LAP Forms
Page Link
| Search for a Form | ||
| Form Number | Form Name | Format |
| Certification | ||
| Sample | Local Agency Program Certification Tool | Word Form |
| Sample | Local Agency Program Certification-Materials Testing and Acceptance Quality Assurance Review | Word Form |
| Sample | Sub Recipient Compliance Assessment Tool | Word Form |
| Agreements and Exhibits | ||
| 350-000-15 | Emergency Local Government Emergency Relief Reimbursement Agreement | Word Form |
| 525-010-40 | Local Agency Program Agreement | Search for Form |
| 525-010-32 | Local Agency Program Supplemental Agreement | Word Form |
| Project Certifications | ||
| Sample | Clear Letter - No Environmental Permit Required | Word Form |
| Sample | Clear Letter - Permits Required | Word Form |
| Sample | Clear Letter - Railroad | Word Form |
| Sample | Clear Letter - Utilities | Word Form |
| 575-095-05 | LAP Right of Way Certification, Certification with Exceptions and LAP Initial Design and Build | Consolidated Forms |
| Procurement - Professional Services and Construction | ||
| Title VI & Non-Discrimination | Appendices A&E, Nondiscrimination Contract Assurances (required in all contracts) | Word Form |
| 275-030-11 | DBE Bid Package Information | PDF Form Word Form |
| 375-020-27 | Contract Bond (in Bid Blank) | PDF Form |
| 375-030-32 | Certification Regarding Debarment, Suspension...for Federal Aid Contracts | Word Form |
| 375-030-33 | Lobbying Certification | Word Form |
| 375-030-34 | Disclosure of Lobbying | Word Form |
| 375-030-91 | Vendor Eligibility Prior to Contract of Award | Word Form |
| 375-030-83 | DBE Bid Opportunity Form | Word Form |
| PSU Procurement | ||
| 525-010-49 | Local Agency Program (LAP) Checklist for Federally Funded Professional Services Contracts Federal and State Requirements | Word Form |
| 375-030-18 | Consultant Affirmation | PDF Form Word Form |
| 375-020-08 | Proposal (in Bid Blank) | FORM |
| 375-020-30 | Contract Affidavit (in Bid Blank) | PDF Form |
| 375-030-30 | Truth in Negotiation | Word Form |
| 375-030-50 | Conflict of Interest Certification | Word Form |
| 375-040-84 | LAP Terms for Federal Aid Professional Services Contracts | PDF Form Word Form |
| Sample | Calculating Fee mock Up Calculating Fee Mock Up How to Guide - Developed by District 6 | Excel Form PDF Form |
| 700-010-04 | Estimate of Contract Time | Excel Form |
| Construction Procurement | ||
| FHWA 1273 | Required Contract Provisions - Federal-Aid Construction Contracts | PDF Form |
| 525-010-44 | Local Agency Program (LAP) Checklist for Construction Contracts (Phase 58)-Federal Requirements | Word Form |
| 575-060-13 | Non-Collusion Declaration of Compliance | Word Form |
| 525-010-46 | LAP Certification of Current Capacity | PDF Form Word Form |
| Construction Administration
| ||
| Sample | QAR Checklist - Developed by District 4 and District 6 | Word Form |
| Sample | QAR Checklist - Developed by District 4 and District 6 - Geotech | Word Form |
| 700-050-56 | Daily Log (Sample) | Page Link |
| 700-010-38 | Certification of Payment (Sample) | PDF Form |
| 700-010-42 | Certification for Stockpiled Materials (Sample) | PDF Form |
| Invoicing | ||
| 525-010-54 | Local Programs Project Monitoring Status Report | Word Form Instructions |
| 525-010-53 | Local Programs Invoicing Template | Excel Form |
| Project Close Out | ||
| 525-010-42 | Local Agency Program Final Inspection and Acceptance of Federal-Aid Project | PDF Form Word Form |
| 525-010-47 | Local Agency Program Record of Final Plans and Documents | Word Form Instructions |
| 525-010-50 | Local Agency Program Performance Evaluation | Word Form |