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Last modified
10/20/2017 9:41:51 AM
Creation date
6/19/2017 12:38:47 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
06/13/2017
Control Number
2017-089
Agenda Item Number
8.H.
Entity Name
Florida Department of Transportation
Hurricane Matthew
Federal Highway Adminsitration
Subject
Local Government Emergency Relief Reimbursement Agreement
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I <br /> Report Number <br /> 613' DETAILED DAMAGE INSPECTION REPORT t- A cam,--�e2 <br /> U.S.Department <br /> i of Transportation (Title 23, Federal-aid Highways) Sheet Z <br /> I Federal HighwayZ <br /> Administration - pf <br /> i Location(Name of Road and Milepost) FHWA Disaster Number <br /> A_rrluc,,,, t eA..;;,---k ...` r L 2 — C2 <br /> • <br /> Inspection Date • I - <br /> (I/ZZ /t(Q II <br /> Description of Damage Federal-aid Route Iqumber <br /> ,I TA,-- t(,_ ( n t`k �i.�h\1.�Z \ 1_`�c.4 w`—\..- m4–r.t -'`3 !) / , <br /> ` \ State County <br /> «2 <br /> FL ` -'\ <br /> Cost <br /> Cost Estimate <br /> Description of Work to Dale Unit Unit Price QuantityCost <br /> (Equipment.Labor,and Materials) <br /> I Completed I Remaining <br /> i I R;`P1t c;_c,ci., .-•f! c.1h.1 0 Ne,Ett+�.L1 <br /> c? c a... >,E,( 1-t-tk :,v i s! t 4\aJ _ ( i _ . <br /> L a.L 0 (%421 f Z2 72(--`'') I I I -2 s,Y. I <br /> 1=€i.:,� LSA 2s}7' tp4.`122.- <br /> 1 1 $ +I rice (e=. <br /> a M ca+t l_ ( C1,:.-Y•t F,_,,\l e..A i M:r....-E +1� ' 1342 Cs—' <br /> IDI f <br /> _' I 1 <br /> !WI —^• <br /> I <br /> Method I \\ Subtotal I44 <br /> $41 t 11 <br /> r <br /> I,_•);Local Forces 0 State Forces 0 Contract PUCE i <br /> Emergency Repair Total <br /> I, I i <br /> • <br /> II <br /> II ! I <br /> i 1 <br /> - I { <br /> En-1 I I ! - <br /> TA <br /> c2 1 <br /> I I I <br /> 't i I + . <br /> € 1 I 1 <br /> I Method Subtotal <br /> II <br /> ❑Local Forces State Forces PE/CE <br /> U ❑Contract <br /> Right-of-Way <br /> Perm.Repair Totals i <br /> Environmental Assessment Recomm ndation (9 1 <br /> II Categorical Exclusion — <br /> °EA/EIS LI_ 1 qt <br /> Estimated Total. <br /> Recommendation _ IF. Engineer Date <br /> 7✓Eligible i Ineligible iq / I <br /> Concurrence St e Engineer Dat / <br /> Yes _i No II/ <br /> j L <br /> Concurrence Y cat l Agenc sentativev ) <br /> y <br /> i'Yes No --- i� '; O J/^Z <br /> Form FHWA-1547(Rev.4-98) <br /> / t <br /> • <br />
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