Info

							      Active and Pending Balances Report for On-Call Right-of-Way Services Consultants


      Name of Firm:



Contract balance information is required from those consultants who currently have active or
pending contracts with INDOT. This report is to be used by firms who provide any of the
following categories of on-call Right-of-Way Services, but who do not perform other types of
services for INDOT. The Right-of-Way Services include appraisal, appraisal review,
negotiations, title research or relocation.


The blue highlighted cells   are to be edited for this page and for the tabed sheets as applicable.
  Name of Firm:      0

 Contract Description:                                                                                    1
     Contract Number:                                           Expiration Date:
  A. Total Contract Amount:           $                       B. Mos. Remaining:
 C. Total Value of PO's Encumbered: $                           (If B. is less than 6 mos. then H. = 0)
D. Remaining Contract Balance Available (A. minus C.):                                        $0
E. Original Monthly Amount (A./ 24):              $0
F. Remaining Monthly Amount (D./ B.):             $0
G. Less of E. or F. :                             $0
H. Annualized Contract Balance (G. x {lesser of B. or 12}):                                   $0
  Name of Firm:      0

 Contract Description:                                                                                    5
     Contract Number:                                           Expiration Date:
  A. Total Contract Amount:           $                       B. Mos. Remaining:
 C. Total Value of PO's Encumbered: $                           (If B. is less than 6 mos. then H. = 0)
D. Remaining Contract Balance Available (A. minus C.):                                        $0
E. Original Monthly Amount (A./ 24):              $0
F. Remaining Monthly Amount (D./ B.):             $0
G. Less of E. or F. :                             $0
H. Annualized Contract Balance (G. x {lesser of B. or 12}):                                   $0
Name of Firm:                                               0

Contract                  Contract   Estimated Annualized
                    No.
Description               Number     Contract Balance
                0    1

                0    2

                0    3

                0    4

                0    5

                0    6

                0    7

                0    8

                                                       $0.00