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BK:00027 PG Local Share Certification for Funding (This form is required for EACH separate funding request) County of Lee (Legal Name of Applicant) Local matching funds will be required for all application submittals. For projects requiring operating funds, the required local match is 50 percent of net operating expenses. For projects requiring capital funds, the required local match is 10 percent of the net cost of the project, subject to the availability of state funds. Applicants should be prepared to incur a 20 percent local match in case state funds are not available. The local match must be provided from sources other than federal Department of Transportation funds. Guidance is provided in the 5310 Overview about eligible sources of matching funds. Applicants are responsible for verifying the eligibility of non -USDOT federal funds the applicant proposes to use as their local match. Requested Funding Amounts I, the undersigned representing (Legal Name of Applicant) County of Lee do hereby certify to the North Carolina Department of Transportation, that the required local funds will be available as of July 1, 2015 f C>�, C aA)J)10 -I/ - Signature of Authorized Official Charles T. Parks, Chairman Type Name and Title of Authorized Official November 3, 2014 Date Net Local Share Local Source(s) Project Cost Capital $ $ (10 %) 1. (Vehicles & Other) 2. 3. Operating $ 44,185 $ 22,093 (50% of net) 1. Contract Revenue 2. 3. TOTAL $ 44,185 $ 22,093 I, the undersigned representing (Legal Name of Applicant) County of Lee do hereby certify to the North Carolina Department of Transportation, that the required local funds will be available as of July 1, 2015 f C>�, C aA)J)10 -I/ - Signature of Authorized Official Charles T. Parks, Chairman Type Name and Title of Authorized Official November 3, 2014 Date