INSTRUCTIONSFOR THETIME EXTENSIONREQUEST (Pre-Construction)

ThepurposeoftheDepartmentofTransportation’sTime Extension Requestform(Form)istostandardizeandstreamlinethetime extensionrequestprocessfor requesting additional time needed to start or complete allocated COS (PA&ED,PS&E,andRight-of-WaySupport) phases.TheFormwillbecomprisedofasingle page,dividedintofoursections,withsupportingdocumentationtobeattachedasnoted.

WhenisaTime ExtensionRequestFormneeded?

TheFormisrequiredforallStateHighwayOperationandProtectionProgram(SHOPP)projectsonthestatehighwaysystemfor COSphases/activitieswhen additional time is needed due to unforeseen reason(s).

SECTION 1–RequestInformation

Component

Designatesthephase(s)requested.Selectoneofthefollowing:

•PA&ED

•PS&E

•R/W Support

Original Deadline

Deadline to “Start” a Pre-Construction phase: Allocation plus six months. Deadline to “End” a Pre-Construction phase: “Start” date plus 36 months. Date(s) entered in MM/DD/YY format are required.

Months

Enter the number of months requested for each phase.

Extended Deadline

The original deadline plus the number of months requested for the time extension.

Last Saved

Enter the date(in mm/dd/yy format) when this form is last saved or revised. The default is the date of entry.

SECTION 2– ProjectInformation

ProjectID

Thisisthe10-digitCaltrans Project ID (also called EFIS) number.

District

TheDepartment’sDistricts.

County

Countywhereprojectislocated.Use“Various”whenaprojectcrossestwoormorecounties.

Program Code

Enter the Accounting / TRAMS Code for the project.

Route

Statehighwayorinterstateroutenumber. Useprimaryroutenumberwhenprojectaffectstwoormoreroutes.

PostMiles

Statehighwayroutepostmiles.

TheDepartment’sExpenditureAuthorization(EA)number.LeaveblankifnotaStateHighwaySystemproject.

PPNO

ProjectPlanning(PPNO)number. SHOPPprojectsmusthaveaPPNO.ThisnumbercanbefoundinCTIPS.

Project Location/Description

ThisistheprojectlocationandscopeofworkasitiscurrentlyprogrammedinCTIPS.ThedescriptionenteredhereshouldbethesameasfoundinCTIPS.Evenifthescopeischanged,pleaserefertothescopeasiscurrentlyprogrammed.

SECTION 3–Reason for Delay

Thepurposeofthissectionistocaptureinformation regarding thecurrent disposition oftherequestingreaterdetail.This informationis importantfordiscussionofthemeritsoftherequestwiththeCTCwhenproceedingtowardtime extension. TheFORMisnotconsideredacompletesubmittalwithoutallnecessarysupportingdocumentationincluded.

1. Providetheassumptionmadeandthechangesthathavecausedthedelay.Explainwhytheoriginaldeadline(s) cannot be met.

2.Explainwhat changed since the allocation date.

SECTION 4–Approvals

Approvals:Name, title, and signature of the Project Manager and SFP are required prior to submittal.

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