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APPLICATION FOR Version 7103 <br /> FEDERAL ASSISTANCE 2.DATE SUBMITTED Applicant Identifier <br /> 5/31/2013 <br /> 1.TYPE OF SUBMISSION: 3.DATE RECEIVED BY STATE State Application Identifier <br /> Application Pre-application <br /> P_ onstruction Construction 4.DATE RECEIVED BY FEDERAL AGENCY Federal Identifier <br /> bNornon-Construction Non-Construction <br /> 5.APPLICANT INFORMATION <br /> Legal Name: Organizational Unit: <br /> Department: <br /> Indian River County Community Development Dept. <br /> Organizational DUNS: Division: <br /> 079208989 Metropolitan Planning Organization(MPO) <br /> Address: Name and telephone number of person to be contacted on matters <br /> Street: involving this application(give area code) <br /> 1801 27th Street Prefix: First Name: <br /> Brian <br /> City: Middle Name <br /> Vero Beach T <br /> County: Last Name <br /> Indian River County Freeman <br /> State: <br /> te: ip2960 a Suffix: <br /> Country: Email: <br /> USA bfreeman@ircgov.com <br /> 6.EMPLOYER IDENTIFICATION NUMBER(EIN): Phone Number(give area code) Fax Number(give area code) <br /> El R—©oao©o® (772)226-1990 (772)978-1806 <br /> 8.TYPE OF APPLICATION: 7.TYPE OF APPLICANT: (See back of form for Application Types) <br /> F New Continuation IC Revision B <br /> If Revision,enter appropriate letter(s)in box(es) <br /> (See back of form for description of letters.) ❑ ❑ Other(specify) <br /> Other(specify) 9.NAME OF FEDERAL AGENCY: <br /> Federal Transit Administration <br /> 10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: 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 /> (Name of Program): <br /> `owurbanized Area Formula Program <br /> 12.AREAS AFFECTED BY PROJECT(Cities, Counties, States, etc.): <br /> Indian River County <br /> 13.PROPOSED PROJECT 14.CONGRESSIONAL DISTRICTS OF: <br /> Start Date: Ending Date: a.Applicantb.Project <br /> 07/01/2013 12/31/2014 FL-8 L-8 <br /> 15.ESTIMATED FUNDING: 16.IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE <br /> RDER 12372 PROCESS? <br /> a. FederalUU THIS PREAPPLICATION/APPLICATION WAS MADE <br /> 64,110 a.Yes. AVAILABLE TO THE STATE EXECUTIVE ORDER 12372 <br /> b.Applicant uv PROCESS FOR REVIEW ON <br /> c.State DATE: <br /> 32,055 UU <br /> d.Local 32,055 b.No. 171 PROGRAM IS NOT COVERED BY E.O. 12372 <br /> e.Other UU n OR PROGRAM HAS NOT BEEN SELECTED BY STATE <br /> FOR REVIEW <br /> f.Program Income $ UU <br /> 17.IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT? <br /> g.TOTAL $ 128,220-VU 11 Yes If"Yes"attach an explanation. U No <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 /> TTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED. <br /> a.Authorized Representative Prefix First Name Middle Name <br /> Robert M <br /> Last Name Suffix <br /> Keating <br /> Title c.Telephone Number(give area code) <br /> imunity Development Director 772 226/1254 <br /> jnature of Authorized Representative Date Signed <br /> 05131/2013 <br /> Previous Edition Usable Standard Form 424(Rev.9-2003) <br /> Authorized for Local Reproduction Prescribed by OMB Circular A-102 <br /> Attachment 2 42 <br />