CHAIR AND COMMISSIONERS Reference No.: 2.5e.(X)

CALIFORNIA TRANSPORTATION COMMISSION Month XX-XX, XXXX

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M e m o r a n d u m

To: CHAIR AND COMMISSIONERS
CALIFORNIA TRANSPORTATION COMMISSION /

CTC Meeting: Month XX-XX, 20XX

Reference No.: 2.5e.(X)

Action Item
From: NORMA ORTEGA
Chief Financial Officer /

Prepared by: District Director Name

District XX - Director
Subject: SUPPLEMENTAL FUNDS ALLOCATION FOR PREVIOUSLY VOTED PROJECT
(PPNO XX-XXXX)
RESOLUTION FA-XX-XX

ISSUE

Should the California Transportation Commission (Commission) approve the California Department of Transportation’s (Department’s) request for an additional $X,XXX,XXX (Supplemental Funds Request amount) in Construction Capital and $X,XXX,XXX (Supplemental Funds Request amount) in Construction Support for the PROGRAM (example: State Highway Operation Protection Program (SHOPP) or State Transportation Improvement Program (STIP)) PROGRAM CATEGORY (example: Seismic Safety Retrofit, Roadside Safety Improvement, Pavement Rehabilitation) (PPNO XXXX) on ROUTE (example: Interstate 5 (I-5)), in COUNTY NAME (example: Los Angeles County), to complete construction?

RECOMMENDATION

The Department recommends that the Commission allocate an additional $ X,XXX,XXX (Supplemental Funds Request amount) in Construction Capital for the previously approved PROGRAM and PROGRAM CATEGORY (PPNO XXXX) on ROUTE, in COUNTY NAME, to complete construction.

RESOLUTION

Resolved, that $ X,XXX,XXX in Construction Capital (Construction Capital Component Funds Request amount) be allocated from the Budget Act of 20XX, Budget Act Items 2660-XXX-XXXX and 2660-XXX-XXXX and $ X,XXX,XXX (Construction Support Component Funds Request amount) in Construction Support be allocated from Budget Act Item 2660-XXX-XXX, to provide funds to close out the construction contract of the following project.

Dist-Co-Rte / Construction Component / Original
Allocated
Amount / Total Authorized Amount / Supplemental
Funds
Request / Revised
Amount / % Over Original Allocated Amount
XX-XXX-XXX / Capital / $X,XXX,XXX / $X,XXX,XXX / $X,XXX,XXX / $X,XXX,XXX / XX.X%
XX-XXX-XXX / Support / $X,XXX,XXX / $X,XXX,XXX / $X,XXX,XXX / $X,XXX,XXX / XX.X%
Total Supplemental Funds Request / $X,XXX,XXX

Total Authorized Amount = Original Allocated Amount + G-12 Adjustment

Revised Amount = Total Authorized Amount + Supplemental Funds Request

% Over Original Allocated Amount = _ Supplemental Fund Request .

Original Allocated Amount

PROJECT DESCRIPTION

Describe in detail the project location, scope of work, and other relevant information related to this supplemental funds request. DO NOT USE THE CTIPS PROJECT DESCRIPTION.

REASON FOR INCREASE

Use the following terms when making reference to the different project development phases:

·  Project Initiation Document (PID) phase

·  Project Approval and Environmental Document (PA&ED) phase

·  Plans, Specifications and Estimate (PS&E) phase

·  Right of Way (R/W) phase

·  Construction (CON) phase

Explain in detail the reason(s) for the cost increase and the need for additional funds. Include options that were considered and special considerations. Start with a summary sentence listing the reason(s) for the cost increase: “The cost estimate increase to complete construction of this project is due to reason #1, reason #2, etc.”

Reason #1 (XX percent of the Support Cost Increase)

This section explains in detail reason #1. Include efforts to mitigate, options that were considered and reason(s) it was not successful.

Reason #2 (XX percent of the Support Cost Increase)

This section explains in detail reason #2. Include efforts to mitigate, options that were considered and reason(s) it was not successful.

RISK ANALYSIS

This section summarizes potential risks identified in the Construction phase Risk Register that are related to the reason(s) for the cost increase to complete construction of this project.

EXPECTED IMPACTS

This section summarizes identified potential risks during the Construction phase that may impact the Construction Capital and/or Construction Support.

CONSEQUENCES

The Department has determined that additional funds are needed to complete construction. If this request for an additional $ X,XXX,XXX (Supplemental Funds Request amount) in Construction Capital and $ X,XXX,XXX (Supplemental Funds Request amount) in Construction Support is not approved, the Department will not be able to complete this PROGRAM and PROGRAM CATEGORY project.

REQUIRED SIGNATURES

Signatures are required only for internal distribution to the HQ Supplemental Executive Committee. This section will be removed after the HQ Supplemental Executive Committee review meeting. The final Book Item cover page will be signed by the District Director and the Chief Financial Officer.

Name (Print) / Signature / Title / Date
XXXXXXXXXXXXX / Project Manager / XX/XX/XX
XXXXXXXXXXXXX / SFP or District Director / XX/XX/XX

Attachment (Vote Box to be generated by OCTCL)

“Provide a safe, sustainable, integrated and efficient transportation system

to enhance California’s economy and livability”