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TfL Lane Rental FundingApplication FormV4.2 September 2017
Lane Rental Governance Committee – Funding Request Application Form
Note: Please view the guidance at the end of the document for a quick reference guide
1. Applicant InformationApplicant Type: Highway Authority Utility Company Other – specify: Name of Organisation: Full Postal Address: Contact Name: Contact Email Address: Contact Telephone No: 2. Sponsor Information (Lane Rental Governance Committee Member)Name of Organisation: Full Postal Address: Contact Name: Contact Email Address: Contact Telephone No: 3. Application DetailsProject Title: Bid Category:
Innovative Technology Innovative Techniques/Working Practices Infrastructure Improvements Extraordinary Measures to Reduce
Congestion Improvements to Skills/Capability Improvements to Asset Data Record
Collection/Accessibility Other – specify:
Project Driver(s): Reduce Disruption from Street Works Reduce Adverse Effects Caused by
Street Works Political Mitigate Reputational Damage Legislative Technical (e.g. contractual,
system/equipment obsolescence) Other – specify:
Lane Rental Governance Committee – Funding Request Application Form
Note: Please view the guidance at the end of the document for a quick reference guide
Description of Proposal (including existing arrangements):
Estimated Duration to Deliver Proposal: Estimated Project Start Date:
4. FinanceProportion of Project to be Funded: a) Full project cost b) Partial project cost c) Trial only Brief Description of Wider Project (where b and/or c has been selected):
Capital Costs (Funded elements only) 5 Year Revenue Costs (for information purposes only)
Staff Time £ Staff Time £ Equipment Costs £ Equipment Costs £ Other Costs £ Specify:
Other Costs £ Specify:
Total Capital Costs £ Total Revenue Costs £
Estimating Error Contingency ( %) £ Estimating Error Contingency ( %) £
Total Funding Requested (Capital costs only): £ Additional Project Costs (above requested funding): £ Source of Additional Funding: Total Project Costs (Capital costs only): £
Estimated Life Span of Lane Rental Funded Investment: Cost of using existing techniques/technology £ 5. BenefitDescription of Expected Benefits:
Lane Rental Governance Committee – Funding Request Application Form
Note: Please view the guidance at the end of the document for a quick reference guide
a) Applicability of Benefit:Scope of Benefit:
Full Project Partial Project Trial Only Trial and Business as Usual OperationalDuration of Benefit (Asset Life Span, Construction Period, Trial): Locality where Benefit will Accrue:
Site(s) Specific Pan-London National International Laboratory/Off-Site
Other – specify: Known Site Location(s): Unknown Site Locations(s):
Site no Street name Borough Road network type Total no of sites:
1 Transport for London Road Network 2 Strategic Road Network (Borough) 3 Local Road Network (Borough) 4 Various (TLRN and Borough)
Stakeholder(s) that will Benefit: Specific Road User(s) All Road Users Specific Highway
Authority(s) All Highway Authorities Specific Work Promoter(s) All Work
Promoters Industry Wide Other – specify:
Road User(s) that will Benefit:
Type Volume Predicted Impact Type Volum
e Predicted Impact
Pedestrians Buses
Cyclists Motor Vehicles
b) Benefits Realisation: Measure of Success Baseline Expected Value1. 2. 3. Value of Benefit (calculated from data provided above): c) Benefit Cost Ratio:
Lane Rental Governance Committee – Funding Request Application Form
Note: Please view the guidance at the end of the document for a quick reference guide
Benefit to Cost Ratio Calculation (calculated from data provided above): 6. Supplementary Information Provided to Support ApplicationStakeholder(s) that will Benefit:
Approved Business Case Feasibility Study Technical Report Supporting Statement on Benefit Supporting Statement on Value of Benefit Other – specify:
7. Funding Eligibility (Organisations External to TfL)I confirm that this proposal is ‘conducive to the provision of safe, integrated, Yes No N/A efficient and economic transport facilities or services to, from or within Greater London.If Yes, say how: ‘I confirm that this proposal will not benefit this organisation over any other competitors and agree that the outcomes of this funded project to which this funding (if granted) is applied will be fully shared and made publicly available’.
Yes No N/A If Yes, say how competitors will be made aware of the project outcomes:
8. Declaration
I confirm that the foregoing details are correct.Name: Organisation: Date:
Submit completed form to: [email protected]
Email: [email protected]
