R2024-254 Brush College Road over Faries Parkway and the Norfolk Southern Railroad Tracks 3

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Instructions for BLR 05311 -Page 2 of 3 Right-of-Way Job Number Insert the job number assigned for Right-of-Way for the project, if applicable.The number will begin with a"R". Project Number Insert the project number assigned to the Right-of-Way for the project, if applicable. Reason for Modification Brief explanation of why project costs have changed. Location Use the add location button to add additional locations if needed. Local Street/Road Name Insert the local street/road name. Key Route Insert the key route of the street/road listed above. Length Insert the length in miles as it pertains to the location listed above. For a structure insert 0.01. Station From Insert the beginning station of the project as it pertains to the key route for this location for this project. To Insert the ending station of the project as it pertains to the key route for this location for this project. Location Termini Insert the beginning and ending termini as it pertains to this location for this project. Existing Structure Number(s) Insert the existing structure number(s)for this project. Add Location Use this button to add additional locations.A total of four additional locations can be added. If there are more than 5 locations, do not add each location. Instead, insert"Various"in the first location field. Addenda Within the Addenda table, check the box as applicable. Insert the item number of the addenda and a description of the item. 1. Location Map Attach a location map to this agreement showing all locations being improved by this project. 2. Division of Cost Insert the division of cost page (see separate instructions for completing this document). 3. LPA Appropriation Resolution For State-Let construction projects,the LPA must pass an appropriation resolution covering the local share of the project.Attach the resolution for this appropriation. 4. IDOT Fiscal Approval Signature Page Approved Local Public Agency The appropriate LPA official shall insert their name,sign,and date. Insert the LPA's TIN number, DUNS Number, and the UEI (note the UEI will be replacing the DUNS Number https://sam.gov/content/duns-uei). Illinois Dept.of Transportation The appropriate IDOT official shall sign and date here. Division of Cost Table When the LPA desires to use one or more lump-sum amounts before the federal percentage is calculated,specify the order in which it should be used and the"not to exceed"amount.The following provides an example of the wording that may be used: Lump-sum$60,000 TARP funds not to exceed 50%of final cost of project credited to the project to be utilized first. Lump-sum to be utilized second not to exceed $20,000 EDP funds. Lump-sum to be utilized third not to exceed$40,000 SMA funds. These specified amounts will be used in sequence with the federal and local percentages calculated after they are deducted When the LPA desires to use a percent"not to exceed"commitment the federal and state funds will be used concurrently at the specified percentages up to the"not to exceed"amount Example: Maximum STIR participation 80%not to exceed $100,000 Lump-sum SMA not to exceed $20,000 to be used as a match to the federal funds Be advised that the"not to exceed"amount specified under a percentage commitment will be tied up and unavailable for programming until the project is closed out and a documentation review has been completed by IDOT or FHWA, if required. Completed 06/11/24 BLR 05311 (Rev.01/18/23)