Risk Management Transit Lift Gate Reimbursement Application This targeted grant program provides reimbursement for the purchase of liftgates for transit vehicles equipped with mounted wheelchair lifts. These gates operate similar to a railroad crossing arm, and offer an engineered solution to the unguarded opening that is created when a wheelchair lift is left unattended. A passenger falling through this opening can lead to severe injury or even death. This reimbursement program was established effective July 1, 2020, and is subject to renewal each year by the NCACC RMP Board of Trustees. The program provides up to a $4,500  reimbursement for the installation, maintenance, or transfer of the liftgates. Funds are awarded each year until expended. PROGRAM REQUIREMENTS: The purchase of the liftgates must be through Grant Services, LLC. Member is responsible for coordinating a date and time of installation of the liftgates. Once payment for the devices and associated installation has been paid, the county or agency must submit documentation of installation and invoice and copy of payment confirmation to the NCACC Risk Management Pool. All reimbursements will be paid to the county or agency by electronic fund transfer. To establish the mechanism for electronic payment, please contact Bob Carruth.  TO QUALIFY FOR REIMBURSEMENT, EACH MEMBER MUST: Complete and submit: (1) The Lift Gate Reimbursement Application, and (2) upload a copy of the purchase order or paid invoice. Reimbursements normally take 2-4 weeks for payment, and are done electronically. If current banking information is not on file with the NCACC, it will need to be completed as well. Contact Name * County/Entity * Phone * Date * Mandatory Field * First-time purchase Transfer Lift Gate Purchase Information Quantity Description of Items Vendor Unit Price Total Price RMS Use Only Upload Lift Gate Invoice (PDF preferred) * Drop a file here or click to upload Choose File Maximum file size: 26.21MB plus1 Add Lift Gate minus1 Remove Lift Gate Total Quantity Total Price Reimbursement is limited to $4,500 (Up to 3 gates per fiscal year). I understand that my county/entity must be a current member of the NCACC Liability & Property Pool. Form Completed By Manager/Director/Finance Officer Enter your email to receive a copy of this submission. If you are human, leave this field blank. Submit