ࡱ                >  	               #          %          "    3 	                  bjbj΃                  	 *2      	                                                               l                         X      X      X                                 8   <     X  \                   T      T      T            7      7      7      )     +      +      +      +      +      +  $   `       |   O                     X      7                      3     7      7      7      O                        T                ;  d                       7  "     8   T      X            )                                                                    7      )        |                 E      @     X                                                              E      T          l\  x	        Y     E              E    z  0         E            o  Z        E            l     ~                                 Department of Transportationfrom:	BureaU OF highway design	date:	______________	UTILITIES SECTION			project:	________________________________________	 CONTROL Forms.CheckBox.1 \s fed no.:	________________________________________	 CONTROL Forms.CheckBox.1 \s state no.:	________________________________________	 CONTROL Forms.CheckBox.1 \s  	State Aid Highway/State Aid Bridge)to:	William J. Cass, P.E.	THRU:	William J. Oldenburg, P.E.	Director of Project Development		Administrator of Highway Designmemorandum CONTROL Forms.CheckBox.1 \s  CONTROL Forms.CheckBox.1 \s  CONTROL Forms.CheckBox.1 \s AGREEMENT  for _____________________________________________________________________________ FOR YOUR SIGNATURE:WRITTEN BY: 	________________________________	DATE: ______________CHECKED BY: 	________________________________	DATE: ______________PROOFREAD BY: 	________________________________	DATE: ______________APPROVED BY (Section Chief or Assistant):	________________________________	DATE: ______________FINAL APPROVAL (Section Chief or Assistant Initials):	__________	DATE: ______________MAILED FOR EXECUTION BY: 	________________________________	DATE: ______________ (Two Originals)	 UTILITY/MUNICIPALITY EXECUTION DATE: ______________IF FEDERAL OVERSIGHT (NON-EXEMPT):Unexecuted MAILED FOR REVIEW BY: 	___________________________	DATE: ______________Executed MAILED FOR APPROVAL BY: 	___________________________	DATE: ______________ (Two Copies to FHWA)	  FEDERAL APPROVAL DATE: ______________DISTRIBUTION (AFTER UTILITY EXECUTION OR FEDERAL APPROVAL):DISTRIBUTED BY: 	_______________________________	DATE: ______________ CONTROL Forms.CheckBox.1 \s  CONTROL Forms.CheckBox.1 \s 	ORIGINALS TO:  	(Utility Agreement File, Utility, Municipality)		COPIES	         2	Construction (1 each as noted)2(Office File & Contract Administrator)1	Coordinators Project File11	Finance & Contracts  Karyn Olson11	Highway Design File11	District __(Appropriate District When Involved)1	City/Town of ___________________(When Involved)1	Right-of-Way(When Involved)1	Turnpikes(When Involved)1	______________________________(Other When Involved)1	Engineering Audit1For Tracking Purposes                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 D  E  b  c  d  e  f                      
          5  6  7  9  V  W  X  Z  w   ż   x                     j  CJ UjT
CJ UVaJ j  CJ UjT
CJ UVaJ j    CJ UCJ  CJ  CJ  
5CJ \ ;CJ ;CJ j`  ;CJ U jT
CJ UVaJ j4  ;CJ U jT
CJ UVaJ jT
CJ UVaJ j    ;CJ U ;CJ  +       R  h      f        
                                                                                                                                                                                                             $ dP   a$   P    $ d   a$   $    a$ $    ^  a$   P   ^     $ 4   a$
  $   a$  $ 8P    a$
  $ 8   a$   P <         
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          w  x  y  z            0  1  t  u                  ,  -  R  t  u      	  	  	  	  2	  3	  4	  	  	  	  	  
  
  
  
  Y
  Z
  
  
  
  
  
  
  
  
  
  ȽѯȩԤ            j    CJ U	j  UjT
CJ UVaJ 	j    U
5CJ \ >*CJ >*CJ 
W        5CJ W       \ 
5CJ \ CJ  CJ  CJ  
5CJ \ CJ  CJ EH
  j    CJ Uj
  CJ UjT
CJ UVaJ  5        0  1  t  u              t  u      	  	                                                                                                                                                                                                                                                                                                               $$d &d N    P    a$            $a$   < 	   P  <  	  	  	  2	  3	  4	  	  	  	  	  
  
  
  
                                                                                                                                                  }                                      
  $ P < a$   $$d &d N    P    a$  $ \ <    a$     
   h <       ,            h <        $ P<  
 $ $ P< a$    $$d &d N    P    a$ 
  Y
  Z
  
  
  $  -  8  Y  Z  \                                                                                                                                                                                                                                                                                               $ P $If   a$  $ P $If   a$   $ hP  $If   a$    h,P      h                $a$   $ P a$ 
  
  
  
  
  #  $  &  -  7  8      
                                                                                                                                                                                                                                                                                                                                                       CJ  CJ  >*CJ CJ EH
  CJ EH  CJ  j    CJ Uj  CJ UjT
CJ UVaJ                                               u            h            u                                   u            h            u                                                $ P $If   a$  $ P $If   a$   $ hP  $If   a$ m  $$If   l 4\ x$                  h                                                $6                                                4 
l a   
            l                       y            l            y                                                                                                                                             $ P $If   a$  $ P $If   a$   $ hP  $If   a$j  $$If   l \ x$                  h                                              $6                                                4 
l a                                                  y            l                                                                                                                                             $ P $If   a$  $ P $If   a$   $ hP  $If   a$j  $$If   l \ x$                  h                                                $6                                                4 
l a        C  D  E  U  V  e  f  g  w                         y            l            y                                   y            l            y                                                        $ P $If   a$  $ P $If   a$   $ hP  $If   a$j  $$If   l \ x$                  h                                              $6                                                4 
l a   
w  x                        |                       y            l            y                                   y            l            y                                             $ P $If   a$  $ P $If   a$   $ hP  $If   a$j  $$If   l \ x$                  h                                          $6                                             4 
l a                                                                {           l                                                {            c            c                      $ P a$   $ hP  $If   a$j  $$If   l \ x$                  h                                          $6                                             4 
l a    $ P $If   a$  $ P $If   a$     	  
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       $ P a$    ( &P 1h/ =!"#$%  j                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      4  D d                    ;                                 P   
   	   
  S    A	   ?            "             2   @f@忤 l     D     `!d  @f@忤                H  2   xcdd``Ġ$XHs3D@,&Q@;?T.P'Y6E 8dNX@fXz0Y&FS3}6aX)$37X/\!(?71!bD VpZ/FI`؈AAB!IԔԢԢ+?`}<]  ,@H<v d 9<N(
[N3`!#`9&80sŚG?GPu)xLUGEuxBARJ3S ,  D d                    ;                                 J   
   
   
  C    A   ?         "            2   vpS j     x    `!b  vpSŴ                  0   xcdd``Ġ$XHs3D@,&Q@;?T.P'Y6E 8dX@fXz0Y&FS3}6aX)$37X/\!(?71!bD VpZ.ǗvFI`́؈AAB!NIԔԢ׊܂+?`}<] 	1 13c( dGԁS@ȠfC0#X'0\T]J~!FQQPGԁR:T 7  D d                    ;                                 J   
      
  C    A   ?         "            2   BQk˳ī3  u         `!m  BQk˳ī3                 $  ;   xRJ@=3bpuBm`GX4H~??l Ee;7+jt枛9gn u+ UʀCP=]lZbEl	)ƘM;e<:rOem˄5-[.^pa7HIe%qa蹜kT=
MPM:nwt_fEDEwG	2wsë#˚Q۟@ż<kħa~7p~qyTc_?;C_M|~wzMV  D d                    J                                 J   
      
  C    A   ?         "            2 p  X,u(PHN L         `!D  X,u(PHN          x      p p2    xcdd``>Ġ$XHs3D@,&1
f KH^h,"J2@6?VA,F& #LĔLf ep``
M-VK-WMc<?K뀸l'Fy 6bfbPRaTҼYLCy0rT`8v /F0$rL?qa5ďR4 :*g
 "  D d                    TJ                                 J   
      
  C    A   ?         "            2 n  |aOeqI J         `!B  |aOeqI          l       p2    xcdd``>Ġ$XHs3D@,&1f KH^h,"J2@6?VA,F& #LĔLf ep``
M-VK-WMc<]l'FY 6bfbPLa҂ԼA,0>
g!#`9&80sŚG?GPu)xLUGEuxBARJ3S 
  D d                    J                                 J   
      
  C    A   ?         "            2 l  u$	eAB H     
    `!@  u$	eAB          x      p p2    xcdd``>Ġ$XHs3D@,&1
f KH^h,"J2@6?VA,F& #LĔLf ep``
M-VK-WMc<=l'FY 6bfbPRaԼ .Q(f!4ǁSr^ da`d !A,ĀfXG.%IꨨB#@@)Rfp  x	  D d                    J                                 J   
      
  C    A   ?         "            2 k  k$. G         `!?  k$.x          U      Z p2    xcdd``Ġ$XHs3D@,&1Pf KH^h,"J2n@6?VA,F& #LĔLf ep``
M-VK-WMc<?Kq#$N@l tdf!
E%@qv(;PHŁSR^ da`d !A,ĀfXG.%IꨨB#@@)Qfp  R  D d                    ;                                 J   
      
  C    A   ?         "            2 o  $6#hk K         `!C  $6#hk~          `           xcdd``Ġ$XHs3D@,&Qf KH^h,                        	   
                                                                   !   U   $   *   ;   '   (   )   +   /   ,   -   .   0   1   2   5   3   4   6   :   7   8   9   <   =   R   >   A   ?   @   B   F   C   D   E   G   H   I   L   J   K   M   Q   N   O   P   S   T   V   W   X   c   Y   Z   [   \   ]   ^   _   `   a   b   d   e   g   h   i   j   k   l   m   n   o   p   q   R o o t   E n t r y                                              5   	           F            n\&   \      D a t a                                                         
                                              W o r d D o c u m e n t                                          4                                           *2      O b j e c t P o o l                                                                      /^\n\            _ 1 4 0 9 3 9 1 2 4 6                                               @ҋB  `    /^\/^\             P R I N T                                                                                                     C o m p O b j                                                                                               v        O b j I n f o                                                                                                                        	   
                                                          "   #   $   %   &   '   (   )   *   +   ,   -   .   /   0   1   2   3   4   5   6   7   8   9   :   <   @   B   C   D   E   F   G   H   I   J   K   L   M   N   O   P   Q   R   S   T   U   V   W   X   Y   Z   [   ]   a   c   d   e   f   g   h   i   j   k   l   m   n   o   p   q   r   s   t   u   v   w   x   y   z   {   }    m,   	     #                                   -  	   !           -  	   !                          .                        @ Times New Roman Xwaw @w7f   -    	    ;   2
         Federal Oversight: (NHS/Non-NHS)        	            	 	   	    	 	   #  @	           (                                   doq doq doq doq doq doq doq doq doq doqdoqdoqdoqdoqdoqdoqdoqdoqdoq     '         '                    ʦ                                         ʦ                                         ʦ                                         ʦ                                         ʦ                                                                                                                     '                                                                  
  @ҋB  `   Microsoft Forms 2.0 CheckBox    Embedded Object    Forms.CheckBox.1 9q                                                                                    C h e c k B o x 4 1 1 1 1 1 1 1 1 1                              H F                 c  1  0IFederal Oversight: ( O C X N A M E                                                      	                                          (       c o n t e n t s                                                                                         p       _ 1 4 0 9 3 9 1 2 4 8                                                      @ҋB  `    /^\`\             P R I N T                                                                                          !   |      NHS/Non-NHS)   5           Times New Roman                  0,   	     #                                   -  	   !           -  	   !                          .                        @ Times New Roman Xwaw @wf   -    	    7   2
        Federal Exempt: (NHS/Non-NHS)            	      	 	   	    	 	   #  @	           (                                   doq doq doq doq doq doq doq doq doq doqdoqdoqdoqdoqdoqdoqdoqdoqdoq     '           '                    ʦ                                         ʦ                                         ʦ                                         ʦ                                         ʦ                                                                                                                     '          
  @ҋB  `   Microsoft Forms 2.0 CheckBox    Embedded Object    Forms.CheckBox.1 9q                                                                                    C h e c k B o x 5 1 1 1 1 1 1 1 1 1                              H F                %  1  0?Federal Exempt: (NHS C o m p O b j                                                                                            ;   v        O b j I n f o                                                                                      =           O C X N A M E                                                                                             >   (       c o n t e n t s                                                                                      ?   p       /Non-NHS)      5           Times New Roman                  ,   	     #                                   -  	   !           -  	   !                          .                        @ Times New Roman Xwaw @w7f   -    	    >   2
  "      Non-Federal: (Betterment/Turnpike/	                    	              #  @	           (                                 _ 1 4 0 9 3 9 1 2 4 9                                               @ҋB  `    `\`\             P R I N T                                                                                          A          C o m p O b j                                                                                            \   v        O b j I n f o                                                                                      ^            doq doq doq doq doq doq doq doq doq doqdoqdoqdoqdoqdoqdoqdoqdoqdoq     '           '                    ʦ                                         ʦ                                         ʦ                                         ʦ                                         ʦ                                                                                                                     '           '                                      
  @ҋB  `   Microsoft Forms 2.0 CheckBox    Embedded Object    Forms.CheckBox.1 9q                                                                                    C h e c k B o x 1 1 1 1 1 1 1 1 1 1                              O C X N A M E                                                                                             _   (       c o n t e n t s                                                                                      `   t       _ 1 4 0 9 3 9 1 2 5 1                                            
   "      @ҋB  `    `\`\             P R I N T                                                                                          b   L       L F              "    1  0HNon-Federal: (Betterment/Turnpike/     5           Times New Roman              gF   	     #                   x                -  	   !   x        -  	   !   i               x        .                        @ Times New Roman Xwaw @wf   -    	       2
      u  Force AccountE             #  @	           (                                   doq doq doq doq doq doq doq doq doq doqdoqdoqdoqdoqdoqdoqdoqdoqdoq     '           '                    ʦ                                         ʦ                                         ʦ                                         ʦ                                         ʦ                                                                                                                     '                                                          
  @ҋB  `   Microsoft Forms 2.0 CheckBox    Embedded Object    Forms.CheckBox.1 9q                                                                                    C h e c k B o x 6 1 1 1 1 1 1 1 1                                C o m p O b j                                                                                            |   v        O b j I n f o                                                                                      ~           O C X N A M E                                                                                                &       c o n t e n t s                                                                                         `                                                                                                                                                                                                                                                                                                                                            8 F                ^  =  0lForce Account+    5           Times New Roman                                  *F   	     #                   l                -  	   !   l        -  	   !   ]               l        .                        @ Times New Roman Xwaw @w7f   -    	       2
      i  Supplemental            #  @	           (                                 _ 1 4 0 9 3 9 1 2 5 3                                               @ҋB  `    `\b\             P R I N T                                                                                             H       C o m p O b j                                                                                                v        O b j I n f o                                                                                                  doq doq doq doq doq doq doq doq doq doqdoqdoqdoqdoqdoqdoqdoqdoqdoq     '           '                    ʦ                                         ʦ                                         ʦ                                         ʦ                                         ʦ                                                                                                                     '                                                              
  @ҋB  `   Microsoft Forms 2.0 CheckBox    Embedded Object    Forms.CheckBox.1 9q                                                                                    C h e c k B o x 7 1 1 1 1 1 1 1 1                                O C X N A M E                                                      !                                          &       c o n t e n t s                                                                                         \       _ 1 4 0 9 3 9 1 2 5 4                                                (   $   @ҋB  `    b\b\             P R I N T                                                                                             ^       4 F                6  =  0"Supplemental   5           Times New Roman                                      gF   	     #                   x                -  	   !   x        -  	   !   i               x        .                        @ Times New Roman Xwaw @wf   -    	       2
      u  Amendment to            #  @	           (                                   doq doq doq doq doq doq doq doq doq doqdoqdoqdoqdoqdoqdoqdoqdoqdoq     '                                    ʦ                                         ʦ                                         ʦ                                         ʦ                                         ʦ                                                                                                                     '           '                                        
  @ҋB  `   Microsoft Forms 2.0 CheckBox    Embedded Object    Forms.CheckBox.1 9q                                                                                    C h e c k B o x 8 1 1 1 1 1 1 1 1                                C o m p O b j                                                  #   &                                          v        O b j I n f o                                                                                                 O C X N A M E                                                   %   '                                          &       c o n t e n t s                                                                                         \        4 F                ^  =  0?Amendment to   5           Times New Roman                                      F   	     #                   U                -  	   !   U        -  	   !   F               U        .                        @ Times New Roman Xwaw @w7f   -    	       2
  	    R  Two Partyt 	        #  @	           (                                 _ 1 4 0 9 3 9 1 2 5 5                                            .   *   @ҋB  `    b\[e\             P R I N T                                                                                             @       C o m p O b j                                                  )   ,                                          v        O b j I n f o                                                                                                  doq doq doq doq doq doq doq doq doq doqdoqdoqdoqdoqdoqdoqdoqdoqdoq     '           '                    ʦ                                         ʦ                                         ʦ                                         ʦ                                         ʦ                                                                                                                     '      
  @ҋB  `   Microsoft Forms 2.0 CheckBox    Embedded Object    Forms.CheckBox.1 9q                                                                                    C h e c k B o x 2 1 1 1 1 1 1 1 1 1                              4 F              	    M  0lTwo Party&   5    O C X N A M E                                                   +   -                                          (       c o n t e n t s                                                                                         \       _ 1 4 0 9 3 9 1 2 5 7                                             0   @ҋB  `    [e\g\             P R I N T                                                                                             \              Times New Roman                                      	,   	     #                   `                -  	   !   `        -  	   !   Q               `        .                        @ Times New Roman Xwaw @wf   -    	       2
      ]  Three Party3           #  @	           (                                   doq doq doq doq doq doq doq doq doq doqdoqdoqdoqdoqdoqdoqdoqdoqdoq     '         '     '                    ʦ                                         ʦ                                         ʦ                                         ʦ                                         ʦ                                                                                                                     '           '                                          
  @ҋB  `   Microsoft Forms 2.0 CheckBox    Embedded Object    Forms.CheckBox.1 9q                                                                                    C h e c k B o x 3 1 1 1 1 1 1 1 1 1                              4 F                	  -  0Three Party   5    C o m p O b j                                                  /   2                                          v        O b j I n f o                                                                                                 O C X N A M E                                                   1   3                                          (       c o n t e n t s                                                                                         \                     
                                             !  "  #  $  %  &  '  (  )  *  +  ,  -  .  0  1  2  3  4  5  6  7  8  9  :  ;  <  =  >  ?  @  A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  [  \  ^  _  `  a  b  c  d  e  f  g  j  k  l  m  n  o  r          Times New Roman                                                           Oh +'0                                                       	   ,     8  
   T     `     l     x                                  DEPARTMENT OF TRANSPORTATION                    n34elr                            forceacctbuckslip.dot         n34elr        1         Microsoft Word 9.0  @    G    @     ]@    ڂ@    f	V         1 T a b l e                                                          ?                                       f          S u m m a r y I n f o r m a t i o n                           (    6                                                D o c u m e n t S u m m a r y I n f o r m a t i o n           8                                     	  8      M a c r o s                                                       =                       g\l\            "J2@6?VA,F& #LĔLf ep``
M-VK-WMc<=l'FIF\B@
$C2RSJ*8>da`Bf fҠqT`8Y4lfd q01`+<z?K/cҨ:*Ã":PzTg* v}                                                                                                                                                                                                                                                                                                               [                                                                                ՜. +,0           h      p                                                                          NHDOT                  	     #	                                     DEPARTMENT OF TRANSPORTATION             Title                 o    S               b<  c                pɵDr@|                             V B A                                                            9                       g\j\            T h i s D o c u m e n t                                          ;   :                                         -      _ V B A _ P R O J E C T                                                                               /  l      d i r                                                                                                 ]              >/N%               x    , CheckBox4111111111, 0, 72, MSForms, CheckBox, CheckBox5111111111, 1, 73, MSForms, CheckBox, CheckBox1111111111, 2, 74, MSForms, CheckBox+ CheckBox611111111, 3, 75, MSForms, CheckBox+ CheckBox711111111, 4, 76, MSForms, CheckBox+ CheckBox811111111, 5, 77, MSForms, CheckBox, CheckBox2111111111, 6, 78, MSForms, CheckBox, CheckBox3111111111, 7, 79, MSForms, CheckBox                                    ME                    P    SL   S   S   s    <     <     <     <       N 0 { 0 0 0 2 0 9 0 6 - 0 0 0 0 - 0 0 0 0 - C 0 0 0 - 0 0 0 0 0 0 0 0 0 0 4 6 }      P   (                  %     %   *h   4 L0        @H         %   *   < X`      @I         %   *   D d      @J         %   *!   L p      @K         %   *#(  T |      @L         %   *%X  \       @M         %   *'  d P     @N         %   *)l      @O       0   8      (    X  h                      %   @             %                       8                          L         * \ R 8 0 0 4 * # 6 7                                                                   x     , Attribut e VB_Nam e = "Thi sDocument"

Bas0{00020P906- 0C $0046}|GlobalSpacFalsedCreatablPredecla Id TruBExposeTempl ateDerivBustomizD2ControlCheck Box41 ,  0, 72, M SForms, W#5#1 #3O3#"!D743#6I,  "75s7G!76s8G!t77s2E F "783@"79                    am   	  	               * \ G { 0 0 0 2 0 4 E F - 0 0 0 0 - 0 0 0 0 - C 0 0 0 - 0 0 0 0 0 0 0 0 0 0 4 6 } # 4 . 0 # 9 # C : \ P R O G R A ~ 1 \ C O M M O N ~ 1 \ M I C R O S ~ 1 \ V B A \ V B A 6 \ V B E 6 . D L L # V i s u a l   B a s i c   F o r   A p p l i c a t i o n s             * \ G { 0 0 0 2 0 9 0 5 - 0 0 0 0 - 0 0 0 0 - C 0 0 0 - 0 0 0 0 0 0 0 0 0 0 4 6 } # 8 . 1 # 0 # C : \ P r o g r a m   F i l e s \ M i c r o s o f t   O f f i c e   2 0 0 0 \ O f f i c e \ M S W O R D 9 . O L B # M i c r o s o f t   W o r d   9 . 0   O b j e c t   L i b r a r y              * \ G { 0 0 0 2 0 4 3 0 - 0 0 0 0 - 0 0 0 0 - C 0 0 0 - 0 0 0 0 0 0 0 0 0 0 4 6 } # 2 . 0 # 0 # C : \ W I N D O W S \ s y s t e m 3 2 \ s t d o l e 2 . t l b # O L E   A u t o m a t i o n             * \ G { 2 D F 8 D 0 4 C - 5 B F A - 1 0 1 B - B D E 5 - 0 0 A A 0 0 4 4 D E 5 2 } # 2 . 1 # 0 # C : \ P r o g r a m   F i l e s \ M i c r o s o f t   O f f i c e   2 0 0 0 \ O f f i c e \ M S O 9 . D L L # M i c r o s o f t   O f f i c e   9 . 0   O b j e c t   L i b r a r y              * \ G { 0 D 4 5 2 E E 1 - E 0 8 F - 1 0 1 A - 8 5 2 E - 0 2 6 0 8 C 4 D 0 B B 4 } # 2 . 0 # 0 # C : \ W I N D O W S \ s y s t e m 3 2 \ F M 2 0 . D L L # M i c r o s o f t   F o r m s   2 . 0   O b j e c t   L i b r a r y            * \ G { 4 5 1 E C 9 F B - D B 3 2 - 4 E F 3 - 9 C D 6 - C A 5 0 A C 7 8 7 6 7 6 } # 2 . 0 # 0 # C : \ D O C U M E ~ 1 \ n 3 4 e l r \ L O C A L S ~ 1 \ T e m p \ W o r d 8 . 0 \ M S F o r m s . e x d # M i c r o s o f t   F o r m s   2 . 0   O b j e c t   L i b r a r y              .E.`M          
       FQ                      b  T h i s D o c u m e n t  0 > 5 1 f c f c 4 6  T h i s D o c u m e n t <                  2~B]zK>dQ   `          L'  Wordk VBA Win16~ Win32 Mac VBA6# Project1
 stdole` Project- ThisDocument< 	   _Evaluate   Officeu    MSFormsC CheckBox4111111111d CheckBox5111111111r^ CheckBox1111111111x CheckBox611111111, CheckBox711111111 CheckBox811111111 CheckBox2111111111q CheckBox3111111111Fk Documentj T                                                                0*	 pH  d   ProjectQ (  @=
l	FQ J<
 rstdole>s t  d o l eP  h %^ * \G{00020430- C 
0046}# 2.0#0#C: \WINDOWS \system32\e2.tlb #OLE Automation ` EOfficEO f i cEE2DF 8D04C-5B FA-101B-BDE5EAAC42Egra m Files\ Microsoft 6 2 _\ \MSO9.DLL#9.0 Ob Libra,ry F MS Forms> A 	M S F r@ m s 3  D452EE@1-E08F[A-8 -0260 8C4D0BB4aPFM20'B @]&/ ; "1 hnAn00}t#0n# 504 	 A45 1EC9FB-D B32-4EF3 -9CD6-CA 50AC78767IDOCUME ~1\n34el r\LOCALSTemp\Wo`rd8.0 c7.xexdc<@"  .E.`MA" bThisDo cumentG T i@lD@lc u@oe n *2  HB1BE,!<"B+B P R O J E C T w m                                                >                                       h  )       P R O J E C T                                                    8   <                                       i        P R O J E C T l k                                                                                     p          C o m p O b j                                                  7                                          q  j       ThisDocument T h i s D o c u m e n t                            ID="{8ED95C40-AFFB-40DB-9C85-30C644050864}"
Document=ThisDocument/&H00000000
Name="Project"
HelpContextID="0"
VersionCompatible32="393222000"
CMG="1B19C4E3DBE7DBE7DBE7DBE7"
DPB="3634E9081F383B393B393B"
GC="51538E338F338FCC"

[Host Extender Info]
&H00000001={3832D640-CF90-11CF-8E43-00A0C911005A};VBE;&H00000000
&H00000002={000209F2-0000-0000-C000-000000000046};Word8.0;&H00000000
                                                            @ҋB  `                                           
  	           F   Microsoft Word Document 
   MSWordDoc    Word.Document.8 9q                                                                                                                                                                                                                                                                                                                                                                    
  i           8  @ 8   N o r m a l       CJ _HaJ mH	sH	tH	L    L  	 H e a d i n g   1     $$ P  @& a$  5>*CJ \ R @  R  	 H e a d i n g   2     $$ P<  @&a$  5CJ W <f\B    B  	 H e a d i n g   3     $ ,P   @& >*CJ              < A@ <   D e f a u l t   P a r a g r a p h   F o n t             . >@  .   T i t l e     $a$	 5;\ 6 J@ 6   S u b t i t l e     $a$ 5;>*\" W@ "   S t r o n g    5\,   ",   H e a d e r      !   ,    2,   F o o t e r      !   < B  B<  	 B o d y   T e x t      P<      CJ X C@ RX   B o d y   T e x t   I n d e n t   !  $ P    ^a$  CJ        	                                                           	  	  2         z         	                  R   h        f        
              0  1  t  u              t  u              2  3  4                  Y  Z      $  -  8  Y  Z  \                                               C  D  E  U  V  e  f  g  w  x                               	  	  	  	  	  	  	  	     0          @   0          @   0          @   0              0              0              0          @  0          @  0          @   0          @   0          @  0          @  0          @   0              0          @   0          @   0          @   0          @   0       }  @   0          @   0          @   0          @   0       }  @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0       }  @   0          @   0          @   0          @  0          @  0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0       7  @   0       7  @   0          @   0       7  @   0          @   0       7      0          @   0          @   0       7  @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0              0              0              0              0              0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0          @   0              0                                                                    w  
    
              	  
          w                                            
                     D  b  d    5  7  8  V  X  Y  w  y              	  WWWWWWWW                                                        	                                                                                                        / X   2 $   o\Ս0u q        2 $   ,[k{
8 k        @                           0    (    	                    
          B    
        S              	   ?          	          	  	  	           	  	  	                    D  e                z          #  #  ]  k                                    U  U  V  V  w  w  x  x                   	  	  	                                                               n 3 4 e l r 3 S : \ A D M I N \ T E M P L A T E S \ U t i l i t i e s \ 2 f o r c e a c c t b u c k s l i p . d o t       1  2  8  Y  Z  \                                               C  D  E  U  V  e  f  g  w  x                               	  	  	  	  	  	  	                                                                                                                                @       E                    	     @      U n k n o w n                                   G  z                  T i m e s   N e w   R o m a n   5                       S y m b o l   3&  z                  A r i a l   "  q   h    /	'1	'JdF    [                               !                                                                                                                                                                                                                                                                                                                            r0    d      	          q                                                           2Q                                         D E P A R T M E N T   O F   T R A N S P O R T A T I O N          n 3 4 e l r  n 3 4 e l r                         