2016 Measure B Planning/Non-Capital Projects Complete Streets Checklist

2016 Measure B Planning/Non-Capital Projects Complete Streets Checklist
The 2016 Measure B Program requires all planning projects to consider Complete Streets improvements and to incorporate pedestrian, bicycle, transit infrastructure, green infrastructure, or information technology improvements identified in local, regional, or countywide planning documents if they fall within the project limits, unless an exception is declared and approved by the 2016 Measure B Program.
INSTRUCTIONS
- Use this form only for planning projects that receive 2016 Measure B funding through the Bicycle and Pedestrian Planning Studies Competitive Grant Program. Capital projects and pavement programs funded by 2016 Measure B Local Streets and Roads should use separate forms:
  - Local Streets & Roads Pavement Program Complete Streets Self-Declaration Form
  - Capital Projects Complete Streets Self-Declaration Form
- Transit operations and education/encouragement programs funded by 2016 Measure B are not required to fill out this form.
- You can navigate through the form by clicking individual tabs on the top of this form.
- You can save your work by clicking the "Save" button at the bottom of the page. You will be prompted to either sign up with an email account, or "skip create an account". If you chose not to create an account, you will be asked to enter an email address to receive a shareable link. You or your colleague may use the same link to continue working on the application.
  - Note: if you have submitted the project checklist and wish to make edits, you must go back to the submission and click "submit" again to save the changes. There will not be a "save" button in the re-submission.
- The form must be signed by the Public Works Director, Agency Manager, equivalent senior level staff, or his/her designee.
- Submit form when requesting funding. Submit an updated form with each new funding request or when project enters another major phase.
- VTA 2016 Measure B Program Office will post the completed form on the Transparency Website.
- Please email 2016MeasureB@vta.org if you have any questions.
To ensure ease of signature through Jotform:
1) Be prepared to share the login information for the account filling out the application, if the signee is not the one filing out the form. The signee may login to the account to sign the form OR
2) Do not make an account – this will create a shareable link for the application that can be sent to the signee when ready.
PART 1: SPONSOR INFORMATION
1. Project Sponsor(s)*
List the primary project sponsor first and any other project partners.
2. Person to contact regarding this Complete Streets Checklist:*

First NameLast Name
3. Email*
example@example.com
4. Phone Number*
Please enter a valid phone number.
PART 2: PROJECT INFORMATION
5. Project Name*
6. Project Limits*
7. Project Map (Geospatial Format)*

Maximize size of each file upload: 10.6MB. You can upload multiple files. Acceptable formats are: shp, dbf, shx, geojson, json, gml, kml, kmz, xml.
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8. Project Map (Image Format)*

Project map should include a scale. Maximize size of each file upload: 10.6MB. You can upload multiple files. PDF and JPG are preferred.
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9. Project Description*
Describe the project scope, purpose, and need briefly. Provide a project webpage URL, if applicable.
10. Checklist status*

First submittal for this projectUpdate of a prior submittal
11. Are you requesting a project-level exception? Project sponsor requests that the project not be required to fill out the Complete Streets checklist under the following exceptions(s):*

Yes. Funding will be used for a freeway mainline project that does not impact or modify the local transportation network (e.g., local roadways, shared use paths, bicycle/pedestrian bridges, etc.)Yes. Funding will be used for emergency maintenance, repair, or reconstruction.Yes." Other" justification for project-level exception. (Detail answer in box below).No. You will complete the remaining questions in the checklist.
11.a If "Yes. 'Other'", justify the project's request for a project-level exception.
NOTE: If project sponsor selects 'Yes' in question 11 and requests a project-level exception, you can skip to the end of the checklist for exception declaration and DocuSign signature.

PART 3: EXISTING CONDITIONS
11. What are the major trip generators within the study corridor, if any (existing and future)?*

SchoolsMajor EmployersCommunity Resources/DestinationsMedium to high-density residentialHealthcare facilitiesDaily Needs (grocery, retail, etc)Other
11.a If "Other" was selected, list below.

12. How do people travel through the study area, now or in the future? Applicants are required to provide data for all modes that currently travel through the study area.*

	Travels through project limits now	Will travel through project limits in the future?	Have counts been conducted?	Count* data (peak period)
Bicycle
Pedestrian
Heavy Rail Transit (BART, ACE, Caltrain)
VTA Light Rail Transit
Bus Transit
Motorist
Heavy Vehicles

*Project sponsors are required to provide transit ridership data (average weekday ridership of stops in the project area) and volumes. Volumes for other modes should be provided for at least one mid-block location during a peak period. Please include specific location(s) of count, date conducted & data source in question 12.a.

Useful links:
12.a. Please briefly describe specific location(s) of count, date conducted & data source. Define the "peak period" used. If counts are not conducted, indicate when project will collect counts and potential collection method.*

13. Some user groups require special accommodations. Which user groups are anticipated to travel through the project frequently, now or in the future? NOTE: While all projects must accommodate children, seniors, and people with disabilities, this question is intended to identify if there are unusual circumstances that may warrant accommodations above legal mandates.*

	Frequently travels through project limits now	Will frequently travel through project limits in the future	Note any nearby schools, senior centers, services for people with disabilities
People 18 Years or Younger
People 65 Years or Older
People with Visual Impairments
People with Auditory Impairments
People with Mobility Impairments

14. Describe how the planning effort addresses the needs of those with increased access or mobility requirements such as the user groups listed in the table above.*

PART 4: INFRASTRUCTURE
15. Briefly describe the improvements to pedestrian infrastructure included in this study. Does the study examine any gaps in the pedestrian network? *
16. Briefly describe the improvements to bicycle infrastructure included in this study. Does the study examine any gaps in the bicycle network? *
17. Briefly describe the improvements to green infrastructure and storm water management systems included in this study. Please include quantities and locations if known.*

PART 6: EQUITY
19. Identify vulnerable communities that either exist within the study area, or will benefit from the study. Describe how the identified vulnerable communities will benefit. Vulnerable communities include persons with Limited English Proficiency (LEP), persons with disabilities, minority persons, low-income persons, older adults (65 and older), youth (5–18 years old), and communities disproportionately impacted by past discriminatory practices. Applicant may also use CalEnviroScreen 4.0 or MTC Equity Priority Community (EPC) as designations, if applicable. *

PART 7: SAFETY

20. How many reported pedestrian, bicycle, and vehicle collisions have occurred within the project limits within the most recently available 3-year timeframe? Utilize local sources or TIMS and note near crashes (if data is available).*

	Total Severe Injury	Total Fatal	Total Number of Injuries	Timeframe	Data source
Pedestrian-involved collisions
Bicycle-involved collisions
Motor vehicle-only collisions

21. Is the study area a concern for near-miss collisions? Provide detail as applicable. *
22. How will the study address, if at all, the safety of users within the study area?*

PART 8: PUBLIC INPUT

Purpose of this section is to document any public input and community engagement process.
23. Have you solicited input from existing/future bicycle, pedestrian, transit users, or vulnerable communities of the project?*

Yes, please answer question 24.No, please answer question 25.
24. If "Yes" to Question 23, please identify key user groups that were engaged and briefly describe how input was solicited. Please also list the major comment themes and how project addresses these comments.
25. If "No" to Question 23, please list planned public engagement activities and identify key user groups in your engagement plan.
26. How was input from the Bicycle and Pedestrian Advisory Committee (BPAC) or equivalent committee solicited? Consider involvement from local, neighboring, or VTA BPAC.*

Presentation(s) at BPACInvitation for BPAC members to participate in public outreach meetings, surveys, other outreach activities related to the projectBPAC member(s) participated in working group, subcommittee, or other group to provide inputOther
27. How may the public comment on your project?*
For example, you can provide a webpage and project contact email to receive public comments.

PART 9: EXCEPTIONS TO PROVIDING COMPLETE STREETS
The expectation is that pedestrian, bicycle, and transit infrastructure or information technology systems identified in local, regional, or countywide planning documents will be incorporated into transportation projects receiving funding if they fall within the project limits.

However, exceptions will be considered where exceptional circumstances prohibit adherence to this policy. Infrastructure or technology that is identified in a local, regional, or county planning document may be excluded from a transportation project in circumstances where:
- The cost of providing the Complete Streets element is disproportionate to the overall cost of the project, as set forth in the Federal Highway Administration Accommodating Bicycle and Pedestrian Travel.
- A roadway user is legally prohibited from using the transportation facility.
- There is an absence of existing and future need.
- Detrimental environmental or social impacts outweigh the need for the infrastructure or technology.
NOTE: Declaring an exception does not automatically disqualify a project from receiving 2016 Measure B funding. The purpose of the declaration is to publicly document the rationale behind design decisions.
28. Please check one:*

Project sponsor has no exceptions to declare.Project sponsor has determined that there is at least one exception where pedestrian, bicycle, or transit infrastructure, or information technology systems identified in local, regional, or countywide plan and falling within the project limits is not being incorporated in this project.
30. If there is at least one exception to providing complete streets, please describe the exception(s), explain the justification for the exception and provide supporting documentations if needed.
File Upload: Supporting documents for the exception.

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PART 10: REVIEW & SIGN
The completed Checklist must be reviewed and signed by Public Works Director, Agency Manager or equivalent senior level staff or his/her designee. You only need to sign using one of the methods below -- either through the Docusign Widget or through the Handsign Widget.

Please forward the URL of this form to the signee to enter the email and name for DocuSign. The signee does not need a DocuSign to complete this signature process.

You can click "Print PDF" to save a copy of this Checklist.

MAKE SURE TO SUBMIT THIS ENTIRE FORM AFTER SIGNING USING THE "SUBMIT BUTTON" AT THE BOTTOM OF THE PAGE.
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2016 Measure B Planning/Non-Capital Projects Complete Streets Checklist

PART 1: SPONSOR INFORMATION

PART 2: PROJECT INFORMATION

PART 3: EXISTING CONDITIONS

PART 4: INFRASTRUCTURE

PART 5: PLANNING GUIDE & DESIGN MANUALS

PART 6: EQUITY

PART 7: SAFETY

PART 8: PUBLIC INPUT

PART 9: EXCEPTIONS TO PROVIDING COMPLETE STREETS

PART 10: REVIEW & SIGN