FAA Form 5100-144 (02/22) Page i of v
U.S. Department
of Transportation
Federal Aviation
Administration
FAA Form 5100-144, Bipartisan Infrastructure Law ,
Airport Terminal and Tower Project Information
Paperwork Reduction Act Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB Control Number. The OMB Control Number for this information collection is 2120-0806. Public reporting for this collection of information is estimated to be approximately 6 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, completing and reviewing the collection of information. All responses to this collection of information are required to obtain or retain a benefit under the Bipartisan Infrastructure Law (BIL) (P.L. 117-58). Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Federal Aviation Administration, 10101 Hillwood Parkway, Fort Worth, TX 76177-1524.
Instructions for FAA Form 5100-144,
Bipartisan Infrastructure Law,
Airport Terminal and Tower Project Information
This form is provided to assist airports in completing the submission requirements established in the related Notice of Funding Opportunity published in the Federal Register. The FRN requires requests to be submitted via email. This form lets the FAA process requests more quickly based on uniform information responsive to the FRN. Do not include any Personal Identifiable Information in the open text boxes.
Once the form is complete, save a copy of the form electronically to your files for future reference. Next, scroll to the bottom of the form and choose the “Submit” button. That creates a new email message with the PDF attached. Or, as a backup method, you can manually email the form to: [email protected].
FAA Form 5100-144 (02/22) Page ii of v
General Airport Information
Airport Name: Enter the official airport name.
LOCID: Enter the airport’s FAA location identifier code.
State Code: Choose the appropriate two letter code for the State, U. S. Territory, Independent Country, or Department of Interior from the drop-down list.
Point of Contact’s Name: The Point of Contact (POC) must be the Airport Sponsor.
Point of Contact’s Title: Enter the Airport POC’s Title.
POC’s Phone Number: Enter the Airport POC’s phone number and extension number, if any.
Example: (555) 222-4444 ext.158
POC’s Email Address: Enter the Airport POC’s email address.
Project Overview
Project Type
Choose the project type (Terminal or Tower).
Project Description
In 75 words or less, enter a complete project description.
Target Timeframe for Grant Award and Construction Start Enter the month and year that grant can be accepted and the project can start.
Project Status
Total (Estimated) Project Cost
Enter most recent cost estimate for the entire project, in whole dollars.
Amount of Funding Requested
Enter amount of funding requested under this program, in whole dollars.
Match Available
Does the Sponsor have matching funds? Choose Yes or No.
Delivery Method
Choose the delivery method (Design/Bid, Design/Build, CM at Risk, Other). If “Other,” state the proposed delivery method in the next field.
Bid or Guaranteed Maximum Price (GMP)
Choose whether or not project has been publicly bid. If “No,” provide an estimated bid date in the next field.
FAA Form 5100-144 (02/22) Page iii of v
Phased Project
Choose whether or not the project will be completed over multiple phases. If “Yes,” list phase number and total number of phases in the next field.
Do you have a comprehensive financial plan?
Choose Yes or No to indicate if a funding plan for the entire project is currently available.
Is the project on an approved Airport Layout Plan (ALP)? Choose Yes or No. If “Yes,” enter the approval date in the next field.
Is environmental determination complete?
Choose Yes or No. If “Yes,” enter the approval date in the next field.
Is airspace approval complete?
Choose Yes, No, or N/A (not applicable). If “Yes,” enter the airspace case number in the next field.
Current Enplanements
Enter enplanement number from previous calendar year.
Forecast Enplanements
Based on your most recently approved forecast, provide the enplanement number from the last year of the forecast and provide forecast year.
Existing Square Footage
Provide square footage of existing terminal building or tower.
Proposed Square Footage
Provide anticipated total square footage of terminal building or tower once project is complete.
Is this project phased and/or associated with an approved Bipartisan Infrastructure Law, Airport Improvement Program (AIP) or Passenger Facility Charge (PFC) project? Choose Yes or No. Choose “Yes” if the project is currently funded by an existing BIL grant, AIP grant or approved under a PFC application. If “Yes,” provide project information such as project number (AIP grant number), amount of PFC or AIP funds, approval date of the PFC application, execution date of the grant, etc.
FAA Form 5100-144 (02/22) Page iv of v
Program Considerations
Check all that apply to your proposed terminal building or tower project. If an item is selected, a narrative must be included describing how the project satisfies the criteria. Address the following areas within character limits defined below.
Terminal and Tower
Increase Capacity and Passenger Access
Check this box if the project will increase capacity and passenger access to the airport. Explain and provide justification in the next field. (Maximum Characters 300) Replacing Aging Infrastructure
Check this box if the project will replace aging infrastructure that has exceeded its useful life.
Explain and provide justification in the next field. (Maximum Characters 300) Achieves Compliance with Americans with Disabilities Act and Expands Accessibility for Persons with Disabilities
Check this box if the project will expand accessibility for persons with disabilities. Explain and provide justification in the next field. (Maximum Characters 300) Improves Airport Access for Historically Disadvantaged Populations Check this box if the project will improve access for Historically Disadvantaged Populations.
Explain and provide justification in the next field. (Maximum Characters 300) Improves Energy Efficiency
Check this box if the project improves energy efficiency for the airport. Explain and provide justification in the next field. (Maximum Characters 300) Improves Airfield Safety through Terminal or Tower Relocation Check this box if the project improves airfield safety. Explain and provide justification in the next field. (Maximum Characters 300)
Encourages Actual and Potential Competition
Check this box if the project encourages actual and potential competition. Explain how this objective is met through this project in the next field. (Maximum Characters 300) Good Paying Jobs
Check this box if the project will create good-paying jobs. Explain and provide justification in the next field. (Maximum Characters 300)
FAA Form 5100-144 (02/22) Page v of v
Tower Only
If the project is for a tower, also complete this section of the form.
Project Type. Choose “Airport Owned, FAA Operated” for an airport-owned tower with FAA controllers. Choose “Contract Tower Program” for an airport owned tower in the Federal Contract Tower program.
Siting Study. Has a Siting Study been completed for the Air Traffic Control Tower Project? Choose Yes or No.
Relocating
Check this box if the project will be relocating an existing Air Traffic Control Tower. Explain and provide justification in the next field. (Maximum Characters: 300) Reconstructing
Check this box if the project will reconstruct a replacement tower in the same location of the existing Air Traffic Control Tower. Explain and provide justification in the next field. (Maximum Characters: 300)
Repairing
Check this box if the project will be a repair of an existing Air Traffic Control Tower. Explain and provide justification in the next field. (Maximum Characters: 300) Improving Airport Owned Tower
Check this box if the project will add improvements to an existing Air Traffic Control Tower.
Explain and provide justification in the next field. (Maximum Characters: 300) FAA Form 5100-144 (02/22) Page 1 of 5
U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL AVIATION ADMINISTRATION
OMB CONTROL NUMBER: 2120-0806
EXPIRATION DATE: 8/31/2022
Bipartisan Infrastructure Law,
Airport Terminal and Tower Project Information
General
Airport Name:
LOCID:
State Code:
Point of Contact’s Name:
Point of Contact’s Title:
POC’s Phone Number:
POC’s Email Address:
Project Overview
Project Type: Terminal Tower
Project Description (75 words or less):
Target timeframe dates: Grant Award: Construction Start:
FAA Form 5100-144 (02/22) Page 2 of 5
Project Status
Total (Estimated) Project Cost:
Amount of Funding Requested:
Match Available: Yes No
Delivery Method (choose one):
Design/Bid Design/Build CM at Risk Other:
Bid or GMP: Yes No. If “No,” Estimated bid/GMP date:
Phased Project: Yes No. If “Yes,”Phase: of
Do you have a comprehensive financial plan? Yes No
Is the project on an approved ALP?
Yes No. If “Yes,” enter the approval date:
Is environmental determination complete?
Yes No. If “Yes,” enter the approval date:
Is airspace approval complete?
Yes No N/A.
If “Yes,” enter the airspace case number:
Current Enplanements:
Approved Forecasted Enplanements: Year:
Existing Square Footage:
Proposed Square Footage:
Is this project phased and/or associated with an approved BIL, AIP or PFC project? Yes No N/A
If “Yes,” describe:
sq. ft.
sq. ft.
FAA Form 5100-144 (02/22) Page 3 of 5
Program Considerations (Terminal and Tower)
If you check a box below, you must describe how the project satisfies the criteria.
Check all that apply to the proposed project.
Increase Capacity and Passenger Access. Description (Maximum Characters: 300):
Replacing Aging Infrastructure. Description (Maximum Characters: 300):
Achieves Compliance with Americans with Disabilities Act and Expands Accessibility for Persons with Disabilities. Description (Maximum Characters: 300):
Improves Airport Access for Historically Disadvantaged Populations.
Description (Maximum Characters: 300):
Improves Energy Efficiency. Description (Maximum Characters: 300):
Improves Airfield Safety through Terminal or Tower Relocation.
Description (Maximum Characters: 300):
FAA Form 5100-144 (02/22) Page 4 of 5
Encourages Actual and Potential Competition. Description (Maximum Characters: 300):
Good Paying Jobs. Description (Maximum Characters: 300):
Program Considerations (Tower Only)
If the project is for a tower, also complete this section of the form.
Project Type. The project type for this grant application (choose one or both):
Airport Owned, FAA Operated Tower
Contract Tower Program
Siting Study. Has a Siting Study been completed for the Air Traffic Control Tower Project?” Yes No
If you check a box below, also describe how the project satisfies the criteria.
Check all that apply to the proposed project.
Relocating. Description (Maximum Characters: 300):
Reconstructing. Description (Maximum Characters: 300):
Repairing. Description (Maximum Characters: 300):
FAA Form 5100-144 (02/22) Page 5 of 5
Improving Airport Owned Tower. Description (Maximum Characters: 300):
Certifications
By electronically signing this document, I hereby certify that we have followed, or will follow, all procurement processes required under 2 CFR 200, including but not limited to:
• Davis Bacon
• Buy American
• Consultant Selection
Name:
Signature: Date (if not in signature):
Title: