W. Va. Code R. agency 220, tit. 220, ser. 220-02, app A
DATE
Commissioner of the DMTF
West Virginia Department of Transportation
Bldg. 5, State Capitol Complex
1900 Kanawha Blvd. E.
Charleston, WV 25305
Dear Commissioner:
The (NAME OF APPLICANT) hereby submits an Application for ($##,#### THE AMOUNT BEING APPLIED FOR) in SFY (YEAR) Grant Funds under the Matching Funds Grant program for use at the (NAME OF APPLICANT). The Grant Funds will be used [FOR Direct Grant: DESCRIBE PROPOSED SPENDING AND SKIP TO INCLUDED DOCUMENTS SECTION BELOW / FOR MATCHING GRANT CONTINUE] in conjunction with (FAA / AIP or BIL Grant ##-####-YYYY-###) for (DESCRIBE IN DETAIL THE PROPOSED PROJECT(S)). The amount requested from DMTF represents (2.5 / 5%) of the total eligible project cost. The Applicant will be responsible for 100% of any or all non-eligible items. The final eligible project breakout would be (90% FAA, 5% local share and 5% DMTF OR 95% FAA, 2.5% local share and 2.5% DMTF) subject to the program:
Total project value: $__________________
Total eligible project value: $__________________
FAA share (90 OR 95%): $__________________
Applicants share (2.5 or 5%): $__________________
DMTF share (2.5 or 5%): $__________________
The following documents have been included:
* A copy of a resolution from (GOVERNING BODY) authorizing the submission of this application.
* Signed copy of the Grant Application
* Copy of the executed FAA Grant. * A copy of the most recent Audit Report for Applicant
Should you have any questions or need further information, please contact (LOCAL CONTACT PERSON, ADDRESS, E-MAIL ADDRESS AND TELEPHONE NUMBER).
Respectfully,
SIGNATURE
NAME/TITLE
W. Va. Code R. agency 220, tit. 220, ser. 220-02, app A