certification acceptance assessment packet...• sample a/e rfq package – copies of what the...
TRANSCRIPT
A D O T L o c a l P u b l i c A g e n c y S e c t i o n O c t o b e r 1 9 2 0 1 8
Certification Acceptance Assessment Packet
1
Table of Contents
Certification Acceptance Assessment Packet 3 Purpose 3 Objective 3 Goal3 Schedule 3 Instructions 3
LPA Commonly Used Acronyms 4
Procurement of Materials andor Install 5 Agency Documents Approved By ADOT Procurement Group 5 Submit to ADOT LPA Section before December 7 2018 5 Assessment Questions 5
Procurement of a Consultant 6 Agency Documents Approved By ADOT ECS Section 6 Submit to ADOT LPA Section before December 31 2018 6 Assessment Questions 6
Roadway Pavement Design 8 Agency Document Reviewed By ADOT LPA Section 8 Submit to ADOT LPA Section before January 31 2019 8 Assessment Questions 8
Roadway Design Guidelines 9 Agency Document Reviewed By ADOT LPA Section 9 Submit to ADOT LPA Section before January 31 2019 9 Assessment Questions 9
Roadway Design Exceptions 10 Agency Document Reviewed By ADOT Roadway Engineering Group 10 Submit to ADOT LPA Section before January 31 2019 10 Assessment Questions 10
Materials QA Program 11 Agency Document Reviewed By ADOT Construction-Materials Group 11 Submit to ADOT LPA Section before January 31 2019 11 Assessment Questions 11
ROW Procedures 12 Agency Document Reviewed By ADOT ROW Section 12 Submit to ADOT LPA Section before January 31 2019 12 Assessment Questions 12
DBE Procedures 14 Agency Documents Reviewed By ADOT BECO 14 Submit to ADOT LPA Section before February 28 2019 14 Assessment Questions 14
Project Delivery Manual 16 Agency Documents Reviewed By ADOT LPA Section 16 Submit to ADOT LPA Section before March 29 2019 16 Assessment Questions 16
Staffing Plan 18 Agency Documents Reviewed By ADOT LPA Section 18
2
Submit to ADOT LPA Section before March 29 2019 18 Assessment Questions 18
Bid Analysis amp Award Procedures 19 Agency Documents Reviewed By ADOT LPA Section 19 Submit to ADOT LPA Section before March 29 2019 19 Assessment Questions 19
Subcontract Approval Procedures 20 Agency Documents Reviewed By ADOT LPA Section 20 Submit to ADOT LPA Section before April 30 2019 20 Assessment Questions 20
Financial Management Procedures 21 Agency Documents Reviewed By ADOT LPA Section 21 Submit to ADOT LPA Section before April 30 2019 21 Assessment Questions 21
3
Certification Acceptance Assessment Packet
Purpose Through the CA Agreement ADOT and the CA Agency will adhere to the responsibilities and requirements set forth by Federal Highway Administration (FHWA) when implementing the Federal Aid Highway Program (FAHP) in Arizona
Objective Define requirements of delegated authority from ADOT to the CA Agency for delivery of the FAHP under ADOTrsquos CA Program
Goal Provide ADOTrsquos expectations for the CA Agency project development program in delivering the FAHP including the necessary project delivery processes and procedures
Schedule Submittals Submit to ADOT LPA Section by Procurement (Materials andor Install) December 7 2018 Procurement (Consultant) December 31 2018 Roadway (Pavement Design Design Guidelines and Design Exceptions) January 31 2019 Materials (Quality Assurance) January 31 2019 Right-of-Way January 31 2019 Disadvantaged Business Enterprises (DBE) February 28 2019 Project Delivery Manual March 29 2019 Staffing March 29 2019 Bid Analysis and Award March 29 2019 Subcontractor Approval April 30 2019 Performance Measures (Finance and Reporting) April 30 2019
Instructions The Certification Acceptance Assessment Packet provides guidance for the Agency to evaluate andor develop procedures in the administrative areas identified in the CA Agreement for compliance in delivering the FAHP The packet contains a list of essential documents and assessment questions related to each administrative area requiring ADOT review and approval It is not mandatory for the Agency to have a single procedural document or manual for delivering the FAHP however it is highly recommended For each section of the packet
bull Note the due date for the submittal of the checklist and corresponding document(s) listed Documents provided after the final ADOT submittal date for that submittal may jeopardize the Agencyrsquos CA status
bull Locate the Agency document(s) or manual(s) where procedures are housed for delivering FAHP projects bull Compare and evaluate the current Agency procedures contained within the Agencyrsquos document(s) or manual(s)
with the questions on the checklist bull Update the current Agency procedures where necessary bull Answer ldquoyesrdquo or ldquonordquo for each question Provide a brief explanation for each ldquonordquo answer bull Identify the document page and paragraph for each question bull Fill in the ldquoPrepared byrdquo box identifying who in the Agency verified the Agencyrsquos procedures and answered each
question to complete the checklist bull Submit the checklist and corresponding document(s) to the ADOT LPA Section
Email all questions regarding the packet to Jennifer VanVenRoy at JVanvenroyazdotgov
4
LPA Commonly Used Acronyms AASHTO American Association of State Highway Transportation Officials ADA Americans with Disabilities Act AE ArchitecturalEngineering ADOT Arizona Department of Transportation BECO Business Engagement Compliance Office CA Certification Acceptance CFR Code of Federal Regulations CUF Commercially Useful Function DBE Disadvantaged Business Enterprise ECS Engineering Consultants Section EEO Equal Employment Opportunity EPRISE DBE Special Provisions FAHP Federal-aid Highway Program FHWA Federal Highway Administration GFE Good Faith Effort IGA Intergovernmental Agreement LPA Local Public Agency MAG Maricopa Association of Governments NCHRP National Cooperative Highway Research Program NEPA National Environmental Policy Act of 1969 NHS National Highway System NOT Notice of Termination OJT On-the-Job Training QA Quality Assurance PAG Pima Association of Governments PSampE Plans Specifications and Estimates QBS Qualifications Based Selection RDG Roadway Design Group RFQ Request for Qualifications ROW Right-of-Way SWPPP Stormwater Pollution Prevention Plan
5
Procurement of Materials andor Install
Agency Documents Approved By ADOT Procurement Group bull Completed ADOT Procurement Code Checklist (Appendix C) bull Procurement Code bull Other Procurement Procedures or Contract Documents as needed
Submit to ADOT LPA Section before December 7 2018
Assessment Questions Question YN Document Page Paragraph Do the Procurement Procedures or Contract Documents require the following for federal-aid contracts
Written competitive bidding thresholds for informal bids and purchases between $10000 and $100000 are to be awarded to a small business if possible
Bid Lists compiled and maintained through ProcureAZ or similar eProcurement method
Verification of employment records of contractors and subcontractors using e-verify
Compliance with the Significant Procurement Role requirements
Agency ndash Prepared by ADOT ndash Approved by Signature Signature Printed Name Printed Name Title Title Date Date
6
Procurement of a Consultant
Agency Documents Approved By ADOT ECS Section bull Completed Certification Acceptance Contract Administration Procedures Review Checklist (Appendix A) bull Procurement Procedures ndash written process for advertising evaluating selecting and negotiating contracts bull Contract Procedures ndash written process for contract administration and management bull Sample AE RFQ Package ndash copies of what the Agency advertises as part of its solicitation bull Sample Contract Boilerplate Documents ndash copies of contract document used for FAHP projects
Submit to ADOT LPA Section before December 31 2018
Assessment Questions Question YN Document Page Paragraph Is the Agency submitting Design Consultant Contracting (Procurement) Procedures If yes
Do the Agencyrsquos Design Consultant Contracting (Procurement) procedures meet the federal and state laws regulations and all other applicable requirements for qualification-based selection (QBS) process
Does the Agency use an ADOT approved prequalification process
If no does the Agency use ADOTrsquos prequalification list
Do the Agencyrsquos Procedures Require notification to the ADOT PM of kickoff and progress meetings
Inform the ADOT PM of error and omission actions taken
Require contacting the ADOT PM for approval and FHWA concurrence before terminating a federal-aid contract
Include a tracking and reporting process for on-call assignments if applicable
On-Call Design Procurement Procedures Is the Agency submitting Design Consultant On-Call Procurement Procedures If yes
Does the Agencyrsquos Procedures include On-Call procurement procedures
Do the CA Agencyrsquos procedures identify and define one of the two task or work orders assignment processes
Mini QBS procedures Regional selection
Do the CA Agencyrsquos procedures Include a tracking and reporting process for on-call assignments
Will the Agency be requesting an approval from ADOT before advertising for procurement of On-Call services
See Appendix B for additional resources
7
Agency ndash Prepared by ADOT ndash Approved by Signature Signature Printed Name Printed Name Title Title Date Date
8
Roadway Pavement Design
Agency Document Reviewed By ADOT LPA Section Pavement Design Guidelines
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local NHS Roadways
Does the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
Is MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
For NHS Roadways do the Agencyrsquos standards comply with 23 CFR 626
On Local Non - NHS Roadways Does the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local non-NHS RoadsStreets
Is MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
For Agency Projects within ADOT Right-of-Way do the Agencyrsquos Pavement Design Guidelines comply with the following
bull ADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
bull ADOT Materials Preliminary Design Guide bull AASHTO Design Guidelines
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
9
Roadway Design Guidelines
Agency Document Reviewed By ADOT LPA Section Roadway Design Guidelines
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local NHS Roadways
Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
Do the Agencyrsquos Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
On Local non-NHS Roadways Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local non-NHS RoadsStreets
For State Agency Projects within ADOT Right-of-Way do the Agencyrsquos Roadway Design confirm and comply with the following
bull AASHTO Controlling Design Criteria bull ADOT Roadway Design Guidelines (RDG) bull All other applicable adopted and published
ADOT design standard and guidelines
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
10
Roadway Design Exceptions
Agency Document Reviewed By ADOT Roadway Engineering Group Design Exception Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local - NHS Roadways
Does the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
Do the Agencyrsquos procedures include submitting to and obtaining approval from the FHWA for design exceptions
On Local Non - NHS Roadways Does the Agency have an adopted and published Design Exception procedure
For Agency Projects within ADOT Right-of-Way a Does the Agency have an adopted and
published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
b Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
c Do the Agencyrsquos procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
11
Materials QA Program
Agency Document Reviewed By ADOT Construction-Materials Group Materials QA Program or a letter signed by the Designated Approval Authority stating that the Agency adopts the ADOT Materials QA Program
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own ADOT-approved Materials QA Program
If no has the Agency adopted the ADOT Materials QA Program
Does the Materials QA Program Require the inclusion of the materials memo in the construction authorization packet and project file
Require the inclusion of the ADOT-approved Materials QA Project Plan in the construction authorization packet
Apply the Buy America provision to the entire FAHP project
Require verification that the Buy America certifications accompany each material shipment including steel or iron products
Require visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
12
ROW Procedures
Agency Document Approved By ADOT ROW Section ROW Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own written ROW manual If ldquoNordquo please explain If ldquoYesrdquo has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
If the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
Is the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 (b)
Does the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
Does the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 (c)
Does the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
Does the Agency request property donations from non-governmental owners whose Real Property Interest is required for Title 23 projects If ldquoYesrdquo does that donation meet the requirement per 23 CFR 710505(a)
Does the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
Does the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
Does the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
Is the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
13
of the Agency Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
Does the Agency include the preparation of right of way plans in their Federal Aid projects (CFR or Statute reference) If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
Does the Agency maintain a written logdiary (contact report) of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
14
DBE Procedures Agency Documents Reviewed By ADOT BECO
DBE Procedures
Submit to ADOT LPA Section before February 28 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency follow the current ADOT FHWA DBE Plan Does the Agency follow the current DBE EPRISE (DBE contract language)
Does the Agency have a DBE Liaison Do the DBE Procedures require the agency to
Follow the most current DBE Plan DBE EPRISE (DBE contract language)
Submit the required documents to ADOT BECO for Federal-aid Highway Program (FAHP) projects to be assessed for DBE Goal and ensuring the DBE Goal is ldquovalidrdquo for advertisement
Obtain from BECO and provide to bidders and proposers all current BECO LPA Forms
Include a ldquovalidrdquo DBE goal percentage in advertisement solicitations and contract documents
Provide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
Conduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
Ensure receipt of Bid Verification Notice from ADOT BECO before contract award
Ensure Good Faith Effort (GFE) documentation is provided to meet requirements of EPRISE Specifications (as applicable)
Notify ADOT PM and ADOT BECO of contract award or rejection of bids
Report contract awards to BECO by the 10th of the month following contract award
Ensure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
Monitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment amp Payment Reporting Provisions
15
Question YN Document Page Paragraph Monitor and enforce the Prompt Payment amp Payment Reporting Provisions for prime contractor payments to subcontractors
Monitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
Monitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
Conduct a Commercially Useful Function (CUF) review for each DBE on a FAHP project
Obtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
Monitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
Monitor LPA DBE System in preparation for the semi-annual reporting by ensuring contract payments are up date
Ensure timely closeout of contracts in the LPA DBE System
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
16
Project Delivery Manual
Agency Documents Reviewed By ADOT LPA Section bull FAHP Project Delivery Manual ndash title page table of contents publication or modification date bull Other manuals as needed ndash title page table of contents publication or modification date bull Schedule for updating the Project Delivery Manual and any other manuals listed below
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have a single Project Delivery Manual Does the Project Delivery Manual contain or incorporate through reference the following
Staffing Plan Communication Plan Training Plan Roadway Pavement Design Guidelines Roadway Design Guidelines Roadway Design Exception Procedures Materials QA Program ROW Procedures Procurement of a Consultant Procurement of Materials andor Install Bid Analysis and Award Procedures Subcontract Approval Procedures ADA Transition Plan Title VI Program Plan DBE Procedures Financial Management Procedures Audit and Oversight Procedures Reporting Procedures
Does the Project Delivery Manual or another manual address the following
Request for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
Pre-planning Project initiation Scoping document PSampE development Environmental document Utilities clearance Railroad clearance Materials memo Pre-construction meetings SWPPP Labor compliance Inspector daily diaries Supplemental agreements Progress payments Prompt pay
17
Question YN Document Page Paragraph Claims Final acceptance Project closeout Record keeping EEO OJT Authorization Reimbursement
Do the FAHP Contract Approval Procedures require the contract include the following as applicable
Buy America Requirements FHWA Non-Collusion Statement FHWA Form 1273 USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Sanctions and Penalties for Breach of Contract Termination for Cause and Convenience Clean Air ActFederal Water Pollution Control Act Debarment and Suspension Byrd Anti Lobbying Amendment Language regarding compliance with and federal and state immigration laws and regulations
Title VI Assurances and Appendices A and E Does the Project Delivery Manual include a schedule for updating the manual(s)
Is the Project Delivery Manual posted on the Agencyrsquos internal website or made readily available for all staff involved in FAHP projects
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
18
Staffing Plan
Agency Documents Reviewed By ADOT LPA Section Organizational Chart
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agencyrsquos Organizational Chart accurately identify current Key Personnel
Does the Agencyrsquos Organizational Chart identify position title and contact information for each Key Personnel
Does the Agency have a well-documented process for addingdeletingmodifying Key Personnel Does the Agencyrsquos process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
See the list of Key Personnel and Roles and Responsibility below for more information
Key Personnel Role and Responsibility Designated Approval Authority Official with the authority to formally assume responsibility for the
implementation of the project development program and delivery of FAHP projects
CA Liaison An executive decision maker with working knowledge of the CA Program and main point of contact for ADOT
Responsible Charge Note If the responsible charge is not a full-time Agency employee the Agency must designate a full-time employee in responsible charge for the project
Title VI Coordinator Designated individual directly responsible for the management and administration of the Agencyrsquos ADOT-approved Title VI Program Plan
ADA Coordinator Designated individual directly responsible for the Agencyrsquos compliance with its ADA Transition Plan
DBE Liaison Designated individual directly responsible for implementing and monitoring DBE Program activities and advising the Agency fully and properly of DBE Program Plan issues
ROW Agent Designated individual directly responsible for the Agencyrsquos compliance with federal requirements for ROW activities administration of appraisal acquisition and relocation activities and preparation of the ROW Plan and ROW Clearance Letter
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
1
Table of Contents
Certification Acceptance Assessment Packet 3 Purpose 3 Objective 3 Goal3 Schedule 3 Instructions 3
LPA Commonly Used Acronyms 4
Procurement of Materials andor Install 5 Agency Documents Approved By ADOT Procurement Group 5 Submit to ADOT LPA Section before December 7 2018 5 Assessment Questions 5
Procurement of a Consultant 6 Agency Documents Approved By ADOT ECS Section 6 Submit to ADOT LPA Section before December 31 2018 6 Assessment Questions 6
Roadway Pavement Design 8 Agency Document Reviewed By ADOT LPA Section 8 Submit to ADOT LPA Section before January 31 2019 8 Assessment Questions 8
Roadway Design Guidelines 9 Agency Document Reviewed By ADOT LPA Section 9 Submit to ADOT LPA Section before January 31 2019 9 Assessment Questions 9
Roadway Design Exceptions 10 Agency Document Reviewed By ADOT Roadway Engineering Group 10 Submit to ADOT LPA Section before January 31 2019 10 Assessment Questions 10
Materials QA Program 11 Agency Document Reviewed By ADOT Construction-Materials Group 11 Submit to ADOT LPA Section before January 31 2019 11 Assessment Questions 11
ROW Procedures 12 Agency Document Reviewed By ADOT ROW Section 12 Submit to ADOT LPA Section before January 31 2019 12 Assessment Questions 12
DBE Procedures 14 Agency Documents Reviewed By ADOT BECO 14 Submit to ADOT LPA Section before February 28 2019 14 Assessment Questions 14
Project Delivery Manual 16 Agency Documents Reviewed By ADOT LPA Section 16 Submit to ADOT LPA Section before March 29 2019 16 Assessment Questions 16
Staffing Plan 18 Agency Documents Reviewed By ADOT LPA Section 18
2
Submit to ADOT LPA Section before March 29 2019 18 Assessment Questions 18
Bid Analysis amp Award Procedures 19 Agency Documents Reviewed By ADOT LPA Section 19 Submit to ADOT LPA Section before March 29 2019 19 Assessment Questions 19
Subcontract Approval Procedures 20 Agency Documents Reviewed By ADOT LPA Section 20 Submit to ADOT LPA Section before April 30 2019 20 Assessment Questions 20
Financial Management Procedures 21 Agency Documents Reviewed By ADOT LPA Section 21 Submit to ADOT LPA Section before April 30 2019 21 Assessment Questions 21
3
Certification Acceptance Assessment Packet
Purpose Through the CA Agreement ADOT and the CA Agency will adhere to the responsibilities and requirements set forth by Federal Highway Administration (FHWA) when implementing the Federal Aid Highway Program (FAHP) in Arizona
Objective Define requirements of delegated authority from ADOT to the CA Agency for delivery of the FAHP under ADOTrsquos CA Program
Goal Provide ADOTrsquos expectations for the CA Agency project development program in delivering the FAHP including the necessary project delivery processes and procedures
Schedule Submittals Submit to ADOT LPA Section by Procurement (Materials andor Install) December 7 2018 Procurement (Consultant) December 31 2018 Roadway (Pavement Design Design Guidelines and Design Exceptions) January 31 2019 Materials (Quality Assurance) January 31 2019 Right-of-Way January 31 2019 Disadvantaged Business Enterprises (DBE) February 28 2019 Project Delivery Manual March 29 2019 Staffing March 29 2019 Bid Analysis and Award March 29 2019 Subcontractor Approval April 30 2019 Performance Measures (Finance and Reporting) April 30 2019
Instructions The Certification Acceptance Assessment Packet provides guidance for the Agency to evaluate andor develop procedures in the administrative areas identified in the CA Agreement for compliance in delivering the FAHP The packet contains a list of essential documents and assessment questions related to each administrative area requiring ADOT review and approval It is not mandatory for the Agency to have a single procedural document or manual for delivering the FAHP however it is highly recommended For each section of the packet
bull Note the due date for the submittal of the checklist and corresponding document(s) listed Documents provided after the final ADOT submittal date for that submittal may jeopardize the Agencyrsquos CA status
bull Locate the Agency document(s) or manual(s) where procedures are housed for delivering FAHP projects bull Compare and evaluate the current Agency procedures contained within the Agencyrsquos document(s) or manual(s)
with the questions on the checklist bull Update the current Agency procedures where necessary bull Answer ldquoyesrdquo or ldquonordquo for each question Provide a brief explanation for each ldquonordquo answer bull Identify the document page and paragraph for each question bull Fill in the ldquoPrepared byrdquo box identifying who in the Agency verified the Agencyrsquos procedures and answered each
question to complete the checklist bull Submit the checklist and corresponding document(s) to the ADOT LPA Section
Email all questions regarding the packet to Jennifer VanVenRoy at JVanvenroyazdotgov
4
LPA Commonly Used Acronyms AASHTO American Association of State Highway Transportation Officials ADA Americans with Disabilities Act AE ArchitecturalEngineering ADOT Arizona Department of Transportation BECO Business Engagement Compliance Office CA Certification Acceptance CFR Code of Federal Regulations CUF Commercially Useful Function DBE Disadvantaged Business Enterprise ECS Engineering Consultants Section EEO Equal Employment Opportunity EPRISE DBE Special Provisions FAHP Federal-aid Highway Program FHWA Federal Highway Administration GFE Good Faith Effort IGA Intergovernmental Agreement LPA Local Public Agency MAG Maricopa Association of Governments NCHRP National Cooperative Highway Research Program NEPA National Environmental Policy Act of 1969 NHS National Highway System NOT Notice of Termination OJT On-the-Job Training QA Quality Assurance PAG Pima Association of Governments PSampE Plans Specifications and Estimates QBS Qualifications Based Selection RDG Roadway Design Group RFQ Request for Qualifications ROW Right-of-Way SWPPP Stormwater Pollution Prevention Plan
5
Procurement of Materials andor Install
Agency Documents Approved By ADOT Procurement Group bull Completed ADOT Procurement Code Checklist (Appendix C) bull Procurement Code bull Other Procurement Procedures or Contract Documents as needed
Submit to ADOT LPA Section before December 7 2018
Assessment Questions Question YN Document Page Paragraph Do the Procurement Procedures or Contract Documents require the following for federal-aid contracts
Written competitive bidding thresholds for informal bids and purchases between $10000 and $100000 are to be awarded to a small business if possible
Bid Lists compiled and maintained through ProcureAZ or similar eProcurement method
Verification of employment records of contractors and subcontractors using e-verify
Compliance with the Significant Procurement Role requirements
Agency ndash Prepared by ADOT ndash Approved by Signature Signature Printed Name Printed Name Title Title Date Date
6
Procurement of a Consultant
Agency Documents Approved By ADOT ECS Section bull Completed Certification Acceptance Contract Administration Procedures Review Checklist (Appendix A) bull Procurement Procedures ndash written process for advertising evaluating selecting and negotiating contracts bull Contract Procedures ndash written process for contract administration and management bull Sample AE RFQ Package ndash copies of what the Agency advertises as part of its solicitation bull Sample Contract Boilerplate Documents ndash copies of contract document used for FAHP projects
Submit to ADOT LPA Section before December 31 2018
Assessment Questions Question YN Document Page Paragraph Is the Agency submitting Design Consultant Contracting (Procurement) Procedures If yes
Do the Agencyrsquos Design Consultant Contracting (Procurement) procedures meet the federal and state laws regulations and all other applicable requirements for qualification-based selection (QBS) process
Does the Agency use an ADOT approved prequalification process
If no does the Agency use ADOTrsquos prequalification list
Do the Agencyrsquos Procedures Require notification to the ADOT PM of kickoff and progress meetings
Inform the ADOT PM of error and omission actions taken
Require contacting the ADOT PM for approval and FHWA concurrence before terminating a federal-aid contract
Include a tracking and reporting process for on-call assignments if applicable
On-Call Design Procurement Procedures Is the Agency submitting Design Consultant On-Call Procurement Procedures If yes
Does the Agencyrsquos Procedures include On-Call procurement procedures
Do the CA Agencyrsquos procedures identify and define one of the two task or work orders assignment processes
Mini QBS procedures Regional selection
Do the CA Agencyrsquos procedures Include a tracking and reporting process for on-call assignments
Will the Agency be requesting an approval from ADOT before advertising for procurement of On-Call services
See Appendix B for additional resources
7
Agency ndash Prepared by ADOT ndash Approved by Signature Signature Printed Name Printed Name Title Title Date Date
8
Roadway Pavement Design
Agency Document Reviewed By ADOT LPA Section Pavement Design Guidelines
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local NHS Roadways
Does the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
Is MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
For NHS Roadways do the Agencyrsquos standards comply with 23 CFR 626
On Local Non - NHS Roadways Does the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local non-NHS RoadsStreets
Is MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
For Agency Projects within ADOT Right-of-Way do the Agencyrsquos Pavement Design Guidelines comply with the following
bull ADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
bull ADOT Materials Preliminary Design Guide bull AASHTO Design Guidelines
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
9
Roadway Design Guidelines
Agency Document Reviewed By ADOT LPA Section Roadway Design Guidelines
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local NHS Roadways
Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
Do the Agencyrsquos Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
On Local non-NHS Roadways Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local non-NHS RoadsStreets
For State Agency Projects within ADOT Right-of-Way do the Agencyrsquos Roadway Design confirm and comply with the following
bull AASHTO Controlling Design Criteria bull ADOT Roadway Design Guidelines (RDG) bull All other applicable adopted and published
ADOT design standard and guidelines
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
10
Roadway Design Exceptions
Agency Document Reviewed By ADOT Roadway Engineering Group Design Exception Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local - NHS Roadways
Does the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
Do the Agencyrsquos procedures include submitting to and obtaining approval from the FHWA for design exceptions
On Local Non - NHS Roadways Does the Agency have an adopted and published Design Exception procedure
For Agency Projects within ADOT Right-of-Way a Does the Agency have an adopted and
published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
b Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
c Do the Agencyrsquos procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
11
Materials QA Program
Agency Document Reviewed By ADOT Construction-Materials Group Materials QA Program or a letter signed by the Designated Approval Authority stating that the Agency adopts the ADOT Materials QA Program
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own ADOT-approved Materials QA Program
If no has the Agency adopted the ADOT Materials QA Program
Does the Materials QA Program Require the inclusion of the materials memo in the construction authorization packet and project file
Require the inclusion of the ADOT-approved Materials QA Project Plan in the construction authorization packet
Apply the Buy America provision to the entire FAHP project
Require verification that the Buy America certifications accompany each material shipment including steel or iron products
Require visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
12
ROW Procedures
Agency Document Approved By ADOT ROW Section ROW Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own written ROW manual If ldquoNordquo please explain If ldquoYesrdquo has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
If the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
Is the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 (b)
Does the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
Does the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 (c)
Does the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
Does the Agency request property donations from non-governmental owners whose Real Property Interest is required for Title 23 projects If ldquoYesrdquo does that donation meet the requirement per 23 CFR 710505(a)
Does the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
Does the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
Does the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
Is the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
13
of the Agency Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
Does the Agency include the preparation of right of way plans in their Federal Aid projects (CFR or Statute reference) If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
Does the Agency maintain a written logdiary (contact report) of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
14
DBE Procedures Agency Documents Reviewed By ADOT BECO
DBE Procedures
Submit to ADOT LPA Section before February 28 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency follow the current ADOT FHWA DBE Plan Does the Agency follow the current DBE EPRISE (DBE contract language)
Does the Agency have a DBE Liaison Do the DBE Procedures require the agency to
Follow the most current DBE Plan DBE EPRISE (DBE contract language)
Submit the required documents to ADOT BECO for Federal-aid Highway Program (FAHP) projects to be assessed for DBE Goal and ensuring the DBE Goal is ldquovalidrdquo for advertisement
Obtain from BECO and provide to bidders and proposers all current BECO LPA Forms
Include a ldquovalidrdquo DBE goal percentage in advertisement solicitations and contract documents
Provide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
Conduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
Ensure receipt of Bid Verification Notice from ADOT BECO before contract award
Ensure Good Faith Effort (GFE) documentation is provided to meet requirements of EPRISE Specifications (as applicable)
Notify ADOT PM and ADOT BECO of contract award or rejection of bids
Report contract awards to BECO by the 10th of the month following contract award
Ensure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
Monitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment amp Payment Reporting Provisions
15
Question YN Document Page Paragraph Monitor and enforce the Prompt Payment amp Payment Reporting Provisions for prime contractor payments to subcontractors
Monitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
Monitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
Conduct a Commercially Useful Function (CUF) review for each DBE on a FAHP project
Obtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
Monitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
Monitor LPA DBE System in preparation for the semi-annual reporting by ensuring contract payments are up date
Ensure timely closeout of contracts in the LPA DBE System
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
16
Project Delivery Manual
Agency Documents Reviewed By ADOT LPA Section bull FAHP Project Delivery Manual ndash title page table of contents publication or modification date bull Other manuals as needed ndash title page table of contents publication or modification date bull Schedule for updating the Project Delivery Manual and any other manuals listed below
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have a single Project Delivery Manual Does the Project Delivery Manual contain or incorporate through reference the following
Staffing Plan Communication Plan Training Plan Roadway Pavement Design Guidelines Roadway Design Guidelines Roadway Design Exception Procedures Materials QA Program ROW Procedures Procurement of a Consultant Procurement of Materials andor Install Bid Analysis and Award Procedures Subcontract Approval Procedures ADA Transition Plan Title VI Program Plan DBE Procedures Financial Management Procedures Audit and Oversight Procedures Reporting Procedures
Does the Project Delivery Manual or another manual address the following
Request for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
Pre-planning Project initiation Scoping document PSampE development Environmental document Utilities clearance Railroad clearance Materials memo Pre-construction meetings SWPPP Labor compliance Inspector daily diaries Supplemental agreements Progress payments Prompt pay
17
Question YN Document Page Paragraph Claims Final acceptance Project closeout Record keeping EEO OJT Authorization Reimbursement
Do the FAHP Contract Approval Procedures require the contract include the following as applicable
Buy America Requirements FHWA Non-Collusion Statement FHWA Form 1273 USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Sanctions and Penalties for Breach of Contract Termination for Cause and Convenience Clean Air ActFederal Water Pollution Control Act Debarment and Suspension Byrd Anti Lobbying Amendment Language regarding compliance with and federal and state immigration laws and regulations
Title VI Assurances and Appendices A and E Does the Project Delivery Manual include a schedule for updating the manual(s)
Is the Project Delivery Manual posted on the Agencyrsquos internal website or made readily available for all staff involved in FAHP projects
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
18
Staffing Plan
Agency Documents Reviewed By ADOT LPA Section Organizational Chart
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agencyrsquos Organizational Chart accurately identify current Key Personnel
Does the Agencyrsquos Organizational Chart identify position title and contact information for each Key Personnel
Does the Agency have a well-documented process for addingdeletingmodifying Key Personnel Does the Agencyrsquos process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
See the list of Key Personnel and Roles and Responsibility below for more information
Key Personnel Role and Responsibility Designated Approval Authority Official with the authority to formally assume responsibility for the
implementation of the project development program and delivery of FAHP projects
CA Liaison An executive decision maker with working knowledge of the CA Program and main point of contact for ADOT
Responsible Charge Note If the responsible charge is not a full-time Agency employee the Agency must designate a full-time employee in responsible charge for the project
Title VI Coordinator Designated individual directly responsible for the management and administration of the Agencyrsquos ADOT-approved Title VI Program Plan
ADA Coordinator Designated individual directly responsible for the Agencyrsquos compliance with its ADA Transition Plan
DBE Liaison Designated individual directly responsible for implementing and monitoring DBE Program activities and advising the Agency fully and properly of DBE Program Plan issues
ROW Agent Designated individual directly responsible for the Agencyrsquos compliance with federal requirements for ROW activities administration of appraisal acquisition and relocation activities and preparation of the ROW Plan and ROW Clearance Letter
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
2
Submit to ADOT LPA Section before March 29 2019 18 Assessment Questions 18
Bid Analysis amp Award Procedures 19 Agency Documents Reviewed By ADOT LPA Section 19 Submit to ADOT LPA Section before March 29 2019 19 Assessment Questions 19
Subcontract Approval Procedures 20 Agency Documents Reviewed By ADOT LPA Section 20 Submit to ADOT LPA Section before April 30 2019 20 Assessment Questions 20
Financial Management Procedures 21 Agency Documents Reviewed By ADOT LPA Section 21 Submit to ADOT LPA Section before April 30 2019 21 Assessment Questions 21
3
Certification Acceptance Assessment Packet
Purpose Through the CA Agreement ADOT and the CA Agency will adhere to the responsibilities and requirements set forth by Federal Highway Administration (FHWA) when implementing the Federal Aid Highway Program (FAHP) in Arizona
Objective Define requirements of delegated authority from ADOT to the CA Agency for delivery of the FAHP under ADOTrsquos CA Program
Goal Provide ADOTrsquos expectations for the CA Agency project development program in delivering the FAHP including the necessary project delivery processes and procedures
Schedule Submittals Submit to ADOT LPA Section by Procurement (Materials andor Install) December 7 2018 Procurement (Consultant) December 31 2018 Roadway (Pavement Design Design Guidelines and Design Exceptions) January 31 2019 Materials (Quality Assurance) January 31 2019 Right-of-Way January 31 2019 Disadvantaged Business Enterprises (DBE) February 28 2019 Project Delivery Manual March 29 2019 Staffing March 29 2019 Bid Analysis and Award March 29 2019 Subcontractor Approval April 30 2019 Performance Measures (Finance and Reporting) April 30 2019
Instructions The Certification Acceptance Assessment Packet provides guidance for the Agency to evaluate andor develop procedures in the administrative areas identified in the CA Agreement for compliance in delivering the FAHP The packet contains a list of essential documents and assessment questions related to each administrative area requiring ADOT review and approval It is not mandatory for the Agency to have a single procedural document or manual for delivering the FAHP however it is highly recommended For each section of the packet
bull Note the due date for the submittal of the checklist and corresponding document(s) listed Documents provided after the final ADOT submittal date for that submittal may jeopardize the Agencyrsquos CA status
bull Locate the Agency document(s) or manual(s) where procedures are housed for delivering FAHP projects bull Compare and evaluate the current Agency procedures contained within the Agencyrsquos document(s) or manual(s)
with the questions on the checklist bull Update the current Agency procedures where necessary bull Answer ldquoyesrdquo or ldquonordquo for each question Provide a brief explanation for each ldquonordquo answer bull Identify the document page and paragraph for each question bull Fill in the ldquoPrepared byrdquo box identifying who in the Agency verified the Agencyrsquos procedures and answered each
question to complete the checklist bull Submit the checklist and corresponding document(s) to the ADOT LPA Section
Email all questions regarding the packet to Jennifer VanVenRoy at JVanvenroyazdotgov
4
LPA Commonly Used Acronyms AASHTO American Association of State Highway Transportation Officials ADA Americans with Disabilities Act AE ArchitecturalEngineering ADOT Arizona Department of Transportation BECO Business Engagement Compliance Office CA Certification Acceptance CFR Code of Federal Regulations CUF Commercially Useful Function DBE Disadvantaged Business Enterprise ECS Engineering Consultants Section EEO Equal Employment Opportunity EPRISE DBE Special Provisions FAHP Federal-aid Highway Program FHWA Federal Highway Administration GFE Good Faith Effort IGA Intergovernmental Agreement LPA Local Public Agency MAG Maricopa Association of Governments NCHRP National Cooperative Highway Research Program NEPA National Environmental Policy Act of 1969 NHS National Highway System NOT Notice of Termination OJT On-the-Job Training QA Quality Assurance PAG Pima Association of Governments PSampE Plans Specifications and Estimates QBS Qualifications Based Selection RDG Roadway Design Group RFQ Request for Qualifications ROW Right-of-Way SWPPP Stormwater Pollution Prevention Plan
5
Procurement of Materials andor Install
Agency Documents Approved By ADOT Procurement Group bull Completed ADOT Procurement Code Checklist (Appendix C) bull Procurement Code bull Other Procurement Procedures or Contract Documents as needed
Submit to ADOT LPA Section before December 7 2018
Assessment Questions Question YN Document Page Paragraph Do the Procurement Procedures or Contract Documents require the following for federal-aid contracts
Written competitive bidding thresholds for informal bids and purchases between $10000 and $100000 are to be awarded to a small business if possible
Bid Lists compiled and maintained through ProcureAZ or similar eProcurement method
Verification of employment records of contractors and subcontractors using e-verify
Compliance with the Significant Procurement Role requirements
Agency ndash Prepared by ADOT ndash Approved by Signature Signature Printed Name Printed Name Title Title Date Date
6
Procurement of a Consultant
Agency Documents Approved By ADOT ECS Section bull Completed Certification Acceptance Contract Administration Procedures Review Checklist (Appendix A) bull Procurement Procedures ndash written process for advertising evaluating selecting and negotiating contracts bull Contract Procedures ndash written process for contract administration and management bull Sample AE RFQ Package ndash copies of what the Agency advertises as part of its solicitation bull Sample Contract Boilerplate Documents ndash copies of contract document used for FAHP projects
Submit to ADOT LPA Section before December 31 2018
Assessment Questions Question YN Document Page Paragraph Is the Agency submitting Design Consultant Contracting (Procurement) Procedures If yes
Do the Agencyrsquos Design Consultant Contracting (Procurement) procedures meet the federal and state laws regulations and all other applicable requirements for qualification-based selection (QBS) process
Does the Agency use an ADOT approved prequalification process
If no does the Agency use ADOTrsquos prequalification list
Do the Agencyrsquos Procedures Require notification to the ADOT PM of kickoff and progress meetings
Inform the ADOT PM of error and omission actions taken
Require contacting the ADOT PM for approval and FHWA concurrence before terminating a federal-aid contract
Include a tracking and reporting process for on-call assignments if applicable
On-Call Design Procurement Procedures Is the Agency submitting Design Consultant On-Call Procurement Procedures If yes
Does the Agencyrsquos Procedures include On-Call procurement procedures
Do the CA Agencyrsquos procedures identify and define one of the two task or work orders assignment processes
Mini QBS procedures Regional selection
Do the CA Agencyrsquos procedures Include a tracking and reporting process for on-call assignments
Will the Agency be requesting an approval from ADOT before advertising for procurement of On-Call services
See Appendix B for additional resources
7
Agency ndash Prepared by ADOT ndash Approved by Signature Signature Printed Name Printed Name Title Title Date Date
8
Roadway Pavement Design
Agency Document Reviewed By ADOT LPA Section Pavement Design Guidelines
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local NHS Roadways
Does the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
Is MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
For NHS Roadways do the Agencyrsquos standards comply with 23 CFR 626
On Local Non - NHS Roadways Does the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local non-NHS RoadsStreets
Is MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
For Agency Projects within ADOT Right-of-Way do the Agencyrsquos Pavement Design Guidelines comply with the following
bull ADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
bull ADOT Materials Preliminary Design Guide bull AASHTO Design Guidelines
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
9
Roadway Design Guidelines
Agency Document Reviewed By ADOT LPA Section Roadway Design Guidelines
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local NHS Roadways
Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
Do the Agencyrsquos Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
On Local non-NHS Roadways Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local non-NHS RoadsStreets
For State Agency Projects within ADOT Right-of-Way do the Agencyrsquos Roadway Design confirm and comply with the following
bull AASHTO Controlling Design Criteria bull ADOT Roadway Design Guidelines (RDG) bull All other applicable adopted and published
ADOT design standard and guidelines
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
10
Roadway Design Exceptions
Agency Document Reviewed By ADOT Roadway Engineering Group Design Exception Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local - NHS Roadways
Does the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
Do the Agencyrsquos procedures include submitting to and obtaining approval from the FHWA for design exceptions
On Local Non - NHS Roadways Does the Agency have an adopted and published Design Exception procedure
For Agency Projects within ADOT Right-of-Way a Does the Agency have an adopted and
published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
b Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
c Do the Agencyrsquos procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
11
Materials QA Program
Agency Document Reviewed By ADOT Construction-Materials Group Materials QA Program or a letter signed by the Designated Approval Authority stating that the Agency adopts the ADOT Materials QA Program
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own ADOT-approved Materials QA Program
If no has the Agency adopted the ADOT Materials QA Program
Does the Materials QA Program Require the inclusion of the materials memo in the construction authorization packet and project file
Require the inclusion of the ADOT-approved Materials QA Project Plan in the construction authorization packet
Apply the Buy America provision to the entire FAHP project
Require verification that the Buy America certifications accompany each material shipment including steel or iron products
Require visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
12
ROW Procedures
Agency Document Approved By ADOT ROW Section ROW Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own written ROW manual If ldquoNordquo please explain If ldquoYesrdquo has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
If the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
Is the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 (b)
Does the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
Does the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 (c)
Does the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
Does the Agency request property donations from non-governmental owners whose Real Property Interest is required for Title 23 projects If ldquoYesrdquo does that donation meet the requirement per 23 CFR 710505(a)
Does the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
Does the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
Does the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
Is the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
13
of the Agency Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
Does the Agency include the preparation of right of way plans in their Federal Aid projects (CFR or Statute reference) If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
Does the Agency maintain a written logdiary (contact report) of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
14
DBE Procedures Agency Documents Reviewed By ADOT BECO
DBE Procedures
Submit to ADOT LPA Section before February 28 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency follow the current ADOT FHWA DBE Plan Does the Agency follow the current DBE EPRISE (DBE contract language)
Does the Agency have a DBE Liaison Do the DBE Procedures require the agency to
Follow the most current DBE Plan DBE EPRISE (DBE contract language)
Submit the required documents to ADOT BECO for Federal-aid Highway Program (FAHP) projects to be assessed for DBE Goal and ensuring the DBE Goal is ldquovalidrdquo for advertisement
Obtain from BECO and provide to bidders and proposers all current BECO LPA Forms
Include a ldquovalidrdquo DBE goal percentage in advertisement solicitations and contract documents
Provide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
Conduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
Ensure receipt of Bid Verification Notice from ADOT BECO before contract award
Ensure Good Faith Effort (GFE) documentation is provided to meet requirements of EPRISE Specifications (as applicable)
Notify ADOT PM and ADOT BECO of contract award or rejection of bids
Report contract awards to BECO by the 10th of the month following contract award
Ensure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
Monitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment amp Payment Reporting Provisions
15
Question YN Document Page Paragraph Monitor and enforce the Prompt Payment amp Payment Reporting Provisions for prime contractor payments to subcontractors
Monitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
Monitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
Conduct a Commercially Useful Function (CUF) review for each DBE on a FAHP project
Obtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
Monitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
Monitor LPA DBE System in preparation for the semi-annual reporting by ensuring contract payments are up date
Ensure timely closeout of contracts in the LPA DBE System
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
16
Project Delivery Manual
Agency Documents Reviewed By ADOT LPA Section bull FAHP Project Delivery Manual ndash title page table of contents publication or modification date bull Other manuals as needed ndash title page table of contents publication or modification date bull Schedule for updating the Project Delivery Manual and any other manuals listed below
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have a single Project Delivery Manual Does the Project Delivery Manual contain or incorporate through reference the following
Staffing Plan Communication Plan Training Plan Roadway Pavement Design Guidelines Roadway Design Guidelines Roadway Design Exception Procedures Materials QA Program ROW Procedures Procurement of a Consultant Procurement of Materials andor Install Bid Analysis and Award Procedures Subcontract Approval Procedures ADA Transition Plan Title VI Program Plan DBE Procedures Financial Management Procedures Audit and Oversight Procedures Reporting Procedures
Does the Project Delivery Manual or another manual address the following
Request for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
Pre-planning Project initiation Scoping document PSampE development Environmental document Utilities clearance Railroad clearance Materials memo Pre-construction meetings SWPPP Labor compliance Inspector daily diaries Supplemental agreements Progress payments Prompt pay
17
Question YN Document Page Paragraph Claims Final acceptance Project closeout Record keeping EEO OJT Authorization Reimbursement
Do the FAHP Contract Approval Procedures require the contract include the following as applicable
Buy America Requirements FHWA Non-Collusion Statement FHWA Form 1273 USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Sanctions and Penalties for Breach of Contract Termination for Cause and Convenience Clean Air ActFederal Water Pollution Control Act Debarment and Suspension Byrd Anti Lobbying Amendment Language regarding compliance with and federal and state immigration laws and regulations
Title VI Assurances and Appendices A and E Does the Project Delivery Manual include a schedule for updating the manual(s)
Is the Project Delivery Manual posted on the Agencyrsquos internal website or made readily available for all staff involved in FAHP projects
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
18
Staffing Plan
Agency Documents Reviewed By ADOT LPA Section Organizational Chart
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agencyrsquos Organizational Chart accurately identify current Key Personnel
Does the Agencyrsquos Organizational Chart identify position title and contact information for each Key Personnel
Does the Agency have a well-documented process for addingdeletingmodifying Key Personnel Does the Agencyrsquos process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
See the list of Key Personnel and Roles and Responsibility below for more information
Key Personnel Role and Responsibility Designated Approval Authority Official with the authority to formally assume responsibility for the
implementation of the project development program and delivery of FAHP projects
CA Liaison An executive decision maker with working knowledge of the CA Program and main point of contact for ADOT
Responsible Charge Note If the responsible charge is not a full-time Agency employee the Agency must designate a full-time employee in responsible charge for the project
Title VI Coordinator Designated individual directly responsible for the management and administration of the Agencyrsquos ADOT-approved Title VI Program Plan
ADA Coordinator Designated individual directly responsible for the Agencyrsquos compliance with its ADA Transition Plan
DBE Liaison Designated individual directly responsible for implementing and monitoring DBE Program activities and advising the Agency fully and properly of DBE Program Plan issues
ROW Agent Designated individual directly responsible for the Agencyrsquos compliance with federal requirements for ROW activities administration of appraisal acquisition and relocation activities and preparation of the ROW Plan and ROW Clearance Letter
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
3
Certification Acceptance Assessment Packet
Purpose Through the CA Agreement ADOT and the CA Agency will adhere to the responsibilities and requirements set forth by Federal Highway Administration (FHWA) when implementing the Federal Aid Highway Program (FAHP) in Arizona
Objective Define requirements of delegated authority from ADOT to the CA Agency for delivery of the FAHP under ADOTrsquos CA Program
Goal Provide ADOTrsquos expectations for the CA Agency project development program in delivering the FAHP including the necessary project delivery processes and procedures
Schedule Submittals Submit to ADOT LPA Section by Procurement (Materials andor Install) December 7 2018 Procurement (Consultant) December 31 2018 Roadway (Pavement Design Design Guidelines and Design Exceptions) January 31 2019 Materials (Quality Assurance) January 31 2019 Right-of-Way January 31 2019 Disadvantaged Business Enterprises (DBE) February 28 2019 Project Delivery Manual March 29 2019 Staffing March 29 2019 Bid Analysis and Award March 29 2019 Subcontractor Approval April 30 2019 Performance Measures (Finance and Reporting) April 30 2019
Instructions The Certification Acceptance Assessment Packet provides guidance for the Agency to evaluate andor develop procedures in the administrative areas identified in the CA Agreement for compliance in delivering the FAHP The packet contains a list of essential documents and assessment questions related to each administrative area requiring ADOT review and approval It is not mandatory for the Agency to have a single procedural document or manual for delivering the FAHP however it is highly recommended For each section of the packet
bull Note the due date for the submittal of the checklist and corresponding document(s) listed Documents provided after the final ADOT submittal date for that submittal may jeopardize the Agencyrsquos CA status
bull Locate the Agency document(s) or manual(s) where procedures are housed for delivering FAHP projects bull Compare and evaluate the current Agency procedures contained within the Agencyrsquos document(s) or manual(s)
with the questions on the checklist bull Update the current Agency procedures where necessary bull Answer ldquoyesrdquo or ldquonordquo for each question Provide a brief explanation for each ldquonordquo answer bull Identify the document page and paragraph for each question bull Fill in the ldquoPrepared byrdquo box identifying who in the Agency verified the Agencyrsquos procedures and answered each
question to complete the checklist bull Submit the checklist and corresponding document(s) to the ADOT LPA Section
Email all questions regarding the packet to Jennifer VanVenRoy at JVanvenroyazdotgov
4
LPA Commonly Used Acronyms AASHTO American Association of State Highway Transportation Officials ADA Americans with Disabilities Act AE ArchitecturalEngineering ADOT Arizona Department of Transportation BECO Business Engagement Compliance Office CA Certification Acceptance CFR Code of Federal Regulations CUF Commercially Useful Function DBE Disadvantaged Business Enterprise ECS Engineering Consultants Section EEO Equal Employment Opportunity EPRISE DBE Special Provisions FAHP Federal-aid Highway Program FHWA Federal Highway Administration GFE Good Faith Effort IGA Intergovernmental Agreement LPA Local Public Agency MAG Maricopa Association of Governments NCHRP National Cooperative Highway Research Program NEPA National Environmental Policy Act of 1969 NHS National Highway System NOT Notice of Termination OJT On-the-Job Training QA Quality Assurance PAG Pima Association of Governments PSampE Plans Specifications and Estimates QBS Qualifications Based Selection RDG Roadway Design Group RFQ Request for Qualifications ROW Right-of-Way SWPPP Stormwater Pollution Prevention Plan
5
Procurement of Materials andor Install
Agency Documents Approved By ADOT Procurement Group bull Completed ADOT Procurement Code Checklist (Appendix C) bull Procurement Code bull Other Procurement Procedures or Contract Documents as needed
Submit to ADOT LPA Section before December 7 2018
Assessment Questions Question YN Document Page Paragraph Do the Procurement Procedures or Contract Documents require the following for federal-aid contracts
Written competitive bidding thresholds for informal bids and purchases between $10000 and $100000 are to be awarded to a small business if possible
Bid Lists compiled and maintained through ProcureAZ or similar eProcurement method
Verification of employment records of contractors and subcontractors using e-verify
Compliance with the Significant Procurement Role requirements
Agency ndash Prepared by ADOT ndash Approved by Signature Signature Printed Name Printed Name Title Title Date Date
6
Procurement of a Consultant
Agency Documents Approved By ADOT ECS Section bull Completed Certification Acceptance Contract Administration Procedures Review Checklist (Appendix A) bull Procurement Procedures ndash written process for advertising evaluating selecting and negotiating contracts bull Contract Procedures ndash written process for contract administration and management bull Sample AE RFQ Package ndash copies of what the Agency advertises as part of its solicitation bull Sample Contract Boilerplate Documents ndash copies of contract document used for FAHP projects
Submit to ADOT LPA Section before December 31 2018
Assessment Questions Question YN Document Page Paragraph Is the Agency submitting Design Consultant Contracting (Procurement) Procedures If yes
Do the Agencyrsquos Design Consultant Contracting (Procurement) procedures meet the federal and state laws regulations and all other applicable requirements for qualification-based selection (QBS) process
Does the Agency use an ADOT approved prequalification process
If no does the Agency use ADOTrsquos prequalification list
Do the Agencyrsquos Procedures Require notification to the ADOT PM of kickoff and progress meetings
Inform the ADOT PM of error and omission actions taken
Require contacting the ADOT PM for approval and FHWA concurrence before terminating a federal-aid contract
Include a tracking and reporting process for on-call assignments if applicable
On-Call Design Procurement Procedures Is the Agency submitting Design Consultant On-Call Procurement Procedures If yes
Does the Agencyrsquos Procedures include On-Call procurement procedures
Do the CA Agencyrsquos procedures identify and define one of the two task or work orders assignment processes
Mini QBS procedures Regional selection
Do the CA Agencyrsquos procedures Include a tracking and reporting process for on-call assignments
Will the Agency be requesting an approval from ADOT before advertising for procurement of On-Call services
See Appendix B for additional resources
7
Agency ndash Prepared by ADOT ndash Approved by Signature Signature Printed Name Printed Name Title Title Date Date
8
Roadway Pavement Design
Agency Document Reviewed By ADOT LPA Section Pavement Design Guidelines
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local NHS Roadways
Does the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
Is MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
For NHS Roadways do the Agencyrsquos standards comply with 23 CFR 626
On Local Non - NHS Roadways Does the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local non-NHS RoadsStreets
Is MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
For Agency Projects within ADOT Right-of-Way do the Agencyrsquos Pavement Design Guidelines comply with the following
bull ADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
bull ADOT Materials Preliminary Design Guide bull AASHTO Design Guidelines
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
9
Roadway Design Guidelines
Agency Document Reviewed By ADOT LPA Section Roadway Design Guidelines
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local NHS Roadways
Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
Do the Agencyrsquos Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
On Local non-NHS Roadways Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local non-NHS RoadsStreets
For State Agency Projects within ADOT Right-of-Way do the Agencyrsquos Roadway Design confirm and comply with the following
bull AASHTO Controlling Design Criteria bull ADOT Roadway Design Guidelines (RDG) bull All other applicable adopted and published
ADOT design standard and guidelines
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
10
Roadway Design Exceptions
Agency Document Reviewed By ADOT Roadway Engineering Group Design Exception Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local - NHS Roadways
Does the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
Do the Agencyrsquos procedures include submitting to and obtaining approval from the FHWA for design exceptions
On Local Non - NHS Roadways Does the Agency have an adopted and published Design Exception procedure
For Agency Projects within ADOT Right-of-Way a Does the Agency have an adopted and
published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
b Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
c Do the Agencyrsquos procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
11
Materials QA Program
Agency Document Reviewed By ADOT Construction-Materials Group Materials QA Program or a letter signed by the Designated Approval Authority stating that the Agency adopts the ADOT Materials QA Program
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own ADOT-approved Materials QA Program
If no has the Agency adopted the ADOT Materials QA Program
Does the Materials QA Program Require the inclusion of the materials memo in the construction authorization packet and project file
Require the inclusion of the ADOT-approved Materials QA Project Plan in the construction authorization packet
Apply the Buy America provision to the entire FAHP project
Require verification that the Buy America certifications accompany each material shipment including steel or iron products
Require visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
12
ROW Procedures
Agency Document Approved By ADOT ROW Section ROW Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own written ROW manual If ldquoNordquo please explain If ldquoYesrdquo has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
If the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
Is the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 (b)
Does the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
Does the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 (c)
Does the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
Does the Agency request property donations from non-governmental owners whose Real Property Interest is required for Title 23 projects If ldquoYesrdquo does that donation meet the requirement per 23 CFR 710505(a)
Does the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
Does the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
Does the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
Is the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
13
of the Agency Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
Does the Agency include the preparation of right of way plans in their Federal Aid projects (CFR or Statute reference) If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
Does the Agency maintain a written logdiary (contact report) of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
14
DBE Procedures Agency Documents Reviewed By ADOT BECO
DBE Procedures
Submit to ADOT LPA Section before February 28 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency follow the current ADOT FHWA DBE Plan Does the Agency follow the current DBE EPRISE (DBE contract language)
Does the Agency have a DBE Liaison Do the DBE Procedures require the agency to
Follow the most current DBE Plan DBE EPRISE (DBE contract language)
Submit the required documents to ADOT BECO for Federal-aid Highway Program (FAHP) projects to be assessed for DBE Goal and ensuring the DBE Goal is ldquovalidrdquo for advertisement
Obtain from BECO and provide to bidders and proposers all current BECO LPA Forms
Include a ldquovalidrdquo DBE goal percentage in advertisement solicitations and contract documents
Provide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
Conduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
Ensure receipt of Bid Verification Notice from ADOT BECO before contract award
Ensure Good Faith Effort (GFE) documentation is provided to meet requirements of EPRISE Specifications (as applicable)
Notify ADOT PM and ADOT BECO of contract award or rejection of bids
Report contract awards to BECO by the 10th of the month following contract award
Ensure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
Monitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment amp Payment Reporting Provisions
15
Question YN Document Page Paragraph Monitor and enforce the Prompt Payment amp Payment Reporting Provisions for prime contractor payments to subcontractors
Monitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
Monitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
Conduct a Commercially Useful Function (CUF) review for each DBE on a FAHP project
Obtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
Monitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
Monitor LPA DBE System in preparation for the semi-annual reporting by ensuring contract payments are up date
Ensure timely closeout of contracts in the LPA DBE System
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
16
Project Delivery Manual
Agency Documents Reviewed By ADOT LPA Section bull FAHP Project Delivery Manual ndash title page table of contents publication or modification date bull Other manuals as needed ndash title page table of contents publication or modification date bull Schedule for updating the Project Delivery Manual and any other manuals listed below
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have a single Project Delivery Manual Does the Project Delivery Manual contain or incorporate through reference the following
Staffing Plan Communication Plan Training Plan Roadway Pavement Design Guidelines Roadway Design Guidelines Roadway Design Exception Procedures Materials QA Program ROW Procedures Procurement of a Consultant Procurement of Materials andor Install Bid Analysis and Award Procedures Subcontract Approval Procedures ADA Transition Plan Title VI Program Plan DBE Procedures Financial Management Procedures Audit and Oversight Procedures Reporting Procedures
Does the Project Delivery Manual or another manual address the following
Request for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
Pre-planning Project initiation Scoping document PSampE development Environmental document Utilities clearance Railroad clearance Materials memo Pre-construction meetings SWPPP Labor compliance Inspector daily diaries Supplemental agreements Progress payments Prompt pay
17
Question YN Document Page Paragraph Claims Final acceptance Project closeout Record keeping EEO OJT Authorization Reimbursement
Do the FAHP Contract Approval Procedures require the contract include the following as applicable
Buy America Requirements FHWA Non-Collusion Statement FHWA Form 1273 USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Sanctions and Penalties for Breach of Contract Termination for Cause and Convenience Clean Air ActFederal Water Pollution Control Act Debarment and Suspension Byrd Anti Lobbying Amendment Language regarding compliance with and federal and state immigration laws and regulations
Title VI Assurances and Appendices A and E Does the Project Delivery Manual include a schedule for updating the manual(s)
Is the Project Delivery Manual posted on the Agencyrsquos internal website or made readily available for all staff involved in FAHP projects
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
18
Staffing Plan
Agency Documents Reviewed By ADOT LPA Section Organizational Chart
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agencyrsquos Organizational Chart accurately identify current Key Personnel
Does the Agencyrsquos Organizational Chart identify position title and contact information for each Key Personnel
Does the Agency have a well-documented process for addingdeletingmodifying Key Personnel Does the Agencyrsquos process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
See the list of Key Personnel and Roles and Responsibility below for more information
Key Personnel Role and Responsibility Designated Approval Authority Official with the authority to formally assume responsibility for the
implementation of the project development program and delivery of FAHP projects
CA Liaison An executive decision maker with working knowledge of the CA Program and main point of contact for ADOT
Responsible Charge Note If the responsible charge is not a full-time Agency employee the Agency must designate a full-time employee in responsible charge for the project
Title VI Coordinator Designated individual directly responsible for the management and administration of the Agencyrsquos ADOT-approved Title VI Program Plan
ADA Coordinator Designated individual directly responsible for the Agencyrsquos compliance with its ADA Transition Plan
DBE Liaison Designated individual directly responsible for implementing and monitoring DBE Program activities and advising the Agency fully and properly of DBE Program Plan issues
ROW Agent Designated individual directly responsible for the Agencyrsquos compliance with federal requirements for ROW activities administration of appraisal acquisition and relocation activities and preparation of the ROW Plan and ROW Clearance Letter
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
4
LPA Commonly Used Acronyms AASHTO American Association of State Highway Transportation Officials ADA Americans with Disabilities Act AE ArchitecturalEngineering ADOT Arizona Department of Transportation BECO Business Engagement Compliance Office CA Certification Acceptance CFR Code of Federal Regulations CUF Commercially Useful Function DBE Disadvantaged Business Enterprise ECS Engineering Consultants Section EEO Equal Employment Opportunity EPRISE DBE Special Provisions FAHP Federal-aid Highway Program FHWA Federal Highway Administration GFE Good Faith Effort IGA Intergovernmental Agreement LPA Local Public Agency MAG Maricopa Association of Governments NCHRP National Cooperative Highway Research Program NEPA National Environmental Policy Act of 1969 NHS National Highway System NOT Notice of Termination OJT On-the-Job Training QA Quality Assurance PAG Pima Association of Governments PSampE Plans Specifications and Estimates QBS Qualifications Based Selection RDG Roadway Design Group RFQ Request for Qualifications ROW Right-of-Way SWPPP Stormwater Pollution Prevention Plan
5
Procurement of Materials andor Install
Agency Documents Approved By ADOT Procurement Group bull Completed ADOT Procurement Code Checklist (Appendix C) bull Procurement Code bull Other Procurement Procedures or Contract Documents as needed
Submit to ADOT LPA Section before December 7 2018
Assessment Questions Question YN Document Page Paragraph Do the Procurement Procedures or Contract Documents require the following for federal-aid contracts
Written competitive bidding thresholds for informal bids and purchases between $10000 and $100000 are to be awarded to a small business if possible
Bid Lists compiled and maintained through ProcureAZ or similar eProcurement method
Verification of employment records of contractors and subcontractors using e-verify
Compliance with the Significant Procurement Role requirements
Agency ndash Prepared by ADOT ndash Approved by Signature Signature Printed Name Printed Name Title Title Date Date
6
Procurement of a Consultant
Agency Documents Approved By ADOT ECS Section bull Completed Certification Acceptance Contract Administration Procedures Review Checklist (Appendix A) bull Procurement Procedures ndash written process for advertising evaluating selecting and negotiating contracts bull Contract Procedures ndash written process for contract administration and management bull Sample AE RFQ Package ndash copies of what the Agency advertises as part of its solicitation bull Sample Contract Boilerplate Documents ndash copies of contract document used for FAHP projects
Submit to ADOT LPA Section before December 31 2018
Assessment Questions Question YN Document Page Paragraph Is the Agency submitting Design Consultant Contracting (Procurement) Procedures If yes
Do the Agencyrsquos Design Consultant Contracting (Procurement) procedures meet the federal and state laws regulations and all other applicable requirements for qualification-based selection (QBS) process
Does the Agency use an ADOT approved prequalification process
If no does the Agency use ADOTrsquos prequalification list
Do the Agencyrsquos Procedures Require notification to the ADOT PM of kickoff and progress meetings
Inform the ADOT PM of error and omission actions taken
Require contacting the ADOT PM for approval and FHWA concurrence before terminating a federal-aid contract
Include a tracking and reporting process for on-call assignments if applicable
On-Call Design Procurement Procedures Is the Agency submitting Design Consultant On-Call Procurement Procedures If yes
Does the Agencyrsquos Procedures include On-Call procurement procedures
Do the CA Agencyrsquos procedures identify and define one of the two task or work orders assignment processes
Mini QBS procedures Regional selection
Do the CA Agencyrsquos procedures Include a tracking and reporting process for on-call assignments
Will the Agency be requesting an approval from ADOT before advertising for procurement of On-Call services
See Appendix B for additional resources
7
Agency ndash Prepared by ADOT ndash Approved by Signature Signature Printed Name Printed Name Title Title Date Date
8
Roadway Pavement Design
Agency Document Reviewed By ADOT LPA Section Pavement Design Guidelines
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local NHS Roadways
Does the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
Is MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
For NHS Roadways do the Agencyrsquos standards comply with 23 CFR 626
On Local Non - NHS Roadways Does the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local non-NHS RoadsStreets
Is MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
For Agency Projects within ADOT Right-of-Way do the Agencyrsquos Pavement Design Guidelines comply with the following
bull ADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
bull ADOT Materials Preliminary Design Guide bull AASHTO Design Guidelines
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
9
Roadway Design Guidelines
Agency Document Reviewed By ADOT LPA Section Roadway Design Guidelines
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local NHS Roadways
Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
Do the Agencyrsquos Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
On Local non-NHS Roadways Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local non-NHS RoadsStreets
For State Agency Projects within ADOT Right-of-Way do the Agencyrsquos Roadway Design confirm and comply with the following
bull AASHTO Controlling Design Criteria bull ADOT Roadway Design Guidelines (RDG) bull All other applicable adopted and published
ADOT design standard and guidelines
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
10
Roadway Design Exceptions
Agency Document Reviewed By ADOT Roadway Engineering Group Design Exception Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local - NHS Roadways
Does the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
Do the Agencyrsquos procedures include submitting to and obtaining approval from the FHWA for design exceptions
On Local Non - NHS Roadways Does the Agency have an adopted and published Design Exception procedure
For Agency Projects within ADOT Right-of-Way a Does the Agency have an adopted and
published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
b Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
c Do the Agencyrsquos procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
11
Materials QA Program
Agency Document Reviewed By ADOT Construction-Materials Group Materials QA Program or a letter signed by the Designated Approval Authority stating that the Agency adopts the ADOT Materials QA Program
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own ADOT-approved Materials QA Program
If no has the Agency adopted the ADOT Materials QA Program
Does the Materials QA Program Require the inclusion of the materials memo in the construction authorization packet and project file
Require the inclusion of the ADOT-approved Materials QA Project Plan in the construction authorization packet
Apply the Buy America provision to the entire FAHP project
Require verification that the Buy America certifications accompany each material shipment including steel or iron products
Require visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
12
ROW Procedures
Agency Document Approved By ADOT ROW Section ROW Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own written ROW manual If ldquoNordquo please explain If ldquoYesrdquo has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
If the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
Is the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 (b)
Does the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
Does the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 (c)
Does the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
Does the Agency request property donations from non-governmental owners whose Real Property Interest is required for Title 23 projects If ldquoYesrdquo does that donation meet the requirement per 23 CFR 710505(a)
Does the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
Does the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
Does the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
Is the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
13
of the Agency Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
Does the Agency include the preparation of right of way plans in their Federal Aid projects (CFR or Statute reference) If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
Does the Agency maintain a written logdiary (contact report) of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
14
DBE Procedures Agency Documents Reviewed By ADOT BECO
DBE Procedures
Submit to ADOT LPA Section before February 28 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency follow the current ADOT FHWA DBE Plan Does the Agency follow the current DBE EPRISE (DBE contract language)
Does the Agency have a DBE Liaison Do the DBE Procedures require the agency to
Follow the most current DBE Plan DBE EPRISE (DBE contract language)
Submit the required documents to ADOT BECO for Federal-aid Highway Program (FAHP) projects to be assessed for DBE Goal and ensuring the DBE Goal is ldquovalidrdquo for advertisement
Obtain from BECO and provide to bidders and proposers all current BECO LPA Forms
Include a ldquovalidrdquo DBE goal percentage in advertisement solicitations and contract documents
Provide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
Conduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
Ensure receipt of Bid Verification Notice from ADOT BECO before contract award
Ensure Good Faith Effort (GFE) documentation is provided to meet requirements of EPRISE Specifications (as applicable)
Notify ADOT PM and ADOT BECO of contract award or rejection of bids
Report contract awards to BECO by the 10th of the month following contract award
Ensure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
Monitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment amp Payment Reporting Provisions
15
Question YN Document Page Paragraph Monitor and enforce the Prompt Payment amp Payment Reporting Provisions for prime contractor payments to subcontractors
Monitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
Monitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
Conduct a Commercially Useful Function (CUF) review for each DBE on a FAHP project
Obtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
Monitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
Monitor LPA DBE System in preparation for the semi-annual reporting by ensuring contract payments are up date
Ensure timely closeout of contracts in the LPA DBE System
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
16
Project Delivery Manual
Agency Documents Reviewed By ADOT LPA Section bull FAHP Project Delivery Manual ndash title page table of contents publication or modification date bull Other manuals as needed ndash title page table of contents publication or modification date bull Schedule for updating the Project Delivery Manual and any other manuals listed below
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have a single Project Delivery Manual Does the Project Delivery Manual contain or incorporate through reference the following
Staffing Plan Communication Plan Training Plan Roadway Pavement Design Guidelines Roadway Design Guidelines Roadway Design Exception Procedures Materials QA Program ROW Procedures Procurement of a Consultant Procurement of Materials andor Install Bid Analysis and Award Procedures Subcontract Approval Procedures ADA Transition Plan Title VI Program Plan DBE Procedures Financial Management Procedures Audit and Oversight Procedures Reporting Procedures
Does the Project Delivery Manual or another manual address the following
Request for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
Pre-planning Project initiation Scoping document PSampE development Environmental document Utilities clearance Railroad clearance Materials memo Pre-construction meetings SWPPP Labor compliance Inspector daily diaries Supplemental agreements Progress payments Prompt pay
17
Question YN Document Page Paragraph Claims Final acceptance Project closeout Record keeping EEO OJT Authorization Reimbursement
Do the FAHP Contract Approval Procedures require the contract include the following as applicable
Buy America Requirements FHWA Non-Collusion Statement FHWA Form 1273 USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Sanctions and Penalties for Breach of Contract Termination for Cause and Convenience Clean Air ActFederal Water Pollution Control Act Debarment and Suspension Byrd Anti Lobbying Amendment Language regarding compliance with and federal and state immigration laws and regulations
Title VI Assurances and Appendices A and E Does the Project Delivery Manual include a schedule for updating the manual(s)
Is the Project Delivery Manual posted on the Agencyrsquos internal website or made readily available for all staff involved in FAHP projects
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
18
Staffing Plan
Agency Documents Reviewed By ADOT LPA Section Organizational Chart
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agencyrsquos Organizational Chart accurately identify current Key Personnel
Does the Agencyrsquos Organizational Chart identify position title and contact information for each Key Personnel
Does the Agency have a well-documented process for addingdeletingmodifying Key Personnel Does the Agencyrsquos process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
See the list of Key Personnel and Roles and Responsibility below for more information
Key Personnel Role and Responsibility Designated Approval Authority Official with the authority to formally assume responsibility for the
implementation of the project development program and delivery of FAHP projects
CA Liaison An executive decision maker with working knowledge of the CA Program and main point of contact for ADOT
Responsible Charge Note If the responsible charge is not a full-time Agency employee the Agency must designate a full-time employee in responsible charge for the project
Title VI Coordinator Designated individual directly responsible for the management and administration of the Agencyrsquos ADOT-approved Title VI Program Plan
ADA Coordinator Designated individual directly responsible for the Agencyrsquos compliance with its ADA Transition Plan
DBE Liaison Designated individual directly responsible for implementing and monitoring DBE Program activities and advising the Agency fully and properly of DBE Program Plan issues
ROW Agent Designated individual directly responsible for the Agencyrsquos compliance with federal requirements for ROW activities administration of appraisal acquisition and relocation activities and preparation of the ROW Plan and ROW Clearance Letter
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
5
Procurement of Materials andor Install
Agency Documents Approved By ADOT Procurement Group bull Completed ADOT Procurement Code Checklist (Appendix C) bull Procurement Code bull Other Procurement Procedures or Contract Documents as needed
Submit to ADOT LPA Section before December 7 2018
Assessment Questions Question YN Document Page Paragraph Do the Procurement Procedures or Contract Documents require the following for federal-aid contracts
Written competitive bidding thresholds for informal bids and purchases between $10000 and $100000 are to be awarded to a small business if possible
Bid Lists compiled and maintained through ProcureAZ or similar eProcurement method
Verification of employment records of contractors and subcontractors using e-verify
Compliance with the Significant Procurement Role requirements
Agency ndash Prepared by ADOT ndash Approved by Signature Signature Printed Name Printed Name Title Title Date Date
6
Procurement of a Consultant
Agency Documents Approved By ADOT ECS Section bull Completed Certification Acceptance Contract Administration Procedures Review Checklist (Appendix A) bull Procurement Procedures ndash written process for advertising evaluating selecting and negotiating contracts bull Contract Procedures ndash written process for contract administration and management bull Sample AE RFQ Package ndash copies of what the Agency advertises as part of its solicitation bull Sample Contract Boilerplate Documents ndash copies of contract document used for FAHP projects
Submit to ADOT LPA Section before December 31 2018
Assessment Questions Question YN Document Page Paragraph Is the Agency submitting Design Consultant Contracting (Procurement) Procedures If yes
Do the Agencyrsquos Design Consultant Contracting (Procurement) procedures meet the federal and state laws regulations and all other applicable requirements for qualification-based selection (QBS) process
Does the Agency use an ADOT approved prequalification process
If no does the Agency use ADOTrsquos prequalification list
Do the Agencyrsquos Procedures Require notification to the ADOT PM of kickoff and progress meetings
Inform the ADOT PM of error and omission actions taken
Require contacting the ADOT PM for approval and FHWA concurrence before terminating a federal-aid contract
Include a tracking and reporting process for on-call assignments if applicable
On-Call Design Procurement Procedures Is the Agency submitting Design Consultant On-Call Procurement Procedures If yes
Does the Agencyrsquos Procedures include On-Call procurement procedures
Do the CA Agencyrsquos procedures identify and define one of the two task or work orders assignment processes
Mini QBS procedures Regional selection
Do the CA Agencyrsquos procedures Include a tracking and reporting process for on-call assignments
Will the Agency be requesting an approval from ADOT before advertising for procurement of On-Call services
See Appendix B for additional resources
7
Agency ndash Prepared by ADOT ndash Approved by Signature Signature Printed Name Printed Name Title Title Date Date
8
Roadway Pavement Design
Agency Document Reviewed By ADOT LPA Section Pavement Design Guidelines
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local NHS Roadways
Does the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
Is MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
For NHS Roadways do the Agencyrsquos standards comply with 23 CFR 626
On Local Non - NHS Roadways Does the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local non-NHS RoadsStreets
Is MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
For Agency Projects within ADOT Right-of-Way do the Agencyrsquos Pavement Design Guidelines comply with the following
bull ADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
bull ADOT Materials Preliminary Design Guide bull AASHTO Design Guidelines
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
9
Roadway Design Guidelines
Agency Document Reviewed By ADOT LPA Section Roadway Design Guidelines
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local NHS Roadways
Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
Do the Agencyrsquos Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
On Local non-NHS Roadways Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local non-NHS RoadsStreets
For State Agency Projects within ADOT Right-of-Way do the Agencyrsquos Roadway Design confirm and comply with the following
bull AASHTO Controlling Design Criteria bull ADOT Roadway Design Guidelines (RDG) bull All other applicable adopted and published
ADOT design standard and guidelines
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
10
Roadway Design Exceptions
Agency Document Reviewed By ADOT Roadway Engineering Group Design Exception Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local - NHS Roadways
Does the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
Do the Agencyrsquos procedures include submitting to and obtaining approval from the FHWA for design exceptions
On Local Non - NHS Roadways Does the Agency have an adopted and published Design Exception procedure
For Agency Projects within ADOT Right-of-Way a Does the Agency have an adopted and
published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
b Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
c Do the Agencyrsquos procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
11
Materials QA Program
Agency Document Reviewed By ADOT Construction-Materials Group Materials QA Program or a letter signed by the Designated Approval Authority stating that the Agency adopts the ADOT Materials QA Program
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own ADOT-approved Materials QA Program
If no has the Agency adopted the ADOT Materials QA Program
Does the Materials QA Program Require the inclusion of the materials memo in the construction authorization packet and project file
Require the inclusion of the ADOT-approved Materials QA Project Plan in the construction authorization packet
Apply the Buy America provision to the entire FAHP project
Require verification that the Buy America certifications accompany each material shipment including steel or iron products
Require visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
12
ROW Procedures
Agency Document Approved By ADOT ROW Section ROW Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own written ROW manual If ldquoNordquo please explain If ldquoYesrdquo has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
If the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
Is the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 (b)
Does the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
Does the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 (c)
Does the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
Does the Agency request property donations from non-governmental owners whose Real Property Interest is required for Title 23 projects If ldquoYesrdquo does that donation meet the requirement per 23 CFR 710505(a)
Does the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
Does the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
Does the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
Is the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
13
of the Agency Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
Does the Agency include the preparation of right of way plans in their Federal Aid projects (CFR or Statute reference) If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
Does the Agency maintain a written logdiary (contact report) of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
14
DBE Procedures Agency Documents Reviewed By ADOT BECO
DBE Procedures
Submit to ADOT LPA Section before February 28 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency follow the current ADOT FHWA DBE Plan Does the Agency follow the current DBE EPRISE (DBE contract language)
Does the Agency have a DBE Liaison Do the DBE Procedures require the agency to
Follow the most current DBE Plan DBE EPRISE (DBE contract language)
Submit the required documents to ADOT BECO for Federal-aid Highway Program (FAHP) projects to be assessed for DBE Goal and ensuring the DBE Goal is ldquovalidrdquo for advertisement
Obtain from BECO and provide to bidders and proposers all current BECO LPA Forms
Include a ldquovalidrdquo DBE goal percentage in advertisement solicitations and contract documents
Provide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
Conduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
Ensure receipt of Bid Verification Notice from ADOT BECO before contract award
Ensure Good Faith Effort (GFE) documentation is provided to meet requirements of EPRISE Specifications (as applicable)
Notify ADOT PM and ADOT BECO of contract award or rejection of bids
Report contract awards to BECO by the 10th of the month following contract award
Ensure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
Monitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment amp Payment Reporting Provisions
15
Question YN Document Page Paragraph Monitor and enforce the Prompt Payment amp Payment Reporting Provisions for prime contractor payments to subcontractors
Monitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
Monitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
Conduct a Commercially Useful Function (CUF) review for each DBE on a FAHP project
Obtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
Monitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
Monitor LPA DBE System in preparation for the semi-annual reporting by ensuring contract payments are up date
Ensure timely closeout of contracts in the LPA DBE System
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
16
Project Delivery Manual
Agency Documents Reviewed By ADOT LPA Section bull FAHP Project Delivery Manual ndash title page table of contents publication or modification date bull Other manuals as needed ndash title page table of contents publication or modification date bull Schedule for updating the Project Delivery Manual and any other manuals listed below
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have a single Project Delivery Manual Does the Project Delivery Manual contain or incorporate through reference the following
Staffing Plan Communication Plan Training Plan Roadway Pavement Design Guidelines Roadway Design Guidelines Roadway Design Exception Procedures Materials QA Program ROW Procedures Procurement of a Consultant Procurement of Materials andor Install Bid Analysis and Award Procedures Subcontract Approval Procedures ADA Transition Plan Title VI Program Plan DBE Procedures Financial Management Procedures Audit and Oversight Procedures Reporting Procedures
Does the Project Delivery Manual or another manual address the following
Request for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
Pre-planning Project initiation Scoping document PSampE development Environmental document Utilities clearance Railroad clearance Materials memo Pre-construction meetings SWPPP Labor compliance Inspector daily diaries Supplemental agreements Progress payments Prompt pay
17
Question YN Document Page Paragraph Claims Final acceptance Project closeout Record keeping EEO OJT Authorization Reimbursement
Do the FAHP Contract Approval Procedures require the contract include the following as applicable
Buy America Requirements FHWA Non-Collusion Statement FHWA Form 1273 USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Sanctions and Penalties for Breach of Contract Termination for Cause and Convenience Clean Air ActFederal Water Pollution Control Act Debarment and Suspension Byrd Anti Lobbying Amendment Language regarding compliance with and federal and state immigration laws and regulations
Title VI Assurances and Appendices A and E Does the Project Delivery Manual include a schedule for updating the manual(s)
Is the Project Delivery Manual posted on the Agencyrsquos internal website or made readily available for all staff involved in FAHP projects
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
18
Staffing Plan
Agency Documents Reviewed By ADOT LPA Section Organizational Chart
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agencyrsquos Organizational Chart accurately identify current Key Personnel
Does the Agencyrsquos Organizational Chart identify position title and contact information for each Key Personnel
Does the Agency have a well-documented process for addingdeletingmodifying Key Personnel Does the Agencyrsquos process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
See the list of Key Personnel and Roles and Responsibility below for more information
Key Personnel Role and Responsibility Designated Approval Authority Official with the authority to formally assume responsibility for the
implementation of the project development program and delivery of FAHP projects
CA Liaison An executive decision maker with working knowledge of the CA Program and main point of contact for ADOT
Responsible Charge Note If the responsible charge is not a full-time Agency employee the Agency must designate a full-time employee in responsible charge for the project
Title VI Coordinator Designated individual directly responsible for the management and administration of the Agencyrsquos ADOT-approved Title VI Program Plan
ADA Coordinator Designated individual directly responsible for the Agencyrsquos compliance with its ADA Transition Plan
DBE Liaison Designated individual directly responsible for implementing and monitoring DBE Program activities and advising the Agency fully and properly of DBE Program Plan issues
ROW Agent Designated individual directly responsible for the Agencyrsquos compliance with federal requirements for ROW activities administration of appraisal acquisition and relocation activities and preparation of the ROW Plan and ROW Clearance Letter
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
6
Procurement of a Consultant
Agency Documents Approved By ADOT ECS Section bull Completed Certification Acceptance Contract Administration Procedures Review Checklist (Appendix A) bull Procurement Procedures ndash written process for advertising evaluating selecting and negotiating contracts bull Contract Procedures ndash written process for contract administration and management bull Sample AE RFQ Package ndash copies of what the Agency advertises as part of its solicitation bull Sample Contract Boilerplate Documents ndash copies of contract document used for FAHP projects
Submit to ADOT LPA Section before December 31 2018
Assessment Questions Question YN Document Page Paragraph Is the Agency submitting Design Consultant Contracting (Procurement) Procedures If yes
Do the Agencyrsquos Design Consultant Contracting (Procurement) procedures meet the federal and state laws regulations and all other applicable requirements for qualification-based selection (QBS) process
Does the Agency use an ADOT approved prequalification process
If no does the Agency use ADOTrsquos prequalification list
Do the Agencyrsquos Procedures Require notification to the ADOT PM of kickoff and progress meetings
Inform the ADOT PM of error and omission actions taken
Require contacting the ADOT PM for approval and FHWA concurrence before terminating a federal-aid contract
Include a tracking and reporting process for on-call assignments if applicable
On-Call Design Procurement Procedures Is the Agency submitting Design Consultant On-Call Procurement Procedures If yes
Does the Agencyrsquos Procedures include On-Call procurement procedures
Do the CA Agencyrsquos procedures identify and define one of the two task or work orders assignment processes
Mini QBS procedures Regional selection
Do the CA Agencyrsquos procedures Include a tracking and reporting process for on-call assignments
Will the Agency be requesting an approval from ADOT before advertising for procurement of On-Call services
See Appendix B for additional resources
7
Agency ndash Prepared by ADOT ndash Approved by Signature Signature Printed Name Printed Name Title Title Date Date
8
Roadway Pavement Design
Agency Document Reviewed By ADOT LPA Section Pavement Design Guidelines
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local NHS Roadways
Does the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
Is MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
For NHS Roadways do the Agencyrsquos standards comply with 23 CFR 626
On Local Non - NHS Roadways Does the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local non-NHS RoadsStreets
Is MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
For Agency Projects within ADOT Right-of-Way do the Agencyrsquos Pavement Design Guidelines comply with the following
bull ADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
bull ADOT Materials Preliminary Design Guide bull AASHTO Design Guidelines
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
9
Roadway Design Guidelines
Agency Document Reviewed By ADOT LPA Section Roadway Design Guidelines
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local NHS Roadways
Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
Do the Agencyrsquos Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
On Local non-NHS Roadways Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local non-NHS RoadsStreets
For State Agency Projects within ADOT Right-of-Way do the Agencyrsquos Roadway Design confirm and comply with the following
bull AASHTO Controlling Design Criteria bull ADOT Roadway Design Guidelines (RDG) bull All other applicable adopted and published
ADOT design standard and guidelines
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
10
Roadway Design Exceptions
Agency Document Reviewed By ADOT Roadway Engineering Group Design Exception Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local - NHS Roadways
Does the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
Do the Agencyrsquos procedures include submitting to and obtaining approval from the FHWA for design exceptions
On Local Non - NHS Roadways Does the Agency have an adopted and published Design Exception procedure
For Agency Projects within ADOT Right-of-Way a Does the Agency have an adopted and
published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
b Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
c Do the Agencyrsquos procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
11
Materials QA Program
Agency Document Reviewed By ADOT Construction-Materials Group Materials QA Program or a letter signed by the Designated Approval Authority stating that the Agency adopts the ADOT Materials QA Program
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own ADOT-approved Materials QA Program
If no has the Agency adopted the ADOT Materials QA Program
Does the Materials QA Program Require the inclusion of the materials memo in the construction authorization packet and project file
Require the inclusion of the ADOT-approved Materials QA Project Plan in the construction authorization packet
Apply the Buy America provision to the entire FAHP project
Require verification that the Buy America certifications accompany each material shipment including steel or iron products
Require visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
12
ROW Procedures
Agency Document Approved By ADOT ROW Section ROW Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own written ROW manual If ldquoNordquo please explain If ldquoYesrdquo has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
If the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
Is the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 (b)
Does the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
Does the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 (c)
Does the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
Does the Agency request property donations from non-governmental owners whose Real Property Interest is required for Title 23 projects If ldquoYesrdquo does that donation meet the requirement per 23 CFR 710505(a)
Does the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
Does the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
Does the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
Is the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
13
of the Agency Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
Does the Agency include the preparation of right of way plans in their Federal Aid projects (CFR or Statute reference) If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
Does the Agency maintain a written logdiary (contact report) of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
14
DBE Procedures Agency Documents Reviewed By ADOT BECO
DBE Procedures
Submit to ADOT LPA Section before February 28 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency follow the current ADOT FHWA DBE Plan Does the Agency follow the current DBE EPRISE (DBE contract language)
Does the Agency have a DBE Liaison Do the DBE Procedures require the agency to
Follow the most current DBE Plan DBE EPRISE (DBE contract language)
Submit the required documents to ADOT BECO for Federal-aid Highway Program (FAHP) projects to be assessed for DBE Goal and ensuring the DBE Goal is ldquovalidrdquo for advertisement
Obtain from BECO and provide to bidders and proposers all current BECO LPA Forms
Include a ldquovalidrdquo DBE goal percentage in advertisement solicitations and contract documents
Provide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
Conduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
Ensure receipt of Bid Verification Notice from ADOT BECO before contract award
Ensure Good Faith Effort (GFE) documentation is provided to meet requirements of EPRISE Specifications (as applicable)
Notify ADOT PM and ADOT BECO of contract award or rejection of bids
Report contract awards to BECO by the 10th of the month following contract award
Ensure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
Monitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment amp Payment Reporting Provisions
15
Question YN Document Page Paragraph Monitor and enforce the Prompt Payment amp Payment Reporting Provisions for prime contractor payments to subcontractors
Monitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
Monitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
Conduct a Commercially Useful Function (CUF) review for each DBE on a FAHP project
Obtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
Monitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
Monitor LPA DBE System in preparation for the semi-annual reporting by ensuring contract payments are up date
Ensure timely closeout of contracts in the LPA DBE System
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
16
Project Delivery Manual
Agency Documents Reviewed By ADOT LPA Section bull FAHP Project Delivery Manual ndash title page table of contents publication or modification date bull Other manuals as needed ndash title page table of contents publication or modification date bull Schedule for updating the Project Delivery Manual and any other manuals listed below
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have a single Project Delivery Manual Does the Project Delivery Manual contain or incorporate through reference the following
Staffing Plan Communication Plan Training Plan Roadway Pavement Design Guidelines Roadway Design Guidelines Roadway Design Exception Procedures Materials QA Program ROW Procedures Procurement of a Consultant Procurement of Materials andor Install Bid Analysis and Award Procedures Subcontract Approval Procedures ADA Transition Plan Title VI Program Plan DBE Procedures Financial Management Procedures Audit and Oversight Procedures Reporting Procedures
Does the Project Delivery Manual or another manual address the following
Request for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
Pre-planning Project initiation Scoping document PSampE development Environmental document Utilities clearance Railroad clearance Materials memo Pre-construction meetings SWPPP Labor compliance Inspector daily diaries Supplemental agreements Progress payments Prompt pay
17
Question YN Document Page Paragraph Claims Final acceptance Project closeout Record keeping EEO OJT Authorization Reimbursement
Do the FAHP Contract Approval Procedures require the contract include the following as applicable
Buy America Requirements FHWA Non-Collusion Statement FHWA Form 1273 USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Sanctions and Penalties for Breach of Contract Termination for Cause and Convenience Clean Air ActFederal Water Pollution Control Act Debarment and Suspension Byrd Anti Lobbying Amendment Language regarding compliance with and federal and state immigration laws and regulations
Title VI Assurances and Appendices A and E Does the Project Delivery Manual include a schedule for updating the manual(s)
Is the Project Delivery Manual posted on the Agencyrsquos internal website or made readily available for all staff involved in FAHP projects
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
18
Staffing Plan
Agency Documents Reviewed By ADOT LPA Section Organizational Chart
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agencyrsquos Organizational Chart accurately identify current Key Personnel
Does the Agencyrsquos Organizational Chart identify position title and contact information for each Key Personnel
Does the Agency have a well-documented process for addingdeletingmodifying Key Personnel Does the Agencyrsquos process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
See the list of Key Personnel and Roles and Responsibility below for more information
Key Personnel Role and Responsibility Designated Approval Authority Official with the authority to formally assume responsibility for the
implementation of the project development program and delivery of FAHP projects
CA Liaison An executive decision maker with working knowledge of the CA Program and main point of contact for ADOT
Responsible Charge Note If the responsible charge is not a full-time Agency employee the Agency must designate a full-time employee in responsible charge for the project
Title VI Coordinator Designated individual directly responsible for the management and administration of the Agencyrsquos ADOT-approved Title VI Program Plan
ADA Coordinator Designated individual directly responsible for the Agencyrsquos compliance with its ADA Transition Plan
DBE Liaison Designated individual directly responsible for implementing and monitoring DBE Program activities and advising the Agency fully and properly of DBE Program Plan issues
ROW Agent Designated individual directly responsible for the Agencyrsquos compliance with federal requirements for ROW activities administration of appraisal acquisition and relocation activities and preparation of the ROW Plan and ROW Clearance Letter
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
7
Agency ndash Prepared by ADOT ndash Approved by Signature Signature Printed Name Printed Name Title Title Date Date
8
Roadway Pavement Design
Agency Document Reviewed By ADOT LPA Section Pavement Design Guidelines
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local NHS Roadways
Does the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
Is MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
For NHS Roadways do the Agencyrsquos standards comply with 23 CFR 626
On Local Non - NHS Roadways Does the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local non-NHS RoadsStreets
Is MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
For Agency Projects within ADOT Right-of-Way do the Agencyrsquos Pavement Design Guidelines comply with the following
bull ADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
bull ADOT Materials Preliminary Design Guide bull AASHTO Design Guidelines
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
9
Roadway Design Guidelines
Agency Document Reviewed By ADOT LPA Section Roadway Design Guidelines
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local NHS Roadways
Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
Do the Agencyrsquos Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
On Local non-NHS Roadways Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local non-NHS RoadsStreets
For State Agency Projects within ADOT Right-of-Way do the Agencyrsquos Roadway Design confirm and comply with the following
bull AASHTO Controlling Design Criteria bull ADOT Roadway Design Guidelines (RDG) bull All other applicable adopted and published
ADOT design standard and guidelines
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
10
Roadway Design Exceptions
Agency Document Reviewed By ADOT Roadway Engineering Group Design Exception Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local - NHS Roadways
Does the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
Do the Agencyrsquos procedures include submitting to and obtaining approval from the FHWA for design exceptions
On Local Non - NHS Roadways Does the Agency have an adopted and published Design Exception procedure
For Agency Projects within ADOT Right-of-Way a Does the Agency have an adopted and
published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
b Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
c Do the Agencyrsquos procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
11
Materials QA Program
Agency Document Reviewed By ADOT Construction-Materials Group Materials QA Program or a letter signed by the Designated Approval Authority stating that the Agency adopts the ADOT Materials QA Program
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own ADOT-approved Materials QA Program
If no has the Agency adopted the ADOT Materials QA Program
Does the Materials QA Program Require the inclusion of the materials memo in the construction authorization packet and project file
Require the inclusion of the ADOT-approved Materials QA Project Plan in the construction authorization packet
Apply the Buy America provision to the entire FAHP project
Require verification that the Buy America certifications accompany each material shipment including steel or iron products
Require visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
12
ROW Procedures
Agency Document Approved By ADOT ROW Section ROW Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own written ROW manual If ldquoNordquo please explain If ldquoYesrdquo has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
If the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
Is the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 (b)
Does the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
Does the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 (c)
Does the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
Does the Agency request property donations from non-governmental owners whose Real Property Interest is required for Title 23 projects If ldquoYesrdquo does that donation meet the requirement per 23 CFR 710505(a)
Does the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
Does the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
Does the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
Is the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
13
of the Agency Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
Does the Agency include the preparation of right of way plans in their Federal Aid projects (CFR or Statute reference) If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
Does the Agency maintain a written logdiary (contact report) of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
14
DBE Procedures Agency Documents Reviewed By ADOT BECO
DBE Procedures
Submit to ADOT LPA Section before February 28 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency follow the current ADOT FHWA DBE Plan Does the Agency follow the current DBE EPRISE (DBE contract language)
Does the Agency have a DBE Liaison Do the DBE Procedures require the agency to
Follow the most current DBE Plan DBE EPRISE (DBE contract language)
Submit the required documents to ADOT BECO for Federal-aid Highway Program (FAHP) projects to be assessed for DBE Goal and ensuring the DBE Goal is ldquovalidrdquo for advertisement
Obtain from BECO and provide to bidders and proposers all current BECO LPA Forms
Include a ldquovalidrdquo DBE goal percentage in advertisement solicitations and contract documents
Provide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
Conduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
Ensure receipt of Bid Verification Notice from ADOT BECO before contract award
Ensure Good Faith Effort (GFE) documentation is provided to meet requirements of EPRISE Specifications (as applicable)
Notify ADOT PM and ADOT BECO of contract award or rejection of bids
Report contract awards to BECO by the 10th of the month following contract award
Ensure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
Monitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment amp Payment Reporting Provisions
15
Question YN Document Page Paragraph Monitor and enforce the Prompt Payment amp Payment Reporting Provisions for prime contractor payments to subcontractors
Monitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
Monitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
Conduct a Commercially Useful Function (CUF) review for each DBE on a FAHP project
Obtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
Monitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
Monitor LPA DBE System in preparation for the semi-annual reporting by ensuring contract payments are up date
Ensure timely closeout of contracts in the LPA DBE System
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
16
Project Delivery Manual
Agency Documents Reviewed By ADOT LPA Section bull FAHP Project Delivery Manual ndash title page table of contents publication or modification date bull Other manuals as needed ndash title page table of contents publication or modification date bull Schedule for updating the Project Delivery Manual and any other manuals listed below
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have a single Project Delivery Manual Does the Project Delivery Manual contain or incorporate through reference the following
Staffing Plan Communication Plan Training Plan Roadway Pavement Design Guidelines Roadway Design Guidelines Roadway Design Exception Procedures Materials QA Program ROW Procedures Procurement of a Consultant Procurement of Materials andor Install Bid Analysis and Award Procedures Subcontract Approval Procedures ADA Transition Plan Title VI Program Plan DBE Procedures Financial Management Procedures Audit and Oversight Procedures Reporting Procedures
Does the Project Delivery Manual or another manual address the following
Request for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
Pre-planning Project initiation Scoping document PSampE development Environmental document Utilities clearance Railroad clearance Materials memo Pre-construction meetings SWPPP Labor compliance Inspector daily diaries Supplemental agreements Progress payments Prompt pay
17
Question YN Document Page Paragraph Claims Final acceptance Project closeout Record keeping EEO OJT Authorization Reimbursement
Do the FAHP Contract Approval Procedures require the contract include the following as applicable
Buy America Requirements FHWA Non-Collusion Statement FHWA Form 1273 USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Sanctions and Penalties for Breach of Contract Termination for Cause and Convenience Clean Air ActFederal Water Pollution Control Act Debarment and Suspension Byrd Anti Lobbying Amendment Language regarding compliance with and federal and state immigration laws and regulations
Title VI Assurances and Appendices A and E Does the Project Delivery Manual include a schedule for updating the manual(s)
Is the Project Delivery Manual posted on the Agencyrsquos internal website or made readily available for all staff involved in FAHP projects
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
18
Staffing Plan
Agency Documents Reviewed By ADOT LPA Section Organizational Chart
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agencyrsquos Organizational Chart accurately identify current Key Personnel
Does the Agencyrsquos Organizational Chart identify position title and contact information for each Key Personnel
Does the Agency have a well-documented process for addingdeletingmodifying Key Personnel Does the Agencyrsquos process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
See the list of Key Personnel and Roles and Responsibility below for more information
Key Personnel Role and Responsibility Designated Approval Authority Official with the authority to formally assume responsibility for the
implementation of the project development program and delivery of FAHP projects
CA Liaison An executive decision maker with working knowledge of the CA Program and main point of contact for ADOT
Responsible Charge Note If the responsible charge is not a full-time Agency employee the Agency must designate a full-time employee in responsible charge for the project
Title VI Coordinator Designated individual directly responsible for the management and administration of the Agencyrsquos ADOT-approved Title VI Program Plan
ADA Coordinator Designated individual directly responsible for the Agencyrsquos compliance with its ADA Transition Plan
DBE Liaison Designated individual directly responsible for implementing and monitoring DBE Program activities and advising the Agency fully and properly of DBE Program Plan issues
ROW Agent Designated individual directly responsible for the Agencyrsquos compliance with federal requirements for ROW activities administration of appraisal acquisition and relocation activities and preparation of the ROW Plan and ROW Clearance Letter
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
8
Roadway Pavement Design
Agency Document Reviewed By ADOT LPA Section Pavement Design Guidelines
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local NHS Roadways
Does the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
Is MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
For NHS Roadways do the Agencyrsquos standards comply with 23 CFR 626
On Local Non - NHS Roadways Does the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local non-NHS RoadsStreets
Is MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
For Agency Projects within ADOT Right-of-Way do the Agencyrsquos Pavement Design Guidelines comply with the following
bull ADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
bull ADOT Materials Preliminary Design Guide bull AASHTO Design Guidelines
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
9
Roadway Design Guidelines
Agency Document Reviewed By ADOT LPA Section Roadway Design Guidelines
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local NHS Roadways
Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
Do the Agencyrsquos Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
On Local non-NHS Roadways Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local non-NHS RoadsStreets
For State Agency Projects within ADOT Right-of-Way do the Agencyrsquos Roadway Design confirm and comply with the following
bull AASHTO Controlling Design Criteria bull ADOT Roadway Design Guidelines (RDG) bull All other applicable adopted and published
ADOT design standard and guidelines
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
10
Roadway Design Exceptions
Agency Document Reviewed By ADOT Roadway Engineering Group Design Exception Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local - NHS Roadways
Does the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
Do the Agencyrsquos procedures include submitting to and obtaining approval from the FHWA for design exceptions
On Local Non - NHS Roadways Does the Agency have an adopted and published Design Exception procedure
For Agency Projects within ADOT Right-of-Way a Does the Agency have an adopted and
published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
b Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
c Do the Agencyrsquos procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
11
Materials QA Program
Agency Document Reviewed By ADOT Construction-Materials Group Materials QA Program or a letter signed by the Designated Approval Authority stating that the Agency adopts the ADOT Materials QA Program
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own ADOT-approved Materials QA Program
If no has the Agency adopted the ADOT Materials QA Program
Does the Materials QA Program Require the inclusion of the materials memo in the construction authorization packet and project file
Require the inclusion of the ADOT-approved Materials QA Project Plan in the construction authorization packet
Apply the Buy America provision to the entire FAHP project
Require verification that the Buy America certifications accompany each material shipment including steel or iron products
Require visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
12
ROW Procedures
Agency Document Approved By ADOT ROW Section ROW Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own written ROW manual If ldquoNordquo please explain If ldquoYesrdquo has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
If the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
Is the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 (b)
Does the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
Does the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 (c)
Does the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
Does the Agency request property donations from non-governmental owners whose Real Property Interest is required for Title 23 projects If ldquoYesrdquo does that donation meet the requirement per 23 CFR 710505(a)
Does the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
Does the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
Does the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
Is the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
13
of the Agency Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
Does the Agency include the preparation of right of way plans in their Federal Aid projects (CFR or Statute reference) If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
Does the Agency maintain a written logdiary (contact report) of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
14
DBE Procedures Agency Documents Reviewed By ADOT BECO
DBE Procedures
Submit to ADOT LPA Section before February 28 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency follow the current ADOT FHWA DBE Plan Does the Agency follow the current DBE EPRISE (DBE contract language)
Does the Agency have a DBE Liaison Do the DBE Procedures require the agency to
Follow the most current DBE Plan DBE EPRISE (DBE contract language)
Submit the required documents to ADOT BECO for Federal-aid Highway Program (FAHP) projects to be assessed for DBE Goal and ensuring the DBE Goal is ldquovalidrdquo for advertisement
Obtain from BECO and provide to bidders and proposers all current BECO LPA Forms
Include a ldquovalidrdquo DBE goal percentage in advertisement solicitations and contract documents
Provide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
Conduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
Ensure receipt of Bid Verification Notice from ADOT BECO before contract award
Ensure Good Faith Effort (GFE) documentation is provided to meet requirements of EPRISE Specifications (as applicable)
Notify ADOT PM and ADOT BECO of contract award or rejection of bids
Report contract awards to BECO by the 10th of the month following contract award
Ensure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
Monitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment amp Payment Reporting Provisions
15
Question YN Document Page Paragraph Monitor and enforce the Prompt Payment amp Payment Reporting Provisions for prime contractor payments to subcontractors
Monitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
Monitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
Conduct a Commercially Useful Function (CUF) review for each DBE on a FAHP project
Obtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
Monitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
Monitor LPA DBE System in preparation for the semi-annual reporting by ensuring contract payments are up date
Ensure timely closeout of contracts in the LPA DBE System
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
16
Project Delivery Manual
Agency Documents Reviewed By ADOT LPA Section bull FAHP Project Delivery Manual ndash title page table of contents publication or modification date bull Other manuals as needed ndash title page table of contents publication or modification date bull Schedule for updating the Project Delivery Manual and any other manuals listed below
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have a single Project Delivery Manual Does the Project Delivery Manual contain or incorporate through reference the following
Staffing Plan Communication Plan Training Plan Roadway Pavement Design Guidelines Roadway Design Guidelines Roadway Design Exception Procedures Materials QA Program ROW Procedures Procurement of a Consultant Procurement of Materials andor Install Bid Analysis and Award Procedures Subcontract Approval Procedures ADA Transition Plan Title VI Program Plan DBE Procedures Financial Management Procedures Audit and Oversight Procedures Reporting Procedures
Does the Project Delivery Manual or another manual address the following
Request for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
Pre-planning Project initiation Scoping document PSampE development Environmental document Utilities clearance Railroad clearance Materials memo Pre-construction meetings SWPPP Labor compliance Inspector daily diaries Supplemental agreements Progress payments Prompt pay
17
Question YN Document Page Paragraph Claims Final acceptance Project closeout Record keeping EEO OJT Authorization Reimbursement
Do the FAHP Contract Approval Procedures require the contract include the following as applicable
Buy America Requirements FHWA Non-Collusion Statement FHWA Form 1273 USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Sanctions and Penalties for Breach of Contract Termination for Cause and Convenience Clean Air ActFederal Water Pollution Control Act Debarment and Suspension Byrd Anti Lobbying Amendment Language regarding compliance with and federal and state immigration laws and regulations
Title VI Assurances and Appendices A and E Does the Project Delivery Manual include a schedule for updating the manual(s)
Is the Project Delivery Manual posted on the Agencyrsquos internal website or made readily available for all staff involved in FAHP projects
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
18
Staffing Plan
Agency Documents Reviewed By ADOT LPA Section Organizational Chart
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agencyrsquos Organizational Chart accurately identify current Key Personnel
Does the Agencyrsquos Organizational Chart identify position title and contact information for each Key Personnel
Does the Agency have a well-documented process for addingdeletingmodifying Key Personnel Does the Agencyrsquos process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
See the list of Key Personnel and Roles and Responsibility below for more information
Key Personnel Role and Responsibility Designated Approval Authority Official with the authority to formally assume responsibility for the
implementation of the project development program and delivery of FAHP projects
CA Liaison An executive decision maker with working knowledge of the CA Program and main point of contact for ADOT
Responsible Charge Note If the responsible charge is not a full-time Agency employee the Agency must designate a full-time employee in responsible charge for the project
Title VI Coordinator Designated individual directly responsible for the management and administration of the Agencyrsquos ADOT-approved Title VI Program Plan
ADA Coordinator Designated individual directly responsible for the Agencyrsquos compliance with its ADA Transition Plan
DBE Liaison Designated individual directly responsible for implementing and monitoring DBE Program activities and advising the Agency fully and properly of DBE Program Plan issues
ROW Agent Designated individual directly responsible for the Agencyrsquos compliance with federal requirements for ROW activities administration of appraisal acquisition and relocation activities and preparation of the ROW Plan and ROW Clearance Letter
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
9
Roadway Design Guidelines
Agency Document Reviewed By ADOT LPA Section Roadway Design Guidelines
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local NHS Roadways
Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
Do the Agencyrsquos Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
On Local non-NHS Roadways Does the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local non-NHS RoadsStreets
For State Agency Projects within ADOT Right-of-Way do the Agencyrsquos Roadway Design confirm and comply with the following
bull AASHTO Controlling Design Criteria bull ADOT Roadway Design Guidelines (RDG) bull All other applicable adopted and published
ADOT design standard and guidelines
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
10
Roadway Design Exceptions
Agency Document Reviewed By ADOT Roadway Engineering Group Design Exception Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local - NHS Roadways
Does the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
Do the Agencyrsquos procedures include submitting to and obtaining approval from the FHWA for design exceptions
On Local Non - NHS Roadways Does the Agency have an adopted and published Design Exception procedure
For Agency Projects within ADOT Right-of-Way a Does the Agency have an adopted and
published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
b Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
c Do the Agencyrsquos procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
11
Materials QA Program
Agency Document Reviewed By ADOT Construction-Materials Group Materials QA Program or a letter signed by the Designated Approval Authority stating that the Agency adopts the ADOT Materials QA Program
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own ADOT-approved Materials QA Program
If no has the Agency adopted the ADOT Materials QA Program
Does the Materials QA Program Require the inclusion of the materials memo in the construction authorization packet and project file
Require the inclusion of the ADOT-approved Materials QA Project Plan in the construction authorization packet
Apply the Buy America provision to the entire FAHP project
Require verification that the Buy America certifications accompany each material shipment including steel or iron products
Require visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
12
ROW Procedures
Agency Document Approved By ADOT ROW Section ROW Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own written ROW manual If ldquoNordquo please explain If ldquoYesrdquo has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
If the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
Is the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 (b)
Does the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
Does the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 (c)
Does the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
Does the Agency request property donations from non-governmental owners whose Real Property Interest is required for Title 23 projects If ldquoYesrdquo does that donation meet the requirement per 23 CFR 710505(a)
Does the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
Does the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
Does the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
Is the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
13
of the Agency Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
Does the Agency include the preparation of right of way plans in their Federal Aid projects (CFR or Statute reference) If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
Does the Agency maintain a written logdiary (contact report) of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
14
DBE Procedures Agency Documents Reviewed By ADOT BECO
DBE Procedures
Submit to ADOT LPA Section before February 28 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency follow the current ADOT FHWA DBE Plan Does the Agency follow the current DBE EPRISE (DBE contract language)
Does the Agency have a DBE Liaison Do the DBE Procedures require the agency to
Follow the most current DBE Plan DBE EPRISE (DBE contract language)
Submit the required documents to ADOT BECO for Federal-aid Highway Program (FAHP) projects to be assessed for DBE Goal and ensuring the DBE Goal is ldquovalidrdquo for advertisement
Obtain from BECO and provide to bidders and proposers all current BECO LPA Forms
Include a ldquovalidrdquo DBE goal percentage in advertisement solicitations and contract documents
Provide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
Conduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
Ensure receipt of Bid Verification Notice from ADOT BECO before contract award
Ensure Good Faith Effort (GFE) documentation is provided to meet requirements of EPRISE Specifications (as applicable)
Notify ADOT PM and ADOT BECO of contract award or rejection of bids
Report contract awards to BECO by the 10th of the month following contract award
Ensure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
Monitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment amp Payment Reporting Provisions
15
Question YN Document Page Paragraph Monitor and enforce the Prompt Payment amp Payment Reporting Provisions for prime contractor payments to subcontractors
Monitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
Monitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
Conduct a Commercially Useful Function (CUF) review for each DBE on a FAHP project
Obtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
Monitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
Monitor LPA DBE System in preparation for the semi-annual reporting by ensuring contract payments are up date
Ensure timely closeout of contracts in the LPA DBE System
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
16
Project Delivery Manual
Agency Documents Reviewed By ADOT LPA Section bull FAHP Project Delivery Manual ndash title page table of contents publication or modification date bull Other manuals as needed ndash title page table of contents publication or modification date bull Schedule for updating the Project Delivery Manual and any other manuals listed below
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have a single Project Delivery Manual Does the Project Delivery Manual contain or incorporate through reference the following
Staffing Plan Communication Plan Training Plan Roadway Pavement Design Guidelines Roadway Design Guidelines Roadway Design Exception Procedures Materials QA Program ROW Procedures Procurement of a Consultant Procurement of Materials andor Install Bid Analysis and Award Procedures Subcontract Approval Procedures ADA Transition Plan Title VI Program Plan DBE Procedures Financial Management Procedures Audit and Oversight Procedures Reporting Procedures
Does the Project Delivery Manual or another manual address the following
Request for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
Pre-planning Project initiation Scoping document PSampE development Environmental document Utilities clearance Railroad clearance Materials memo Pre-construction meetings SWPPP Labor compliance Inspector daily diaries Supplemental agreements Progress payments Prompt pay
17
Question YN Document Page Paragraph Claims Final acceptance Project closeout Record keeping EEO OJT Authorization Reimbursement
Do the FAHP Contract Approval Procedures require the contract include the following as applicable
Buy America Requirements FHWA Non-Collusion Statement FHWA Form 1273 USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Sanctions and Penalties for Breach of Contract Termination for Cause and Convenience Clean Air ActFederal Water Pollution Control Act Debarment and Suspension Byrd Anti Lobbying Amendment Language regarding compliance with and federal and state immigration laws and regulations
Title VI Assurances and Appendices A and E Does the Project Delivery Manual include a schedule for updating the manual(s)
Is the Project Delivery Manual posted on the Agencyrsquos internal website or made readily available for all staff involved in FAHP projects
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
18
Staffing Plan
Agency Documents Reviewed By ADOT LPA Section Organizational Chart
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agencyrsquos Organizational Chart accurately identify current Key Personnel
Does the Agencyrsquos Organizational Chart identify position title and contact information for each Key Personnel
Does the Agency have a well-documented process for addingdeletingmodifying Key Personnel Does the Agencyrsquos process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
See the list of Key Personnel and Roles and Responsibility below for more information
Key Personnel Role and Responsibility Designated Approval Authority Official with the authority to formally assume responsibility for the
implementation of the project development program and delivery of FAHP projects
CA Liaison An executive decision maker with working knowledge of the CA Program and main point of contact for ADOT
Responsible Charge Note If the responsible charge is not a full-time Agency employee the Agency must designate a full-time employee in responsible charge for the project
Title VI Coordinator Designated individual directly responsible for the management and administration of the Agencyrsquos ADOT-approved Title VI Program Plan
ADA Coordinator Designated individual directly responsible for the Agencyrsquos compliance with its ADA Transition Plan
DBE Liaison Designated individual directly responsible for implementing and monitoring DBE Program activities and advising the Agency fully and properly of DBE Program Plan issues
ROW Agent Designated individual directly responsible for the Agencyrsquos compliance with federal requirements for ROW activities administration of appraisal acquisition and relocation activities and preparation of the ROW Plan and ROW Clearance Letter
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
10
Roadway Design Exceptions
Agency Document Reviewed By ADOT Roadway Engineering Group Design Exception Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph On Local - NHS Roadways
Does the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
Do the Agencyrsquos procedures include submitting to and obtaining approval from the FHWA for design exceptions
On Local Non - NHS Roadways Does the Agency have an adopted and published Design Exception procedure
For Agency Projects within ADOT Right-of-Way a Does the Agency have an adopted and
published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
b Do the Agencyrsquos procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
c Do the Agencyrsquos procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
11
Materials QA Program
Agency Document Reviewed By ADOT Construction-Materials Group Materials QA Program or a letter signed by the Designated Approval Authority stating that the Agency adopts the ADOT Materials QA Program
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own ADOT-approved Materials QA Program
If no has the Agency adopted the ADOT Materials QA Program
Does the Materials QA Program Require the inclusion of the materials memo in the construction authorization packet and project file
Require the inclusion of the ADOT-approved Materials QA Project Plan in the construction authorization packet
Apply the Buy America provision to the entire FAHP project
Require verification that the Buy America certifications accompany each material shipment including steel or iron products
Require visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
12
ROW Procedures
Agency Document Approved By ADOT ROW Section ROW Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own written ROW manual If ldquoNordquo please explain If ldquoYesrdquo has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
If the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
Is the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 (b)
Does the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
Does the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 (c)
Does the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
Does the Agency request property donations from non-governmental owners whose Real Property Interest is required for Title 23 projects If ldquoYesrdquo does that donation meet the requirement per 23 CFR 710505(a)
Does the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
Does the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
Does the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
Is the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
13
of the Agency Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
Does the Agency include the preparation of right of way plans in their Federal Aid projects (CFR or Statute reference) If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
Does the Agency maintain a written logdiary (contact report) of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
14
DBE Procedures Agency Documents Reviewed By ADOT BECO
DBE Procedures
Submit to ADOT LPA Section before February 28 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency follow the current ADOT FHWA DBE Plan Does the Agency follow the current DBE EPRISE (DBE contract language)
Does the Agency have a DBE Liaison Do the DBE Procedures require the agency to
Follow the most current DBE Plan DBE EPRISE (DBE contract language)
Submit the required documents to ADOT BECO for Federal-aid Highway Program (FAHP) projects to be assessed for DBE Goal and ensuring the DBE Goal is ldquovalidrdquo for advertisement
Obtain from BECO and provide to bidders and proposers all current BECO LPA Forms
Include a ldquovalidrdquo DBE goal percentage in advertisement solicitations and contract documents
Provide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
Conduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
Ensure receipt of Bid Verification Notice from ADOT BECO before contract award
Ensure Good Faith Effort (GFE) documentation is provided to meet requirements of EPRISE Specifications (as applicable)
Notify ADOT PM and ADOT BECO of contract award or rejection of bids
Report contract awards to BECO by the 10th of the month following contract award
Ensure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
Monitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment amp Payment Reporting Provisions
15
Question YN Document Page Paragraph Monitor and enforce the Prompt Payment amp Payment Reporting Provisions for prime contractor payments to subcontractors
Monitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
Monitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
Conduct a Commercially Useful Function (CUF) review for each DBE on a FAHP project
Obtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
Monitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
Monitor LPA DBE System in preparation for the semi-annual reporting by ensuring contract payments are up date
Ensure timely closeout of contracts in the LPA DBE System
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
16
Project Delivery Manual
Agency Documents Reviewed By ADOT LPA Section bull FAHP Project Delivery Manual ndash title page table of contents publication or modification date bull Other manuals as needed ndash title page table of contents publication or modification date bull Schedule for updating the Project Delivery Manual and any other manuals listed below
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have a single Project Delivery Manual Does the Project Delivery Manual contain or incorporate through reference the following
Staffing Plan Communication Plan Training Plan Roadway Pavement Design Guidelines Roadway Design Guidelines Roadway Design Exception Procedures Materials QA Program ROW Procedures Procurement of a Consultant Procurement of Materials andor Install Bid Analysis and Award Procedures Subcontract Approval Procedures ADA Transition Plan Title VI Program Plan DBE Procedures Financial Management Procedures Audit and Oversight Procedures Reporting Procedures
Does the Project Delivery Manual or another manual address the following
Request for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
Pre-planning Project initiation Scoping document PSampE development Environmental document Utilities clearance Railroad clearance Materials memo Pre-construction meetings SWPPP Labor compliance Inspector daily diaries Supplemental agreements Progress payments Prompt pay
17
Question YN Document Page Paragraph Claims Final acceptance Project closeout Record keeping EEO OJT Authorization Reimbursement
Do the FAHP Contract Approval Procedures require the contract include the following as applicable
Buy America Requirements FHWA Non-Collusion Statement FHWA Form 1273 USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Sanctions and Penalties for Breach of Contract Termination for Cause and Convenience Clean Air ActFederal Water Pollution Control Act Debarment and Suspension Byrd Anti Lobbying Amendment Language regarding compliance with and federal and state immigration laws and regulations
Title VI Assurances and Appendices A and E Does the Project Delivery Manual include a schedule for updating the manual(s)
Is the Project Delivery Manual posted on the Agencyrsquos internal website or made readily available for all staff involved in FAHP projects
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
18
Staffing Plan
Agency Documents Reviewed By ADOT LPA Section Organizational Chart
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agencyrsquos Organizational Chart accurately identify current Key Personnel
Does the Agencyrsquos Organizational Chart identify position title and contact information for each Key Personnel
Does the Agency have a well-documented process for addingdeletingmodifying Key Personnel Does the Agencyrsquos process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
See the list of Key Personnel and Roles and Responsibility below for more information
Key Personnel Role and Responsibility Designated Approval Authority Official with the authority to formally assume responsibility for the
implementation of the project development program and delivery of FAHP projects
CA Liaison An executive decision maker with working knowledge of the CA Program and main point of contact for ADOT
Responsible Charge Note If the responsible charge is not a full-time Agency employee the Agency must designate a full-time employee in responsible charge for the project
Title VI Coordinator Designated individual directly responsible for the management and administration of the Agencyrsquos ADOT-approved Title VI Program Plan
ADA Coordinator Designated individual directly responsible for the Agencyrsquos compliance with its ADA Transition Plan
DBE Liaison Designated individual directly responsible for implementing and monitoring DBE Program activities and advising the Agency fully and properly of DBE Program Plan issues
ROW Agent Designated individual directly responsible for the Agencyrsquos compliance with federal requirements for ROW activities administration of appraisal acquisition and relocation activities and preparation of the ROW Plan and ROW Clearance Letter
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
11
Materials QA Program
Agency Document Reviewed By ADOT Construction-Materials Group Materials QA Program or a letter signed by the Designated Approval Authority stating that the Agency adopts the ADOT Materials QA Program
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own ADOT-approved Materials QA Program
If no has the Agency adopted the ADOT Materials QA Program
Does the Materials QA Program Require the inclusion of the materials memo in the construction authorization packet and project file
Require the inclusion of the ADOT-approved Materials QA Project Plan in the construction authorization packet
Apply the Buy America provision to the entire FAHP project
Require verification that the Buy America certifications accompany each material shipment including steel or iron products
Require visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
See Appendix B for additional resources
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
12
ROW Procedures
Agency Document Approved By ADOT ROW Section ROW Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own written ROW manual If ldquoNordquo please explain If ldquoYesrdquo has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
If the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
Is the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 (b)
Does the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
Does the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 (c)
Does the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
Does the Agency request property donations from non-governmental owners whose Real Property Interest is required for Title 23 projects If ldquoYesrdquo does that donation meet the requirement per 23 CFR 710505(a)
Does the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
Does the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
Does the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
Is the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
13
of the Agency Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
Does the Agency include the preparation of right of way plans in their Federal Aid projects (CFR or Statute reference) If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
Does the Agency maintain a written logdiary (contact report) of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
14
DBE Procedures Agency Documents Reviewed By ADOT BECO
DBE Procedures
Submit to ADOT LPA Section before February 28 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency follow the current ADOT FHWA DBE Plan Does the Agency follow the current DBE EPRISE (DBE contract language)
Does the Agency have a DBE Liaison Do the DBE Procedures require the agency to
Follow the most current DBE Plan DBE EPRISE (DBE contract language)
Submit the required documents to ADOT BECO for Federal-aid Highway Program (FAHP) projects to be assessed for DBE Goal and ensuring the DBE Goal is ldquovalidrdquo for advertisement
Obtain from BECO and provide to bidders and proposers all current BECO LPA Forms
Include a ldquovalidrdquo DBE goal percentage in advertisement solicitations and contract documents
Provide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
Conduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
Ensure receipt of Bid Verification Notice from ADOT BECO before contract award
Ensure Good Faith Effort (GFE) documentation is provided to meet requirements of EPRISE Specifications (as applicable)
Notify ADOT PM and ADOT BECO of contract award or rejection of bids
Report contract awards to BECO by the 10th of the month following contract award
Ensure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
Monitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment amp Payment Reporting Provisions
15
Question YN Document Page Paragraph Monitor and enforce the Prompt Payment amp Payment Reporting Provisions for prime contractor payments to subcontractors
Monitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
Monitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
Conduct a Commercially Useful Function (CUF) review for each DBE on a FAHP project
Obtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
Monitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
Monitor LPA DBE System in preparation for the semi-annual reporting by ensuring contract payments are up date
Ensure timely closeout of contracts in the LPA DBE System
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
16
Project Delivery Manual
Agency Documents Reviewed By ADOT LPA Section bull FAHP Project Delivery Manual ndash title page table of contents publication or modification date bull Other manuals as needed ndash title page table of contents publication or modification date bull Schedule for updating the Project Delivery Manual and any other manuals listed below
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have a single Project Delivery Manual Does the Project Delivery Manual contain or incorporate through reference the following
Staffing Plan Communication Plan Training Plan Roadway Pavement Design Guidelines Roadway Design Guidelines Roadway Design Exception Procedures Materials QA Program ROW Procedures Procurement of a Consultant Procurement of Materials andor Install Bid Analysis and Award Procedures Subcontract Approval Procedures ADA Transition Plan Title VI Program Plan DBE Procedures Financial Management Procedures Audit and Oversight Procedures Reporting Procedures
Does the Project Delivery Manual or another manual address the following
Request for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
Pre-planning Project initiation Scoping document PSampE development Environmental document Utilities clearance Railroad clearance Materials memo Pre-construction meetings SWPPP Labor compliance Inspector daily diaries Supplemental agreements Progress payments Prompt pay
17
Question YN Document Page Paragraph Claims Final acceptance Project closeout Record keeping EEO OJT Authorization Reimbursement
Do the FAHP Contract Approval Procedures require the contract include the following as applicable
Buy America Requirements FHWA Non-Collusion Statement FHWA Form 1273 USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Sanctions and Penalties for Breach of Contract Termination for Cause and Convenience Clean Air ActFederal Water Pollution Control Act Debarment and Suspension Byrd Anti Lobbying Amendment Language regarding compliance with and federal and state immigration laws and regulations
Title VI Assurances and Appendices A and E Does the Project Delivery Manual include a schedule for updating the manual(s)
Is the Project Delivery Manual posted on the Agencyrsquos internal website or made readily available for all staff involved in FAHP projects
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
18
Staffing Plan
Agency Documents Reviewed By ADOT LPA Section Organizational Chart
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agencyrsquos Organizational Chart accurately identify current Key Personnel
Does the Agencyrsquos Organizational Chart identify position title and contact information for each Key Personnel
Does the Agency have a well-documented process for addingdeletingmodifying Key Personnel Does the Agencyrsquos process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
See the list of Key Personnel and Roles and Responsibility below for more information
Key Personnel Role and Responsibility Designated Approval Authority Official with the authority to formally assume responsibility for the
implementation of the project development program and delivery of FAHP projects
CA Liaison An executive decision maker with working knowledge of the CA Program and main point of contact for ADOT
Responsible Charge Note If the responsible charge is not a full-time Agency employee the Agency must designate a full-time employee in responsible charge for the project
Title VI Coordinator Designated individual directly responsible for the management and administration of the Agencyrsquos ADOT-approved Title VI Program Plan
ADA Coordinator Designated individual directly responsible for the Agencyrsquos compliance with its ADA Transition Plan
DBE Liaison Designated individual directly responsible for implementing and monitoring DBE Program activities and advising the Agency fully and properly of DBE Program Plan issues
ROW Agent Designated individual directly responsible for the Agencyrsquos compliance with federal requirements for ROW activities administration of appraisal acquisition and relocation activities and preparation of the ROW Plan and ROW Clearance Letter
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
12
ROW Procedures
Agency Document Approved By ADOT ROW Section ROW Procedures
Submit to ADOT LPA Section before January 31 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have its own written ROW manual If ldquoNordquo please explain If ldquoYesrdquo has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
If the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
Is the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 (b)
Does the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
Does the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 (c)
Does the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
Does the Agency request property donations from non-governmental owners whose Real Property Interest is required for Title 23 projects If ldquoYesrdquo does that donation meet the requirement per 23 CFR 710505(a)
Does the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
Does the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
Does the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
Is the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
13
of the Agency Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
Does the Agency include the preparation of right of way plans in their Federal Aid projects (CFR or Statute reference) If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
Does the Agency maintain a written logdiary (contact report) of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
14
DBE Procedures Agency Documents Reviewed By ADOT BECO
DBE Procedures
Submit to ADOT LPA Section before February 28 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency follow the current ADOT FHWA DBE Plan Does the Agency follow the current DBE EPRISE (DBE contract language)
Does the Agency have a DBE Liaison Do the DBE Procedures require the agency to
Follow the most current DBE Plan DBE EPRISE (DBE contract language)
Submit the required documents to ADOT BECO for Federal-aid Highway Program (FAHP) projects to be assessed for DBE Goal and ensuring the DBE Goal is ldquovalidrdquo for advertisement
Obtain from BECO and provide to bidders and proposers all current BECO LPA Forms
Include a ldquovalidrdquo DBE goal percentage in advertisement solicitations and contract documents
Provide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
Conduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
Ensure receipt of Bid Verification Notice from ADOT BECO before contract award
Ensure Good Faith Effort (GFE) documentation is provided to meet requirements of EPRISE Specifications (as applicable)
Notify ADOT PM and ADOT BECO of contract award or rejection of bids
Report contract awards to BECO by the 10th of the month following contract award
Ensure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
Monitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment amp Payment Reporting Provisions
15
Question YN Document Page Paragraph Monitor and enforce the Prompt Payment amp Payment Reporting Provisions for prime contractor payments to subcontractors
Monitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
Monitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
Conduct a Commercially Useful Function (CUF) review for each DBE on a FAHP project
Obtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
Monitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
Monitor LPA DBE System in preparation for the semi-annual reporting by ensuring contract payments are up date
Ensure timely closeout of contracts in the LPA DBE System
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
16
Project Delivery Manual
Agency Documents Reviewed By ADOT LPA Section bull FAHP Project Delivery Manual ndash title page table of contents publication or modification date bull Other manuals as needed ndash title page table of contents publication or modification date bull Schedule for updating the Project Delivery Manual and any other manuals listed below
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have a single Project Delivery Manual Does the Project Delivery Manual contain or incorporate through reference the following
Staffing Plan Communication Plan Training Plan Roadway Pavement Design Guidelines Roadway Design Guidelines Roadway Design Exception Procedures Materials QA Program ROW Procedures Procurement of a Consultant Procurement of Materials andor Install Bid Analysis and Award Procedures Subcontract Approval Procedures ADA Transition Plan Title VI Program Plan DBE Procedures Financial Management Procedures Audit and Oversight Procedures Reporting Procedures
Does the Project Delivery Manual or another manual address the following
Request for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
Pre-planning Project initiation Scoping document PSampE development Environmental document Utilities clearance Railroad clearance Materials memo Pre-construction meetings SWPPP Labor compliance Inspector daily diaries Supplemental agreements Progress payments Prompt pay
17
Question YN Document Page Paragraph Claims Final acceptance Project closeout Record keeping EEO OJT Authorization Reimbursement
Do the FAHP Contract Approval Procedures require the contract include the following as applicable
Buy America Requirements FHWA Non-Collusion Statement FHWA Form 1273 USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Sanctions and Penalties for Breach of Contract Termination for Cause and Convenience Clean Air ActFederal Water Pollution Control Act Debarment and Suspension Byrd Anti Lobbying Amendment Language regarding compliance with and federal and state immigration laws and regulations
Title VI Assurances and Appendices A and E Does the Project Delivery Manual include a schedule for updating the manual(s)
Is the Project Delivery Manual posted on the Agencyrsquos internal website or made readily available for all staff involved in FAHP projects
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
18
Staffing Plan
Agency Documents Reviewed By ADOT LPA Section Organizational Chart
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agencyrsquos Organizational Chart accurately identify current Key Personnel
Does the Agencyrsquos Organizational Chart identify position title and contact information for each Key Personnel
Does the Agency have a well-documented process for addingdeletingmodifying Key Personnel Does the Agencyrsquos process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
See the list of Key Personnel and Roles and Responsibility below for more information
Key Personnel Role and Responsibility Designated Approval Authority Official with the authority to formally assume responsibility for the
implementation of the project development program and delivery of FAHP projects
CA Liaison An executive decision maker with working knowledge of the CA Program and main point of contact for ADOT
Responsible Charge Note If the responsible charge is not a full-time Agency employee the Agency must designate a full-time employee in responsible charge for the project
Title VI Coordinator Designated individual directly responsible for the management and administration of the Agencyrsquos ADOT-approved Title VI Program Plan
ADA Coordinator Designated individual directly responsible for the Agencyrsquos compliance with its ADA Transition Plan
DBE Liaison Designated individual directly responsible for implementing and monitoring DBE Program activities and advising the Agency fully and properly of DBE Program Plan issues
ROW Agent Designated individual directly responsible for the Agencyrsquos compliance with federal requirements for ROW activities administration of appraisal acquisition and relocation activities and preparation of the ROW Plan and ROW Clearance Letter
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
13
of the Agency Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
Does the Agency include the preparation of right of way plans in their Federal Aid projects (CFR or Statute reference) If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
Does the Agency maintain a written logdiary (contact report) of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
14
DBE Procedures Agency Documents Reviewed By ADOT BECO
DBE Procedures
Submit to ADOT LPA Section before February 28 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency follow the current ADOT FHWA DBE Plan Does the Agency follow the current DBE EPRISE (DBE contract language)
Does the Agency have a DBE Liaison Do the DBE Procedures require the agency to
Follow the most current DBE Plan DBE EPRISE (DBE contract language)
Submit the required documents to ADOT BECO for Federal-aid Highway Program (FAHP) projects to be assessed for DBE Goal and ensuring the DBE Goal is ldquovalidrdquo for advertisement
Obtain from BECO and provide to bidders and proposers all current BECO LPA Forms
Include a ldquovalidrdquo DBE goal percentage in advertisement solicitations and contract documents
Provide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
Conduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
Ensure receipt of Bid Verification Notice from ADOT BECO before contract award
Ensure Good Faith Effort (GFE) documentation is provided to meet requirements of EPRISE Specifications (as applicable)
Notify ADOT PM and ADOT BECO of contract award or rejection of bids
Report contract awards to BECO by the 10th of the month following contract award
Ensure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
Monitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment amp Payment Reporting Provisions
15
Question YN Document Page Paragraph Monitor and enforce the Prompt Payment amp Payment Reporting Provisions for prime contractor payments to subcontractors
Monitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
Monitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
Conduct a Commercially Useful Function (CUF) review for each DBE on a FAHP project
Obtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
Monitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
Monitor LPA DBE System in preparation for the semi-annual reporting by ensuring contract payments are up date
Ensure timely closeout of contracts in the LPA DBE System
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
16
Project Delivery Manual
Agency Documents Reviewed By ADOT LPA Section bull FAHP Project Delivery Manual ndash title page table of contents publication or modification date bull Other manuals as needed ndash title page table of contents publication or modification date bull Schedule for updating the Project Delivery Manual and any other manuals listed below
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have a single Project Delivery Manual Does the Project Delivery Manual contain or incorporate through reference the following
Staffing Plan Communication Plan Training Plan Roadway Pavement Design Guidelines Roadway Design Guidelines Roadway Design Exception Procedures Materials QA Program ROW Procedures Procurement of a Consultant Procurement of Materials andor Install Bid Analysis and Award Procedures Subcontract Approval Procedures ADA Transition Plan Title VI Program Plan DBE Procedures Financial Management Procedures Audit and Oversight Procedures Reporting Procedures
Does the Project Delivery Manual or another manual address the following
Request for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
Pre-planning Project initiation Scoping document PSampE development Environmental document Utilities clearance Railroad clearance Materials memo Pre-construction meetings SWPPP Labor compliance Inspector daily diaries Supplemental agreements Progress payments Prompt pay
17
Question YN Document Page Paragraph Claims Final acceptance Project closeout Record keeping EEO OJT Authorization Reimbursement
Do the FAHP Contract Approval Procedures require the contract include the following as applicable
Buy America Requirements FHWA Non-Collusion Statement FHWA Form 1273 USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Sanctions and Penalties for Breach of Contract Termination for Cause and Convenience Clean Air ActFederal Water Pollution Control Act Debarment and Suspension Byrd Anti Lobbying Amendment Language regarding compliance with and federal and state immigration laws and regulations
Title VI Assurances and Appendices A and E Does the Project Delivery Manual include a schedule for updating the manual(s)
Is the Project Delivery Manual posted on the Agencyrsquos internal website or made readily available for all staff involved in FAHP projects
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
18
Staffing Plan
Agency Documents Reviewed By ADOT LPA Section Organizational Chart
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agencyrsquos Organizational Chart accurately identify current Key Personnel
Does the Agencyrsquos Organizational Chart identify position title and contact information for each Key Personnel
Does the Agency have a well-documented process for addingdeletingmodifying Key Personnel Does the Agencyrsquos process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
See the list of Key Personnel and Roles and Responsibility below for more information
Key Personnel Role and Responsibility Designated Approval Authority Official with the authority to formally assume responsibility for the
implementation of the project development program and delivery of FAHP projects
CA Liaison An executive decision maker with working knowledge of the CA Program and main point of contact for ADOT
Responsible Charge Note If the responsible charge is not a full-time Agency employee the Agency must designate a full-time employee in responsible charge for the project
Title VI Coordinator Designated individual directly responsible for the management and administration of the Agencyrsquos ADOT-approved Title VI Program Plan
ADA Coordinator Designated individual directly responsible for the Agencyrsquos compliance with its ADA Transition Plan
DBE Liaison Designated individual directly responsible for implementing and monitoring DBE Program activities and advising the Agency fully and properly of DBE Program Plan issues
ROW Agent Designated individual directly responsible for the Agencyrsquos compliance with federal requirements for ROW activities administration of appraisal acquisition and relocation activities and preparation of the ROW Plan and ROW Clearance Letter
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
14
DBE Procedures Agency Documents Reviewed By ADOT BECO
DBE Procedures
Submit to ADOT LPA Section before February 28 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency follow the current ADOT FHWA DBE Plan Does the Agency follow the current DBE EPRISE (DBE contract language)
Does the Agency have a DBE Liaison Do the DBE Procedures require the agency to
Follow the most current DBE Plan DBE EPRISE (DBE contract language)
Submit the required documents to ADOT BECO for Federal-aid Highway Program (FAHP) projects to be assessed for DBE Goal and ensuring the DBE Goal is ldquovalidrdquo for advertisement
Obtain from BECO and provide to bidders and proposers all current BECO LPA Forms
Include a ldquovalidrdquo DBE goal percentage in advertisement solicitations and contract documents
Provide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
Conduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
Ensure receipt of Bid Verification Notice from ADOT BECO before contract award
Ensure Good Faith Effort (GFE) documentation is provided to meet requirements of EPRISE Specifications (as applicable)
Notify ADOT PM and ADOT BECO of contract award or rejection of bids
Report contract awards to BECO by the 10th of the month following contract award
Ensure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
Monitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment amp Payment Reporting Provisions
15
Question YN Document Page Paragraph Monitor and enforce the Prompt Payment amp Payment Reporting Provisions for prime contractor payments to subcontractors
Monitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
Monitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
Conduct a Commercially Useful Function (CUF) review for each DBE on a FAHP project
Obtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
Monitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
Monitor LPA DBE System in preparation for the semi-annual reporting by ensuring contract payments are up date
Ensure timely closeout of contracts in the LPA DBE System
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
16
Project Delivery Manual
Agency Documents Reviewed By ADOT LPA Section bull FAHP Project Delivery Manual ndash title page table of contents publication or modification date bull Other manuals as needed ndash title page table of contents publication or modification date bull Schedule for updating the Project Delivery Manual and any other manuals listed below
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have a single Project Delivery Manual Does the Project Delivery Manual contain or incorporate through reference the following
Staffing Plan Communication Plan Training Plan Roadway Pavement Design Guidelines Roadway Design Guidelines Roadway Design Exception Procedures Materials QA Program ROW Procedures Procurement of a Consultant Procurement of Materials andor Install Bid Analysis and Award Procedures Subcontract Approval Procedures ADA Transition Plan Title VI Program Plan DBE Procedures Financial Management Procedures Audit and Oversight Procedures Reporting Procedures
Does the Project Delivery Manual or another manual address the following
Request for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
Pre-planning Project initiation Scoping document PSampE development Environmental document Utilities clearance Railroad clearance Materials memo Pre-construction meetings SWPPP Labor compliance Inspector daily diaries Supplemental agreements Progress payments Prompt pay
17
Question YN Document Page Paragraph Claims Final acceptance Project closeout Record keeping EEO OJT Authorization Reimbursement
Do the FAHP Contract Approval Procedures require the contract include the following as applicable
Buy America Requirements FHWA Non-Collusion Statement FHWA Form 1273 USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Sanctions and Penalties for Breach of Contract Termination for Cause and Convenience Clean Air ActFederal Water Pollution Control Act Debarment and Suspension Byrd Anti Lobbying Amendment Language regarding compliance with and federal and state immigration laws and regulations
Title VI Assurances and Appendices A and E Does the Project Delivery Manual include a schedule for updating the manual(s)
Is the Project Delivery Manual posted on the Agencyrsquos internal website or made readily available for all staff involved in FAHP projects
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
18
Staffing Plan
Agency Documents Reviewed By ADOT LPA Section Organizational Chart
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agencyrsquos Organizational Chart accurately identify current Key Personnel
Does the Agencyrsquos Organizational Chart identify position title and contact information for each Key Personnel
Does the Agency have a well-documented process for addingdeletingmodifying Key Personnel Does the Agencyrsquos process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
See the list of Key Personnel and Roles and Responsibility below for more information
Key Personnel Role and Responsibility Designated Approval Authority Official with the authority to formally assume responsibility for the
implementation of the project development program and delivery of FAHP projects
CA Liaison An executive decision maker with working knowledge of the CA Program and main point of contact for ADOT
Responsible Charge Note If the responsible charge is not a full-time Agency employee the Agency must designate a full-time employee in responsible charge for the project
Title VI Coordinator Designated individual directly responsible for the management and administration of the Agencyrsquos ADOT-approved Title VI Program Plan
ADA Coordinator Designated individual directly responsible for the Agencyrsquos compliance with its ADA Transition Plan
DBE Liaison Designated individual directly responsible for implementing and monitoring DBE Program activities and advising the Agency fully and properly of DBE Program Plan issues
ROW Agent Designated individual directly responsible for the Agencyrsquos compliance with federal requirements for ROW activities administration of appraisal acquisition and relocation activities and preparation of the ROW Plan and ROW Clearance Letter
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
15
Question YN Document Page Paragraph Monitor and enforce the Prompt Payment amp Payment Reporting Provisions for prime contractor payments to subcontractors
Monitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
Monitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
Conduct a Commercially Useful Function (CUF) review for each DBE on a FAHP project
Obtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
Monitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
Monitor LPA DBE System in preparation for the semi-annual reporting by ensuring contract payments are up date
Ensure timely closeout of contracts in the LPA DBE System
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
16
Project Delivery Manual
Agency Documents Reviewed By ADOT LPA Section bull FAHP Project Delivery Manual ndash title page table of contents publication or modification date bull Other manuals as needed ndash title page table of contents publication or modification date bull Schedule for updating the Project Delivery Manual and any other manuals listed below
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have a single Project Delivery Manual Does the Project Delivery Manual contain or incorporate through reference the following
Staffing Plan Communication Plan Training Plan Roadway Pavement Design Guidelines Roadway Design Guidelines Roadway Design Exception Procedures Materials QA Program ROW Procedures Procurement of a Consultant Procurement of Materials andor Install Bid Analysis and Award Procedures Subcontract Approval Procedures ADA Transition Plan Title VI Program Plan DBE Procedures Financial Management Procedures Audit and Oversight Procedures Reporting Procedures
Does the Project Delivery Manual or another manual address the following
Request for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
Pre-planning Project initiation Scoping document PSampE development Environmental document Utilities clearance Railroad clearance Materials memo Pre-construction meetings SWPPP Labor compliance Inspector daily diaries Supplemental agreements Progress payments Prompt pay
17
Question YN Document Page Paragraph Claims Final acceptance Project closeout Record keeping EEO OJT Authorization Reimbursement
Do the FAHP Contract Approval Procedures require the contract include the following as applicable
Buy America Requirements FHWA Non-Collusion Statement FHWA Form 1273 USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Sanctions and Penalties for Breach of Contract Termination for Cause and Convenience Clean Air ActFederal Water Pollution Control Act Debarment and Suspension Byrd Anti Lobbying Amendment Language regarding compliance with and federal and state immigration laws and regulations
Title VI Assurances and Appendices A and E Does the Project Delivery Manual include a schedule for updating the manual(s)
Is the Project Delivery Manual posted on the Agencyrsquos internal website or made readily available for all staff involved in FAHP projects
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
18
Staffing Plan
Agency Documents Reviewed By ADOT LPA Section Organizational Chart
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agencyrsquos Organizational Chart accurately identify current Key Personnel
Does the Agencyrsquos Organizational Chart identify position title and contact information for each Key Personnel
Does the Agency have a well-documented process for addingdeletingmodifying Key Personnel Does the Agencyrsquos process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
See the list of Key Personnel and Roles and Responsibility below for more information
Key Personnel Role and Responsibility Designated Approval Authority Official with the authority to formally assume responsibility for the
implementation of the project development program and delivery of FAHP projects
CA Liaison An executive decision maker with working knowledge of the CA Program and main point of contact for ADOT
Responsible Charge Note If the responsible charge is not a full-time Agency employee the Agency must designate a full-time employee in responsible charge for the project
Title VI Coordinator Designated individual directly responsible for the management and administration of the Agencyrsquos ADOT-approved Title VI Program Plan
ADA Coordinator Designated individual directly responsible for the Agencyrsquos compliance with its ADA Transition Plan
DBE Liaison Designated individual directly responsible for implementing and monitoring DBE Program activities and advising the Agency fully and properly of DBE Program Plan issues
ROW Agent Designated individual directly responsible for the Agencyrsquos compliance with federal requirements for ROW activities administration of appraisal acquisition and relocation activities and preparation of the ROW Plan and ROW Clearance Letter
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
16
Project Delivery Manual
Agency Documents Reviewed By ADOT LPA Section bull FAHP Project Delivery Manual ndash title page table of contents publication or modification date bull Other manuals as needed ndash title page table of contents publication or modification date bull Schedule for updating the Project Delivery Manual and any other manuals listed below
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agency have a single Project Delivery Manual Does the Project Delivery Manual contain or incorporate through reference the following
Staffing Plan Communication Plan Training Plan Roadway Pavement Design Guidelines Roadway Design Guidelines Roadway Design Exception Procedures Materials QA Program ROW Procedures Procurement of a Consultant Procurement of Materials andor Install Bid Analysis and Award Procedures Subcontract Approval Procedures ADA Transition Plan Title VI Program Plan DBE Procedures Financial Management Procedures Audit and Oversight Procedures Reporting Procedures
Does the Project Delivery Manual or another manual address the following
Request for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
Pre-planning Project initiation Scoping document PSampE development Environmental document Utilities clearance Railroad clearance Materials memo Pre-construction meetings SWPPP Labor compliance Inspector daily diaries Supplemental agreements Progress payments Prompt pay
17
Question YN Document Page Paragraph Claims Final acceptance Project closeout Record keeping EEO OJT Authorization Reimbursement
Do the FAHP Contract Approval Procedures require the contract include the following as applicable
Buy America Requirements FHWA Non-Collusion Statement FHWA Form 1273 USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Sanctions and Penalties for Breach of Contract Termination for Cause and Convenience Clean Air ActFederal Water Pollution Control Act Debarment and Suspension Byrd Anti Lobbying Amendment Language regarding compliance with and federal and state immigration laws and regulations
Title VI Assurances and Appendices A and E Does the Project Delivery Manual include a schedule for updating the manual(s)
Is the Project Delivery Manual posted on the Agencyrsquos internal website or made readily available for all staff involved in FAHP projects
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
18
Staffing Plan
Agency Documents Reviewed By ADOT LPA Section Organizational Chart
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agencyrsquos Organizational Chart accurately identify current Key Personnel
Does the Agencyrsquos Organizational Chart identify position title and contact information for each Key Personnel
Does the Agency have a well-documented process for addingdeletingmodifying Key Personnel Does the Agencyrsquos process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
See the list of Key Personnel and Roles and Responsibility below for more information
Key Personnel Role and Responsibility Designated Approval Authority Official with the authority to formally assume responsibility for the
implementation of the project development program and delivery of FAHP projects
CA Liaison An executive decision maker with working knowledge of the CA Program and main point of contact for ADOT
Responsible Charge Note If the responsible charge is not a full-time Agency employee the Agency must designate a full-time employee in responsible charge for the project
Title VI Coordinator Designated individual directly responsible for the management and administration of the Agencyrsquos ADOT-approved Title VI Program Plan
ADA Coordinator Designated individual directly responsible for the Agencyrsquos compliance with its ADA Transition Plan
DBE Liaison Designated individual directly responsible for implementing and monitoring DBE Program activities and advising the Agency fully and properly of DBE Program Plan issues
ROW Agent Designated individual directly responsible for the Agencyrsquos compliance with federal requirements for ROW activities administration of appraisal acquisition and relocation activities and preparation of the ROW Plan and ROW Clearance Letter
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
17
Question YN Document Page Paragraph Claims Final acceptance Project closeout Record keeping EEO OJT Authorization Reimbursement
Do the FAHP Contract Approval Procedures require the contract include the following as applicable
Buy America Requirements FHWA Non-Collusion Statement FHWA Form 1273 USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Sanctions and Penalties for Breach of Contract Termination for Cause and Convenience Clean Air ActFederal Water Pollution Control Act Debarment and Suspension Byrd Anti Lobbying Amendment Language regarding compliance with and federal and state immigration laws and regulations
Title VI Assurances and Appendices A and E Does the Project Delivery Manual include a schedule for updating the manual(s)
Is the Project Delivery Manual posted on the Agencyrsquos internal website or made readily available for all staff involved in FAHP projects
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
18
Staffing Plan
Agency Documents Reviewed By ADOT LPA Section Organizational Chart
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agencyrsquos Organizational Chart accurately identify current Key Personnel
Does the Agencyrsquos Organizational Chart identify position title and contact information for each Key Personnel
Does the Agency have a well-documented process for addingdeletingmodifying Key Personnel Does the Agencyrsquos process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
See the list of Key Personnel and Roles and Responsibility below for more information
Key Personnel Role and Responsibility Designated Approval Authority Official with the authority to formally assume responsibility for the
implementation of the project development program and delivery of FAHP projects
CA Liaison An executive decision maker with working knowledge of the CA Program and main point of contact for ADOT
Responsible Charge Note If the responsible charge is not a full-time Agency employee the Agency must designate a full-time employee in responsible charge for the project
Title VI Coordinator Designated individual directly responsible for the management and administration of the Agencyrsquos ADOT-approved Title VI Program Plan
ADA Coordinator Designated individual directly responsible for the Agencyrsquos compliance with its ADA Transition Plan
DBE Liaison Designated individual directly responsible for implementing and monitoring DBE Program activities and advising the Agency fully and properly of DBE Program Plan issues
ROW Agent Designated individual directly responsible for the Agencyrsquos compliance with federal requirements for ROW activities administration of appraisal acquisition and relocation activities and preparation of the ROW Plan and ROW Clearance Letter
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
18
Staffing Plan
Agency Documents Reviewed By ADOT LPA Section Organizational Chart
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Does the Agencyrsquos Organizational Chart accurately identify current Key Personnel
Does the Agencyrsquos Organizational Chart identify position title and contact information for each Key Personnel
Does the Agency have a well-documented process for addingdeletingmodifying Key Personnel Does the Agencyrsquos process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
See the list of Key Personnel and Roles and Responsibility below for more information
Key Personnel Role and Responsibility Designated Approval Authority Official with the authority to formally assume responsibility for the
implementation of the project development program and delivery of FAHP projects
CA Liaison An executive decision maker with working knowledge of the CA Program and main point of contact for ADOT
Responsible Charge Note If the responsible charge is not a full-time Agency employee the Agency must designate a full-time employee in responsible charge for the project
Title VI Coordinator Designated individual directly responsible for the management and administration of the Agencyrsquos ADOT-approved Title VI Program Plan
ADA Coordinator Designated individual directly responsible for the Agencyrsquos compliance with its ADA Transition Plan
DBE Liaison Designated individual directly responsible for implementing and monitoring DBE Program activities and advising the Agency fully and properly of DBE Program Plan issues
ROW Agent Designated individual directly responsible for the Agencyrsquos compliance with federal requirements for ROW activities administration of appraisal acquisition and relocation activities and preparation of the ROW Plan and ROW Clearance Letter
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
19
Bid Analysis amp Award Procedures Agency Documents Reviewed By ADOT LPA Section
bull Bid Analysis amp Award Procedures bull Bid Analysis Documentation Template (form or checklist is acceptable)
Submit to ADOT LPA Section before March 29 2019
Assessment Questions Question YN Document Page Paragraph Do the Bid Analysis amp Award Procedures comply with 23 CFR 635114
Do your bidding procedures and related documents comply with 23 CFR 635110(c) which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
20
Subcontract Approval Procedures
Agency Documents Reviewed By ADOT LPA Section bull Subcontractor Approval Procedures bull Subcontractor Request Form or equivalent
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Subcontractor Approval Procedures require the subcontract include the following as applicable
ADOT project number Executed date Correct name of prime or higher tier company Correct name of subcontractor Signature of prime or higher tier and subcontractor with dates and titles
Record retention language Language regarding compliance with federal and state immigration laws and regulations
EEO Clause Form FHWA-1273 Title VI Assurances and Appendices A and E USDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action (Exec Order 11246) and EEO Contract Specifications (Exec Order 11246)
Project Wage Determination DBE Contractor Compliance Agreement Assurances
Do the Subcontractor Approval Procedures require For committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
Verification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
Use of a Subcontractor Request Form or equivalent Verification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract (ie bid item dollar amount)
See Appendix B for additional resources
Prepared by Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
21
Financial Management Procedures
Agency Documents Reviewed By ADOT LPA Section bull Financial Management Procedures
Submit to ADOT LPA Section before April 30 2019
Assessment Questions Question YN Document Page Paragraph Do the Financial Management Procedures
Identify the financial management system used Require federal authorization before eligible costs can be incurred
Address progress payments to contractors Require adequate source documentation to support progress payments (ie contractorvendor invoices time sheets expense vouchers materials records certifications)
Identify the approval process before making payments to the contractor
Identify a process for avoiding duplicate payments Comply with the Arizona Prompt Payment Act Identify standards for determining whether costs are allowable for federal reimbursement
Describe the process for seeking federal reimbursement through ADOT
Include a quarterly reimbursement billing process Include a process for communicating project extensions (ie rebid construction delays delays in advertising for design etc) to ADOT
Agency ndash Prepared by ADOT ndash Reviewed by Signature Signature Printed Name Printed Name Title Title Date Date
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
Appendix A
ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-
consultantsLocalPublicAgencyConsultantProcurementdocuments
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
Appendix B Resources
Procurement of a Consultant ADOT ECS Certification Acceptance Agency Contract Administration Guidelines for Federal-aid Project httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Certification Acceptance Contract Administration Procedures Review Checklist httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Terms and Conditions httpswwwazdotgovbusinessengineering-consultantsLocalPublicAgencyConsultantProcurementdocuments ADOT ECS Forms and Templates httpswwwazdotgovbusinessengineering-consultantsFormsandTemplates Procurement of Materials andor Install ADOA-SPO Form 120 ndash Procurement Disclosure Statement httpsspoazgovspo-forms Pavement Design Policy ADOT Materials Section Preliminary Engineering and Design Manual httpazdotgovbusinessengineering-and-constructionMaterialsGroupmaterials-manuals
Design Exceptions Procedures ADOT Roadway Engineering Group Design Exception and Design Variance Process Guide httpsazdotgovbusinessengineering-and-constructionroadway-engineeringroadway-designstandards-and-guidelines FHWA Guidance on NHS Design Standards and Design Exceptions httpwwwfhwadotgovdesignstandardsqacfm Materials QA Program ADOT Materials Quality Assurance Program httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADOT Local Public Agency Certification Acceptance Quality Assurance Requirements httpswwwazdotgovbusinessengineering-and-constructionconstruction-and-materialsquality-assurance ADA Transition Plan Civil Rights Americans with Disabilities Act Transition Plans httpswwwfhwadotgovfederal-aidessentialscompanionresources32transitionplanspdf Questions and Answers about ADASection 504 httpswwwfhwadotgovcivilrightsprogramsada_sect504qacfm NCHRP ADA Transition Plans A Guide to Best Management Practices httpwwwfhwadotgovindivdocsada_transition_plans_reportpdf
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4
State Transportation Agency (STA) Responsibilities httpswwwfhwadotgovresourcecenterteamscivilrights Subcontractor Approval Procedures System for Award Management httpswwwsamgovportalSAM11
- Certification Acceptance Assessment Packet
-
- Purpose
- Objective
- Goal
- Schedule
- Instructions
-
- LPA Commonly Used Acronyms
- Procurement of Materials andor Install
-
- Agency Documents Approved By ADOT Procurement Group
- Submit to ADOT LPA Section before December 7 2018
- Assessment Questions
-
- Procurement of a Consultant
-
- Agency Documents Approved By ADOT ECS Section
- Submit to ADOT LPA Section before December 31 2018
- Assessment Questions
-
- Roadway Pavement Design
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Guidelines
-
- Agency Document Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Roadway Design Exceptions
-
- Agency Document Reviewed By ADOT Roadway Engineering Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- Materials QA Program
-
- Agency Document Reviewed By ADOT Construction-Materials Group
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- ROW Procedures
-
- Agency Document Approved By ADOT ROW Section
- Submit to ADOT LPA Section before January 31 2019
- Assessment Questions
-
- DBE Procedures
-
- Agency Documents Reviewed By ADOT BECO
- Submit to ADOT LPA Section before February 28 2019
- Assessment Questions
-
- Project Delivery Manual
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Staffing Plan
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Bid Analysis amp Award Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before March 29 2019
- Assessment Questions
-
- Subcontract Approval Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- Financial Management Procedures
-
- Agency Documents Reviewed By ADOT LPA Section
- Submit to ADOT LPA Section before April 30 2019
- Assessment Questions
-
- YNWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- Document Page ParagraphWritten competitive bidding thresholds for informal bids and purchases between 10000 and 100000 are to be awarded to a small business if possible
- YNBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- Document Page ParagraphBid Lists compiled and maintained through ProcureAZ or similar eProcurement method
- YNVerification of employment records of contractors and subcontractors using everify
- Document Page ParagraphVerification of employment records of contractors and subcontractors using everify
- YNCompliance with the Significant Procurement Role requirements
- Document Page ParagraphCompliance with the Significant Procurement Role requirements
- Signature
- Signature_2
- Printed Name
- Printed Name_2
- Title
- Title_2
- Date
- Date_2
- YNIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant Contracting Procurement Procedures If yes
- YNDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- Document Page ParagraphDo the Agencys Design Consultant Contracting Procurement procedures meet the federal and state laws regulations and all other applicable requirements for qualificationbased selection QBS process
- YNDoes the Agency use an ADOT approved prequalification process
- Document Page ParagraphDoes the Agency use an ADOT approved prequalification process
- YNIf no does the Agency use ADOTs prequalification list
- Document Page ParagraphIf no does the Agency use ADOTs prequalification list
- YNRequire notification to the ADOT PM of kickoff and progress meetings
- Document Page ParagraphRequire notification to the ADOT PM of kickoff and progress meetings
- YNInform the ADOT PM of error and omission actions taken
- Document Page ParagraphInform the ADOT PM of error and omission actions taken
- YNRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- Document Page ParagraphRequire contacting the ADOT PM for approval and FHWA concurrence before terminating a federalaid contract
- YNInclude a tracking and reporting process for oncall assignments if applicable
- Document Page ParagraphInclude a tracking and reporting process for oncall assignments if applicable
- YNIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- Document Page ParagraphIs the Agency submitting Design Consultant OnCall Procurement Procedures If yes
- YNDoes the Agencys Procedures include OnCall procurement procedures
- Document Page ParagraphDoes the Agencys Procedures include OnCall procurement procedures
- YNDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- Document Page ParagraphDo the CA Agencys procedures identify and define one of the two task or work orders assignment processes
- YNMini QBS procedures
- Document Page ParagraphMini QBS procedures
- YNRegional selection
- Document Page ParagraphRegional selection
- YNDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- Document Page ParagraphDo the CA Agencys procedures Include a tracking and reporting process for oncall assignments
- YNWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Document Page ParagraphWill the Agency be requesting an approval from ADOT before advertising for procurement of OnCall services
- Signature_3
- Signature_4
- Printed Name_3
- Printed Name_4
- Title_3
- Title_4
- Date_3
- Date_4
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local NHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated
- YNFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- Document Page ParagraphFor NHS Roadways do the Agencys standards comply with 23 CFR 626
- YNDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Pavement Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- Document Page ParagraphIs MAG Uniform Standard Specifications and Details or PAG Standard Specifications for Public Improvements incorporated_2
- YNADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- Document Page ParagraphADOT Standard Specifications for Road and Bridge Construction and Stored Specifications
- YNADOT Materials Preliminary Design Guide
- Document Page ParagraphADOT Materials Preliminary Design Guide
- YNAASHTO Design Guidelines
- Document Page ParagraphAASHTO Design Guidelines
- Signature_5
- Signature_6
- Printed Name_5
- Printed Name_6
- Title_5
- Title_6
- Date_5
- Date_6
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local NHS RoadsStreets
- YNDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys Roadway Design Standards incorporate and conform to the AASHTO Controlling Design Criteria
- YNDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- Document Page ParagraphDoes the Agency have its own adopted and published Roadway Design Standards for the design and construction of Local nonNHS RoadsStreets
- YNAASHTO Controlling Design Criteria
- Document Page ParagraphAASHTO Controlling Design Criteria
- YNADOT Roadway Design Guidelines RDG
- Document Page ParagraphADOT Roadway Design Guidelines RDG
- YNAll other applicable adopted and published ADOT design standard and guidelines
- Document Page ParagraphAll other applicable adopted and published ADOT design standard and guidelines
- Signature_7
- Signature_8
- Printed Name_7
- Printed Name_8
- Title_7
- Title_8
- Date_7
- Date_8
- YNDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure that follows FHWA Design Exception procedures
- YNDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- Document Page ParagraphDo the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria
- YNDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- Document Page ParagraphDo the Agencys procedures include submitting to and obtaining approval from the FHWA for design exceptions
- YNDoes the Agency have an adopted and published Design Exception procedure
- Document Page ParagraphDoes the Agency have an adopted and published Design Exception procedure
- YNa Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- Document Page Paragrapha Does the Agency have an adopted and published Design Exception procedure that follows FHWA and ADOT Design Exception procedures
- YNb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- Document Page Paragraphb Do the Agencys procedures address documentation and requirements for addressing exceptions to the AASHTO Controlling Design Criteria and ADOT Roadway Design Guidelines
- YNc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Document Page Paragraphc Do the Agencys procedures include submitting to and obtaining approval from ADOT and the FHWA for design exceptions
- Signature_9
- Signature_10
- Printed Name_9
- Printed Name_10
- Title_9
- Title_10
- Date_9
- Date_10
- YNDoes the Agency have its own ADOTapproved Materials QA Program
- Document Page ParagraphDoes the Agency have its own ADOTapproved Materials QA Program
- YNIf no has the Agency adopted the ADOT Materials QA Program
- Document Page ParagraphIf no has the Agency adopted the ADOT Materials QA Program
- YNRequire the inclusion of the materials memo in the construction authorization packet and project file
- Document Page ParagraphRequire the inclusion of the materials memo in the construction authorization packet and project file
- YNRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- Document Page ParagraphRequire the inclusion of the ADOTapproved Materials QA Project Plan in the construction authorization packet
- YNApply the Buy America provision to the entire FAHP project
- Document Page ParagraphApply the Buy America provision to the entire FAHP project
- YNRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- Document Page ParagraphRequire verification that the Buy America certifications accompany each material shipment including steel or iron products
- YNRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Document Page ParagraphRequire visual inspection and documentation in the daily diaries of the Buy America certifications when materials are delivered to the project site
- Signature_11
- Signature_12
- Printed Name_11
- Printed Name_12
- Title_11
- Title_12
- Date_11
- Date_12
- YNDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- Document Page ParagraphDoes the Agency have its own written ROW manual If No please explain If Yes has the Agency ROW manual been submitted and approved for use on Federal Aid Projects
- YNIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- Document Page ParagraphIf the Agency uses its own ROW manual has it been updated to reflect changes created by updates to Title 23 Parts 635 710 and 810
- YNIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- Document Page ParagraphIs the Agency adequately staffed equipped and organized to discharge all its real property related responsibilities as per 23 CFR Part 710201 b
- YNDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- Document Page ParagraphDoes the Agency have a property management section that maintains records of Real Property Interest acquired and disposed of in accordance with Title 23 funds and is the management process spelled out in ROW manual
- YNDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group a request for concurrence of Right of Way clearance prior to advertising a project for construction noting that one of four conditions have been met per 23 CFR Part 635309 c
- YNDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- Document Page ParagraphDoes the Agency submit to the ADOT ROW Group all conditional Right of Way clearances for approval and concurrence by FHWA prior to advertisement of all federal aid projects
- YNDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- Document Page ParagraphDoes the Agency request property donations from non governmental owners whose Real Property Interest is required for Title 23 projects If Yes does that donation meet the requirement per 23 CFR 710505a
- YNDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- Document Page ParagraphDoes the Agency submit all administrative settlements to the ADOT ROW Group for concurrence before finalizing them with a property owner as part of the program oversight responsibilities
- YNDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- Document Page ParagraphDoes the Agency avoid contact with an affected property owner for purposes of negotiation and relocation assistance until after NEPA approval except as provided for in 23 CFR 710501 and 710503
- YNDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- Document Page ParagraphDoes the Agency perform acquisition and related relocation assistance activities in accordance with 49 CFR Part 24 and 23 CFR 710
- YNIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- Document Page ParagraphIs the amount the Agency believes to be just compensation for a Real Property Interest approved by a responsible official
- of the Agency
- Does the Agency provide a person affected by a project with a written description of the Real Property Interest acquisition process under state and federal law which clearly informs the owners of their rights and obligations
- Does the Agency include the preparation of right of way plans in their Federal Aid projects CFR or Statute reference If no how does the Agency depict real property acquisitions for their project personnel appraisers and project impact communication with the property owners
- Does the Agency maintain a written logdiary contact report of each and every contact with the property owner including the agency acquisition person who contacted them date of contact person contacted matters discussed and any and all outcomes in sufficient detail that if another agentnegotiator had to take over a new agent could continue as if they had worked on the parcel assignment all along and that it would reveal the acquisitionrelocation was accomplished in accordance with the federal guidelines
- Signature_13
- Signature_14
- Printed Name_13
- Printed Name_14
- Title_13
- Title_14
- Date_13
- Date_14
- YNDoes the Agency follow the current ADOT FHWA DBE Plan
- Document Page ParagraphDoes the Agency follow the current ADOT FHWA DBE Plan
- YNDoes the Agency follow the current DBE EPRISE DBE contract language
- Document Page ParagraphDoes the Agency follow the current DBE EPRISE DBE contract language
- YNDoes the Agency have a DBE Liaison
- Document Page ParagraphDoes the Agency have a DBE Liaison
- YNFollow the most current DBE Plan DBE EPRISE DBE contract language
- Document Page ParagraphFollow the most current DBE Plan DBE EPRISE DBE contract language
- YNSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- Document Page ParagraphSubmit the required documents to ADOT BECO for Federalaid Highway Program FAHP projects to be assessed for DBE Goal and ensuring the DBE Goal is valid for advertisement
- YNObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- Document Page ParagraphObtain from BECO and provide to bidders and proposers all current BECO LPA Forms
- YNInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- Document Page ParagraphInclude a valid DBE goal percentage in advertisement solicitations and contract documents
- YNProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- Document Page ParagraphProvide written notice to BECO and the ADOT PM immediately before termination of a FAHP contract related to the DBE Program
- YNConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- Document Page ParagraphConduct a bid analysis process to justify the approval or rejection of submitted DBE Assurance Form and DBE Affidavits forms and request concurrence from ADOT BECO
- YNEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- Document Page ParagraphEnsure receipt of Bid Verification Notice from ADOT BECO before contract award
- YNEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- Document Page ParagraphEnsure Good Faith Effort GFE documentation is provided to meet requirements of EPRISE Specifications as applicable
- YNNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- Document Page ParagraphNotify ADOT PM and ADOT BECO of contract award or rejection of bids
- YNReport contract awards to BECO by the 10th of the month following contract award
- Document Page ParagraphReport contract awards to BECO by the 10th of the month following contract award
- YNEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- Document Page ParagraphEnsure committed DBEs subcontracts are provided to agency by prime at preconstruction meeting
- YNMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- Document Page ParagraphMonitor contract contractor and subcontractor information and report prime payments in the LPA DBE System in accordance with Prompt Payment Payment Reporting Provisions
- YNMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- Document Page ParagraphMonitor and enforce the Prompt Payment Payment Reporting Provisions for prime contractor payments to subcontractors
- YNMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- Document Page ParagraphMonitor DBE participation to ensure the Termination Substitution Reduction EPRISE specifications are met
- YNMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- Document Page ParagraphMonitor DBE utilization on projects notifying ADOT BECO when aware of a potential issue that may affect DBE commitments made at award
- YNConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- Document Page ParagraphConduct a Commercially Useful Function CUF review for each DBE on a FAHP project
- YNObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- Document Page ParagraphObtain Certification of Final DBE Payment forms from prime contractor and determine if established DBE goal has been met
- YNMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- Document Page ParagraphMonitor FAHP contracts for compliance and consider imposing sanctions when a contractor fails to be in compliance with EPRISE specifications
- YNMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- Document Page ParagraphMonitor LPA DBE System in preparation for the semi annual reporting by ensuring contract payments are up date
- YNEnsure timely closeout of contracts in the LPA DBE System
- Document Page ParagraphEnsure timely closeout of contracts in the LPA DBE System
- Signature_15
- Signature_16
- Printed Name_15
- Printed Name_16
- Title_15
- Title_16
- Date_15
- Date_16
- YNDoes the Agency have a single Project Delivery Manual
- Document Page ParagraphDoes the Agency have a single Project Delivery Manual
- YNStaffing Plan
- Document Page ParagraphStaffing Plan
- YNCommunication Plan
- Document Page ParagraphCommunication Plan
- YNTraining Plan
- Document Page ParagraphTraining Plan
- YNRoadway Pavement Design Guidelines
- Document Page ParagraphRoadway Pavement Design Guidelines
- YNRoadway Design Guidelines
- Document Page ParagraphRoadway Design Guidelines
- YNRoadway Design Exception Procedures
- Document Page ParagraphRoadway Design Exception Procedures
- YNMaterials QA Program
- Document Page ParagraphMaterials QA Program
- YNROW Procedures
- Document Page ParagraphROW Procedures
- YNProcurement of a Consultant
- Document Page ParagraphProcurement of a Consultant
- YNProcurement of Materials andor Install
- Document Page ParagraphProcurement of Materials andor Install
- YNBid Analysis and Award Procedures
- Document Page ParagraphBid Analysis and Award Procedures
- YNSubcontract Approval Procedures
- Document Page ParagraphSubcontract Approval Procedures
- YNADA Transition Plan
- Document Page ParagraphADA Transition Plan
- YNTitle VI Program Plan
- Document Page ParagraphTitle VI Program Plan
- YNDBE Procedures
- Document Page ParagraphDBE Procedures
- YNFinancial Management Procedures
- Document Page ParagraphFinancial Management Procedures
- YNAudit and Oversight Procedures
- Document Page ParagraphAudit and Oversight Procedures
- YNReporting Procedures
- Document Page ParagraphReporting Procedures
- YNRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- Document Page ParagraphRequest for proposal qualifications andor bids will be issued within 90 days from FHWA authorization
- YNPreplanning
- Document Page ParagraphPreplanning
- YNProject initiation
- Document Page ParagraphProject initiation
- YNScoping document
- Document Page ParagraphScoping document
- YNPSE development
- Document Page ParagraphPSE development
- YNEnvironmental document
- Document Page ParagraphEnvironmental document
- YNUtilities clearance
- Document Page ParagraphUtilities clearance
- YNRailroad clearance
- Document Page ParagraphRailroad clearance
- YNMaterials memo
- Document Page ParagraphMaterials memo
- YNPreconstruction meetings
- Document Page ParagraphPreconstruction meetings
- YNSWPPP
- Document Page ParagraphSWPPP
- YNLabor compliance
- Document Page ParagraphLabor compliance
- YNInspector daily diaries
- Document Page ParagraphInspector daily diaries
- YNSupplemental agreements
- Document Page ParagraphSupplemental agreements
- YNProgress payments
- Document Page ParagraphProgress payments
- YNPrompt pay
- Document Page ParagraphPrompt pay
- YNClaims
- Document Page ParagraphClaims
- YNFinal acceptance
- Document Page ParagraphFinal acceptance
- YNProject closeout
- Document Page ParagraphProject closeout
- YNRecord keeping
- Document Page ParagraphRecord keeping
- YNEEO
- Document Page ParagraphEEO
- YNOJT
- Document Page ParagraphOJT
- YNAuthorization
- Document Page ParagraphAuthorization
- YNReimbursement
- Document Page ParagraphReimbursement
- YNBuy America Requirements
- Document Page ParagraphBuy America Requirements
- YNFHWA NonCollusion Statement
- Document Page ParagraphFHWA NonCollusion Statement
- YNFHWA Form 1273
- Document Page ParagraphFHWA Form 1273
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246
- YNSanctions and Penalties for Breach of Contract
- Document Page ParagraphSanctions and Penalties for Breach of Contract
- YNTermination for Cause and Convenience
- Document Page ParagraphTermination for Cause and Convenience
- YNClean Air ActFederal Water Pollution Control Act
- Document Page ParagraphClean Air ActFederal Water Pollution Control Act
- YNDebarment and Suspension
- Document Page ParagraphDebarment and Suspension
- YNByrd Anti Lobbying Amendment
- Document Page ParagraphByrd Anti Lobbying Amendment
- YNLanguage regarding compliance with and federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with and federal and state immigration laws and regulations
- YNTitle VI Assurances and Appendices A and E
- Document Page ParagraphTitle VI Assurances and Appendices A and E
- YNDoes the Project Delivery Manual include a schedule for updating the manuals
- Document Page ParagraphDoes the Project Delivery Manual include a schedule for updating the manuals
- YNIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Document Page ParagraphIs the Project Delivery Manual posted on the Agencys internal website or made readily available for all staff involved in FAHP projects
- Signature_17
- Signature_18
- Printed Name_17
- Printed Name_18
- Title_17
- Title_18
- Date_17
- Date_18
- YNDoes the Agencys Organizational Chart accurately identify current Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart accurately identify current Key Personnel
- YNDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- Document Page ParagraphDoes the Agencys Organizational Chart identify position title and contact information for each Key Personnel
- YNDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Document Page ParagraphDoes the Agency have a welldocumented process for addingdeletingmodifying Key Personnel Does the Agencys process include providing an advance written notice to the ADOT LPA Section when Key Personnel changes occur
- Signature_19
- Signature_20
- Printed Name_19
- Printed Name_20
- Title_19
- Title_20
- Date_19
- Date_20
- YNDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- Document Page ParagraphDo the Bid Analysis Award Procedures comply with 23 CFR 635114
- YNDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Document Page ParagraphDo your bidding procedures and related documents comply with 23 CFR 635110c which allows the contractor to bid on the contract prior to obtaining a license before award of a contract
- Signature_21
- Signature_22
- Printed Name_21
- Printed Name_22
- Title_21
- Title_22
- Date_21
- Date_22
- YNADOT project number
- Document Page ParagraphADOT project number
- YNExecuted date
- Document Page ParagraphExecuted date
- YNCorrect name of prime or higher tier company
- Document Page ParagraphCorrect name of prime or higher tier company
- YNCorrect name of subcontractor
- Document Page ParagraphCorrect name of subcontractor
- YNSignature of prime or higher tier and subcontractor with dates and titles
- Document Page ParagraphSignature of prime or higher tier and subcontractor with dates and titles
- YNRecord retention language
- Document Page ParagraphRecord retention language
- YNLanguage regarding compliance with federal and state immigration laws and regulations
- Document Page ParagraphLanguage regarding compliance with federal and state immigration laws and regulations
- YNEEO Clause
- Document Page ParagraphEEO Clause
- YNForm FHWA1273
- Document Page ParagraphForm FHWA1273
- YNTitle VI Assurances and Appendices A and E_2
- Document Page ParagraphTitle VI Assurances and Appendices A and E_2
- YNUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- Document Page ParagraphUSDOL OFCCP EEO Clause Notice of Requirement for Affirmative Action Exec Order 11246 and EEO Contract Specifications Exec Order 11246_2
- YNProject Wage Determination
- Document Page ParagraphProject Wage Determination
- YNDBE Contractor Compliance Agreement Assurances
- Document Page ParagraphDBE Contractor Compliance Agreement Assurances
- YNFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- Document Page ParagraphFor committed DBE subcontractors verification that the subcontract amount is equal to or greater than the DBE committed amount
- YNVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- Document Page ParagraphVerification that the subcontractor has an ROC license for the work to be performed if applicable and is not suspended or debarred
- YNUse of a Subcontractor Request Form or equivalent
- Document Page ParagraphUse of a Subcontractor Request Form or equivalent
- YNVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Document Page ParagraphVerification that information on the Subcontractor Request Form or equivalent matches the information in the subcontract ie bid item dollar amount
- Signature_23
- Signature_24
- Printed Name_23
- Printed Name_24
- Title_23
- Title_24
- Date_23
- Date_24
- YNIdentify the financial management system used
- Document Page ParagraphIdentify the financial management system used
- YNRequire federal authorization before eligible costs can be incurred
- Document Page ParagraphRequire federal authorization before eligible costs can be incurred
- YNAddress progress payments to contractors
- Document Page ParagraphAddress progress payments to contractors
- YNRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- Document Page ParagraphRequire adequate source documentation to support progress payments ie contractorvendor invoices time sheets expense vouchers materials records certifications
- YNIdentify the approval process before making payments to the contractor
- Document Page ParagraphIdentify the approval process before making payments to the contractor
- YNIdentify a process for avoiding duplicate payments
- Document Page ParagraphIdentify a process for avoiding duplicate payments
- YNComply with the Arizona Prompt Payment Act
- Document Page ParagraphComply with the Arizona Prompt Payment Act
- YNIdentify standards for determining whether costs are allowable for federal reimbursement
- Document Page ParagraphIdentify standards for determining whether costs are allowable for federal reimbursement
- YNDescribe the process for seeking federal reimbursement through ADOT
- Document Page ParagraphDescribe the process for seeking federal reimbursement through ADOT
- YNInclude a quarterly reimbursement billing process
- Document Page ParagraphInclude a quarterly reimbursement billing process
- YNInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Document Page ParagraphInclude a process for communicating project extensions ie rebid construction delays delays in advertising for design etc to ADOT
- Signature_25
- Signature_26
- Printed Name_25
- Printed Name_26
- Title_25
- Title_26
- Date_25
- Date_26
- Text1
- Text2
- Text3
- Text4