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Federal Aviation Administration (FAA) - 20190624-5603 Contract Tracking> Thank You Page 1 of 2 BOULDER set, -n -a n il I STANDARD OFFICE OF THE CITY ATTORNEY Contract Routing Cover Sheet JUN 2 6 2019 Please print and attach to your document T0: You can view the status of your contract using the Contract Tracking Status Page. Routing Number 20190624-5603 Originating Dept Public Works Contact Person Denis Godfrey Phone Number 303-441-3108 Project Manager/Contract Denis Godfrey E-mail godfreyd2@bouldercolorado.gov Administrator Counter Parties US Department of Transportation, Federal Aviation Admin. Contract Title/Type Agreement for Transfer of Entitlements Number 2120-0569 Description the City of Boulder,sponsor of the Boulder Municipal Airport,transfers or loans It's FAA 2018 AIP non-primary entitlement(NPE)to the Cortez CO Municipal Airport for use In a 2019 AIP project. Cortez will In tum transfer It's 2019 NPE to Boulder for a 2020 airport Improvement project Special Instructions kJe 11(e c W ci140-c1 1 ztra c,Pie�, bac k , pI ek ie !t 1 Amount 150,000 Expense Type 00-1 Dept.Head Signature NOTE;Originating Department:Identify with a check mark all areas document needs to be routed. J- N �—J8fe5Td7r -O _ O CAO r— 1 © City Manager CJS O. Central Records ZC: fv CID https://work.bouldercolorado.gov/ContractTracking/ser-vlet/Controller 6/24/2019 1 Q U.S. Department Northwest Mountain Region Denver Airports District Office of Transportation Colorado• Idaho • Montana• Oregon Utah 26805 E.68th Ave., Suite 224 Federal Aviation Washington •Wyoming Denver, CO 80249 Administration May 2,2019 Mr.Denis Godfrey,Manager Boulder Municipal airport 3327Airport Road Boulder, Colorado 80301 Dear Mr. Godfrey; Enclosed are three copies of the Airport Improvement Program(AIP)"Agreement For Transfer of Entitlements." This agreement will transfer$150,000 of fiscal years 2018 AIP funds from Boulder Municipal Airport to Cortez Municipal Airport. Please complete this agreement by having the authorized officials execute the appropriate sections. Certification by the attorney should be completed following the acceptance and dated on or after the acceptance date. Your normal procedures for accepting documents such as this in accordance with local and state law should be followed, but evidence of such procedure is not required by the Federal Aviation Administration. After execution and certification of the"Agreement For Transfer of Entitlements," please return two copies to this office. The other copy is for your records. Sincerely, y Marc C. Miller,Acting Manager Denver Airports District Office Enclosures US Department of Transportation OMB CONTROL NUMBER:2120-0569 Federal Aviation Administration EXPIRATION DATE:8/3112019 Request for FAA Approval of Agreement for Transfer of Entitlements In accordance with 49 USC§47117(c)(2), Name of Transferring Sponsor: City of Boulder, Colorado hereby waives receipt of the following amount of funds apportioned to it under 49 USC§47117(c)for the: Name of Transferring Airport(and LOCID): Boulder Municipal Airport(BDU) for each fiscal year listed below: Entitlement Type (Passenger,Cargo or Fiscal Year Amount Nonprlmary) NP 2018 $150,000 Total $150,000 The Federal Aviation Administration has determined that the waived amount will be made available to: Name of Airport(and LOCID)Receiving Transferred Entitlements: Cortez Municipal Airport(CEZ) Name of Receiving Airport's Sponsor: City of Cortez, Colorado a public use airport in the same state or geographical areas as the transferring airport for eligible projects under 49 USC§47104(a). The waiver expires on the earlier of September 30, 2019 or when the availability of apportioned funds lapses under 49 USC§47117(b). For the United states of America,Federal Aviation Administration: Signature: Name: Marc C. Miller Title:Acting Manager, Denver Airports District Office Date:May 2, 2019 FAA Form 5100-110(1117)SUPERSEDES PREVIOUS EDITION Page 1 of 2 • y Certification of Transferring Sponsor I declare under penalty of perjury that the foregoing is true and correct. I understand that knowingly and willfully providing false information to the federal government is a violation of 18 USC§ 1001 (False Statements)and could subject me to fines, imprisonment, or both. Executed on thisJ 1 day of 2019 Name of Sponsor: City of Boulder, Colorado Name of Sponsor's Authorized Official: C 16,n 60 1A C Title of Sponsor's Authorized Official: I ,V 1 r - Signature of Sponsor's Authorized Official: �J ✓✓ Certificate of Transferring /Sponsor's Attorney L I, -(/GG S acting as Attorney for the Sponsor do hereby certify that in my opinion the Sponsor empowered to enter into the foregoing Agreement under the laws of the state of Colorado. Further, I have examined the foregoing 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 49 USC§47101, et seq. Dated at ���d� , co (City, State), this day of 2019 i Signature of Sponsor's Attorney: t FAA Form 5100-110(1117)SUPERSEDES PREVIOUS EDITION Page 2 of 2