PROJECT SCOPE STATEMENT
Date Prepared: Prepared By:
Project Stage: Project Name:
Highway: CSJ: County: Length: miles
Project Description:
Limits: From:
To:
Describe the project location as it currently is and what needs to be fixed, including # of
lanes, sidewalks, major intersections, structures, pavement scores, etc.
Project Need:
Describe the proposed work to be performed to address the project need.
Project Solution:
Include what type of work WILL NOT be performed in this project.
Project Exclusions:
Project Team: Project Manager Name
Design Lead Name
Designer Name
Designer Name
ENV Lead Name
ROW Lead Name
Utilities Lead Name
Traffic Lead Name
Construction Lead Name
Area Engineer’s Office Name
TxDOT
District Engineer Name
Stakeholders:
TP&D Name
UTP Team Name
External
Name
Stakeholders:
Name
Name
Name
Consultant: Project Manager Name
Design Lead Name
Sub Consultants Name
TxDOTCONNECT
Project comments:
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Other:
PROJECT CONSTRAINTS, ASSUMPTIONS, and RISKS
Provide a list of items that limit a project team’s options such as schedule, resources,
Constraints:
budget, and technology.
Provide a list of considerations that are considered true, certain, or real for planning
Assumptions:
purposes. (i.e. Project will not require additional ROW)
Risks: Provide a list of unknown occurrences that may affect the project for better or worse.
(Attach Risk Register) (i.e. New structures may impact existing wetlands)
MILESTONES
(attach P6 schedule) Target Date: Actual Date:
Start Date
30% PS&E Milestone
60% PS&E Milestone
90% PS&E Milestone
95% PS&E Milestone
100% PS&E Milestone
Ready to Let Date:
Proposed Let Date:
Est. Construction Start:
Est. Construction Finish:
BUDGET
Estimate Range
Item Minimum $ Maximum $
Planning
Preliminary
Engineering
(attach Estimate
Construction Spreadsheet)
Right Of Way
Utilities
Other 1
Other 2
TOTALS
INITIAL PROJECT NEEDS
Activity Completion Date Responsible
☐ Survey
☐ SUE
☐ Pavement Design
☐ Utility/ROW Permits
☐ Environmental (APD Stagegate Checklist)
☐ FAA Obstruction Evaluation
☐ Railroad Coordination
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☐ TPP Traffic Request
☐ Bridge Inspection Reports
☐ Crash Data
☐ Pedestrian/Bicycle Facilities
☐ Public Involvement meetings
☐ Other
REQUIRED AGREEMENTS, PERMITS and CERTIFICATIONS
Ye
No Responsible
s
Railroad Agreement
Names:
☐ ☐
Utility Escrow Agreement
Names:
☐ ☐
Third Party Funding Escrow Agreement
Names:
☐ ☐
☐ ☐ FAA Certification
☐ ☐ Construction Speed Zone
☐ ☐ Environmental Certification
☐ ☐ US Coast Guard Permit
☐ ☐ US Army Corps of Engineer Permit
☐ ☐ NOI (SWP3)
☐ ☐ Signal Agreements
☐ ☐ ROW Certification
☐ ☐ ROW Encroachment Letters
☐ ☐ Utility Certification
☐ ☐ Utility Permits/Agreements
☐ ☐ Other
PROJECT RESEARCH
Activity Completion Date Responsible
☐ Existing Typical Sections
☐ Existing Drainage Plans and Studies
☐ Existing Roadway Plans
☐ Existing Structure
☐ Existing ROW Map
☐ Existing Utilities
☐ Existing Utility Permits
☐ Pavement Scores
☐ Traffic Data
☐ Crash Data
☐ Initial Stagegate Checklist
☐ Other
☐
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☐
☐
Enter District/Division Name Page 4 of 4 Last reviewed: 06/28/2022