APPENDIX C

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### SMALL COMMUNITY AIR SERVICE DEVELOPMENT PROGRAM

DOCKET OST

- 2011

- 0119

SUMMARY INFORMATION

All applicants mus t submit this information with their proposal , along with a completed form SF424 on http://

www.grants.gov.



### A. APPLICANT INF ORMATION: (CHECK ALL THAT APPLY)

X Not a Consortium ⁭ Interstate Consortium ⁭ Intrastate Consortium

⁭ Community now receives EAS subsidy

X Community (or Consortium member) previously received a Small Community Grant

If previous recipient : Date of Grant: __2007

______ E xpiration date o f grant:

_________ _



### B. P UBLIC /P RIVATE P ARTNERSHIPS : (L IST ORGANIZATION NAMES )

Public Private

1. ____

_______________________________ 1.Coalition of community groups and the

Montgomery Chamber of Commerce

2._____

________________ _______________ 2.______________________________________

3.____________________________________ 3.______________________________________

4.____________________________________ 4.______________________________________

5._______

_____________________________ 5.______________________________________



### C. P ROJECT P ROPOSAL : (CHECK ALL THAT APPLY)

⁭ X Marketing ⁭ Upgrade Aircraft ⁭ X New Route

⁭ Travel Bank ⁭ Service Restoration ⁭ Subsidy

⁭ Surface Transportation ⁭ Region al Service Revenue Guarantee ⁭

X Launch New Carrier Start Up Cost Offset First Service

Study ⁭ Secure Additional Carrier Other (explain below)

_____________________________________________________________________ ____________________________

_________________________________________________________________________________ ________________APPENDIX C

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⁭



### D. E XISTING L ANDING A IDS AT L OCAL A IRPORT:

⁭ X Full ILS ⁭ X Outer/Middle Marker X Published Instrument Approach

⁭ X Localizer ⁭ X Other (specify ) NDB, GPS



### E. PROJECT COSTS: DO NOT ENTER TEXT IN SHADED AREA

LINE DESCRIPTION SUB TOTAL TOTAL AMOUNT

1 Federal amount requested $4 00,000

2 State cash financial contribution $ 80,000

Local cash financial contribution

3a Airport cash funds

3b Non

- airport cash funds $80,000

3 Total local cash funds ( 3a +3b ) $480,000

4 TOTAL CASH FUNDING ( 1+2+3 ) $480,000

In

- Kind cont ribution

5a Airport In

- Kind contribution**

5b Other In

- Kind contribution**

5 TOTAL IN

- KIND CONTRIBUTION

( 5a + 5b )

6 TOTAL PROJECT COST (4+8) $480,000



### F. IN

- KIND CONTRIBUTIONS**

For funds in lines 5a (Airport In

- Kind contribution) and 7b (Oth er In

- Kind contribution), please describe the

source(s) of fund(s) for each.APPENDIX C

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### G. IS THIS APPLICATION SUBJECT TO REVIEW BY STATE UNDER EXECUTIVE ORDER 12372 PROCESS?

⁭ a

. This application was made a vailable to the State under the Executive Order 12372 Process for review on

(date)

___________________.

⁭ b. Program is subject to E.O. 12372, but has not been selected by the State for review.

X c. Program is not covered by E.O. 12372.



### H. IS THE APPLI CANT DELINQUENT ON ANY FEDERAL DEBT? (IF “YES”, PROVIDE EXPLANATION)

⁭ No

- X ⁭ Yes (explain)

________________________________________________________________________________________________________________

___________________________ __________________ _____________________________________________