HomeMy WebLinkAboutContracts & Agreements_02-2023OMB Number: 4040-0004
Expiration Date: 12/31/2019
Application for Federal Assistance SF-424
" 1. Type of Submission:
Preapplicatlon
® Application
Changed/Corrected Application
' 2. Type of Application: " If Revision, select appropriate letter(s):
® New
Continuation " Other (Specify):
Revision
* 3. Date Received: 4. Applicant Identifier:
12/31/2022
6a. Federal Entity Identifier:
6b. Federal Award Identifier:
State Use Only:
6. Date Received by State:
7. Stale Application Identifier:
8. APPLICANT INFORMATION:
*a. Legal Name: ICity
of Redlands, Redlands Municipal Airport
* b. Employer/Taxpayer Identification Number (EIN(TIN):
"c. Organizational DUNS:
09471220500D0
95-6000766
d. Address:
"Streed: P.O. Sox 3005
Slreet2: 135 Cajon Street, Suite 222
*City:
County/Parish:
Redlands
San Bernardino
'Stale:
CA: California
Province:
*Country:
USA: UNITED STATES
* Zip / Postal Code:
92373-4746
e. Organizational Unit:
Department Name:
Division Name:
Redlands Municipal Airport
Facilities and Community Services
f. Name and contact Information of person to be contacted on matters involving this application:
Prefix: Mr. *First Name: lAdarian
Middle Name: Amiri-Jerome
*Last Name: Lawson
Suffix:
Title: Airport Supervisor
Organizational Affiliation:
Airport Grant Administrator
*Telephone Number: 909-557-8520
Fax Number:
*Email:
alawson@cityofredlands.org
Application for Federal Assistance SF-424
* 9. Type of Applicant 1: Select Applicant Type:
C: City or 'Township Government
Type of Applicant 2: Select Applicant Type:
Type of Applicant 3: Select Applicant Type:
* Other (specify):
10. Name of Federal Agency:
Federal Aviation Administration
11. Catalog of Federal domestic Assistance Number:
20.106
CFDA Title:
Airport Capital Improvement Plan
12. Funding Opportunity Number:
`Title;
Runway 08/26 Rehabilitate (Seal Coat & Resealing of Joints), West Apron Rehabilitate ( Seal Coat &
Resealing of ,joints)
13. Competition Identification Number:
N/A
Title:
14. Areas Affected by Project (Cities, Counties, States, etc.):
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15. Descriptive Title of Applicant's Project:
Runway OB/26 (PCI 73) Rehabilitation to improve the pavement for the same class of aircraft, West
Apron (PCI 43) Rehabilitation to improve pavement for the same class of aircraft.
Attach supporting documents as specified in agency instructions,
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Application for Federal Assistance SF-424
16. Congressional Districts Of:
'a, Applicant cA-031 ' b. Program/Project cA-031
Attach an additional list of Program/Project Congressional Districts if needed.
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17. Proposed Project:
* a. Start DateQ5/0112023 * b. End Date: 07/31/2023
18. Estimated Funding ($}:
a. Federal 360, i50.00
b. Applicant 24,408.601
' c. State 24, 40B.00
d. Local
e. Other
f. Program Income
g.TOTAL 1 408,956.00
* 19. Is Application Subject to Review By State Under Executive Order 12372 Process?
® a. This application was made available to the State under the Executive Order 12372 Process for review on
b. Program is subject to E.O. 12372 but has not been selected by the State for review.
El c. Program is not covered by E.O. 12372.
* 20. Is the Applicant Delinquent On Any Federal Debt? (it "Yes," provide explanation in attachment.)
Yes ® No
If "Yes", provide explanation and attach
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21. *By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements
herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances'* and agree to
comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may
subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001)
® — I AGREE
** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency
specific instructions.
Authorized Representative:
Prefix: Mr. First Name: Eddie
Middle Name:
* Last Name: Tej eda
Suffix:
' Title: -yor
* Telephone Number: 909-798-7531 Fax Number:
*Email: etejeda@citycfredlands.orq
' Signature of Authorized Representative:
' Date Signed:
f