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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:

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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:

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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.