Application for Public Transportation Capital Assistance Grant

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Application for Public Transportation Capital Assistance Grant

    Application for Public


    Capital Assistance Grant


    Required application items are listed on the attached checklist. The applicant will be advised of any missing or supplemental information required with respect to checklist items, or other supporting

    documentation. The Department considers the application as representing the applicant’s intent to undertake the proposed project promptly if approved.

In the course of its review and evaluation of an application, the Department may require the applicant

    to submit additional information in support of the proposed project. When the Department is satisfied that all information necessary for evaluation of the application has been submitted, a final review will be undertaken. Projects will be judged on the basis of consistency with, and

    achievement of program goals and objectives, public transportation system needs, regional impact, and funding availability.

Once review of the application is complete, the Department will recomend its approval to the

    Governor. Upon approval by the Governor, the Department will process grant contracts for execution by the applicant and the Department.

Instructions for this application are contained in Appendix F.

    Attached is a checklist provided to assist preparers of applications in meeting all of the requirements of the application process. All items are required unless otherwise indicated. Completed applications should be sent to the following address:


     Illinois Department of Transportation

     Division of Public and Intermodal Transportation nd 300 W. Adams, 2 Floor

     Chicago, IL 60606

Printed 4/4/2012 Page 1 of 13 DPIT 100

Application for Capital Assistance Grant (Continued)


    Not Items Applicable Enclosed

     1. Completed Application Form

     A. Project Description

     B. Project Justification

     C. Proposed Project Budget

     D. Implementation Schedule

     2. Public Notice (Appendix A and B)

     3. Historic Preservation (Appendix C)

     4. Opinion of Counsel (Appendix D)

     5. Applicant’s Governing Board Resolution (Appendix E)

     Note: Include this checklist with the application submittal (indicate by cover letter items which are


    Printed 4/4/2012 Page 2 of 13 DPIT 100

Application for Capital Assistance Grant (Continued)

     Legal Name of Applicant Date of Application

Street Address, City, and Zip Code

    Contact Person Title Telephone Number

     ( ) -

     ( ) -

     The hereby applies to the Illinois Department of Transportation for a Capital Improvement Grant. Required resolutions, certifications and other documents in support of this grant request are attached and are considered a part of this application.

     Project Description: (Attach additional pages as necessary)

     In support of this application, I offer the above data and attached supporting documents as

    required. I certify that the statements herein and in the supporting documents are correct and


    Applicant Date

    Name of Authorized Official Title

    Signature Attest

    Printed 4/4/2012 Page 3 of 13 DPIT 100

Application for Capital Assistance Grant (Continued)

     Project Justification:(Attach additional.pages if necessary)

     Proposed Project Budget:

     Activity Description Amount

     $ 0.00

     $ 0.00

     $ 0.00

     $ 0.00

     $ 0.00

     $ 0.00

     $ 0.00

     $ 0.00

     $ 0.00

     $ 0.00

    $ 0.00 Total

Printed 4/4/2012 Page 4 of 13 DPIT 100

Application for Capital Assistance Grant (Continued)

     Implementation Schedule

    Implementation Schedule - Show anticipated contract obligations and cash disbursements by

    fiscal quarter after project approval. Percentages may be used, but please include dollar

    amounts as well.

    Fiscal Quarter Major Activity Initiated Contract obligations Cash Disbursements

     FY , Q

     FY , Q

     FY , Q

     FY , Q

     FY , Q

     FY , Q

     FY , Q

     FY , Q

     FY , Q

     FY , Q

     FY , Q

     FY , Q

    Printed 4/4/2012 Page 5 of 13 DPIT 100

Application for Capital Assistance Grant (Continued)

     Appendix A: Notice of Opportunity for Public Hearing (Sample Language)


    Opportunity for Public Hearing

    On Proposed (Name of Project)

Notice is hearby given that an opportunity for a public hearing is being offered to all persons

    interested in the proposed improvement of (Facility Name) in (Name of County) County.

    The proposed improvement will consist of (Brief Description of the Project Including Nature, Size, Location and Limits).

    Maps, sketches, environmental studies and other information pertinent to the location and design of the improvement are available for inspection, review, and copying at the office of the (Local Agency Department or Official). Comments on the project information should be received by the (Name and Designation of Local Agency Official) at the address given below

    on or before (Mo./Day/Yr.).

    Any individual, group, business, or public agency may request that a public hearing be held regarding this improvement by submitting a written request to (Name and Designation of

    Local Agency Official) at the address given below on or before (Mo./Day/Yr.).

    However, all interested persons desiring more information are encouraged to contact the (Designation of Local Agency Official) by telephone (Phone No.) before requesting a public


     (Name, Designation and Address)

     (of the Local Agency Official)

Printed 4/4/2012 Page 6 of 13 DPIT 100

Application for Capital Assistance Grant (Continued)

    Appendix B: Public Hearing Notice (Sample Language)

    Notice of Public Hearing

    (Name of Applicant)

    RE: Capital Assistance Grant Application, Improvements to (Description and Location of Project


I. Notice is hereby given that a public hearing will be held by the (Name of Applicant).





For the purpose of considering a project for which financial assistance is being sought from the

    Illinois Department of Transportation, pursuant to its Capital Grants Program. The project is generally described as follows:

    A. Project Description: (Brief Description of the Project Including Nature, Size, Location

    and Limits).

    B. Relocation: Relocation Assistance will not be required.

    C. Environment: This project is being implemented to minimize environmental impacts.

    D. Comprehensive Planning: This project is in conformance with comprehensive

    transportation planning in the area.

    E. Elderly and Handicapped: All new facilities included in this project will be accessible to

    the elderly and handicapped.

    II. At the hearing, the (Name of Applicant) will afford an opportunity for interested persons or agencies to be heard with respect to the social, economic, and environmental aspects of the

    project. Interested persons may submit orally or in writing evidence and recommendations with

    respect to said project.

    III. The (Name of Applicant) requests that any hearing impaired person wishing to attend this Public Hearing notify the (Applicant Contact Person & Telephone No.) at least one week before

    the scheduled hearing date so that arrangements can be made to provide an interpreter.

IV. A copy of the application for a state grant for the proposed project will be made available for

    public inspection at (Name & Address of Applicant).

    (Contact Person Name), (Title)



Printed 4/4/2012 Page 7 of 13 DPIT 100

Application for Capital Assistance Grant (Continued)

    Appendix C

    Historic Preservation

    Basic Review Information Requirements

If the project can be considered one of those projects shown in the attached list as having no

    effect on historic preservation, please simply indicate same.

On the other hand, in order to request the comments of the State Historic Preservation Officer

    concerning possible project effects on cultural resources for purposes of the National Historic

    Preservation Act or the Illinois State Agency Historic Resources Protection Act, the following

    information should be provided:

1. Description of proposed undertaking.

2. Name of managing, funding, or licensing agency (state or federal).

3. Name of satellite agencies involved in project (state and federal).

4. Project address(es); street, municipality, and county.

    5. Map (USGS 7.5 minute series topographic) of project location, and project site plan, if applicable.

6. Current photos of all standing structures within the project area (no Xerox).

7. Project plans and specifications if applicable.

8. Participating federal, state, and local funding sources/programs.

    This information should be addressed to:

    Deputy Historic Preservation Officer

    Preservation Services Division

    Illinois Historic Preservation Agency

    Old State Capitol

    Springfield, IL 62701

    Printed 4/4/2012 Page 8 of 13 DPIT 100

Application for Capital Assistance Grant (Continued)

    Appendix C (Continued)

    Projects With No Effect on Historic Preservation

1. Purchase or rehabilitation of rolling stock.

2. Equipment purchases and installation.

3. Replacement / installation of railroad crossing signal systems.

    4. Rebuild / resurface an existing parking lot as long as no enlargement occurs.

    5. Construction of bus turnouts of less than one acre on existing right-of-way.

    6. Construction of bus layover facilities of less than one acre on existing right-of-way.

7. Construction of passenger stations / shelters of less than one acre on existing property

    where no demolition occurs.

8. Construction of sidewalks on existing right-of-way.

9. Parking deck replacement or expansion (vertical).

    10. Underground fuel storage replacement / installation on transit property.

11. Rehabilitation work done on existing facilities less than 40 years old (garages, stations, rail

    yards, buildings, structures, electrical, signal, and communication systems).

12. Replacement of ballast, ties, and rail on existing right-of-way.

    13. Replacement of bridges less than 40 years old where no more than one acre of new right-

    of-way is required.

14. Construction of pedestrian canopies.

    15. Engineering / planning studies for the classes of action included above.

    Printed 4/4/2012 Page 9 of 13 DPIT 100

    Application for Capital Assistance Grant (Continued)

    Appendix D: Opinion of Counsel (Sample Language)

     Opinion of Counsel

    (Sample Language)

I, the undersigned am an attorney, licensed by and duly admitted to practice law in the State

    of Illinois and am counsel for and attorney for the (Name of Applicant). In this capacity, my opinion has been requested concerning the eligibility of the (Name of Applicant) for grant

    assistance under the provisions of the Civil Administrative Code of Illinois [20 ILCS 2705/49 et

    seq.]. You are hereby advised as follows:

1. The (Name of Applicant) is an eligible recipient as defined in state regulations.

2. There are no provisions in the (Name of Applicant)'s charter or by-laws or in the statutes

    of the State, the United States of America, or any other local ordinances that preclude or

    prohibit the (Name of Applicant) from making said application for or contracting with the

    State for the purpose of receiving a State capital improvement grant.

3. The undersigned has no knowledge of any pending or threatened litigation, in either

    Federal or State courts which would adversely affect this application, or which seeks to

    prohibit the (Name of Applicant) from contracting with the State for the purpose of

    receiving a State capital improvement grant.

Based upon the foregoing, I am of the opinion that the (Name of Applicant) is an eligible

    recipient under the provisions of the Act, and that it is fully empowered and authorized to

    apply for and to accept the grant from the State.

Signature: ____________________________

    (Attorney’s Name)

Attorney for: (Name of Applicant)


    Printed 4/4/2012 Page 10 of 13 DPIT 100

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