Attachment 7: Sponsor Certification for AIP Grant Closeout
(Sponsor’s Final Project Report for Grant Closeout)
Sponsor’s Name / Airport / AIP Grant NumberProject Description
Section 47105(d) of the Federal Aviation Reauthorization Act of 1996, as amended (herein called the Act), authorizes the Secretary to require certification from sponsors that they will comply with statutory and administrative requirements. The following list of certified items includes major requirements for this aspect of project implementation. However, the list is not comprehensive, nor does it relieve sponsors from fully complying with all applicable statutory and administrative standards. Every certified item must be marked. Each certified item with a "no" response must be fully explained in an attachment to this certification. If the item is not applicable to this project, mark the item as “N/A”. General Standards for AIP Grant Closeouts are available through FAA Order 5100.38C, the Airport Improvement Handbook.Pursuant to the provisions of Section 509(d) of the Airport and Airway Improvement Act of 1982, I hereby certify that:
1. The Final Payment Summary Request Worksheet (dated ______) has been submitted.
2. The Final Pay Request SF-271 Form (dated ______) has been submitted (except for letter-of-credit grants).
3. The DBE Requirements have been met:
a. Original DBE Goal: ______%
b. Actual DBE Utilized*: ______%
*NOTE: If DBE Goal was not met, please describe how Good Faith efforts were made.
4. The List of Grant Special Conditions and Compliance with Each has been submitted, (dated ______).
5. The Final Project Report is attached, (dated ______) (For Construction and Building Grants only).
This is a brief project summary. Include the following items as applicable:
a. Project History with significant events during the life of the project identified.
b. Discuss Significant Dates as appropriate (e.g.—Bid Opening, Award of Contract, Construction Start, Construction Complete, Final Inspection, Final Payment, etc.)
c. Discuss Significant Change Orders and Significant Changes in Quantities
6. The Materials Certificate has been submitted (dated ______).
7. Final As-Built Drawings have been provided on CD. (date, if applicable: ______).
8. The As-Built, Revised, or Updated ALP has been submitted to the FAA, (dated/submitted ______) and has been verified with the 5010 Airport Master Record Data and Sketch. ( Y / N )
9. The 5010 Airport Master Record and Sketch have been updated. ( Y / N )
a. Date updated or submitted: ______
10. Equipment: The Inventory of Non-Expendable Personal Property document(s) is/are attached. ( Y / N )
I further certify that, for the project identified herein, the responses to the forgoing items are correct as marked, and that the attachments, if any, are correct and complete.
Sponsor’s Authorized Representative (Signature) /