3. Local Agency Program General Information 1. Local Agency Program (LAP) is a re- imbursement program 2. Each Invoice to FDOT should only include one invoice from Contractor to Agency 3. Invoice Packages shall be submitted to Kathy White, CC Ops Center 4. Provide Hard copy as well as electronic version via email or CD. 5. Cover letter is Optional 6. 3 copies of Invoice Package a.Construction Reimbursement (10 docs) b.CEI Reimbursement (2 docs)

4. Documentation/Info Required The following forms/documents, twelve in total, will be required with each invoice from the Agency besides the cover letter. These forms/documents should be included in the following order: 1) LAP Project Invoice Summary 2) Invoice Summary from Contractor to Agency 3) Invoice Submittal Checklist 4) Cancelled check or proof of alternative payment method 5) Certification Disbursement of previous payment to Subcontractors 6) LAP Monthly Progress Report 7) Cost Summary 8) Application and Certification for Payment (AIA form G702) 9) Schedule of Values (includes Over runs/Under runs) 10) Change Order Tracking form 11) CEI Weekly Summary of Hours and Activities 12) CEI Job Duties

5. Documentation/Info Not Required The following documents and or information are not required with the invoice package from the Agency. These documents/information hinder the approval process and will cause the invoice package to be rejected: Time Sheets (unless specifically required for in house CEI) Personal employee information such as: Medical/Dental Insurance Premiums paid by employee Child support, Alimony payments PTO /Vacation/Holidays Fringe Benefits The following is an example of items that will cause the invoice package to be rejected: Not providing the required 12 forms previously mentioned Invoice package too large requiring a 3 ring binder/large clips Project not in compliance Final Invoice that do not include proper Close Out documentation Mathematical errors. Incorrect Retainage or not discounting the Retainage

6. LAP Project Invoice Summary Form #1 General Information

7. Example “2” Ex “425861-2-58-01” Ex “AQA-77” Ex “ June 30 2014”

8. LAP Project Invoice Summary Form #1 Financial Information

9. LAP Project Invoice Summary Starting Date of Billing Period Ending Date of Billing Period Does not include other items such as administrative costs etc.. Per the Agreement (only show if based on Percentage) Actual amount FDOT/FHWA has agreed to pay the Agency Participating Amount Incurred to Date Rows # 5, #6 and #7 should only reflect the amounts related to the Participating Amounts. Participating + non- participating and doesn’t include other items such as admin costs

10. CEI Invoice Example Form #2

11. Invoice Submittal Checklist Form #3

12. Invoice Submittal Checklist Form #3

13. Final Invoice

14. Invoice Submittal Checklist Form #3

15. Invoice Submittal Checklist Form #3

16. Checklist Questions Are there any questions with respect to the checklist?

17. Cancelled Checks/Payment Options Form #4 Options to Cancelled check include: 1. Visa Reimbursement Options 2. Electronic Transfer

18. Disbursement Certification Form #5 Contractor is certifying that they have paid their subs Exception Part- Used if a sub is not getting paid – Must attach Notification sent to Subcontractor explaining why payment was withheld Section where you are notarizing this form

19. Monthly Construction Progress Report Form #6 Data Section Text Section

20. Text Section of the Progress Report

21. Monthly Construction Progress Report Form #6 Data Section Text Section ON/OFF State Hwy

22. Cost Summary Form #7 Summary of invoices from Contractor to Agency

23. Application & Certificate for Payment (From Contractor to Agency) Form #8 Participating + non- participating items only Only account for C/O’s approved by FDOT LAP Program

24. Schedule of Values Form #9

25. Schedule of Values

26. Change Order Tracking Form Form #10

27. CEI Weekly Labor Summary Form #11

28. CEI Job Duties Form #12

29. Ways To Jeopardize Funding Construct a project prior to entering into an agreement. Not invoicing regularly Non Compliance with LAP Agreement requirements - State and Federal

30. Request For Reimbursement (Invoicing) FDOT and/or FHWA have the authority to de-obligate project funds Reimbursement Program Agency pays 3 rd Party (Contractor) FDOT reimburses Agency FHWA reimburses FDOT General Requirements