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HTML Version of the Expression of Interest Template

The HTML version is available for viewing only. Please download the template (MS Word Template - 40KB), fill it out, and return it as an attachment to your submittal or via U.S. mail. To view MS Word files you need the Microsoft Word Viewer.


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U.S. Department of Transportation
Federal Highway Administration

Tolling and Pricing Opportunities
Expression of Interest


If you have any questions completing this form, please contact Jennifer Ahlin at (202) 493-0334. Please complete all applicable information and attach this request via email to TollingandPricingTeam@dot.gov or via U.S. mail to:

Tolling and Pricing Team
Federal Highway Administration
Office of Innovative Program Delivery, Attn: Patrick DeCorla-Souza
1200 New Jersey Avenue, SE, Mail Stop E84-320
Washington, DC, 20590

Please copy your respective FHWA State Division Office



A) What is the requesting agency, authority, or public company? What is the lead office within the requesting agency, authority, or private company?

Name(s):


Project Website (if applicable) or Your Agency/Company Website:



B) Contact Information

Name:

Title:

Address:

Phone:

E-mail:


C) What is the requesting agency seeking? (Please mark appropriate box)
unchecked box Funding ONLY for this project or study (Federal authority already granted or not necessary).

unchecked box Federal Tolling Authority ONLY for this project or study (no funds requested).

unchecked box Funding AND tolling authority for this project or study.

unchecked box Other, not listed.

Please briefly elaborate:


D) Please provide a brief description of the tolling or pricing project or study. Please identify and describe the subject facility or general area to be tolled, priced or studied (i.e. name of project/study, location, length, level of service, problem to be addressed, etc.)?
empty text box



E) Which type of facility is proposed to be tolled or studied?
unchecked box Interstate

unchecked box Non-Interstate

unchecked box Project contains both types of facilities

unchecked box Project is not specific to any type of facility

F) Does the toll project involve ANY construction?
unchecked box No           unchecked box Yes (if so, please mark all that apply)         unchecked box Not applicable

unchecked box New construction                 unchecked box Expansion          unchecked box Rehabilitation        unchecked box Reconstruction

unchecked box HOV to HOT Conversion       unchecked box Other not listed.

Please briefly elaborate


G) Does an HOV lane(s) currently exist on the facility?
unchecked box No             unchecked box Yes             unchecked box Not applicable

H) What is the timetable to enact the tolling or pricing project or study?
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I) Are there expressions of support from public officials or the public? Have any public meetings been held? If no public meetings or expressions of support are available, please indicate the agency’s plans for ensuring adequate public involvement and seeking public support for the toll project or study.
empty text box



J) Where known (and if applicable), what is plan for implementing tolls or prices and the strategies to vary toll rates or prices (i.e., the formulae for variable pricing)?
empty text box



K) What is the reason(s) of the toll project or study? Please mark all that apply.
unchecked box Financing construction

unchecked box Reducing congestion

unchecked box Improving air quality

unchecked box Other not listed.

Please briefly elaborate:


L) Please provide a description of the public and/or private agency that will be responsible for operation, maintenance, and/or enforcement for the toll project or study?
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M) Please provide a description of how, if at all, any private entities are involved in the up-front costs, or will share in project responsibilities, debt retirement, or revenues?
empty text box



N) Please provide any additional information you feel is necessary.
empty text box


Expression of Interest-FHWA Office of Operations
Version 1.0 12/05

Office of Operations