Federal Certifications and AssurancesforSection 5311 Operating ProjectsCalendar Year 2012Prepared by Wisconsin Department of TransportationBureau of Transit and Local RoadsUpdated: 1-28-2011NOTE: This booklet contains certifications and assurances which must be submitted with the application for federal operating funds. Background InformationIn accordance with 49 U.S.C. 5323(n), the following certifications and assurances have been compiled for Federal Transit Administration (FTA) assistance programs. FTA requests each Applicant to provide as many certifications and assurances as needed for all programs for which the Applicant intends to seek FTA assistance during Federal Fiscal Year 2012.FTA requests the Applicant read each certification and assurance carefully and select all certifications and assurances that may apply to the programs for which it expects to seek Federal assistance.FTA and the Applicant understand and agree that not every provision of these certifications and assurances will apply to every Applicant or every project for which FTA provides Federal financial assistance. The type of project and the selection of the statute authorizing Federal financial assistance for the project will determine which provisions apply. The terms of these certifications and assurance reflect applicable requirements of FTAs enabling legislation currently in effect.The Applicant also understands and agrees that these certifications and assurances are special pre-award requirements specifically prescribed by Federal law or regulation and do not encompass all Federal laws, regulations, and directives that may apply to the Applicant or its project. A comprehensive list of those Federal laws, regulations, and directives is contained in the current FTA Master Agreement MA(17) for Federal Fiscal Year 2012 at the FTA Web site http:/fta.dot.gov/documents/17-Master.pdf Each Applicant is ultimately responsible for compliance with the provisions of the certifications and assurances applicable to itself or its project irrespective of participation in the project by any subrecipient. The Applicant understands and agrees that when it applies for that consortium, joint venture, partnership, or team is responsible for compliance with the certifications and assurances the Applicant selects.InstructionsStep #1: Read through each Certification and Assurance. Step #2: Initial each of the Certifications and Assurances in the table below indicating you have read and understand each one. Signatures are required on the signature page and on Q-2(Title VI) and P-1. The person initialing and signing must have the legal authority to make such certifications on behalf of the organization applying for funding. Step #3: Submit the initialed and signed Certifications and Assurances booklet with your application.Certification/AssuranceTitlePlease Initial each AssuranceQ-1Standard AssurancesQ-2 Nondiscrimination Assurance (Includes Title VI form Signature Required)Q-3Compliance with FTA EEO Policy and RequirementsQ-4Assurance of Nondiscrimination on the Basis of DisabilityQ-5Disadvantaged Business Enterprise (DBE) AssuranceQ-6LobbyingQ-7Debarment, Suspension, and Other ExclusionsQ-8Protections for Private Transportation ProvidersQ-9Charter Service AgreementQ-10School Transportation AgreementQ-11Demand Responsive ServiceQ-12Intelligent Transportation SystemsQ-13Procurement ComplianceQ-14Alcohol Misuse and Prohibited Drug UseP-1Labor Protection Signature Required Attachments: Reference Information Special Section 5333(b) warranty for application to the small urban and rural programs Provisions of the National (Model) Section 5333(b) agreement for incorporation in the Special Warranty Statutes, Regulations, Executive Orders, and Administrative RequirementsChief Elected or Administrative Official StatementThe undersigned chief elected or administrative official hereby certifies that the applicant has read and understands the Certifications and Assurances initialed in the table above and further assures that, as a condition to receiving federal financial assistance from the Wisconsin Department of Transportation, the applicant will comply with the requirements as specified in the applicable attached Certifications and Assurances in implementing and managing the project awarded.The person whose signature appears below is authorized to sign this assurance on behalf of the grant applicant or recipient.Grant Recipient:Signature of Chief Elected or Administrative OfficialPrinted Name:Date:Attorney StatementThe undersigned chief legal counsel for the Applicant hereby certifies that the Applicant has authority under state and local law to comply with the