HomeMy WebLinkAboutPROJECT WORKSHEET - CATEGORY B - 5/16/2007 FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0151
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DECLARATION NO: PROJECT NO. FIPS NO. DATE CATEGORY
FEMA- 1688 -DR- IA RH-013 013-82425-00 5/16/2007 B
DAMAGE FACILITY WORK COMPLETE AS OF:
Various Street signs 5/16/2007 100 %
APPLICANT COUNTY
CITY OF WATERLOO BLACK HAWK
LOCATION LATITUDE LONGITUDE
CITY WIDE 42.52374 -92.35783
DAMAGE DESCRIPTION AND DIMENSIONS:
The severe winter storm between 2-23 and 3-2-07 deposited ice knocking out power to the city, shutting down all traffic
signals. The traffic department set up 14 temporary stop signs at intersections where traffic lights were not operating. The
storm caused 18 signs on wooden posts and 3 signs on metal posts. The posts on these broke due to high winds and thick
ice.
SCOPE OF WORK:
Wen power was lost during the severe winter storm, employees put 14 temporary stop signs at major intersections controlled
by traffic signals. When power was restored, these signs were picked up. The thick ice and high winds along caused signs
on 18 wooden posts at$14.53 per post and 3 signs on metal posts at$30 per post to break off.
Does the Scope of Work change the pre-disaster condition at site? n Yes n No
Special Consideration issues included? Yes n No Hazard Mitigation proposal included? I I Yes ri No
Is there insurance coverage on facility? n Yes n No
PROJECT COST
ITEM CODE NARRATIVE QUANTITYIUNIT UNIT PRICE COST
WORK COMPLETED / $
1 9007 Force account labor / $
2 9008 Force account equipment 1 / LS $ 851.03 $ 851.03
3 9009 Materials 1 / LS $ 345.87 $ 345.87
/ $ - $
/ $ - $
/ $ - $ -
/ $ - $ -
/ $ - $ -
/ $ - $ -
✓1-\., U C� 4— TOTAL COST $ 1,196 90
PREPARED BY: M DEAN U TITLE: TATE PAC
FEMA Form 90-91, SEP 98
FEDERAL EMERGENCY MANAGEMENT AGENCY
SPECIAL CONSIDERATIONS QUESTIONS
1. APPLICANTS NAME 2. FIPS NUMBER 3. DATE
City of Waterloo 013-82425-00 5/17/2007
4. PROJECT NAME 5. LOCATION
RH-013 City wide
Form must be filled out-for each project.
1. Does the damaged facility or item of work have insurance and/or is it an insurable risk? (e.g.,buildings, equipment, vehicles, etc.)
Yes ❑x No 0 Unsure Comments
2. Is the damaged facility located within a floodplain or coastal high hazard area,or does it have an impact on a floodplain or wetland'?
El Yes ❑x No El Unsure Comments A creek in the city runs trhough the structure
3. Is the damaged facility or item of work located within or adjacent to a Coastal Barrier Resource System Unit or an Otherwise Protected Area?
0 Yes ❑x No ❑ Unsure Comments
4. Will the proposed facility repairs/reconstruction change the pre-disaster condition? (e.g.,footprint,material,location, capacity, use or function)
0 Yes ❑x No 0 Unsure Comments
5. Does the applicant have a hazard mitigation proposal or would the applicant like technical assistance for a hazard proposal?
0 Yes 0 No 0 Unsure Comments
6. Is the damaged facility on the National Register of Historic Places or the state historic listing? Is it older than 50 years? Are there more,similar
buildings near the site?
0 Yes Ej No Ei Unsure Comments
7. Are there any pristine or undisturbed areas on,or near,the project site? Are there large tracts of forestland?
ElYes 0 No ❑ Unsure Comments
8. Are there any hazardous materials at or adjacent to the damaged facility and/or item of work?
0 Yes a No Unsure Comments
9. Are there any other environmentally or controversial issues associated with the damaged facility and/or item of work?
ElYes ❑x No 0 Unsure Comments
PREPARED BY: TITLE:
FEMA Form 90-120, NOV 98
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