STATE OF CALIFORNIA• DEPARTMENT OF TRANSPORTATION
HBP SCOPE/COST/SCHEDULE CHANGE REQUEST
LAPG 6-D (NEW 05/2019)
Local Assistance Program Guidelines
See Section 6.3, Chapter 6 of the Local Assistance Program Guidelines (LAPG) for information about this form.
NBI Bridge No.:
Project Number:
37C0765 Local Bridge No.: 37C-0765
BHLS 5213-(039) (Caltrans to provide project number for new projects) Responsible Agency: City Of Sunnyvale
Caltrans District:
Project Manager:
Phone Number:
Email:
Project Location:
Project Limits:
Type of Work:
Work Description:
4 Nasser Fakih
(408) 730-7617
[email protected]
City of Sunnyvale, Fair Oaks Avenue Overhead over Hendy Avenue & Caltrain/UPRR Tracks Fair Oaks A venue Between Evelyn Avenue and Kifer Road.
Bridge Rehabilitation
Bridge widening and rehabilitation, rail replacement, median barrier replacement, addition of sidewalk, ADA ramps, remove pedestrian over-crossing, roadway work and utility relocations
1. Describe reason for Scope/Cost/Schedule Change Request (or attach separate pages) This request is for additional funds:
A) An additional $920,000 is needed for the City's consultant construction management and design firms to provide support for the extended project duration resulting from several delays and changes that have extended the completion time by about 12 months. See Attachment 1. for details. B) An additional $570,177 is needed to extend Temporary Construction Easement durations. See Attachment 1 for details.
This 6-D Request was originally signed and submitted on March 23, 2022, and did not include the increased right of way costs(B), and included $150,000 less for Construction Management and Design support costs (A). The request is updated based on updated completion dates and project management cost estimates, and the review comments provided by DLA. Plant establishment is anticipated to be completed at the end of January 2022. With approval of this request, the City expects the project to be completed within budget and does not foresee the need for additional funds requests. However discussions to resolve disputed issues are on-going. Every effort is being made to stay within available construction budget, but there is a potential that issues could elevate to formal claims that require additional funding to resolve. The City does not currently have a value for potential dispute cost settlements.
ADA Notice For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
Attachment 4
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
HBP SCOPE/COST/SCHEDULE CHANGE REQUEST
LAPG 6-D (NEW 05/2019)
Local Assistance Program Guidelines
NBI Bridge Number: 37C0765
Estimated Construction Costs
(Exclude contingencies, supplementary work, and Construction Engineering) HBP Participating
(round to nearest $1,000)
Non- HBP Participating
(round to nearest $1,000)
Construct Bridge 12,019,000 $0
Bridge Removal $265,000 $450,000
Slope Protection $0 $0
Channel Work $0 $0
Detour - Stage Construction $866,000 $0
Approach Roadway 2,571,000 $0
Utility Relocation 1,405,000 $0
Mobilization $810,000 $0
Total 17,936,000 $450,000
Total Cost: 18,386,000
l tems that are Non-HBP Participating could be participating through other federal programs. See the LAPG for other eligibility requirements of other programs. Local agencies that are unsure which project costs are HBP participating should contact the DLAE for resolution.
NOTE: Total of only the HBP participating costs should carry over to the Construction line (Direct Costs) on the next page Specify the type of other federal funds on this project:
- ---------------------------- -
ADA Notice For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
Attachment 4
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
HBP SCOPE/COST/SCHEDULE CHANGE REQUEST
LAPG 6-D (NEW 05/2019)
Local Assistance Program Guidelines
Local Agency Certification
Caltrans, please notify this agency to confirm this project requested scope/cost/schedule changes for this project have been incorporated in the HBP Multi-Year Plan. I understand that reimbursable work shall not commence until a Request for Authorization (E76) has been processed by Caltrans and a notice to proceed has been received by this agency.
I certify that this project is in compliance with the Highway Bridge Program, Chapter 6 of the Local Assistance Program Guidelines.
One original of this application (with attachments) and one electronic copy will be included in the transmittal package to the DLAE.
Nasser Fakih
Local Agency Project Manager (print)
Local Agency Project Manager (signature)
l a [oz
Date
Attachments: (only if question #2 is answered "No")
1) LAPG 6-B HBP Special Cost Approval Checklist, Chapter 6 of the LAPG 2) D Other:
3) Request for Authorization is included in this application package for expedited processing? [] Yes [] No
Thank you for assembling the application package. Please send this package to your DLAE for review. Please e-mail your suggestions to improve this form to [email protected] or [email protected].
For Caltrans use only:
I have reviewed this application for completeness and have forwarded copies to the Office of Bridge Bond and Safety Programs and Structures Local Assistance, as needed. (check one).
Program Management and Structures Local Assistance, as needed. (check one) D I recommend approval. (attach comments as needed)
D I do not recommend approval for the following reasons: See attached memo/ email to the Office of Bridge, Bond and Safety Programs.
D I request SLA review of this application for the following reason: (attach memo I email justifying increased Caltrans oversight).
DLAE or authorized staff (print)
DLAE or authorized staff (signature) Date
ADA Notice For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms Manageme nt Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
Attachment 4
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
HBP SCOPE/COST/SCHEDULE CHANGE REQUEST
LAPG 6-D (NEW 05/2019)
Local Assistance Program Guidelines
NBI Bridge Number: 37C0765
Summary of HBP Participating Costs
Please indicate the HBP total participating (eligible for reimbursement) costs for this project, rounded to the nearest $1,000. If the amounts below are approved, Caltrans may program the HBP funds needed for this project. New projects must be prioritized before programmed. Other federal funds (RSTP, ATP, etc.) needed for this project should be shown in the Exhibit 7-B Field Review form, Chapter 7 of the LAPM.
Target dates represent a commitment by the local agency when the project will need HBP funding. Failure to meet target dates may cause funds to be reprogrammed to other projects by other local agencies. The reprogramming of HBP funds is at the discretion of Caltrans. Federal Fiscal Years (FFY) are from October 1 - September 30. All programming is done by FFY.
PE = Preliminary Engineering (Not to exceed 25% of CON and consultant contract management and quality assurance not to exceed 15% of consultant costs).
RAV = Right of Way
CE = Construction Engineering (Not to exceed 15% of CON) CON = Construction
Cont = Contingency (including supplement work) not to exceed 25% (preliminary estimate) nor 10% of CON for final design.
Enter CE % Rate: 24%
Enter Contingency % Rate: 10%
Direct Costs Indirect Costs* HBP Participating $ Target Dates (month/year)
PE 2,941,000 + $0 = 2,941,000 3/2012
R/W 3,896,000 + $0 = 3,896,000 11/2019
CON 17,936,000
CE 4,261,952.32
I
$0
I
Cont 1,793,600
CON SUM 23,991,552.32 + $0 = 23,991,552.32 11/2022
Total Participating Cost 30,828,552.32
Enter Fed. Match Rate: I 88.53%
I
HBP Requested Cost 27,293,000
See Chapter 5 Invoicing, of the LAPM for approval of indirect costs.
Participating costs exclude ineligible work items. Please review the HBP Program Guidelines for reimbursable scopes of work and program cost limits. Other federal funds will be shown in the Exhibit 7-B Field Review Form, Chapter 7 of the LAPM.
ADA Notice For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
Attachment 4
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
HBP SCOPE/COST/SCHEDULE CHANGE REQUEST
LAPG 6-D (NEW 05/2019)
Local Assistance Program Guidelines
NBI Bridge Number: 37C0765
2. If this is a request for scope change (not cost or schedule), please prepare an LAPG 6-A HBP Application/Scope Definition. Will a revised LAPG 6-A be submitted?
[] YES [] NO [X] Not Applicable
(If Yes, please skip to the sign off on the Local Agency Certification page of this form, and submit this form with the LAPG 6-A package) (If No, please submit attachments as shown on Local Agency Certification page of this form)
3. Identify and justify "betterments" that are HBP participating but are not related to the major deficiencies of this bridge. (attach additional pages as needed)
Not Applicable.
4. Refer to LAPG 6-B HBP Special Cost Approval Checklist. Identify and justify specific items requiring Caltrans funding approval. (attach additional pages as needed)
For Construction management and project close-out extending through December 2022:
Additional Ghirardelli Associates construction management amount of $772,000 is anticipated for additional 12 months of support.
Additional Biggs Cardosa construction support amount of $148,000 is anticipated for additional 9 months of design support.
Total additional A&E cost of$920,000 is anticipated. The construction management cost increase requested over the previous submittal includes additional project close -out duration and costs resulting from change orders, extra work documentation and payments, required adjustments of compensation, and potential disputes. 30% of over 75 Contract Change Orders issued or to be issued are just for the unanticipated underground utility conflicts encountered throughout the project. See Attachment 1 for explanation of contract time extensions.
5. Other comments (identify Non-HBP Participating work):
None
ADA Notice For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
Attachment 4