INTRA DEPARTMENTAL CORRESPONDENCE
SUBJECT:ProjectProgram Modification RequestDATE:
TO:Elias Archuleta, P.E.
Chief Engineer
Office of Infrastructure Divisions
FROM:
PROJECT DATA
CN/PN:Route:
MP’s:
Termini:
District:
County:
Project Scope:
Check all that apply and give explanation:
Changes to Let Date (pick one below and fill in each box):
The initial change for the project Let Date, when it is moved out of the yearly quarter (a PPMR is not needed if initially moved in the quarter).
Current Production Date Proposed Production Date
Reason (explain in detail for tracking purposes):
After initial PPMR, anytime the Let Date is moved, in a quarter or out of a quarter a PPMR is needed.
Current Production Date Proposed Production Date
Reason (explain in detail for tracking purposes):
What could have been done to avoid this additional date move?
Production Date change moving past month of August will be moved out of the designated fiscal year and is subject to STIP Amendment.
Current Production Date Proposed Production Date
Reason (explain in detail for tracking purposes):
Delete Project (except as noted in the Administrative Modifications section of STIP Procedures)
Reason:
There is a substantial change to the scope (e.g. change impacting the capacity of the project, changing the project scope such as from rehabilitation to reconstruction).
Current Scope:
New Scope:
There is a change in the availability (adding or deleting funds by Congressional action) of earmarked (special appropriation) or awarded (ASIP, TAP, Discretionary) funds.
Change:
The project is moving into or out of the first four federal fiscal years of a STIP/TIP or into the FY baseline.
Current Year: New Year:
New Production Date:
Reason:
Changes in a project’s total programmed amount greater or less than 20% or an amount greater than $2,000,000 that is not scheduled for production before the next quarterly amendment (per STIP Policies & Procedures).
Current Amount:
New Amount:
Reason:
Changes in the termini of a capacity project beyond limits presented to the public during the public involvement process – Submit a copy of the Environmental Document of this change
(If let date changed, see above and fill in).
A copy of the Environmental Document with this change is attached.
Reason for Change:
Other:
Reason:
Current Production Date Proposed Production Date
Current Amount: New Amount:
Current Scope: New Scope:
Recommended:
______
Design Regional Manager/District Design Manager
Concur / Approve:
______
District Engineer
Concur / Approve:
______
Chief Engineer
Xc: Engineering Program Manager
STIP Coordinator, Project Scheduling Unit
Project Scheduling Unit Use Only
Date Received:
______
(initial)
Date Entered/Submittal of Copy:
______
(initial)
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