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Forms and Documents

Links

Books and Documents

Templates

The links below provide access to the most up-to-date versions of the document templates, to be used by consultants providing utility coordination services to the Utility Section of the NHDOT.


Template Name Description
Pole Relocation Summary Sheet Spreadsheet used to summarize existing and relocated utility pole locations.
Process Guide Spreadsheet used by Utility Coordinators to track the progress of a project.
Water and Sewer Checklist Spreadsheet used by Utility Coordinators to ensure the completeness of water and sewer line submissions made by consultants and utility companies.
Telephone, CATV & Communication 1st Verification Letter A letter sent to telephone, cable TV and Communications companies requesting information regarding their facilities in a project area.
Fire Department 1st Verification Letter A letter sent to fire departments requesting information regarding their facilities in a project area.
Gas Line 1st Verification Letter A letter sent to natural gas companies requesting information regarding their facilities in a project area.
Power 1st Verification Letter A letter sent to power companies requesting information regarding their facilities in a project area.
Sewer 1st Verification Letter A letter sent to sewer companies requesting information regarding their facilities in a project.
Steam 1st Verification Letter A letter sent to steam companies requesting information regarding their facilities in a project area.
Water and Fire 1st Verification Letter A letter sent to municipalities where the fire department manages a water system and possibly fire alarm cable requesting information regarding their facilities in a project area
Water and Sewer 1st Verification Letter A letter sent to municipalities where a single department manages both the water and sewer systems requesting information regarding their facilities in a project area.
Water 1st Verification Letter A letter sent to water companies requesting information regarding their facilities in a project area.
2nd Verification Letter A general letter sent to any utility company requesting additional information regarding their facilities in a project area.
Advance ROW Purchase Request Memo A memo written to the Bureau of Right-of-Way requesting early purchase of property to accommodate utility relocations.
Force Account Routing Form Document for routing force account for execution and distribution.
Force Account Agreement Master agreement for most force account agreements.
Amendment to Agreement Master document for creating an amendment to a previously executed agreement.
PSNH Installation Supplemental Agreement Agreement that references a master agreement between the NHDOT and PSNH and used to reimburse PSNH for lighting installations.
PSNH Relocation Supplemental Agreement Agreement that references a master agreement between the NHDOT and PSNH and used to reimburse PSNH for the relocation of PSNH facilities within PSNH-owned rights-of-way.
Agreement Cover Letter Cover letter for any of the above-mentioned agreement types.
Agreement Authorization to Proceed Letter Letter authorizing the commencement of work to be performed under the executed agreement.
Use and Occupancy Agreement Agreement that allows a utility to occupy either Controlled Access Right-of-Way of Limited Access Right-of-Way.
Use and Occupancy Cover Letter Cover letter for a Use and Occupancy permit submission.
Use and Occupancy Completion Letter Letter notifying utility of the completion of an executed Used and Occupancy permit.
Bid Invitation Letter Letter inviting a utility to witness the opening of bids. Used primarily when the State's Contractor will perform utility relocation work.
Bid Payment Request Letter Request to a utility to pay their portion of work to be performed by the State's Contractor. The letter states the successful bidder's estimate for the utility work.
Easement Submission Memo Memo written to the Bureau of Right-of-Way accompanying easement documentation from a utility company and requests that the bureau includes the information on the Right-of-Way plans.
Light Estimate Request Letter Letter to a utility company requesting an estimate for proposed highway lighting.
Force Account Estimate Request Letter Letter to a utility company requesting an estimate for utility relocation work.
Federal Cover Letter for Executed Agreement Cover letter sent to Federal Highway Administration accompanying an executed agreement (force account, supplemental, or amendment) for approval. Used only on federal oversight projects.
Federal Cover Letter for
Un-executed Agreement
Cover letter sent to Federal Highway Administration accompanying an unexecuted agreement (force account, supplemental, or amendment) for approval. Used only on federal oversight projects. Also, this letter is only used when unforeseen circumstances require special authorization in order for the utility work to proceed.
Late Submission Letter Letter sent to a utility company when they have missed a submission deadline by more than two weeks.
Longitudinal Exception Request Memo Exception request to the NHDOT Commissioner for longitudinal utility installations with the Limited Access Right-of-Way.
Pole Approval Letter, Maintainer Letter written to a pole maintainer approving a proposed pole relocation plan.
Pole Approval Letter, Co-Owner Letter written to a pole co-owner approving a proposed pole relocation plan.
Pole Approval Letter, Tenant Letter written to a pole tenant approving a proposed pole relocation plan.
Pole Relocation Request Letter, Maintainer Letter written to a pole maintainer requesting that specified poles be relocated. Accompanied by plans, cross sections, and a Pole Relocation Summary Sheet.
Pole Relocation Request Letter, Co-Owner Letter written to a pole co-owner requesting that specified poles be relocated. Accompanied by plans and a Pole Relocation Summary Sheet.
Pole Relocation Request Letter,Tenant Letter written to a pole tenant indicating that a relocation request has been made to the maintainer and co-owner for the relocation of specified poles. Accompanied by plans and a Pole Relocation Summary Sheet.
Utility Section Prosecution of Work Sample Used to develop the Utility Section of the Prosecution of Work.
Pre-Hearing Utility Meeting Invitation Letter inviting utility company representatives to a Pre-Hearing Utility Meeting.
Received Bids Letter Letter written to advise utility companies that a project has been advertised for bids. Accompanied by half-scale plans and a copy of the Prosecution of Work and Traffic Control plans for review.
Survey Request Form Form requesting that the Survey Section perform specified survey work.
Transmittal Letter Form used when sending documents within the NHDOT or in some cases to utility companies when a specific letter does not apply.
Utility & Railroad Certificate Utility & Railroad Certificate for all projects.
Underground Relocation Request Letter Letter written to an owner of an underground utility facility requesting that a plan be submitted outlining utility relocations at specified locations. Accompanied by plans and cross sections.
Utility Evaluation Memo 30% Memo written to the Project Manager outlining possible utility impacts to a project as determined at the time of the Pre-Hearing Utility Meeting.
Utility Evaluation Memo 70% Memo written to the Project Manager outlining relocation requirements as determined at the Slope and Drain stage of plan development.
Utility Request Form Form used by design teams requesting utility coordination efforts (verification requests, relocation requests or lighting design) be performed.
Underground & pole relocation request letter, maintainer Letter written to pole maintainer, requesting that specified poles and underground facilities be relocated. Accompanied by plans, cross sections and Pole Relocation Summary Sheet.
Underground & pole relocation request letter,
co-owner
Letter written to pole Co-owner, requesting that specified poles and underground facilities be relocated. Accompanied by plans, cross sections and a Pole Relocation Summary Sheet.
Underground & pole relocation request letter, tenant Letter written to pole tenant, requesting that specified poles and underground facilities be relocated. Accompanied by plans, cross sections and a Pole Relocation Summary Sheet.
Underground relocation approval letter Letter written to utility approving a proposed underground relocation plan.
Force Account Agreement completion letter Letter written to utility notifying that agreement process has been completed.

 





New Hampshire Department of Transportation
PO Box 483 | 7 Hazen Drive | Concord, NH | 03302-0483
Tel: 603.271-3734 | Fax: 603.271.3914

copyright 2015. State of New Hampshire