REQUEST FOR REIMBURSEMENT PROCEDURES (INVOICING)

1. REQUEST FOR REIMBURSEMENT PROCEDURES(INVOICING)

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

3. 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: • LAP Project Invoice Summary • Invoice Summary from Contractor to Agency • Invoice Submittal Checklist • Cancelled check or proof of alternative payment method • Certification Disbursement of previous payment to Subcontractors • LAP Monthly Progress Report • Cost Summary • Application and Certification for Payment (AIA form G702) • Schedule of Values (includes Over runs/Under runs) • Change Order Tracking form • CEI Weekly Summary of Hours and Activities • CEI Job Duties

4. 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

5. LAP Project Invoice Summary General Information Form #1

6. General Information Example “2” Ex “AQA-77” Ex “425861-2-58-01” Ex “ June 30 2014”

7. LAP Project Invoice Summary Financial Information Form #1

8. LAP Project Invoice Summary Per the Agreement (only show if based on Percentage) Starting Date of Billing Period 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 Does not include other items such as administrative costs etc.. Actual amount FDOT/FHWA has agreed to pay the Agency Participating Amount Incurred to Date Ending Date of Billing Period

9. CEI Invoice Example Form #2

10. Invoice Submittal Checklist Form #3

11. Invoice Submittal Checklist Form #3

12. Final Invoice

13. Invoice Submittal Checklist Form #3

14. Invoice Submittal Checklist Form #3

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

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

17. Disbursement Certification 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 Form #5

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

19. Text Section of the Progress Report

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

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

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

23. Schedule of Values Form #9

24. Schedule of Values

25. Change Order Tracking Form Form #10

26. CEI Weekly Labor Summary Form #11

27. CEI Job Duties Form #12

28. 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

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

30. QUESTIONS