Local AAA Projects on the SHS

Division of Local Assistance - Office Bulletin DLA-OB 11-13 – Administering Local Federal-Funded Projects on the State Highway System Office of Implementation Revised – August 1, 2014

ATTACHMENT C - AUTHORIZING LOCAL FEDERAL FUNDS FOR LOCALLY-ADMINISTERED PROJECTS ON THE STATE HIGHWAY UNDER CONSTRUCTION COOPERATIVE AGREEMENT

of 5 08/01/2014 Federal-Aid Project No. :______Advantage ID: ______

Project Description: ______

______Dist.-Co.-Rte-PM: ______

Caltrans Project Coordinator: ______DLAE: ______

NOTE: FOR PROJECTS APPROVED UNDER THE PERMIT PROCESS, SUBMIT COPY OF ISSUED PERMIT AND SKIP THIS CHECKLIST. OVERSIGHT RESPONSI- BILITY INITIALS or N/A DATE DLAE/Staff Proj. Coord. DLAE/Proj. Coord.

CONSTRUCTION DOCUMENTATION / TASK

Request for authorization to proceed for Construction X Current FTIP show- ing programmed funding amount X Executed Coopera- tive Agreement with Caltrans (as amend- ed) X FHWA allocation no- tification (if discre- tionary funding) X

Project Report X Modified Access Re- port (if interchange modification on Inter- state) X CTC Allocation of any STIP funding X Caltrans concurrence to advertise X FHWA concurrence to advertise (full FHWA oversight; public interest find- ings) X

Engineers Estimate X Signed Agency Fi- nance letter (PM for State funds) X X Approved NEPA doc- ument X Division of Local Assistance - Office Bulletin DLA-OB 11-13 – Administering Local Federal-Funded Projects on the State Highway System Office of Implementation Revised – August 1, 2014

Right of Way Certifi- cation X Final Value Analysis Study (>$25M Road- way, >$20M Bridge) X Encroachment Permit If Double Permits Re- quired X Design Oversight Ap- proval (Sign-off) X OVERSIGHT RESPONSI- BILITY INITIALS or N/A DATE DLAE/Staff Proj. Coord. DLAE/Proj. Coord.

CONSTRUCTION DOCUMENTATION / TASK (CONT.)

PS&E Oversight Ap- proval (Sign-off) X

DBE Goals X Approved Supple- mental Work and State-furnished Mate- rials X Emissions Benefits Calculations (if CMAQ funding) X Approved Financial Plan (if all segments >$100M total) X Approved Project Management Plan (if all segments >$500M total) X

CERTIFICATION STATEMENT:

I/We hereby state that the actions initialed above for the referenced project have been completed and requirements have been met for the authorization of funds for Construction.

Caltrans Project Co- ordinator Date DLAE Date

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Division of Local Assistance - Office Bulletin DLA-OB 11-13 – Administering Local Federal-Funded Projects on the State Highway System Office of Implementation Revised – August 1, 2014

of 5 08/01/2014