OKI Coordinated Public Transit Human Services Transportation Plan ...

OKI Coordinated Public Transit - Human Services Plan - Appendix AAPPLICATION FORM—JOB ACCESS/REVERSE COMMUTE (SECTION 5316) ANDNEW FREEDOM (SECTION 5317) FEDERAL FUNDSOKI Regional Council of GovernmentsApplicant:Address:Date:Contact Person/Title/e-mail address:What type of eligible applicant is the organization?:Private non-profit agencyState or local governmental authorityOperator of public transportation services (including private operators orpublic transportation services)Description of Agency, including mission statement if applicable:Does the Agency have a current JARC or New Freedom Project?If yes, indicate date of award, amount of federal funds awarded and remaining balance of federal fundsDescription of Proposed Project:(refer to pages 2 - 7 of the Competitive Selection Process for a listing of eligible projects)Projected Cost Estimate of Project:The federal share of eligible capital and planning costs may not exceed 80% of the net cost of the activity.The federal share of the eligible operating costs may not exceed 50% of the net operating costs of the activity.Type of funds requested:Job Access and Reverse CommuteNew FreedomTotal Federal Funds requestedFederal percentageTotal Match providedMatch percentageTotal cost of project 100% (total federal & matchpercentages must equal 100)Eligible capital and planning projects require a 20 percent match of net project costEligible operating projects require a 50 percent match of net operating costsAppendix A 1A-12Revised June 2011