HomeMy WebLinkAboutContract 51955 AFW Entitlement Grant Application 2019
Alliance Fort Worth Airport
IP Grant Number 3,48-0296- -2019
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CITY SECRETARY
'"O TRACT NO.
FEDERAL AVIATION ADMINISTRATION
AIP
GRANT APPLICATION
RECEIVEL)
OFMIX,RECORD 118212019
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mysEmEr noY
OMB Number:4040-0004
Expiration Date:1213112019
Application for Federal Assistance SF-424
'I Type-ol'Submission 'Z.Type of ApplkaNun, `If Revision,select appropriate letter(s):
❑ Preapplication ❑X New
XJ Application Continuation 'Other(Specify):
❑Changed/Corrected Application ❑Revision
*3.Date Received: 4.Applicant Identifier:
5a.Federal Entity Identifier: 5b.Federal Award Identifier:
20-106
State Use Only:
6.Date Received by State:E== 7.Slate Application Identifier:
8.APPLICANT INFORMATION:
`a.Legal Name: _tty of Fort Wor_h
"b.Employerfraxpayer Identification Number(EINfnN): *c.Organizational DUNS:
]'J-5005;,6.. p r31')04S86
d.Address:
'Streetl: F1 American C-onc-Evrser Suite 73q
Streetl:
"city: L' rf WArl,rl
CountylParish:
*State:
Province:
•Country: USA: UNITED STATES
*Zip 1 Postal Code: r r.- ,F
e.Organizational Unit:
Department Name: Division Name:
Aviation Department
f.Name and contact information of person to be contacted on matters involving this application:
Prefix: Mr. E First Name:
Middle Name: J,
*Last Name: I.,• , i
Suffix: #
Title: President
Organizational Affiliation:
Alliance Air Services
*Telephone Number: St7-g?.•t-r,ut;N Fax Number: 817-430-2875
"Email: Cam.harrisC+hil.I. onH-rnq
Application for Federal Assistance SF-424
9.Type of Applicant 1:Select Applicant Type:
'=ty -3e Town9hip i.;ovei:nment
Type of Applicant 2:Select Applicant Type:
I E-11
Type of Applicant 3:Select Applicant Type:
'Other(specify):
10.Name of Federal Agency:
E'ederftl AviQtIorp ;Vill-r,t3tr9tlon, SW Kohl 1%, F'41ct Wll rtti, VX
11.Catalog of Federal Domestic Assistance Number:
20-106
CFDA Title:
Airport Improvement Plan
*12.Funding Opportunity Number:
3-49-A295- -2[FI9
'Ti0e:
eVizca13am=-3L3F. air-powt 119h ing and pa kem,i-.r i.rnP3-L-)VPMrn.Sr 1)pdate41 Ay-P and
,program managaiaent sarvices.
1
13.Competition Identification Number:
Title:
14.Areas Affected by Project(Cities,Counties,States,etc.):
Gity of I-ort Worthand City of Haslet. A&I AlIachmoni
Portions ofTarrant and Denton Counties.
"15.Descriptive Title of Applicant's Project:
R,ehabilitace ItWY EGL c-encarlir— Llghta {deaign�earjatrection� .
Aahabilirate TWY A CenreSli[L lights IcV0acru^ti4n} .
Miecellanaou,- Pavprnert Rffpaire [design and Conatrurtiari.
Update Airpnrt EAyoar_ Plan (ALPI ,
Proglrain IranagemonC SetviCea ;gVntgt ma11ngt*mo#1t: end CiP updates) -
Attach supporting documents as specified in agency instructions.
Add Allq�h rdpL 1aal; l" .'+II.,;I.I; nl: V-1-A'?
Application for Federal Assistance SF-424
16.Congressional Districts Of:
*a.Applicant 12, *b.Program/Project
Attach an additional list of Program/Project Congressional Districts if needed.
J�.url Allachn�on!
17.Proposed Project:
*a.Start Date: D 4{4;/2 019 *b.End Date:
18.Estimated Funding($):
"a.Federal 91312,0 a 13,Sria
*b.Applicant 31U0,000.00
c.State
"d.Local
*e.Other
*f. Program income
*g.TOTAL $1,000,000.00
*19,li%-A0p11asNori Subject to Revlow By Slate Uhder!Executive Order 12972 Procdsa
❑ a.This application was made available to the State under the Executive Order 12372 Process for review on
b.Program is subject to E-O.12372 but has not been selected by the State for review.
n c.Program is not covered by E.O.12372.
20.Is the Applicant DOlinqLtgnt On Any Fudaral Dalai? (It"Yes,"prvs+rlde oxplsnatlon In attarrhrnent,)
❑Yes ❑X No
If"Yes",provide explanation and attach
21.*By signing this application,I certify(1)to the statements contained in the list of certifications**and(2)that the statements
herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to
comply with any resulting terms if I accept an award.I am aware that any false,fictitious,or fraudulent statements or claims may
subject me to criminal,civil,or administrative penalties.(U.S.Code,Title 218,Section 1001)
M"I AUR#<E
— The list of certifications and assurances, or an intemet site where you may obtain this list, is contained in the announcement or agency
specific instructions.
Authorized Representative:
Prefix: Mr. *First Name:
Middle!Name:
*Last Name: conte
Suffix: I Ell
*Title: eal_stant< Cit:f Managac
*Telephone Number: Fax Number:
*Email: fernando.cos;taBfor tuarthctxas,gow
*Signature of Authorized Representative: *Date Signed: f
as IND LEGALITY:
tml tart City Att �hcy ���
4U.S.Department of Transportation OMB CONTROL NUMBER:2120-0569
4 Federal Aviation Administration EXPIRATION DATE:8/31/2019
Application for Federal Assistance (Development and Equipment Projects)
DART II — PROJECT APPROVAL INFORMATION
Part II-SECTION A
The term "Sponsor"refers to the applicant name provided in box 8 of the associated SF-424 form.
Item 1.
Does Sponsor maintain an active registration in the System for Award Management N Yes ❑No
(www.SAM.gov)?
Item 2.
Can Sponsor commence the work identified in the application in the fiscal year the 0 Yes ❑No ❑ NIA
grant is made or within six months after the grant is made, whichever is later?
Item 3.
Are there any foreseeable events that would delay completion of the project? If yes, 0 Yes ❑No ❑NIA
provide attachment to this form that lists the events.
Item 4.
Will the project(s)covered by this request have impacts or effects on the
environment that require mitigating measures? If yes, attach a summary listing of ❑Yes 0 No ❑NIA
mitigating measures to this application and identify the name and date of the
environmental document(s).
Item 5_
Is the project covered by this request included in an approved Passenger Facility
Charge (PFC)application or other Federal assistance program? If yes, please ❑Yes 0 No ❑ NIA
identify other funding sources by checking all applicable boxes.
❑ The project is included in an approved PFC application.
If included in an approved PFC application,
does the application only address AIP matching share? ❑Yes ❑No
❑The project is included in another Federal Assistance program. Its CFDA number is below.
Item 6.
Will the requested Federal assistance include Sponsor indirect costs as described in ❑Yes 0 No ❑NIA
2 CFR Appendix VII to Part 200, States and Local Government and Indian Tribe
Indirect Cost Proposals?
If the request for Federal assistance includes a claim for allowable indirect costs, select the applicable indirect cost rate
the Sponsor proposes to apply:
❑ De Minimis rate of 10%as permitted by 2 CFR§200.414.
❑ Negotiated Rate equal to % as approved by (the Cognizant Agency)
on (Date) (2 CFR part 200, appendix VII).
Note:Refer to the instructions for limitations of application associated with claiming Sponsor indirect costs.
FAA Form 5100-100(3116)SUPERSEDES PREVIOUS EDITION Pago 1 of 7
OMB CONTROL NUMBER:2120-0569
OMB EXPIRATION DATE:8/31/2019
PART II -SECTION B
Certification Regarding lobbying
The declarations made on this page are under the signature of the authorized representative as identified in box 21 of
form SF-424, to which this form is attached. The term "Sponsor"refers to the applicant name provided in box 8 of the
associated SF-424 form.
The Authorized Representative certifies,to the best of his or her knowledge and belief, that:
(1)No Federal appropriated funds have been paid or will be paid, by or on behalf of the Sponsor, to any person
for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer
or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any
Federal contract, the making of any Federal grant, the making of any Federal loan,the entering into of any
cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal
contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer
or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract,
grant, loan, or cooperative agreement, the Authorized Representative shall complete and submit Standard
Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
(3)The Authorized Representative shall require that the language of this certification be included in the award
documents for all sub-awards at all tiers (including subcontracts, subgrants, and contracts under grants, loans,
and cooperative agreements)and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was
made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by section 1352, title 31, U.S. Code.Any person who fails to file the required certification
shall be subject to a civil penalty of not less than $10,000 and not more than$100,000 for each such failure.
FAA Form 5100-100(3116)SUPERSEDES PREVIOUS EDITION Page 2 of 7
OMB CONTROL NUMBER:2120-0569
OMB EXPIRATION DATE:813112019
PART II—SECTION C
The Sponsor hereby represents and certifies as follows:
1. Compatible Land Use--The Sponsor has taken the following actions to assure compatible usage of land adjacent
to or in the vicinity of the airport:
The City of Fort Worth adopted Ordinance No. 10121, dated June 2, 1998, entitled FORT WORTH ALLIANCE
AIRPORT ZONING OVERLAY, related to height and land use zoning.
2. Defaults—The Sponsor is not in default on any obligation to the United States or any agency of the United States
Government relative to the development, operation, or maintenance of any airport, except as stated herewith:
None.
3. Possible Disabilities—There are no facts or circumstances (including the existence of effective or proposed leases,
use agreements or other legal instruments affecting use of the Airport or the existence of pending litigation or other
legal proceedings)which in reasonable probability might make it impossible for the Sponsor to carry out and complete
the Project or carry out the provisions of the Grant Assurances, either by limiting its legal or financial ability or
otherwise, except as follows:
None.
4. Consistency with Local Plans—The project is reasonably consistent with plans existing at the time of submission
of this application)of public agencies that are authorized by the State in which the project is located to plan for the
development of the area surrounding the airport.
Yes.
5. Consideration of Local Interest—It has given fair consideration to the interest of communities in or near where the
project may be located.
Yes.
6. Consultation with Users—In making a decision to undertake an airport development project under Title 49, United
States Code, it has consulted with airport users that will potentially be affected by the project(§47105(a)(2)).
Yes.
7. Public Hearings— In projects involving the location of an airport, an airport runway or a major runway extension, it
has afforded the opportunity for public hearings for the purpose of considering the economic, social, and environmental
effects of the airport or runway location and its consistency with goals and objectives of such planning as has been
carried out by the community and it shall, when requested by the Secretary, submit a copy of the transcript of such
hearings to the Secretary. Further, for such projects, it has on its management board either voting representation from
the communities where the project is located or has advised the communities that they have the right to petition the
Secretary concerning a proposed project.
Yes.
8.Air and Water Quality Standards—In projects involving airport location, a major runway extension, or runway
location it will provide for the Governor of the state in which the project is located to certify in writing to the Secretary
that the project will be located, designed, constructed, and operated so as to comply with applicable and air and water
quality standardsr In any case where such standards have not been approved and where applicable air and water
quality standards have been promulgated by the Administrator of the Environmental Protection Agency, certification
shall be obtained from such Administrator. Notice of certification or refusal to certify shall be provided within sixty days
after the project application has been received by the Secretary.
Acknowledged.
FAA Form 5100-100(3116)SUPERSEDES PREVIOUS EDITION Page 3 of 7
OMB CONTROL NUMBER:2120-0569
DMB EXPIRATION DATE:8/31/2019
PART 11—SECTION C (Continued)
9. Exclusive Rights—There is no grant of an exclusive right for the conduct of any aeronautical activity at any airport
owned or controlled by the Sponsor except as follows:
None.
10. Land—(a)The sponsor holds the following property interest in the following areas of land,which are to be developed
or used as part of or in connection with the Airport subject to the following exceptions, encumbrances, and adverse
interests, all of which areas are identified on the aforementioned property map designated as Exhibit"A". [1]
The Alliance Airport runways, taxiways and associated pavement areas are the property of the City of Fort Worth (fee
simple).
The Sponsor further certifies that the above is based on a title examination by a qualified attorney or title company and
that such attorney or title company has determined that the Sponsor holds the above property interests.
(b)The Sponsor will acquire within a reasonable time, but in any event prior to the start of any construction work
under the Project, the following property interest in the following areas of land on which such construction work is to be
performed, all of which areas are identified on the aforementioned property map designated as Exhibit"A". [1]
(c)The Sponsor will acquire within a reasonable time, and if feasible prior to the completion of all construction
work under the Project,the following property interest in the following areas of land which are to be developed or used
as part of or in connection with the Airport as it will be upon completion of the Project, all of which areas are identified on
the aforementioned property map designated as Exhibit"A". [1]
1 State the character of property interest in each area and list and identify for each all exceptions, encumbrances, and adverse
interests of every kind and nature,including liens,easements, leases,etc.The separate areas of land need only be identified here by
the area numbers shown on the property map.
FAA Form 5100-100(3116)SUPERSEDES PREVIOUS EDITION Page 4 of 7
BUDGET
INFORMATION
OMB CONTROL NUMBER:2120-0569
OMB EXPIRATION DATE:8/31/2019
PART III - BUDGET WOIRMATIOW. -CONSTRUCTION
SECTION A--GENERAL
1. Federal Domestic Assistance Catalog Number: 20-106
2. Functional or Other Breakout:
SECTION E—CALCULATION OF FEDERAL GRANT
Latest Approved Adjustment Total
Cost Classification Amount +or(-)Amount Amount
(Use only for (Use only for Required
revisions) revisions
1. Administration expense $45,000
2_ Preliminary expense
3. Land,structures, right-of-way
4. Architectural engineering basic fees 90,000
5. Other Architectural engineering fees
6. Project inspection fees
7. Land development
8. Relocation Expenses
9. Relocation payments to Individuals and Businesses
10. Demolition and removal 90,000
11. Construction and project improvement 630,000
12. Equipment
13. Miscellaneous 45,000
14. Subtotal(Lines 1 through 13) $ 900,000
15. Estimated Income(if applicable)
16. Net Project Amount(Line 14 minus 15) 900,000
17. Less: Ineligible Exclusions(Section C,line 23 g.)
18.Subtotal(Lines 16 through 17) $900,000
19. Federal Share requested of Line 18 900,000
20. Grantee share 100,000
21. Other shares
22. TOTAL PROJECT(Lines 19,20&21) $ 1,000,000
FAA Form 5100-100(3/16)SUPERSEDES PREVIOUS EDITION Page 5 of 7
L.uNA,r D LAN®
OMB CONTROL NUMBER:2120-0569
OMB EXPIRATION DATE:8/31/2019
SECTION C—EXCLUSIONS
Amount Ineligible for
23.Classification(Description of non-participating work) Participation
a.
b.
C.
d.
e.
f.
g. Total
SECTION D—PROPOSED METHOD OF FINANCING NON-FEDERAL SHARE
24_Grantee Share--Fund Categories Amount
a.Securities
b. Mortgages
c.Appropriations(by Applicant)
d. Bonds
e.-fax Levies
f. Non-Cash
g. Other(Explain): Sponsor Local Share-Land Credits 100,000
h.TOTAL-Grantee share $ 100,000
25.Other Shares Amount
a.State
b.Other
c.TOTAL-Other Shares
26.TOTAL NON-FEDERAL FINANCING $ 100,000
SECTION E—REMARKS
(Attach sheets if additional space is required)
Grantee share is provided through the value of donated land as the complete and local share, Parcels 5-AIL, 5-H,
COFW 3-2 and FE-13.
FAA Form 5100-100(3116)SUPERSEDES PREVIOUS EDITION Page 6 of 7
OMB CONTROL NUMBER:2120-0569
OMB EXPIRATION DATE:6/31/2019
PART IV—PROGRAM NARRATIVE
(Suggested Format)
PROJECT: Miscellaneous Airport Improvements; lighting and paving.
AIRPORT: Fort Worth Alliance Airport
1. Objective:
Miscellaneous Pavement Repairs for design,construction and construction oversight focusing on RWY 16L-34R south of TWY Hotel.
Rehabilitate RWY 16L-34R Centerline Lights for design,construction and construction oversight of replacement electrical cable.
Rehabilitate TWY Alpha Centerline Lights for construction and construction oversight for removal and replacement of fixtures and
cable.
Update Airport Layout Plan; update the current ALP drawing set to include completed projects and anticipated projects.
Program Management is for grant management and CIP updates;City of Fort Worth coordination, annual CIP updates and annual
grant applications.
2. Benefits Anticipated:
Pavement repairs and lighting improvements increase airfield safety and compliance by upgrading airfield circuitry and repair of
damaged and deteriorating pavement areas for increased aircraft safety and FOD mitigation. The Airport Layout Plan is necessary
to reflect recently completed airport improvement projects and anticipated improvements on the airport. Program Management
Assistance is required for annual CIP updates,grant management coordination between the City of Fort Worth,the Airport and the
FAA along with annual grant application assistance.
3.Approach: (See approved Scope of Work in Final Application)
Upon funding, these projects will be designed and constructed as scoped.
4. Geographic Location:
The Fort Worth Alliance Airport is located jointly in Tarrant and Denton Counties. The Airport is located north of the
central business district of the City of Fort Worth. The primary location of the project(s)are on the Airport as
indicated on attached graphic.
S. If Applicable, Provide Additional Information:
6. Sponsor's Representative: (include address&telephone number)
Thomas J. Harris, President PH: 817-224-6008
Alliance Air Services
2221 Alliance Boulevard, Suite 100
Fort Worth, Texas 76177
FAA Form 5100-100(3116)SUPERSEDES PREVIOUS EDITION Page 7 of 7
PROJECT EXHIBITS
2019 AIP PROJECT DESCRIPTIONS
1. Miscellaneous Pavement Repairs (design and construction
Overview: This project is for design, construction and construction oversight. Project
will consist of pavement removal and replacement. Focus area will be Runway 16L-
34R south of Taxiway Hotel.
Major Work Items: PCC pavement removal and replacement. Potential for airfield
lighting replacement if airfield lighting is located within the concrete pavement panel
in need of replacement.
Justification: Airfield paving in various locations show signs of deterioration and
have the potential to lead to FOD generation.
Environmental: This project is anticipated to pose minimal impacts, as defined in
FAA Order 5050.413, NEPA, Chapter 6, Categorical Exclusion. Our preliminary
determination is that FAA CATEX 309b and associated construction emissions will
meet the environmental review and approval for this project.All components of this
project are replacement of existing components.
2. Rehabilitate Runway 16L-34R Centerline Lights (design and construction
Overview: This project is for design, construction and construction oversight. Project
will consist of removal and replacement of Runway 16L-34R centerline electrical
cable.
Major Work Items: Removal and replacement L-824C electrical cable. Potential for
pavement removal and replacement and conduit removal and replacement if conduit
is found to be obstructed or collapsed.
Justification: Current centerline light electrical cable infrastructure is obsolete and in
need of replacement.
Environmental: This project is anticipated to pose minimal impacts, as defined in
FAA Order 5050.413, NEPA, Chapter 6, Categorical Exclusion. Our preliminary
determination is that FAA CATEX 309b and associated construction emissions will
meet the environmental review and approval for this project.All components of this
project are replacement of existing components.
3. Rehabilitate Taxiway Alpha Centerline Lights (construction)
Overview: This project is for construction and construction oversight. Project will
consist of removal and replacement of Taxiway A centerline lighting fixtures, and
airfield electrical cable.
Major Work Items: Removal and replacement of L-852 lighting fixtures,
transformers and L-824C electrical cable. Potential for pavement removal and
replacement and conduit removal and replacement if conduit is found to be
obstructed or collapsed.
Justification: Current taxiway centerline lighting infrastructure is obsolete and in
need of replacement.
Environmental: This project is anticipated to pose minimal impacts, as defined in
FAA Order 5050.46, NEPA, Chapter 6, Categorical Exclusion. Our preliminary
determination is that FAA CATEX 309b and associated construction emissions will
meet the environmental review and approval for this project. All components of this
project are replacement of existing components.
4. Update Airport Layout Plan ALP
Overview: This project is to update the current ALP drawing set, approved in
January 25, 2016, to include recently completed projects and update anticipated
projects.
Major Work Items: Revision to 18 CADD drawings to reflect recently completed
projects and update anticipated projects.
Justification: Major projects have been completed since the previous version was
approved.
Environmental: None.
S. Program Management Services
Overview: This project is for Grant management and CIP updates
Major Work Items: Monthly grant management assistance, annual CIP updates,
and annual grant application preparation.
Justification: Required to obtain federal funding.
Environmental: None.
Project Location Map
Fort Worth Alliance Airport is located jointly in Tarrant and Denton Counties. The Airport is located north
of the central business district of Fort Worth. Primary location of the project(s) is on the Airport.
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FEDERAL AVIATION ADMINISTRATION
AIP
SPONSOR CERTIFICATIONS
04W
U.S. Department
of Transportation
Federal Aviation
Administration
FAA Form 5100-129, Construction Project Fina! Acceptance —
,Airport Improvement Program Sponsor Certification
Paperwork Reduction Act Burden Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a
person be subject to a penalty for failure to comply with a collection of information subject to the
requirements of the Paperwork Reduction Act unless that collection of information displays a currently
valid OMB Control Number. The OMB Control Number for this information collection is 2120-0569. Public
reporting for this collection of information is estimated to be approximately 8 hours per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, completing and reviewing the collection of information. All responses to this collection of
information are required under 49 U.S.C. Section 47105 to retain a benefit and to meet the reporting
requirements of 2 CFR 200. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden to the Federal Aviation
Administration at: 800 Independence Ave. SW,Washington, DC 20591,Attn: Information Collection
Clearance Officer,ASP-110.
FAA Form 5100-129
'* U.S.Department of Transportation OMB CONTROL NUMBER:2120-0569
Federal Aviation Administration EXPIRATION DATE:8/3112019
Construction Project Final Acceptance
Airport Improvement Program Sponsor Certification
Sponsor: City of Fort Worth
Airport: Fort Worth Alliance Airport
Project Number: 3-48-0296- -2019
Description of Work:
Application
49 USC§47105(d), authorizes the Secretary to require me certification from the sponsor that it will
comply with the statutory and administrative requirements in carrying out a project under the Airport
Improvement Program. General standards for final acceptance and close out of federally funded
construction projects are in 2 CFR§200.343—Closeout and supplemented by FAA Order 5100.38.The
sponsor must determine that project costs are accurate and proper in accordance with specific
requirements of the grant agreement and contract documents.
Certification Statements
Except for certification statements below marked not applicable (NIA), this list includes major
requirements of the construction project. Selecting"Yes"represents sponsor acknowledgment and
confirmation of the certification statement. The term "will" means Sponsor action taken at appropriate
time based on the certification statement focus area, but no later than the end of the project period of
performance. This list is not comprehensive and does not relieve the sponsor from fully complying with
all applicable statutory and administrative standards. The source of the requirement is referenced within
parenthesis.
1. The personnel engaged in project administration, engineering supervision, project inspection, and
acceptance testing were or will be determined to be qualified and competent to perform the work
(Grant Assurance).
Q Yes ❑ No ❑NIA
2. Construction records, including daily logs,were or will be kept by the resident
engineer/construction inspector that fully document contractor's performance in complying with:
a. Technical standards(Advisory Circular(AC) 15015370-12);
b. Contract requirements (2 CFR part 200 and FAA Order 5100.38); and
c. Construction safety and phasing plan measures (AC 150/5370-2).
❑x Yes ❑No ❑NIA
3. All acceptance tests specified in the project specifications were or will be performed and
documented. (AC 150/5370-12).
0 Yes ❑ No ❑NIA
FAA Form 5100-129(1117)SUPERSEDES PREVIOUS EDITION page 1 of 3
4. Sponsor has taken or will take appropriate corrective action for any test result outside of
allowable tolerances (AC 160/6370-12).
Q Yes L] N o ❑ NIA
5. Pay reduction factors required by the specifications were applied or will be applied in computing
final payments with a summary made available to the FAA(AC 15015370-10).
❑X Yes ❑ No ❑ NIA
6. Sponsor has notified, or will promptly notify the Federal Aviation Administration (FAA)of the
following occurrences:
a. Violations of any federal requirements set forth or included by reference in the contract
documents (2 CFR part 200);
b. Disputes or complaints concerning federal labor standards (29 CFR part 5); and
c. Violations of or complaints addressing conformance with Equal Employment Opportunity or
Disadvantaged Business Enterprise requirements (41 CFR Chapter 60 and 49 CFR part 26).
X❑Yes ❑ No ❑ NIA
7. Weekly payroll records and statements of compliance were or will be submitted by the prime
contractor and reviewed by the sponsor for conformance with federal labor and civil rights
requirements as required by FAA and U.S. Department of Labor(29 CFR Part 5).
❑X Yes ❑ No ❑ NIA
8. Payments to the contractor were or will be made in conformance with federal requirements and
contract provisions using sponsor internal controls that include:
a. Retaining source documentation of payments and verifying contractor billing statements
against actual performance(2 CFR§200.302 and FAA Order 5100.38);
b. Prompt payment of subcontractors for satisfactory performance of work(49 CFR§26.29);
c. Release of applicable retainage upon satisfactory performance of work(49 CFR§26.29);
and
d. Verification that payments to DBEs represent work the DBE performed by carrying out a
commercially useful function (49 CFR§26.55).
Q Yes ❑ No ❑ NIA
9. A final project inspection was or will be conducted with representatives of the sponsor and the
contractor present that ensure:
a. Physical completion of project work in conformance with approved plans and specifications
(Order 5100.38);
b. Necessary actions to correct punch list items identified during final inspection are complete
(Order 5100.38); and
c. Preparation of a record of final inspection and distribution to parties to the contract
(Order 5100.38);
Q Yes ❑ No ❑ NIA
10. The project was or will be accomplished without material deviations, changes, or modifications
from approved plans and specifications, except as approved by the FAA(Order 5100.38).
0 Yes [] No ❑ NIA
FAA Form 5100-129(1117)SUPERSEDES PREVIOUS EDITION page 2 of 3
11. The construction of all buildings have complied or will comply with the seismic construction
requirements of 49 CFR§41.120.
❑X Yes ❑ No ❑ N/A
12. For development projects, sponsor has taken or will take the following close-out actions:
a. Submit to the FAA a final test and quality assurance report summarizing acceptance test
results, as applicable (Grant Condition);
b. Complete all environmental requirements as established within the project environmental
determination (Oder 5100.38); and
c. Prepare and retain as-built plans(Order 5100.38).
Q Yes ❑ No ❑ NIA
13. Sponsor has revised or will revise their airport layout plan (ALP)that reflects improvements made
and has submitted or will submit an updated ALP to the FAA no later than 90 days from the
period of performance end date. (49 USC§47107 and Order 5100.38).
0 Yes ❑ No ❑ NIA
Attach documentation clarifying any above item marked with"Nd' response.
Sponsor's Certification
I certify,for the project identified herein, responses to the forgoing items are accurate as marked and
additional documentation for any item marked "no" is correct and complete.
Executed on this day of FcbIvno Z0,9f .
Name of Sponsor: City of Fort Worth
Name of Sponsor's Authorized Official William Welstead
Title of Sponsor's Authorized Official: Airport System Director
I
Signature of Sponsors Authorized Official:
a
I declare under penalty of perjury that the foregoing is true and correct. I understand that knowingly and
willfully providing false information to the federal government is a violation of 18 USC§ 1001 (False
Statements)and could subject me to fines, imprisonment, or both.
Ef)FFICIALECORDETARY
FAA Form 5100-129(1117)SUPERSEDES PREVIOUS EDITION � '
a
U.S. Department
of Transportation
Federal Aviation
Administration
FAA Form 5100-130, Drug-Free Workplace — Airport Improvement}
Program Sponsor Certification
Paperwork Reduction Act Burden Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a
person be subject to a penalty for failure to comply with a collection of information subject to the
requirements of the Paperwork Reduction Act unless that collection of information displays a currently
valid OMB Control Number. The OMB Control Number for this information collection is 2120-0569. Public
reporting for this collection of information is estimated to be approximately 8 hours per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, completing and reviewing the collection of information. All responses to this collection of
information are required under 49 U.S.C. Section 47105 to retain a benefit and to meet the reporting
requirements of 2 CFR 200. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden to the Federal Aviation
Administration at: 800 Independence Ave. SW,Washington, DC 20591,Attn: Information Collection
Clearance Officer,ASP-110.
FAA Form 5100-130
U.S.Department of Transportation OMB CONTROL NUMBER:2120-0569
I Federal Aviation Administration EXPIRATION DATE:8/31/2019
Drag-Free Workplace
.Airport Improvement Program Sponsor Certification
Sponsor: City of Fort Worth
Airport: Fort Worth Alliance Airport
Project Number: 3-48-0296- -2019
Description of Work:
Application
49 USC§47105(d)authorizes the Secretary to require certification from the sponsor that it will comply
with the statutory and administrative requirements in carrying out a project under the Airport Improvement
Program (AIP). General requirements on the drug-free workplace within federal grant programs are
described in 2 CFR part 182. Sponsors are required to certify they will be, or will continue to provide, a
drug-free workplace in accordance with the regulation. The AIP project grant agreement contains specific
assurances on the Drug-Free Workplace Act of 1988.
Certification Statements
Except for certification statements below marked as not applicable(NIA), this list includes major
requirements of the construction project. Selecting"Yes"represents sponsor acknowledgement and
confirmation of the certification statement. The term "will" means Sponsor action taken at appropriate time
based on the certification statement focus area, but no later than the end of the project period of
performance. This list is not comprehensive and does not relieve the sponsor from fully complying with all
applicable statutory and administrative standards. The source of the requirement is referenced within
parenthesis.
1. A statement has been or will be published prior to commencement of project notifying employees
that the unlawful manufacture, distribution, dispensing, possession,or use of a controlled
substance is prohibited in the sponsor's workplace, and specifying the actions to be taken against
employees for violation of such prohibition (2 CFR§ 182.205).
El Yes ❑ No ❑ NIA
2. An ongoing drug-free awareness program (2 CFR§ 182.215) has been or will be established
prior to commencement of project to inform employees about:
a. The dangers of drug abuse in the workplace;
b. The sponsor's policy of maintaining a drug-free workplace;
c. Any available drug counseling, rehabilitation, and employee assistance programs; and
d. The penalties that may be imposed upon employees for drug abuse violations occurring
in the workplace.
0 Yes ❑ No ❑ NIA
FAA Form 5100-130(1117)SUPERSEDES PREVIOUS EDITION Page 7 of 3
3. Each employee to be engaged in the performance of the work has been or will be given a copy of
the statement required within item 1 above prior to commencement of project(2 CFR§ 182.210).
Yes ❑ No ❑NIA
4. Employees have been or will be notified in the statement required by item 1 above that, as a
condition employment under the grant(2 CFR§ 182.205(c)),the employee will:
a. Abide by the terms of the statement; and
b. Notify the employer in writing of his or her conviction for a violation of a criminal drug
statute occurring in the workplace no later than five calendar days after such conviction.
❑x Yes ❑No ❑NIA
5. The Federal Aviation Administration (FAA)will be notified in writing within 10 calendar days after
receiving notice under item 4b above from an employee or otherwise receiving actual notice of
such conviction (2 CFR§ 182.225). Employers of convicted employees must provide notice,
including position title of the employee, to the FAA(2 CFR§ 182.300).
❑x Yes ❑ No ❑NIA
6. One of the following actions (2 CFR§ 182.225(b))will be taken within 30 calendar days of
receiving a notice under item 4b above with respect to any employee who is so convicted:
a. Take appropriate personnel action against such an employee, up to and including
termination, consistent with the requirements of the Rehabilitation Act of 1973, as
amended; and
b. Require such employee to participate satisfactorily in drug abuse assistance or
rehabilitation programs approved for such purposes by a federal, state, or local health,
law enforcement, or other appropriate agency.
Ed Yes ❑No ❑ NIA
7. A good faith effort will be made, on a continuous basis,to maintain a drug-free workplace through
implementation of items 1 through 6 above (2 CFR§ 182.200).
El Yes ❑No ❑ N/A
Site(s) of performance of work(2 CFR§ 182.230):
Location 1
Name of Location: Fort worth Alliance Airport
Address: 2221 Alliance Boulevard, Fort Worth,Texas 76177
Location 2 (if applicable)
Name of Location:
Address:
Location 3 (if applicable)
Name of Location:
Address:
FAA Form 5100-130(1117)SUPERSEDES PREVIOUS EDITION Page 2 of 3
Attach documentation clarifying any above item marked with a "No"response.
Sponsor's Certification
I certify,for the project identified herein, responses to the forgoing items are accurate as marked and
additional documentation for any item marked "no" is correct and complete.
Executed on this day of � e,AVV4 ZCq/�
Name of Sponsor: City of Fort Worth /
Name of Sponsor's Authorized Official: William Welstead
Title of Sponsor's Authorized Official: Aiport System Director
Signature of Sponsor's Authorized Official: x/w/z/
I declare under penalty of perjury that the foregoing is true and correct. I understand that knowingly and
willfully providing false information to the federal government is a violation of 18 USC § 1001 (False
Statements) and could subject me to fines, imprisonment, or both.
0MCIAL RECORD
CITY SECRETARY
FAA Form 5100-130(1117)SUPERSEDES PREVIOUS EDITION FT- WPaag�e� WI
U.S. Department
of Transportation
Federal Aviation
Administration
I=AA Form 5100131, Equipment and Construction Contracts
Airport Improvement Sponsor Certification
Paperwork Reduction Act Burden Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a
person be subject to a penalty for failure to comply with a collection of information subject to the
requirements of the Paperwork Reduction Act unless that collection of information displays a currently
valid OMB Control Number.The OMB Control Number for this information collection is 2120-0569. Public
reporting for this collection of information is estimated to be approximately 8 hours per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, completing and reviewing the collection of information. All responses to this collection of
information are required under 49 U.S.C. Section 47105 to retain a benefit and to meet the reporting
requirements of 2 CFR 200. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden to the Federal Aviation
Administration at: 800 Independence Ave. SW,Washington, DC 20591,Attn: Information Collection
Clearance Officer,ASP-110.
FAA Form 5100-131
U.S.Department of Transportation OMB CONTROL NUMBER:2120-0569
Federal Aviation Administration EXPIRATION DATE: 8/31/2019
Equipment and Construction Contracts
Airport Improvement Sponsor Certification
Sponsor: City of Fort Worth
Airport: Fort Worth Alliance Airport
Project Number: 3-48-0298- -2019
Description of Work:
Application
49 USC§47105(d)authorizes the Secretary to require certification from the sponsor that it will comply
with the statutory and administrative requirements in carrying out a project under the Airport Improvement
Program (AIP). General procurement standards for equipment and construction contracts within Federal
grant programs are described in 2 CFR§§200.317-200.326. Labor and Civil Rights Standards
applicable to the AIP are established by the Department of Labor(www.dol.gov)AIP Grant Assurance
CA—General Federal Requirements identifies all applicable Federal Laws, regulations, executive orders,
policies, guidelines and requirements for assistance under the AIP. Sponsors may use state and local
procedures provided the procurement conforms to these federal standards.
This certification applies to all equipment and construction projects. Equipment projects may or may not
employ laborers and mechanics that qualify the project as a "covered contract" under requirements
established by the Department of Labor requirements. Sponsor shall provide appropriate responses to
the certification statements that reflect the character of the project regardless of whether the contract is
for a construction project or an equipment project.
Certification Statements
Except for certification statements below marked as not applicable(NIA), this list includes major
requirements of the construction project. Selecting"Yes" represents sponsor acknowledgement and
confirmation of the certification statement. The term"will" means Sponsor action taken at appropriate
time based on the certification statement focus area, but no later than the end of the project period of
performance.This list is not comprehensive and does not relieve the sponsor from fully complying with all
applicable statutory and administrative standards.The source of the requirement is referenced within
parenthesis.
1. A written code or standard of conduct is or will be in effect prior to commencement of the project
that governs the performance of the sponsor's officers, employees, or agents in soliciting,
awarding and administering procurement contracts (2 CFR§200.318).
NYes ❑ No ❑ N/A
FAA Form 5100-131 (1117)SUPERSEDES PREVIOUS EDITION Page 1 of 4
2. For all contracts, qualified and competent personnel are or will be engaged to perform contract
administration, engineering supervision, construction inspection, and testing
(Grant Assurance C.17).
x❑Yes ❑ No ❑ NIA
3. Sponsors that are required to have a Disadvantage Business Enterprise(DBE) program on file
with the FAA have included or will include clauses required by Title VI of the Civil Rights Act and
49 CFR Part 26 for Disadvantaged Business Enterprises in all contracts and subcontracts.
p Yes ❑ No ❑ NIA
4. Sponsors required to have a DBE program on file with the FAA have implemented or will
implement monitoring and enforcement measures that:
a. Ensure work committed to Disadvantaged Business Enterprises at contract award is
actually performed by the named DBEs (49 CFR§26.37(b));
b. Include written certification that the sponsor has reviewed contract records and has
monitored work sites for performance by DBE firms (49 CFR§26.37(b)); and
c. Provides for a running tally of payments made to DBE firms and a means for comparing
actual attainments (i.e. payments)to original commitments (49 CFR§26.37(c)).
❑x Yes ❑ No ❑ NIA
5. Sponsor procurement actions using the competitive sealed bid method (2 CFR§200.320(c)).was
or will be:
a. Publicly advertised, allowing a sufficient response time to solicit an adequate number of
interested contractors or vendors;
b. Prepared to include a complete, adequate and realistic specification that defines the
items or services in sufficient detail to allow prospective bidders to respond;
c. Publicly opened at a time and place prescribed in the invitation for bids;and
d. Prepared in a manner that result in a firm fixed price contract award to the lowest
responsive and responsible bidder.
Yes ❑ No ❑ NIA
6. For projects the Sponsor proposes to use the competitive proposal procurement method (2 CFR§
200.320(d)), Sponsor has requested or will request FAA approval prior to proceeding with a
competitive proposal procurement by submitting to the FAA the following:
a. Written justification that supports use of competitive proposal method in lieu of the
preferred sealed bid procurement method;
b. Plan for publicizing and soliciting an adequate number of qualified sources; and
c. Listing of evaluation factors along with relative importance of the factors.
❑x Yes ❑ No ❑ NIA
7. For construction and equipment installation projects,the bid solicitation includes or will include the
current federal wage rate schedule(s)for the appropriate type of work classifications (2 CFR Part
200,Appendix II).
❑9 Yes ❑ No ❑ NIA
FAA Form 5100-131 (1117)SUPERSEDES PREVIOUS EDITION Page 2 of 4
8. Concurrence was or will be obtained from the Federal Aviation Administration (FAA) prior to
contract award under any of the following circumstances (Order 5100.38D):
a. Only one qualified person/firm submits a responsive bid;
b. Award is to be made to other than the lowest responsible bidder; and
c. Life cycle costing is a factor in selecting the lowest responsive bidder.
0Yes El No ❑ NIA
9. All construction and equipment installation contracts contain or will contain provisions for:
a. Access to Records (§ 200.336)
b. Buy American Preferences(Title 49 U.S.C. § 50101)
c. Civil Rights-General Provisions and Title VI Assurances(41 CFR part 60)
d. Federal Fair Labor Standards (29 U.S.C. §201, et seq)
e. Occupational Safety and Health Act requirements (20 CFR part 1920)
f. Seismic Safety—building construction (49 CFR part 41)
g. State Energy Conservation Requirements-as applicable(2 CFR part 200,Appendix II)
h. U.S.Trade Restriction (49 CFR part 30)
i. Veterans Preference (49 USC§47112(c))
x❑ Yes ❑ No ❑ NIA
10. All construction and equipment installation contracts exceeding $2,000 contain or will contain the
provisions established by:
a. Davis-Bacon and Related Acts (29 CFR part 5)
b. Copeland "Anti-Kickback"Act(29 CFR parts 3 and 5)
❑x Yes ❑ No ❑ NIA
11. All construction and equipment installation contracts exceeding $3,000 contain or will contain a
contract provision that discourages distracted driving (E.O. 13513).
Yes ❑ No ❑ NIA
12. All contracts exceeding $10,000 contain or will contain the following provisions as applicable:
a. Construction and equipment installation projects-Applicable clauses from
41 CFR Part 60 for compliance with Executive Orders 11246 and 11375 on Equal
Employment Opportunity;
b. Construction and equipment installation-Contract Clause prohibiting segregated facilities
in accordance with 41 CFR part 60-1.8;
c. Requirement to maximize use of products containing recovered materials in accordance
with 2 CFR§200.322 and 40 CFR part 247; and
d. Provisions that address termination for cause and termination for convenience
(2 CFR Part 200,Appendix II).
.XI1, Yes ❑ No ❑ NIA
FAA Form 5100-131 (1117)SUPERSEDES PREVIOUS EDITION Page 3 of 4
13. All contracts and subcontracts exceeding $25,000: Measures are in place or will be in place (e.g.
checking the System for Award Management)that ensure contracts and subcontracts are not
awarded to individuals or firms suspended, debarred, or excluded from participating in federally
assisted projects (2 CFR parts 180 and 1200).
x❑ Yes ❑ No ❑ NIA
14. Contracts exceeding the simplified acquisition threshold (currently$150,000)include or will include
provisions, as applicable, that address the following:
a. Construction and equipment installation contracts-a bid guarantee of 5%, a performance
bond of 100%, and a payment bond of 100% (2 CFR§200.325);
b. Construction and equipment installation contracts- requirements of the Contract Work
Hours and Safety Standards Act(40 USC 3701-3708, Sections 103 and 107);
c. Restrictions on Lobbying and Influencing (2 CFR part 200,Appendix I1);
d. Conditions specifying administrative, contractual and legal remedies for instances where
contractor of vendor violate or breach the terms and conditions of the contract(2 CFR
§200,Appendix 11); and
e. All Contracts-Applicable standards and requirements issued under Section 306 of the
Clean Air Act(42 USC 7401-7671 q), Section 508 of the Clean Water Act(33 USC 1251-
1387, and Executive Order 11738.
nx. Yes ❑ No ❑ NIA
Attach documentation clarifying any above item marked with "No" response.
Sponsor's Certification
I certify, for the project identified herein, responses to the forgoing items are accurate as marked and
additional documentation for any item marked "no" is correct and complete.
Executed on this -� day of FtWvOkl y 2c7l Gt .
Name of Sponsor: City of Fort Worth
Name of Sponsor's Authorized Official: William Welstead
Title of Sponsor's Authorized Official: Airport System Director
Signature of Sponsor's Authorized Official:
I declare under penalty of perjury that the foregoing is true and correct. I understand that knowingly and
willfully providing false information to the federal government is a violation of 18 USC§ 1001 (False
Statements)and could subject me to fines, imprisonment, or both.
iCIiCIALWCF R ;K)-)WkV.
C1` S CRETARIr
r r.FAA Form 5100-131 (1117)SUPERSEDES PREVIOUS EDITfONo o
dl�
U.S. Department
of Transportation
Federal Aviation
Administration
FAA Form 5100®132, Project Plans and Specifications — Airport
Improvement Program Sponsor Certification
Paperwork Reduction Act Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a
person be subject to a penalty for failure to comply with a collection of information subject to the
requirements of the Paperwork Reduction Act unless that collection of information displays a.currently
valid OMB Control Number. The OMB Control Number for this information collection is 2120-0569. Public
reporting for this collection of information is estimated to be approximately 8 hours per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, completing and reviewing the collection of information. All responses to this collection of
information are required under 49 U.S.C. Section 47105 to retain a benefit and to meet the reporting
requirements of 2 CFR 200. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden to the Federal Aviation
Administration at: 800 Independence Ave. SW, Washington, DC 20591,Attn: Information Collection
Clearance Officer,ASP-110.
FAA Form 5100-132
U.S.Department of Transportation OMB CONTROL NUMBER:2120-0569
Federal Aviation Administration EXPIRATION DATE:8/31/2019
Project Plans and Specifications
Airport Improvement Program Sponsor Certification
Sponsor: City of Fort Worth
Airport: Fort Worth Alliance Airport
Project Number: 3-48-0296- 2019
Description of Work:
Application
49 USC §47105(d) authorizes the Secretary to require certification from the sponsor that it will comply
with the statutory and administrative requirements in carrying out a project under the Airport Improvement
Program (AIP). Labor and civil rights standards applicable to AIP are established by the Department of
Labor(www.dol.gov/). AIP Grant Assurance C.1—General Federal Requirements identifies applicable
federal laws, regulations, executive orders, policies, guidelines and requirements for assistance under
AIP. A list of current advisory circulars with specific standards for procurement, design or construction of
airports, and installation of equipment and.facilities is referenced in standard airport sponsor Grant
Assurance 34 contained in the grant agreement.
Certification Statements
Except for certification statements below marked as not applicable (NIA), this list includes major
requirements of the construction project. Selecting"Yes"represents sponsor acknowledgement and
confirmation of the certification statement. The term "will' means Sponsor action taken at appropriate
time based on the certification statement focus area, but no later than the end of the project period of
performance.This list is not comprehensive and does not relieve the sponsor from fully complying with all
applicable statutory and administrative standards. The source of the requirement is referenced within
parenthesis.
1. The plans and specifications were or will be prepared in accordance with applicable federal
standards and requirements, so that no deviation or modification to standards set forth in the
advisory circulars, or FAA-accepted state standard, is necessary other than those explicitly
approved by the Federal Aviation Administration(FAA)(14 USC§47105).
❑x Yes ❑ No ❑NIA
2. Specifications incorporate or will incorporate a clear and accurate description of the technical
requirement for the material or product that does not contain limiting or proprietary features that
unduly restrict competition (2 CFR§200.319).
p Yes ❑ No ❑NIA
FAA Form 5100-132(1117)SUPERSEDES PREVIOUS EDITION Page t of 3
3. The development that is included or will be included in the plans is depicted on the current airport
layout plan as approved by the FAA(14 USC§47107).
0 Yes ❑ No ❑ NIA
4. Development and features that are ineligible or unallowable for AIP funding have been or will be
omitted from the plans and specifications(FAA Order 5100.38, par. 3-43).
0 Yes ❑ No ❑NIA
5. The specification does not use or will not use"brand name"or equal to convey requirements
unless sponsor requests and receives approval from the FAA to use brand name (FAA Order
5100.38, Table U-5).
0 Yes ❑ No ❑ NIA
6. The specification does not impose or will not impose geographical preference in their
procurement requirements(2 CFR§200.319(b)and FAA Order 5100.38,Table U-5).
0 Yes ❑ No ❑ NIA
7. The use of prequalified lists of individuals, firms or products include or will include sufficient
qualified sources that ensure open and free competition and that does not preclude potential
entities from qualifying during the solicitation period (2 CFR§319(d)).
0 Yes ❑ No ❑ NIA
8. Solicitations with bid alternates include or will include explicit information that establish a basis for
award of contract that is free of arbitrary decisions by the sponsor(2 CFR§200.319(a)(7)).
0 Yes ❑ No ❑ NIA
9. Concurrence was or will be obtained from the FAA if Sponsor incorporates a value engineering
clause into the contract(FAA Order 5100.38, par. 3-57).
0 Yes ❑ No ❑ NIA
10. The plans and specifications incorporate or will incorporate applicable requirements and
recommendations set forth in the federally approved environmental finding (49 USC§47106(c)).
❑ Yes ❑ No ❑ NIA
11. The design of all buildings comply or will comply with the seismic design requirements of 49 CFR
§41.120. (FAA Order 5100.38d, par. 3-92)
❑x Yes ❑ No ❑ NIA
12. The project specification include or will include process control and acceptance tests required for
the project by as per the applicable standard:
a. Construction and installation as contained in Advisory Circular(AC) 15015370-10.
0 Yes [] No ❑ NIA
FAA Form 5100-132(1117)SUPERSEDES PREVIOUS EDITION Page 2 of 3
b. Snow Removal Equipment as contained in AC 150/5220-20.
p Yes ❑ No ❑ NIA
c. Aircraft Rescue and Fire Fighting(ARFF)vehicles as contained in AC 150/5220-10.
0 Yes [-] No ❑ NIA
13. For construction activities within or near aircraft operational areas(AOA):
a. The Sponsor has or will prepare a construction safety and phasing plan (CSPP)conforming
to Advisory Circular 15015370-2.
b. Compliance with CSPP safety provisions has been or will be incorporated into the plans
and specifications as a contractor requirement.
c. Sponsor will not initiate work until receiving FAA's concurrence with the CSPP (FAA Order
5100.38, Par. 5-29).
Q Yes ❑ No ❑ NIA
14. The project was or will be physically completed without federal participation in costs due to errors
and omissions in the plans and specifications that were foreseeable at the time of project design
(49 USC §47110(b)(1)and FAA Order 5100.38d, par.3-100).
❑x Yes ❑ No ❑ NIA
Attach documentation clarifying any above item marked with "No"response.
Sponsor's Certification
I certify, for the project identified herein, responses to the forgoing items are accurate as marked and
additional documentation for any item marked "no" is correct and complete.
Executed on this day of fqk . , 200
Name of Sponsor: City of Fort Worth
Name of Sponsor's Authorized Official: Fernando Costa
Title of Sponsor's Authorized Official: Assistant City Manager
Signature of Sponsor's Authorized Official• Lua�-a� L.rorL�•
I declare under penalty of perjury that the foregoing is true and correct. I understand that knowingly and
willfully providing false information to the federal government is a violation of 18 USC§ 1001 (False
Statements)and could subject me to fines, im nsonment, or both.
7W,b-iwed by:
�'a
*1 1. OPROVED AS TO FORM AND LEGALITY,
ff IL
M J. a se Cr-
r Assitant City At cr cp
FAA Form 5100-132(1117)SUPERSED PF 1= US IT•I.O ., _— �' �' - -a_°
rF!'r.
L RECORD
7tx .� SEC RETARY
R�Ii,` .
U.S. Department
of Transportation
Federal Aviation
Administration
FAA Form 5100-132, project Plans and Specifications — Airport
Improvement program Sponsor Certification
Paperwork Reduction Act Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a
person be subject to a penalty for failure to comply with a collection of information subject to the
requirements of the Paperwork Reduction Act unless that collection of information displays a currently.
valid OMB Control Number. The OMB Control Number for this information collection is 2120-0569. Public
reporting for this collection of information is estimated to be approximately 8 hours per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, completing and reviewing the collection of information. All responses to this collection of
information are required under 49 U.S.C. Section 47105 to retain a benefit and to meet the reporting
requirements of 2 CFR 200. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden to the Federal Aviation
Administration at: 800 Independence Ave. SW,Washington, DC 20591, Attn: Information Collection
Clearance Officer,ASP-'110.
FAA Form 5100-132
U.S.Department of Transportation OMB CONTROL NUMBER:2120-0569
Federal Aviation Administration EXPIRATION DATE:8/3112019
Project Plans and Specifications
Airport Improvement Program Sponsor Certification
Sponsor: City of Fort Worth
Airport: Fort Worth Alliance Airport
Project Number: 3-48-0296- 2019
Description of Work:
Application
49 USC§47105(d)authorizes the Secretary to require certification from the sponsor that it will comply
with the statutory and administrative requirements in carrying out a project under the Airport Improvement
Program (AIP). Labor and civil rights standards applicable to AIP are established by the Department of
Labor(www.dol.gov/). AIP Grant Assurance C.1—General Federal Requirements identifies applicable
federal laws, regulations, executive orders, policies, guidelines and requirements for assistance under
AIP. A list of current advisory circulars with specific standards for procurement, design or construction of
airports, and installation of equipment and facilities is referenced in standard airport sponsor Grant
Assurance 34 contained in the grant agreement.
Certification Statements
Except for certification statements below marked as not applicable (NIA), this list includes major
requirements of the construction project. Selecting"Yes" represents sponsor acknowledgement and
confirmation of the certification statement. The term"will' means Sponsor action taken at appropriate
time based on the certification statement focus area, but no later than the end of the project period of
performance.This list is not comprehensive and does not relieve the sponsor from fully complying with all
applicable statutory and administrative standards. The source of the requirement is referenced within
parenthesis.
1. The plans and specifications were or will be prepared in accordance with applicable federal
standards and requirements, so that no deviation or modification to standards set forth in the
advisory circulars, or FAA-accepted state standard, is necessary other than those explicitly
approved by the Federal Aviation Administration (FAA) (14 USC§47105).
p Yes ❑ No ❑NIA
2. Specifications incorporate or will incorporate a clear and accurate description of the technical
requirement for the material or product that does not contain limiting or proprietary features that
unduly restrict competition (2 CFR§200.319).
p Yes ❑ No ❑NIA
FAA Form 5100-132(1117)SUPERSEDES PREVIOUS EDITION Page 1 of 3
I The development that is included or will be included in the plans is depicted on the current airport
layout plan as approved by the FAA(14 USC §47107).
0 Yes ❑ No ❑ NIA
4. Development and features that are ineligible or unallowable for AIP funding have been or will be
omitted from the plans and specifications (FAA Order 5100.38, par. 3-43).
Yes ❑ No ❑ NIA
5. The specification does not use or will not use "brand name"or equal to convey requirements
unless sponsor requests and receives approval from the FAA to use brand name (FAA Order
5100.38, Table U-5).
0 Yes ❑ No ❑ NIA
6. The specification does not impose or will not impose geographical preference in their
procurement requirements (2 CFR§200.319(b)and FAA Order 5100.38, Table U-5).
0 Yes ❑ No ❑ NIA
7. The use of prequalified lists of individuals,firms or products include or will include sufficient
qualified sources that ensure open and free competition and that does not preclude potential
entities from qualifying during the solicitation period (2 CFR§319(d)).
El Yes ❑ No ❑ NIA
8. Solicitations with bid alternates include or will include explicit information that establish a basis for
award of contract that is free of arbitrary decisions by the sponsor(2 CFR§200.319(a)(7)).
N Yes ❑ No ❑ NIA
9. Concurrence was or will be obtained from the FAA if Sponsor incorporates a value engineering
clause into the contract(FAA Order 5100.38, par. 3-57).
M Yes ❑ No ❑ NIA
10. The plans and specifications incorporate or will incorporate applicable requirements and
recommendations set forth in the federally approved environmental finding (49 USC§47106(c)).
❑ Yes ❑ No ❑ NIA
11. The design of all buildings comply or will comply with the seismic design requirements of 49 CFR
§41.120. (FAA Order 5100.38d, par. 3-92)
p Yes ❑ No ❑ NIA
12. The project specification include or will include process control and acceptance tests required for
the project by as per the applicable standard:
a. Construction and installation as contained in Advisory Circular(AC) 15015370-10.
0 Yes ❑ No ❑ NIA
FAA Form 5100-132(1117)SUPERSEDES PREVIOUS EDITION Page 2 of 3
b. Snow Removal Equipment as contained in AC 15015220-20.
[@ Yes ❑ No ❑ NIA
c. Aircraft Rescue and Fire Fighting (ARFF)vehicles as contained in AC 15015220-10.
❑p Yes [-] No ❑ NIA
13. For construction activities within or near aircraft operational areas(AOA)-
a. The Sponsor has or will prepare a construction safety and phasing plan (CSPP)conforming
to Advisory Circular 150/5370-2.
b. Compliance with CSPP safety provisions has been or will be incorporated into the plans
and specifications as a contractor requirement.
c. Sponsor will not initiate work until receiving FAA's concurrence with the CSPP (FAA Order
5100.38, Par. 5-29).
x❑ Yes ❑ No ❑ NIA
14. The project was or will be physically completed without federal participation in costs due to errors
and omissions in the plans and specifications that were foreseeable at the time of project design
(49 USC§47110(b)(1)and FAA Order 5100.38d, par. 3-100).
❑p Yes [--] No ❑ NIA
Attach documentation clarifying any above item marked with "No" response.
Sponsor's Certification
1 certify,for the project identified herein, responses to the forgoing items are accurate as marked and
additional documentation for any item marked"no"is correct and complete.
Executed on this day of Fe.WAry Vl 1
Name of Sponsor: City of Fort Worth
Name of Sponsor's Authorized Official: William Welstead
Title of Sponsor's Authorized Official: Airport System Manager
Signature of Sponsor's Authorized Official:
I declare under penalty of perjury that the foregoing is true and correct. I understand that knowingly and
willfully providing false information to the federal government is a violation of 18 USC § 1001 (False
Statements)and could subject me to fines, imprisonment, or both.
OFFICIAL MORE
FAA Form 5100-132(1117)SUPERSEDES PREVIOUS EDITION p
Obw
U.S. Department
of Transportation
Federal Aviation
Administration
FAA Form 5100-133, Real Property Acquisition
Airport Improvement Program Sponsor Certificati®n
Paperwork Reduction Act Burden Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a
person be subject to a penalty for failure to comply with a collection of information subject to the
requirements of the Paperwork Reduction Act unless that collection of information displays a currently
valid OMB Control Number. The OMB Control Number for this information collection is 2120-0569. Public
reporting for this collection of information is estimated to be approximately 8 hours per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, completing and reviewing the collection of information. All responses to this collection of
information are required under 49 U.S.C. Section 47105 to retain a benefit and to meet the reporting
requirements of 2 CFR 200. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden to the Federal Aviation
Administration at: 800 Independence Ave. SW,Washington, DC 20591, Attn: Information Collection
Clearance Officer,ASP-110.
FAA Form 5100-133
U.S.Department of Transportation OMB CONTROL NUMBER:2120-0569
Federal Aviation Administration EXPIRATION DATE:8/31/2019
Real Property Acquisition
Airport Improvement Program Sponsor Certification
Sponsor: City of Fork Worth
Airport: Fort Worth Alliance Airport
Project Number: 3-48-0296- -2019
Description of Work:
Application
49 USC§47105(d)authorizes the Secretary to require certification from the sponsor that it will comply
with the statutory and administrative requirements in carrying out a project under the Airport Improvement
Program (AIP). General requirements on real property acquisition and relocation assistance are in
49 CFR Part 24. The AIP project grant agreement contains specific requirements and assurances on the
Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (Uniform Act), as
amended.
Certification Statements
Except for certification statements below marked not applicable (NIA),this list includes major
requirements of the real property acquisition project. Selecting "Yes" represents sponsor
acknowledgement and confirmation of the certification statement.The term "will"means Sponsor action
taken at appropriate time based on the certification statement focus area, but no later than the end of the
project period of performance.This list is not comprehensive and does not relieve the sponsor from fully
complying with all applicable statutory and administrative standards.
1. The sponsor's attorney or other official has or will have good and sufficient title as well as title
evidence on property in the project.
9 Yes ❑No ❑NIA
2. If defects and/or encumbrances exist in the title that adversely impact the sponsor's intended use
of property in the project,they have been or will be extinguished, modified, or subordinated.
❑x Yes ❑No ❑NIA
3. If property for airport development is or will be leased, the following conditions have been met:
a. The term is for 20 years or the useful life of the project;
b. The lessor is a public agency; and
c. The lease contains no provisions that prevent full compliance with the grant agreement.
[9Yes ❑No ❑NIA
FAA Form 5100-133(1117)SUPERSEDES PREVIOUS EDITION Page 1 of 3
4. Property in the project is or will be in conformance with the current Exhibit A property map, which
is based on deeds, title opinions, land surveys,the approved airport layout plan, and project
documentation.
M Yes ❑No ❑NIA
5. For any acquisition of property interest in noise sensitive approach zones and related areas,
property interest was or will be obtained to ensure land is used for purposes compatible with
noise levels associated with operation of the airport.
0 Yes ❑No ❑NIA
6. For any acquisition of property interest in runway protection zones and areas related to
14 CFR 77 surfaces or to clear other airport surfaces, property interest was or will be obtained for
the following:
a. The right of flight;
b. The right of ingress and egress to remove obstructions; and
c. The right to restrict the establishment of future obstructions.
0 Yes []No ❑NIA
7. Appraisals prepared by qualified real estate appraisers hired by the sponsor include or will
include the following:
a. Valuation data to estimate the current market value for the property interest acquired on
each parcel; and
b. Verification that an opportunity has been provided to the property owner or representative
to accompany appraisers during inspections.
0 Yes ❑No ❑NIA
8. Each appraisal has been or will be reviewed by a qualified review appraiser to recommend an
amount for the offer of just compensation, and the written appraisals as well as review appraisal
are available to Federal Aviation Administration (FAA)for review.
0 Yes ❑No ❑NIA
9. A written offer to acquire each parcel was or will be presented to the property owner for not less
than the approved amount of just compensation.
0 Yes ❑No ❑NIA
10. Effort was or will be made to acquire each property through the following negotiation procedures:
a. No coercive action to induce agreement; and
b. Supporting documents for settlements included in the project files.
0 Yes ❑No ❑NIA
FAA Form 5100-133(1117)SUPERSEDES PREVIOUS EDITION Page 2 of 3
11. If a negotiated settlement is not reached, the following procedures were or will be used:
a. Condemnation initiated and a court deposit not less than the just compensation made
prior to possession of the property; and
b. Supporting documents for awards included in the project tiles.
x❑Yes ❑No ❑NIA
12. If displacement of persons, businesses, farm operations, or non-profit organizations is involved, a
relocation assistance program was or will be established,with displaced parties receiving general
information on the program in writing, including relocation eligibility, and a 90-day notice to
vacate.
❑x Yes ❑No ❑NIA
13. Relocation assistance services, comparable replacement housing, and payment of necessary
relocation expenses were or will be provided within a reasonable time period for each displaced
occupant in accordance with the Uniform Act.
[]Yes ❑No ❑NIA
Attach documentation clarifying any above item marked with "No" response.
Sponsor's Certification
I certify, for the project identified herein, responses to the forgoing items are accurate as marked and
additional documentation for any item marked "no" is correct and complete.
Executed on this day of
Name of Sponsor: City of Fort Worth
Name of Sponsor's Authorized Official: William Welstead
Title of Sponsor's Authorized Official: Airport System Director
Signature of Sponsor's Designated Official Representative: / �..
I declare under penalty of perjury that the foregoing is true and correct. I understand that knowingly and
willfully providing false information to the federal government is a violation of 18 USC§ 1001 (False
Statements)and could subject me to fines, imprisonment, or both.
OFFICIAL RIXORD
FAA Form 5100-133(1117)SUPERSEDES PREVIOUS EDITION 01 MgSfCfFA ETA RY
44403W
U.S. Department
of Transportation
Federal Aviation
Administration
FAA Form 5100-134, Selection of Consultants — Airport
Improvement Program Sponsor Certification
Paperwork Reduction Act Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a
person be subject to a penalty for failure to comply with a collection of information subject to the
requirements of the Paperwork Reduction Act unless that collection of information displays a currently
valid OMB Control Number. The OMB Control Number for this information collection is 2120-0569. Public
reporting for this collection of information is estimated to be approximately 8 hours per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, completing and reviewing the collection of information. All responses to this collection of
information are required under 49 U.S.C. Section 47105 to retain a benefit and to meet the reporting
requirements of 2 CFR 200. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden to the Federal Aviation
Administration at: 800 Independence Ave. SW, Washington, DC 20591,Attn: Information Collection
Clearance Officer,ASP-110.
FAA Form 5100-134
U.S.Department of Transportation OMB CONTROL NUMBER:2120-0569
Federal Aviation Administration EXPIRATION DATE:$13112019
Selection of Consultants
Airport Improvement Program Sponsor Certification
Sponsor: City of Fort Worth
Airport: Fort Worth Alliance Airport
Project Number: 3-48-0296- -2019
Description of Work:
Application
49 USC§47105(d)authorizes the Secretary to require certification from the sponsor that it will comply
with the statutory and administrative requirements in carrying out a project under the Airport Improvement
Program (AIP). General requirements for selection of consultant services within federal grant programs
are described in 2 CFR§§200.317-200.326. Sponsors may use other qualifications-based procedures
provided they are equivalent to standards of Title 40 chapter 11 and FAA Advisory Circular 150/5100-14,
Architectural, Engineering,and Planning Consultant Services for Airport Grant Projects.
Certification Statements
Except for certification statements below marked as not applicable (NIA), this list includes major
requirements of the construction project. Selecting"Yes"represents sponsor acknowledgement and
confirmation of the certification statement.The term "will'means Sponsor action taken at appropriate time
based on the certification statement focus area, but no later than the end of the project period of
performance. This list is not comprehensive and does not relieve the sponsor from fully complying with all
applicable statutory and administrative standards. The source of the requirement is referenced within
parenthesis.
1. Sponsor acknowledges their responsibility for the settlement of all contractual and administrative
issues arising out of their procurement actions (2 CFR§200.318(k)).
❑x Yes ❑No ❑NIA
2. Sponsor procurement actions ensure or will ensure full and open competition that does not
unduly limit competition (2 CFR§200.319).
x❑Yes ❑No ❑NIA
3. Sponsor has excluded or will exclude any entity that develops or drafts specifications,
requirements, or statements of work associated with the development of a request-for-
qualifications (RFQ)from competing for the advertised services(2 CFR§200.319).
px Yes []No ❑NIA
FAA Form 5100-134(2117)SUPERSEDES PREVIOUS EDITION Page 1 of 3
4. The advertisement describes or will describe specific project statements-of-work that provide
clear detail of required services without unduly restricting competition (2 CFR§ 200.319).
x❑Yes ❑No ❑NIA
5. Sponsor has publicized or will publicize a RFQ that:
a. Solicits an adequate number of qualified sources (2 CFR§200.320(d)); and
b. Identifies all evaluation criteria and relative importance(2 CFR§200.320(d)).
x❑Yes ❑No ❑NIA
6. Sponsor has based or will base selection on qualifications, experience, and disadvantaged
business enterprise participation with price not being a selection factor(2 CFR§200.320(d)).
Z Yes ❑No ❑NIA
7. Sponsor has verified or will verify that agreements exceeding $25,000 are not awarded to
individuals or firms suspended, debarred or otherwise excluded from participating in federally
assisted projects(2 CFR§180.300).
p Yes ❑No ❑NIA
8. A/E services covering multiple projects: Sponsor has agreed to or will agree to:
a. Refrain from initiating work covered by this procurement beyond five years from the date
of selection (AC 150/5100-14); and
b. Retain the right to conduct new procurement actions for projects identified or not
identified in the RFQ (AC 15015100-14).
0 Yes ❑No ❑NIA
9. Sponsor has negotiated or will negotiate a fair and reasonable fee with the firm they select as
most qualified for the services identified in the RFQ (2 CFR§200.323).
10 Yes ❑No ❑NIA
10. The Sponsor's contract identifies or will identify costs associated with ineligible work separately
from costs associated with eligible work(2 GFR§200.302).
0 Yes ❑No ❑NIA
11. Sponsor has prepared or will prepare a record of negotiations detailing the history of the
procurement action, rationale for contract type and basis for contract fees(2 CFR§200.318(i)).
p Yes ❑No ❑NIA
12. Sponsor has incorporated or will incorporate mandatory contact provisions in the consultant
contract for AIP-assisted work(49 U.S.C. Chapter 471 and 2 CFR part 200 Appendix II)
EJ Yes ❑No ❑NIA
FAA Form 5100-134(2117)SUPERSEDES PREVIOUS EDITION Page 2 of 3
13. For contracts that apply a time-and-material payment provision (also known as hourly rates,
specific rates of compensation, and labor rates), the Sponsor has established or will establish:
a. Justification that there is no other suitable contract method for the services (2 CFR
§200.3180));
b. A ceiling price that the consultant exceeds at their risk (2 CFR§200.3180)); and
c. A high degree of oversight that assures consultant is performing work in an efficient
manner with effective cost controls in place 2 CFR§200.3180?).
[x Yes ❑No ❑NIA
14. Sponsor is not using or will not use the prohibited cost-plus-percentage-of-cost(CPPC)contract
method. (2 CFR§200.323(d)).
P9 Yes ❑No ❑NIA
Attach documentation clarifying any above item marked with "no" response.
Sponsor's Certification
I certify, for the project identified herein, responses to the forgoing items are accurate as marked and
additional documentation for any item marked"no" is correct and complete.
I declare under penalty of perjury that the foregoing is true and correct. I understand that knowingly and
willfully providing false information to the federal government is a violation of 18 USC§ 1001 (False
Statements)and could subject me to fines, imprisonment, or both.nr
Executed on this 1 ! day of {re,6wk/7 , zap
Name of Sponsor: City of Fort Worth
Name of Sponsor's Authorized Official: William Welstead
Title of Sponsor's Authorized Official: Airport System Director
Signature of Sponsor's Authorized Official:
I declare under penalty of perjury that the foregoing is true and correct. I understand that knowingly and
willfully providing false information to the federal government is a violation of 18 USC§ 1001 (False
Statements)and could subject me to fines, imprisonment, or both.
FAA Form 5100-134(2117)SUPERSEDES PREVIOUS EDITION! Page 3 of 3
U.S. Department
of Transportation
Federal Aviation
Administration
FAA Form 5100-135, Certification and Disclosure Regarding
Potential Conflicts of Interest — Airport Improvement Program
Sponsor Certification
Paperwork Reduction Act Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a
person be subject to a penalty for failure to comply with a collection of information subject to the
requirements of the Paperwork Reduction Act unless that collection of information displays a currently
valid OMB Control Number. The OMB Control Number for this information collection is 2120-0569. Public
reporting for this collection of information is estimated to be approximately 8 hours per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, completing and reviewing the collection of information. All responses to this collection of
information are required under 49 U.S.C. Section 47105 to retain a benefit and to meet the reporting
requirements of 2 CFR 200. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden to the Federal Aviation
Administration at: 800 Independence Ave. SW,Washington, DC 20591, Attn: Information Collection
Clearance Officer,ASP-110.
FAA Form 5100-135
U.S.Department of Transportation OMB CONTROL NUMBER:2120-0569
*✓ Federal Aviation Administration EXPIRATION DATE:8/31/2019
Certification and Disclosure Regarding Potential Conflicts of Interest
Airport Improvement Program Sponsor Certification
Sponsor: City of Fort Worth
Airport: Fort Worth Alliance Airport
Project Number: 3-48-0296- 2019
Description of Work.
Application
Title 2 CFR§200.112 and§ 1201.112 address Federal Aviation Administration (FAA)requirements for
conflict of interest.As a condition of eligibility under the Airport Improvement Program (AIP), sponsors
must comply with FAA policy on conflict of interest. Such a conflict would arise when any of the following
have a financial or other interest in the firm selected for award:
a) The employee, officer or agent,
b) Any member of his immediate family,
c) His or her partner, or
d) An organization which employs, or is about to employ, any of the above.
Selecting "Yes" represents sponsor or sub-recipient acknowledgement and confirmation of the
certification statement. Selecting "No" represents sponsor or sub-recipient disclosure that it cannot fully
comply with the certification statement. If"No"is selected, provide support information explaining the
negative response as an attachment to this form. This includes whether the sponsor has established
standards for financial interest that are not substantial or unsolicited gifts are of nominal value(2 CFR§
200.318(c)). The term "will" means Sponsor action taken at appropriate time based on the certification
statement focus area, but no later than the end of the project period of performance.
Certification Statements
1. The sponsor or sub-recipient maintains a written standards of conduct governing conflict of
interest and the performance of their employees engaged in the award and administration of
contracts(2 CFR§200.318(c)). To the extent permitted by state or local law or regulations, such
standards of conduct provide for penalties, sanctions, or other disciplinary actions for violations of
such standards by the sponsor's and sub-recipient's officers,employees, or agents, or by
contractors or their agents.
0 Yes ❑ No
FAA Form 5100-135(2/17)SUPERSEDES PREVIOUS EDITION Page 1 of 2
2. The sponsor's or sub-recipient's officers, employees or agents have not and will not solicit or
accept gratuities,favors or anything of monetary value from contractors, potential contractors, or
parties to sub-agreements(2 CFR§200.318(c)).
0 Yes ❑ No
3. The sponsor or sub-recipient certifies that is has disclosed and will disclose to the FAA any
known potential conflict of interest(2 CFR§ 1200.112).
p Yes ❑ No
Attach documentation clarifying any above item marked with "no" response.
Sponsor's Certification
I certify,for the project identified herein, responses to the forgoing items are accurate as marked and
have the explanation for any item marked "no"is correct and complete.
Executed on this day of Nk"V4/
Name of Sponsor: City of Fort Worth
Name of Sponsor's Authorized Official: William Welstead
Title of Sponsor's Authorized Official: Airport System Director
Signature of Sponsor's Authorized Official:
I declare under penalty of perjury that the foregoing is true and correct. I understand that knowingly and
willfully providing false information to the federal government is a violation of 18 USC § 1001 (False
Statements) and could subject me to fines, imprisonment, or both.
CHY SECRETARY
FAA Form 5100-135(2117)SUPERSEDES PREVIOUS EDITION p e tp4P,yX
STANDARD DOT TITLE VI ASSURANCES
THE CITY OF FORT WORTH, TEXAS (hereinafter referred to as the Sponsor) hereby agrees
that as a condition to receiving Federal financial assistance from the Department of
Transportation (DOT), it will comply with Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d
et seq.) and an requirements imposed by 49 CFR Part 21, Nondiscrimination in Federally
Assisted Programs of the Department of Transportation - Effectuation of Title VI of the Civil
Rights Act of 1964 (hereinafter referred to as the"Regulations")to the end that no person in the
United States shall, on the ground of race, color, or national origin, be excluded from
participation in, be denied the benefits of, or be otherwise subjected to discrimination under any
program or activity for which the applicant receives Federal financial assistance and will
immediately take any measures necessary to effectuate this agreement. Without limiting the
above general assurance, the Sponsor agrees concerning this grant that:
1. Each "program" and "facility" (as defined in Section 21.23(a) and 21.23(b» will be conducted
or operated in compliance with all requirements of the Regulations.
2. It will insert the clauses of Attachment 1 of this assurance in every contract subject to the Act
and the Regulations.
3. Where Federal financial assistance is received to construct a facility, or part of a facility, the
assurance shall extend to the entire facility and facilities operated in connection therewith.
4. Where Federal financial assistance is in the form or for the acquisition of real property or an
interest in real property, the assurance shall extend to rights to space on, over, or under such
property.
5. It will include the appropriate clauses set forth in Attachment 2 of this assurance, as a
covenant running with the land, in any future deeds, leases, permits, licenses, and similar
agreements entered into by the Sponsor with other parties:
(a)for the subsequent transfer of real property acquired or improved with Federal financial
assistance under this project; and
(b) for the construction or use of or access to space on, over, or under real property acquired or
improved with Federal financial assistance under this Project.
6. This assurance obligates the Sponsor for the period during which Federal financial assistance
is extended to the program, except where the Federal financial assistance is to provide, or is in
the form of personal property or real property or interest therein or structures or improvements
thereon, in which case the assurance obligates the Sponsor or any transferee for the longer of
the following periods:
(a) the period during which the property is used for a purpose for which Federal financial
assistance is extended, or for another purpose involving the provision of similar services or
benefits; or
(b) the period during which the Sponsor retains ownership or possession of the property.
7. It will provide for such methods of administration for the program as are found by the
Secretary of Transportation of the official to whom he delegates specific authority to give
reasonable guarantees that it, other sponsors, subgrantees, contractors, subcontractors,
transferees, successors in interest, and other participants of Federal financial assistance under
such program will comply with all requirements imposed or pursuant to the act, the Regulations,
and this assurance.
8. It agrees that the United States has a right to seek judicial enforcement with regard to any
matter arising under the Act, the Regulations, and this assurance.
THIS ASSURANCE is given in consideration of and for the purpose of obtaining Federal
financial assistance for this Project and is binding on its contractors, the Sponsor,
subcontractors, transferees, successors in interest and other participants in the Project. The
person or persons whose signatures appear below are authorized to sign this assurance on
behalf of the Sponsor.
Dated: ZMv l `t
City of Fort Worth
(!Name of Sponsor)
Signature of Sp o sor's e ' rimed Official Representative)
William Welstead
(Name of Sponsor's Designated Official Representative)
Airport System Director
(Typed Title of S ons is Designated Official Representative)
Lg1Z;ih
(Date)
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
FEDERAL AVIATION ADMINISTRATION
AIP GRANT
SPONSOR ASSURANCES
L AV/
ter° r 'y FAA
Airports
qo 0
�NISTRQ�
ASSURANCES
Airport Sponsors
A. General.
1. These assurances shall be complied with in the performance of grant agreements for
airport development, airport planning, and noise compatibility program grants for
airport sponsors.
2. These assurances are required to be submitted as part of the project application by
sponsors requesting funds under the provisions of Title 44, U.S.C., subtitle VII, as
amended. As used herein, the term "public agency sponsor" means a public agency
with control of a public-use airport; the term "private sponsor" means a private owner
of a public-use airport; and the term "sponsor" includes both public agency sponsors
and private sponsors.
3. Upon acceptance of this grant offer by the sponsor, these assurances are incorporated
in and become part of this grant agreement.
B. Duration and Applicability.
1. Airport development or Noise Compatibility Program Projects Undertaken by a
Public Agency Sponsor.
The terms, conditions and assurances of this grant agreement shall remain in full
force and effect throughout the useful Iife of the facilities developed or equipment
acquired for an airport development or noise compatibility program project, or
throughout the useful life of the project items installed within a facility under a noise
compatibility program project, but in any event not to exceed twenty (20) years from
the date of acceptance of a grant offer of Federal funds for the project. However,
there shall be no limit on the duration of the assurances regarding Exclusive Rights
and Airport Revenue so Iong as the airport is used as an airport. There shall be no
limit on the duration of the terms, conditions, and assurances with respect to real
property acquired with federal funds. Furthermore, the duration of the Civil Rights
assurance shall be specified in the assurances.
2. Airport Development or Noise Compatibility Projects Undertaken by a Private
Sponsor.
The preceding paragraph 1 also applies to a private sponsor except that the useful life
of project items installed within a facility or the useful life of the facilities developed
or equipment acquired under an airport development or noise compatibility program
project shall be no less than ten (10) years from the date of acceptance of Federal aid
for the project.
Airport Sponsor Assurances 312014 Page 1 of 20
3. Airport Planning Undertaken by a Sponsor.
Unless otherwise specified in this grant agreement, only Assurances 1, 2, 3, 5, 6, 13,
18, 25, 30, 32, 33, and 34 in Section C apply to planning projects. The terms,
conditions, and assurances of this grant agreement shall remain in full force and effect
during the life of the project; there shall be no limit on the duration of the assurances
regarding Airport Revenue so long as the airport is used as an airport.
C. Sponsor Certification.
The sponsor hereby assures and certifies, with respect to this grant that:
.1. General Federal Requirements.
It will comply with all applicable Federal laws,regulations, executive orders,
policies, guidelines, and requirements as they relate to the application, acceptance and
use of Federal funds for this project including but not limited to the following:
Federal Legislation
a. Title 49, U.S.C., subtitle VII, as amended.
b. Davis-Bacon Act - 40 U.S.C. 276(a), et seg.t
c. Federal Fair Labor Standards Act - 29 U.S.C. 201, et seq.
d. Hatch Act—5 U.S.C. 1501, et seg.2
e. Uniform Relocation Assistance and Real Property Acquisition Policies Act of
1970 Title 42 U.S.C. 4601, et seg.1 2
f. National Historic Preservation Act of 1966 - Section 106 - 16 U.S.C. 470(f).1
g. Archeological and Historic Preservation Act of 1974 - 16 U.S.C. 469 through
469c.1
h. Native Americans Grave Repatriation Act - 25 U.S.C. Section 3001, et sea.
i. Clean Air Act, P.L. 90-148, as amended.
j. Coastal Zone Management Act, P.L. 93-205, as amended.
k. Flood Disaster Protection Act of 1973 - Section 102(a) - 42 U.S.C. 4012a.1
1. Title 49,U.S.C., Section 303, (formerly known as Section 4(f))
m. Rehabilitation Act of 1973 - 29 U.S.C. 794.
n. Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat. 252)
(prohibits discrimination on the basis of race, color, national origin);
o. Americans with Disabilities Act of 1990, as amended, (42 U.S.C. § 12101 et
seq.), prohibits discrimination on the basis of disability).
p. Age Discrimination Act of 1975 -42 U.S.C. 6101, et seq.
q. American Indian Religious Freedom Act, P.L. 95-341, as amended.
r. Architectural Barriers Act of 1968 -42 U.S.C. 4151, et seal
s. Power plant and Industrial Fuel Use Act of 1978 - Section 403- 2 U.S.C. 8373.1
t. Contract Work Hours and Safety Standards Act -40 U.S.C. 327, et seg.1
u. Copeland Anti-kickback Act - 18 U.S.C. 874.1
v. National Environmental Policy Act of 1969 -42 U.S.C. 4321, et seq.'
w. Wild and Scenic Rivers Act, P.L. 90-542, as amended.
x. Single Audit Act of 1984 - 31 U.S.C. 7501, et seM.2
y. Drug-Free Workplace Act of 1988 -41 U.S.C. 702 through 706.
Airport Sponsor Assurances 312014 Page 2 of 20
z. The Federal Funding Accountability and Transparency Act of 2006, as amended
(Pub. L. 109-282, as amended by section 6202 of Pub. L. 110-252).
Executive Orders
a. Executive Order 11246 - EquaI Employment Opportunity
b. Executive Order 11990 - Protection of Wetlands
c. Executive Order 11998 Flood Plain Management
d. Executive Order 12372 - Intergovernmental Review of Federal Programs
e. Executive Order 12699 - Seismic Safety of Federal and Federally Assisted New
Building Construction'
f. Executive Order 12898 - Environmental Justice
Federal Regulations
a. 2 CFR Part 180 - OMB Guidelines to Agencies on Governmentwide Debarment
and Suspension (Nonprocurement).
b. 2 CFR Part 200, Uniform Administrative Requirements, Cost Principles, and
Audit Requirements for Federal Awards. [OMB Circular A-87 Cost Principles
Applicable to Grants and Contracts with State and Local Governments, and OMB
Circular A-133 - Audits of States, Local Governments, and Non-Profit
Organizations].4,s'6
c. 2 CFR Part 1200—Nonprocurement Suspension and Debarment
d. 14 CFR Part 13 - Investigative and Enforcement Procedures 14 CFR Part 16 -
Rules of Practice For Federally Assisted Airport Enforcement Proceedings.
e. 14 CFR Part 150 -Airport noise compatibility planning.
f. 28 CFR Part 35-Discrimination on the Basis of Disability in State and Local
Government Services.
g. 28 CFR § 50.3 -U.S. Department of Justice Guidelines for Enforcement of Title
VI of the Civil Rights Act of 1964.
h. 29 CFR Part 1 - Procedures for predetermination of wage rates.'
i. 29 CFR Part 3 - Contractors and subcontractors on public building or public work
financed in whole or part by loans or grants from the United States.'
j. 29 CFR Part 5 - Labor standards provisions applicable to contracts covering
federally financed and assisted construction (also labor standards provisions
applicable to non-construction contracts subject to the Contract Work Hours and
Safety Standards Act).'
k. 41 CFR Part 60 - Office of Federal Contract Compliance Programs, Equal
Employment Opportunity, Department of Labor (Federal and federally assisted
contracting requirements).'
1. 49 CFR Part 18 - Uniform administrative requirements for grants and cooperative
agreements to state and local governments.3
m. 49 CFR Part 20 - New restrictions on lobbying.
n. 49 CFR Part 21 --Nondiscrimination in federally-assisted programs of the
Department of Transportation - effectuation of Title VI of the Civil Rights Act of
1964.
o. 49 CFR Part 23 - Participation by Disadvantage Business Enterprise in Airport
Concessions.
Airport Sponsor Assurances 312014 Page 3 of 20
p. 49 CFR Part 24 Uniform Relocation Assistance and Real Property Acquisition
for Federal and Federally Assisted Programs.!2
q. 49 CFR Part 26 Participation by Disadvantaged Business Enterprises in
Department of Transportation Programs.
r. 49 CFR Part 27 --Nondiscrimination on the Basis of Handicap in Programs and
Activities Receiving or Benefiting from Federal Financial Assistance.'
s. 49 CFR Part 28—Enforcement of Nondiscrimination on the Basis of Handicap in
Programs or Activities conducted by the Department of Transportation.
t. 49 CFR Part 30 - Denial of public works contracts to suppliers of goods and
services of countries that deny procurement market access to U.S. contractors.
u. 49 CFR Part 32—Governmentwide Requirements for Drug-Free Workplace
(Financial Assistance)
v. 49 CFR Part 37—Transportation Services for Individuals with Disabilities
(ADA).
w. 49 CFR Part 41 - Seismic safety of Federal and federally assisted or regulated
.new building construction.
Specific Assurances
Specific assurances required to be included in grant agreements by any of the above
laws, regulations or circulars are incorporated by reference in this grant agreement.
Footnotes to Assurance C.I.
' These laws do not apply to airport planning sponsors.
2 These laws do nQt apply to private sponsors.
3 49 CFR Part 18 and 2 CFR Part 200 contain requirements for State and Local
Governments receiving Federal assistance. Any requirement levied upon State
and Local Governments by this regulation and circular shall also be applicable
to private sponsors receiving Federal assistance under Title 49, United States
Code.
4 On December 26, 2013 at 78 FR 78590, the Office of Management and Budget
(OMB) issued the Uniform Administrative Requirements, Cost Principles, and
Audit Requirements for Federal Awards in 2 CFR Part 200. 2 CFR Part 200
replaces and combines the former Uniform Administrative Requirements for
Grants (OMB Circular A-102 and Circular A-110 or 2 CFR Part 215 or
Circular) as well as the Cost Principles (Circulars A-21 or 2 CFR part 220;
Circular A-87 or 2 CFR part 225; and A-122, 2 CFR part 230). Additionally it
replaces Circular A-133 guidance on the Single Annual Audit. In accordance
with 2 CFR section 200.110, the standards set forth in Part 200 which affect
administration of Federal awards issued by Federal agencies become effective
once implemented by Federal agencies or when any future amendment to this
Part becomes final. Federal agencies, including the Department of
Transportation, must implement the policies and procedures applicable to
Federal awards by promulgating a regulation to be effective by December 26,
2014 unless different provisions are required by statute or approved by OMB.
Airport Sponsor Assurances 3/2014 Page 4 of 20
5 Cost principles established in 2 CFR part 200 subpart E must be used as
guidelines for determining the eligibility of specific types of expenses.
6 Audit requirements established in 2 CFR part 200 subpart F are the guidelines
for audits.
2. Responsibility and Authority of the Sponsor.
a. Public Agency Sponsor:
It has legal authority to apply for this grant, and to finance and carry out the proposed
project; that a resolution, motion or similar action has been duly adopted or passed as
an official act of the applicant's governing body authorizing the filing of the
application, including all understandings and assurances contained therein, and
directing and authorizing the person identified as the official representative of the
applicant to act in connection with the application and to provide such additional
information as may be required.
b. Private Sponsor:
It has legal authority to apply for this grant and to finance and carry out the proposed
project and comply with all terms, conditions, and assurances of this grant agreement.
It shall designate an official representative and shall in writing direct and authorize
that person to file this application, including all understandings and assurances
contained therein; to act in connection with this application; and to provide such
additional information as may be required.
3. Sponsor Fund Availability.
It has sufficient funds available for that portion of the project costs which are not to
be paid by the United States. It has sufficient funds available to assure operation and
maintenance of items funded under this grant agreement which it will own or control.
4. Good Title.
a. It, a public agency or the Federal government, holds good title, satisfactory to the
Secretary, to the landing area of the airport or site thereof, or will give assurance
satisfactory to the Secretary that good title will be acquired.
b. For noise compatibility program projects to be carried out on the property of the
sponsor, it holds good title satisfactory to the Secretary to that portion of the
property upon which Federal funds will be expended or will give assurance to the
Secretary that good title will be obtained.
S. Preserving Rights and Powers.
a. It will not take or permit any action which would operate to deprive it of any of
the rights and powers necessary to perform any or all of the terms, conditions, and
assurances in this grant agreement without the written approval of the Secretary,
and will act promptly to acquire, extinguish or modify any outstanding rights or
claims of right of others which would interfere with such performance by the
sponsor. This shall be done in a manner acceptable to the Secretary.
Airport Sponsor Assurances 312014 Page 5 of 20
b. It will not sell, lease, encumber, or otherwise transfer or dispose of any part of its
title or other interests in the property shown on Exhibit A to this application or,
for a noise compatibility program project, that portion of the property upon which
Federal funds have been expended, for the duration of the terms, conditions, and
assurances in this grant agreement without approval by the Secretary. If the
transferee is found by the Secretary to be eligible under Title 49, United States
Code, to assume the obligations of this grant agreement and to have the power,
authority, and financial resources to carry out all such obligations, the sponsor
shall insert in the contract or document transferring or disposing of the sponsor's
interest, and make binding upon the transferee all of the terms, conditions, and
assurances contained in this grant agreement.
c. For all noise compatibility program projects which are to be carried out by
another unit of local government or are on property owned by a unit of local
government other than the sponsor, it will enter into an agreement with that
government. Except as otherwise specified by the Secretary, that agreement shall
obligate that government to the same terms, conditions, and assurances that would
be applicable to it if it applied directly to the FAA for a grant to undertake the
noise compatibility program project. That agreement and changes thereto must be
satisfactory to the Secretary. It will take steps to enforce this agreement against
the local government if there is substantial non-compliance with the terms of the
agreement.
d. For noise compatibility program projects to be carried out on privately owned
property, it will enter into an agreement with the owner of that property which
includes provisions specified by the Secretary. It will take steps to enforce this
agreement against the property owner whenever there is substantial non-
compliance with the terms of the agreement.
e. If the sponsor is a private sponsor, it will take steps satisfactory to the Secretary to
ensure that the airport will continue to function as a public-use airport in
accordance with these assurances for the duration of these assurances.
f. If an arrangement is made for management and operation of the airport by any
agency or person other than the sponsor or an employee of the sponsor, the
sponsor will reserve sufficient rights and authority to insure that the airport will
be operated and maintained in accordance Title 49, United States Code, the
regulations and the terms, conditions and assurances in this grant agreement and
shall insure that such arrangement also requires compliance therewith.
g. Sponsors of commercial service airports will not permit or enter into any
arrangement that results in permission for the owner or tenant of a property used
as a residence, or zoned for residential use, to taxi an aircraft between that
property and any Iocation on airport. Sponsors of general aviation airports
entering into any arrangement that results in permission for the owner of
residential real property adjacent to or near the airport must comply with the
requirements of Sec. 136 of Public Law 112-95 and the sponsor assurances.
Airport Sponsor Assurances 3/2014 Page 6 of 20
6. Consistency with Local Plans.
The project is reasonably consistent with plans (existing at the time of submission of
this application) of public agencies that are authorized by the State in which the
project is located to plan for the development of the area surrounding the airport.
7. Consideration of Local Interest.
It has given fair consideration to the interest of communities in or near where the
project may be located.
8. Consultation with Users.
In making a decision to undertake any airport development project under Title 49,
United States Code, it has undertaken reasonable consultations with affected parties
using the airport at which project is proposed.
9. Public Hearings.
In projects involving the location of an airport, an airport runway, or a major runway
extension, it has afforded the opportunity for public hearings for the purpose of
considering the economic, social, and environmental effects of the airport or runway
location and its consistency with goals and objectives of such planning as has been
carried out by the community and it shall, when requested by the Secretary, submit a
copy of the transcript of such hearings to the Secretary. Further, for such projects, it
has on its management board either voting representation from the communities
where the project is located or has advised the communities that they have the right to
petition the Secretary concerning a proposed project.
10. Metropolitan Planning Organization.
In projects involving the location of an airport, an airport runway, or a major runway
extension at a medium or Iarge hub airport, the sponsor has made available to and has
provided upon request to the metropolitan planning organization in the area in which
the airport is located, if any, a copy of the proposed amendment to the airport layout
plan to depict the project and a copy of any airport master plan in which the project is
described or depicted.
11. Pavement Preventive Maintenance.
With respect to a project approved after January 1, 1995, for the replacement or
reconstruction of pavement at the airport, it assures or certifies that it has
implemented an effective airport pavement maintenance-management program and it
assures that it will use such program for the useful life of any pavement constructed,
reconstructed or repaired with Federal financial assistance at the airport. It will
provide such reports on pavement condition and pavement management programs as
the Secretary determines may be useful.
12. Terminal Development Prerequisites.
For projects which include terminal development at a public use airport, as defined in
Title 49, it has, on the date of submittal of the project grant application, all the safety
equipment required for certification of such airport under section 44706 of Title 49,
United States Code, and all the security equipment required by rule or regulation, and
Airport Sponsor Assurances 3/2014 Page 7 of 20
has provided for access to the passenger enplaning and deplaning area of such airport
to passengers enplaning and deplaning from aircraft other than air carrier aircraft.
13. Accounting System,Audit,and Record Keeping Requirements.
a. It shall keep aH project accounts and records which fully disclose the amount and
disposition by the recipient of the proceeds of this grant, the total cost of the
project in connection with which this grant is given or used, and the amount or
nature of that portion of the cost of the project supplied by other sources, and such
other financial records pertinent to the project. The accounts and records shall be
kept in accordance with an accounting system that will facilitate an effective audit
in accordance with the Single Audit Act of 1984.
b. It shall make available to the Secretary and the Comptroller General of the United
States, or any of their duly authorized representatives, for the purpose of audit and
examination, any books, documents,papers, and records of the recipient that are
pertinent to this grant. The Secretary may require that an appropriate audit be
conducted by a recipient. In any case in which an independent audit is made of the
accounts of a sponsor relating to the disposition of the proceeds of a grant or
relating to the project in connection with which this grant was given or used, it
shall file a certified copy of such audit with the Comptroller General of the United
States not later than six (6) months following the close of the fiscal year for which
the audit was made.
14. Minimum Wage Rates.
It shall include, in all contracts in excess of$2,000 for work on any projects funded
under this grant agreement which involve labor, provisions establishing minimum
rates of wages, to be predetermined by the Secretary of Labor, in accordance with the
Davis-Bacon Act, as amended (40 U.S.C. 276a-276a-5), which contractors shall pay
to skilled and unskilled labor, and such minimum rates shall be stated in the invitation
for bids and shall be included in proposals or bids for the work.
15. Veteran's Preference.
It shall include in all contracts for work on any project funded under this grant
agreement which involve labor, such provisions as are necessary to insure that, in the
employment of labor (except in executive, administrative, and supervisory positions),
preference shall be given to Vietnam era veterans, Persian Gulf veterans,
Afghanistan-Iraq war veterans, disabled veterans, and small business concerns owned
and controlled by disabled veterans as defined in Section 47112 of Title 49, United
States Code. However, this preference shall apply only where the individuals are
available and qualified to perform the work to which the employment relates.
16. Conformity to Plans and Specifications.
It will execute the project subject to plans, specifications, and schedules approved by
the Secretary. Such plans, specifications, and schedules shall be submitted to the
Secretary prior to commencement of site preparation, construction, or other
performance under this grant agreement, and, upon approval of the Secretary, shall be
incorporated into this grant agreement. Any modification to the approved plans,
Airport sponsor Assurances 3/2014 Page 8 of 20
t
specifications, and schedules shall also be subject to approval of the Secretary, and
incorporated into this grant agreement.
17. Construction Inspection and Approval.
It will provide and maintain competent technical supervision at the construction site
throughout the project to assure that the work conforms to the plans, specifications,
and schedules approved by the Secretary for the project. It shall subject the
construction work on any project contained in an approved project application to
inspection and approval by the Secretary and such work shall be in accordance with
regulations and procedures prescribed by the Secretary. Such regulations and
procedures shall require such cost and progress reporting by the sponsor or sponsors
of such project as the Secretary shall deem necessary.
18. Planning Projects.
In carrying out planning projects:
a. It will execute the project in accordance with the approved program narrative
contained in the project application or with the modifications similarly approved.
b. It will furnish the Secretary with such periodic reports as required pertaining to
the planning project and planning work activities.
c. It will include in all published material prepared in connection with the planning
project a notice that the material was prepared under a grant provided by the
United States.
d. It will make such material available for examination by the public, and agrees that
no material prepared with funds under this project shall be subject to copyright in
the United States or any other country.
c. It will give the Secretary unrestricted authority to publish, disclose, distribute, and
otherwise use any of the material prepared in connection with this grant.
f. It will grant the Secretary the right to disapprove the sponsor's employment of
specific consultants and their subcontractors to do all or any part of this project as
well as the right to disapprove the proposed scope and cost of professional
services.
g. It will grant the Secretary the right to disapprove the use of the sponsor's
employees to do all or any part of the project.
h. It understands and agrees that the Secretary's approval of this project grant or the
Secretary's approval of any planning material developed as part of this grant does
not constitute or imply any assurance or commitment on the part of the Secretary
to approve any pending or future application for a Federal airport grant.
19. Operation and Maintenance.
a. The airport and all facilities which are necessary to serve the aeronautical users of
the airport, other than facilities owned or controlled by the United States, shall be
operated at all times in a safe and serviceable condition and in accordance with
the minimum standards as may be required or prescribed by applicable Federal,
Airport Sponsor Assurances 312014 Page 9 of 20
state and local agencies for maintenance and operation. It will not cause or permit
any activity or action thereon which would interfere with its use for airport
purposes. It will suitably operate and maintain the airport and all facilities thereon
or connected therewith, with due regard to climatic and flood conditions. Any
proposal to temporarily close the airport for non-aeronautical purposes must first
be approved by the Secretary. In furtherance of this assurance, the sponsor will
have in effect arrangements for-
1) Operating the airport's aeronautical facilities whenever required;
2) Promptly marking and lighting hazards resulting from airport conditions,
including temporary conditions; and
3) Promptly notifying airmen of any condition affecting aeronautical use of the
airport. Nothing contained herein shall be construed to require that the airport
be operated for aeronautical use during temporary periods when snow, flood
or other climatic conditions interfere with such operation and maintenance.
Further, nothing herein shall be construed as requiring the maintenance,
repair,restoration, or replacement of any structure or facility which is
substantially damaged or destroyed due to an act of God or other condition or
circumstance beyond the control of the sponsor.
b. It will suitably operate and maintain noise compatibility program items that it
owns or controls upon which Federal funds have been expended.
20. Hazard Removal and Mitigation.
It will take appropriate actionn to assure that such terminal airspace as is required to
protect instrument and visual operations to the airport(including established
minimum flight altitudes) will be adequately cleared and protected by removing,
lowering, relocating, marking, or lighting or otherwise mitigating existing airport
hazards and by preventing the establishment or creation of future airport hazards.
21. Compatible Land Use.
It will take appropriate action, to the extent reasonable, including the adoption of
zoning laws, to restrict the use of land adjacent to or in the immediate vicinity of the
airport to activities and purposes compatible with normal airport operations, including
landing and takeoff of aircraft. In addition, if the project is for noise compatibility
program implementation, it will not cause or permit any change in land use, within its
jurisdiction, that will reduce its compatibility, with respect to the airport, of the noise
compatibility program measures upon which Federal funds have been expended.
22. Economic Nondiscrimination.
a. It will make the airport available as an airport for public use on reasonable terms
and without unjust discrimination to all types, kinds and classes of aeronautical
activities, including commercial aeronautical activities offering services to the
public at the airport.
b. In any agreement, contract, lease, or other arrangement under which a right or
privilege at the airport is granted to any person, firm, or corporation to conduct or
Airport Sponsor Assurances 3/2014 Page 10 of 20
to engage in any aeronautical activity for furnishing services to the public at the
airport, the sponsor will insert and enforce provisions requiring the contractor to-
1) furnish said services on a reasonable, and not unjustly discriminatory, basis to
all users thereof, and
2) charge reasonable, and not unjustly discriminatory, prices for each unit or
service,provided that the contractor may be allowed to make reasonable and
nondiscriminatory discounts, rebates, or other similar types of price reductions
to volume purchasers.
c. Each fixed-based operator at the airport shall be subject to the same rates, fees,
rentals, and other charges as are uniformly applicable to all other fixed-based
operators making the same or similar uses of such airport and utilizing the same
or similar facilities.
d. Each air carrier using such airport shall have the right to service itself or to use
any fixed-based operator that is authorized or permitted by the airport to serve any
air carrier at such airport.
c. Each air carrier using such airport(whether as a tenant, non-tenant, or subtenant
of another air carrier tenant) shall be subject to such nondiscriminatory and
substantially comparable rules, regulations, conditions, rates, fees, rentals, and
other charges with respect to facilities directly and substantially related to
providing air transportation as are applicable to all such air carriers which make
similar use of such airport and utilize similar facilities, subject to reasonable
classifications such as tenants or non-tenants and signatory carriers and non-
signatory carriers. Classification or status as tenant or signatory shall not be
unreasonably withheld by any airport provided an air carrier assumes obligations
substantially similar to those already imposed on air carriers in such classification
or status.
f. It will not exercise or grant any right or privilege which operates to prevent any
person, firm, or corporation operating aircraft on the airport from performing any
services on its own aircraft with its own employees [including, but not limited to
maintenance, repair, and fueling] that it may choose to perforin.
g. In the event the sponsor itself exercises any of the rights and privileges referred to
in this assurance, the services involved will be provided on the same conditions as
would apply to the furnishing of such services by commercial aeronautical service
providers authorized by the sponsor under these provisions.
h. The sponsor may establish such reasonable, and not unjustly discriminatory,
conditions to be met by all users of the airport as may be necessary for the safe
and efficient operation of the airport.
i. The sponsor may prohibit or limit any given type, kind or class of aeronautical
use of the airport if such action is necessary for the safe operation of the airport or
necessary to serve the civil aviation needs of the public.
Airport Sponsor Assurances 312014 Page 11 of 20
23. Exclusive Rights.
It will permit no exclusive right for the use of the airport by any person providing, or
intending to provide, aeronautical services to the public. For purposes of this
paragraph, the providing of the services at an airport by a single fixed-based operator
shall not be construed as an exclusive right if both of the following apply:
a. It would be unreasonably costly, burdensome, or impractical for more than one
fixed-based operator to provide such services, and
b. If allowing more than one fixed-based operator to provide such services would
require the reduction of space leased pursuant to an existing agreement between
such single fixed-based operator and such airport. It further agrees that it will not,
either directly or indirectly, grant or permit any person, firm, or corporation, the
exclusive right at the airport to conduct any aeronautical activities, including, but
not limited to charter flights,pilot training, aircraft rental and sightseeing, aerial
photography, crop dusting, aerial advertising and surveying, air carrier operations,
aircraft sales and services, sale of aviation petroleum products whether or not
conducted in conjunction with other aeronautical activity, repair and maintenance
of aircraft, sale of aircraft parts, and any other activities which because of their
direct relationship to the operation of aircraft can be regarded as an aeronautical
activity, and that it will terminate any exclusive right to conduct an aeronautical
activity now existing at such an airport before the grant of any assistance under
Title 49, United States Code.
24. Fee and Rental Structure.
It will maintain a fee and rental structure for the facilities and services at the airport
which will make the airport as self-sustaining as possible under the circumstances
existing at the particular airport, taking into account such factors as the volume of
traffic and economy of collection. No part of the Federal share of an airport
development, airport planning or noise compatibility project for which a grant is
made under Title 49, United States Code, the Airport and Airway Improvement Act
of 1982, the Federal Airport Act or the Airport and Airway Development Act of 1970
shall be included in the rate basis in establishing fees, rates, and charges for users of
that airport.
25. Airport Revenues.
a. All revenues generated by the airport and any local taxes on aviation fuel
established after December 30, 1987, will be expended by it for the capital or
operating costs of the airport; the local airport system; or other local facilities
which are owned or operated by the owner or operator of the airport and which
are directly and substantially related to the actual air transportation of passengers
or property; or for noise mitigation purposes on or off the airport. The following
exceptions apply to this paragraph:
1) If covenants or assurances in debt obligations issued before September 3,
1982, by the owner or operator of the airport, or provisions enacted before
September 3, 1982, in governing statutes controlling the owner or operator's
financing,provide for the use of the revenues from any of the airport owner or
Airport Sponsor Assurances 3/2014 Page 12 of 20
operator's facilities, including the airport, to support not only the airport but
also the airport owner or operator's general debt obligations or other facilities,
then this limitation on the use of all revenues generated by the airport (and, in
the case of a public airport, local taxes on aviation fuel) shall not apply.
2) If the Secretary approves the sale of a privately owned airport to a public
sponsor and provides funding for any portion of the public sponsor's
acquisition of land, this limitation on the use of all revenues generated by the
sale shall not apply to certain proceeds from the sale. This is conditioned on
repayment to the Secretary by the private owner of an amount equal to the
remaining unamortized portion (amortized over a 20-year period) of any
airport improvement grant made to the private owner for any purpose other
than land acquisition on or after October 1, 1996, plus an amount equal to the
federal share of the current fair market value of any land acquired with an
airport improvement grant made to that airport on or after October 1, 1996.
3) Certain revenue derived from or generated by mineral extraction, production,
lease, or other means at a general aviation airport (as defined at Section 47102
of title 49 United States Code), if the FAA determines the airport sponsor
meets the requirements set forth in Sec. 813 of Public Law 112-95.
b. As part of the annual audit required under the Single Audit Act of 1984, the
sponsor will direct that the audit will review, and the resulting audit report will
provide an opinion concerning, the use of airport revenue and taxes in paragraph
(a), and indicating whether funds paid or transferred to the owner or operator are
paid or transferred in a manner consistent with Title 49, United States Code and
any other applicable provision of law, including any regulation promulgated by
the Secretary or Administrator.
c. Any civil penalties or other sanctions will be imposed for violation of this
assurance in accordance with the provisions of Section 47107 of Title 49, United
States Code.
26. Reports and Inspections.
It will:
a. submit to the Secretary such annual or special financial and operations reports as
the Secretary may reasonably request and make such reports available to the
public; make available to the public at reasonable times and places a report of the
airport budget in a format prescribed by the Secretary;
b, for airport development projects, make the airport and all airport records and
documents affecting the airport, including deeds, leases, operation and use
agreements,regulations and other instruments, available for inspection by any
duly authorized agent of the Secretary upon reasonable request;
c. for noise compatibility program projects, make records and documents relating to
the project and continued compliance with the terms, conditions, and assurances
of this grant agreement including deeds, leases, agreements, regulations, and other
instruments, available for inspection by any duly authorized agent of the Secretary
upon reasonable request; and
Airport Sponsor Assurances 312014 Page 13 of 20
d. in a format and time prescribed by the Secretary, provide to the Secretary and
make available to the public following each of its fiscal years, an annual report
listing in detail:
1) all amounts paid by the airport to any other unit of government and the
purposes for which each such payment was made; and
2) all services and property provided by the airport to other units of government
and the amount of compensation received for provision of each such service
and property.
27. Use by Government Aircraft.
It will make available all of the facilities of the airport developed with Federal
financial assistance and all those usable for landing and takeoff of aircraft to the
United States for use by Government aircraft in common with other aircraft at all
times without charge, except, if the use by Government aircraft is substantial, charge
may be made for a reasonable share, proportional to such use, for the cost of
operating and maintaining the facilities used. Unless otherwise determined by the
Secretary, or otherwise agreed to by the sponsor and the using agency, substantial use
of an airport by Government aircraft will be considered to exist when operations of
such aircraft are in excess of those which, in the opinion of the Secretary, would
unduly interfere with use of the landing areas by other authorized aircraft, or during
any calendar month that—
a. Five (5) or more Government aircraft are regularly based at the airport or on Iand
adjacent thereto; or
b. The total number of movements (counting each landing as a movement) of
Government aircraft is 300 or more, or the gross accumulative weight of
Government aircraft using the airport (the total movement of Government aircraft
multiplied by gross weights of such aircraft)is in excess of five million pounds.
28. Land for Federal Facilities.
It will furnish without cost to the Federal Government for use in connection with any
air traffic control or air navigation activities, or weather-reporting and communication
activities related to air traffic control, any areas of land or water, or estate therein, or
rights in buildings of the sponsor as the Secretary considers necessary or desirable for
construction, operation, and maintenance at Federal expense of space or facilities for
such purposes. Such areas or any portion thereof will be made available as provided
herein within four months after receipt of a written request from the Secretary.
29. Airport Layout Plan.
a. It will keep up to date at all times an airport layout pian of the airport showing
1) boundaries of the airport and all proposed additions thereto, together with the
boundaries of all offsite areas owned or controlled by the sponsor for airport
purposes and proposed additions thereto;
2) the location and nature of all existing and proposed airport facilities and
structures (such as runways, taxiways, aprons, terminal buildings, hangars and
Airport Sponsor Assurances 312014 Page 14 of 20
roads), including all proposed extensions and reductions of existing airport
facilities;
3) the location of all existing and proposed nonaviation areas and of all existing
improvements thereon; and
4) all proposed and existing access points used to taxi aircraft across the airport's
property boundary. Such airport layout plans and each amendment, revision,
or modification thereof, shall be subject to the approval of the Secretary which
approval shall be evidenced by the signature of a duly authorized
representative of the Secretary on the face of the airport layout plan. The
sponsor will not make or permit any changes or alterations in the airport or
any of its facilities which are not in conformity with the airport layout plan as
approved by the Secretary and which might, in the opinion of the Secretary,
adversely affect the safety, utility or efficiency of the airport.
b. If a change or alteration in the airport or the facilities is made which the Secretary
determines adversely affects the safety, utility, or efficiency of any federally
owned, leased, or funded property on or off the airport and which is not in
conformity with the airport layout plan as approved by the Secretary, the owner or
operator will, if requested, by the Secretary (1) eliminate such adverse effect in a
manner approved by the Secretary; or(2) bear all costs of relocating such
property (or replacement thereof) to a site acceptable to the Secretary and all costs
of restoring such property (or replacement thereof) to the level of safety, utility,
efficiency, and cost of operation existing before the unapproved change in the
airport or its facilities except in the case of a relocation or replacement of an
existing airport facility due to a change in the Secretary's design standards beyond
the control of the airport sponsor.
30. Civil Rights.
It will promptly take any measures necessary to ensure that no person in the United
States shall, on the grounds of race, creed, color, national origin, sex, age, or
disability be excluded from participation in, be denied the benefits of, or be otherwise
subjected to discrimination in any activity conducted with, or benefiting from, funds
received from this grant.
a. Using the definitions of activity, facility and program as found and defined in §§
21.23 (b) and 21.23 (e) of 49 CFR § 21, the sponsor will facilitate all programs,
operate all facilities, or conduct all programs in compliance with all non-
discrimination requirements imposed by, or pursuant to these assurances.
b. Applicability
1) Programs and Activities. If the sponsor has received a grant (or other federal
assistance) for any of the sponsor's program or activities,these requirements
extend to all of the sponsor's programs and activities.
2) Facilities. Where it receives a grant or other federal financial assistance to
construct, expand, renovate, remodel, alter or acquire a facility, or part of a
facility, the assurance extends to the entire facility and facilities operated in
connection therewith.
Airport Sponsor Assurances 312014 Page 15 of 20
3) Real Property. Where the sponsor receives a grant or other Federal financial
assistance in the form of, or for the acquisition of real property or an interest
in real property, the assurance will extend to rights to space on, over, or under
such property.
c. Duration.
The sponsor agrees that it is obligated to this assurance for the period during
which Federal financial assistance is extended to the program, except where the
Federal financial assistance is to provide, or is in the form of, personal property,
or real property, or interest therein, or structures or improvements thereon, in
which case the assurance obligates the sponsor, or any transferee for the longer of
the following periods:
1) So long as the airport is used as an airport, or for another purpose involving
the provision of similar services or benefits; or
2) So long as the sponsor retains ownership or possession of the property.
d. Required Solicitation Language. It will include the following notification in all
solicitations for bids, Requests For Proposals for work, or material under this
grant agreement and in all proposals for agreements, including airport
concessions, regardless of funding source:
"The Name of Sponsor), in accordance with the provisions of Title VI of the
Civil Rights Act of 1964 (78 Stat. 252, 42 U.S.C. §§ 2000d to 2000d-4) and the
Regulations, hereby notifies all bidders that it will affirmatively ensure that any
contract entered into pursuant to this advertisement, disadvantaged business
enterprises and airport concession disadvantaged business enterprises will be
afforded full and fair opportunity to submit bids in response to this invitation and
will not be discriminated against on the grounds of race, color, or national origin
in consideration for an award."
e. Required Contract Provisions.
1) It will insert the non-discrimination contract clauses requiring compliance
with the acts and regulations relative to non-discrimination in Federally-
assisted programs of the DOT, and incorporating the acts and regulations into
the contracts by reference in every contract or agreement subject to the non-
discrimination in Federally-assisted programs of the DOT acts and
regulations.
2) It will include a list of the pertinent non-discrimination authorities in every
contract that is subject to the non-discrimination acts and regulations.
3) It will insert non-discrimination contract clauses as a covenant running with
the Iand, in any deed from the United States effecting or recording a transfer
of real property, structures, use, or improvements thereon or interest therein to
a sponsor.
4) It will insert non-discrimination contract clauses prohibiting discrimination on
the basis of race, color, national origin, creed, sex, age, or handicap as a
Airport Sponsor Assurances 3/2014 Page 16 of 20
covenant running with the land, in any future deeds, leases, license, permits,
or similar instruments entered into by the sponsor with other parties:
a) For the subsequent transfer of real property acquired or improved under
the applicable activity, project, or program; and
b) For the construction or use of, or access to, space on, over, or under real
property acquired or improved under the applicable activity, project, or
program.
f. It will provide for such methods of administration for the program as are found by
the Secretary to give reasonable guarantee that it, other recipients, sub-recipients,
sub-grantees, contractors, subcontractors, consultants, transferees, successors in
interest, and other participants of Federal financial assistance under such program
will comply with all requirements imposed or pursuant to the acts, the regulations,
and this assurance.
g. It agrees that the United States has a right to seek judicial enforcement with
regard to any matter arising under the acts, the regulations, and this assurance.
31. Disposal of Land.
a. For land purchased under a grant for airport noise compatibility purposes,
including land serving as a noise buffer, it will dispose of the land, when the Iand
is no longer needed for such purposes, at fair market value, at the earliest
practicable time. That portion of the proceeds of such disposition which is
proportionate to the United States' share of acquisition of such land will be, at the
discretion of the Secretary, (1) reinvested in another project at the airport, or (2)
transferred to another eligible airport as prescribed by the Secretary. The
Secretary shall give preference to the following, in descending orclpr, (1)
reinvestment in an approved noise compatibility project, (2)reinvestment in an
approved project that is eligible for grant funding under Section 47117(e) of title
49 United States Code, (3) reinvestment in an approved airport development
project that is eligible for grant funding under Sections 47114, 47115, or 47117 of
title 49 United States Code, (4) transferred to an eligible sponsor of another public
airport to be reinvested in an approved noise compatibility project at that airport,
and (5) paid to the Secretary for deposit in the Airport and Airway Trust Fund. If
land acquired under a grant for noise compatibility purposes is leased at fair
market value and consistent with noise buffering purposes, the lease will not be
considered a disposal of the land. Revenues derived from such a lease may be
used for an approved airport development project that would otherwise be eligible
for grant funding or any permitted use of airport revenue.
b. For land purchased under a grant for airport development purposes (other than
noise compatibility), it will, when the land is no longer needed for airport
purposes, dispose of such land at fair market value or make available to the
Secretary an amount equal to the United States' proportionate share of the fair
market value of the land. That portion of the proceeds of such disposition which
is proportionate to the United States' share of the cost of acquisition of such land
will, (1) upon application to the Secretary, be reinvested or transferred to another
Airport Sponsor Assurances 312014 Page 17 of20
eligible airport as prescribed by the Secretary. The Secretary shall give
preference to the following, in descending order: (1) reinvestment in an approved
noise compatibility project, (2) reinvestment in an approved project that is eligible
for grant funding under Section 47117(e) of title 49 United States Code, (3)
reinvestment in an approved airport development project that is eligible for grant
funding under Sections 47114, 47115, or 47117 of title 49 United States Code, (4)
transferred to an eligible sponsor of another public airport to be reinvested in an
approved noise compatibility project at that airport, and (5)paid to the Secretary
for deposit in the Airport and Airway Trust Fund.
c. Land shall be considered to be needed for airport purposes under this assurance if
(1) it may be needed for aeronautical purposes (including runway protection
zones) or serve as noise buffer land, and (2) the revenue from interim uses of such
land contributes to the financial self-sufficiency of the airport. Further, land
purchased with a grant received by an airport operator or owner before December
31, 1987, will be considered to be needed for airport purposes if the Secretary or
Federal agency making such grant before December 31, 1987, was notified by the
operator or owner of the uses of such land, did not object to such use, and the land
continues to be used for that purpose, such use having commenced no later than
December 15, 1989.
d. Disposition of such land under (a) (b) or (c) will be subject to the retention or
reservation of any interest or right therein necessary to ensure that such land will
only be used for purposes which are compatible with noise levels associated with
operation of the airport.
32. Engineering and Design Services.
It will award each contract, or sub-contract for program management, construction
management, planning studies, feasibility studies, architectural services,preliminary
engineering, design, engineering, surveying, mapping or related services with respect
to the project in the same manner as a contract for architectural and engineering
services is negotiated under Title IX of the Federal Property and Administrative
Services Act of 1949 or an equivalent qualifications-based requirement prescribed for
or by the sponsor of the airport.
33. Foreign Market Restrictions.
It will not allow funds provided under this grant to be used to fund any project which
uses any product or service of a foreign country during the period in which such
foreign country is listed by the United States Trade Representative as denying fair
and equitable market opportunities for products and suppliers of the United States in
procurement and construction.
34. Policies, Standards,and Specifications.
It will carry out the project in accordance with policies, standards, and specifications
approved by the Secretary including but not limited to the advisory circulars listed in
the Current FAA Advisory Circulars for AIP projects, dated (the latest
approved version as of this grant offer) and included in this grant, and in accordance
Airport Sponsor Assurances 312014 Page 18 of 20
with applicable state policies, standards, and specifications approved by the
Secretary.
35. Relocation and Real Property Acquisition.
a. It will be guided in acquiring real property, to the greatest extent practicable under
State law, by the land acquisition policies in Subpart B of 49 CFR Part 24 and
will pay or reimburse property owners for necessary expenses as specified in
Subpart B.
b. It will provide a relocation assistance program offering the services described in
Subpart C and fair and reasonable relocation payments and assistance to displaced
persons as required in Subpart D and E of 49 CFR Part 24.
c. It will make available within a reasonable period of time prior to displacement,
comparable replacement dwellings to displaced persons in accordance with
Subpart E of 49 CFR Part 24.
36. Access By Intercity Buses.
The airport owner or operator will permit, to the maximum extent practicable,
intercity buses or other modes of transportation to have access to the airport;
however, it has no obligation to fund special facilities for intercity buses or for other
modes of transportation.
37. Disadvantaged Business Enterprises.
The sponsor shall not discriminate on the basis of race, color, national origin or sex in
the award and performance of any DOT-assisted contract covered by 49 CFR Part 26,
or in the award and performance of any concession activity contract covered by 49
CFR Part 23. In addition, the sponsor shall not discriminate on the basis of race,
color, national origin or sex in the administration of its DBE and ACDBE programs
or the requirements of 49 CFR Parts 23 and 26. The sponsor shall take all necessary
and reasonable steps under 49 CFR Parts 23 and 26 to ensure nondiscrimination in the
award and administration of DOT-assisted contracts, and/or concession
contracts. The sponsor's DBE and ACDBE programs, as required by 49 CFR Parts
26 and 23, and as approved by DOT, are incorporated by reference in this
agreement. Implementation of these programs is a legal obligation and failure to
carry out its terms shall be treated as a violation of this agreement. Upon notification
to the sponsor of its failure to carry out its approved program, the Department may
impose sanctions as provided for under Parts 26 and 23 and may, in appropriate cases,
refer the matter for enforcement under 18 U.S.C. 1001 and/or the Program Fraud
Civil Remedies Act of 1936 (31 U.S.C. 3801).
38. Hangar Construction.
If the airport owner or operator and a person who owns an aircraft agree that a hangar
is to be constructed at the airport for the aircraft at the aircraft owner's expense, the
airport owner or operator will grant to the aircraft owner for the hangar a long term
lease that is subject to such terms and conditions on the hangar as the airport owner or
operator may impose.
Airport Sponsor Assurances 312014 Page 19 of 20
39. Competitive Access.
a. If the airport owner or operator of a medium or large hub airport (as defined in
section 47102 of title 49, U.S.C.) has been unable to accommodate one or more
requests by an air carrier for access to gates or other facilities at that airport in
order to allow the air carrier to provide service to the airport or to expand service
at the airport, the airport owner or operator shall transmit a report to the Secretary
that-
1) Describes the requests;
2) Provides an explanation as to why the requests could not be accommodated;
and
3) Provides a time frame within which, if any, the airport will be able to
accommodate the requests.
b. Such report shall be due on either February I or August 1 of each year if the
airport has been unable to accommodate the request(s) in the six month period
prior to the applicable due date.
Airport Sponsor Assurances 312014 Page 20 of 20
FEDERAL AVIATION ADMINISTRATION
REQUIRED
ADVISORY CIRCULARS
FOR USE IN
AIP & PFC APPROVE® PROJECTS
o¢p.L AV,(
'o FM
Airports
7 0
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Current FAA Advisory Circulars Required for Use in AIP
Funded and PFC Approved Projects
Updated: 2/20/2018
View the most current versions of these ACs and any associated changes at:
http://www.faa._qov/airports/resources/advisory circulars and
hftp://www.faa.gov/regulations policies/advisory circulars/
f NUMBER TITLE
7017460-1 L Obstruction Marking and Lighting
Change 1
15015020-1 Noise Control and Compatibility Planning for Airports
150/5070-613 Airport Master Plans
Changes 1 -2
15015070-7 The Airport System Planning Process
Change 1
150/5100-13B Development of State Standards for Nonprimary Airports
15015200-28F Notices to Airmen (NOTAMs)for Airport Operators
15015200-30D Airport Field Condition Assessments and Winter Operations Safety
Change 1
15015200-31C Airport Emergency Plan
Changes 1 -2
15015210-5D Painting, Marking, and Lighting of Vehicles Used on an Airport
15015210-7D Aircraft Rescue and Fire Fighting Communications
150/5210-13C Airport Water Rescue Plans and Equipment
150/5210-14B Aircraft Rescue Fire Fighting Equipment,Tools and Clothing
150/5210-15A Aircraft Rescue and Firefighting Station Building Design
15015210-18A Systems for Interactive Training of Airport Personnel
FAA Advisory Circulars Required for Use in Updated 2/20/2018 Page I of 5
AIP Funded and PFG Approved Projects ARP
HUMBER TILE
15015210-19A Driver's Enhanced Vision System (DEVs)
15015220-10E Guide Specification for Aircraft Rescue and Fire Fighting (ARFF)Vehicles
15015220-16E Automated Weather Observing Systems (AWOS)for Non-Federal
Applications
15015220-17B Aircraft Rescue and Fire Fighting (ARFF)Training Facilities
15015220-1 BA Buildings for Storage and Maintenance of Airport Snow and Ice Control
Equipment and Materials
15015220-20A Airport Snow and Ice Control Equipment
15015220-21C Aircraft Boarding Equipment
15015220-22B Engineered Materials Arresting Systems (EMAS)for Aircraft Overruns
15015220-23 Frangible Connections
150/5220-24 Foreign Object Debris Detection Equipment
150/5220-25 Airport Avian Radar Systems
15015220-26, Airport Ground Vehicle Automatic Dependent Surveillance- Broadcast(ADS-
Changes 1 -2 B) Out Squitter Equipment
15015300-713 FAA Policy on Facility Relocations Occasioned by Airport Improvements or
Changes
15015300-13A, Airport Design
Change 1
15015300-14C Design of Aircraft Deicing Facilities
15015300-16A General Guidance and Specifications for Aeronautical Surveys: Establishment
of Geodetic Control and Submission to the National Geodetic Survey
15015300-17C Standards for Using Remote Sensing Technologies in Airport Surveys
Change 1
15015300-18B General Guidance and Specifications for Submission of Aeronautical Surveys
Change 1 to NGS: Field Data Collection and Geographic Information System (GIS)
Standards
15015320-5D Airport Drainage Design
15015320-6F Airport Pavement Design and Evaluation
FAA Advisory Circulars Required for Use in Updated 2/20/2018 Page 2 of 5
AIP Funded and PFC Approved Projects ARP
NUMBER TITLE
15015320-12C, Measurement, Construction, and Maintenance of Skid Resistant Airport
Changes 1 -8 Pavement Surfaces
15015320-15A Management of Airport industrial Waste
15015325-413 Runway Length Requirements for Airport Design
15015335-5C Standardized Method of Reporting Airport Pavement Strength - PCN
15015340-1 L Standards for Airport Markings
15015340-5D Segmented Circle Airport Marker System
15015340-18F Standards for Airport Sign Systems
15015340-26C Maintenance of Airport Visual Aid Facilities
15015340-30J Design and Installation Details for Airport Visual Aids
15015345-3G Specification for L-821, Panels for the Control of Airport Lighting
15015345-513 Circuit Selector Switch
15015345-71F Specification for L-824 Underground Electrical Cable for Airport Lighting
Circuits
15015345-1 OH Specification for Constant Current Regulators and Regulator Monitors
15015345-12F Specification for Airport and Heliport Beacons
15015345-13B Specification for L-841 Auxiliary Relay Cabinet Assembly for Pilot Control of
Airport Lighting Circuits
15015345-26D FAA Specification For L-823 Plug and Receptacle, Cable Connectors
15015345-27E Specification for Wind Cone Assemblies
15015345-28G Precision Approach Path Indicator(PAPI)Systems
15015345-39D Specification for L-853, Runway and Taxiway Retroreflective Markers
15015345-42H Specification for Airport Light Bases, Transformer Housings, Junction Boxes,
and Accessories
15015345-43H Specification for Obstruction Lighting Equipment
15015345-44K Specification for Runway and Taxiway Signs
15015345-45C Low-impact Resistant(LIR)Structures
150/5345-46E Specification for Runway and Taxiway Light Fixtures
FAA Advisory Circulars Required for Use in Updated 2/20/2018 Pago 3 of 5
AIP Funded and PFC Approved Projects ARP
NUMBER T LE
15015345-47C Specification for Series to Series Isolation Transformers for Airport Lighting
Systems
15015345-49D Specification L-854, Radio Control Equipment
150/5345-50B Specification for Portable Runway and Taxiway Lights
15015345-51 B Specification for Discharge-Type Flashing Light Equipment
15015345-52A Generic Visual Glideslope Indicators (GVGI)
15015345-53D Airport Lighting Equipment Certification Program
15015345-54B Specification for L-884, Power and Control Unit for Land and Hold Short
Lighting Systems
15015345-55A Specification for L-893, Lighted Visual Aid to Indicate Temporary Runway
Closure
15015345-56B Specification for L-890 Airport Lighting Control and Monitoring System
(ALCMS)
15015360-12F Airport Signing and Graphics
15015360-13 Planning and Design Guidelines for Airport Terminal Facilities
Change 1
15015360-14A Access to Airports By Individuals With Disabilities
15015370-2G Operational Safety on Airports During Construction
15015370-10G Standards for Specifying Construction of Airports
15015370-11 B Use of Nondestructive Testing in the Evaluation of Airport Pavements
15015370-13A Off-Peak Construction of Airport Pavements Using Hot-Mix Asphalt
15015370-15B Airside Applications for Artificial Turf
15015370-16 Rapid Construction of Rigid (Portland Cement Concrete)Airfield Pavements
15015370-17 Airside Use of Heated Pavement Systems
150/5390-2C Heliport Design
15015395-1A Seaplane Bases
FAA Advisory Circulars Required for Use in Updated 2/20/2078 Page 4 of 5
AIP Funded and PFC Approved Projects ARP
THE FOLLOWING ADDITIONAL APPLY TO AIP PROJECTS ONLY
Updated: 1/29/2018
NUMBER TITLE
150!5100-14E, Architectural, Engineering, and Planning Consultant Services for Airport Grant
Changell Projects
15015100-17, Land Acquisition and Relocation Assistance for Airport Improvement Program
Changes 1 -7 Assisted Projects
15015300-15A Use of Value Engineering for Engineering and Design of Airport Grant Projects
150/5320-17A Airfield Pavement Surface Evaluation and Rating Manuals
15015370-12B Quality Management for Federally Funded Airport Construction Projects
150/5380-6C Guidelines and Procedures for Maintenance of Airport Pavements
15015380-713 Airport Pavement Management Program
15015380-9 Guidelines and Procedures for Measuring Airfield Pavement Roughness
FAA Advisory Circulars Required for Use in Updated 2/24/2018 Page 5 of 5
AIP Funded and PFC Approved Projects ARP
City of Fort Worth,. 'teras
Mayor and G n un of ommun 'cadpon
COUNCIL ACTION: Approved on 211212019 - Ordinance No..23570-02-2019
DATE: Tuesday, February 12, 2019 REFERENCE NO.: **G-19486
LOG NAME: 55AFW 2019 CARGO ENTITLEMENT GRANT
SUBJECT.
Authorize Application For and Acceptance of the Fiscal Year 2019 Airport Cargo Entitlement Grant, if
Awarded, from the Federal Aviation Administration, in an Amount Up to $900,000.00, for Airport Lighting
and Pavement Improvements, Updated Airport Layout Plan, and Program Management Services at Fort
Worth Alliance Airport, Authorize,Use of Land Credits for the City's Match, in an Amount Up to
$100,000.00, and Adopt Appropriation Ordinance (COUNCIL DISTRICT 7)
RECOMMENDATION.
It is recommended that the City Council:
1. Authorize the application for and acceptance of the FY2019 Airport Cargo Entitlement Grant, if
awarded, from the Federal Aviation Administration in an amount up to $900,000.00, for airport fighting and
pavement improvements, updated airport layout plan, and program management services at Fort Worth
Alliance Airport;
2. Authorize the use of land credits in an amount up to $100,000.00 for the City's in-kind local match of
ten percent of the project cost; and
3. Adopt appropriation ordinance increasing the estimated receipts and appropriations in the Muni Airport
Grants Federal Fund in the amount of$1,000,000.00, subject to receipt of grant.
DISCUSSION:
Each year Fort Worth Alliance Airport is eligible to receive Airport Cargo Entitlement funds from the
Federal Aviation Administration based on the amount of cargo activity from the previous calendar year and
discretionary dollars available in the Airport Improvement Program. The total amount of entitlement funds
available to Fort Worth Alliance Airport this year, is an amount up to $900,000.00.
This year the Fiscal Year 2019 Cargo Entitlement grant will be used to rehabilitate the Runway 16L/34R
and Taxiway Alpha centerline lights, miscellaneous pavement repairs, update the Airport Layout Plan, and
program management services.
Existing land credits remaining from the original land donation for Fort Worth Alliance Airport will be used
for the City's 10 percent in-kind match.
Indirect costs are not eligible for reimbursement.
AVIATION ADVISORY BOARD APPROVAL - On January 17, 2019, the Aviation Advisory Board voted to
recommend that the City Council approve this action.
Lognarne: 55AFW 2019 CARGO ENTITLEMENT GRANT Page I of 2
Fort Worth Alliance Airport is located in COUNCIL DISTRICT 7.
This contract will be with a governmental entity, state agency or public institution of higher
education: Federal Aviation Administration.
FISCAL INFORMATION 1 CERTIFICATION:
The Director of Finance certifies that upon approval of the above recommendations, receipt of the grant
and adoption of the attached ordinance, funds will be available in the current capital budget, as
appropriated, of the Muni Airport Grants Federal Fund. This is a reimbursement grant.
FUND IDENTIFIERS (FIDs):
TO _
Fund Department JAccoun Project Program ctivity Budget Reference # moun
ID ID Year (Chartfield 2)
FROi)fl
Fund Department ccoun Project JProgram ctivity Budget Reference # mount
ID ID Year (Chartfield 2)
CERTIFICATIONS:
Submitted for City Manager's Office by: Fernando Costa (6122)
Originating Department Head: Bill Welstead (5402)
Additional Information Contact: Dakota Shaw (5407)
ATTACHMENTS
1. 55AFW 2019 CARGO ENTITLEMENT GRANT 55003 A019(1).docx (Public)
2. MC MAP.pdf (Public)
Logname: 55AFW 2019 CARGO ENTITLEMENT GRANT Page 2 of 2