Section 1 - Project Information
Local Agency Project Sponsor:
Project Title:
Project Category:
Section #:
State Job Number:
ITEP #:
Section 2 –Project PlanRequired For All ITEP Project Sponsors
As project sponsor, do you plan to move forward with this project?...... Yes No
- If “Yes”, you will need to complete the entire form.
- If “No”, you only need to complete the remainder of Section 2.
Notice: if you answered “No”, then all remaining unused ITEP funds will be released back to ITEP.
Have you utilized federal ITEP funds for any part of this project? ...... YesNo
Notice: If you have been reimbursed federal ITEP funds for Preliminary Engineering or any other facet related to the project and have elected to discontinue your project, you may have to repay those funds to the Federal Highway Administration (FHWA). Please consult with your local IDOT District Local Roads office to see what options are available, such as submittal of a No-Build Waiver.
Please tell us why you have decided not to continue with this project.
If you do not wish to continue with your ITEP project and want to release your funds,
you are not required to complete the rest of this form.
Section 3 - Funding
1) Project sponsors are required to provide a 20% local match and cover any ineligible items. Do you have the local match funds available in your current budget for this project? … Yes No
2) If “No”, when do you anticipate funds will be available? (mm/yyyy): /
3) Have you identified ineligible items in your project? ...... YesNo
4) If “Yes”, have you identified a funding source for ineligible items?...... YesNo
5) If “No”, when do you anticipate funds will be available? (mm/yyyy): /
Section 4 – Preliminary Engineering
1) Is Phase I engineering being funded with ITEP or Local funds?...... ITEP Local
2) Has Preliminary Engineering (Phase I) been started?...... Yes No
3) Does your project require a Project Development Report? ...... Yes No
4) If “Yes”, has the Project Development Report been approved?...... Yes No
5) Does your project require environmental signoffs?...... Yes No
6) If “Yes”, have you received the required environmental signoffs?...... Yes No
7) Is Phase II engineering being funded with ITEP or Local funds?...... ITEP Local
8) Has Preliminary Engineering (Phase II) been started?...... Yes No
a)Has Pre-final Plans, Special Provisions and Estimate (PS&E)
been submitted?...... Yes No
b) Has Final PS&E been submitted?...... Yes No
c) Has Final PS&E been approved?...... Yes No
Section 5 – Land Acquisition
1) Is Right-of-Way (ROW) required for your project (including easements)?...Yes No
2) Has allROW, including any easements, been secured?...... Yes No
3) If “Yes”, has the ROW been certified by the IDOT District Office?...... Yes No
Section 6 – Letting
Anticipated letting date: (mm/yyyy): /
Section 7 – Delays
If you have experienced any delays with your project please describe what those are and what, if anything, is being done to resolve those issues.
Printed 4/21/2019Page 1 of 2OPP 2270 (05/28/14)