ROCIS-0572-0059- Spreadsheet Update 29 July 2020.xls

ROCIS-0572-0059- Spreadsheet Update 29 July 2020.xls

Telecommunications System Construction Policies and Procedures

OMB: 0572-0059

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USDA - RUS
Title of Information Document




OMB No.














Telecommunication Engineering & Construction





0572-0059











SUMMARY OF INFORMATION COLLECTION
Contracts




Date Prepared




















2020










INSTRUCTIONS:

> (f) TOTAL
(h) TOTAL
(k) TOTAL











Use this form when a single information collection document involves multiple reporting and


> - = (e) Average - = (g) Average - = (j) Average










recordkeeping requirements.


> (d) TOTAL
(f) TOTAL
(i) TOTAL











IDENTIFICATION OF REPORTING AND RECORDKEEPING REQUIREMENTS




ANNUAL BURDEN
















FORM

REPORTS


RECORDS













NO(s) NO. OF NO. OF TOTAL HOURS TOTAL NO. OF ANNUAL TOTAL










SECTION OF
(If "none" RESPON- RESPONSES ANNUAL PER HOURS RECORD- HOURS PER RECORD-










REGULATIONS DESCRIPTION so state) DENTS PER RESPONSES RESPONSE (Col. f & g) KEEPERS RECORD- KEEPING














RESPON- (Col. d & e)


KEEPER HOURS














DENT




(Col. i & j)










(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k)

































Construction Certification Program





































1753 Construction Work Plan and Cost Distribution 157 8 1 8 12.00 96.00










Subpart J










































1753 Certification of Contractor or Force Account Proposal 158 8 1 8 3.00 24.00










Subpart J Approval









































1753 Summary of Completed Construction 159 2 1 2 6.00 12.00













Subpart J










































1753 Certification Borrower Contract Addendum N/A 0 0 0 1.00 0.00













Subpart J

0 0 0








































































































Architects and Engineers Qualifications 179 6 1 6 2.00 12.00























































1753.48(g) Construction Change Order 216 60 1 60 1.00 60.00














● When changes or correction are necessary the borrower's



















engineer will prepare a construction change order. A copy


















of each is attached to the construction inventory required


















to close out the contract







































IDENTIFICATION OF REPORTING AND RECORDKEEPING REQUIREMENTS




ANNUAL BURDEN
















FORM

REPORTS

















NO(s) NO. OF NO. OF TOTAL HOURS TOTAL













SECTION OF
(If "none" RESPON- RESPONSES ANNUAL PER HOURS













REGULATIONS DESCRIPTION so state) DENTS PER RESPONSES RESPONSE (Col. f & g)

















RESPON- (Col. d & e)



















DENT
















(a) (b) (c) (d) (e) (f) (g) (h)




































Engineering and Architectural Services







































1753 Postloan Engineering Service Contract 217


















Subpart B ● Approval of Postloan Engineering Service Contract
66 1 66 7.00 462.00














● Approval of Postloan Engineering… - Broadband Program
5 1 5 7.00 35.00














The Postloan Engr. Serv. Contract inclds. using the following forms:




















RUS Form 217a-Project Design, Assistance and Coordination:




















RUS Form 217b-Central Office Equipment Engineering Services;




















RUS Form 217c-Transmission Facilities Engineering Services;




















RUS Form 217d-Building Engineering Services;




















RUS Form 217e-Outside Plant Staking Services;




















RUS Form 217f-Outside Plant Contract Doc. Phase Engr. Servs.




















RUS Form 217g-Outside Plant Construction Phase Engr. Servs.






















































































Miscellaneous Engineering Services Forms










































Assignment of Engineering Service Contract 242 0 0 0 0.50 0.00



































1753.15, Engineering Service Contract - Special Services - Telephone 245 1 1 1 0.75 0.75













81 ● Engineering services for minor construction may be




















contracted using Form 245 (This contract form does not

















require RUS approval).



















































































RE Act Equal Opportunity Addendum 270


















NAFTA ● Form 773 issued for minor construction by contract.
26 2.22 58 0.25 14.43














● Form 773, small scale constuction - Broadband Program
4 3.33 13 0.25 3.33



































IDENTIFICATION OF REPORTING AND RECORDKEEPING REQUIREMENTS




ANNUAL BURDEN
















FORM

REPORTS

















NO(s) NO. OF NO. OF TOTAL HOURS TOTAL













SECTION OF
(If "none" RESPON- RESPONSES ANNUAL PER HOURS













REGULATIONS DESCRIPTION so state) DENTS PER RESPONSES RESPONSE (Col. f & g)

















RESPON- (Col. d & e)



















DENT
















(a) (b) (c) (d) (e) (f) (g) (h)



































1753.49 Bidder's Qualifications




















● Submission of bidders' qualifications to the borrower and its 274 51 3.8 194 1.00 193.80














engineer.







































1753.49 Bidder's Qualifications for Buried Plant Construction


















● Submission of bidders' qualifications to the borrower and its 276

















engineer.
46 3.8 175 1.00 174.80

































175349 Tabulation of Materials Furnished by Borrower


















● Closeout of major outside plans construction by contract. 281

















60 3.84 230 2.00 460.80













1753.8(b) Subcontracts (Under Construction or Equipment)


















● Approval of subcontracts (per 1753.8(b)) 282 334 2.28 762 0.75 571.14



































1753.16 Certificate of Architect


















● Approval of final statement of cost-architectural services 284 0 0 0 0.50 0.00














● Approval of final statement… - Broadband Program 284 0 1 0 0.50 0.00

























































1737 Interim Financing Construction 375















Subpart E Telecommunications Program
25 1.2 30 0.25 7.50














Broadband Program
0 0 0 0.25 0.00



































1753.38 Software License Agreement 390

















Telecommunications Program
0 1.6 0 1.00 0.00














Broadband Program
0 5.4 0 1.00 0.00



































IDENTIFICATION OF REPORTING AND RECORDKEEPING REQUIREMENTS




ANNUAL BURDEN
















FORM

REPORTS

















NO(s) NO. OF NO. OF TOTAL HOURS TOTAL













SECTION OF
(If "none" RESPON- RESPONSES ANNUAL PER HOURS













REGULATIONS DESCRIPTION so state) DENTS PER RESPONSES RESPONSE (Col. f & g)

















RESPON- (Col. d & e)



















DENT
















(a) (b) (c) (d) (e) (f) (g) (h)






































































































Statement of Engineering Fees - Telecommunications

















1753.17 ● Estimates 506 66 1 66 6.00 396.00














● Estimates - Broadband Program
5 1 5 6.00 30.00













1753.17 ● Final
66 1 66 6.00 396.00














● Final - Broadband Program
5 1 5 6.00 30.00



































IDENTIFICATION OF REPORTING AND RECORDKEEPING REQUIREMENTS




ANNUAL BURDEN
















FORM

REPORTS

















NO(s) NO. OF NO. OF TOTAL HOURS TOTAL













SECTION OF
(If "none" RESPON- RESPONSES ANNUAL PER HOURS













REGULATIONS DESCRIPTION so state) DENTS PER RESPONSES RESPONSE (Col. f & g)

















RESPON- (Col. d & e)



















DENT
















(a) (b) (c) (d) (e) (f) (g) (h)




































Major Outside Plant Construction





































Telephone System Construction Contract (Labor and Materials)



















1753.47 ● Approval of plans and specifications for major outside 515

















plant construction by contract
60 3.8 228 4.00 912.00













1753.48 ● Approval of the outside plant contract
60 3.8 228 6.00 1368.00














● Approval of plans and specifications for major outside


















plant construction by contract - Broadband Program
0 1.4 0 8.00 0.00














● Approval of the outside plant contract - Broadband
0 1.4 0 4.00 0.00













1753.48 ● Owner-Furnished Materials Information included under RUS Form 787 below.

















1753.48 ● Approval of negotiated contracts
3 1 3 2.00 6.00














● Approval of negotiated contracts - Broadband
1 1 1 4.00 4.00














● Owner-Furnished Materials - Broadband Information included under RUS Form 787 below.





























































1753.39 Results of Acceptance Test 517 0 2.02 0 1.00 0



































1753.57 Biweekly Progress Report of Telephone Construction




















and Engineering Service 521 2 26 52 1.00 52





































































































1753.49 Statement of Construction Telephone System - Outside Plant



















Subpart F ● Closeout of major outside plant construction by contract 527 60 2.02 121 1.25 151.50



































IDENTIFICATION OF REPORTING AND RECORDKEEPING REQUIREMENTS




ANNUAL BURDEN
















FORM

REPORTS

















NO(s) NO. OF NO. OF TOTAL HOURS TOTAL













SECTION OF
(If "none" RESPON- RESPONSES ANNUAL PER HOURS













REGULATIONS DESCRIPTION so state) DENTS PER RESPONSES RESPONSE (Col. f & g)

















RESPON- (Col. d & e)



















DENT
















(a) (b) (c) (d) (e) (f) (g) (h)






































































































Miscellaneous Outside Plant Construction Forms









































1753.49 Final Inventory, Telephone Construction Contract




















(Labor and Materials) 724 60 2.02 121 0.75 90.90














● Closeout of major outside plant construction by contract





































1753.49 Final Inventory, Telephone Construction Contract


















(Labor and Materials) - Detailed 724a 60 2.02 121 3.00 363.60














● Tabulation of Assembly Units







































1753.49 Final Inventory, Telephone Construction Contract


















(Labor and Materials) - Detailed 724b 0 2.02 0 0.75 0.00














● Removals





































1753.78 Certificate of Contractor and Indemnity Agreement


















(Line Extensions) 743



















● Upon completion and inspection the borrower obtains


















from the contractor a final invoice and Form 743
26 2.22 58 0.50 28.86














● Upon completion and inspection the borrower obtains




















from the contractor a final invoice and Form 743 - Broadband
4 2.33 9 0.50 4.66













































































IDENTIFICATION OF REPORTING AND RECORDKEEPING REQUIREMENTS




ANNUAL BURDEN
















FORM

REPORTS

















NO(s) NO. OF NO. OF TOTAL HOURS TOTAL













SECTION OF
(If "none" RESPON- RESPONSES ANNUAL PER HOURS













REGULATIONS DESCRIPTION so state) DENTS PER RESPONSES RESPONSE (Col. f & g)

















RESPON- (Col. d & e)



















DENT
















(a) (b) (c) (d) (e) (f) (g) (h)




































Contract Closeout Certification

















1753.18 ● Non-form certification N/A 60 1 60 0.50 30.00














● Broadband Program 756 0 1.6 0 0.50 0.00



































1753.81-82 Summary of Work Order


















Inspection by GFR 771 30 2.23 67 0.50 33.45














Inspection by licensed Engineer or Borrower's Staff Engineer 771a 26 2.22 58 0.50 28.86














Broadband Program 771a 4 2.33 9 0.50 4.66



































1753 Miscellaneous Construction Work and Maintenance


















Service Contract 773



















● Issued for minor construction by contract
26 2.22 58 2.00 115.44














● Issued for small-scale construction -Broadband Program
4 2.33 9 3.00 27.96

































1753.48 (f) Supplement A to Construction Contract RUS Form 515 787

















● Approval for the borrower to furnished materials for outside


















plant construction by contract
26 3.85 100 0.25 25.03














● Approval for the borrower to furnished materials for outside




















plant construction by contract - Broadband
1 5 5 0.25 1.25

































1753.58 Telephone Force Account Construction - Final Inventory




















Closeout of major outside plant construction by force account 817 2 2.22 4 2.00 8.88















817a 2 2.22 4 2.00 8.88















817b 2 2.22 4 2.00 8.88



































1753.15 Preloan Engineering Service Contract, Telephone

















(a)(2) System Design 835 0 0 0 0.75 0.00

































1753.80 (g) Minor construction - request to establish a work order fund


















for specific construction project n/a 0 0 0 2.00 0.00














Minor construction - request to establish a work order fund




















for specific construction project - Broadband n/a 0 0 0 2.00 0.00

































1753.27 Construction of building - award of contract



















n/a 0 1 0 2.00 0.00













1753.48 (a) Outside plant major construction - award of construction in


















accordance with procedures n/a 60 3.8 228 1.50 342.00



































1753.48 (b) Outside plant major construction - RUS approval of negotiated n/a 9 1 9 1.50 13.50














proposals









































1753.68 (b) Special equipment - approval of the


















proposal for initial purchase of equipment n/a 0 0 0 1.50 0.00














Core network and access equipment - approval of the




















proposal for initial purchase of equipment - Broadband n/a 0 0 0 1.50 0.00



































IDENTIFICATION OF REPORTING AND RECORDKEEPING REQUIREMENTS




ANNUAL BURDEN
















FORM

REPORTS

















NO(s) NO. OF NO. OF TOTAL HOURS TOTAL













SECTION OF
(If "none" RESPON- RESPONSES ANNUAL PER HOURS













REGULATIONS DESCRIPTION so state) DENTS PER RESPONSES RESPONSE (Col. f & g)

















RESPON- (Col. d & e)



















DENT
















(a) (b) (c) (d) (e) (f) (g) (h)



































1753.36 Core network and access equipment - request for approval


















to negotiate for the purpose of standardization on a n/a 0 1 0 1.25 0.00














system basis


















Core network and access equipment - request for approval




















to negotiate for the purpose of standardization on a




















system basis - Broadband n/a 0 1 0 1.50 0.00

































1753.3 During the preconstruction review, obtain approval for any




















construction that does not conform to RUS standards and n/a 0 0 0 1.50 0.00














specifications or the approved Loan Design





































1753.6 Approval to use other than new or nonstandard materials


















and equipment n/a 0 0 0 1.50 0.00














Approval to use other than new or nonstandard materials


















and equipment - Broadband n/a 0 0 0 1.00 0.00

































Total burden hours for forms approved under OMB Docket 0572-0059

1,432 2.317 3,319 1.9918 6,609.86


























































FORMS APPROVED UNDER OTHER OMB DOCKETS





















Forms approved under OMB Docket No. 0572-0107

















1753, 1788 Contractor's Bond 168b 60 2.06 124 0.02 1.98













1753, 1788 Contractor's Bond (less than $1 million) 168c 0 1 0 0.02 0.00













1753.30 Certificate of Completion - Contract Construction for Building 181 1 1 1 0.10 0.10














Closeout of Contract Form 257 for Building Construction.









































1753 Certificate ("Buy American") 213 0 0 0 0.02 0.00































1753 Equipment Contract 395 74 2 148 1.50 419
Subpart E, H










































1753.37, 38, Certificate of Completion, Equipment Contract 395a 98 1.29 126 0.50 63.21













39, 68 (Including Installation)









































1753.37, 38, Certificate of Completion, Equipment Contract 395b 49 1.29 63 0.50 31.61













39, 68 (Not Including Installation)









































1753.37, 38, Certificate of Contractor and Indemnity Agreement 395c 98 1.29 126 0.50 63.21













39, 68 (Use only for installation contracts)









































1753.37, 38, Report in writing, including all measurements, any 395d 98 1.29 126 0.75 94.82













39, 68 acceptance test report and other information required under




















Part II of applicable specifications









































1753.30, Waiver and Release of Lien 224 60 1.95 117 0.02 1.87













39, 49 ● Closeout of Contract Form 257 for building construction

















● Closeout of major outside plant contraction by contract





































1753.30, Certificate of Contractor 231 1 1 1 0.02 0.02













39, 49



















1753.11, Construction or Equipment Contract Amendment 238 34 1.83 62 0.02 1.00













28, 38, 68



















1753 Contract to Construct Building 257 1 1 1 0.08 0.08













Subpart D





















Bid Bond 307 70 2.06 144 0.02 2.31






































Form approved under OMB Docket No. 0572-0023

















1744.66 Financial Requirements Statement 481 211 2.22 468 2.00 936.84






































Form approved under OMB Docket No. 0572-0074

















1744.66 Certification of Authority 675 25 2.16 54 0.10 5.40






































Form approved under OMB Docket No. 0572-0118

















Subpart B Architectural Services Contract 220 2 1 2 1.00 2.00



































Total burden hours for forms approved under other OMB Dockets

572.00 3 1,564.91 1.04 1,622.93













File Typeapplication/vnd.ms-excel
AuthorDawn Wolfgang
Last Modified ByJones, Robin.M - RD, WASHINGTON, DC
File Modified2020-11-12
File Created1999-05-21

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