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