Application of Contents Applicant: County/Region: Contact Person: ________________________ Phone Number: _______________________ Table of Contents: Page (s) Checklist (Return Applicable Items to Caltrans) COMPLETE THE REQUIRED SECTIONS Application Checklist/Table of Contents 2 PART I Coordinated Plan Certification 3 – PART II Private Nonprofit-Corporation Status Inquiry 4 – and Certification PART III General Certification and Assurances 5 – PART IV Lawsuits/Complaints 8 – PART V Applicant Profile 9 – PART VI Applicant’s Annual Budget 10 – COMPLETE THE APPLICABLE SECTION(S) PART VII Funding Request Small Urban 12 – – PART VIII– Funding Request Non Urban (Rural) 13 – ATTACHMENT A Operating Assistance Information 14-19 – ATTACHMENT B Mobility Management 20-25 – ATTACHMENT C Capital-Vehicle/Other Equipment 26-35 – ATTACHMENT D Capital-Accessibility Improvement 36-46 – Application Prepared By: Phone:
Application of Contents Applicant: County/Region: Contact Person: ________________________ Phone Number: _______________________ Table of Contents: Page (s) Checklist (Return Applicable Items to Caltrans) COMPLETE THE REQUIRED SECTIONS Application Checklist/Table of Contents 2 PART I – Coordinated Plan Certification 3 PART II – Private Nonprofit-Corporation Status Inquiry and Certification 4 PART III – General Certification and Assurances 5 PART IV – Lawsuits/Complaints 8 PART V – Applicant Profile 9 PART VI – Applicant’s Annual Budget 10 COMPLETE THE APPLICABLE SECTION(S) PART VII – Funding Request – Small Urban 12 PART VIII– Funding Request – Non Urban (Rural) 13 ATTACHMENT A – Operating Assistance Information 14-19 ATTACHMENT B – Mobility Management 20-25 ATTACHMENT C – Capital-Vehicle/Other Equipment 26-35 ATTACHMENT D – Capital-Accessibility Improvement 36-46 Application Prepared By: Phone:
nfapplication011212.docx