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BK:00026 PG -0123 <br />Local Share Certification for Funding <br />(This form is required for EACH separate funding request) <br />County of Lee <br />(Legal Name of Applicant) <br />REMINDER: Local matching funds will be required for all application submittals. For projects requiring operating <br />funds, the required local match is 50 percent of net operating expenses. For projects requiring capital funds, the <br />required local match is 10 percent of the net cost of the project, subject to the availability of state funds. Applicants <br />should be prepared to incur a 20 percent local match in case state funds are not available. <br />The local match may be provided from sources such as an undistributed cash surplus; a replacement or reserve <br />fund; State or local appropriations; dedicated tax revenues; private donations; revenue from service contracts; toll <br />revenue credits; and net income generated from advertising and concessions. Income from contracts to provide <br />human service transportation may be used either to reduce the net project cost (treated as revenue) or to provide <br />local match for operating assistance. In either case, the cost of providing the contract service must be included in the <br />total project cost. No FTA program funds can be used as a source of local match for other FTA programs, even <br />when used to contract for service. <br />Local match may be derived from other Federal funding programs that are eligible to be expended for <br />transportation, other than DOT programs. Examples of types of programs that are potential sources of local match <br />include: employment training, aging; community services; vocational rehabilitation services; and Temporary <br />Assistance for Needy Families (TANF). To be eligible for local match for FTA funds, the other Federal funds must <br />be used for activities included in the total net project costs of the FTA grant. <br />Requested Funding Amounts <br />I, the undersigned representing (Legal Name of Applicant) County of Lee do hereby certify to the North Carolina <br />Department of Transportation, tha a required local funds will be available as of July 1, 2014 <br />Signature of Authorized Official <br />Charles T. Parks, Chairman Lee County Board of C ommissioners <br />Type Name and Title of Authorized Official <br />November 4, 2103 <br />Date <br />Net <br />Local Share <br />Local Source(s) <br />Project <br />Cost <br />Capital <br />$ <br />$00 %) <br />1 <br />(Vehicles & Other) <br />2. <br />3. <br />Operating <br />$ 71,156 <br />$ 35,578 (50% of net) <br />1. Contract Revenue <br />2. <br />3. <br />TOTAL <br />$ 71,156 <br />$ 35,578 <br />I, the undersigned representing (Legal Name of Applicant) County of Lee do hereby certify to the North Carolina <br />Department of Transportation, tha a required local funds will be available as of July 1, 2014 <br />Signature of Authorized Official <br />Charles T. Parks, Chairman Lee County Board of C ommissioners <br />Type Name and Title of Authorized Official <br />November 4, 2103 <br />Date <br />