HomeMy WebLinkAboutIowa Department of Transportation-Iowa Grade Crossing Surface Repair Fund Application Iowa Department of Transportation
Form 291302wd (08-07)
IOWA GRADE CROSSING SURFACE REPAIR FUND APPLICATION
This notice is to inform the Office of Rail Transportation of the Iowa Department of Transportation that the
and the
(Highway Authority)
Union Pacific Railroad are submitting this
(Railroad)
application to use the Iowa Grade Crossing Surface Repair Fund for reconstruction of the crossing located at
Waterloo 200781L
Location U.S. DOT-MR-DOT No
Black Hawk
County
General scope of project:
Number of tracks to be repaired 1
Number of tracks to be removed 0
Crossing Width (or surface material width) 80
(Width includes footage curb to curb, thru sidewalks, recreational trails, or shoulders)
Roadway width 24 Number of Sidewalks (1 or 2) 2
Proposed surface material Concrete
Preliminary Cost Estimate:
Labor $49,000.00
Material $51,000.00
Equipment $2,000.00
Approach work $9,000.00
Total $111,000.00
Use of this document is to reserve a place on the Iowa Grade Crossing Surface Repair Fund waiting list. Prior
to writing an agreement, a field review with the railroad, highway jurisdiction, and Iowa Department of
Transportation will be held to agree on the details of work to be performed.The highway authority and railroad
must agree to each pay 20 percent of the total project cost.
)7)/L-C
Signature,Hig�way Authority Signature, Railroad Rep entafive
r f Ck,f-C- I 1r a yo y' Manager Industry and Public Projects
Title Title
—® September 21,2009
Date Date
Return Completed Form To:
Mary Jo Key
•
Office of Rail Transportation
Iowa Department of Transportation
800 Lincoln Way
Ames, Iowa 50010
515-239-1108 Fax:515-233-7983
E-Mail: Mary.Jo.KevRdot.state.ia.us
fcA Iowa Department of Transportation a4a4/AeA4 �I
Form 291302wd (08-07) hLp 4vr .1 a OF- 9' `
IOWA GRADE CROSSING SURFACE REPAIR FUND APPLICATION
This notice is to inform the Office of Rail Transportation of the Iowa Department of Transportation that the
City of Waterloo and the
(Highway Authority)
Chicago Central&Pacific Railroad are submitting this
(Railroad)
application to use the Iowa Grade Crossing Surface Repair Fund for reconstruction of the crossing located at
Burton Street 307 173S
Location U.S. DOT-MR-DOT No
Black Hawk
County
General scope of project:
Number of tracks to be repaired 2
Number of tracks to be removed 0
Crossing Width (or surface material width) 75
(Width includes footage curb to curb, thru sidewalks, recreational trails, or shoulders)
Roadway width 50 Number of Sidewalks (1 or 2)
Proposed surface material Full Depth Rubber
Preliminary Cost Estimate:
Labor $21,200.00
Material $83,800.00
Equipment $9,300.00
Approach work $26,900
Total $141,200.00
Use of this document is to reserve a place on the Iowa Grade Crossing Surface Repair Fund waiting list. Prior
to writing an agreement, a field review with the railroad, highway jurisdiction, and Iowa Department of
Transportation will be held to agree on the details of work to be performed.The highway authority and railroad
must agree to each pay 20 percent of the total project cost.
��- ' 2w- � ,
Signature, Highway Authority Signature, ilroad Representative
mayor C G1blic NOvI6S I'4 ittflage_�^
Title Title
q - 67/1/4
Date Date
Return Completed Form To:
Mary Jo Key
Office of Rail Transportation
Iowa Department of Transportation
800 Lincoln Way
Ames, Iowa 50010
515-239-1108 Fax: 515-233-7983
E-Mail: Mary.Jo.Keyc dot.state.ia.us
ilkIowa Department of Transportation
Form 291302wd (08-07)
IOWA GRADE CROSSING SURFACE REPAIR FUND APPLICATION
This notice is to inform the Office of Rail Transportation of the Iowa Department of Transportation that the
City of Waterloo and the
(Highway Authority)
Chicago Central &Pacific Railroad are submitting this
(Railroad)
application to use the Iowa Grade Crossing Surface Repair Fund for reconstruction of the crossing located at
Columbia Street 307 168V
Location U.S. DOT—AAR-DOT No
Black Hawk
County
General scope of project:
Number of tracks to be repaired 2
Number of tracks to be removed 0
Crossing Width (or surface material width) 90
(Width includes footage curb to curb,thru sidewalks, recreational trails, or shoulders)
Roadway width 31 Number of Sidewalks (1 or 2)
Proposed surface material Full Depth Rubber
Preliminary Cost Estimate:
Labor $21,200.00
Material $96,600.00
Equipment $10,400.00
Approach work $28,200.00
Total $156,400.00
Use of this document is to reserve a place on the Iowa Grade Crossing Surface Repair Fund waiting list. Prior
to writing an agreement, a field review with the railroad, highway jurisdiction, and Iowa Department of
Transportation will be held to agree on the details of work to be performed.The highway authority and railroad
must agree to each pay 20 percent of the total project cost. All°114
Signature, Highway Authority Signature ailroad Representative
OG.yo r l ��liG hid;"KS l '1f 7a9e
Title Title
q- 24-o 9 9/1p
Date Date
Return Completed Form To:
Mary Jo Key
Office of Rail Transportation
Iowa Department of Transportation
800 Lincoln Way
Ames, Iowa 50010
515-239-1108 Fax:515-233-7983
E-Mail: Marv.Jo.Kevt dot.state.ia.us
Or:8N Iowa Departmentd of
oa Transportation
Form -07)
IOWA GRADE CROSSING SURFACE REPAIR FUND APPLICATION
This notice is to inform the Office of Rail Transportation of the Iowa Department of Transportation that the
City of Waterloo and the
(Highway Authority)
Chicago Central &Pacific Railroad are submitting this
(Railroad)
application to use the Iowa Grade Crossing Surface Repair Fund for reconstruction of the crossing located at
Dawson Street 307 167N
Location U.S. DOT—MR-DOT No
Black Hawk
County
General scope of project:
Number of tracks to be repaired 2
Number of tracks to be removed 0
Crossing Width (or surface material width) 102
(Width includes footage curb to curb, thru sidewalks, recreational trails, or shoulders)
Roadway width 31 Number of Sidewalks (1 or 2)
Proposed surface material Full Depth Rubber
Preliminary Cost Estimate:
Labor $21,200.00
Material $109,500.00
Equipment $11,500.00
Approach work $29,600.00
Total $171,800.00
Use of this document is to reserve a place on the Iowa Grade Crossing Surface Repair Fund waiting list. Prior
to writing an agreement, a field review with the railroad, highway jurisdiction, and Iowa Department of
Transportation will be held to agree on the details of work to be performed.The highway authority and railroad
must agree to each pay 20 percent of the total project cost.
'NU/L. hoLLk
Signature, Highway Authori Signature, Railroad Representative
Play° r Public Works Manager
Title Title
q-O I-O 1 September 1, 2009
Date Date
Return Completed Form To:
Mary Jo Key
Office of Rail Transportation
Iowa Department of Transportation
800 Lincoln Way
Ames, Iowa 50010
515-239-1108 Fax: 515-233-7983
E-Mail: Mary.Jo.Kevaa.dot.state.ia.us
Iowa Depart
l soent2wd o oa oansportation
Form 7)
NIGIO
IOWA GRADE CROSSING SURFACE REPAIR FUND APPLICATION
This notice is to inform the Office of Rail Transportation of the Iowa Department of Transportation that the
City of Waterloo and the
(Highway Authority)
Chicago Central &Pacific Railroad are submitting this
(Railroad)
application to use the Iowa Grade Crossing Surface Repair Fund for reconstruction of the crossing located at
Flectcher Avenue 911 774P
Location U.S. DOT—AAR-DOT No
Black Hawk
County
General scope of project:
Number of tracks to be repaired 1
Number of tracks to be removed 0
Crossing Width (or surface material width) 117
(Width includes footage curb to curb, thru sidewalks, recreational trails, or shoulders)
Roadway width 92 Number of Sidewalks (1 or 2)
Proposed surface material Full Depth Rubber
Preliminary Cost Estimate:
Labor $21,200.00
Material $73,300.00
Equipment $8,400.00
Approach work $25,700.00
Total $128,600.00
Use of this document is to reserve a place on the Iowa Grade Crossing Surface Repair Fund waiting list. Prior
to writing an agreement, a field review with the railroad, highway jurisdiction, and Iowa Department of
Transportation will be held to agree on the details of work to be performed.The highway authority and railroad
must agree to each pay 20 percent of the total project hAnkL)
Signature, Railroad
Signature, Highway Authority 9Representative
ThGt.ye' r Public Works Manager
Title Title
9 - t - 0 5 September 1, 2009
Date Date
Return Completed Form To:
Mary Jo Key
Office of Rail Transportation
Iowa Department of Transportation
800 Lincoln Way
Ames, Iowa 50010
515-239-1108 Fax:515-233-7983
E-Mail: Marv.Jo.Kevl dot.state.ia.us
Iowa P2a2r9tiTticti
o ogT oansportation
IOWA GRADE CROSSING SURFACE REPAIR FUND APPLICATION
This notice is to inform the Office of Rail Transportation of the Iowa Department of Transportation that the
City of Waterloo and the
(Highway Authority)
Chicago Central &Pacific Railroad are submitting this
(Railroad)
application to use the Iowa Grade Crossing Surface Repair Fund for reconstruction of the crossing located at
Rainbow Dr, MP 2.43 Northland Oil Spur 307 897M
Location U.S. DOT—AAR-DOT No
Black Hawk
County
General scope of project:
Number of tracks to be repaired 2
Number of tracks to be removed 0
Crossing Width (or surface material width) 54
(Width includes footage curb to curb, thru sidewalks, recreational trails, or shoulders)
Roadway width 48 Number of Sidewalks (1 or 2)
Proposed surface material Full Depth Rubber
Preliminary Cost Estimate:
Labor $20,500.00
Material $64,000.00
Equipment $7,400.00
Approach work $23,000.00
Total $114,900.00
Use of this document is to reserve a place on the Iowa Grade Crossing Surface Repair Fund waiting list. Prior
to writing an agreement, a field review with the railroad, highway jurisdiction, and Iowa Department of
Transportation will be held to agree on the details of work to be performed.The highway authority and railroad
must agree to each pay 20 percent of the total project cost.
Signature, Highway Authority Signature, Railroad Representative
ch Q yo r Public Works Manager
Title Title
4'-1/-o'1 September 1, 2009
Date Date
Return Completed Form To:
Mary Jo Key
Office of Rail Transportation
Iowa Department of Transportation
800 Lincoln Way
Ames, Iowa 50010
515-239-1108 Fax:515-233-7983
E-Mail: Mary.Jo.Kev(a?.dot.state.ia.us
Iowa Department of Transportation
Form )
IOWA GRADE CROSSING SURFACE REPAIR FUND APPLICATION
This notice is to inform the Office of Rail Transportation of the Iowa Department of Transportation that the
City of Waterloo and the
(Highway Authority)
Chicago Central &Pacific Railroad are submitting this
(Railroad)
application to use the Iowa Grade Crossing Surface Repair Fund for reconstruction of the crossing located at
Colorado Street - MP 274.54 Waterloo Sub 307 115W
Location U.S. DOT—AAR-DOT No
Black Hawk
County
General scope of project:
Number of tracks to be repaired 2
Number of tracks to be removed 0
Crossing Width (or surface material width) 57
(Width includes footage curb to curb, thru sidewalks, recreational trails, or shoulders)
Roadway width 29 Number of Sidewalks (1 or 2)
Proposed surface material Full Depth Rubber
Preliminary Cost Estimate:
Labor $21,200.00
Material $65,500.00
Equipment $7,700.00
Approach work $24,900.00
Total $119,300.00
Use of this document is to reserve a place on the Iowa Grade Crossing Surface Repair Fund waiting list. Prior
to writing an agreement, a field review with the railroad, highway jurisdiction, and Iowa Department of
Transportation will be held to agree on the details of work to be performed.The highway authority and railroad
must agree to each pay 20 percent of the total project cost.
azit
Signatu e, Highway Authority Signature, Railroad Representative
ray° r Public Works Manager
Title Title
q-a/-pc, September 1, 2009
Date Date
Return Completed Form To:
Mary Jo Key
Office of Rail Transportation
Iowa Department of Transportation
800 Lincoln Way
Ames, Iowa 50010
515-239-1108 Fax: 515-233-7983
E-Mail: Marv.Jo.Kev(o)dot.state.ia.us
OrA Iowa Depa s Dent o oT-r�a�nsportation
IOWA GRADE CROSSING SURFACE REPAIR FUND APPLICATION
This notice is to inform the Office of Rail Transportation of the Iowa Department of Transportation that the
City of Waterloo and the
(Highway Authority)
Chicago Central &Pacific Railroad are submitting this
(Railroad)
application to use the Iowa Grade Crossing Surface Repair Fund for reconstruction of the crossing located at
Polk Street -MP 274.68 Waterloo Sub 307 116D
Location U.S. DOT—AAR-DOT No
Black Hawk
County
General scope of project:
Number of tracks to be repaired 2
Number of tracks to be removed 0
Crossing Width (or surface material width) 102
(Width includes footage curb to curb, thru sidewalks, recreational trails, or shoulders)
Roadway width 31 Number of Sidewalks (1 or 2)
Proposed surface material Full Depth Rubber
Preliminary Cost Estimate:
Labor $21,200.00
Material $109,500.00
Equipment $11,500.00
Approach work $29,600.00
Total $171,800.00
Use of this document is to reserve a place on the Iowa Grade Crossing Surface Repair Fund waiting list. Prior
to writing an agreement, a field review with the railroad, highway jurisdiction, and Iowa Department of
Transportation will be held to agree on the details of work to be performed.The highway authority and railroad
must agree to each pay 20 percent of the total project cost.
Signature, Highway Authority Signature, Railroad Representative
1)74 y n r Public Works Manager
Title Title
9-1frO/ September 1, 2009
Date Date
Return Completed Form To:
Mary Jo Key
Office of Rail Transportation
Iowa Department of Transportation
800 Lincoln Way
Ames, Iowa 50010
515-239-1108 Fax:515-233-7983
E-Mail: Marv.Jo.Key(a.dot.state.ia.us
Iowa Department of Transportation
l`� Form 291302wd (08-07)
IOWA GRADE CROSSING SURFACE REPAIR FUND APPLICATION
This notice is to inform the Office of Rail Transportation of the Iowa Department of Transportationthattke
0 ,f,
and thre
(Highway Authority)
c.v �o✓�i wy Lv, are submitting this
(Railroad)
application to use the Iowa Grade Crossing Surface Repair Fund for reconstruction of the crossing located at
Xes71- 871' 31-cecf Go7 S ?9
Location U.S. DOT—AAR-DOT No
.13/Act /74w 1�C
County
General scope of project:
Number of tracks to be repaired /
Number of tracks to be removed 0
Crossing Width (or surface material width) 0
(Width includes footage curb to curb, thru sidewalks, recreational trails, or shoulders)
Roadway width 3 Number of Sidewalks (1 or 2) —
Proposed surface material e o c C f .�C
Preliminary Cost Estimate:
Labor $ /0, 000
Material $ 32, 000
Equipment $ 0-1 3O0
Approach work $ 6 000
Total $0.00 5,, ,300
Use of this document is to reserve a place on the Iowa Grade Crossing Surface Repair Fund waiting list. Prior
to writing an agreement, a field review with the railroad, highway jurisdiction, and Iowa Department of
Transportation will be held to agree on the details of work to be performed. The highway authority and railroad
must agree to each pay 20 percent of the total project cost.
% ice/
Si ature, Highway Authority Signature, Railroad Representative
mayor goc,J .,4-7a51-ev
Title Title
ol- Clot 3 , 2009
Date Date
Return Completed Form To:
Mary Jo Key
Office of Rail Transportation
Iowa Department of Transportation
800 Lincoln Way
Ames, Iowa 50010
515-239-1108 Fax: 515-233-7983
E-Mail: Mary.Jo.KeV(a�dot.state.ia.us
-vivisf -A\ (w ftiv/A:irk r- @.E,--v,E\-L--J
gviti Mfi, PA.A51
CLIENT NAME: City of Waterloo
ASC ACCOUNT NUMBER: C528
ADDRESS 1 715 Mulberry Street
CITY, STATE,ZIP Waterloo, IA 50703
PHONE 319-291-4323
ASC's system provider, CS Stars, has chosen Gould & Lamb as their strategic partner for
MMSEA queries & submissions. ASC will pass these fees on to you with no additional
charges at the time we are invoiced by CS Stars. The charges to ASC per client for this
service are:
$ 680.00 - 1 time implementation/programming fee.
$1,920.00 - Annual transmission/submission fee beginning on the date of first
transmission.
By your signature below you acknowledge and agree to pay the fees outlined above
within 30 days of the date of ASC's invoice.
ASC will be unable to proceed with programming and/or transmission to, or on behalf of,
your carrier until receipt of the signed form.
Signed:
Signed by (print or type): Tim Hurl
Title: Mayor
Date: q- .2/ 09
RETURN TO Ann Massey, Business Systems Coordinator
Alternative Service Concepts, LLC., 2501 McGavock Pike, Suite 802, Nashville, TN 37214
E-mail Ann.Massey@ASCRisk.com or Fax: 615-360-1343
2aSF01080509
ifAIowa Department of Transportation
Form 291302wd (08-07)
IOWA GRADE CROSSING SURFACE REPAIR FUND APPLICATION
This notice is to inform the Office of Rail Transportation of the Iowa Department of Transportation that the
and the
(Highway Authority)
o CA /yi o i71-4 G ci ,e1A. ,-/4.0 ay �O: are submitting this
(Railroad)
application to use the Iowa Grade Crossing Surface Repair Fund for reconstruction of the crossing located at
West ?Ill 0 ? S 80 X
Location U.S. DOT—AAR-DOT No
c8 /0k K1i1c40, f(
County
General scope of project:
Number of tracks to be repaired
Number of tracks to be removed 0
Crossing Width (or surface material width) 8 /
(Width includes footage curb to curb, thru sidewalks, recreational trails, or shoulders)
Roadway width 14 S Number of Sidewalks (1 or 2) /
Proposed surface material Co it
Preliminary Cost Estimate:
Labor $ /),/ Oct
Material $ SOS DOO
Equipment $ G/ 2 00
Approach work $ ?, D DO
Total $0.00 75 /a)
Use of this document is to reserve a place on the Iowa Grade Crossing Surface Repair Fund waiting list. Prior
to writing an agreement, a field review with the railroad, highway jurisdiction, and Iowa Department of
Transportation will be held to agree on the details of work to be performed. The highway authority and railroad
must agree to each pay 20 percent of the total project cost.
/?•-et
Signature, Highway AuthoritySignature, Representative
Railroad Re resentative
/
Olayor /fouct� 14e✓
Title Title
q- 3 Zoo 9
Date Date
Return Completed Form To:
Mary Jo Key
Office of Rail Transportation
Iowa Department of Transportation
800 Lincoln Way
Ames, Iowa 50010
515-239-1108 Fax: 515-233-7983
E-Mail: Marv.Jo.Kev@dot.state.ia.us
4