HomeMy WebLinkAboutContract • CAG-13-141
U.S. Department of Transportation
Federal Aviation Administration
Grant Agreement
Part 1 —Offer
Renton Municipal Airport
Renton, Washington
Date of Offer: Thursday, June 20, 2013
Project Number: 3-53-0055-024-2013
Contract Number: DOT-FA13NM-0004
To: City of Renton, Washington (herein called the "Sponsor")
From The United States of America (acting through the Federal Aviation
Administration, herein called the "FAA")
WHEREAS, the Sponsor has submitted to the FAA a Project Application dated
1112512012, for a grant of Federal funds for a project at or associated with the
Renton Municipal Airport which Project Application, as approved by the FAA, is
hereby incorporated herein and made a part hereof; and WHEREAS, the FAA
has approved a project for the Airport (herein called the "Project") consisting of
the following:
Rehabilitate Taxiway B (Phase 4); Remove obstruction (removes
existing dilapidated wood blast fence that penetrates surfaces with
a lower blast fence); Improve service road (replace with lower blast
fence);
all as more particularly described in the Project Application.
FAA Form 5100-37 PG 1 (10-89) Page 1 of 13
ORIGINAL
f
NOW THEREFORE, pursuant to and for the purpose of carrying out the
provisions of Title 49, United States Code, and in consideration of (a) the
Sponsor's adoption and ratification of the representations and assurances
contained in said Project Application and its acceptance of this Offer as
hereinafter provided, and (b) the benefits to accrue to the United States and the
public from the accomplishment of the Project and compliance with the
assurances and conditions as herein provided, THE FEDERAL AVIATION
ADMINISTRATION, FOR AND ON BEHALF OF THE UNITED STATES,
HEREBY OFFERS AND AGREES to pay, as the United States share of the
allowable costs incurred in accomplishing the Project, 90.00 percentum of all
allowable Project costs.
This Offer is made on and subject to the following terms and conditions:
Part I - Conditions
1) The maximum obligation of the United States payable under this Offer shall
be $7,150,000.00. For the purposes of any future grant amendments which
may increase the foregoing maximum obligation of the United States under
the provisions of Section 47108(b) of the Act, the following amounts are being
specified for this purpose:
$ 0.00 For planning
$ 7,150,000.00 For airport development or noise program
implementation
Please note that this grant offer may be funded all or in part, with funds from
the Small Airport Fund.
2) The allowable costs of the-project shall not include any costs determined by
the FAA to be ineligible for consideration as to allowability under the
provisions of the Act.
3) Payment of the United States' share of the allowable project costs will be
made pursuant to and in accordance with the provisions of such regulations
and procedures as the Secretary shall prescribe. Final determination of the
United States' share will be based upon the final audit of the total amount of
allowable project costs and settlement will be made for any upward or
downward adjustments to the Federal share of costs.
4) The Sponsor shall carry out and complete the Project without undue delays
and in accordance with the terms hereof, and such regulations and
procedures as the Secretary shall prescribe, and agrees to comply with the
assurances which were made part of the project application.
FAA Form 5100-37 PG 2 (.10-89) Page 2 of 13
5) The FAA reserves the right to amend or withdraw this Offer at any time prior
to its acceptance by the Sponsor.
6) This Offer shall expire and the United States shall not be obligated to pay any
part of the costs of the project unless this Offer has been accepted by the
Sponsor on or before Wednesday, July 17, 2013, or such subsequent date as
may be prescribed in writing by the FAA.
7) The Sponsor shall take all steps, including litigation if necessary, to recover
Federal funds spent fraudulently, wastefully, or in violation of Federal antitrust
statutes, or misused in any other manner in any project upon which Federal
funds have been expended. For the purposes of this grant agreement the
term "Federal funds" means funds however used or disbursed by the Sponsor
that were originally paid pursuant to this or any other Federal grant
agreement. It shall obtain the approval of the Secretary as to any
determination of the amount of the Federal share of such funds. It shall
return the recovered Federal share, including funds recovered by settlement,
order, or judgment to the Secretary. It shall furnish upon request , all
documents and records pertaining to the determination of the amount of the
Federal share or to any settlement, litigation, negotiation;"or other efforts
taken to recover such funds. All settlements or other final positions of the
Sponsor, in court or otherwise, involving the recovery of such Federal share
shall be approved in advance by the Secretary.
8) The United States shall not be responsible or liable for damage to property or
injury to persons which may arise from, or be incident to, compliance with this
grant agreement.
9) Trafficking in persons:
a) Provisions applicable to a recipient that is a private entity.
i) You as the recipient, your employees, subrecipients under this award,
and subrecipients' employees may not—
(1) Engage in severe forms of trafficking in persons during the period
of time that the award is in effect;
(2) Procure a commercial sex act during the period of time that the
award is in effect; or
(3) Use forced labor in the performance of the award or subawards
under the award.
ii) We as the Federal awarding agency may unilaterally terminate this
award, without penalty, if you or a subreceipient that is a private entity—
(1) Is determined to have violated a prohibition in paragraph a.1 of this
award term; or
(2) Has an employee who is determined by the agency official
authorized to terminate the award to have violated a prohibition in
ara ra h a.1 of this award term through conduct that is either—
(a) P 9
(a) Associated with performance under this award; or
FAA Form 5100-37 PG 3(10-89) Rage.3 of 13
i
(b) Imputed to your or the subrecipient using the standards and due
process for imputing the conduct of an individual to an
organization that are provided in 2 CFR part 180, "OMB
Guidelines to Agencies on Governmentwide Debarment and
Suspension (Nonprocurement)," as implemented by our agency
at 49 CFR Part 29.
b) Provision applicable to a recipient other than a private entity.
i) We as the Federal awarding agency may unilaterally terminate this
award, without penalty, if a subrecipient that is a private entity—
(1) Is determined to have violated an applicable prohibition in
paragraph a.1 of this award term; or
(2) Has an employee who is determined by the agency official
authorized to terminate the award to have violated an applicable
prohibition in paragraph a.1 of this award term through conduct that
is either—
(a)Associated with performance under this award; or
(b) Imputed to the subrecipient using the standards and due
process for imputing the conduct of an individual to an
organization that are provided in 2 CFR part 180, "OMB
Guidelines to Agencies on Governmentwide Debarment and
Suspension (Nonprocurement)," as implemented by our agency
at 49 CFR Part 29.
c) Provisions applicable to any recipient.
i) You must inform us immediately of any information you receive from
any source alleging a violation of a prohibition in paragraph a.1 of this
award term.
ii) Our right to terminate unilaterally that is described in paragraph a.2 or,
b of this section:
(1) Implements section 106(g) of the Trafficking Victims Protection Act
of 2000 (TVPA), as amended (22 U.S.C. 7104 (g)), and
(2) Is in addition to all other remedies for noncompliance that are
available to us under this award.
iii) You must include the requirements of paragraph a.1 of this award term
in any subaward you make to a private entity.
d) Definitions. For purposes of this award term:
i) "Employee" means either:
(1) An individual employed by you or a subrecipient who is engaged in
the performance of the project or program under this award; or
(2) Another person engaged in the performance of the project or
program under this award and not compensated by you including,
but not limited to, a volunteer or individual whose services are
contributed by a third party as an in-kind contribution toward cost
sharing or matching requirements.
ii) "Forced labor" means labor obtained by any of the following methods
the recruitment, harboring, transportation, provision, or obtaining of a
person for labor or services, through the use of force, fraud, or
coercion for the purpose of subjection to involuntary servitude,
peonage, debt bondage, or slavery.
FAA Form 5100-37 PG 4 (10-89) Page 4 of 13
•
iii) "Private entity":
(1) Means any entity other than a State, local government, Indian tribe,
or foreign public entity, as those terms are defined in 2 CFR
175.25.
(2) Includes:
(a) A nonprofit organization, including any nonprofit institution of
higher education, hospital, or tribal organization other than one
included in the definition of Indian tribe at 2 CFR 175.25(b).
(b) A for-profit organization.
iv) "Severe forms of trafficking in persons," "commercial sex act," and
"coercion" have the meanings given at section 103 of the TVPA, as
amended (22 U.S.C. 7102).
10)System of Award Management and Universal Identifier Requirements
a) Requirement for System of Award Management (SAM)
i Unless you are exempted from this requirement under 2 CFR 25.110
} Y p q
you as the recipient must maintain the currency of your information in
the SAM until you submit the final financial report required under this
award or receive the final payment, whichever is later. This requires
that you review and update the information at least annually after the
initial registration, and more frequently if required by changes in your
information or another award term.
b) Requirement for Data Universal Numbering System (DUNS) Numbers
i) If you are authorized to make subawards under this award, you:
(1) Must notify potential subrecipients that no entity (see definition in
paragraph c of this award term) may receive a subaward from you
unless the entity has provided its DUNS number to you.
(2) May not make a subaward to an entity unless the entity has
provided its DUNS number to you.
c) Definitions
i) For purposes of this award term:
(1) System of Award Management (SAM means the Federal repository
into which an entity must provide information required for the
conduct of business as a recipient. Additional information about
registration procedures may be found at the SAM Internet site
(currently at httpslltvww.sam.gov/portal��blWSAMl}.
(2) Data Universal Numbering System (DUNS) number means the
nine-digit number established and assigned by Dun and Bradstreet,
Inc. (D&B) to uniquely identify business entities. A DUNS number
may be obtained from D&B by telephone (currently 866-705-5711)
or the Internet (currently at http;llfeocgov,dr7b.comlwebform).
(3) Entity, as it is used in this award term, means all of the following, as
defined at 2 CFR part 25, subpart C:
(a) A Governmental organization, which is a State, local
government, or Indian Tribe;
(b) A foreign public entity;
(c) A domestic or foreign nonprofit organization;
(d) A domestic or foreign for-profit organization; and
FAA Farm 5100-37 PG 5 (10-89) Page 5 of 13
(e) A Federal agency, but only as a subrecipient under an award or
subaward to a non-Federal entity.
Y
(4) Subaward:
(a) This term means a legal instrument to provide support for the
performance of any portion of the substantive project or
program for which you received this award and that you as the
recipient award to an eligible subrecipient.
(b) The term does not include your procurement of property and
services needed to carry out the project or program (for further
I
explanation, see Sec. 210 of the attachment to OMB Circular A---
133, "Audits of States, Local Governments, and Non--Profit
Organizations"). A subaward may be provided through any
legal agreement, including an agreement that you consider a
contract.
(5) Subrecipient means an entity that:
(a) Receives a subaward from you under this award; and
(b) Is accountable to you for the use of the Federal funds provided
by the subaward.
(c) A subaward may be provided through any legal agreement,
including an agreement that you consider a contract.
i
11)ELECTRONIC GRANT PAYMENT(S): The requirements set forth in these
terms and conditions supersede previous financial invoicing requirements for
FAA grantees. Each payment request under this grant agreement must be
made electronically via the Delphi elnvoicing System for Department of
Transportation (DOT) Financial Assistance Awardees. The following are the
procedures for accessing and utilizing the Delphi elnvoicing System.
a) Grant Recipient Requirements.
i) Grantees must have Internet access to register and submit payment
requests through the Delphi elnvoicing system unless, under limited
circumstances, a waiver is granted by the FAA and DOT under section
(c) below.
ii) Grantees must submit payment requests electronically and the FAA
will process payment requests electronically.
b) System User Access.
i) Grantees must contact the FAA Airports District/Regional Office and
officially submit a written request to sign up for the system. The FAA
Office of Airports will provide the grantee's name, email address and
telephone number to the DOT Financial Management Office. The DOT
will then invite the grantee via email to sign up for the system and
require the grantee to complete two forms. The grantee will complete
a web based DOT registration form and download the Proof of
Identification form to verify the grantee's identity,
ii) The grantee must complete the Proof of Identification form, and
present it to a Notary Public for verification. The grantee will return the
notarized form to:
FAA Form 5100-37 PG 6(10-89) Page 6 of 13
DOT Enterprise Services Center
FAA Accounts Payable, AMZ-100
PO Box 25710
Oklahoma City, OK 73125
iii. The DOT will validate the both forms and email a user ID and
password to the grantee. Grantees should contact the FAA Airports
District/Regional Office with any changes to their system information.
Note: Additional information, including access forms and training
materials, can be found on the DOT elnvoicing website
(http://www.dot.gov/cfo/delphi-elnvoicingg-system.html).
c) Waivers. DOT Financial Management officials may, on a case by case
basis, waive the requirement to register and use the electronic grant
payment system based on user requests and concurrence of the FAA.
Waiver request forms can be obtained on the DOT elnvoicing website
(http://www.dot.gov/cfo/delphi-einvoicinci-system.htmi) or by contacting
the FAA Airports District/Regional Office. Recipients must explain why
they are unable to use or access the Internet to register and enter
payment requests.
i) All waiver requests should be sent to the FAA Airports
District/Regional Office for concurrence, prior to sending to the
Director of the Office of Financial Management, US Department of
Transportation, Office of Financial Management, B-307 room W93-
431, 1200 New Jersey Avenue SE, Washington DC 20590-0001,
DOTE lectronic[nvoicing ,dot.gov. The Director of the DOT Office of
Financial Management will confirm or deny the request within
approximately 30 days.
ii) If a grantee is granted a waiver, the grantee should submit all hard-
copy invoices directly to:
DOT/FAA
PO Box 25082
AMZ-110
Oklahoma City, OK 73125
FAA Form 5100-37 PG 7 (10-89) Page 7 of 13
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Special Conditions
1) It is mutually understood and agreed that if, during the life of the project, the
FAA determines that the maximum grant obligation of the United States
exceeds the expected needs of the Sponsor by $25,000.00 or five percent
(5%), whichever is greater, the maximum obligation of the United States can
be unilaterally reduced by letter from the FAA advising of the budget change.
Conversely, if there is an overrun in the total actual eligible and allowable
development and land project costs, FAA may increase the maximum grant
obligation of the United States to cover the amount of the overrun not to
exceed the statutory percent limitation and will advise the Sponsor by letter of
the increase. If the increase in project costs is attributable to planning items,
the maximum United States obligation may not be increased. It is further
understood and agreed that if, during the life of the project, the FAA
determines that a change in the grant description is advantageous and in the
best interests of the United States, the change in grant description will be
unilaterally amended by letter from the FAA. Upon issuance of the
aforementioned letter, either the grant obligation of the United States is
adjusted to the amount specified or the grant description is amended to the
description specified.
2) In accordance with Section 47108(b) of the Act, as amended, the maximum
obligation of the United States, as stated in Condition No. 1 of this Grant
Offer:
a) may not be increased for a planning project;
b) may be increased by not more than 15 percent for development projects;
c) may be increased by not more than 15 percent or by an amount not to
exceed 25 percent of the total increase in allowable costs attributable to
the acquisition of land or interests in land, whichever is greater, based on
current credible appraisals or a court award in condemnation.
3) In accordance with Section 47108(b) of the Act, as amended, the maximum
obligation of the United States, as stated in Condition No. 1 of this Grant
Offer.
a) may not be increased for a planning project;
b) may be increased by not more than 15 percent for development projects;
c) may be increased by not more than 15 percent for land projects.
4) Unless otherwise approved by the FAA, the Sponsor will not acquire or permit
any contractor or subcontractor to acquire any steel or manufactured products
produced outside the United States to be used for any project for airport
development or noise compatibility for which funds are provided under this
grant. The Sponsor will include in every contract a provision implementing
this special condition.
5) The Sponsor agrees to perform the following:
a) Furnish a construction management program to FAA prior to the start of
construction which shall detail the measures and procedures to be used to
FAA Form 5100-37 PG 8(10-89) Page 8 of 13
I
comply with the quality control provisions of the construction contract
including, but not limited to, all quality control provisions and tests required
by the Federal specifications. The program shall include as a minimum:
i) The name of the person representing the Sponsor who has overall
responsibility for contract administration for the project and the
authority to take necessary actions to comply with the contract.
ii) Names of testing laboratories and consulting engineer firms with
quality control responsibilities on the project, together with a
description of the services to be provided.
iii) Procedures for determining that testing laboratories meet the
requirements of the American Society of Testing and Materials
standards on laboratory evaluation, referenced in the contract
specifications (D 3666, C 1077).
iv) Qualifications of engineering supervision and construction inspection
personnel.
v) A listing of all tests required by the contract specifications, including
the type and frequency of tests to be taken, the method of sampling,
the applicable test standard, and the acceptance criteria or tolerances
permitted for each type of test.
vi) Procedures for ensuring that the tests are taken in accordance with the
program, that they are documented daily, and that the proper
corrective actions, where necessary are undertaken.
b) Submit at completion of the project, a final test and quality control report
documenting the results of all tests performed, highlighting those tests that
failed or did not meet the applicable test standard. The report shall
include the pay reductions applied and reasons for accepting any out-of-
tolerance material. An interim test and quality control report shall be
submitted, if requested by the FAA.
c) Failure to provide a complete report as described in paragraph b, or failure
to perform such tests, shall, absent any compelling justification, result in a
reduction in Federal participation for costs incurred in connection with
construction of the applicable pavement. Such reduction shall be at the
discretion of the FAA and will be based on the type or types of required
tests not performed or not documented and will be commensurate with the
proportion of applicable pavement with respect to the total pavement
constructed under the grant agreement.
d) The FAA, at its discretion, reserves the right to conduct independent tests
and to reduce grant payments accordingly if such independent tests
determine that sponsor test results are inaccurate.
6) For a project to replace or reconstruct pavement at the airport, the Sponsor
shall implement an effective airport pavement maintenance management
program as required by Airport Sponsor Assurance Number 11. The Sponsor
shall use such program for the useful life of any pavement constructed,
reconstructed, or repaired with Federal financial assistance at the airport. An
effective pavement maintenance management program is one that details the
procedures to be followed to assure that proper pavement maintenance, both
preventive and repair, is performed. An airport sponsor may use any form of
FAA Form 5100-37 PG 9 (10-89) Page 9 of 13
i
inspection program it deems appropriate. The program must, as a minimum,
include the following:
a) Pavement Inventory. The following must be depicted in an appropriate
form and level of detail
i) location of all runways, taxiways, and aprons;
ii) dimensions;
iii) type of pavement, and;
iv) year of construction or most recent major rehabilitation.
b) Inspection Schedule.
i) Detailed Inspection. A detailed inspection must be performed at least
once a year. If a history of recorded pavement deterioration is
available, i.e., Pavement Condition Index (PCI) survey as set forth in
Advisory Circular 15015380-6, "Guidelines and Procedures for
Maintenance of Airport Pavements," the frequency of inspections may
be extended to three years.
ii) Drive-By Inspection. A drive-by inspection must be performed a
minimum of once per month to detect unexpected changes in the
pavement condition.
c) Record Keeping_ Complete information on the findings of all detailed
inspections and on the maintenance performed must be recorded and
kept on file for a minimum of five years. The types of distress, their
locations, and remedial action, scheduled or performed, must be
documented. The minimum information to be recorded is listed below:
i) inspection date;
ii) location;
iii) distress types;
iv) maintenance scheduled or performed.
(1) For drive-by inspections, the date of inspection and any
maintenance performed must be recorded.
d) Information Retrieval. An airport sponsor may use any form of record
keeping it deems appropriate, so long as the information and records
produced by the pavement survey can be retrieved to provide a report to
the FAA as may be required.
e) Reference: Refer to Advisory Circular 150/5380-6, "Guidelines and
Procedures for Maintenance of Airport Pavements," for specific guidelines
and procedures for maintaining airport pavements and establishing an
effective maintenance program. Specific types of distress, their probable
causes, inspection guidelines, and recommended methods of repair are
presented.
7) The Sponsor shall provide for an annual audit in accordance with Office of
Management and Budget Circular A-133. The Sponsor shall provide one
copy of the completed A-133 Audit to the FAA Airports District Office and
three copies of the audit to; Federal Audit Clearinghouse, Bureau of the
Census, 1201 10th Street, Jeffersonville, IN 47132.
FAA Form 5100-37 PG 10(10-89) Page 10 of 13
8) Financial Reporting Requirements. The Sponsor agrees to submit a Federal
Financial Report (FAA Form SF-425) for all open grants to the Airports District
Office within 90 days following the end of each Federal fiscal year and with
each Final Project Closeout Report. The sponsor further agrees to submit an
.Outlay Report and Request for Reimbursement (FAA Form SF-271) or
Request for Advance or Reimbursement (FAA Form SF-270 for non-
construction projects) to the Airports District Office within 90 days following
the end of each Federal fiscal year and with each Final Project Closeout
Report.
9) The Sponsor understands and agrees that in accordance with 49 USC 47111,
no a men totaling p y is tota g more than 90 percent of United States Government's
share of the project's estimated allowable cost may be made before the
project is determined to be satisfactorily completed.
FAA Form 5100-37 PG 11 (10-89) Page 11 of 13
The Sponsor's acceptance of this Offer and ratification and adoption of the Project
Application incorporated herein shall be evidenced by execution of this instrument by the
Sponsor, as hereinafter provided, and this Offer and Acceptance shall comprise a Grant
Agreement, as provided by the Act constituting the contractual obligations and rights of
the United States and the Sponsor with respect to the accomplishment of the Project
and compliance with the assurances and conditions as provided herein. Such Grant
Agreement shall become effective upon the Sponsor's acceptance of this Offer.
UNITED STATES OF AMERICA
FEDERAL AVIATION ADMINISTRATION
By
Carol Vii, Manager Sedgy Ie Airports District Office
Part II -Acceptance
The Sponsor does hereby ratify and adopt all assurances, statements, representations,
warranties, covenants, and agreements contained in the Project Application and
incorporated materials referred to in the foregoing Offer and does hereby accept this
Offer and by such acceptance agrees to comply with all of the terms and conditions in
this Offer and in the Project Application.
I declare under penalty of perjury that the foregoing is true and correct. Knowingly and
willfully providing false information to the Federal government is a violation of 18 U.S.0
Section 1001 (False Statements) and could subject you to fines, imprisonment or both.
Executed this o day of 2013
City o Renton, Washington
By
Attest:
Sponsor's Designated Official Representative
Title: Denis Law, Mayor
Bonnie I . Walton, City Clerk
CERTIFICATE OF SPONSOR'S ATTORNEY
I Lawrence Warren acting as Attorney for the Sponsor do hereby certify:
That in my opinion the Sponsor is empowered to enter into the foregoing Grant
Agreement under the laws of the State of Washington. Further; I have examined the
foregoing Grant Agreement and the actions taken by said Sponsor and Sponsor's official
representative has been duly authorized and that the execution thereof is in all respects
due and proper and in accordance with the laws of the said State and the Act. In
addition, for grants involving projects to be carried out on property not owned by the
Sponsor, there are no legal impediments that will prevent full performance by the
Sponsor. Further, it is my opinion that the said Grant Agreement constitutes a legal and
binding Obligation of the Sponsofrin ggcordance with the terms thereof.
Dated at - this :: � day of-z 2013.
Signature of Sponsor's Attorney
FAA Form 5100-37 PG 12=,t`10-8pc-•:..,,.,,:r ''' Page 12 of 13
A-133 Single Audit Certification Form
The Sing le. Audit Act of 19841 implemented by OMB Circular A-133 (Audits of States. Local Governments.
and Non-Profit Oroanirations)establishes audit requirements for State and local governments that receive
feiicr.il aid. State or local governntenis(City, County,Airport Board)that expend 5500,000 or more a year
(calendar or fiscal) in total federal financial assistance must conduct an audit and submit it to the Federal Audit
Clearinghouse, for more information oil the Single Audit Act requirements please reference the following web
site. lilt p:'rhar ter.ce
This notice is our request for a copy of your most recent audit, whether or not there are,any significant findings.
In accordance With your Airport Improvement Program(AIP)grant agreement,you must also provide the
following certification to your local Airports District-Office(ADO). Please fill out the information below by
checking the appropriate linc(s),sign,date, and return this form to the FAA local ADO identified at the bottom
of the Conn,
Airport 5pgpsor Information:
..........
Sp�i€i�i:�'�amti 1`iscoLt:aEe nd>ir 1 jai t:ndint
._...._
..
Srwn,oj ,Repi,e,twi mii c Name
e Rcp ctiea�ithtc a ride
_ ._.._._ ... .. ........... .................. ......_.....,
Please check the appropriate.linc(s):
❑ We are subject to the A-133 Single Audit requirements(expended.5500,000 or more in total Federal
funds for the fiscal calendar year noted above)wgj.are taking the following action:
❑ The A-133 single audit for this fiscal=calendar year has been submitted to the FAA.
❑ '['he A-133 single audit for this fiscal/calendar year is attached.
❑
The A-133 sinole audit report will be submitted to the FAA as soon as this.audit is available.
❑ We are exempt from the SingIc Audit A-133 requirements for the Iiscallcalendar noted above.
Sponsor C'ertif'ication:
Sign€ LIR' 17stc
Return to: FAA. Seattle Airports District Office
1601'Lind Avenue SW, Suite 250
Seattle. WA 98051-3356
FAA Form 5100-37 PG 13 (10-89) Page 13 of 13
• •
�1
v A-133 Single Audit Certification Form
The Single Audit Act of 1984,implemented by OMB Circular A-133 (Audits of States,Local Governments,
and Non-Profit Organizations)establishes audit requirements for State and local governments that receive
Federal aid. State or local governments(City,County,Airport Board)that expend$500,000 or more a year
(calendar or fiscal)in total Federal financial assistance must conduct an audit and submit it to the Federal Audit
Clearinghouse.For more information on the Single Audit Act requirements please reference the following web
site:bM2://harvester.census.Qov/sac/
This notice is our request for a copy of your most recent audit,whether or not there are any significant findings.
In accordance with your Airport Improvement Program(AIP)grant agreement,you must also provide the
following certification to your local Airports District Office(ADO). Please fill out the information below by
checking the appropriate line(s),sign,date,and return this form to the FAA local ADO identified at the bottom
of the form.
Airport Sponsor Information:
City of Renton 2012
Sponsor Name Fiscal/Calendar Year Ending
Renton Municipal Airport
Airport Name
Ryan Zulauf Airport Manager
Sponsor's Representative Name Representative's Title
425-430-7471 rzulauf@rentonwa.gov
Telephone Email
Please check the appropriate line(s):
X We are subject to the A-133 Single Audit requirements(expended$500,000 or more in total
Federal funds for the fiscal/calendar year noted above)and are taking the following action:
❑ The A-133 single audit for this fiscal/calendar year has been submitted to the FAA.
❑ The A-133 single audit for this fiscal/calendar year is attached.
The A-133 single audit report will be submitted to the FAA as soon as this audit is available.
❑ We are exempt from the Single Audit A-133 requirements for the fiscal/calendar noted above.
Sponsor Certificati
Signature
Dale
Denis Law,Mayor
Return to: FAA, Seattle Airports District'Officr, t test
1601 Lind Avenue SW, s4f} �254
Seattle,WA 98057-3356 Bonnie I . Walton, City Clerk