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HomeMy WebLinkAboutIowa Department of Transportation-9/27/2010Form 231025 (03-09) �® Iowa Department of Transportation �1 Iowa Safe Routes to School Infrastructure Grant Application CONTACT INFORMATION SHEET Complete the information below and include this page as the first page of your application. The person identified as the Contact will be the main point of contact for Iowa DOT staff. Organization (check one) City County El State Project Title: Highland Elementary Safe Routes to School Contact Name: Wayne Castle Contact Title: Associate Engineer Organization: City of Waterloo Engineering Department Mailing Address: 715 Mulberry Street City, State, Zip: Waterloo, Iowa 50703 Best Phone # to Call: (319) 291-4312 Contact E-mail: wayne.castle@waterloo-ia.org Contact Fax: (319) 291-4262 Amount of SRTS Funding Requested: School District: Waterloo Community $165,795 School Name: Highland Elementary Brief Description of Your Project and Location: (one or two lines only) Sidewalk infill with street and railroad crossing improvements along the main routes connecting the new Highland Elementary with the established neighborhoods in northeast Waterloo. The award of Safe Routes to School funds; any subsequent funding or letting of contracts for design, construction, reconstruction, improvement or maintenance; and the fumishing of materials for this project 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 Safe Routes to School 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 applicant. I understand the following OFFICIAL ENDORSEMENT binds the applicant to assume responsibility for adequate maintenance of any new or improved facilities. I understand that, although this information is sufficient to secure a commitment of funds, an executed contract between the applicant and the Department is required prior to authorization of funds. Represent f the City of Waterlo Signature Ernest G. Clark, Mayor Typed Name and Title Date (419'i (90 Date 1