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Home My Public Portal About2023.05.16 SF271 McCall AIP 027-2020 Final Report 2022 Flat FINALOMB Number: 4040–0011 Expiration Date: 02/28/2022 1. TYPE OF REQUEST FINAL PARTIAL 2. BASIS OF REQUEST CASH ACCRUAL OUTLAY REPORT AND REQUEST FOR REIMBURSEMENT FOR CONSTRUCTION PROGRAMS 3. FEDERAL SPONSORING AGENCY AND ORGANIZATIONAL ELEMENT TO WHICH THIS REPORT IS SUBMITTED FAA - Helena ADO 4. FEDERAL GRANT OR OTHER IDENTIFYING NUMBER ASSIGNED BY FEDERAL AGENCY AIP 3-16-0023-027-2020 5. PARTIAL PAYMENT REQUEST NUMBER FOR THIS REQUEST Final 6. EMPLOYER IDENTIFICATION NUMBER 82-6000022 7. FINANCIAL ASSISTANCE IDENTIFICATION NUMBER DOT-FA20NM-2039 05/31/202305/31/202310/01/202010/01/2020 8.PERIOD COVERED BY THIS REQUEST From: To: Name:City of McCall 9. RECIPIENT ORGANIZATION Street1: Street2: City: State: ZIP / Postal Code: Country: County: Province: 216 East Park Street McCall Valley ID: IdahoID: Idaho USA: UNITED STATESUSA: UNITED STATES 83638-3832 Name: 10. PAYEE (Where check is to be sent if different than item 9) Street1: Street2: City: State: ZIP / Postal Code: Country: County: Province: DocuSign Envelope ID: A46B0D8B-C246-4DAC-9625-538BDEA426E9 11.STATUS OF FUNDS CLASSIFICATION (a)Construct Parallel Taxiway (b)(c) 7,311.03a. Administrative expense 7,311.03 TOTAL b. Preliminary expense c. Land, structures, right-of-way 495,715.22d. Architectural engineering basic fees 495,715.22 e. Other architectural engineering fees 372,392.54372,392.54f. Project inspection fees g. Land development h. Relocation expense l. Equipment $$$$ PROGRAMS FUNCTIONS ACTIVITIES i. Relocation payments to individuals and businesses j. Demolition and removal k. Construction and project improvement cost 6,371,368.156,371,368.15 m. Miscellaneous cost n. Total cumulative to date (sum of lines a thru m) o. Deductions for program income p. Net cumulative to date (line n minus line o) q. Federal share to date 7,246,786.007,246,786.00 r. Rehabilitation grants (100% reimbursement) s. Total Federal share (sum of lines q and r) t. Federal payments previously requested u. Amount requested for reimbursement v. Percentage of physical completion of project 100.00100.00 % % % % 7,246,786.94 7,246,786.94 7,246,786.94 7,246,786.94 7,246,786.00 7,246,786.00 $$$$ DocuSign Envelope ID: A46B0D8B-C246-4DAC-9625-538BDEA426E9 I certify that to the best of my knowledge and belief the billed costs or disbursements are in accordance with the terms of the project and that the reimbursement represents the Federal share due which has not been previously requested and that an inspection has been performed and all work is in accordance with the terms of the award. SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL DATE REPORT SUBMITTED TYPED OR PRINTED NAME AND TITLE Prefix:Mr.Mr.First Name:Robert Middle Name: Last Name:Giles Suffix: Title:Mayor TELEPHONE (Area code, number, and extension) (208) 634-7142 12.CERTIFICATION a. RECIPIENT SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL DATE SIGNED TYPED OR PRINTED NAME AND TITLE Prefix:First Name:Middle Name: Last Name:Suffix: Title: TELEPHONE (Area code, number, and extension) b. REPRESENTATIVE CERTIFYING TO LINE 11V DocuSign Envelope ID: A46B0D8B-C246-4DAC-9625-538BDEA426E9 INSTRUCTIONS Public reporting burden for this collection of information is estimated to average 60 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0004), Washington, DC 20503. PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY. Please type or print legibly. Items 3, 4, 5, 8, 9, 10, 11s and 11v are self explanatory; specific instructions for other items are as follows: 1 Mark the appropriate box. If the request is final, the amounts billed should represent the final cost of the project. 2 Show whether amounts are computed on an accrued expenditure or cash disbursement basis. 6 Enter the Employer Identification Number (EIN) assigned by the U.S. Internal Revenue Service or FICE (institution) code if requested by the Federal agency. 7 This space is reserved for an account number or other identifying number that may be assigned by the recipient. 11 The purpose of vertical columns (a) through (c) is to provide space for separate cost breakdowns when a large project has been planned and budgeted by program, function or activity. If additional columns are needed, use as many additional forms as needed and indicate page number in space provided in upper right; however, the summary totals of all programs, functions, or activities should be shown in the "total" column on the first page. All amounts are reported on a cumulative basis. 11a Enter amounts expended for such items as travel, legal fees, rental of vehicles and any other administrative expenses. Include the amount of interest expense when authorized by program legislation. Also show the amount of interest expense on a separate sheet. 11b Enter amounts pertaining to the work of locating and designing, making surveys and maps, sinking test holes, and all other work required prior to actual construction. 11c Enter all amounts directly associated with the acquisition of land, existing structures and related right-of-way. 11d Enter basic fees for services of architectural engineers. 11e Enter other architectural engineering services. Do not include any amounts shown on line d. 11f Enter inspection and audit fees of construction and related programs. 11g Enter all amounts associated with the development of land where the primary purpose of the grant is land improvement. The amount pertaining to land development normally associated with major construction should be excluded from this category and entered on line k. 11h Enter the dollar amounts used to provide relocation advisory assistance and net costs of replacement housing (last resort). Do not include amounts needed for relocation administrative expenses; these amounts should be included in amounts shown on line a. 11i Enter the amount of relocation payments made by the recipient to displaced persons, farms, business concerns, and nonprofit organizations. Item Entry 11j Enter gross salaries and wages of employees of the recipient and payments to third party contractors directly engaged in performing demolition or removal of structures from developed land. All proceeds from the sale of salvage or the removal of structures should be credited to this account; thereby reflecting net amounts if required by the Federal agency. 11k Enter those amounts associated with the actual construction of, addition to, or restoration of a facility. Also, include in this category, the amounts for project improvements such as sewers, streets, landscaping, and lighting. 11l Enter amounts for all equipment, both fixed and movable, exclusive of equipment used for construction. For example, permanently attached laboratory tables, built-in audio visual systems, movable desks, chairs, and laboratory equipment. 11m Enter the amounts of all items not specifically mentioned above. 11n Enter the total cumulative amount to date which should be the sum of lines a through m. 11o Enter the total amount of program income applied to the grant or contract agreement except income included on line j. Identify on a separate sheet of paper the sources and types of the income. 11p Enter the net cumulative amount to date which should be the amount shown on line n minus the amount on line o. 11q Enter the Federal share of the amount shown on line p. 11r Enter the amount of rehabilitation grant payments made to individuals when program legislation provides 100 percent payment by the Federal agency. 11t Enter the total amount of Federal payments previously requested, if this form is used for requesting reimbursement. 11u Enter the amount now being requested for reimbursement. This amount should be the difference between the amounts shown on lines s and t. If different, explain on a separate sheet. 12a To be completed by the official recipient official who is responsible for the operation of the program. The date should be the actual date the form is submitted to the Federal agency. 12b To be completed by the official representative who is certifying to the percent of project completion as provided for in the terms of the grant or agreement. Item Entry DocuSign Envelope ID: A46B0D8B-C246-4DAC-9625-538BDEA426E9