Tile mosaic and sculpture designed by Guy Harvey on towers at four corners of the bridge_Port St. Lucie

LAP Forms


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Form NumberForm NameFormat
Certification
 Local Agency Program Certification ToolWord
 Local Agency Program Certification - Materials Testing and Acceptance Quality Assurance ReviewWord
 Sub Recipient Compliance Assessment ToolWord
Agreements and Exhibits
350-000-15Emergency Local Government Emergency Relief Reimbursement AgreementWord
525-010-32 Local Agency Program Supplemental Agreement Word
525-010-40Local Agency Program AgreementWord
525-010-40ALocal Agency Program Agreement - Exhibit A - Project Description and ResponsibilitiesWord
525-010-40BLocal Agency Program Agreement - Exhibit B - Schedule of Financial AssistanceWord
525-010-40CLocal Agency Program Agreement - Exhibit C - Title VI AssurancesWord
525-010-40DLocal Agency Program Agreement - Exhibit D - Recipient ResolutionWord
525-010-40ELocal Agency Program Agreement - Exhibit E - Federal Financial Assistance (Single Audit Act)Word
525-010-40FLocal Agency Program Agreement - Exhibit F - Contract Payment RequirementsWord
525-010-40GLocal Agency Program Agreement - Exhibit G - FHWA 1273Word
525-010-40HLocal Agency Program Agreement - Exhibit H - Alternative Advance Payment Financial Provisions Word
525-010-40ILocal Agency Program Agreement - Exhibit I - State Funds AddendumWord
525-010-40JLocal Agency Program Agreement - Exhibit J - State Financial AssistanceWord
525-010-40KLocal Agency Program Agreement - Exhibit K - Advance Project ReimbursementWord
525-010-40LLocal Agency Program Agreement - Exhibit L - Landscape MaintenanceWord
525-010-40MLocal Agency Program Agreement - Exhibit M - Roadway Lighting MaintenanceWord
525-010-40NLocal Agency Program Agreement - Exhibit N - Traffic Signal MaintenanceWord
525-010-40OLocal Agency Program Agreement - Exhibit O - Terms & Conditions of Construction in Department Right of WayWord
Project Certifications
 Clear Letter - No Environmental Permit RequiredWord
 Clear Letter - Permits RequiredWord
 Clear Letter - RailroadWord
 Clear Letter - UtilitiesWord
575-095-05LAP Right of Way Certification, Certification with Exceptions and LAP Initial Design and BuildConsolidated
Procurement - Professional Services and Construction
 Appendices A&E, Nondiscrimination Contract Assurances (required in all contracts)Word
275-030-11DBE Bid Package InformationWord
375-020-27Contract Bond (in Bid Blank)PDF
375-030-32Certification Regarding Debarment, Suspension...for Federal Aid ContractsWord
375-030-33Lobbying CertificationWord
375-030-34Disclosure of LobbyingWord
375-030-91Vendor Eligibility Prior to Contract of AwardWord
375-030-83DBE Bid Opportunity FormWord
PSU Procurement
525-010-49Local Agency Program (LAP) Checklist for Federally Funded Professional Services Contracts Federal and State RequirementsWord
375-030-18Consultant AffirmationPDF | Word
375-020-08Proposal (in Bid Blank)Consolidated
375-020-30Contract Affidavit (in Bid Blank)PDF
375-030-30Truth in NegotiationWord
375-030-50Conflict of Interest CertificationWord
375-040-84LAP Terms for Federal Aid Professional Services ContractsWord
 Calculating Fee Mockup Excel | PDF
700-010-04Estimate of Contract TimeExcel
Construction Procurement
FHWA 1273Required Contract Provisions - Federal-Aid Construction ContractsPDF
525-010-44Local Agency Program (LAP) Checklist for Construction Contracts (Phase 58)-Federal RequirementsWord
575-060-13Non-Collusion Declaration of ComplianceWord
525-010-46LAP Certification of Current CapacityPDF | Word
Construction Administration
 QAR Checklist - Developed by District 4 and District 6Word
 QAR Checklist - Developed by District 4 and District 6 - GeotechWord
700-050-56Daily Log (Sample) 
700-010-38Certification of Payment (Sample)PDF
700-010-42Certification for Stockpiled Materials (Sample)PDF
Invoicing
525-010-54Local Programs Project Monitoring Status ReportWord
525-010-54Instructions for the Local Programs Project Monitoring Status ReportPDF
525-010-53Local Programs Invoicing TemplateExcel
Project Close Out
525-010-42Local Agency Program Final Inspection and Acceptance of Federal-Aid ProjectPDF | Word
525-010-47Local Agency Program Record of Final Plans and DocumentsWord
525-010-50Local Agency Program Performance EvaluationWord