Agenda 10-01-19 Item 5-a - NCDOT Public Transportation Division Public Transportation – 5311 Community Transportation Program Grant Application for FY2021

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6 FEDERAL FISCAL YEAR 2019 FTA CERTIFICATIONS AND ASSURANCES SIGNATURE PAGE (Required of all Applicants for federal assistance to be awarded by FTA in FY 2019) AFFIRMATION OF APPLICANT Name of the Applicant: Orange County BY SIGNING BELOW,on behalf of the Applicant,I declare that it has duly authorized me to make these Certifications and Assurances and bind its compliance.Thus,it agrees to comply with all federal laws,regulations, and requirements,follow applicable federal guidance,and comply with the Certifications and Assurances as indicated on the foregoing page applicable to each application its Authorized Representative makes to the Federal Transit Administration(FTA)in federal fiscal year 2019,irrespective of whether the individual that acted on his or her Applicant's behalf continues to represent it. FTA intends that the Certifications and Assurances the Applicant selects on the other side of this document should apply to each Award for which it now seeks,or may later seek federal assistance to be awarded during federal fiscal year 2019. The Applicant affirms the truthfulness and accuracy of the Certifications and Assurances it has selected in the statements submitted with this document and any other submission made to FTA,and acknowledges that the Program Fraud Civil Remedies Act of 1986,31 U.S.C.§3801 et seq.,and implementing U.S.DOT regulations, "Program Fraud Civil Remedies,"49 CFR part 31,apply to any certification,assurance or submission made to FTA.The criminal provisions of 18 U.S.C.§1001 apply to any certification,assurance,or submission made in connection with a federal public transportation program authorized by 49 U.S.C.chapter 53 or any other statute In signing this document,I declare under penalties of perjury that the foregoing Certifications and Assurances,and any other sta is made by me n a of the Applicant are true and accurate. Signature Date: 5/16/2019 I " Name Penny Rich,Chair,Orange County Board of Commissioners Authorized Representative of Applicant AFFIRMATION OF APPLICANT'S ATTORNEY For(Name of Applicant): Orange County As the undersigned Attorney for the above-named Applicant,I hereby affirm to the Applicant that it has authority under state,local,or tribal government law,as applicable,to make and comply with the Certifications and Assurances as indicated on the foregoing pages.I further affirm that,in my opinion,the Certifications and Assurances have been legally made and constitute legal and binding obligations on it. I further affirm that,to the best of my knowledge,there is no legislation or litigation pending or imminent that might adversely affect the validity of these Certifications and Assurances,or of the performance of its FTA assisted Award. Signature Date: 5/16/2019 Name John Roberts,County Attorney Attorney for Applicant Each Applicant for federal assistance to be awarded by FTA mustprovide an Affirmation ofApplicant's Attorney pertaining to the Applicant's legal capacity.The Applicant may enter its electronic signature in lieu of the Attorneys signature within TrAMS,provided the Applicant has on file and uploaded to TrAMS this hard-copy Affirmation,signed by the attorney and dated this federal fiscal year.