Forms, Templates, and Examples

​This page provides links to commonly used forms, templates and examples of documents that may be used during the completion of an LPA administered project.  Please keep in mind each project is different and may not require the use of some of these documents.  In addition, the Administering Office may have additional forms not listed below. 

If you have questions regarding any of these examples, please contact your Administering Office.​

 NOTE:
It has come to our attention that the advertising requirements for LPA projects may be misinterpreted.  The construction and maintenance federal regulations, 23 CFR 635.112, Advertising for Bids and Proposals, states "the advertisement and approved plans and specifications shall be available to bidders a minimum of three weeks (21 days) prior to opening of bids....."  The day the bids are opened does not count as an advertising day. 

 

 
 

 Forms

 
  
  
District Administered Project Change Order Form.xlsxDistrict Administered Project Change Order Form
Federal Funding Accountability and Transparency Act (FFATA) Form (Updated August 15, 2012).xlsFederal Funding Accountability and Transparency Act (FFATA) Form (Updated August 15, 2012)
Formal Acceptance Form.pdfFormal Acceptance Form
Office of Local Programs Change Order Form.xlsOffice of Local Programs Change Order Form
Office of Local Programs Daily Inspection Reports.docxOffice of Local Programs Daily Inspection Reports
Office of Local Programs Progress Report Form.docxOffice of Local Programs Progress Report Form
Office of Local Programs Project Closure Form.docxOffice of Local Programs Project Closure Form
Office of Local Programs Reimbursement Request Form.docxOffice of Local Programs Reimbursement Request Form
ROW Certification Form.pdfROW Certification Form
 

 Checklists

 
  
  
Construction Procurement Checklist.pdfConstruction Procurement Checklist
Design Review Checklist (LDRC).docxDesign Review Checklist (LDRC)
Project Development Checklist (PDC).docxProject Development Checklist (PDC)
 

 Examples & Templates

 
  
  
Consent and Release Form.pdfConsent and Release Form
Construction Contract.pdfConstruction Contract
Determination and Findings.pdfDetermination and Findings
Easement (LPA to KYTC).pdfEasement (LPA to KYTC)
Evaluation of Proposals Template.pdfEvaluation of Proposals Template
Fee Simple Deed.pdfFee Simple Deed
Historic Preservation Easement.pdfHistoric Preservation Easement
Materials Certification Documentation.pdfMaterials Certification Documentation
Minor Acquisition Review.PDFMinor Acquisition Review
Non-Construction Procurement Checklist.pdfNon-Construction Procurement Checklist
Non-Construction Procurement Contract.pdfNon-Construction Procurement Contract
Permanent Easement -Citizen to LPA.pdfPermanent Easement -Citizen to LPA
Price Contract - Selection Explanation.pdfPrice Contract - Selection Explanation
Professional Services Contract.pdfProfessional Services Contract
Professional Services Contract-General Provisions.pdfProfessional Services Contract-General Provisions
Professional Services Procurement Flowchart.PDFProfessional Services Procurement Flowchart
Required Affidavit for Bidders Offerors and Contractors.pdfRequired Affidavit for Bidders Offerors and Contractors
Required Contract Provisions for Federal-Aid Construction Contracts (FHWA Form 1273) (Updated May 1 2012).pdfRequired Contract Provisions for Federal-Aid Construction Contracts (FHWA Form 1273) (Updated May 1 2012)
Resolution Authorizing LPA to Enter into a MOA.pdfResolution Authorizing LPA to Enter into a MOA
Resolution to Adopt KRS 45A.pdfResolution to Adopt KRS 45A
Subcontractor Request Form.pdfSubcontractor Request Form