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EXHIBIT 5 <br />19 <br />N E COUNTY <br />NORTH H C: ROLI .A <br />ADA Paratransit Eligibility Application Information and Instructions <br />Orange Public Transportation (OPT) provides complementary paratransit to eligible <br />persons living within 3/ -mile of OPT's fixed routes or those visiting locations within 3/ <br />mile of the fixed routes. <br />Through our Complementary Paratransit services, Orange Public Transportation <br />provides an equivalent accessible transportation option to people who are unable to use <br />the fixed -route bus service because of a disability. Orange Public Transportation <br />provides rides, from origin to destination, within the 3/ -mile of its fixed routes. <br />Transportation services are accessed by completing this application and being <br />certified through Orange Public Transportation, or if you are visiting from another area, <br />by providing documentation of ADA certification from a transportation service in another <br />area of the country. <br />Who should apply for ADA Paratransit services? <br />• People who are unable to use the fixed -route public bus services because of <br />barriers like steep stairs, busy intersections, hills, lack of curb cuts, lack of <br />sidewalks, unavailability of a lift on a public bus, weather - related heat or cold, <br />difficulty traveling along and /or recognizing new destinations. <br />• People with mobility impairments due to visual limitations, arthritis, spinal cord <br />injury, or other physical and /or cognitive limitations that are a barrier to using <br />fixed route services. <br />How do you apply for ADA Paratransit services? <br />• Complete this application and sign the Applicant Agreement section. <br />• Have your doctor, rehabilitation specialist, or other qualified health care provider <br />complete and sign the professional verification section. <br />• Send the completed application to: <br />Orange Public Transportation <br />PO BOX 8181 <br />Hillsborough, NC 27278 <br />Or fax to: (919) 732 -2137 <br />If you need an alternative format of this application or additional information, please <br />contact us at (919) 245 -2008 or pmurphy @orangecountync.gov. <br />