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APPLICATION FOR <br />Versi <br />FEDERAL ASSISTANCE <br />2. DATE SUBMITTED <br />5/20/2014 <br />Applicant Identifier <br />1. <br />Application <br />4 <br />J <br />TYPE OF SUBMISSION: <br />Construction <br />Non -Construction <br />Pre -application <br />Construction <br />7 Non -Construction <br />3. DATE RECEIVED BY STATE <br />State Application Identifier <br />4. DATE RECEIVED BY FEDERAL AGENCY <br />Federal Identifier <br />5. APPLICANT INFORMATION <br />Legal Name: <br />Indian River County <br />Organizational Unit: <br />Department: <br />Community Development Dept. <br />Organizational DUNS: <br />079208989 <br />Division: <br />Metropolitan Planning Organization (MPO) <br />Address: <br />Name and telephone number of person to be contacted on matters <br />involving this application (give area code) <br />Street: <br />1801 27th Street <br />Prefix: <br />First Name: <br />Brian <br />City: <br />Vero Beach <br />Middle Name <br />County: <br />Indian River County <br />Last Name <br />Freeman <br />FL te: <br />Zip Code <br />32960 <br />Suffix: <br />SA Country: <br />Ubfreeman©ircgov.com <br />Email: <br />6. EMPLOYER IDENTIFICATION NUMBER (EIN): <br />9– 6 0 0 0 6 7 4 <br />Phone Number (give area code) <br />(772) 226-1990 <br />Fax Number (give area code) <br />(772) 978-1806 <br />8. TYPE OF APPLICATION: <br />New WI Continuation 'I Revision <br />If Revision, enter appropriate letter(s) in box(es) <br />(See back of form for description of letters.) <br />Other (specify) <br />7. TYPE OF APPLICANT: (See back of form for Application Types) <br />B <br />Other (specify) <br />9. NAME OF FEDERAL AGENCY: <br />Federal Transit Administration <br />10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: <br />2 0 --5 0 g <br />TITLE (Name of Program): -- — — — <br />Nonurbanized Area Formula Program <br />11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT: <br />Fixed route and demand response transit service in nonurbanized areas <br />and small urban areas of Indian River County <br />12. AREAS AFFECTED BY PROJECT (Cities, Counties, States, etc.): <br />Indian River County <br />13. PROPOSED PROJECT <br />14. CONGRESSIONAL DISTRICTS OF: <br />Start Date: <br />7/1/2014 <br />Ending Date: <br />12/31/2015 <br />a. Applicant <br />FL -8 <br />b. Project <br />FL -8 <br />15. ESTIMATED FUNDING: <br />BORDER <br />16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE <br />12372 PROCESS? <br />a. Federal <br />$ oti <br />71,943 <br />j, _ THIS PREAPPLICATION/APPLICATION WAS MADE <br />a. Yes. ,i_. AVAILABLE TO THE STATE EXECUTIVE ORDER 12372 <br />PROCESS FOR REVIEW ON <br />DATE: <br />IS NOT COVERED BY E. O. 12372 <br />b. No. f� <br />ri OR PROGRAM HAS NOT BEEN SELECTED BY STATE <br />-_. FOR REVIEW <br />b. Applicant <br />$ 00 <br />c. State <br />$ .00 <br />d. Local <br />$ 00PROGRAM <br />71,943 <br />e. Other <br />$ .°0 <br />f. Program Income <br />$ .0° <br />17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT? <br />Yes If "Yes" attach an explanation. 7i No <br />g. TOTAL <br />$ °° <br />143,886 <br />18. TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS APPLICATION/PREAPPLICATION ARE TRUE AND CORRECT. THE <br />DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE <br />ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED. <br />a. Authorized Representative <br />Prefix <br />First Name <br />Stan <br />Middle Name <br />Last Name <br />Boling <br />Suffix <br />b. Title <br />Community Development Director <br />c. Telephone Number (give area code) <br />(772) 226-1253 <br />d. Signature of Authorized Representative <br />e. Date Signed <br />05/20/2014 <br />Previous Edition Usable <br />Authorized for Local Reproduction <br />Standard Form 424 (Rev.9-2003) <br />Prescribed by OMB Circular A-102 <br />ATTACHMENT 2 <br />31 <br />