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PRB Meeting Date: 9/12/2023
Request Teleconference Teleconference Phone #:
Video Teleconference

GENERAL INFORMATION
2. Form Date: 3. Project Manager/Presenter: 4. Phone Number(s): 5. Mail Drop:
9/19/2023 10:45:01 AM Michelle Medina (602) 712-6530 205 S 17th Ave, ,
PROJECT INFORMATION
6. Project Name/Location: 7. Type of Work: 8. CPS Id:
CEMETERY WASH EB & JACKRABBIT TI OP EB & WB REHABILITATE BRIDGE IO1Q
9. District: 10. Route: 11. County: 12. Beg. MP: 13. TRACS #: 14. Len. (mi): 15. Fed ID#:
Holbrook 40 Navajo 253.0 F068901D 17.0 040-D(205)T
PROJECT REQUEST SUMMARY
16. Original Program Budget: $500,000 17. Original Program Item #: 103672
Project Budget Project Budget Project Budget
18. Current Approved: 18a. New Project/Change Request: 18b. Final:
$500,000 ($79,000) (0%) $421,000

Funding Source(s) Funding Source(s) 20. JPA #, Signed, Adot Adv.:
19. Current Approved: 19a. New Project/Change Request:
$ 500 Item #:103672 ( ) FY:0 FundSRC: Desc: $ -79 Item #: 76224 (.) FY:0 FundSRC: Desc:  

Current Approved New Project/Change Request  
21. Fiscal Year: 21a. Fiscal Year:  
22. Bid Pkg Rdy Date: 22a. Bid Pkg Rdy Date: 24. Verified all of the new funding sources
23. Bid Adv Date: 23a. Bid Adv Date:

25. DESCRIPTION OF REQUEST
Establish Design Project
26. JUSTIFICATION
This is a request to establish a bridge rehabilitation project. Staff $316K Consultant $65K ICAP $40K
27. CONCERNS OF THE PROJECT TEAM REGARDING THE REQUEST

28. OTHER ALTERNATIVES CONSIDERED


REQUESTED ACTIONS APPROVED/RECOMMENDED ACTIONS
Establish a New Project. Item(s) Approved.


For Project Resource Office information or questions: PRO Mailbox

Arizona Department of Transportation