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                        Noteworthy Practices Manual


            
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                Appendixes
rspcb_npm_Appendixes.pdf (10 MB)


photo of two cars in a single lane roundabout

*Source: Haveseen © 123RF.com*

APPENDIX A – Members of the Technical Oversight Working Group
	APPENDIX B – Sample HSIP Project Application Spreadsheet
	APPENDIX C – California Local Highway Safety Improvement Program Advisory Charter
	APPENDIX D – Environmental Documentation for Federal Projects with Minor Impacts
	APPENDIX E – Sample Determination of No Effect
	APPENDIX F – Memo and Joint Powers Agreement for the Administration of Federal HSIP Safety GrantAPPENDIX A – Members of the Technical Oversight Working Group

**Scott Davis –** Thurston County, Washington Traffic Engineering & Operations Manager and NACE Safety and Technology Committee Chair
	**Lois Goldman –** North Jersey Transportation Planning Authority, Director of Regional Planning
	**Dirk Gowan –** Louisville Metro Public Works, Senior Transportation Planner
	**Daniel Helms –** Mississippi DOT, Manager of Traffic Safety Engineering
	**Emran Rahaman –** Seminole Tribe of Florida, Senior Manager
	**Brian Roberts –** NACE, Executive Director
	**Mark Vizecky –** Minnesota DOT, Local Systems Safety Engineer
	**Patrick Wojahn –** National League of Cities, Board Member, College Park, MarylandAPPENDIX B – Sample HSIP Project Application Spreadsheet

screenshot of the Sample HSIP Project Application Spreadsheet

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APPENDIX C – California Local Highway Safety Improvement Program Advisory Charter

**Mission**
			California Local HSIP Advisory Committee is action oriented and supports the goal of to reduce fatalities and serious injuries on all public roadways in California.**Purpose**
			The committee provides high-level balanced strategic guidance to California’s Local HSIP and other safety programs and efforts regarding safety on California local roadways.**Desired Goals**
			Ensure that California’s Local HSIP and other safety programs and efforts are consistent with California’s SHSP.
				Provide vision and strategic priorities for improving local safety programs and processes.
				Provide recommendation on California Local HSIP and processes.
				Provide recommendation to streamline decision-making, review and project delivery on safety projects.
				Identify funding opportunities to meet local roadway safety needs.
				Encourage, improve and support traffic safety efforts at local agencies.**Members**
			The membership of the Committee shall consist of seven parent organizations. It is the intent that Committee members shall represent both urban and rural areas distributed geographically throughout the State, and to this end, California State Association of Counties and League of California Cities shall have two representatives.

			Caltrans - (3)
			California Transportation Cooperative Committee - (1)
			California State Association of Counties - (2)
			League of California Cities - (2)
			Regional Transportation Planning Agency - (1)
			Metropolitan Planning Organization - (1)
			Rural County Task Force - (1)

			Each representative shall have an alternate that will attend in their absence. Alternates are encouraged to attend but not required. At the discretion of the co-chairs, guests and speakers may attend for specific agenda items.

			The committee is co-chaired by Caltrans and a local representative. The co-chair position for the local member organization can be rotated at any time by the desire of the local representatives.**Advisors and Support**
			Caltrans
			Federal Highway Administration
			Local Technical Assistance Program**Frequency of Meetings**
			The committee will meet six times annually. Co-chairs may call additional meetings or workshops, as necessary.

			Representatives who miss three consecutive meetings may be relieved of their service to the Committee and the member organization will be asked to name a replacement prior to the next meeting.**Roles and Responsibilities**
			The roles and responsibilities of committee members are as follows:
			To act as the accountable representative for your member organization.
				Gather, disseminate, and exchange information and outcomes to your member organization.
				Be an active participant by either listening to other members and be willing to offer suggestions and/or recommendations that are from the member organization.
				Any actions assigned to a committee member will be completed by the next meeting or an agreed upon date.
				Be willing to be assigned to a sub-committee should the need arise.
				Be willing to serve a minimum of two years on the committee.**Reporting Structure**
			The Local HSIP Advisory Committee makes recommendations to the Division Chief, Local Assistance Program.**Decision Process**
			It is desired that decisions by the committee should be made by general consensus. Consensus is defined as reaching a decision that all Committee Members will support after a complete discussion of the issues and differing viewpoints. If consensus cannot be reached, a vote of the committee will be the next action and seven ‘yes’ votes will be required before an action is approved. Recommendations and dissenting opinions will be captured in the meeting documentation.**Amendments**
			This charter can be reviewed, evaluated, adjusted as needed.Charter Approved for Local HSIP Advisory Committee

JESSE BHULLAR       Date
Co-Chair
Office Chief, Bridge, Bond & Safety Program
Caltrans, Division of Local Assistance

TOM MATTSON       Date
Co-Chair
California Transportation Cooperative Committee

STEVEN CASTLEBERRY       Date
California State Association of Counties

DEAN LEHMAN       Date
California State Association of Counties

ANDRW MAXIMOUS       Date
California League of Cities

ADRIANN CARDOSO       Date
Regional Transportation Planning Agency

ROSS MC KEOWN       Date
Metropolitan Planning Organization

ROBERT PETERSON       Date
Local Highway Safety Improvement Program Manager – Caltrans

RICK TIPPETT       Date
Rural County Task Force

GARIN SCHNEIDER       Date
Local Highway Safety Improvement Program
District Local Assistance Engineer – Caltrans

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APPENDIX D – Environmental Documentation for Federal Projects with Minor Impacts

minnesota department of transportation logo

STATE AID FOR LOCAL TRANSPORTATION | Sept 2010

Environmental Documentation for Federal Projects with Minor Impacts | Page 1 of 2

***SP(s)____________ MN Proj. No(s).:____________***

***Project Location:*** (see attached project location map) **____________**

***Project Purpose and Need:____________***

***Project Type:*** check all that apply1
☐ Pavement Markings2
☐ Rumble Stripes
☐ Rumble Strips
☐ Signing Installation2
☐ Guardrail Installation
☐ Shoulder paving (No widening)
☐ Lighting
☐ Engibneering Studies
☐ SRTS Education/Enforcement

***Project Manager***
Name:     ____________
Title:     ____________
Address:     ____________
Address2:     ____________
Phone:     ____________
Email:     ____________

1 *Any other type of work will require a project memo*2 *Project will be designed in accordance with the MMUTCD*

***Estimated project costs***
Federal amount:     ____________
Federal amount other:     ____________ (Enter Funding Type Here)
Other funds:     ____________ (Enter Funding Type Here)
Total Project cost:     ____________

Project is listed in the Select STIP Year State Transportation Improvement Program in year
Year as Sequence number ____________
Desired date to begin work: Month/Year

***Method of Execution of work.***
☐ County/City will let work for competitive bids.
☐ County/City will purchase materials under a competitive process and install with their own forces
(**NO** federal reimbursement for installation costs).
☐ County/City will hire a consultant to perform an engineering study.

***Environmental Impacts:*** Check appropriate boxes

**Section 106 (Cultural Resources)**
☐ No Historic Properties are affected (see attached letter)*(No Adverse Effect or Adverse Effect will require a project memo)*
☐ Engineering Studies (No letter Required)

**Endangered Species**
☐ Project is in a county which has no federal threatened and endangered species
☐ Project will have no impact on federal threatened or endangered species (see attached letter)
☐ Engineering Studies (No letter Required)

minnesota department of transportation logo

STATE AID FOR LOCAL TRANSPORTATION | Sept 2010

Environmental Documentation for Federal Projects with Minor Impacts | Page 2 of 2

***Federal Action Determination Statement***
Based on the environmental study in accordance with 23 CFR 771.117, it is determined that the proposed improvement is a Class II Action (categorical exclusion) anticipated to have no forseeable change on the quality of the human environment.

***Recommended***
County Engineer ____________   Date ____________

***Reviewed and Recommended***
District State Aid Engineer ____________   Date ____________

***Approved***
Director, State Aid for Local Transportation ____________   Date ____________

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APPENDIX E – Sample Determination of No Effect

Summary of Local HSIP Solicitation
State Fiscal Years (SFY) 2017, 2018, 2019 & 2020

**Project Selection:**

A selection team with representation from the State Aid Division (SALT), the Office of Traffic, Safety, and Technology (OTST) and the Federal Highway Administration (FHWA) ranked each application.
	All projects are required to meet the intent of the Strategic Highway Safety Plan (SHSP).
	The applications were first grouped by Area Transportation Partnership (ATP), then into two (2) categories, proactive and reactive strategies.
	Projects were selected from each ATP based on:
	**PROACTIVE PROJECTS:**

	Developed through the County Roadway Safety Plan (CRSP) process
		OR
		Substantial compliance with projects listed in the CRSP
		All modified projects must have provided sound documentation for selection to be considered.**REACTIVE PROJECTS:**

	Benefit/Cost Analysis of 1.0 or greater.
		Location must have a significant crash history that includes a fatal and/or serious injury crashes.
	A list of funded proposals by county is provided in Exhibit A.
	50 applications were funded (37 Counties and 1 City), totaling about $17.2 million.Summary of Funded Proposals by ATP and Project Type.

ATP
			Applications Funded1
			122
			63
			104
			26
			97
			87
			3**Total**
			**50**Project Type
			Funding AwardedChevrons
			$220,050Intersection Modifications
			$1,550,000High Friction Surface Treatment in Curves
			$621,000Intersection Lighting
			$181,600Enhanced Pavement Markings and/or Rumble Strips & Stripes
			$7,980,2472’ Shoulder Paving, Rumble Strips & Safety Edge
			$2,300,284Enhanced Pavement Markings and/or Signs at Intersections
			$405,810Upgraded Signs, Pavement Markings and Intersection Lighting
			$422,573Roundabouts
			$3,476,200**Total**
			**$17,157,764**↑ Return to Top

APPENDIX F – Memo and Joint Powers Agreement for the Administration of Federal HSIP Safety Grant

Minnesota Department of Transportation

Memo

Office Tel: 218-755-6570
Fax: 218-755-6512

**Northwest District**
3920 Highway 2 West
Bemidji, MN 56601

Date: July 22, 2016

To: Howard Preston

Subject: HSIP Projects with multiple Counties under one contract

Howard:

This is in response in response to your inquiry on how our counties in District 2 plan and program projects that include multiple counties under one contract for the Highway Safety Improvement Program (HSIP).

Each year our District County Engineers, my staff, and I have a Spring Construction Meeting, Annual meeting, and a Federal Aid Programming meeting. In addition to those meetings, I meet informally with them at their offices throughout the year for various reasons that sometimes leads to discussions of future HSIP projects.

At our Federal Aid programming meeting each December, we discuss the possible HSIP projects that each county is considering. It is usually at this meeting that they agree to combine the same type of projects together and submit them to the MnDOT Central Office in St. Paul for the year that funding is available. They have found that making a larger contract is more efficient for everyone and is more likely to be funded sooner. For example, the first one in District 2 was a 6” wide edge line stripe that all the counties wanted as they all do some edge line striping each year. In our meeting, we discussed which county would have the time to develop the project, let it, and do the contract administration. Polk County offered and from that project we learned that it wasn’t that difficult to manage a multiple county project as long as there was a clear understanding of the costs and expectations from each county. Since that project as completed, we have had other multiple county projects. Now, often times, the counties decide between themselves in advance of our meeting, who will take the lead in the development and contract administration. We have a 10 county HSIP project for chevrons, several 2 county HSIP projects for intersection sign improvements, and 4 county HSIP project for rumble stripes and strips that have worked out very well. This is now the norm for discussion of HSIP projects at our district federal aid programming meeting.

I believe that the county engineers have developed a trusting environment among themselves that comes from our annual meetings and from doing these types of HSIP projects. These multiple county projects are very successful.

I have included with this letter a copy of the intercounty agreement used for our multiple county edge line project from 2011. If there is any other information you would like, please don’t hesitate to contact me via phone or email.

Sincerely,

L.C. Tasa
District 2 State Aid Engineer

Joint Powers Agreement for the Administration of Federal HSIP Safety Grant

Project No. S.P. 088-070-003

THIS AGREEMENT made and entered on the last day of execution below, between the Eleven MnDOT District 2 Minnesota Counties of Beltrami, Clearwater, Hubbard, Kittson, Lake of the Woods, Marshall, Norman, Pennington, Polk, Red Lake, and Roseau, herein after referred to as the ‘Eleven Counties.’

WITNESSETH:

WHEREAS, each of the Eleven Counties is their own road authority for State Aid Highways; and

WHEREAS, the Eleven Counties desire to provide roadway safety improvements in the form of pavement markings on selected district wide Federal Aid eligible highway routes; and

WHEREAS, the Eleven Counties desire to provide these road safety improvements under one single construction contract; and

WHEREAS, the Eleven Counties wish to clearly identify their mutual duties and responsibilities with respect to the project development, contract administration and project delivery; and

WHEREAS, the Eleven Counties wish to designate Polk County Highway Department as the lead agency for the creation and coordination of activities in the area of project development including creation of final project plans, specifications, advertisements, and bid letting documents; and as the lead agency in the area of contract administration including preparation and solicitation of a contract and bonds from the approved bidder, performing required field documentation, preparation of state and federal reports, making contractor payments, providing field records retention and sustaining the final audit.

NOW, THEREFORE, in consideration of the mutual covenants hereinafter contained, and other good and valuable consideration, all parties agree as follows:

Purpose. The purpose of this Agreement is to define the rights and obligations of the Eleven Counties with respect to the delivery of the project.
	Recitals. The recitals set forth in the whereas clauses above are incorporated by reference as if fully set forth herein.
	Responsibilities of Polk County:
	Polk County shall coordinate the preparation of plans, specifications, estimates, and bid documents in accordance with Mn/DOT State Aid Division requirements.
		Review preliminary plans, specification and bid documents with the Eleven Counties and State Aid Division officials. Relay and direct the revision plans specifications and bid documents to the Eleven Counties.
		Submit final plans, specifications, and bid documents to the Eleven Counties and State Aid for Final Approval.
		Conduct the bid opening and award the Contract.
		Coordinate all contract administration activities in accordance with Mn/DOT State Aid Division requirements on behalf of the Eleven Counties.
		Receive federal funds to be paid by FHWA for the project, pursuant to Minnesota Statutes.
		Perform required field documentation including, preparation and submission of required state and federal reports such as, but not limited to, notices, changes in status, diaries, change orders and payment vouchers.
		Upon completion of all construction activities in an individual county, provide a bill payable to Polk County Highway Department in the amount of that county’s individual required match for construction costs and construction inspection.
		Provide permanent project records retention.
		Sustain the Audit.
	Responsibilities of the Eleven Counties: Provide reimbursement to Polk County for equal share of costs incurred for project delivery on behalf of the other counties. Reimbursable items will include labor for coordination of project delivery in the areas of design, field documentation, and unallocated construction cost.
	Payment of Coordination Costs. Bills and payment for coordination requirements incurred by Polk County will be after the fact. Each county will be billed those costs after all duties described in No. 3 above are completed.
	Insurance. The Eleven Counties agree that they will, at all times during this Agreement, be prepared to meet the statutory limits for liability. Any insurance costs incurred shall be the costs and expenses of the insured party and shall not be included as a cost of the project or reimbursed in any way by the other party. Nothing in this agreement shall constitute a waiver of the statutory limits on liability set forth in Minnesota Statutes Chapter 466 or a waiver of any available immunities or defenses, and the limits of liability under Minnesota Statutes Chapter 466 for some or all of the parties may not be added together to determine the maximum amount of liability for any party.
	Controlling Law. This Agreement shall be governed by the applicable laws of the State of Minnesota.
	Successors and Assigns. The Eleven Counties respectfully bind themselves, their partners, successors and assigns and all legal representatives of such party with respect to all covenants of this Agreement.
	Changes. Except as provided herein, the parties agree that no change or modification to this Agreement or any attachments hereto shall have any force or effect unless the change is reduced to writing, dated and made part of this Agreement. The execution of the change shall be authorized and signed in the same manner as for this Agreement.
	Severability. In the event any provision of this Agreement shall be held invalid or unenforceable, the remaining provisions shall be valid and binding upon the parties unless such invalidity or nonenforceability would cause the Agreement to fail its purpose. One or more waivers by covenant shall not be construed by the other party as a waiver of a subsequent breach of the same by the other party.
	Entire Agreement. This Agreement, including all exhibits, constitutes the entire Agreement between the Eleven Counties and supersedes all prior written or oral Agreements. Any term, condition, prior course of dealing, course of performance, usage of trade, understanding, purchase order or agreement purporting to modify, vary, supplement or explain any provision of this Agreement is null and void and of no effect unless in writing and signed by representatives of both parties authorized to amend this Agreement.
	Effective Date. The Agreement shall be effective upon execution by the parties.
	Liability and Indemnification. Each county shall be solely liable and responsible for all of the work done within their respective county and funded under the agreement. No party to this agreement shall be liable to any other party to this agreement or any third person for damages claimed by virtue of work funded under this agreement and done outside the geographic confines of its own County. Each party to this agreement shall indemnify and hold harmless any other party to this agreement for any claims or action brought against it for work financed under this agreement and performed outside of its county. Each County assumes full and complete responsibility and liability for work done within its own county and funded under this agreement.**Beltrami County**

BY: County Board Chair
DATE: 5/7/10

ATTEST: County Board Clerk
DATE: 5/7/10

Approved as to Form and Execution
Beltrami County Attorney

**Clearwater County**

BY: County Board Chair
DATE: 5/13/10

ATTEST: County Board Clerk
DATE: 5-11-10

Approved as to Form and Execution
Clearwater County Attorney

**Hubbard County**

BY: County Board Chair
DATE: 5/19/10

ATTEST: County Board Clerk
DATE: 5/19/10

Approved as to Form and Execution
Hubbard County Attorney

**Kittson County**

BY: County Board Chair
DATE: 6/1/10

ATTEST: County Board Clerk
DATE: 6-1-10

Approved as to Form and Execution
Kittson County Attorney

**Lake of the Woods County**

BY: County Board Chair
DATE: 6-10-2010

ATTEST: County Board Clerk
DATE: 6-9-10

Approved as to Form and Execution
Lake of the Woods County Attorney

**Marshall County**

BY: County Board Chair
DATE: 6-21-10

ATTEST: County Board Clerk
DATE: 6/18/10

Approved as to Form and Execution
Marshall County Attorney

**Norman County**

BY: County Board Chair
DATE: 6-22-10

ATTEST: County Board Clerk
DATE: 6/22/10

Approved as to Form and Execution
Norman County Attorney

**Pennington County**

BY: County Board Chair
DATE: 6/29/10

ATTEST: County Board Clerk
DATE: 6/29/10

Approved as to Form and Execution
Pennington County Attorney

**Polk County**

BY: County Board Chair
DATE: 7-27-10

ATTEST: County Board Clerk
DATE: 7-27-10

Approved as to Form and Execution
Polk County Attorney

**Red Lake County**

BY: County Board Chair
DATE: 6/20/10

ATTEST: County Board Clerk
DATE: 6-30-10

Approved as to Form and Execution
Red Lake County Attorney

**Roseau County**

BY: County Board Chair
DATE: 7-6-10

ATTEST: County Board Clerk
DATE: 7-16-10

Approved as to Form and Execution
Roseau County Attorney

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