Federal Aviation Administration (FAA) - 20240604-2175 OULDEP
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STANDARD
Contract Routing Cover Sheet
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Routing Number 20240604-2175
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 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 2023 and 2024 fiscal year funds to Leadville-Lake
County 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
V. Dept. Head Signature
NOTE; Originating Department: Identify with a check mark all areas document needs to be routed.
• Purchasing
• Budget
• Sales Tax
V. CAO pp
V• City Manager �'Lm _
• Central Records
Contract Tracking Home I Signature Routing Form I Track Contract Status I Update Contract Status
Ciew
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 30, 2024
Ms. Nuria Rivera-Vandermyde
Boulder City Manager
1777 Broadway
Boulder, CO 80302
Dear Ms. Rivera-Vandermyde,
We are enclosing an electronic copy of the Airport Improvement Program (AIP) "Agreement For
Transfer of Entitlements". This agreement will transfer$150,000 of fiscal years (FY) 2023 and 2024
of Federal funds from Boulder Municipal Airport to Leadville-Lake County 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 e-mail a
copy of the agreement to your FAA Project Manager, Paulette Lugo, at paulette.lugo@faa.gov.
Sincerely,
Jesse Lyman,Acting Manager
Denver Airports District Office
Enclosures
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 LOCID): Boulder Municipal Airport ( BDU )
for each fiscal year listed below:
Entitlement Type
(Passenger, Cargo or Fiscal Year Amount
Nonprimary)
Nonprimary 2023 $ 14,925.00
Nonprimary 2024 $ 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:
Leadville-Lake County Airport ( LXV )
Name of Receiving Airport's Sponsor: Lake County, 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 09/30/2024 (date)or when the availability of
apportioned funds lapses under 49 USC §47117(b).
For the United States of America, Federal Aviation Administration:
J E S S E A LY M A N Digitally signed Date:2024 05.30y
Signature: 14:51:54-06'00'
Name: Jesse Lyman
Title: Acting Manager, Denver Airports District Office
Date: 05/30/2024
FAA Form 5100-110(8/20)SUPERSEDES PREVIOUS EDITION Page 1
Certification of Transferring Sponsor
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 5th day of June 2024
Name of Sponsor: City of Boulder, Colorado
Name of Sponsor's Authorized Official: Nuria Vandermyde-Rivera
Title of Sponsor's Authorized Official: City Manager
Signature of Sponsor's Authorized Official:
Certificate of Transferring Sponsor's Attorney
I, , 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 (City, State),
this day of
Signature of Sponsor's Attorney:
FAA Form 5100-110(8/20)SUPERSEDES PREVIOUS EDITION Page 2