Federal Aviation Administration (FAA) - 20230209-0030 OULDEP
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STANDARD
Contract Routing Cover Sheet
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Routing Number 20230209-0030
Originating Dept PW -Transportation & Mobility
Contact Person John Kinney Phone Number 303-441-4194
Project Manager / Contract John Kinney E-mail kinneyj@bouldercolorado.gov
Administrator
Counter Parties Federal Aviation Administration
Contract Title / Type Airport Improvement Program Agreement for Transfer of Entitlements
Number OMB Control Number 2120-0569
Description By this agreement, the city waives receipt of federal funds apportioned to the Boulder Municipal
Airport. The agreement transfers $150,000 of 2022 and 2023 fiscal year funds to Wray Municipal
Airport.
Special Instructions City Manager signs before City Attorney. Please email the executed e-copy to
kinneyj@bouldercolorado.gov and lopezr@bouldercolorado.gov.
Amount 150,000.00 Expense Type OUTGOING
• Dept. Head Signature
NOTE; Originating Department: Identify with a check mark all areas document needs to be routed.
• Purchasing
• Budget
• Sales Tax
V CAO ltl M
City Manager
Central Records
Contract Tracking Home I Signature Routing Form I Track Contract Status I Update Contract Status
U.S.Department of Transportation OMB CONTROL NUMBER 2120-0569
Federal Aviation Administration EXPIRATION DATE 6/30/2023
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 §47114(c)for
the: Name of Transferring Airport (and LOC1D): Boulder Municipal Airport ( BDU )
for each fiscal year listed below:
Entitlement Type
(Passenger,Cargo or Fiscal Year Amount
Nonprimary)
Nonprimary 2022 $ 14,925.00
Nonprimary 2023 $ 135,075.00
Total $ 150,000.00
The Federal Aviation Administration has determined that the waived amount will be made available to.
Name of Airport(and LOCID) Receiving Transferred Entitlements:
Wray Municipal Airport ( 2V5 )
Name of Receiving Airport's Sponsor: City of Wray, 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 09/30/2023 (date)or when the availability of
apportioned funds lapses under 49 USC§47117(b).
For the United States of America, Federal Aviation Administration:
J O H N P BAU E R Digitally signed by JOHN P BAUER
Signature: Dale:2023.02.03 09:51:26-05'00'
Name: John P. Bauer
Title: Manager, Denver Airports District Office
Date: 02/03/2023
FAA Form 5100-110(8/20)SUPERSEDES PREVIOUS EDITION Page 1
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 this 21 day of February, 2023 ,
Name of Sponsor: City of Boulder, Colorado
Name of Sponsor's Authorized Official:
Title of Sponsor's Authorized Official:
Signature of Sponsor's Authorized Official:
Certificate of Transferring Sponsor's Attorney
I. Lucas Markley , acting as Attorney for the Sponsor do hereby certify
that in my opinion the Sponsor is 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 10 a.m. (City, State),
this 24thday of February
Signature of Sponsor's Attorney, Boulder Colorado
FAA Form 5100-110(8120)SUPERSEDES PREVIOUS EDITION Page 2