Project Initialization / Estimate Form
Status:	Est. Submittal Date:	Work District:
Job Number:	Project Stage:	Length:
Primary County Name :	Primary County #:	Primary Route:	Route System:
Secondary County Name:	Secondary County #:	Secondary Route:
Primary Beg. Log Mile:	Primary End Log Mile:	Primary Rte. Dir.:
Secondary Beg Log Mile:	Secondary End Log Mile:	Secondary Rte. Dir.:
Location:
Proposed Improvement:
Reason for Programming:
Other Remarks:
Cost Estimate Breakdown (in thousands, range is acceptable in early stages):
Single Values or High Range Values
R/W Acquisition	+	R/W Incidental	+	=	R/W Est. Total 0	+
Grading & Drainage	+	Base & Surface	+	Bridge Est.	+	Misc. Est.	=	Contract Estimate 0	+ =	Project Est. Total 0
Preliminary Engr.	+
Construction Engr. 0	+	Const. Contingency 0	=	Const Engr. Total 0	+
Low Range Values
R/W Acquisition	+	R/W Incidental	+	=	R/W Est. Total 0	+
Grading & Drainage	+	Base & Surface	+	Bridge Est.	+	Misc. Est.	=	Contract Estimate 0	+ =	Project Est. Total 0
Preliminary Engr.	+
Construction Engr. 0	+	Const. Contingency 0	=	Const Engr. Total 0	+
Original R/W	Original Construction
CALENDAR YEAR PROJECT BUDGETING
1997	1998	1999	2000	2001	Future	Total
R/W Acquisition Estimate	0
(Includes MoDOT + Funding by Others)
Const. Contract Estimate	0
Funding by Others	0
(RW & Contract - If Applicable)
Project Manager:	Proposed Contracting Schedule (Award Month):	(Award Year):	ADT:
Special Area/ MPO Letter Code:	Bridge Count:	Work Miles:	Work Type 1:	Work Type 2:	Work Type 3:
Primary Regional Planning Commission Number:	Primary Senate District Number:	Primary Representative District Number:
Secondary Regional Planning Commission Number:	Secondary Senate District Number:	Secondary Representative Dist. Number:
If using this form, send via Lotus Notes attachment to userid OTPM.