HomeMy WebLinkAboutIowa Department of Transportation-9/23/2013 (3)Form 230017wd
01-13
General Information
Iowa Department of Transportation
APPLICATION FORM FOR
IOWA CLEAN AIR ATTAINMENT PROGRAM (ICAAP) FUNDS
Applicant
Agency:
City of Waterloo
Contact Person (Name &
Title):
Complete Mailing
Address:
waterloo
city
(Govemment Entity, Non -Profit Organization/; or
Individual/)
Mohammad Elahi
e -Mail: mohammad.elahi@waterloo-
ia.org
408 E. 6th Street
Iowa
State
Street Address and/or Box No.
50703 319-291-4440
Zip Daytime Phone
If more than one agency or organization is involved in this project, please state the name, contact person, mailing
address, and telephone number of the second agency. (Attach an additional page if more than two agencies are
involved.)
Applicant Agency:
Contact Person (Name & Title):
Complete Mailing Address:
e -Mail:
Street Address and/or Box No.
City State
Project Information
Zip Daytime Phone
Project Title2: San Marnan, Crossroads, and Part of U.S. 218 Traffic Signal Adaptive Control System
Project Description (including length, if applicable): Installation of an adaptive traffic signal control system on
San Marnan Drive- Cross Roads area and part of US -218.
*Project priority (1 = highest priority): 1 (a sponsor submitting multiple applications in this funding cycle
must assign a numerical rank or priority to each application.)3
*Assign the proposed project to one or more of the following categories (check one or more):
❑ Transportation -Related Project in the State Implementation Plan (SIP) ❑ Shared -Ride
❑ Transportation Control Measure (TCM) 0 Bicycle or Pedestrian Facility or Program (circle one)
▪ Traffic Flow Improvement (Intersection, Signalization, Other) 0 Intermodal Freight or Passenger (circle one)
❑ Planning and Project Development 0 Alternative Fuels
O Travel Demand Management (TDM) 0 Vehicle Inspection and Maintenance Program
O Transit -Related Improvement
❑ Outreach Activity (Education, Advertising, or Technical
Assistance
* Is the project consistent with the State Implementation Plan for air quality for non -attainment areas?
* Is the project consistent with the MPO's local Congestion Management Plan?
* Is the project consistent with the ® MPO ® RPA 0 statewide Long -Range Transportation Plan?
Page 1 of 6
Yes
El
No Not Applicable
❑ ��
❑ ❑
❑ ❑
Notes: ' Requires public agency as co-sponsor of application.
2 The term "project' means any ICAAP infrastructure or program proposal.
3 The Iowa Department of Transportation will use the priority ratings to reflect the sponsor.
Project Costs (An itemized breakdown must be included on an attached sheet):
Total Cost
Iowa Clean Air Attainment Program Fund Request
Applicant Match (20% Minimum)
1.
2.
3.
$ 500,000
$ 400,000
$ 100,000
List All Applicant Match Sources
Amount
Assured or Anticipated
(Date Anticipated)
G.O. Bond
$100,000.00
July 2014
Are any state funds involved in this project? 0 Yes ® No
If yes, please explain the source and conditions
Are any other federal funds involved in this project? 0 Yes No
If yes, please explain the source and conditions
Estimated Project Development Schedule:
Design Start Date December I, 2014 Completion Date May 1, 2015
Land Acquisition Start Date Completion Date
Construction Start Date June 1, 2015 Completion Date October 2015
Has any part of this project been started? 0 Yes ►Z� No
If yes, explain
How do you plan to measure the success of this project?
Conduct travel time / delay before and after studies.
Page 2 of 6
Required Documentation and Narrative Information
The following documents and narratives must be attached to this application. In the upper right-hand comer of each
document or narrative write the corresponding letter shown below.
A. A NARRATIVE assessing existing congestion/air quality conditions, outlining the concept of the proposed
project, and providing adequate project justification. How will this project reduce congestion, reduce travel or
single occupant vehicle usage, and/or improve air quality? Which transportation -related pollutant(s) are
being addressed: carbon monoxide, ozone, or PM?
• B. A DETAILED MAP identifying the location of the project and clearly differentiating the subject project from
any past or future project phases.
C. An ITEMIZED BREAKDOWN of the total project costs. This documentation does not need to be a detailed,
line -item type of estimate. However, it must accomplish two objectives: first, it must show the method by
which the cost estimate was prepared; and second, it must enable a reviewer to determine if the cost
estimate is reasonable. The manner in which these objectives are achieved may vary widely depending on
the type, scope and complexity of the project. Absent a fully itemized list of costs, some general guidelines
for possible methods of estimating each type of project cost are provided on Attachment A.
® D. A TIME SCHEDULE for the total project development.
® E. An OFFICIAL CERTIFICATION from the applicant's goveming body (authority) that it shall:
(1) commit the necessary local matching funding for project implementation and
(2) upon project completion, be responsible for adequately maintaining and operating the project for
public use during the project's useful life.
® F. AN ADOPTED FORMAL RESOLUTION from the appropriate MPO or RPA declaring the sponsor's
proposed project or program conforms to the MPO's or RPA's regional transportation planning process and
transportation plan and, if applicable, the congestion management plan in TMAs.
G. CALCULATIONS for vehicle emission reductions and total project cost effectiveness for the targeted
pollutants. Project applicant must show through a quantitative analysis how many kilograms of pollutant will
be reduced (CO, VOC, NOx, and, if applicable, PM). Project sponsor must calculate the cost effectiveness
of the project by: Dividing the total annualized project cost by the number of kilograms per year of pollutant
reduced ($ per kg). Applicant must also show all assumptions and source of data used to calculate the
estimates. The applicant must use the most current vehicle emission factors developed by the Iowa DNR
and consistent with EPA's MOBILE 6.2 air quality model. These emission factors are periodically updated
and may be obtained from the Iowa DOT's ICAAP website at:
http://wvwv.iowadot.gov/systems j)lanning/icaanhtm.
H. Completed MINORITY IMPACT STATEMENT attached to application.
►.l
The award of Iowa Clean Air Attainment funds; any subsequent funding or letting of contracts for design,
construction, reconstruction, improvement, or maintenance; and the fumishing of materials shall not involve direct or
indirect interest of any state, county, or city official, elective or appointive. All of the above are prohibited by Iowa
Code Sections 314.2, 362.5, or 331.342. Any award of funding or any letting of a contract in violation of the foregoing
provisions shall invalidate the award of Iowa Clean Air Attainment Program funding and authorize a complete
recovery of any funds previously disbursed.
Certification
To the best of my knowledge and belief, all information included in this application is true and accurate, including the
commitment of all physical and financial resources. This application has been duly authorized by the participating
local authority. I understand the attached OFFICIAL ENDORSEMENT(S) binds the participating local govemments to
assume responsibility for adequate maintenance of any new or improved facilities.
If ICAAP funding assistance is approved for the project described in this application, I understand that an executed
contract between the applicant and the Iowa Department of Transportation is required before such funding assistance
can be authorized for use in implementing the project.
Representing til City of Waterloo
/a;72 (//„e
Signature
(Name of Applicants Goveming Authority)
Date
Ernest G. Clark, Mayor 9-23-13
Typed Name and Title Typed Date
(Governing Authority Official)
Page 4 of 6
orcsAiowa Department of Transportation
Form 105101 (03-09)
MINORITY IMPACT STATEMENT
Pursuant to 2008 Iowa Acts, HF 2393, Iowa Code Section 8.11, all grant applications submitted to the
state of Iowa that are due beginning January 1, 2009 shall include a Minority Impact Statement. This is
the state's mechanism for requiring grant applicants to consider the potential impact of the grant project's
proposed programs or policies on minority groups.
Please choose the statement(s) that pertains to this grant application. Complete all the
information requested for the chosen statement(s). Submit additional pages as necessary.
❑ The proposed grant project programs or policies could have a disproportionate or unique positive
impact on minority persons.
Describe the positive impact expected from this project.
Indicate which group is impacted:
❑ Women ❑ Persons with a disability ❑ Blacks ❑ Latinos 0 Asians
0 Pacific Islanders 0 American Indians ❑ Alaskan Native Americans ❑ Other
0 The proposed grant project programs or policies could have a disproportionate or unique negative
impact on minority persons.
Describe the negative impact expected from this project.
Present the rationale for the existence of the proposed program or policy.
Page 5 of 6
Provide evidence of consultation with representatives of the minority groups impacted.
Indicate which group is impacted:
❑ Women ❑ Persons with a disability ❑ Blacks ❑ Latinos ❑ Asians
❑ Pacific Islanders ❑ American Indians ❑ Alaskan Native Americans ❑ Other
® The proposed grant project programs or policies are not expected to have a disproportionate or
unique impact on minority persons.
Present the rationale for determining no impact. Traffic signal improvement will benefit all users regardless of
minority status.
1 hereby certify that the information on this form is complete and accurate, to the best of my knowledge:
Name:
Title:
Definitions
"Minority Persons," as defined in Iowa Code Section 8.11, means individuals who are women, persons
with a disability, Blacks, Latinos, Asians or Pacific Islanders, American Indians, and Alaskan Native
Americans.
"Disability," as defined in Iowa Code Section 15.102, subsection 7, paragraph "b," subparagraph (1):
b. As used in this subsection:
(1) "Disability" means, with respect to an individual, a physical or mental impairment that
substantially limits one or more of the major life activities of the individual, a record of physical or
mental impairment that substantially limits one or more of the major life activities of the
individual, or being regarded as an individual with a physical or mental impairment that
substantially limits one or more of the major life activities of the individual.
"Disability" does not include any of the following:
(a) Homosexuality or bisexuality.
(b) Transvestism, transsexualism, pedophilia, exhibitionism, voyeurism, gender identity disorders
not resulting from physical impairments or other sexual behavior disorders.
(c) Compulsive gambling, kleptomania, or pyromania.
(d) Psychoactive substance abuse disorders resulting from current illegal use of drugs.
"State Agency," as defined in Iowa Code Section 8.11, means a department, board, bureau, commission,
or other agency or authority of the state of Iowa.
Page 6 of 6
ATTACHMENT A
Itemized breakdown of total project costs guidelines.
Construction Costs — these may be based on historical averages for entire projects of similar size and scope.
Examples include:
• Typical cost / mile of trail (i.e. $200,000 per mile for moderate terrain and limited number of structures)
• Typical cost / square foot of bridge deck
• Typical cost / installed mile of fiber optic traffic signal interconnect cable (i.e. $178,000/mile)
• Typical cost / traffic signal upgrade (i.e. $163,000 per lump sum signal bid item)
Design / Inspection Costs — these may be estimated based on the following typical percentages of construction costs:
• 8-10% for preliminary up through final design and letting activities
• 12-15% for construction inspection activities
Right-of-way Acquisition Costs — these may be estimated based on the following:
• Impact and description of impact
• Typical cost / square foot for permanent right-of-way
• Typical cost / square foot for temporary easements
Utility and Railroad Costs — these may be estimated based on the following:
• Impact and description of impact
• Typical cost / linear foot of relocated or reconstructed facility (track, pipe, electrical lines, etc.)
• Typical cost / installation (RR switches, utility poles, transformers, control boxes, etc.)
Indirect Cost (if Outreach Activity) — if indirect costs are involved, e.g. wages:
• Estimated hours
• Estimated hourly rate, salary
• Estimated fringe, direct
• Other direct cost estimate
• Other indirect cost estimate
Page 7 of 6