Congressman Paul D. Tonko
Transportation Bill Request Form

Please return electronically to:
Joseph.Eaves@mail.house.gov and Nick.Viggiani@mail.house.gov
No Later Than:
Friday, April 24, 2009

Date Submitted:
 
Primary Official�s Contact Information:

       Name:
       Title:
       Address:
       Phone:
       Email:	
       Website:

Staff Contact Information:

       Name:
       Title:
       Address:
       Phone:
       Email:	
       Website:


Name and Address of Organization: (if state or local entity, please identify specific department requesting funding):  


1. Who is the primary Member of Congress sponsoring the project?
	

2. Is this project located in the 21st Congressional District of New York?
If, No please list the other Members of Congress.


3. Will other Members of Congress be submitting project requests supporting the project?  
If, yes please list the other Members of Congress. 


		
4. What type of eligible project under Title 23 (Highways) or Chapter 53 of Title 49 (Public Transit) of the U.S. Code is the project request?  Note: The Committee will not accept requests for non-surface transportation projects, such as transportation museums, horse trails, or historic battlefields, as part of the High Priority Projects program.

    Highway Project (Title 23)

Type:    

Located on a Federal-aid highway? 
       Located on the National Highway System? 
       Located on the Interstate System? 



Public Transit 
Public transit refers to transportation services provided to the general public via a variety of vehicle modes, including buses, subways, light rail, commuter rail, monorail, passenger ferry boats, transit van pools, streetcars, inclined railways, and paratransit vehicles.   Public transit does not include school bus or charter bus services, nor intercity passenger rail (such as Amtrak), high-speed rail, or private rail operations.  For these types of rail projects, please proceed to the Rail section of the form.

Indicate Type with an �X�:
Passenger Vehicles 
Transit Bus or Van	
Transit Rail Car or Locomotive, including Streetcars 
       Transit Ferry 
       
Transit Facilities 
	Vehicle Maintenance or Administration Facility 
Passenger Facility, including Intermodal Facilities, stations, and terminals 

Transit Rights-of-Way 
	Property Acquisition 	
       Corridor Development 
       Rail Track Construction or Maintenance 
       Bus-only Lane Construction or Maintenance 
       
Transit Equipment 
       Vehicle-related Equipment	
       System-related Equipment 
       
       
       
       
  New Start Project (A New Start project is a major new fixed guideway capital project seeking more than $75 million in Federal funds.) 

  Small Start Project (A Small Start project is a new fixed guideway capital project seeking less than $75 million in Federal funds and with a total estimated net capital cost of less than $250 million.) 


Rail 
Intercity Passenger Rail (Intercity rail passenger transportation means rail passenger transportation, except commuter rail passenger transportation.  Commuter rail passenger transportation means short-haul rail passenger transportation in metropolitan and suburban areas usually having reduced fare, multiple-ride, and commuter tickets and morning and evening peak period operations.  Intercity rail passenger transportation projects are not commuter rail projects.  Funds for commuter rail projects should be requested under public transit, not under intercity passenger rail.

Intercity Passenger Rail (Not commuter rail, commuter rail should be requested under public transit)
Is it located within a corridor previously designated by the Secretary of Transportation pursuant to section 104(d)(2) of Title 23, United States Code, or the Northeast Corridor? 
	If Yes, which Corridor: 

Freight Rail
		Pick one.
       Class I Freight Rail
	Class II Freight Rail
	Class III Freight Rail


       Research
       
       University Transportation Center
       Other
       
       
       

5. Did the Federal Highway Administration, Federal Transit Administration, or State Department of Transportation, or public transit agency confirm that the project is eligible under Title 23 (Highways) or Chapter 53 of Title 49 (Public Transit) of the United States Code?

If Yes, which entity confirmed the project eligibility?
       
       FHA, FTA, State DOT, or Public Transit Agency:
       		
       Contact information (Name, Position, Phone):
				
       According to the entity, is the project eligible under Title 23, Title 49, or both:
       			
       			


6. Please identify the state, regional, or local governmental entity that is an eligible recipient of the funds.  (Note:  If a project is a multi-state project, please select the State Department of Transportation which will serve as the lead agency for the project.)



7. Please identify the specific segment or activity for which project funding is requested.  The request must finance at least 80 percent of the total estimated cost of the specific segment or activity by either (1) the amount requested by the Member; or (2) the amount requested by the Member and other specifically designated Federal, state, local, or private funding sources.

Project description (include the specific terminus points of the project or activity, as appropriate:


       
       Project Activities (May select more than 1):
construct 		plan 	  	design 		engineer 

conduct 		develop		deploy		demonstrate

reconstruct	rehabilitate	 replace		retrofit

install		mitigate 		implement		realign

research		environmental review     acquire right-of-way  

conduct alternatives analysis

					
Total estimated cost (please write out in numeral form (e.g., $2,000,000, not $2 million):
	
       Request amount (in numeral form): 
       Percentage of total estimated cost: 
If percentage is less than 80% identify specifically designated Federal, state, local, or private funding that when combined with this request equal at least 80%
       
       Source: 
       Amount of Funding: 
       

8. If you are requesting funding for a specific segment or activity, please describe the overall project of which this segment/activity is a part. Project description (please limit your response to 3-4 sentences; up to 500 characters) and state the total estimated cost.


9. Is the project included in the State�s Long-Range Transportation Plan?
If Yes, please provide the date of approval of the most recent version of the plan and the title of the plan.

10. Is the project included in the Metropolitan Transportation Improvement Program (TIP) and/or State Transportation Improvement Program (STIP)? If Yes, please provide the date of approval of the most recent version of the program(s), and the title of the program(s). 

       Listed in TIP: 
		Date of approval (MM/YYYY): 
       Title of the Program: 
       
       Listed in STIP: 
		Date of approval (MM/YYYY): 
       Title of the Program: 


11. If the project is an intercity passenger rail project, is it included in the State Rail Plan? Please provide the date on which the Governor approved the most recent version of the plan, and the title of the plan.

       Date of approval (MM/YYYY): 
       Title of the plan: 



12. Please describe the current status of the project and the expected schedule for its completion. Please circle the ones that apply. 
Current status
Federal-aid Highway projects: (Select One if Applicable) 
In Planning
In Environmental Review
In Final Design
In Right-of-Way Acquisition
Under Construction


Public Transit projects: (Select One if Applicable)
In Planning
In Alternatives Analysis
In Preliminary Engineering
In Final Design
Under Construction or Procurement

Rail projects: (Select One if Applicable)  
In Planning
In Environmental Review
In Preliminary Engineering
In Design
Under Construction

Research: (Select One if Applicable)
Under Research
Under Development
Under Demonstration
Under Deployment



13. What is the expected date of completion of the project for which you are requesting funding   
   (Between FY2010-FY2020):


14. Please provide a letter of support from a state, regional, or local governmental official specifically supporting the project request.  This letter should discuss the merits of the project; specify the process to provide the public with an opportunity to comment on the project; and identify the other sources of Federal, state, or private funding that will be used to complete this project or project phase.  This letter must contain an explicit statement of support for the project.  In addition, if the project is requesting less than 80 percent of the total estimated cost of the specific segment or activity, the letter must identify other specifically designated Federal, state, local, or private funding sources that, combined with the Member request, equal at least 80 percent of the total estimated cost.  Please use boldface font to highlight these statements in the letter. Please attach letter


15. Does the project have regional or national significance? (A project of regional and national significance is typically a high-cost transportation infrastructure facility that often includes multiple levels of government, agencies, modes of transportation, and transportation goals and planning processes that are not easily addressed or funded within existing surface transportation program categories.  These projects have national and/or regional benefits, including improving economic productivity by facilitating international trade, relieving congestion, and improving transportation safety by facilitating passenger and freight movement.) Please describe the regional or national significance of the project.  Please limit your response to 3-4 sentences (up to 500 characters).


16. Describe the safety, economic development, mobility, and environmental benefits associated with completion of the project. Please limit your response to 2-3 sentences (500 characters) for each section.

Please describe the safety benefits. Please limit your response to 2-3 sentences (500 characters): 


Please describe the economic development benefits. Please limit your response to 2-3 sentences (500 characters):


Please describe the mobility benefits. Please limit your response to 2-3 sentences (500 characters):


Please describe the environmental benefits. Please limit your response to 2-3 sentences (500 characters):


17. Has the project previously received any Federal funding? If, yes please list the bill, the section, project number, amount of funding, and amount obligated.  Please list all federal funding over all years. 

Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users (SAFETEA-LU) (P.L.109-59) 
 			Section: 
       Project Number: 
       Amount of Funding Amount Obligated:
        
       Transportation Equity Act for the 21st Century (TEA 21) (P.L. 105-178) 
			Section: 
       Project Number: 
       Amount of Funding Amount Obligated: 
       
       National Highway System Designation Act of 1995 (NHS Act) (P.L. 104-59) 
       	Section: 
       Project Number: 
       Amount of Funding Amount Obligated: 
       
Intermodal Surface Transportation Efficiency Act of 1991 (ISTEA) (P.L. 102-240) 
       	Section: 
       Project Number: 
       Amount of Funding Amount Obligated: 
       
       Appropriations act(s)
       Public Law Name: 
       Public Law Number: 
       Section: 
       Project Number: 
Amount of Funding Amount Obligated: 

       Other legislation:
       Public Law Name: 
       Public Law Number: 
       Section: 
       Project Number: 
Amount of Funding Amount Obligated: 



18. Has the project received any prior funding from a State, local, or private source? If yes, list the source, amount of funding and amount obligated. 

       Source: 
       Amount of Funding: 
Amount Obligated:


19. Please provide the proposed legislative text (in no more than 250 characters) of the project as you would like it to appear in the bill.  (Please note that project line items carry the force of law, and can only be amended through subsequent public laws.  If Congressional intent (as established through answers listed on this form, or in letters to the Committee) is different from the legislative text, the entity administering the project is required to adhere to the statutory language.)
  


20. Notes or Anything else we should know about the Project:






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