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<br />STATEWIDE TRANSPORTATION ENHANCEMENT PROGRAM <br />Paae 3 <br /> <br />Nomination <br />Form <br /> <br />5. NOMINATING ENTITY. <br /> <br />A. NAME: <br /> <br />B. ADDRESS: <br /> <br />C. CITY: <br /> <br />D. ZIP CODE: <br /> <br />E. CONTACT PERSON: <br /> <br />F. TELEPHONE: <br /> <br />G. FAX NO.: <br /> <br />6. PROJECT LOCATION. <br /> <br />A. CITY/COUNTY: <br /> <br />B. TxDOT DISTRICT(S): <br /> <br />C. ROUTE NUMBER/STREET NAME/FACILITY NAME: <br /> <br />D. PROJECT LIMITS: <br /> <br />From <br /> <br />To <br /> <br />E. PROJECT LENGTH: <br /> <br />7. ESTIMATION OF FUNDS REQUIRED. Following selection by the Texas Transportation <br />Commission and approval by FHWA, all projects will be funded on a cost-reimbursable basis. Costs <br />Incurred before this time are not allowable. Be as accurate as possible. An inaccurate estimate may <br />result in an unexpected increase in the amount of funding required for the local match. Estimated total <br />project cost must Include 10% for project administration, design, engineering, and contingencies. <br /> <br /> Year Funds Local Match Total Project Cost <br /> Required <br />I I $ I $ I $ I <br />