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Do not recreate or revise the pages of this document, as revisions and recreations will not be accepted.
<br /> Failure to return both gapes of the original document by the filing deadline(October 31) may result in the suspension of
<br /> Highway Allocation funds until the documents are filed.
<br /> COUNTY
<br /> ANNUAL CERTIFICATION OF PROGRAM COMPLIANCE
<br /> TO
<br /> NEBRASKA BOARD OF PUBLIC ROADS CLASSIFICATIONS
<br /> AND STANDARDS
<br /> 2021
<br /> In compliance with the provisions of the State of Nebraska Statutes, sections 39-2115, 39-2119, 39-2120,
<br /> 39-2121, and 39-2510(2), requiring annual certification of program compliance to the Board of Public Roads
<br /> Classifications and Standards, the County of “6,11 hereby certifies that it:
<br /> (Print name of county)
<br /> ✓ has developed, adopted, and included in its public records the plans, programs, or standards required by
<br /> sections 39-2115 and 39-2119;
<br /> ✓ meets the plans, programs, or standards of design, construction, and maintenance for its highways,
<br /> roads, or streets;
<br /> ✓ expends all tax revenue for highway, road, or street purposes in accordance with approved plans,
<br /> programs, or standards, including county and municipal tax revenue as well as highway-user revenue
<br /> allocations;
<br /> ✓ uses a system of revenue and costs accounting which clearly includes a comparison of receipts and
<br /> expenditures for approved budgets, plans, programs, and standards;
<br /> ✓ uses a system of budgeting which reflects uses and sources of funds in terms of plans, programs, or
<br /> standards and accomplishments;
<br /> ✓ uses an accounting system including an inventory of machinery, equipment, and supplies;
<br /> ✓ uses an accounting system that tracks equipment operation costs;
<br /> ✓ has included in its public records the information required under subsection (2) of section 39-2510; and
<br /> ✓ has included in its public records a copy of this certification and the resolution of the governing
<br /> body authorizing the :'•Hing • this certificat'• , by the County Board Chairperson.
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<br /> Signature of Co r'WC ' erson(Required) (Dace)
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<br /> H 41 Signature of County Highway Superintendent(Optional) (Date
<br /> %d~%�'i'I!�!` _,�) Return the completed original signing resolution and annual
<br /> ,/,0,t-,.,
<br /> �+ t i.o' '% certification of program compliance byOctober 31, 2021 to:
<br /> 'hi, MRH, , 96�
<br /> Nebraska Board of Public Roads Classifications and Standards
<br /> PO Box 94759
<br /> Lincoln NE 68509
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