Common use of NEEDS AND ESTIMATE SUMMARY Clause in Contracts

NEEDS AND ESTIMATE SUMMARY. All components of the project must be defined in the environmental document if any portion of the project is federally funded. The Municipality agrees to complete all participating and any non-participating work included in this improvement consistent with the environmental document. No work on final engineering and design may occur prior to approval of the environmental document. Funding is limited to the minimum eligible project scope necessary for a safe and effective facility per WisDOT Performance-Based Practical Design policy. The funding for the project for both structure and approach is limited to: • replacement or rehabilitation of the existing facility, • or, meeting minimum bridge standards as outlined in the WisDOT Facilities Development Manual (FDM) or applicable TRANS code, • or, an approved justification based on engineering principles that exceed either Performance-Based Practical Design or the FDM. The Municipality may elect to construct alternative designs but approved Local Bridge Improvement Assistance Program (s84.18(2)(e)) funding will be limited to a maximum of 80 percent of the cost of the minimum eligible scope of the project. Type of facility ▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇ ▇-▇▇-▇▇▇▇ Structure passes over Branch of Plum Creek Clear bridge width 23.1 FT 24 FT Bridge length 26.5 FT 45 FT Total length of approach work 100 FT Number of spans 1 1 Special safety issues No Sidewalk No No Sidewalk along approach No No Bicycle / pedestrian improvements required No Improvement type as indicated on project application Replacement – existing alignment Acquisition of right-of-way Yes Minimal anticipated, less than 0.5 acre of fee and temporary limited easements. Approach width and type 18 FT 18 FT wide, Asphalt Approach shoulder width and type 2 FT wide, Gravel Bridge rail Yes Beam guard No Describe non-participating work included in the project and other work necessary to completely finish the project that will be undertaken independently by the Municipality. Please note that non-participating components of a project/contract are considered part of the overall project and will be subject to applicable federal requirements: A municipality may elect to design a bridge or elements that exceed the current Performance-Based Practical Design policy, or that exceed minimum bridge standards as outlined in the WisDOT Facilities Development Manual (FDM) or applicable TRANS code, or are not justified as necessary based on current engineering principles. All costs for these features will be paid for 100% by the Municipality.

NEEDS AND ESTIMATE SUMMARY. All components of the project must be defined in the environmental document if any portion of the project is federally funded. The Municipality agrees to complete all participating and any non-participating work included in this improvement consistent with the environmental document. No work on final engineering and design may occur prior to approval of the environmental document. Funding is limited to the minimum eligible project scope necessary Existing Facility - Describe and give reason for a safe and effective facility per WisDOT Performance-Based Practical Design policy. The funding for the project for both structure and approach is limited torequest: • replacement or rehabilitation of the existing facility, • or, meeting minimum bridge standards as outlined in the WisDOT Facilities Development Manual (FDM) or applicable TRANS code, • or, an approved justification based on engineering principles that exceed either Performance-Based Practical Design or the FDM. The Municipality may elect to construct alternative designs but approved Local Bridge Improvement Assistance Program (s84.18(2)(e)) funding will be limited to a maximum of 80 percent of the cost of the minimum eligible scope of the project. Type of facility ▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇ ▇is a two-lane, rural cross section roadway with 12ft travel lanes and variable width shoulders. Bike accommodations are present on street, but there are no sidewalks. The route is classified as a minor arterial with an ADT of 16,600. The asphalt pavement is in poor condition with a rating of 4-5. This segment also contains two at-grade railroad crossings and several sub-standard vertical curves. During peak traffic flows, there is significant congestion. Proposed Improvement - Nature of work: Reconstruction with capacity expansion. The proposed work is to reconstruct the road as a four-lane, urban cross-section with curb and gutter and sidewalk. The total project length will be about two miles. The project segment lies within the ▇▇-▇▇▇▇▇▇▇ Structure passes over Branch of Plum Creek Clear bridge width 23.1 FT 24 FT Bridge length 26.5 FT 45 FT Total length of approach flood plain. Railroad crossing surfaces and signals will be upgraded. Additional work 100 FT Number of spans 1 1 Special safety issues No Sidewalk No No Sidewalk along approach No No Bicycle / pedestrian improvements required No Improvement type as indicated on project application Replacement – existing alignment Acquisition of right-of-way Yes Minimal anticipatedwill include storm sewers, less than 0.5 acre of fee standard system lighting, permanent and temporary limited easementspavement marking, and permanent and temporary signing. Approach width and type 18 FT 18 FT wide, Asphalt Approach shoulder width and type 2 FT wide, Gravel Bridge rail Yes Beam guard No Real estate is 100% locally funded for the project. Describe non-participating work included in the project and other work necessary to completely finish the project that will be undertaken independently by the Municipality. Please note that non-participating components of a project/contract are considered part of the overall project and will be subject to applicable federal Federal requirements: A Non-participating items determined in design. The Municipality agrees to the following 2015-2020 Urbanized Area STP-Urban project funding conditions: Project design and construction costs are funded with 80% federal funding up to a maximum of $14,290,624 for all federally-funded project phases when the municipality agrees to provide the remaining 20% and all funds in excess of the $14,290,624 federal funding maximum, in accordance with the STP Urban program guidelines for projects in urbanized areas. Non-participating costs are 100% the responsibility of the municipality. Any work performed by the Municipality prior to federal authorization is not eligible for federal funding. The Municipality will be notified by the State that the project is authorized and available for charging. This project is currently scheduled in State Fiscal Year 2021. In accordance with the State’s sunset policy for Urbanized Area STP Urban projects, the subject 2015-2020 Urbanized Area STP-Urban improvement must be constructed and in final acceptance within six years from the start of State Fiscal Year 2017, or by June 30, 2022. Extensions may elect be available upon approval of a written request by or on behalf of the Municipality to design a bridge WisDOT. The written request shall explain the reasons for project implementation delay and revised timeline for project completion. The dollar amounts shown in the Summary of Costs Table below are estimates. The final Municipal share is dependent on the final federal participation, and actual costs will be used in the final division of cost for billing and reimbursement. In no event shall federal or elements that State funding exceed the current Performance-Based Practical Design policy, or that exceed minimum bridge standards as outlined estimate of $14,290,624 in the Summary of Costs Table, unless such increase is approved in writing by the State through the State’s Change Management Policy prior to the Municipality incurring the increased costs. SUMMARY OF COSTS PHASE Total Est. Cost Federal Funds % RR Funds % Municipal Funds % Design $1,213,951 $799,146 80% $0 0% $414,805 20% + BAL WisDOT Facilities Development Manual Review $21,067 $16,854 80% $0 0% $4,213 20% + BAL RR Crossing (FDMID 390 520H) or applicable TRANS code$242,982 $119,061 49% $94,763 39% $29,158 12% Balance 39% 61% RR Signals (ID 390 520H) $482,884 $386,307 80% 0% $96,577 20% + BAL RR Crossing (ID 390 517A) $240,396 $125,006 52% $84,139 35% $31,251 13% Balance 35% 65% RR Signals (ID 390 517A) $717,033 $573,626 80% $0 0% $143,407 20% + BAL Construction $15,600,350 $12,219,303 80% $0 0% $3,381,047 20% + BAL WisDOT Review $64,150 $51,320 80% $0 0% $12,830 20% + BAL Non-Participating Construction $681,325 $0 0% $0 0% $681,325 100% The percentage of project costs covered by federal funding at approval, or are not justified as necessary 80%, is based on current engineering principlesTIP Committee Action. All costs Due to the federal funding cap, which is $14,290,624 for these features will be paid for 100% all federally-funded project phases, this percentage may change over the life of the project. This request is subject to the terms and conditions that follow (pages 3 – 8) and is made by the Municipality.undersigned under proper authority to make such request for the designated Municipality and upon signature by the State and delivery to the Municipality shall constitute agreement between the Municipality and the State. No term or provision of neither the State/Municipal Agreement nor any of its attachments may be changed, waived or terminated orally but only by an instrument in writing executed by both parties to the State/Municipal Agreement. Signed for and in behalf of City of Brookfield: Name (print): Title: Signature: Date: Signed for and in behalf of City of Brookfield: Name (print): Title: Signature: Date: Signed for and in behalf of the State Name (print): ▇▇▇▇ ▇▇▇▇▇ Title: SE Region Planning Chief Signature: Date:

NEEDS AND ESTIMATE SUMMARY. All components of the project must be defined in the environmental document if any portion of the project is federally funded. The Municipality agrees to complete all participating and any non-participating work included in this improvement consistent with the environmental document. No work on final engineering and design may occur prior to approval of the environmental document. Funding is limited to the minimum eligible project scope necessary for a safe and effective facility per WisDOT Performance-Based Practical Design policy. The funding for the project for both structure and approach is limited to: • replacement or rehabilitation of the existing facility, • or, meeting minimum bridge standards as outlined in the WisDOT Facilities Development Manual (FDM) or applicable TRANS code, • or, an approved justification based on engineering principles that exceed either Performance-Based Practical Design or the FDM. The Municipality may elect to construct alternative designs but approved Local Bridge Improvement Assistance Program (s84.18(2)(e)) funding will be limited to a maximum of 80 percent of the cost of the minimum eligible scope of the project. Type of facility ▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇ ▇-▇▇-▇▇▇▇ Structure passes over Branch of Plum Beaver Dam Creek Clear bridge width 23.1 FT ▇▇ ▇▇ ▇▇ ▇▇ ▇▇▇▇▇▇ length 24 FT Bridge length 26.5 FT 45 25 FT Total length of approach work 100 FT Number of spans 1 1 Special safety issues No Sidewalk No No Yes Sidewalk along approach No No Yes Yes Bicycle / pedestrian improvements required No Yes Improvement type as indicated on project application Replacement – existing alignment Acquisition of right-of-way Yes Minimal anticipated, less than 0.5 acre of fee and temporary limited easements. Approach width and type 18 40 FT 18 40 FT wide, Asphalt Concrete Approach shoulder width and type 2 FT wide, Gravel Curb and Gutter Bridge rail Yes Beam guard No Yes Describe non-participating work included in the project and other work necessary to completely finish the project that will be undertaken independently by the Municipality. Please note that non-participating components of a project/contract are considered part of the overall project and will be subject to applicable federal requirements: A municipality may elect to design a bridge or elements that exceed the current Performance-Based Practical Design policy, or that exceed minimum bridge standards as outlined in the WisDOT Facilities Development Manual (FDM) or applicable TRANS code, or are not justified as necessary based on current engineering principles. All costs for these features will be paid for 100% by the Municipality. The Municipality agrees to the following 2020-2025 Local Bridge Program project funding conditions: Project Design costs are funded with up to 80% state/federal funding up to a funding limit of $120,928. The Municipality agrees to provide the remaining 20% and any funds in excess of the $120,928 state/federal funding limit. Any real estate, railroad, or utility costs are 100% locally funded. Project Construction costs are funded with up to 80% state/federal funding up to a funding limit of $466,480. The Municipality agrees to provide the remaining 20% and any funds in excess of the $466,480 state/federal funding limit. Any real estate, railroad, or utility costs are 100% locally funded. Non-participating costs are 100% the responsibility of the Municipality. Any work performed by the Municipality prior to federal authorization is not eligible for federal funding. The Municipality will be notified by the State that the project is authorized and available for charging. This project is currently scheduled in State Fiscal Year 2023. In accordance with the State’s sunset policy for Local Bridge Program projects, the subject 2020-2025 Local Bridge Program improvement must be constructed and in final acceptance within six years from the start of State Fiscal Year 2021, or by June 30, 2026. Extensions may be available upon approval of a written request by or on behalf of the Municipality to State per WisDOT Change Management policy. The written request shall explain the reasons for project implementation delay and revised timeline for project completion. The dollar amounts shown in the Summary of Costs Table below are estimates. The final Municipal share is dependent on the final federal/state participation, and actual costs will be used in the final division of cost for billing and reimbursement. Additional funds will not be approved for projects where increased costs are due to changes outside of the project scope that were identified in the original application or the most recent State Municipal Agreement (SMA) (whichever is most current). Exceptions to this policy will be allowed when the change is necessary based on safety, conformance with applicable minimum federal and state standards, projected traffic needs, or other factors as determined by WisDOT. Design $ 137,000 $ 109,600 80% $ 27,400 20% + BAL State Review $ 14,160 $ 11,328 80% $ 5,640 20% + BAL Participating Construction $ 489,200 $ 391,360 80% $ 97,840 20% + BAL Construction Engineering $ 78,300 $ 62,640 80% $ 15,660 20% + BAL Non-Participating Construction $ 0 $ 0 0% $ 0 100% State Review $ 15,600 $ 12,480 80% $3,120 20% + BAL *Design ID 4987-02-77 federal/state funding is limited to $ 120,928. *Construction ID 4987-02-78 federal/state funding is limited to $ 466,480. This request is subject to the terms and conditions that follow (pages 4 – 9) and is made by the undersigned under proper authority to make such request for the designated Municipality and upon signature by the State and delivery to the Municipality shall constitute agreement between the Municipality and the State. No term or provision of neither the State/Municipal Agreement nor any of its attachments may be changed, waived or terminated orally but only by an instrument in writing executed by both parties to the State/Municipal Agreement. Date Signature Signed for and in behalf of the State (please sign in blue ink.) Name (print) Title Date Signature Title Name (print) Signed for and in behalf of: City of Green Bay (please sign in blue ink.)

NEEDS AND ESTIMATE SUMMARY. All components of the project must be defined in the environmental document if any portion of the project is federally funded. The Municipality agrees to complete all participating and any non-participating work included in this improvement consistent with the environmental document. No work on final engineering and design may occur prior to approval of the environmental document. Funding is limited to the minimum eligible project scope necessary for a safe and effective facility per WisDOT Performance-Based Practical Design policy. The funding for the project for both structure and approach is limited to: • replacement or rehabilitation of the existing facility, • or, meeting minimum bridge standards as outlined in the WisDOT Facilities Development Manual (FDM) or applicable TRANS code, • or, an approved justification based on engineering principles that exceed either Performance-Based Practical Design or the FDM. The Municipality may elect to construct alternative designs but approved Local Bridge Improvement Assistance Program (s84.18(2)(e)) funding will be limited to a maximum of 80 percent of the cost of the minimum eligible scope of the project. Type of facility ▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇ ▇-▇▇-▇▇▇▇ Structure passes over Branch of Plum Beaver Dam Creek Clear bridge width 23.1 ▇▇ ▇▇ ▇▇ ▇▇ ▇▇▇▇▇▇ length 37 FT 24 FT Bridge length 26.5 FT 45 47 FT Total length of approach work 100 FT Number of spans 1 1 Special safety issues No Sidewalk No No Yes Yes Sidewalk along approach No No Yes Bicycle / pedestrian improvements required No Yes Improvement type as indicated on project application Replacement – existing alignment Acquisition of right-of-way Yes Minimal anticipated, less than 0.5 acre of fee and temporary limited easements. Approach width and type 18 45 FT 18 58 FT wide, Asphalt Concrete Approach shoulder width and type 2 FT wide, Gravel Curb and Gutter Bridge rail Yes Beam guard No Yes Describe non-participating work included in the project and other work necessary to completely finish the project that will be undertaken independently by the Municipality. Please note that non-participating components of a project/contract are considered part of the overall project and will be subject to applicable federal requirements: A municipality may elect to design a bridge or elements that exceed the current Performance-Based Practical Design policy, or that exceed minimum bridge standards as outlined in the WisDOT Facilities Development Manual (FDM) or applicable TRANS code, or are not justified as necessary based on current engineering principles. All costs for these features will be paid for 100% by the Municipality. The Municipality agrees to the following 2020-2025 Local Bridge Program project funding conditions: Project Design costs are funded with up to 80% state/federal funding up to a funding limit of $193,440. The Municipality agrees to provide the remaining 20% and any funds in excess of the $193,440 state/federal funding limit. Any real estate, railroad, or utility costs are 100% locally funded. Project Construction costs are funded with up to 80% state/federal funding up to a funding limit of $791,920. The Municipality agrees to provide the remaining 20% and any funds in excess of the $791,920 state/federal funding limit. Any real estate, railroad, or utility costs are 100% locally funded. Non-participating costs are 100% the responsibility of the Municipality. Any work performed by the Municipality prior to federal authorization is not eligible for federal funding. The Municipality will be notified by the State that the project is authorized and available for charging. This project is currently scheduled in State Fiscal Year 2024. In accordance with the State’s sunset policy for Local Bridge Program projects, the subject 2020-2025 Local Bridge Program improvement must be constructed and in final acceptance within six years from the start of State Fiscal Year 2021, or by June 30, 2026. Extensions may be available upon approval of a written request by or on behalf of the Municipality to State per WisDOT Change Management policy. The written request shall explain the reasons for project implementation delay and revised timeline for project completion. The dollar amounts shown in the Summary of Costs Table below are estimates. The final Municipal share is dependent on the final federal/state participation, and actual costs will be used in the final division of cost for billing and reimbursement. Additional funds will not be approved for projects where increased costs are due to changes outside of the project scope that were identified in the original application or the most recent State Municipal Agreement (SMA) (whichever is most current). Exceptions to this policy will be allowed when the change is necessary based on safety, conformance with applicable minimum federal and state standards, projected traffic needs, or other factors as determined by WisDOT. Design $ 213,600 $ 170,880 80% $ 42,720 20% + BAL State Review $ 28,200 $ 22,560 80% $ 5,640 20% + BAL Participating Construction $ 854,500 $ 683,600 80% $ 170,900 20% + BAL Construction Engineering $ 119,800 $ 95,840 80% $ 23,960 20% + BAL Non-Participating Construction $ 0 $ 0 0% $ 0 100% State Review $ 15,600 $ 12,480 80% $3,120 20% + BAL *Design ID 4987-12-00 federal/state funding is limited to $ 193,440. *Construction ID 4987-12-71 federal/state funding is limited to $ 791,920. This request is subject to the terms and conditions that follow (pages 4 – 9) and is made by the undersigned under proper authority to make such request for the designated Municipality and upon signature by the State and delivery to the Municipality shall constitute agreement between the Municipality and the State. No term or provision of neither the State/Municipal Agreement nor any of its attachments may be changed, waived or terminated orally but only by an instrument in writing executed by both parties to the State/Municipal Agreement. Date Signature Signed for and in behalf of the State (please sign in blue ink.) Name (print) Title Date Signature Title Name (print) Signed for and in behalf of: City of Green Bay (please sign in blue ink.)

NEEDS AND ESTIMATE SUMMARY. All components of the project must be defined in the environmental document if any portion of the project is federally funded. The Municipality agrees to complete all participating and any non-participating work included in this improvement consistent with the environmental document. No work on final engineering and design may occur prior to approval of the environmental document. Funding is limited to the minimum eligible project scope necessary for a safe and effective facility per WisDOT Performance-Based Practical Design policy. The funding for the project for both structure and approach is limited to: • replacement or rehabilitation of the existing facility, • or, meeting minimum bridge standards as outlined in the WisDOT Facilities Development Manual (FDM) or applicable TRANS code, • or, an approved justification based on engineering principles that exceed either Performance-Based Practical Design or the FDM. The Municipality may elect to construct alternative designs but approved Local Bridge Improvement Assistance Program (s84.18(2)(e)) funding will be limited to a maximum of 80 percent of the cost of the minimum eligible scope of the project. Type of facility ▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇ ▇Bridge Bridge ID B-67-▇▇-▇▇▇▇ 0205 Structure passes over Branch of Plum Creek Fox River Clear bridge width 23.1 28 FT 24 28 FT Bridge length 26.5 190 FT 45 190 FT Total length of approach work 100 FT Total Number of spans 1 1 3 3 Special safety issues No Sidewalk No No Yes one side Yes Sidewalk along approach No No Yes Yes Bicycle / pedestrian improvements required No Yes Maintain existing Improvement type as indicated on project application Replacement – existing alignment Bridge Rehab/Deck Overlay Acquisition of right-of-way Yes Minimal anticipated, less than 0.5 acre of fee and temporary limited easements. No Approach width and type 18 28 FT 18 Concrete 28 FT wide, Asphalt Concrete Approach shoulder width and type 2 4 FT wide, Gravel Curb and Gutter Bridge rail Yes Beam guard No Describe non-participating work included in the project and other work necessary to completely finish the project that will be undertaken independently by the Municipality. Please note that non-participating components of a project/contract are considered part of the overall project and will be subject to applicable federal requirements: All work associated with B-67-0248. A municipality may elect to design a bridge or elements that exceed the current Performance-Based Practical Design policy, or that exceed minimum bridge standards as outlined in the WisDOT Facilities Development Manual (FDM) or applicable TRANS code, code or are not justified as necessary based on current engineering principles. All costs for these features will be paid for 100% by the Municipality. The Municipality agrees to the following 2022-2027 Local Bridge Program project funding conditions: Project Design costs are funded with up to 80% state/federal funding up to a funding limit of $60,000. The Municipality agrees to provide the remaining 20% and any funds in excess of the $60,000 state/federal funding limit. Any real estate, railroad, or utility costs are 100% locally funded. Project Construction costs are funded with up to 80% state/federal funding up to a funding limit of $281,600. The Municipality agrees to provide the remaining 20% and any funds in excess of the $281,600 state/federal funding limit. Any real estate, railroad, or utility costs are 100% locally funded. Non-participating costs are 100% the responsibility of the Municipality. Any work performed by the Municipality prior to federal authorization is not eligible for federal funding. The Municipality will be notified by the State that the project is authorized and available for charging. This project is currently scheduled in State Fiscal Year 2024. Sunset date: 06/30/2029 calculated as six years from the beginning of the state fiscal year (SFY) in which a project is initially scheduled. Extensions may be available upon approval of a written request by or on behalf of the Municipality to State per WisDOT Change Management policy. The written request shall explain the reasons for project implementation delay and revised timeline for project completion. The dollar amounts shown in the Summary of Costs Table below are estimates. The final Municipal share is dependent on the final federal/state participation, and actual costs will be used in the final division of cost for billing and reimbursement. In no event shall federal or State funding exceed the estimate in the Summary of Costs table, unless such increase is approved in writing by the State through the State’s Change Management policy prior to the Municipality incurring the increased costs. Additional funds will not be approved for projects where increased costs are due to changes outside of the project scope that were identified in the original application or the most recent State Municipal Agreement (SMA) (whichever is most current). Exceptions to this policy will be allowed when the change is necessary based on safety, conformance with applicable minimum federal and state standards, projected traffic needs, or other factors as determined by WisDOT. TABLE B SUMMARY OF COSTS PHASE Total Est. Cost Federal/State Funds % Municipal Funds % State Review $10,000 $0 0% $10,000 100% Non-Participating Construction $152,000 $0 0% $152,000 100% Construction Engineering $28,000 $0 0% $28,000 100% State Review $10,000 $0 0% $10,000 100% Design $60,000 $48,000 80% $12,000 20% + BAL State Review $15,000 $12,000 80% $3,000 20% + BAL Participating Construction $287,000 $229,600 80% $57,400 20% + BAL Construction Engineering $50,000 $40,000 80% $10,000 20% + BAL Non-Participating Construction $25,000 0% $25,000 100% State Review $15,000 $12,000 80% $3,000 20% + BAL Total Est. Cost Distribution $652,000 $341,600 $310,400 *Design ID 2718-00-03 federal/state funding is limited to $0 *Construction ID 2718-00-73 federal/state funding is limited to $0 *Design ID 2718-00-08 federal/state funding is limited to $60,000 *Construction ID 2718-00-78 federal/state funding is limited to $281,600 This request is subject to the terms and conditions that follow (pages 4 – 9) and is made by the undersigned under proper authority to make such request for the designated Municipality and upon signature by the State and delivery to the Municipality shall constitute agreement between the Municipality and the State. No term or provision of neither the State/Municipal Agreement nor any of its attachments may be changed, waived or terminated orally but only by an instrument in writing executed by both parties to the State/Municipal Agreement. Signed for and in behalf of: City of Waukesha (please sign in blue ink.) Name (print) Title Signature Date Signed for and in behalf of the State (please sign in blue ink.) Name (print): ▇▇▇▇ ▇▇▇▇▇ Title: SE Region Chief Signature Date

NEEDS AND ESTIMATE SUMMARY. All components of the project must be defined in the environmental document if any portion of the project is federally funded. The Municipality agrees to complete all participating and any non-participating work included in this improvement consistent with the environmental document. No work on final engineering and design may occur prior to approval of the environmental document. Funding is limited to the minimum eligible project scope necessary for a safe and effective facility per WisDOT Performancereplace-Based Practical Design in-kind policy. The funding for the project for both structure and approach is limited to: • replacement or rehabilitation of the existing facility, • or, meeting minimum bridge standards as outlined in the WisDOT Facilities Development Manual (FDM) or applicable TRANS code, • or, an approved justification based on engineering principles that exceed either Performancereplace-Based Practical Design in-kind or the FDM. The Municipality may elect to construct alternative designs designs, but approved Local Bridge Improvement Assistance Program (s84.18(2)(e)) funding will be limited to a maximum of 80 percent of the cost of the minimum eligible scope of the project. Application project justification statement: Type of facility ▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇ ▇-▇▇-▇▇▇▇ Structure passes over Branch of Plum Creek Yahara River Clear bridge width 23.1 28.1 FT 24 28.0 FT Bridge length 26.5 38.0 FT 45 48.0 FT Total length of approach work 100 FT Number of spans 1 1 Special safety issues No n/a Sidewalk No No 5 FT wide, 48 FT long Sidewalk costs will be non- participating costs and paid for by the municipality. Sidewalk along approach No No n/a n/a Bicycle / pedestrian improvements required No 10' X 48' wide path Improvement type as indicated on project application Replacement – existing alignment project - Existing Alignment Acquisition of right-of-way Yes Minimal anticipated, less than 0.5 acre of fee and temporary limited easements. No Approach width and type 18 28.1 FT 18 28 FT wide, Asphalt Approach shoulder width and type 2 FT wide, Gravel Curb and Gutter Bridge rail Yes Beam guard No Non-participating work, additional notes: Describe non-participating work included in the project and other work necessary to completely finish the project that will be undertaken independently by the Municipality. Please note that non-participating components of a project/contract are considered part of the overall project and will be subject to applicable federal requirements: A municipality may elect to design a bridge or elements that exceed the current Performancereplace-Based Practical Design in-kind policy, or that exceed minimum bridge standards as outlined in the WisDOT Facilities Development Manual (FDM) or applicable TRANS code, or are not justified as necessary based on current engineering principles. All costs for these features will be paid for 100% by the Municipality. The Municipality agrees to the following 2018-2022 Local Bridge Program project funding conditions: Project Design costs are funded with up to 80% state funding up to a funding limit of $93,184.00. The Municipality agrees to provide the remaining 20% and any funds in excess of the $93,184.00 state funding limit. Any real estate, railroad, or utility costs are 100% locally funded. Project Construction costs are funded with up to 80% state funding up to a funding limit of $594,360.00. The Municipality agrees to provide the remaining 20% and any funds in excess of the $594,360.00 state funding limit. Any real estate, railroad, or utility costs are 100% locally funded. Non-participating costs are 100% the responsibility of the Municipality. Any work performed by the Municipality prior to federal authorization is not eligible for federal funding. The Municipality will be notified by the State that the project is authorized and available for charging. This project is currently scheduled in State Fiscal Year 2021. In accordance with the State’s sunset policy for Local Bridge Program projects, the subject 2018-2022 Local Bridge Program improvement must be constructed and in final acceptance within six years from the start of State Fiscal Year 2019, or by June 30, 2024. Extensions may be available upon approval of a written request by or on behalf of the Municipality to State per WisDOT Change Management policy. The written request shall explain the reasons for project implementation delay and revised timeline for project completion. The dollar amounts shown in the Summary of Costs Table below are estimates. The final Municipal share is dependent on the final federal/state participation, and actual costs will be used in the final division of cost for billing and reimbursement. Additional funds will not be approved for projects where increased costs are due to changes outside of the project scope that were identified in the original application or the most recent State Municipal Agreement (SMA) (whichever is most current). Exceptions to this policy will be allowed when the change is necessary based on safety, conformance with applicable minimum federal and state standards, projected traffic needs, or other factors as determined by WisDOT. Design $108,280.00 $86,624.00 80% $21,656.00 20% + BAL State Review $8,200.00 $6,560.00 80% $1,640.00 20% + BAL Participating Construction $650,000.00 $520,000.00 80% $130,000.00 20% + BAL Construction Engineering $84,500.00 $67,600.00 80% $16,900.00 20% + BAL Non-Participating Construction $195,000.00 0% $195,000.00 100% State Review $8,450.00 $6,760.00 80% $1,690.00 20% + BAL *Design ID 6992-00-04 federal/state funding is limited to $93,184.00 *Construction ID 6992-00-74 federal/state funding is limited to $594,360.00 This request is subject to the terms and conditions that follow (pages 4 – 10) and is made by the undersigned under proper authority to make such request for the designated Municipality and upon signature by the State and delivery to the Municipality shall constitute agreement between the Municipality and the State. No term or provision of neither the State/Municipal Agreement nor any of its attachments may be changed, waived or terminated orally but only by an instrument in writing executed by both parties to the State/Municipal Agreement. Date Signature Title Name (print) Signed for and in behalf of the State (please sign in blue ink.) Date Signature Title Name (print) Signed for and in behalf of: Village of Windsor (please sign in blue ink.)