TEMPLATE

							               ARIZONA DEPARTMENT OF TRANSPORTATION
                                     OFFICE MEMO
                                         Date

TO:      JULIO ALVARADO, P. E.
         Assistant State Engineer
         Construction Section 172A                      Change the colored areas
                                                        to black on your finished
FROM:    Your Name                                      document.
         Title
         Mail Drop
                                                        Save this form as a template. Use
THRU:    District Engineer Name                         "Save as" to create a budget increase.
         Title                                          Remove my explanations on your request before
         Mail Drop                                      turning in. This form contains formulas.


RE:      Project # / TRACS #
         Project Name
         Project Location
ORG:           xxxx

The referenced project requires additional work in order to adequately address the
construction needs at this location. Pertinent fiscal information is as follows:

Original Contract Amount:            $             -    This information is obtained from the CCS.
Five Percent Contingency:                               Click UPDATE on the menu at the top. Click
CE:                                                     FINANCE. When the report comes up, look in the
Post Design:                                            "Agreement Estimate" column. Delete the categories on this sheet
DPS:                                                    that don't apply. Do not make up categories.
Incentives:                                             If you have questions or cannot obtain a copy of the FINANCE report,
JPAs:                                                   call Yvonne Navarro (602 712-6849).
Utilities:
Other:
Original Available:                  $             -    Formula here. Should equal "Total:" in Agree. Est. column on Finance Report.


Actual Construction Costs:           $             -    For all actual costs, bring up the CCS, click UPDATE on top menu, then FINANCE.
Actual Other Construction:                                Look under "125 Report," column. For "Actual Construction Costs" on your request,
Actual CE:                                                enter either "Contractor Pay" or "CPE Payments," whichever is the greatest.
Actual DPS:                                               For CE Costs, we only need the total of all CE costs, shown as "Total CE."
Actual JPAs:
Actual Utilities:
Contract Work Remaining:                                You figure
Additional Other Construction:                          You figure                   Do not make up additional
Additional Supplemental Agree:                          You figure                   categories.
Additional CE Costs:                                    You figure                   List only the lines you need
Additional DPS:                                         You figure                   in your request.
Additional JPAs:                                        You figure                   Take out the categories you do not need.
Additional Utilities:                                   You figure
Additional Construction Costs:                          This line is used to round the total requested amount to the nearest $5,000.
Proposed New Total Needed:           $             -    Formula in this cell. You don't need to enter anything here. It figures for you.
Less Previous Increases:             $             -    Enter minus sign & amt shown in Finance Rept., Agree. Est. column, "Budget Increases."
Requested Amount:                    $             -    Formula here. You don't need to enter anything.


Reason for Increase:                                    Enter a brief description


I recommend that the budget for this project be increased to accommodate this additional
work.
                                                       ____________________________
                                                       RESIDENT ENGINEER


                                                        ____________________________
                                                        DISTRICT ENGINEER
XXX:xx

                                   Be sure to delete or backspace out all the explanation notes. Also your
                                   finished document should be in black.