MA-1047 Port_Facility_Conveyance_Information

OMB No.  2133‐0524
Expiration Date:  7/31/2022
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estimate or any other aspect of this collection of information, including suggestions for reducing this burden to:  Information Collection 
Clearance Officer, Maritime Administration, MAR‐390, 1200 New Jersey Avenue, SE, Washington, DC 20590. 

APPLICATION FOR CONVEYANCE OF PORT FACILITY PROPERTY

APPLICATION is hereby made to the Secretary of the Department of Transportation, acting by
and

through

the

Maritime

Administrator,

______________________________,

a

Maritime

Administration

(“Secretary”)

_______________________________

by

located

the
in

_________________________ (“Applicant”) for conveyance to it, under and pursuant to the power and
authority provided by the National Defense Authorization Act for Fiscal Year 1994, as amended [Public
Law 103-160 at Section 2927, dated November 30, 1993]; the Federal Property and Administrative
Services Act of 1949, as amended (“Property Act”) at 40 U.S.C.A. 554; the Federal Management
Regulation System [41 CFR 102-2]; the Utilization and Disposal of Surplus Federal Real Property for
Development or Operation of a Port Facility Regulation, [Title 46 CFR, Part 387]; and upon the terms,
reservations, restrictions and conditions herein set forth, of surplus Federal real property consisting of
portions of the Federal installation generally known as the ______________________________________
located in or near ___________________________________, in ________________________________,
as more particularly described in Schedule A to this Application and incorporated in the Port Facility
Redevelopment Plan (“PFRP”) (Schedule C) hereto, including certain related personal property described
in Schedule B hereto. All real and personal property identified in Schedules A and B are hereinafter
referred to as the port facility (“Port Facility”). The conveyance is in perpetuity so long as the property is
used in the development or operation of a port facility.

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TERMS AND CONDITIONS
1. ENTIRE AGREEMENT. This Application and any Quitclaim Deed or deeds (“Deed(s)”),
to be executed by the Secretary and the Applicant, shall constitute the entire agreement
between the Applicant and the Secretary unless modified in writing and signed by both
parties.

2. COVENANT AGAINST CONTINGENT FEES. The Applicant warrants that no person or
selling agency has been employed or retained to solicit or secure acceptance of this
Application upon an agreement or understanding for a commission, percentage, brokerage, or
contingent fee, excepting bona fide employees or established commercial or selling agencies
maintained by the Applicant for the purpose of securing business. For breach or violation of
this warranty, the Government of the United States of America (“Government”) shall have
the right to annul this Application without liability, or in its discretion, to require Applicant to
pay to it the full amount of such commission, percentage, brokerage, or contingent fee.

3. CONVEYANCE OF THE PORT FACILITY. This Application sets forth the terms,
reservations, restrictions and conditions to be included in any Deed(s) affecting the final
disposition of the Port Facility. This Application also contains information required by the
Secretary to access the need for the requested surplus Federal property. Upon (1) compliance
with the requirements of Section 120 of the Comprehensive, Environmental Response,
Compensation and Liability Act of 1980, as amended (CERCLA) [42 U.S.C.A. §9620]
(“CERCLA 120”) (2) assignment of the property to the Secretary by the Administrator,
General Services or the Secretary of Defense, in the case of property located at a military
installation closed or realigned pursuant to a base closure law (“Disposal Agency”) and (3)
other requirements, the Secretary shall, by Deed(s) convey to the Applicant all of its rights,
title and interest in and to the Port Facility, and the Applicant shall accept the conveyance or
conveyances.

4. CONDITION OF THE PORT FACILITY. It is understood and agreed that the Port
Facility shall be conveyed “as is, where is” without any warranty or guarantee, expressed or
implied, of any kind or nature, except as otherwise expressly stated in Section 5 below, and
the Federal agency which has accountability for the property involved (“Holding Agency”),
Disposal Agency and the Secretary shall not be responsible for any liability to the Applicant
or third person arising from such condition of the property. The failure of the Applicant to
fully inspect the Port Facility or to be fully informed as to the condition thereof shall not
constitute grounds for any noncompliance with the terms, reservations, restrictions and
conditions terms of any Deed(s).

5. DEED(S), COVENANTS AND CONDITIONS. Any Deed(s) conveying the Port Facility
to the Applicant shall be in form and substance satisfactory to the Secretary, without
warranty, expressed or implied, except that any Deed(s) conveying real property on which
hazardous substances were stored for one year or more, known to have been released, or
disposed of shall contain, as covenants running with the land and binding on the Government,
the covenants required by 42 U.S.C.A. §9620(h)(3) as described in subsection 5a(i) below,
and any Deed(s) conveying real property identified by the Holding Agency and/or Disposal

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Agency pursuant to and in accordance with 42 U.S.C.A. §9620(h)(4) as real property on
which no hazardous substances and no petroleum products (or their derivatives) were stored
for one year or more, known to have been released, or disposed of shall contain, as covenants
running with the land and binding on the Government, the covenants required thereby, as set
out in subsection 5a(ii) below. Any Deed(s) also shall contain covenants running with the
land which require the observance by the Applicant of the terms, reservations, restrictions,
and conditions contained below in Sections 5b to 5aa inclusive; except that the provisions of
subsections 5b(i) and 5b(ii) below shall be included in the Deed(s) as conditions subsequent
rather than as covenants.
a. Information and Covenants Pursuant to 42 U.S.C.A. §9620(h)
i. 42 U.S.C.A. §9620(h)(3). If any hazardous substance was stored for one
year or more, known to have been released, or disposed of, on the real
property, each Deed(s) entered into for the conveyance of such property by
the Government to any other person or entity shall contain, pursuant to 42
U.S.C.A. §9620(h)(3), the following:
1. To the extent such information is available on the basis of a complete
search or the Holding Agency and/or Disposal Agency files, (i) a
notice of the type and quantity of such hazardous substances; (ii)
notice of the time at which such storage, release, or disposal took
place; and (iii) a description of the remedial action taken, if any; and
2. If the Applicant is not a potentially responsible party with respect to
the real property, a covenant warranting that (i) all remedial action
necessary to protect human health and the environment with respect
to any such substance remaining on the property has been taken
before the date of such conveyance, and (ii) any additional remedial
action round to be necessary after the date of such conveyance shall
be conducted by the Government.
3. A clause granting the Government access to the property in any case
in which remedial action or corrective action is round to be necessary
after the date of such conveyance.
ii. 42 U.S.C.A. §9620(h)(4).
1. Pursuant to Section 120(h)(4) of the Comprehensive Environmental
Response, Compensation and Liability Act of 1980, as amended,
CERCLA, 42 U.S.C.A. §9620(h)(4), the Holding Agency and/or
Disposal Agency has identified the herein described tracts of land as
real property on which no hazardous substances and no petroleum
products or their derivatives were stored for one year or more,
known to have been released, or disposed of. The Government
covenants and warrants that in the event that any response action or
corrective action is found to be necessary after the date of
conveyance, such response action or corrective action shall be
conducted by the Government.

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2. The Government reserves a right of access to any and all portions of
the herein described tracts of land for purposes of environmental
investigation or remediation. This reservation includes the right of
access to and use of, to the extent permitted by law, available utilities
at reasonable cost to the Government. These rights shall be
exercisable in any case in which a remedial action or response action
or corrective action is found to be necessary after the date of
conveyance of the herein described tracts of land, or such access is
necessary to carry out a remedial action or response action or
corrective action on adjoining property. Pursuant to this reservation,
the Government and its officers, agents, employees, contractors and
subcontractors shall have the right (upon reasonable notice to the
Applicant or the then owner and any authorized occupant of the
property) to enter upon the herein described tracts of land and
conduct investigations and surveys, to include drilling, testpitting,
boring, data and/or record compilation, and other activities related to
environmental investigation, and to carry out remedial or removal
actions as required or necessary under applicable authorities,
including but not limited to monitoring wells, pumping walls, and
treatment facilities.
b. Use by the Applicant.
i. That, except as provided in subparagraph c of numbered paragraph 5, the
property conveyed shall be used for development or operation of a Port
Facility for the use and benefit of the public, on reasonable terms and without
unjust discrimination. As used in this document, the term Port Facility shall
mean any structure and improved property, including services connected
therewith whether located on waterfront or inland, which is used, or intended
for use, in developing, transferring or assisting maritime commerce and
water related industries, including, but not limited to, terminal and warehouse
buildings, piers, wharves, yards, docks, berths, dry and cold storage spaces,
bulk and liquid storage terminals, tank farms, aprons, cranes and equipment
used to load and discharge cargo and passengers from vessels, multimodal
transfer terminals, transshipment and receiving stations, marinas, foreign
trade zones, shipyards, industrial property, fishing and aquaculture structures,
mixed waterfront complexes, connecting channels and port landside
transportation access routes.
ii. That, except as provided in subparagraph c of the numbered paragraph 5, the
entire Port Facility including all structures, improvements, facilities and
equipment conveyed shall be maintained for the use and benefit of the public
at all times in safe and serviceable condition, to assure its efficient operation
and use, provided, however, that such maintenance shall be required as to
structures, improvements, facilities and equipment only during the useful life
thereof, as determined by the Secretary or his/her successor in function.

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c. No property conveyed shall be mortgaged or otherwise disposed of or rights or
interest granted by the Applicant without the prior written consent of the Secretary.
However, the Secretary will only review leases of five years or more to determine the
interest granted therein.
d. Property conveyed for a Port Facility shall be used and maintained for the use and
benefit of the public on fair and reasonable terms, without discrimination. In
furtherance of this covenant (but without limiting its general applicability and effect)
the Applicant specifically agrees (1) that it shall keep the Port Facility open to all
types and kinds of maritime users without discrimination between such types and
kinds.
Provided, that the Applicant may establish such fair, equal, and
nondiscriminatory conditions to be met by all users of the Port Facilities as may be
necessary for the safe and efficient operation of the Port Facility; and provided,
further, that the Applicant may prohibit or limit any given type and kind of maritime
use of the Port Facility if such action is necessary for the safe operation of the Port
Facility, (2) that in its operation and the operation of port facilities at the port, neither
it nor any person or organization occupying space or facilities thereupon shall
discriminate against any person or class of persons by reason of race, color, creed,
sex, marital status, political affiliation, national origin, religion, handicap or sexual
orientation in the use of any of the facilities provided for the public at the port, and
(3) that in any agreement, contract, lease, or other arrangement under which a right or
privilege at the port is granted to any person, firm or corporation to conduct or
engage in any maritime activity for furnishing services to the public at the port, the
Applicant shall insert and enforce provisions requiring the contractor: (a) to furnish
said service on a fair, equal and nondiscriminatory basis to all users thereof, and (b)
to charge fair, reasonable, and nondiscriminatory prices for each unit for service,
provided, that the contractor may be allowed to make reasonable and
nondiscriminatory discounts, rebates, or other similar types of price reductions to
volume purchasers.
e. The Applicant shall, insofar as it is within its powers and to the extent reasonable,
adequately protect the water and land access to the Port Facility. The Applicant
shall, either by the acquisition and retention of easement or other interest in or rights
for the use of land or by adoption and enforcement of zoning regulations, prevent the
construction, erection or alteration of any structure in the access routes to and from
the Port Facility.
f.

The Applicant shall operate and maintain in a safe and serviceable condition, as
deemed reasonably necessary by the Secretary, the port and all facilities thereon and
connected therewith which are necessary to service the maritime users of the Port
Facility and shall not permit any activity thereon which would interfere with its use
as a Port Facility.

g. The Applicant hereby releases the Government, and shall take whatever action may
be required by the Secretary to assure the complete release of the Government from
any and all liability the Government may be under for restoration or other damage
under any agreement covering the use by the Applicant or its lessees, upon which,
adjacent to which, or in connection with which, any property transferred by this
instrument was located or used.

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h. The Port Facility is subject to the provisions of Title 46 CFR, Part 340.
i.

The Applicant shall: (1) furnish the Secretary with annual or special Port Facility
financial and operational reports as requested, (2) furnish the Secretary with an
annual utilization report that demonstrates that the Port Facility is being used in
accordance with the terms and conditions of the Deed(s), and (3) upon reasonable
request of the Secretary, make available for inspection by any duly authorized
representative of the Secretary, the Port Facility, at which the property described
herein is located, and all Port Facility records and documents affecting the port,
including deeds, leases, operation and use agreements, regulations, and other
instruments and shall furnish to the Secretary a true copy of any such document.

j.

Where construction or major renovation is not required or proposed, the Port Facility
must be placed into use within twelve (12) months from the date of the conveyance.
Where construction or major renovation is contemplated at the time of conveyance,
the property shall be placed in service according to the redevelopment time table
approved by the Secretary in the PFRP Section of the Application.

k. The Applicant shall not enter into any transaction which would operate to deprive it
of any of the rights and powers necessary to perform or comply with any or all of the
terms, reservations, restrictions and conditions set forth herein, if an arrangement is
made for management or operation of the Port Facility by any agency or person other
than the Applicant, it shall reserve sufficient rights and authority to ensure that such
Port Facility shall be operated and maintained in accordance with these terms,
reservations, restrictions and conditions.
l.

The Applicant shall keep up to date at all times a Port Facility layout map of the
property described herein showing: (a) the boundaries of the Port Facility and all
proposed additions thereto, and (b) the location of all existing and proposed port
facilities and structures, including all proposed extensions and reductions of existing
port facilities.

m. That in the event that any of the aforesaid terms, reservations, restrictions and
conditions are not met, observed, or complied with by the Applicant, whether caused
by the legal inability of said Applicant to perform any of the obligations herein set
out, or otherwise, the title, right of possession and all other rights conveyed by any
Deed(s) to the Applicant, or any portion thereof, shall at the option of the Secretary
revert to the Government in its then existing condition sixty (60) days following the
date upon which demand to this effect is made in writing by Secretary or his
successor in function, unless within said sixty (60) days such default or violation
shall have been cured and all such terms, reservations, restrictions and conditions
shall have been met, observed, or complied with, in which event said reversion shall
not occur and title, right of possession, and all other rights conveyed hereby, except
such, if any, as shall have previously reverted, shall remain vested in the Applicant.
n. That if the construction of any of the foregoing terms, reservations, restrictions and
conditions recited herein as provisions or the application of the same as provisions in
any particular instance is held invalid, the particular term, reservation, restriction or
condition in question shall be construed instead merely as conditions upon the breach
of which the Secretary may exercise its option to cause the title, interest, right of

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possession, and all other rights conveyed to the Applicant, or any portion thereof, to
revert to it, and the application of such term, reservation, restrictions or condition as
provision in any other instance and the construction of the remainder of such terms,
reservations, restrictions and conditions as provisions shall not be affected thereby.
o. The Applicant shall remain at all times a State, the District of Columbia, the
Commonwealth of Puerto Rico, Guam, American Samoa, the Virgin Islands, the
Trust Territory of the Pacific Islands, the Commonwealth of the Northern Mariana
Islands, or any other political subdivision, municipality, or instrumentality thereof.
p. The Applicant shall comply at all times with all applicable provisions of law,
including, the Water Resources Development Act of 1990.
q. The Applicant may not modify, amend or otherwise change its approved PFRP
without the prior written consent of the Secretary and shall implement the PFRP as
approved by the Secretary.
r.

The Applicant agrees that in the event, the Secretary exercises its option to revert all,
right, title, and interest in and to any portion of the property to the Government, or
the Applicant voluntarily returns title to the property in lieu of a reverter, then the
Applicant shall provide protection to, and maintenance of the property at all times
until such time as the title is actually reverted or returned to and accepted by the
Government. Such protection and maintenance shall, at a minimum, conform to the
standards prescribed in the GSA Customer Guide to Real Property Disposal, as listed
in Title 41 CFR Chapter 102, Part 75, Section 875 [41 CFR 102-75.875] in effect as
of the date of the conveyance.

s.

The Disposal Agency expressly reserves from the conveyance (1) oil, gas and
mineral rights, (2) improvements without land, (3) military chapels, and (4) property
disposed of pursuant to 204(c) of the Act.

t.

The Government reserves all right, title, and interest in and to all property of
whatsoever nature not specifically conveyed, together with right of removal thereof
from the Port Facility within one (1) year after the date of the Deed(s). During such
period, the Government, its agents, customers, transferees, and successors shall have
the right of ingress to and egress from the Port Facility for the purposes of using,
disposing of by sale or otherwise, and removing such property.

u. Preservation Covenant for Historic Property.
The Applicant hereby covenants, to preserve and maintain any portion of the
_________________________________________, more particularly described
in Schedule A and shown on Schedule A as a Historic Area (“Historic Area”), in
a manner that preserves the overall character of the Historic Area, in accordance
with the recommended approaches in the Secretary of the Interior’s Standards
and Guidelines for Federal Agency Historic Preservation Programs in order
to preserve and enhance those qualities that make the Historic Area eligible for
inclusion in the National Register of Historic Places. This covenant shall be a
binding servitude upon the Historic Area and shall be deemed to run with the
land. This covenant is binding on the Applicant, in perpetuity. The restrictions,

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stipulations and covenants contained herein shall be inserted by the Applicant,
verbatim or by express reference in any other legal instrument by which it
transfers any interest or estate in the Historic Area, or any part thereof.
i. No construction, alteration, remodeling, demolition, disturbance of the
ground surface, or other action shall be undertaken or permitted to be
undertaken on the Historic Area that would materially affect the integrity or
the appearance of the attributes described above without the prior written
permission of the _____________ State Historic Preservation Officer
(“SHPO”). Should the SHPO object to the proposed treatment within __
days of receiving the request arid cannot resolve the differences, the
Applicant shall request the Advisory Council on Historic Preservation
(“Council”) to resolve the dispute. The Council shall provide comments
within __ days of receiving the request from the Applicant. The Applicant
shall consider the Council’s comments in reaching its decision on the
treatment. The Applicant shall report its decision to the Council, and if
practicable, it shall do so prior to initiating the treatment.
ii. Upon acquisition of any standing historic structures, the Applicant shall take
prompt action to secure all of the structure from the elements, vandalism, or
arson. The Applicant shall, to the extent practicable, make every effort to
retain or reuse the historic structures.
iii. Should any archeological site be discovered during any project activities, the
Applicant shall stop work promptly and obtain the comments of the SHPO
regarding appropriate treatment of the site. The final mitigation plan shall be
approved by the SHPO.
iv. The Applicant shall allow the SHPO or his or her designee, at all reasonable
times and upon reasonable advance notice to the Applicant, to inspect the
Historic Area in order to ascertain whether the Applicant is complying with
the conditions of this preservation covenant.
v. The Applicant shall provide the SHPO and the Council with a written
summary of actions taken to implement the provisions of this preservation
covenant within one (1) year after the effective date of the transfer of the
Historic Area.
vi. Failure of the SHPO to exercise any right or remedy granted under this
covenant shall not have the effect of waiving or limiting the exercise by the
SHPO of any other right or remedy or the invocation of such right or remedy
at any other time.
vii. The Applicant may, with the prior written approval of the SHPO, modify for
good cause any or all of the foregoing restrictions. Prior to such action, the
Applicant shall notify the Council of the proposed modification and allow
them __ days to comment.

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v. Lead-Based Paint Covenant.
i. Prior to use of any property on the Port Facility by children less than seven
(7) years of age, the Applicant shall remove all lead-based paint hazards and
all potential lead-based paint hazards from the property in accordance with
all Federal, State and local lead-based paint laws and regulations.
ii. The Applicant agrees to indemnify the Government to the extent allowable
under applicable Law from any liability arising by reason of the Applicant’s
failure to perform the Applicant’s obligations hereunder with respect to the
elimination of immediate lead-based paint health hazards, the prohibition
against the use of lead-paint, and the Applicant’s responsibility for
complying with applicable State and local lead-based paint laws and
regulations.
w. Protection of Wetlands.
Certain portions of the Port Facility may be declared jurisdictional “wetlands,” as
determined by the Army Corps of Engineers. All construction on those portions
of the Port Facility must comply with Department of the Army WETLAND
CONSTRUCTION RESTRICTIONS contained in Title 33, Code of Federal
Regulations, Sections 320 through 330, as amended, and any other applicable
Federal, State, or local wetlands regulations.
x. The Applicant agrees to maintain, indemnify and hold harmless the Secretary and the
Government from any and all claims, demands, costs or judgments for damages to
persons or property that may arise from the use of the property by the Applicant,
guests, employees and lessees.
y. The Applicant agrees that any construction or alteration is prohibited unless a
determination of no hazard to air navigation is issued by the Federal Aviation
Administration in accordance with Title 14 CFR Part 77 or under the authority of the
Federal Aviation Act of 1958, as amended.
z. The Secretary on written request from the Applicant may grant release from any of
the terms, reservations, restrictions and conditions contained in the Deed(s), or the
Secretary may release the Applicant from any terms, restrictions, reservations or
conditions if the Secretary determines that the property so conveyed no longer serves
the purpose for which it was conveyed.
aa. The Secretary shall make reforms, corrections or amendments to the Deed(s) if
necessary to correct such Deed(s) or to conform such Deed(s) to the requirements of
applicable law.

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6. NOTICE OF HAZARDOUS SUBSTANCES. Schedule D contains a notice of hazardous
substances that have been stored for one year or more, or known to have been released, or
disposed of, on certain portions of the real property, and the date(s) that such storage, release,
or disposal took place, as required by Title 40 CFR Part 37:3, and 42 U.S.C.A. §9620(h)(1).
Section 373.3(b) requires that the following statement be prominently displayed:

The information contained in this notice is required under the authority of regulations
promulgated under Section 10(h) of CERCLA or “Superfund” 42 U.S.C.A. §9620(h).

7. PRESENCE OF ASBESTOS. The Port Facility may be improved with buildings and
facilities and equipment that may contain asbestos-containing materials. The Finding of
Suitability to Transfer may disclose the condition and location of any asbestos-containing
materials. WARNING!
a. The Applicant is warned that the Port Facility contains asbestos-containing materials.
Unprotected or unregulated exposure to asbestos in product manufacturing, shipyard,
and building construction workplaces have been associated with asbestos-related
diseases. Both the Occupational Safety and Health Administration (OSHA) and the
Environmental Protection Agency (EPA) regulate asbestos because of the potential
hazards associated with exposure to airborne asbestos fibers. Both OSHA and EPA
have determined that such exposure increases the risk of asbestos-related diseases,
which include certain cancers and which can result in disability or death.
b. The Applicant is invited, urged, and cautioned to inspect the Port Facility prior to
submitting an Application. More particularly, the Applicant is invited, urged, and
cautioned to inspect the Port Facility as to its asbestos content and condition and any
hazardous or environmental conditions relating thereto. The Government shall assist
the Applicant in obtaining any authorization(s) which may be required in order to
carry out any such inspection(s). The Applicant shall be deemed to have relied solely
on its own judgment in assessing the overall condition of all or any portion of the
Port Facility, including without limitation, any asbestos hazards or concerns.
c. No warranties, either express or implied, are given with regard to the condition of the
Port Facility including, without limitation, whether the Port Facility does or does not
contain asbestos or is or is not safe for a particular purpose. The failure of the
Applicant to inspect or to be fully informed as to the condition of all or any portion of
the Port Facility shall not constitute grounds for any claim or demand for adjustment
or withdrawal by the Applicant from the agreement formed by the execution of any
Deed(s).
d. The description of the Port Facility set forth in the Application and any other
information provided therein with respect to the Port Facility is based on the best
information available to the Disposal Agency and is believed to be correct, but an
error or omission, including but not limited to the omission of any information
available to the Disposal Agency or any other Federal agency, shall not constitute
grounds or reason for non-performance of the agreement formed by an acceptance of
the Application by the Disposal Agency or any claim by the Applicant against the

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Government including, without limitation, any claim for allowance, refund,
deduction, or payment of any kind.
e. The Government assumes no liability for damages for personal injury, illness,
disability, or death to the Applicant or to the Applicant’s successors, assigns,
employees, invitees or any other person subject to the Applicant’s control or direction
or to any other person, including members of the general public, arising from or
incident to the purchase, transportation, removal, handling, use, disposition, or other
activity causing or leading to contact of any kind whatsoever with asbestos on the
Port Facility, whether the Applicant, has or have properly warned or failed to
properly warn the individuals(s) injured.
f.

The Applicant further agrees that in its use and occupancy of the Port Facility it shall
comply with all Federal, state, and local laws relating to asbestos.

8. PRESENCE OF LEAD. (Can be deleted if not applicable.) The Applicant is informed that
the property includes improvements that are duly presumed to contain lead-based paint
because they are thought or known to have been constructed before 1978. The hazards of
lead-based paint are often present in dust, paint chips, or surfaces upon which lead-based
paint has been applied. High concentrations of lead in the body can damage the brain,
nervous system, kidneys, or hearing; affect learning and coordination, cause behavioral
problems, blindness, and even death; and cause problems in pregnancy and fetal
development. Lead is especially hazardous to children of less than seven (7) years of age.
a. The Applicant is invited, urged, and cautioned to inspect the property prior to
acquiring it. More particularly, the Applicant is invited, urged, and cautioned to
inspect the property as to its lead-based paint content and condition and any
hazardous or environmental conditions relating thereto. The Disposal Agency shall
assist the Applicant in obtaining any authorization which may be required in order to
carry out any such inspection. The Applicant shall be deemed to have relied solely
on its own judgment in assessing the overall condition of all or any portion of the
property, including, without limitation, any lead-based paint hazards or concerns.
b. All applicable surfaces of structures on the property to be conveyed constructed prior
to 1978 and used by children of less than seven (7) years of age shall be inspected to
determine whether defective paint surfaces exist. For this purpose all defective paint
surfaces shall be assumed to be immediate hazards; and (2) treatment necessary to
eliminate the hazards of lead-based paint shall be taken in accordance with Federal,
State and local lead-based paint laws and regulations.

9. RISK OF LOSS. From time to time, the Disposal Agency assigns property to the Secretary
for conveyance. From the date(s) of the conveyance by the Secretary, the Applicant shall
bear all risks and shall bear any and all losses sustained by reason of damage due to casualty
that may be suffered by the Port Facility and shall bear any and all losses associated
therewith. Notwithstanding any such losses or damage, each and all of the provisions of the
Deed(s) shall remain unimpaired and in full force and effect.

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10. ENTRY INTO POSSESSION OF THE PORT FACILITY. The Applicant agrees to enter
into possession of the Port Facility or such portions thereof as described in Schedule A and B,
from the date(s) of conveyance by the Secretary.

11. ASSIGNMENT BY THE DISPOSAL AGENCY. The Disposal Agency may assign the
property to the Secretary for conveyance to the Applicant upon request by the Secretary.
Upon such assignment and compliance with the requirements of Section 120 of the
Comprehensive, Environmental Response, Compensation and Liability Act of 1980, as
amended CERCLA (42 U.S.C.A. §9620) (“CERCLA 120”), and other legal and policy
requirements, the Secretary shall, by one or more Deed(s) incorporating the applicable terms,
reservations, restrictions and conditions of this Application and any other reservations,
restrictions, easements, and exceptions, required by law or pursuant to this Application,
convey to the Applicant all of its rights, title and interest in and to the Port Facility, and the
Applicant shall accept the conveyance or conveyances.

12. NO ASSIGNMENT BY APPLICANT. No interest therein shall be assigned or transferred
by the Applicant to any other party.

13. OFFICIAL NOT TO BENEFIT. No member of or delegate to U.S. Congress or the State
Assembly shall be admitted to any share or part of any benefit arising from any conveyance
by the Secretary to the Applicant.

14. TITLE VI ASSURANCES. United States Department of Transportation (USDOT) Order
1050.2A requires the Maritime Administration to secure from applicants and recipients
receiving Federal financial assistance certain assurances to ensure that no one is excluded
from participation in Federally funded transportation projects on the grounds of race, color, or
national origin. Schedule E contains the USDOT Standard Title VI/Non-Discrimination
Assurances that Applicant agrees and acknowledges it is required to execute and submit as
part of the Application.

15. SCHEDULES. Five (5) schedules are attached to and made a part of the Application, as
follows:
Schedule A:
Schedule B:
Schedule C:
Schedule D:
Schedule E:

Form MA-1047 (12-2016)

Legal Description of Real Property
Description of Personal Property
Port Facility Redevelopment Plan (PFRP)
Notice Pursuant to CERCLA 120(h) (1)
(Provided by the Holding Agency and/or Disposal Agency)
USDOT Standard Title VI/Non-Discrimination Assurances

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The Applicant on whose behalf I have executed the foregoing Application needs and can utilize said
property and has legal authority, is willing, and is in a position financially and otherwise to assume
immediate care and maintenance of the Port Facility; and I have carefully examined the Application and
all the documents submitted in connection therewith and, to the best of my knowledge, information arid
belief, the statements and representations contained in said Application and related documents are full,
complete, accurate and true.
By:

_______________________________________
(Signature)

Name: _______________________________________
(Printed Name)
Title: _______________________________________
Date: _______________________________________

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INSTRUCTIONS:
APPLICATION FOR CONVEYANCE OF PORT FACILITY PROPERTY
These schedules provide the information required by the Secretary to assess the need for surplus Federal
property for the development or operation of a port facility. In your responses, please use complete
sentences and set out at the beginning of each response, the number and the heading you are responding
to. In an instance where a request for information is not applicable to your program, please include the
heading and state “Not Applicable.” Failure to provide sufficient data will delay review and any final
decision on the PFRP.
Schedule A:

LEGAL DESCRIPTION OF REAL PROPERTY

The following real property is hereby requested for conveyance for port facility use, hereafter
identified as Property A, which property is essential, suitable, desirable or reasonably necessary
to fulfill the immediate and foreseeable requirements of the Applicant for the development or
operation of a port facility, to wit: Property A (legal description)

Schedule B:

DESCRIPTION OF PERSONAL PROPERTY

The following personal property is hereby requested for conveyance for port facility use, in
connection with Property A, which personal property, hereafter identified as Property B, is
essential, suitable, desirable or reasonably necessary to fulfill the immediate and foreseeable
requirements of the Applicant for the development or operation of a port facility, to wit: Property
B (Description)

Schedule C:

PORT FACILITY REDEVELOPMENT PLAN (PFRP)

1. Identification of Applicant
a. Legal name of government entity to which conveyance is to be made and statement
whether applicant is a State, the District of Columbia, the Commonwealth or Puerto
Rico, Guam, American Samoa, the Virgin Islands, the Trust Territory of the Pacific
Islands, the Commonwealth of North Mariana Island, or political subdivision,
municipality, or instrumentality thereof.
b. Name and title of individual authorized by resolution of governing authority to
negotiate the conveyance and accept legal responsibilities for the property.
c. A copy of the document showing-statutory or other authority under which it is
authorized by law to acquire and hold title to the property for the purpose for which it
is to be conveyed.
d. Address and telephone number of applicant.

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2. Proposed Redevelopment Plan
a. In narrative form, give a complete detailed plan of use for the property. Explain how
the land, buildings and/or other improvements will be used to fulfill the needs of the
proposed plan. Include as an exhibit a Port Facility layout plan for the property
showing existing and planned improvements, and proposed land use. The plan must
be adequately documented to reflect well-planned utilization, and should be
effectively supported by written recommendations, endorsements, and studies of
appropriate State agencies, public officials of State and local governments, and
recognized transportation consultants.
b. Indicate time required to bring the property to full utilization. State when
construction, demolition, alteration, or adaptation of facilities will begin and when
commercial port activities shall commence. If the program will not be fully
implemented in the first year after conveyance, state what phase shall be
implemented on what date. Provide a detailed time line of development.
c. List the structures and improvements which will be required for implementation of
the proposed program together with the estimated construction costs. Include
dredging requirements, utility system upgrades and improvements to land
transportation access to ports facilities.
d. A statement and supporting data that the property is currently, or will be located in an
area of serious economic disruption as a result of the Federal installation closure or
realignment.
e. Estimate of jobs lost by the closure and the economic impact on the community.
Estimate the number of jobs that will be created by the proposed plan by job category
and estimate the date of job creation.
f.

A statement of the estimated economic impacts on the region and the state by the
proposed development.

3. Proof of Need and Suitability of Property
a. In narrative form, provide detailed proof of need for the property. This information
should demonstrate both a need for the property and program to be operated thereon,
as well as the suitability of the property for the purpose intended. Submit studies,
statistics, or other data which support need and suitability.
b. A statement that the PFRP is part of a necessary economic development program for
the entire Federal installation closed or realigned.
4. Capital Improvement Program and Financial Plan
a. Statement of sources of present funding for operation and capital improvements
including statement that funds are currently available.
b. If the program contemplates major capital improvement projects and funds are not
currently available, give the sources of the funding.

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c. Provide sources and uses fund statement for the first ten years after conveyance,
including a clear source of funding for the payment of all debt when due.
d. Provide the most recent financial statement of the Applicant.
5. Economic Soundness
a. A written narrative detailing the normal throughput capacity, storage/staging capacity
and level of demand for present port facilities owned, leased and/or operated by the
Applicant. Provide estimated normal throughput capacity, storage/staging capacity
and level of demand for new Port Facility.
b. Demonstrate that the demand for additional port services and facilities is sufficient to
support the development and will not significantly impact the economic viability of
existing competing port services and facilities. Competitors include port services and
facilities in the same geographic area and also on the same coast.
6. Environmental Evaluation
The reuse plan in the PFRP shall comply with the provisions of the National Environmental
Policy Act of 1969 (NEPA), as prepared by the Disposal Agency. Provide a statement that
the PFRP is in the Disposal Agency’s NEPA evaluation and the PFRP will comply with
NEPA.

Schedule E:

USDOT Standard Title VI/Non-Discrimination Assurances

Execute and submit the Standard Title VI/Non-Discrimination Assurances, identifying the
Applicant as the “Recipient,” and the port facility for which real property is being transferred for
as the “Appropriate Program.”

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The United States Department of Transportation (USDOT)
Standard Title VI/Non-Discrimination Assurances
DOT Order No. 1050.2A
The Title of Recipient (herein referred to as the "Recipient"), HEREBY AGREES THAT, as a
condition to receiving any Federal financial assistance from the U.S. Department of Transportation
(DOT), through the Maritime Administration, is subject to and will comply with the following:
Statutory/Regulatory Authorities


Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat. 252), (prohibits
discrimination on the basis of race, color, national origin);



49 C.F.R. Part 21 (entitled Non-discrimination In Federally-Assisted Programs Of The
Department Of Transportation-Effectuation Of Title VI Of The Civil Rights Act Of 1964);



28 C.F.R. § 50.3 (U.S. Department of Justice Guidelines for Enforcement of Title VI of the Civil
Rights Act of 1964);

Modal Operating Administration may include additional Statutory/Regulatory Authorities here.
The preceding statutory and regulatory cites hereinafter are referred to as the "Acts" and "Regulations,"
respectively.
General Assurances
In accordance with the Acts, the Regulations, and other pertinent directives, circulars, policy, memoranda,
and/or guidance, the Recipient hereby gives assurance that it will promptly take any measures necessary
to ensure that:
"No person in the United States shall, on the grounds of race, color, or national origin,
be excluded from participation in, be denied the benefits of, or be otherwise subjected to
discrimination under any program or activity, "for which the Recipient receives Federal
financial assistance from DOT, including the Maritime Administration.
The Civil Rights Restoration Act of 1987 clarified the original intent of Congress, with respect to Title VI
and other Non-discrimination requirements (The Age Discrimination Act of 1975, and Section 504 of the
Rehabilitation Act of 1973), by restoring the broad, institutional-wide scope and coverage of these nondiscrimination statutes and requirements to include all programs and activities of the Recipient, so long as
any portion of the program is Federally assisted.
Modal Operating Administration may include additional General Assurances in this section, or
reference an addendum here.

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Specific Assurances
More specifically, and without limiting the above general Assurance, the Recipient agrees with and gives
the following Assurances with respect to its Federally assisted Port Conveyance Program:
1. The Recipient agrees that each "activity," "facility," or "program," as defined in §§ 21.23 (b) and
21.23 (e) of 49 C.F.R. § 21 will be (with regard to an "activity") facilitated, or will be (with
regard to a "facility") operated, or will be (with regard to a "program") conducted in compliance
with all requirements imposed by, or pursuant to the Acts and the Regulations.
2. The Recipient will insert the following notification in all solicitations for bids, Requests For
Proposals for work, or material subject to the Acts and the Regulations made in connection with
all (Name of Appropriate Program) and, in adapted form, in all proposals for negotiated
agreements regardless of funding source:
"The Title of Recipient, in accordance with the provisions of Title VI of the Civil
Rights Act of 1964 (78 Stat. 252, 42 U.S.C. §§ 2000d to 2000d-4) and the
Regulations, hereby notifies all bidders that it will affirmatively ensure that any
contract entered into pursuant to this advertisement, disadvantaged business
enterprises will be afforded full and fair opportunity to submit bids in response to
this invitation and will not be discriminated against on the grounds of race,
color, or national origin in consideration for an award."
3. The Recipient will insert the clauses of Appendix A and E of this Assurance in every contract or
agreement subject to the Acts and the Regulations.
4. The Recipient will insert the clauses of Appendix B of this Assurance, as a covenant running with
the land, in any deed from the United States effecting or recording a transfer of real property,
structures, use, or improvements thereon or interest therein to a Recipient.
5. That where the Recipient receives Federal financial assistance to construct a facility, or part of a
facility, the Assurance will extend to the entire facility and facilities operated in connection
therewith.
6. That where the Recipient receives Federal financial assistance in the form, or for the acquisition
of real property or an interest in real property, the Assurance will extend to rights to space on,
over, or under such property.
7. That the Recipient will include the clauses set forth in Appendix C and Appendix D of this
Assurance, as a covenant running with the land, in any future deeds, leases, licenses, permits, or
similar instruments entered into by the Recipient with other parties:
a. for the subsequent transfer of real property acquired or improved under the applicable
activity, project, or program; and
b. for the construction or use of, or access to, space on, over, or under real property acquired
or improved under the applicable activity, project, or program.
8. That this Assurance obligates the Recipient for the period during which Federal financial
assistance is extended to the program, except where the Federal financial assistance is to provide,
or is in the form of, personal property, or real property, or interest therein, or structures or

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improvements thereon, in which case the Assurance obligates the Recipient, or any transferee for
the longer of the following periods:
a. the period during which the property is used for a purpose for which the Federal financial
assistance is extended, or for another purpose involving the provision of similar services
or benefits; or
b. the period during which the Recipient retains ownership or possession of the property.
9. The Recipient will provide for such methods of administration for the program as are found by
the Secretary of Transportation or the official to whom he/she delegates specific authority to give
reasonable guarantee that it, other recipients, sub-recipients, sub-grantees, contractors,
subcontractors, consultants, transferees, successors in interest, and other participants of Federal
financial assistance under such program will comply with all requirements imposed or pursuant to
the Acts, the Regulations, and this Assurance.
10. The Recipient agrees that the United States has a right to seek judicial enforcement with regard to
any matter arising under the Acts, the Regulations, and this Assurance.
Modal Operating Administration may include additional Specific Assurances in this section.
By signing this ASSURANCE, Name of the Recipient also agrees to comply (and require any subrecipients, sub-grantees, contractors, successors, transferees, and/or assignees to comply) with all
applicable provisions governing the Department of Transportation access to records, accounts,
documents, information, facilities, and staff. You also recognize that you must comply with any program
or compliance reviews, and/or complaint investigations conducted by the Department of
Transportation. You must keep records, reports, and submit the material for review upon request to the
Department of Transportation, or its designee in a timely, complete, and accurate way. Additionally,
you must comply with all other reporting, data collection, and evaluation requirements, as prescribed by
law or detailed in program guidance.
Name of Recipient gives this ASSURANCE in consideration of and for obtaining any Federal grants,
loans, contracts, agreements, property, and/or discounts, or other Federal-aid and Federal financial
assistance extended after the date hereof to the recipients by the U.S. Department of Transportation under
the Port Conveyance Program. This ASSURANCE is binding on [insert State], other recipients, subrecipients, sub-grantees, contractors, subcontractors and their subcontractors', transferees, successors in
interest, and any other participants in the Port Conveyance Program. The person(s) signing below is
authorized to sign this ASSURANCE on behalf of the Recipient.
_______________________________________
(Name of Recipient)
By:

_______________________________________
(Signature of Authorized Official)
_______________________________________
(Printed Name)
_______________________________________
Date

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APPENDIX A

During the performance of this contract, the contractor, for itself, its assignees, and successors in interest
(hereinafter referred to as the "contractor") agrees as follows:
1. Compliance with Regulations: The contractor (hereinafter includes consultants) will comply
with the Acts and the Regulations relative to Non-discrimination in Federally-assisted programs
of the U.S. Department of Transportation, Maritime Administration, as they may be
amended from time to time, which are herein incorporated by reference and made a part of this
contract.
2. Non-discrimination: The contractor, with regard to the work performed by it during the contract,
will not discriminate on the grounds of race, color, or national origin in the selection and retention
of subcontractors, including procurements of materials and leases of equipment. The contractor
will not participate directly or indirectly in the discrimination prohibited by the Acts and the
Regulations, including employment practices when the contract covers any activity, project, or
program set forth in Appendix B of 49 CFR Part 21.[Include Modal Operating Administration
specific program requirements.]
3. Solicitations for Subcontracts, Including Procurements of Materials and Equipment: In all
solicitations, either by competitive bidding, or negotiation made by the contractor for work to be
performed under a subcontract, including procurements of materials, or leases of equipment, each
potential subcontractor or supplier will be notified by the contractor of the contractor's obligations
under this contract and the Acts and the Regulations relative to Non-discrimination on the
grounds of race, color, or national origin. [Include Modal Operating Administration specific
program requirements.]
4. Information and Reports: The contractor will provide all information and reports required by
the Acts, the Regulations, and directives issued pursuant thereto and will permit access to its
books, records, accounts, other sources of information, and its facilities as may be determined by
the Recipient or the Maritime Administration to be pertinent to ascertain compliance with such
Acts, Regulations, and instructions. Where any information required of a contractor is in the
exclusive possession of another who fails or refuses to furnish the information, the contractor will
so certify to the Recipient or the Maritime Administration, as appropriate, and will set forth
what efforts it has made to obtain the information.
5. Sanctions for Noncompliance: In the event of a contractor's noncompliance with the Nondiscrimination provisions of this contract, the Recipient will impose such contract sanctions as it
or the Maritime Administration may determine to be appropriate, including, but not limited to:
a. withholding payments to the contractor under the contract until the contractor complies;
and/or
b. cancelling, terminating, or suspending a contract, in whole or in part.
A. Incorporation of Provisions: The contractor will include the provisions of paragraphs one
through six in every subcontract, including procurements of materials and leases of equipment,
unless exempt by the Acts, the Regulations and directives issued pursuant thereto. The contractor
will take action with respect to any subcontract or procurement as the Recipient or the Maritime
Administration may direct as a means of enforcing such provisions including sanctions for

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noncompliance. Provided, that if the contractor becomes involved in, or is threatened with
litigation by a subcontractor, or supplier because of such direction, the contractor may request the
Recipient to enter into any litigation to protect the interests of the Recipient. In addition, the
contractor may request the United States to enter into the litigation to protect the interests of the
United States.

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APPENDIX B
CLAUSES FOR DEEDS TRANSFERRING UNITED STATES PROPERTY
The following clauses will be included in deeds effecting or recording the transfer of real property,
structures, or improvements thereon, or granting interest therein from the United States pursuant to the
provisions of Assurance 4:
NOW, THEREFORE, the U.S. Department of Transportation as authorized by law and upon the
condition that the Title of Recipient will accept title to the lands and maintain the project constructed
thereon in accordance with Name of Appropriate Legislative Authority, the Regulations for the
Administration of the Port Conveyance Program, and the policies and procedures prescribed by the
Maritime Administration of the U.S. Department of Transportation in accordance and in compliance
with all requirements imposed by Title 49, Code of Federal Regulations, U.S. Department of
Transportation, Subtitle A, Office of the Secretary, Part 21, Non-discrimination in Federally-assisted
programs of the U.S Department of Transportation pertaining to and effectuating the provisions of Title
VI of the Civil Rights Act of 1964 (78 Stat. 252; 42 U.S.C. §2000d to 2000d-4), does hereby remise,
release, quitclaim and convey unto the Title of Recipient all the right, title and interest of the U.S.
Department of Transportation in and to said lands described in Exhibit A attached hereto and made a part
hereof.
HABENDUM CLAUSE
TO HAVE AND TO HOLD said lands and interests therein unto Title of Recipient and its successors
forever, subject, however, to the covenants, conditions, restrictions and reservations herein contained as
follows, which will remain in effect for the period during which the real property or structures are used
for a purpose for which Federal financial assistance is extended or for another purpose involving the
provision of similar services or benefits and will be binding on the Title of Recipient, its successors and
assigns.
The Title of Recipient, in consideration of the conveyance of said lands and interests in lands, does
hereby covenant and agree as a covenant running with the land for itself, its successors and assigns, that
(1) no person will on the grounds of race, color, or national origin, be excluded from participation in, be
denied the benefits of, or be otherwise subjected to discrimination with regard to any facility located
wholly or in part on, over, or under such lands hereby conveyed [,] [and]* (2) that the Title of Recipient
will use the lands and interests in lands and interests in lands so conveyed, in compliance with all
requirements imposed by or pursuant to Title 49, Code of Federal Regulations, U.S. Department of
Transportation, Subtitle A, Office of the Secretary, Part 21, Non discrimination in Federally-assisted
programs of the U.S. Department of Transportation, Effectuation of Title VI of the Civil Rights Act of
1964, and as said Regulations and Acts may be amended, and (3) that in the event of breach of any of the
above-mentioned non-discrimination conditions, the Department will have a right to enter or re-enter said
lands and facilities on said land, and that above described land and facilities will thereon revert to and
vest in and become the absolute property of the U.S. Department of Transportation and its assigns as such
interest existed prior to this instruction.*
(*Reverter clause and related language to be used only when it is determined that such a clause is
necessary in order to make clear the purpose of Title VI.)

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APPENDIX C
CLAUSES FOR TRANSFER OF REAL PROPERTY ACQUIRED OR IMPROVED UNDER THE
ACTIVITY, FACILITY, OR PROGRAM
The following clauses will be included in deeds, licenses, leases, permits, or similar instruments entered
into by the Title of Recipient pursuant to the provisions of Assurance 7(a):
A. The (grantee, lessee, permittee, etc. as appropriate) for himself/herself, his/her heirs, personal
representatives, successors in interest, and assigns, as a part of the consideration hereof, does
hereby covenant and agree [in the case of deeds and leases add "as a covenant running with the
land"] that:
1. In the event facilities are constructed, maintained, or otherwise operated on the property
described in this (deed, license, lease, permit, etc.) for a purpose for which a U.S. Department
of Transportation activity, facility, or program is extended or for another purpose involving
the provision of similar services or benefits, the (grantee, licensee, lessee, permittee, etc.) will
maintain and operate such facilities and services in compliance with all requirements imposed
by the Acts and Regulations (as may be amended) such that no person on the grounds of race,
color, or national origin, will be excluded from participation in, denied the benefits of, or be
otherwise subjected to discrimination in the use of said facilities.
B. With respect to licenses, leases, permits, etc., in the event of breach of any of the above Nondiscrimination covenants, Title of Recipient will have the right to terminate the (lease, license,
permit, etc.) and to enter, re-enter, and repossess said lands and facilities thereon, and hold the
same as if the (lease, license, permit, etc.) had never been made or issued.*
C. With respect to a deed, in the event of breach of any of the above Non-discrimination covenants,
the Title of Recipient will have the right to enter or re-enter the lands and facilities thereon, and
the above described lands and facilities will there upon revert to and vest in and become the
absolute property of the Title of Recipient and its assigns.*
(*Reverter clause and related language to be used only when it is determined that such a clause is
necessary to make clear the purpose of Title VI.)

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APPENDIX D
CLAUSES FOR CONSTRUCTION/USE/ACCESS TO REAL PROPERTY ACQUIRED UNDER
THE ACTIVITY, FACILITY OR PROGRAM
The following clauses will be included in deeds, licenses, permits, or similar instruments/ agreements
entered into by Title of Recipient pursuant to the provisions of Assurance 7(b):
A. The (grantee, licensee, permittee, etc., as appropriate) for himself/herself, his/her heirs, personal
representatives, successors in interest, and assigns, as a part of the consideration hereof, does
hereby covenant and agree (in the case of deeds and leases add, "as a covenant running with the
land") that (1) no person on the ground of race, color, or national origin, will be excluded from
participation in, denied the benefits of, or be otherwise subjected to discrimination in the use of
said facilities, (2) that in the construction of any improvements on, over, or under such land, and
the furnishing of services thereon, no person on the ground of race, color, or national origin, will
be excluded from participation in, denied the benefits of, or otherwise be subjected to
discrimination, (3) that the (grantee, licensee, lessee, permittee, etc.) will use the premises in
compliance with all other requirements imposed by or pursuant to the Acts and Regulations, as
amended, set forth in this Assurance.
B. With respect to (licenses, leases, permits, etc.), in the event of breach of any of the above Nondiscrimination covenants, Title of Recipient will have the right to terminate the (license, permit,
etc., as appropriate) and to enter or re-enter and repossess said land and the facilities thereon, and
hold the same as if said (license, permit, etc., as appropriate) had never been made or issued.*
C. With respect to deeds, in the event of breach of any of the above Non-discrimination covenants,
Title of Recipient will there upon revert to and vest in and become the absolute property of Title
of Recipient and its assigns.*
(*Reverter clause and related language to be used only when it is determined that such a clause is
necessary to make clear the purpose of Title VI.)

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APPENDIX E
During the performance of this contract, the contractor, for itself, its assignees, and successors in interest
(hereinafter referred to as the "contractor") agrees to comply with the following non-discrimination
statutes and authorities; including but not limited to:
Pertinent Non-Discrimination Authorities:


Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat. 252), (prohibits
discrimination on the basis of race, color, national origin); and 49 CFR Part 21.



The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42
U.S.C. § 4601), (prohibits unfair treatment of persons displaced or whose property has been
acquired because of Federal or Federal-aid programs and projects);



Federal-Aid Highway Act of 1973, (23 U.S.C. § 324 et seq.), (prohibits discrimination on the
basis of sex);



Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. § 794 et seq.), as amended, (prohibits
discrimination on the basis of disability); and 49 CFR Part 27;



The Age Discrimination Act of 1975, as amended, (42 U.S.C. § 6101 et seq.), (prohibits
discrimination on the basis of age);



Airport and Airway Improvement Act of 1982, (49 USC § 471, Section 47123), as amended,
(prohibits discrimination based on race, creed, color, national origin, or sex);



The Civil Rights Restoration Act of 1987, (PL 100-209), (Broadened the scope, coverage and
applicability of Title VI of the Civil Rights Act of 1964, The Age Discrimination Act of 1975 and
Section 504 of the Rehabilitation Act of 1973, by expanding the definition of the terms "programs
or activities" to include all of the programs or activities of the Federal-aid recipients, subrecipients and contractors, whether such programs or activities are Federally funded or not);



Titles II and III of the Americans with Disabilities Act, which prohibit discrimination on the
basis of disability in the operation of public entities, public and private transportation systems,
places of public accommodation, and certain testing entities (42 U.S.C. §§ 12131-12189) as
implemented by Department of Transportation regulations at 49 C.F.R. parts 37 and 38;



The Federal Aviation Administration's Non-discrimination statute (49 U.S.C. § 47123) (prohibits
discrimination on the basis of race, color, national origin, and sex);



Executive Order 12898, Federal Actions to Address Environmental Justice in Minority
Populations and Low-Income Populations, which ensures discrimination against minority
populations by discouraging programs, policies, and activities with disproportionately high and
adverse human health or environmental effects on minority and low-income populations;



Executive Order 13166, Improving Access to Services for Persons with Limited English
Proficiency, and resulting agency guidance, national origin discrimination includes discrimination
because of limited English proficiency (LEP). To ensure compliance with Title VI, you must

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take reasonable steps to ensure that LEP persons have meaningful access to your programs (70
Fed. Reg. at 74087 to 74100);


Title IX of the Education Amendments of 1972, as amended, which prohibits you from
discriminating because of sex in education programs or activities (20 U.S.C. 1681 et seq).

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