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`(r� T�s'�t"" �•t Direct Costs Check Sheet <br /> COMPANY NAME:WHKS <br /> PTB NUMBER:NA-�- --------~�------------__._._.__.._. <br /> TODAYS DATE:11/3/2021 <br /> • a <br /> Per Diem (per GOVERNOR'S TRAVEL CONTROL $0.00` $0.00 <br /> BOARD) 1Up to stale rate maximum <br /> L°dgmg Actual cost(Up to state rate maximum) S0,00 50.00 <br /> (par GOVERNOR'S TRAVEL CONTROL BOARD) <br /> Lodging Taxes and Fees t $0.00 $0.00 <br /> (per GOVERNOR'S TRAVEL CONTROL BOARD) Actual cost i <br /> Air Fara Coach rate,actual cost,requires minimum two weeks'notice, $0.00 $0,00 <br /> 'with prior IDOT approval <br /> Vehicle Mileage(per GOVERNOR'S TRAVELIUp to slate rete maximum X 51,570 $0.560 $28,879.20 <br /> CONTROL BOARD) I j <br /> Vehicle Owned of Leased $32.50/hatf day(4 hours or less)or S65/full day X 0 $65.00, $0.00 <br /> 1 , <br /> Vehicle Rental ;Actual cost(Up to S551day) 50.00. $0.00 <br /> TOPS :Actual cost 50.00 $0.00 <br /> Parking Actual cost I S0.00 $0.00 <br /> Overtime ;Premium portion(Submit supporting documentation) X 1,110 1 $23.34 525,907.40 <br /> Shift Differential ]Actual cost(Based on firm's policy) $0.00; 50.00 <br /> Overnight Delivery/Postage/Courier Service Actual cost(Submit supporting documentation) $0.00 $0.00 <br /> I <br /> Copies of Daliverabies/Mylars(in-house) Actual cost(Submit supporting documentation) S0.00j $0.00 <br /> Copies of Deliverables/Mylars(Outside) :Actual cost(Submit supporting documentation) W 00 50.00 <br /> Project Specific Insurance (Actual cost 50.00' $0.00 <br /> Monuments(Permanent) $0.00 cost 3 50.00` $0.00 <br /> Photo Processing 'Actual cost ' $0.00 $0.00 <br /> 2-Way Radio(Survey or Phase l0 Only) ;Actual cost j SO.OD S0.00 <br /> Telephone Usage(Traffic System Monitoring Only) :Actual cost $0.00 $0.00 <br /> CARD !Actual cost(Max S15/hour) s0.00l $0.00 <br /> Web Site !Actual cost(Submit supporting documentation) j $0.00 $0.00 <br /> i <br /> Advertisements :Actual cost(Submit supporting documentation) $0,00; $0.00 <br /> Public Meeting Facility Rental (Actual cost(Submit supporting documentation) $0,00' $0.00 <br /> Public Meeting Exhibits/Renderings&Equipment ;Actual cost(Submit supporting documentation) I $0.00 $0.00 <br /> i <br /> Recording Fees +Aclualcost $0.00; $0,00 <br /> Transcription(specific to project) !Actual cost 50.00; $0.00 <br /> Courthouse Fees Actual cost 50.00; $0.00 <br /> Storm Sewer Cleaning and Televising !Actual cost(Requires 2-3 quotes with IDOT approval 50.00 $0.00 <br /> Traffic Control and Protection Actual cost(Requires 2-3 quotes with IDOT approval) SO.00s $0.00 <br /> Aerial Photography and Mapping Actual cost(Requires 2-3 quotes with IDOT approval) $0.00 $0.00 <br /> Utility Exploratory Trenching Actual cost(Requires 2.3 quotes with IDOT approval $0.00 $0.00 <br /> Testing of Soil Samples' Actual cost $0.00 $0.00 <br /> Lab Services' Actual cost(Provide breakdown of each cost) <br /> $0.00 30.00 <br /> Equipment andfor Specialized Equipment Rental' Actual cost(Requires 2-3 quotes with IDOT approval) $0.00 $0.00 <br /> Railroad Insurance ; $0.00; $0.00 <br /> Radioed Right of Entry 50.00 $0.00 <br /> Flagging Protection $0.00' $0.00 <br /> i $0.00' $0.00 <br /> 50.00 $0.00 <br /> $0.00 $0.00 <br /> $0.00 $0.00 <br /> i <br /> $0.00 $0.00 <br /> $0.00 $0.00 <br /> 50.00 $0.00 <br /> V other a/lowable costs are needed and not fisted,please add in the above spaces provided <br /> LEGEND <br /> W.O,=Work Order <br /> PRINTED 11/3/2021 A•51 ODE 436(Rev 02/02/17) <br />