ijM??.:,:i , 

'"'f'^Fi'' 

.UM 

,;; -<it#"' 

•J 

P.O. BOX 539 

MILE 1313 ALASKA HIGHWAY 

TOK, ALASKA 99780 

907-883-5191 

FAX-907-883-5194 

Fairbanks lnti Airport 

6450 Airport Way Suite 20 

Fairbanks, Alaska 99709 

907-474-0018 

FAX - 907-474-8954 

Proposal to Provide Essential Air Service 

At Chisana, Alaska 

Docket GST 1998-4S74 

February 17, 2012 

Route TKJ-CZN-TKJ 

Frequency: 2 Round Trips per Week 

Aircraft Type: Cessna 185(3 seats), 206 or 207(4 seats) 

Annual Block Hours 1 190.7 

r .'1 

"'!-:(:; ;x) 

Revenue 

Passenger 

Cargo 

Space Available Cargo 

Mail 

Total Operating Revenue 

Direct Ooeratini! Expenses 

Pilot & Copilot 

Fuel & Oil 

Maintenance 

Depreciation 

Insurance 

Agent fee 

Total Direct Operating Expenses 

Rate 2 

$97.67 

$ ,42 

$ .16 

$ .891988 

Unit cost 

$96.00 per BH 

$102.00 per BH 

$93.00 per BH 

$22.85 per BH 

$47.25 per BH 

Anr»t/ibs. 

95 

2,000 

26,000 

8,000 

$20.00 per CZN dept. 

Indirect Operating Expenses @ 40% of Direct Net of Depreciation 

Total Operating Expenses 

Operating Loss 

Profit Element @5% of Total Operating Expenses 

Subsidy Need (S>100% 

Revenue 

$9,278.65 

$ 840.00 

$4,160.00 

$ 7.135.90 

$21,414.55 

Expense 

$18,307.20 

$19,451.40 

$17,735.10 

$ 4,357.495 

$9,010.58 

$ 2.080.00 

$70,941.78 

$26,633.71 

$97,575.49 

$76,160.94 

$4,878.77 

$81,039.71 

l_Block hours = (TKJ - CZN -TKJ, 1.83 hours) x 2 flights/week x 52 = 190.7 hours 

2.Passenger and Cargo Rates Before Excise Tax 

AIR SCHEDULED, AIR CHARTER IN ALASKA & CANADA, WHEELS, SKIkS, FLOATS, 

PACKAGE HUNTS. FLY-IN FISHING, FLIGHTSEEING, BULK FUEL HAULING 
IMTU ) SIA I FS OF AMKUIC A 

DFPARTMEN r OF TRANSPORTAHON 

OFFK R OF IMF SK( RF f.ARY 

OFFICE OF AVIATION ANALVSl.S 

flTLE VI ASM RANCE 

(Implementinu Fitlc VI of the Civil Ri(>hts .Vet of 1%4, a.s amended) 

ASSURANCE CONCERNING; NONDISCRIMINATION ON HIE 

BASIS OF DISABILITY IN FEDERALLY-ASSISTED PROGRAMS 

AND ACTIVITIES RECEIVING OR BENEFITING FROM 

FEDERAL FINANCIAL ASSISTANCE 

(Implementing the Rehabilitation Act of 1*>73. u.s amended, and the 

\ ir Carrier .Access Act of 1«)86) 

49 CFR Parts 21 and 27 and 14 CFR Parts 271. and 382 

'^C-'^'^^- '' ^ /.^'- "' (• ^^<- ^ ' "^-^ - l.-M^^^'^ KccipiciU) ilHRHBY A(iRhF;S TliAi. 

(Name of Recipient) 

I. As a coiuiiiion to receiving any |-cdcnii linancial a.ssistancc from the 

rx^panmcnt ofT'ransportation. it will comply: with lillc Vi olthc Civil Rights .Vet oi' 1904. 

as amended. 42 U.S.C. 2000d—42 IJ.S.C. 2()()()d-4: all requirements imposed by i)r pursuant 

to: Title 49, Code of Federal Regulations. Part 21. Nondiscrimination in Federally-Assisted 

Programs of the Department ot'! ransportation-hlTectualion of Fille VI ot'the Civil Rights 

Act of 1964; and other pertinent directives so that no person in the United Slates shall, on the 

grounds of race, color, or national origin, be excluded iVom participation in, be denied the 

benefits of, or be otherwise subjected to discrimination under any program or activity lor 

which the Recipient receives Federal llnancial assistance trotn the Department ot" 

Trattsportation. I'his a.ssurdnce is required by I itie 49, Code ol" Federal Regulations, ^ection 

21.7(a) and Title 14. Code of Federal Regiilalii)ns. section 271.9(c). 

II. As a condition to receiving any I eder;tl tinancial ;isj>islance ii'om the 

Department of Transportation, it will comply with: section iiH of the Rehabilitaticui Act o\' 

1973. as amended (29 li.S.C. 794): the Air Carrier Access Act ot 1986 (49 L.S.C. 1374(c)); 

and all requirements im|.X)sed by or pursuant to T itIe M. Code t)f Federal Regulations. Part 

27. Nondiscrimination on the Basis of Handicap in Programs and Activities Receiving uv 

Benefitting from Federal Financial Assistance. Title 14, Code of Federal Regulations. Part 

382, Nondiscrimination on the Basis of Handicap in .Air 1 ravel; and other pertinent directives 
so that no otherwise qualilied person w ith a disiibility, Ix; excluded from participation in. be 

denied the benefits of. be diseriminateti against by reasiMi of such handicap in the pt\)vision 

(.if air tninsportation, or otherwise be subjected to discrimination under any program for 

which the Recipient receives Federal linancial a,ssisiaiice from the Department of 

'Transportation. This assurance is required by Title 49. Cotle of Federal Reguiatit)ns. section 

27.9 and Title 14. CcKie of Federal Regulation.s. ^ections 271.9(c) and 382.9. 

HI. It will promptly take any meaures necessary to cflectuate this agreement. The 

Recipient further agrees that it shall take reasonable actions to guarantee that it. its 

contractors ;ind subcontractors subject to the Department of Transportation regulations cited 

above, transferees, and successors in interest will comply with all requirements imposed or 

pursuant to the statutes and Department ot Transp<,M-tation regulations cited above, other 

pertinent directives, and the above assurances. 

IV. These assurances obligate the Recipient tor the period during which Federal 

tinancial assistance is extended. The Recipient agrees that the United States has a right to 

seek judicial enforcement with regard to any matter arising under the statutes and Department 

of Transpt)rtation regulations cited above, other |->ertinent directives, and the aU)ve 

assurances. 

V. Tliesc assurances are given for the purpose of obtaining Federal subsidy 

under the Essential Air Service Program and are binding on the Recipient contractors, 

subcontractors, transferees, successors in interest, and all odier participants receiving Federal 

subsidy in the Essential Air Service Program. I he person or persons whose signatures 

appear below are authorized to sign this agreement on behalf of the Recipient. 

VI. In addition to these assurances, the Recipient agrees to tile: a summary ol'all 

complaints tiled against it within the pa.st year that allege violation(s) by the Recipient of 

Title VI of the Civil Rights Act of 1964. as amended, section 504 of the Rehabilitation Act of 

1973, as amended, or the Air Carrier Access .Act of 19,S6: or a statement that there have l)ecn 

no coinpiainLs tiled against it. I he sumtnarv should include the date the complaint was (tied, 

the nature of the complaint, the status or outcome of the complaint (Te^. whether it is still 

|x:nding or how it was resolved). 

• . ,.••'• • \ 

Dale Legal Name ol Recipient 

Bv: 

Signature ol Authorized Otiicial 
IJNII El) STATES OF AMERICA 

DEPARTMENT OF FRANSPORF VFION 

OFFICE OF THE SECRE FARV 

OFFICE OF AVIAHON ANALYSIS 

CERTIFICATION RE(;ARI)IN< ; INELl KN ( LNG AC FIVI IIES 

Certification for Contracts, (irants. Loans, 

and Cooperative .\{»rceaicnts 

The undersigned certifies, to the best of his or her know ledge and belief thai: 

(1) No Federal appropriated funds have lx:en paid or will be paid, by or on behalf of the 

undersigned, to any person for inlliiencing or attempting to inlluence an olllcer or employee 

of any agency, a Member of Congress, an officer or employee of Congress, or an employee 

of a Mcinber of Congress in connection with the awarding of any Federal contnicL the 

making of any Federal grant the tnaking of any Federal loan, the entering into of anv 

cooperative agreement and the extension, continuation, renewal, amendment or 

modification of any Federal contract, grant, loan, or coo(x:raiive agreement. 

(2) If any funds other than Federal appropriated funds have been paid or will be paid to any 

person for influencing or attempting to inlluence an ofilccr or employee of any agency, a 

Member of Congress, an officer or employee of Congress, or an employee of a Member of 

(^^ongress in connection wilh this Federal contract granL loan, or coitperalive agreement, the 

undersigned shall complete and submit Standard Fonii-T 1,1 . "Disclosure lonn to Report 

Influencing Activities," in accoixlance wilh its instructions. 

(3) The undersigned shall require that the language of this certification be included in the 

award documents for all subawards at all tiers (including subcontracts, -^ubgranls. and 

contracts under grants, loans and ccx^perative agreements) and that all siibrecipients shall 

certify and disclose accordingK. 

This certification is a material representation of"fact upon which reliance was placed when 

ihis Iransiiction was made or entered into. Submission of this certillcation is a prerequisite 

for making or entering into this trtuisaction imposed by section 1352. title 31. I .'.S. Code. 

Any person who fails to tile the requireil certillcation .shall be subject to a civil penally otnot 

less than SI0.000 and tiot more than .SI00.000 for each such laikire. 

Signature 

•'^/••. -

Title 

, • • i . {. ' '. 

•> ' i ' 

•'... / 

,; ,,^----

. . . •'••- > .•'• -

,'' 

• 

/ ^ / 

I ):ite 

\ii' (. arrier 

Fssential Aif Service Point(s) To Which ( cnitkation Applies 
I NFI El) S FA FES OF AMERK A 

DEPARFVIENTOF IR.ANSPORI.VriON 

OFFIC E OF FIIE SEC RE lARV 

OFFIC E OF AVIA riON ANALYSIS 

CERTiFic:Ari<)N RE(;ARDINC; DRI C;-FREE WORKPLAC E REQLIREMENI S 

IN THE PERFORMANCE OF SLIJSIDIZEl) ESSENTIAL AIR SERVICE 

.A. The subsidized essential air service carrier certifies that it w ill. or will continue, to provide a drugfree workplace by: 

(a) Publishing a statement notifving einplovees thai the unlawful manufacture, distribution, 

dispensing, possession or use of a controlled substance is prohibited in the carrier's workplace, and 

specifying the actions that will be taken against employees for violation of such prohibition; 

(b) Establishing an ongoing drug-free awareness program to inform emplovces ;ibout-

(1) The dangers of drug abuse in the workplace; 

(2) The grantee's policy of maintaining a drug-free workplace; 

(3) Any available dmg counseling, rehabilitation, and employee assistance programs; and 

(4) The penalties that may Ix; imposed upon emplovces for drug abu.se violations 

*iccurring in the workplace; 

(c) Vlaking it a requirement that each empknee to be engaged in the pertl)rm;ince o i work 

supported by the subsidy be given a cv\i\ of the statement required bv paragraph (a): 

(d) Notifying the emplovee in the statement required by paragraph (a) that, as a condition o f 

employment supported by the subsidy, the etnployee will— 

(1) Abide by the temis o f ihe statement; and 

(2) Notify the employer in writing o f his or her conviction for a violation of a criminal 

drug statute occurring in the workplace no later than five calendar d:iys after such 

ci.>nviction; 

(e) Notifying the agency in writing, within ten calendar days alter receiving notice under 

jxiragraph (d)(2) trom an employee or otherwise receiving acttiai notice of conviction, 

fimployers of convicted employees must provide notice, including posititin title, to the 

Office o f Aviation Analysis. Notice shall include the order number of each affected 

subsidized service; 

(t) I'aking one of the following actions, within 30 days of receiving notice under paragraph 

(d)(2), with respect to any emplovee who is --o convicted--

(1) faking appropriate fX'rsonnel action against such an emplovee. up to and including 

termination, consistent with tiie requirements ol the Rehabilitation Act of 197!i. ;is 

amended, or 

(2) Requiring such employee to participate salisliicioriiv in a drug abuse assistance or 

rehabilitation program approved for such purposes by a Federal. Slate or ItKal 

health, law cntbrcement or other appropriate auencv; 
(g) Making a good faith efTort to continue to maintain a drug-free workplace through 

implementation of paragraphs (a), (b), (c), (d), (e) and (f). 

B. The subsidized essential air service carrier may. but is not required to, insert in the space provided 

below the site for the performance of work done in connection with the specific grant. 

Places of Performance (street address, city, county, state, zip code). For the provision of essential air 

service, workplaces include outstations, maintenance sites, headquarters office locations, training sites 

and any other worksites where work is performed that is supported by the subsidy. 

-A 

y^ V'O^i/e / C y-i J^;^iLrt/^s ^Z^-/ />C:^^^//-

Check I j if there are workplaces on file that are not identified here. 

? ,^y 

Signature '' Date 
INSTRUCTIONS FOR CERTIFICATION 

1. By signing and/or submitting this application or grant agreement the .subsidized essential air service 

carrier is providing the certification. 

2. The certification is a material repre.sentation of fact upon which reliance is placed when the agency 

awards die subsidy. If it is later determined that the subsidized carrier knowingly rendered a false 

certification, or otherwise violated the requirements of the Drug-Free Workplace Act, the agency, in 

addition to any other remedies available to the Federal Government, may take action authorized under 

the Drug-Free Workplace Act. 

3. Workplaces under grants, for grantees other than individuals, need not be identified on the 

certification. If known, they may be identified in the subsidy application. If the subsidized carrier does 

not identify the workplaces at the time of application, or upon award if there is no application, the 

carrier must keep the identity of die workplaces on file in its office and make the information available 

for Federal inspection. Failuiie to identify all known workplaces constitutes a violation of the 

subsidized carrier's drug-free workplace requirements. 

4. Workplace identifications must include the actual address of buildings (or parts of buildlng.s) or 

other sites where work under the grant takes place. Categorical descriptions may be used (^.;?., all 

counters at the airports served by the carrier). 

5. If the workplace identified to the agency changes during the performance of the subsidized service, 

the subsidized carrier shall inform the agency of the change, if it previously identified the workplace in 

question. 

6. Definitions of terms in the Nonprocurement Suspension and Debarment common rule (49 CFR Part 

29) and Drug-Free Workplace common rule (49 CFR Part 29, Subpart F) apply to this certification. 

Carriers' attention is called, in particular, to the following definitions from these rules: 

Controlled substance means a controlled substance in Schedules I through V of the Controlled 

Substances Act (21 USC 812) and as further defined by regulation (21 CFR 1308.11 through 1308.15); 

Conviction means a finding of guilt (including a plea of nolo contendere) or imposition of sentence, or 

both, by any judicial body charged with the resp<?nsibility to determine violations of the Federal or 

Slate criminal drug statutes; 

Criminal drug statute means a Federal or non-Federal criminal statute involving the manufacture, 

distribution, dispensing, use, or possession of any controlled substance; 

Employee means the employee of a subsidized carrier directly engaged in the performance of work 

supported by the subsidy, including; (i) All direct charge employees: (ii) All indirect charge 

employees unless their impact or involvement is insignificant to the performance of subsidized service; 

and (iii) Temporary personnel and consultants who are directly engaged in the performance of work 

supptirted by the subsidy and who are on the subsidized carrier's payroll. This definition docs not 

include workers not on the payroll of the subsidized carrier (e.g., volunteers, even if u.sed to meet a 

matching requirement; consultants or independent contractors not on the subsidized carrier's payroll; or 

etnployees of subrecipients or subcontractors in covered workplaces).