"Supplementary Program Financial Information Form - Local Bridge Program" - Connecticut

Supplementary Program Financial Information Form - Local Bridge Program is a legal document that was released by the Connecticut Department of Transportation - a government authority operating within Connecticut.

Form Details:

  • Released on July 1, 2013;
  • The latest edition currently provided by the Connecticut Department of Transportation;
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CONNECTICUT DEPARTMENT OF TRANSPORTATION
L
B
P
OCAL
RIDGE
ROGRAM
SUPPLEMENTARY PROGRAM FINANCIAL INFORMATION
1
________________
FEDERAL PROJECT N
.
:
O
_______________
C
DOT PROJECT N
.:
ONN
O
Town/City/Borough of _______________________________
MUNICIPALITY:
_______________
BRIDGE N
.:
O
__________________________________________________________
LOCATION:
PERIOD COVERED: J
1,_______
J
30, _______ .
ULY
TO
UNE
Note that the period of expenditure may not span the whole fiscal year. However, for audit purposes, the “period covered”
must be the entire fiscal year.
CURRENT PERIOD /
FISCAL YEAR
TOTAL
PROGRAM/GRANT
EXPENDITURES
EXPENDITURES TO
2
3
4
4
IDENTIFICATION No.
PHASE
BY PHASE
DATE, BY PHASE
PE
ROW
UTILITY
CONST
CE
OTHER:
1
For projects with Federal funding.
2
The number used by the municipality to identify the account in financial records, such as the Tax Exempt Proceeds
Fund account number, or capital project number.
3
Preliminary Engineering (PE), Rights of Way (ROW), Municipally-Owned Utilities (UTILITY), Construction
(CONST), Construction Engineering/Inspection/Incidentals (CE), Other – provide explanation (OTHER)
4
The sum of the project expenditures should agree, in total, to the program/grant expenditures, and these costs
should agree with those in the municipal annual audit.
Rev. 07/13
CONNECTICUT DEPARTMENT OF TRANSPORTATION
L
B
P
OCAL
RIDGE
ROGRAM
SUPPLEMENTARY PROGRAM FINANCIAL INFORMATION
1
________________
FEDERAL PROJECT N
.
:
O
_______________
C
DOT PROJECT N
.:
ONN
O
Town/City/Borough of _______________________________
MUNICIPALITY:
_______________
BRIDGE N
.:
O
__________________________________________________________
LOCATION:
PERIOD COVERED: J
1,_______
J
30, _______ .
ULY
TO
UNE
Note that the period of expenditure may not span the whole fiscal year. However, for audit purposes, the “period covered”
must be the entire fiscal year.
CURRENT PERIOD /
FISCAL YEAR
TOTAL
PROGRAM/GRANT
EXPENDITURES
EXPENDITURES TO
2
3
4
4
IDENTIFICATION No.
PHASE
BY PHASE
DATE, BY PHASE
PE
ROW
UTILITY
CONST
CE
OTHER:
1
For projects with Federal funding.
2
The number used by the municipality to identify the account in financial records, such as the Tax Exempt Proceeds
Fund account number, or capital project number.
3
Preliminary Engineering (PE), Rights of Way (ROW), Municipally-Owned Utilities (UTILITY), Construction
(CONST), Construction Engineering/Inspection/Incidentals (CE), Other – provide explanation (OTHER)
4
The sum of the project expenditures should agree, in total, to the program/grant expenditures, and these costs
should agree with those in the municipal annual audit.
Rev. 07/13