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HomeMy WebLinkAboutContracts & Agreements_39B-2023OMB Number: 4040-0004 Expiration Date: 12/31/2019 Application for Federal Assistance SF-424 * 1. Type of Submission: Preapplication Application * 2. Type of Application: * If Revision, select appropriate letter(s): 0 New Continuation Revision * Other (Specify): 0 Application Changed/Corrected * 3. Date Received: 4. Applicant Identifier: 12/31/2022 5a. Federal Entity Identifier: 5b. Federal Award Identifier: State Use Only: 6, Date Received by State: 7. State Application Identifier: 8. APPLICANT INFORMATION: *a. Legal Name: City of Redlands, Redlands Municipal Airport * b. Employer/Taxpayer Identification Number (EIN/TIN): * c. Organizational DUNS: 95-6000766 0947122050000 d. Address: *Streetl: Street2: * City: County/Parish: *State: Province: *Country: * Zip / Postal Code: P.O. Box 3005 35 Cajon Street, Suite 222 Redlands San Bernardino CA: California USA: UNITED STATES 92373-9796 e. Organizational Unit: Department Name: Division Name: Facilities and Community Services Redlands Municipal Airport f. Name and contact information of person to be contacted on matters involving this application: Prefix: Middle Name: * Last Name: Suffix: Mr. * First Name: Adarian Amiri-Jerome Lawson 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.): Add Attachment Delete Attachment View Attachment * 15. Descriptive Title of Applicant's Project: Runway 08/26 (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. Add Attachments Delete Attachments View Attachments 1 Application for Federal Assistance SF-424 16. Congressional Districts Of: * a. Applicant FA-031 * b. Program/Project cA-031 Attach an additional list of Program/Project Congressional Districts if needed. Add Attachment Delete Attachment View Attachment 17. Proposed Project: * a. Start Date: 06/01/2023 * b. End Date: 07/31/2023 18. Estimated Funding ($): * a. Federal * b. Applicant *c. State * d. Local * e. Other *f. Program Income *g.TOTAL 280, 950. 00 15,608.00 15,608.00 312,166.00 * 19. Is Application Subject to Review By State Under Executive Order 12372 Process? was made available to the State under the Executive Order 12372 Process for review on to E.O. 12372 but has not been selected by the State for review. covered by E.O. 12372. a. This application b. Program is subject c. Program is not • * 20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.) Yes No If "Yes", provide explanation and attach Add Attachment Delete Attachment View Attachment 21. *By signing this herein are true, complete comply with any resulting subject me to criminal, application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements and accurate to the best of my knowledge. I also provide the required assurances** and agree to terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may civil, or administrative penalties. (U.S. Code, Title 218, Section 1001) and assurances, or an Internet site where you may obtain this list, is contained in the announcement or agency L **IAGREE ** The list of certifications specific instructions. Authorized Representative: Prefix: Mr. * First Name: Eddie J Middle Name: * Last Name: Tejeda Suffix: * Title: Mayor * Telephone Number: 909-798-7531 Fax Number: * Email: etejeda@cityofredlands.org *Signature of Authorized Representative: . — C / �� / 1 ,`(i;.,/'x * Date Signed: 21,7i_ 2 3