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Chapter 90 Forms

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Chapter 90 Program

  • Project Request Form [24KB]

    The City/Town uses this form to confirm eligibility of a specific project under Chapter 90. This information on the form should provide all details of work to be done, and list all Memorandum of Agreements numbers to be used under Chapter 90. The District Highway Director, with assistance from the District State Aid Engineer, certifies the eligibility of the project.
  • Preliminary Estimate Form [55KB]

    This form is submitted by the city/town to the District Office in order to calculate an initial estimate for the work to be completed under the CH 90 Project being requested. This form should accompany the Chapter 90 Project Request Form.
  • Summary of Bids Form [538KB]

    This form lets MassDOT know that the municipality has procured the goods/services properly by submitting the list of bidders with a notation of the winning bidder.
  • Environmental Punch List [65KB]

    The City/Town submits this form to the District Office to certify environmental approvals and compliance. This form should accompany the Chapter 90 Project Request Form.
  • Reimbursement Request [562KB]

    The City/Town submits this form to document expenditures in order to request reimbursement for previously approved Chapter 90 Projects. This form is submitted with the Chapter 90 List of Materials HED-454 Form and/or the Chapter 90 Payroll HED-600 Form, as well as, copies of invoices.
  • Payroll (600) Form [158KB]

    This form is used by the City/Town to record personnel time used on a specific project under the Chapter 90 program. It is forwarded to and used by the District State Aid Engineer to verify that all personnel and their time qualify under the specific authorizing legislation tied to the Memorandum of Agreement being used to fund the project. This form should accompany the Chapter 90 Final Report.
  • List of Materials (454 Form) [62KB]

    This form is used by the City/Town to record materials used on a specific project under the Chapter 90 program. It is forwarded to and used by the District State Aid Engineer to verify that all materials and their quantities qualify under the specific authorizing legislation tied to the Memorandum of Agreement used to fund the project. This form should accompany the Chapter 90 Final Report.
  • Final Report [88KB]

    This form is to be completed by the municipalities when Chapter 90 approved projects are finalized.
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