the undersigned representing County of Orange , do hereby <br />(Applicant's Name) <br />certify to the North Carolina Department of Transportation that the required local funds for the FY2006 <br />Community Transportation Program are available. <br />We are applying for the following amounts: <br />Project Total Amount Local Share <br />Administrative/Emp Dev. $174.293 $26,144 (15°/a) <br />Capital(Vehicles 8 Other) $ $ (10%) <br />Advanced Technology $ 45,000 $ 4.500 (10%) <br />TOTAL $ 219.293 $ 30.644 <br />(Total of Projects) (Total Local Share) <br />The Local Share Is available from the following sources: <br />Source of Funds Amount <br />General Funds <br />$ 30,644 <br />TOTAL $ <br />These funds will be available as of July 1, 2005 for the FY2006, which has a period of performance of July 1, 2005 - <br />June 30, 2006. <br />Signature of orize fficial <br />Section II <br />