Item 12 - King Street Urban Greening Project

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December 6, 2022 Page 2 The Federal Employer Identification Number (FEIN #) can be listed on this form. If the SSN# is listed instead, please black this out, and once the form is received, Payee Data Records will call the requestor for the Social Security Number. For Section 2, Tribes should check "EXEMPT", and local agencies (e.g., Cities and Counties) should check "ALL OTHERS". Section 6 should contain the following information. Sartinn R _ Pavinn State Ananry STATE AGENCY/DEPARTMENT OFFICE UNIT/SECTION Deptartment of Transportation / Division of Local Assistance Office of Clean California Local Grant Program MAILING ADDRESS FAX TELEPHONE (include area code) 1120 N. Street CITY STATE ZIP CODE E-MAIL ADDRESS Sacramento CA 95814 CleanCA.LocalGrant@dot.ca.gov • A Board, City Council, or Tribal Government resolution (or similar approval document) approving the project and authorizing the agency/tribe to execute the restricted grant agreement with the State of California, Department of Transportation. A sample resolution has been sent with this letter that you can complete with your agency or tribe's information and present to your agency/tribe. Note, some local agencies have a blanket resolution authorizing it to receive state funds and identifying specific managers to sign contracts up to a certain dollar amount. If that applies to your agency/tribe, you can provide this blanket resolution that authorizes the person signing the RGA instead. In general, if you have an existing resolution that you would like to use instead of the sample resolution provided, please reach out to your District Grant Manager to confirm that it meets the criteria for an agency or tribal resolution. • If requesting reimbursement for indirect costs, an approval letter(s) of the indirect cost rate for the fiscal year(s) that your agency/tribe will be claiming indirect costs from either Caltrans or the federal cognizant agency must be provided. See page 15 of the Program Guidelines and the Independent Office of Audits and Investigations website for details: https://ig.dot.ca.gov/resources. To ensure the success of your project, please note the following: • The Clean California Local Gran Program (CCLGP) homepage is located here: https://cleancalifornia.dot.ca.gov/local-grants/local-grant-program. Resources, including the Program Guidelines, are available to applicants from this main page. Please re -familiarize yourself with the Grant Guidelines as they will be included in the RGA package as an attachment. • Prior to executing the RGA, if preconstruction work was not included in Attachment C (Scope of Work, Cost, and Project Schedule Workbook for Infrastructure Projects) as a participating cost, please ensure you have completed all applicable environmental clearances such as CEQA or NEPA. Also, verify that "Provide a safe and reliable transportation network that serves all people and respects the environment"