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pdfU.S. Department
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FAA Form 5100-144, Bipartisan Infrastructure Law,
Airport Terminal and Tower Project Information
Paperwork Reduction Act Burden Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor
shall a person be subject to a penalty for failure to comply with a collection of information
subject to the requirements of the Paperwork Reduction Act unless that collection of information
displays a currently valid OMB Control Number. The OMB Control Number for this information
collection is 2120-0806. Public reporting for this collection of information is estimated to be
approximately 6 hours per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, completing and reviewing the
collection of information. All responses to this collection of information are required to obtain or
retain a benefit under the Bipartisan Infrastructure Law (BIL) (P.L. 117-58). Send comments
regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden to: Information Collection Clearance Officer, Federal
Aviation Administration, 10101 Hillwood Parkway, Fort Worth, TX 76177-1524.
Instructions for FAA Form 5100-144,
Bipartisan Infrastructure Law,
Airport Terminal and Tower Project Information
This form is provided to assist airports in completing the submission requirements established in
the related Notice of Funding Opportunity published in the Federal Register. The FRN requires
requests to be submitted via email. This form lets the FAA process requests more quickly based
on uniform information responsive to the FRN. Do not include any Personal Identifiable
Information in the open text boxes.
Once the form is complete, save a copy of the form electronically to your files for future
reference. Next, scroll to the bottom of the form and choose the “Submit” button. That creates
a new email message with the PDF attached. Or, as a backup method, you can manually email
the form to: [email protected].
Using Digital Signatures: This form allows digital signatures. To access the digital signature
field, save this form to your computer and then reopen it with a PDF reader or editor. The
signature field often does not display when the form is viewed within a web browser.
FAA Form 5100-144 (07/22)
Page i of vi
General Airport Information
Airport Name
Enter the official airport name.
LOCID
Enter the airport’s FAA location identifier code.
Point of Contact’s Name
The Point of Contact (POC) must be the Airport Sponsor.
Point of Contact’s Title
Enter the Airport POC’s Title.
POC’s Phone Number and Extension
Enter the Airport POC’s phone number. The form formats the number when you proceed
to the next field.
If there is an extension number, enter it in the next field after the phone number.
POC’s Email Address
Enter the Airport POC’s email address.
Project Overview
Project Type
Choose the project type (Terminal or Tower).
Multi-Modal Terminal
Choose Yes or No. Choose “Yes” if your project incorporates a connection to another
mode of transportation (i.e. Bus or Rail Station).
Current Project Stage
Choose the stage of the project for which you are requesting funding (Planning,
Environmental, Design or Construction)
Project Description
In 600 characters less, enter a complete project description.
Target Timeframes
•
Date Project Costs Known. Enter the month and year that all project costs will be
known (e.g. professional services contract, bids or GMP received) (mm/yyyy).
•
Date Grant Fully Executed. Enter the month, day, and year the sponsor can fully
execute the grant offer based on known project costs (mm/dd/yyyy).
FAA Form 5100-144 (07/22)
Page ii of vi
•
Construction Start Date. Enter the construction start date month and year
(mm/yyyy).
Project Status
Total (Estimated) Project Cost
Enter most recent cost estimate for the entire project, in whole dollars.
Amount of Funding Requested
Enter amount of funding requested under this program, in whole dollars.
Match Available
Does the Sponsor have matching funds? Choose Yes or No.
Delivery Method
Choose the delivery method (Design/Bid, Design/Build, CM at Risk, Other). If “Other,”
state the proposed delivery method in the next field.
Bid or Guaranteed Maximum Price (GMP)
Choose whether or not project has been publicly bid. If “No,” provide an estimated bid
date in the next field.
Phased Project
Choose whether or not the project will be completed over multiple phases. If “Yes,” list
phase number covered by this application and total number of phases in the next field.
Do you have a comprehensive financial plan?
Choose Yes or No to indicate if a funding plan for the entire project is currently available
for FAA review, if requested.
Is the project on an approved Airport Layout Plan (ALP)?
Choose Yes or No. If “Yes,” enter the approval date in the next field.
Is environmental determination complete?
Choose Yes or No. If “Yes,” enter the approval date in the next field.
Is airspace approval complete?
Choose Yes, No, or N/A (not applicable). If “Yes,” enter the airspace case number in the
next field.
Forecast Enplanements
Based on your most recently approved forecast, provide the enplanement number from
the last year of the forecast and provide forecast year.
FAA Form 5100-144 (07/22)
Page iii of vi
Existing Square Footage
Provide square footage of existing terminal building or tower.
Proposed Square Footage
Provide anticipated total square footage of terminal building or tower once project is
complete.
Is this project associated with an approved Bipartisan Infrastructure Law (BIL), Airport
Improvement Program (AIP) or Passenger Facility Charge (PFC) project?
Choose Yes or No. Choose “Yes” if the project has been or is currently funded by an
existing BIL grant, AIP grant or approved under a PFC application. If “Yes,” provide
existing grant number(s) and/or PFC application number along with the amount of
existing funding. (300 Characters Maximum):
Program Considerations
Check all that apply to your proposed terminal building or tower project. If an item is selected, a
narrative must be included describing how the project satisfies the criteria. Address the
following areas within character limits defined below.
Terminal and Tower
Increase Capacity and Passenger Access
Check this box if the project will increase capacity and passenger access to the airport.
Explain and provide justification in the next field. (450 Characters Maximum).
Replacing Aging Infrastructure
Check this box if the project will replace aging infrastructure that has exceeded its useful
life. Explain and provide justification in the next field. (450 Characters Maximum).
Achieves Compliance with Americans with Disabilities Act and Expands Accessibility for
Persons with Disabilities
Check this box if the project will expand accessibility for persons with disabilities. Explain
and provide justification in the next field. (450 Characters Maximum).
Improves Airport Access for Historically Disadvantaged Populations
Check this box if the project will improve access for Historically Disadvantaged
Populations. Explain and provide justification in the next field. (450 Characters
Maximum).
Improves Energy Efficiency
Check this box if the project improves energy efficiency for the airport. Explain and
provide justification in the next field. (450 Characters Maximum).
FAA Form 5100-144 (07/22)
Page iv of vi
Improves Airfield Safety through Terminal or Tower Relocation
Check this box if the project improves airfield safety. Explain and provide justification in
the next field. (450 Characters Maximum).
Encourages Actual and Potential Competition
Check this box if the project encourages actual and potential competition. Explain how
this objective is met through this project in the next field. (450 Characters Maximum).
Good Paying Jobs
Check this box if the project will create good-paying jobs. Explain and provide
justification in the next field. (450 Characters Maximum).
Tower Only
If the project is for a tower, complete this section of the form.
Project Type
Choose “Contract Tower Program” for an airport owned tower in the Federal Contract
Tower program.
Choose “Airport Owned, Other” for an airport-owned tower not in the Federal Contract
Tower program. Then describe tower staffing (Example: FAA Staffed).
Age of Tower
Enter the age of the tower in years.
Siting Study
Has a Siting Study been completed for the Airport Traffic Control Tower Project? Choose
Yes or No.
Appropriate Project Objectives
Choose all that apply.
•
New
Check this box if the project will construct a new Airport Traffic Control Tower.
•
Relocate
Check this box if the project will be relocating an existing Airport Traffic Control Tower.
•
Reconstruct
Check this box if the project will reconstruct a replacement Tower in the approximate
same location of the existing Airport Traffic Control Tower.
•
Repair
Check this box if the project will be a repair of an existing Airport Traffic Control Tower
e.g., replace roof, replace cab windows, etc.).
FAA Form 5100-144 (07/22)
Page v of vi
•
Improve
Check this box if the project will add improvements to an existing Airport Traffic Control
Tower (e.g., replacing radios, etc.).
Impact on the National Airspace System (NAS)
Description (600 Characters Maximum)
Describe how the project addresses impacts on the NAS including operational
constraints nonstandard facility conditions and age of facility.
Certifications
Signature
Add your digital signature.
Date
If your digital signature does not include a date, enter the date you signed the form.
Name
Enter your name.
Title
Enter your title.
FAA Form 5100-144 (07/22)
Page vi of vi
OMB CONTROL NUMBER: 2120-0806
EXPIRATION DATE: 8/31/2022
U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL AVIATION ADMINISTRATION
Bipartisan Infrastructure Law,
Airport Terminal and Tower Project Information
General
Airport Name:
LOCID:
Point of Contact’s Name:
Point of Contact’s Title:
POC’s Phone Number:
Extension:
POC’s Email Address:
Project Overview
Project Type:
Terminal
Multi-Modal Terminal:
Current Project Stage:
Tower
Yes
No
Planning
Environmental
Design
Construction
Project Description (600 Characters Maximum):
Target Timeframes
Date Project Costs Known (mm/yyyy):
Date Grant Fully Executed (mm/dd/yyyy):
Construction Start Date (mm/yyyy):
FAA Form 5100-144 (07/22)
Page 1 of 5
Project Status
Total (Estimated) Project Cost:
Amount of Funding Requested:
Match Available:
Yes
No
Delivery Method (choose one):
Design/Bid
Design/Build
CM at Risk
Other:
Bid or GMP:
Yes
No. If “No,” Estimated bid/GMP date:
Phased Project:
Yes
No. If “Yes,” Phase:
Do you have a comprehensive financial plan?
of
Yes
No
Is the project on an approved ALP?
Yes
No. If “Yes,” enter the approval date:
Is environmental determination complete?
Yes
No. If “Yes,” enter the approval date:
Is airspace approval complete?
Yes
No
N/A.
If “Yes,” enter the airspace case number:
Approved Forecasted Enplanements:
Year:
Existing Square Footage:
Proposed Square Footage:
Is this project phased and/or associated with an approved BIL, AIP or PFC project?
Yes
No
N/A
Added data: If “Yes,” provide the grant number(s), and/or PFC application number, along with
the amount of existing funding. (300 Characters Maximum):
FAA Form 5100-144 (07/22)
Page 2 of 5
Program Considerations (Terminal and Tower)
If you check a box below, you must describe how the project satisfies the criteria.
Check all that apply to the proposed project.
Increase Capacity and Passenger Access. Description (450 Characters Maximum):
Replacing Aging Infrastructure. Description (450 Characters Maximum):
Achieves Compliance with Americans with Disabilities Act and Expands Accessibility for
Persons with Disabilities. Description (450 Characters Maximum):
Improves Airport Access for Historically Disadvantaged Populations.
Description (450 Characters Maximum):
Improves Energy Efficiency. Description (450 Characters Maximum):
FAA Form 5100-144 (07/22)
Page 3 of 5
Improves Airfield Safety through Terminal or Tower Relocation.
Description (450 Characters Maximum):
Encourages Actual and Potential Competition. Description (450 Characters Maximum):
Good Paying Jobs. Description (450 Characters Maximum):
Program Considerations (Tower Only)
If the project is for a tower, also complete this section of the form.
Project Type. The project type for this grant application (choose one or both).
Airport Owned, Contract Tower Program
Airport Owned, Other. Describe staffing:
Age of Tower (Years):
Siting Study. Has a Siting Study been completed for the Airport Traffic Control Tower Project?”
Yes
No
FAA Form 5100-144 (07/22)
Page 4 of 5
If you check a box below, also describe how the project satisfies the criteria.
Check all that apply to the proposed project.
Appropriate Project Objective (choose all that apply):
New
Relocate
Reconstruct
Repair
Improve
Impact on the National Airspace System. Description (600 Characters Maximum):
Certifications
By entering my name below, I hereby certify that I am authorized to submit this form on behalf of the
airport sponsor, all information is true and accurate to the best of my knowledge, and have or will
follow, all procurement processes required under 2 CFR 200, including but not limited to:
•
Davis Bacon
•
Buy American
•
Consultant Selection
•
Disadvantaged Business Enterprise
Signature:
Date:
Name:
Title:
Submit by Email
FAA Form 5100-144 (07/22)
Page 5 of 5
File Type | application/pdf |
File Title | FAA Form 5100-144, Bipartisan Infrastructure Law, Airport Terminal and Tower Project Information |
Subject | airport funding |
Author | [email protected] |
File Modified | 2022-07-11 |
File Created | 2022-07-05 |