CARS Form A

2013--2017 Project Application for the

County Assistance Road System (CARS) Program

Submit one form for each project. Make copies of this form as needed.	Complete & Return by April 13, 2012

Submitting City:	Number 1 Priority (Y/N):

Project Location:

Joint Project With:	Administrating City:

Contact Name & Title:	County Commission District(s) #:

Estimated Project Schedule: Start Date (mo/yr):	Completion Date (mo/yr):

Current Average Daily Traffic (ADT):	Accident History (Prior 3 Years):

Project Type:	Capacity	Major Maintenance	Bridge Replacement	Bridge Rehabilitation

Route Enhancement	System Management

Current Level of Service (LOS) [System Management Projects Only]:

Sufficiency Rating (Bridge Projects):	Pavement Condition:	Good	Fair	Poor

Detailed Description of Existing Facility:

Detailed Description of Project Scope:

Project Cost Information *
1.	Design Cost:
2.	Right-of-way acquisition cost:
3.	Utility relocation Cost:
4.	Construction cost:
5.	Construction engineering cost:
Total project cost:
Calculation of CARS Eligible costs:
A.	Sum item # 4 & 5 above	(+)
B.	Federal Aid Participation	(-)
C.	State Aid Participation	(-)
D.	Other Non-local Participation	(-)
Subtotal (CARS eligible costs)
CARS Funding request
(Request cannot exceed 50% of the CARS eligible costs)
Funding participation by other cities:
City Name:
Funding:
City Name:
Funding:

*Program policies require that a licensed professional engineer prepare and seal construction cost estimates for upcoming fiscal year projects (i.e., 2013 Program Projects). A copy of the sealed estimates must be furnished for all 2013 CARS Program requests.

document 1

project application for CARS program

2011-2015

description of project scope

Jackie Eatinger

2012-04-19

Irina Idelson

Public Works