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GRT began its operation on January 1, 2000 by assuming the operations of the former Kitchener Transit (which also served Waterloo) and Cambridge Transit from the cities, and placing them under the jurisdiction of the regional government. By the end of that year, operations had been fully synchronized and services established to connect the two operating areas, which was not previously possible by public means.
In recent years, many low-floor, wheelchair-accessible buses have been purchased, and these now constitiute the majority of the fleet. Most operating buses are less than 20 years old; a few older buses are used primarily for high-school special runs.
In 2004, the Region began preliminary design work on an existing proposal to construct a light rail system. The initial stage would serve the main transportation corridor in Kitchener-Waterloo, using rail corridors and on-street lanes to carry 14 km of track to 10 stations. Further expansion plans would bring the service south to Cambridge and north to St. Jacobs and Elmira. The Ontario government has given its support to the plan.