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59 <br /> ATTACHMENT 4 <br /> Local Share Certification for Funding <br /> (This form is required for EACH separate funding request) <br /> Orange County <br /> (Legal Name of Applicant) <br /> Local matching funds will be required for all application submittals. For projects requiring capital funds,the <br /> required local match is 10 percent of the net cost of the project, subject to the availability of state funds. <br /> Applicants should be prepared to incur a 20 percent local match in case state funds are not available. <br /> The local match must be provided from sources other than federal Department of Transportation funds. <br /> Guidance is provided FTA's website about eligible sources of matching funds. Applicants are responsible <br /> for verifying the eligibility of non-USDOT federal funds the applicant proposes to use as their local match. <br /> Requested Funding Amounts <br /> Net Local Share Local Source(s) <br /> Cost <br /> Capital $212,902_______$21,290 (10%)_________ 1.Local General Operating <br /> (Vehicles& Other) <br /> 2. <br /> 3. <br /> _.............................................................TOTAL.........$...212,902............._...$...21,290.................................................................................... .........................................................................................................................._ <br /> I,the undersigned representing(Legal Name of Applicant)Orange County do hereby certify to the North <br /> Carolina Department of Transportation,that the required local funds will be available as of July 1,2017. <br /> Signature of Authorized Official <br /> Chair of the Board of County Commissioners <br /> Type Name and Title of Authorized Official <br /> Date <br />