HomeMy Public PortalAboutGDOT Local Maintenance & Improvement Grant for 2014 Revised 6/18/2013
GEORGIA DEPARTMENT OF TRANSPORTATION
LOCAL MAINTENANCE&IMPROVEMENT GRANT(LMIG)
APPLICATION FOR FISCAL YEAR 2014
TYPE OR PRINT LEGIBLY. ALL SECTIONS MUST BE COMPLETED.
All Applications must be submitted by the Local Governing Official to the Georgia Department of Transportation, Office of
Local Grants,600 West Peachtree Street NW,Atlanta,Georgia 30308.
LOCAL GOVERNMENT INFORMATION
Date of Application:_ 7 /,z / 13
Name of local government: C- I j r T ,bet, Gyy
Address: # 3 / AriW Z
Contact Person and Title: d / et, . 41,
Contact Person's Phone Number: Z. 0
Contact Person's Fax Number: I 769.7
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Contact Person's Email: j� e / / . • !�<
Is the Priority List attached? )(Yes ' INo
LOCAL GOVERNMENT AFFIDAVIT AND CERTIFICATION
I, -J L° )/ 1)-,►I (Name), the „DJ(�Ge 6L 6/f 1� e), on behalf of
f_/'-'�/ 7;���j�p _(local government), who being duly sworn do swear that the information given
herein is True o the'best of his/her knowledge and belief. Local Government swears and certifies that it has read and
understands the LMIG General Guidelines and Rules and that it has complied with and will comply with the same.
Local government further swears and certifies that it has read and understands the regulations for the Georgia Planning
Act of 1989 (O.C.G.A. §45-12-200,et seq.),Service Delivery Strategy Act(O.C.G.A. § 36-70-20,et seq.),and the Local
Government Budgets and Audits Act (O.C.G.A. 36-81-1 et seq.) and will comply in full with said provisions. Local
government further swears and certifies that the roads or sections of roads described and shown on the local government's
Project List are dedicated public roads and are part of the Public Road System in said county/city. Local government
further swears and certifies that it complied with federal and/or state environmental protection laws and at the completion
of the project(s),it met the match requirements as stated in the Transportation Investment ACT(TIA).
Further,the local government shall be responsible for any claim, damage, loss or expense that is attributable to negligent
acts, errors, or omissions related to the designs, drawings, specifications, work and other services furnished by or on
behalf of the local government pursuant to this Application("Loss").To the extent provided by law,the local government
further agrees to hold harmless and indemnify the DEPARTMENT and the State of Georgia from all suits or claims that
may arise from said Loss.
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Revised 6/18/2013
GEORGIA DEPARTMENT OF TRANSPORTATION
LOCAL MAINTENANCE& IMPROVEMENT GRANT(LMIG)
APPLICATION FOR FISCAL YEAR 2013
LOCAL GOVERNMENT AFFIDAVIT AND CERTIFICATION
If the local government fails to comply with these General Guidelines and Rules, or fails to comply with its Application and
Certification,or fails to cooperate with the auditor(s)or fails to maintain and retain sufficient records,the DEPARTMENT may,at
its discretion, prohibit the local government from participating in the LMIG program in the future and may pursue any available
legal remedy to obtain reimbursement of the LMIG funds. Furthermore, if in the estimation of the DEPARTMENT,a roadway or
bridge shows evidence of failure(s) due to poor workmanship, the use of substandard materials, or the failure to follow the
required design and construction guidelines as set forth herein, the Department may pursue any available legal remedy to obtain
reimbursement of the allocated LMIG funds or prohibit local government from participating in the LMIG program until such time
as corrections are made to address the deficiencies or reimbursement is made.
Local Government:
E-Verify Number
___(Signature) Sworn to and subscribed before me,
-I (Print) This j 51/4 of j( �,2013
Mayor/Commission Chairperson In the .re -nce of:
(Date)
J /
N•T , ' PUBLC
SEAL:
y commission Expires:
SHARON S.SHAVER
Notary Public,Chatham County,GA
My Commission Expires Dec. 5, 2015
FOR GDOT USE ONLY
The local government's Application is hereby granted and the amount allocated to the local government is
. Such allocation must be spent on any or all of those projects listed in the Project List.
This day of _,20___
Terry L Gable
Local Grants Administrator
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CIP 6 YEAR ROAD PAVING
2014, $50,000 plus $25,000 LMIG = $75,000
a) Veterans Drive 530 ft $10,600
b.) Chatham Ave. 2,000 ft $40,000
c.) Venetian Dr. 1,100 ft $22,000
Total = $72,600
2015 $70,000 plus $25,000 LMIG = $95,000
a.) 12th st. (Jones — Ven.) = $23,000
b.) Butler Ave (16th — 19th) = $32,000
c.) 7th st. 1850 ft = $37,000
d.) 18th 650 ft = $13,000
Total = $105,000
2016 $70,000 plus $25,000 LMIG = $95,000
a.) Lovell Ave (4th — Butler) = $26,000
b.) 7th Ave 1000 ft = $20,000
c.) 5th Ave 2100 ft = $42,000
Total = $ 88,000
2017 $70,000 plus $25,000 LMIG = $ 95,000