Project Value Project Type Project Owner/Manager Project Description/ Role Project Name: Name: Payment ☐Availability Below $100M Project Location: ☐ $100M-$500M Start Date: End Date: ☐ ☐Design-Build Title: Above $500M Project Description: ☐ w/ ATC ☐Design-Build Agency: ☐Design-Build-Maintain Services Value* Telephone: ☐Design-Bid-Build _____________ ☐Concession Email: at Risk ☐CM ☐Other: Describe role and services provided relevant to this Project: Project Name: Name: Payment ☐Availability Below $100M ☐ $100M-$500M Project Location: ☐ ☐Design-Build Title: Above $500M Start Date: End Date: ☐ w/ ATC ☐Design-Build Agency: Project Description: ☐Design-Build-Maintain Services Value* Telephone: ☐Design-Bid-Build _____________ ☐Concession Email: at Risk ☐CM ☐Other: Describe role and services provided relevant to this Project: Project Name: Name: Payment ☐Availability Below $100M ☐ $100M-$500M Project Location: ☐ ☐Design-Build Title: Above $500M Start Date: End Date: w/ ATC ☐ ☐Design-Build Agency: Project Description: ☐Design-Build-Maintain Services Value* Telephone: ☐Design-Bid-Build _____________ ☐Concession Email: at Risk ☐CM ☐Other: Describe role and services provided relevant to this Project: * Provide the value of the work performed under your supervision (i.e. design, construction, ROW acquisition, etc.)
Project Description/ Role Project Value Project Type Project Owner/Manager Project Name: Project Location: Start Date: End Date: Project Description: ☐ Below $100M ☐ $100M-$500M ☐ Above $500M Services Value* _____________ ☐Availability Payment ☐Design-Build ☐Design-Build w/ ATC ☐Design-Build-Maintain ☐Design-Bid-Build ☐Concession ☐CM at Risk ☐Other: Name: Title: Agency: Telephone: Email: Describe role and services provided relevant to this Project: Project Name: Project Location: Start Date: End Date: Project Description: ☐ Below $100M ☐ $100M-$500M ☐ Above $500M Services Value* _____________ ☐Availability Payment ☐Design-Build ☐Design-Build w/ ATC ☐Design-Build-Maintain ☐Design-Bid-Build ☐Concession ☐CM at Risk ☐Other: Name: Title: Agency: Telephone: Email: Describe role and services provided relevant to this Project: Project Name: Project Location: Start Date: End Date: Project Description: ☐ Below $100M ☐ $100M-$500M ☐ Above $500M Services Value* _____________ ☐Availability Payment ☐Design-Build ☐Design-Build w/ ATC ☐Design-Build-Maintain ☐Design-Bid-Build ☐Concession ☐CM at Risk ☐Other: Name: Title: Agency: Telephone: Email: Describe role and services provided relevant to this Project: * Provide the value of the work performed under your supervision (i.e. design, construction, ROW acquisition, etc.)
addendum-4-forms.docx