R2024-252 Brush College Road over Faries Parkway and the Norfolk Southern Railroad Tracks 1

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Instructions for BLR 05311 -Page 1 of 3 NOTE: Form instructions should not be included when the form is submit. This form shall be used when a local public agency(LPA)project involves Federal-Aid,with or without state funds and this standard form is sufficient to describe all details of the agreement.This form serves as an amendment to BLR 05310. For more information refer to the Bureau of Local Roads and Streets Manual(BLRS)Chapter 5. For signature requirements refer to Chapter 2, Section 3.05(b)of the BLRS manual. When filling out this form electronically, once a field is initially completed,fields requiring the same information will be auto- populated. Amendment No. Insert the amendment number as it applies to this amendment. Local Public Agency Name of LPA Insert the name of the LPA County Insert the name of the county in which the LPA is located. Section Number Insert the section number applied to this project. Fund Type Insert the funding type(s)being used for this project(e.g. STU, STIR, ITEP,etc.) ITEP,SRTS, HSIP Number Insert the ITEP, SRTS, HSIP number assigned to this project. MPO Name From the drop down choose the MPO in which the project is located. If the project is not located within an MPO,select N/A. Types to choose from are: Bi-State Bi-State Regional Commission CMAP Chicago Metropolitan Planning Organization CUUATS Champaign/Urbana Urban Area Transportation Study DATS Danville Area Transportation Study DMATS Dubuque Metropolitan Area Transportation Study DSATS DeKalb/Sycamore Area Transportation Study DUATS Decatur Urbanized Area Transportation Study EWGCG East-West Gateway Council of Governments KATS Kankakee Area Transportation Study MCRPC McLean County Regional Planning Commission PPUATS Peoria/Pekin Urban Area Transportation Study RPC Region 1 Planning Council SATS Springfield Area Transportation Study SEMPO South East Metropolitan Planning Organization SIMPO Southern Illinois Metropolitan Planning Organization SLATS State Line Area Transportation Study MPO Tip Number Insert the MPO Tip Number assigned to this project,this is required for all projects located within the MPO planning boundaries if applicable. If not, insert"N/A". Construction on State Letting Check this box if the construction portion of this project will be on a state held letting. Day Labor Check this box if the project will be constructed using day labor. Local Administered Engineering Check this box if the LPA is administering the engineering locally. Right-of-Way Check this box if Right-Of-Way is part of the project. Construction Job Number Insert the job number assigned for the construction portion,the number will begin with a"C" Project Number Insert the project number assigned to the construction portion of this project. Engineering Job Number Insert the job number assigned for the engineering portion of this project. Project Number Insert the project number assigned to the engineering portion of this project. Completed 06/11/24 BLR 05311 (Rev.01/18/23)