Proforma C

PRADHAN MANTRI GRAM SADAK YOJANA ( PMGSY -III)

CHECK LIST FOR P.I.U. & S.T.A.
( For Indvidual Road Works )
To be filled by PIU.

1. Location :- State: Punjab District : Patiala Block Bhunerheri

2. Package No:-

3. Name of the Road: From Patiala-Pehowa Road (Devigarh) To Haryana Border via KishanpurGharam and Rajgarh

4. Total Length (Km) - 11.04 In Built up area - 2.04 Km In Open Area - 9.00 Km

5. Type of proposal : Upgradation

If portion of the proposed road is existing PMGSY road than indiacte

Name of the road : L/T No.
Year of sanction under PMGSY Year of completion Design Traffic ( CVPD/ ESAL)

Yes NO
Whether road deteriorated due non maintenance

6. Estimated Cost Rs :
Normal Area
Cost sharing pattern for this road Special Area (90:10)
(60:40)
Item Total Cost in Rs. Average Cost per Km. Lakhs

Flexible Pavement 420.39

Rigid Pavement 0.00
Others ( CD Works, Protective works & Misc items) 23.56

Cost due to higher specification such as carriage way width, Higher 339.83
Axle load , Hard shoulders, Shifting of Utilities

GST & LWF 94.05

Total Project Cost 877.83
MoRD Share

State Share

7. Is the road a part of DRRP and Approved CUCPL Yes/No Yes

a) If Yes , Through Route/ MRL No. T -12 or MRL-
b) Names of benefitted habitations
Name of Habitation Population Overall Weightage

Ram Nagar Chuniwala 4453 96.41

Mehon 1694 36.68
KisanPur 960 20.78
Gharam 3165 68.53
Rajgarh 813 17.60

Total weight 11085 240.00

c) Utility value = Total weight/ Length of road 21.74

d) Name of facilities located on this proposed road as per DRRP: Mehon Agro Agro Industry
Mehon Transport/Admin Panchayat Headquarter
Mehon Agro Agro Industry
Mehon Agro Agro Industry
Gharam Transport/Admin Panchayat Headquarter
Gharam Education High School - General
Gharam Medical Veterinary Hospital
Gharam Medical Primary Health Centre
Gharam Transport/Admin Bus Stand
Gharam Transport/Admin Fuel Station
Gharam Transport/Admin Bank
Kishanpur Transport/Admin Panchayat Headquarter
Raj garh Transport/Admin Panchayat Headquarter
e)Whether the proposed road leads to MDR SH NH

f) Average PCI of the road to which proposed TR or MRL will be connected 4

g) Average PCI value of proposed road 1.78
h) If PCI of MDR / SH / NH is 3 or below , whether the State's undertaking for simultaneouly Yes No
upgrading it from State fund is avaible

i) Age of the proposed road 40 Years

j) Existing surface of proposed road BT

k) Cummalative maintenance expenditure in last three years( in lacs) 23 Lacs
l) Whether the road proposed using new technologies Yes No
If Yes, Name of the technology proposed
8. a) Whether the Proposed Road has the desired carriage way Carriage way Roadway width Road land width
width,Roadway width and Road Land Width (RLW )
8. a) Whether the Proposed Road has the desired carriage way
width,Roadway width and Road Land Width (RLW )
yes No yes No yes No

b) Indicate the actual widths of the following for the proposed road In the Built Up Area (m) In the Open Area (m)

i) Carriageway 3.05/5.50 3.05/5.50

ii) Roadway 5.50 5.50

iii) Road Land Width 10.06 10.06

c) Indicate the proposed widths of the following for the proposed road In the Built Up Area (m) In the Open Area (m)

i) Carriageway 3.75 3.75

ii) Roadway 6.20 6.20

INDEX MAP (not to scale ) : Attached saperately

Enroute Habitations Name / Chainage

H1/F1 H2/F2 H3/F3
MDR-42

H- Habitation
MSH-6
ROAD

F-Facilities name

CD1 CD2 CD3

9 Name of Road :
Cross Section details

a) Cross Section of The Existing road showing different component layers.

Item Thickness
RD 0-8.480, 8.990-11.04
OGPC 20
WBM 225
RD 8.480,-8.990
OGPC 20
WBM 375

b) Cross Section of The Proposed road showing different component layers

(Should be as per Actual Provisions of DPR) Item Thickness
RD 0-8.480, 8.990-11.04
OGPC 20
BM 50
WBM 225
GSB G-1 200
RD 8.480,-8.990
OGPC 20
BM 50

10 Base year traffic volume

Month & Year of Traffic Volume Count =

Day Vehicle Class Total
Cars, Jeeps, Motorized Light Commercial Trucks Agricultural Buses Cycles Cycle Animal
Vans, Three Two Vehicles Unlade Laden Unladen
Laden Tractors/Traliors
Laden Unladen Laden Unladen Rickshaw Drawn
Wheelers Whelers n s Vehicles
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Day 1 223 713 202 29 78 17 192 69 21 13 972 27 82
Day 2 227 776 201 21 72 4 155 45 15 11 1046 14 66
Day 3 217 770 192 21 67 4 152 43 15 11 1055 13 67
Day 4 222 718 203 16 75 14 158 36 20 8 961 24 70
Day 5 229 774 212 20 66 2 161 38 17 14 1011 15 73
Day 6 218 768 189 15 73 4 178 43 21 13 1041 17 68
Day 7 214 766 195 27 75 15 185 46 14 11 1026 16 74
Total 1550 5285 1394 149 506 60 1181 320 123 81 7112 126 500
Average 221 755 199 21 72 9 169 46 18 12 1016 18 71
Daily
Traffic
PCU 1 0.50 1.50 1.50 3 3 1.50 1.50 3 3 0.50 2 6
Factor
Average 221 378 299 32 217 26 253 69 53 35 508 36 429 2554
Daily
Traffic in
PCU's
3 days traffic cound is required in case design is done using IRC SP:72-2015 and 7 day count required in case design is done with IRC 37:2018
a Traffic Details in case degisn is done as per SP IRC 72:2015
Expected AADT (Commercial Vehicle) CVPD Total of Laden and Unladen commercial vehicles, Truck, Buses and agricultural Tractor/trailors (Before applying the PCU factor)
(6+7+8+9+10+11)
AADT after one year opening of road to the traffic from
76.62 9.09 178.84 48.46 18.63 12.27
the date of census = AADT X 1.06

VDF factor as per IRC : SP 72 2015 2.86 0.34 0.31 0.02 2.86 0.34
Total VDF AADT X VDF factor 219.14 3.09 55.44 0.97 53.27 4.17 336.08
ESAL formula= To x 4811 x L
To = 336.08
L = 1
ESAL application
= 336.08 X 4811 X1 = 1616876
or 1.62 msa
b Traffic Details in case degisn is done as per IRC 37-2001 /IRC 37 :2012
 A= Intitial traffic in the year of completion of construction in terms of the number of commericial vehicles per
day
D= Lane distribution factor
F= Vehicle damage factor
n= Design life in years
r= growth rate adopted %
N= The cumulative number of standard axles to be catered for the design in terms of msa
CVPD

11. Subgrade CBR ( for Different Sections ) =

Chainage RD 0.50 KM RD 1.50 KM RD 2.50 KM RD 3.50 KM RD 4.50 KM RD 5.50 KM RD 6.50 KM RD 7.50 KM RD 8.50 KM RD 9.50 KM RD 10.50 KM
Design
4.88 5.17 4.80 5.68 5.24 5.17 5.02 5.82 5.63 5.31 4.73
CBR %

12. Cost Details of upgradation proposal

A. Pavement Components
Description of layer Thickness in mm Quantity Rate Rs Cost Rs.

Clearing, scarifying, dismantling existing CDs etc - 3.075 29,325.01 90181

Earth Work - in Excavation/ Cutting 1629.80 27.28 44456
Earthwork- in Filling (Embankment) 1629.80 40.59 66159
Earthwork- in Filling (Embankment) 7711.35 319.95 2467215
Dismentling of flexible pavement 1147.03 246.40 282631
Compacting original ground supporting 11055.75 30.12 332980
embankment.

Subgrade (if provided seperately)/ Treated subgrade 0 0 0

Shoulders (If not considered in the Earthwork) 0

Providing and layiong brick edging. 21282.00 61.07 1299676

Laying, rolling and consolidation rthe old material received from 688.22 372.13 256109
scarification.
Granular Sub base 1758.37 1,303.85 2292652
0
Soil + Aggregate Mix 0 0 0
0
WBM Gr -I I 75mm 2208.78 1,970.67 4352791

WBM Gr -I I I 150mm 6041.32 2,045.56 12357880

0
WMM - 0 0 0
Bituminous Layers 0
0
Prime Coat 40437.07 28.55 1154532

Tack Coat @225kg per SQm 42989.57 7.89 339027

Tack Coat @275kg per SQm 43309.57 9.28 401860
OGPC /SDBC/BC ( SDBC / BC if designed by IRC 37) 20mm 43309.57 97.20 4209647

Seal Coat 43309.57 32.20 1394474

BM /DBM ( if designed by IRC 37-2018) 50mm 2149.48 4,976.40 10696659

Surface Dressing

Total cost of Flexible pavement 42038928

Cement Concrete Road
IRCSP 62:2014 IRC 58-2011 0

Design done with 0

GSB 0
WBM/WMM 0
Dry lean concrete( DLC) 0
Concrete for Pavement (M30) 0
Total Cost of Concrete Pavement 0
B: C D Works
Location - Chainage ( Similar Type of CD's may be grouped Type of CD & their Nos Total Length of Culvert Cost in Rs.( in lacs)
together)
i Existing CD ( requiring repair)
Dismentling of CD Structure -22121

ii New proposed CD ( including complete replacement of existing

CDs)
600mm dia Hume Pipe Culvert 6 0.60 Mtr 447036

450mm dia Hume Pipe Culvert 11 0.45 Mtr 683887

1.50 Mtr Span Slab Culvert 1 1.70 Mtrt 1033822

0.60 Mtr Span Slab Culvert 2 0.70 Mtr 213200

Total Cost of CD works in lacs 2355823

C. Protection works
Chainage
Length( m) Cost in Rs Average cost / m
From To
Retaining wall 3047 3090 43
5700 5730 30
5810 5890 80
5963 5983 20
6070 6140 70
6670 6740 70
313 4238307 13541
W type crash barrier 6685.00 18791535 2811
Breast wall
Toe wall
Gabbion
Pitching / turfing for slopes
Total cost of protection works 23029842

D. Pucca Side Drains (if Provided) Chainage Length Cost in Rs Average cost / m
(m)
From To
300x300mm L.S. 8235 8310 75
RS 8235 8280 45
L.S. 10260 10500 240 360 695160 1931
450x450mm L.S. 8270 8390 120
R.S 8240 8300 60
RS 8360 8440 80
L.S. 10460 10620 160 420 905940 2157
600x600mm L.S. 8390 8440 50
L.S. 10620 10720 100 150 408150 2721
Repair of Existing Drain R.S 8430 8450 20
R.S 8340 8380 40
8495 8610 115 175 251650 1438
Slab for Drains 149.00 244548 1641
Total cost of side drains works 2505448
E. Road Logo, other Road Furniture including Road safety signs
Number Cost in Rs Average cost / km
Number of Boards 221 779537 70610
Road Studs 1423 415450 37631
Road Marking with thermoplastic Sqm 2260.55 1371770 124255
Rumble strips 3.00 29642 2685
Boundary Pillers 71.00 73605 6667
Total cost of road furniture 2670004 241848
F. Any other Provisions (Please Specify) Hard Shpulder with dry brick on edge flooring 14390.00 5446543 493346
DPR Preparation charges etc. 11.04 331200 30000
Total Cost of the Project (Rs) (Without GST) 78377788 7099437.32
GST 12% 9405334 851932.39
Total Cost of the Project (Rs) (With 12% GST) 87783122 7951369.71
13. Five Year Routine Maintenance
Year Cost in lakhs % Cost Cost /km
To be estimated as per provision of Operation Manual I 560489 0.64% 50769
II 795063 0.91% 72017
III 1294161 1.47% 117225
IV 1671454 1.90% 151400
V 2083241 2.37% 188699
Renewal coat after 5 years 8523300 9.71% 772038

Total Maintenance Cost 14927707 17.01% 1352147

Maintenance after 6th years renewal coat

I 695627 0.79% 63010

II 1073901 1.22% 97274

III 1964828 2.24% 177974

IV 2608568 2.97% 236283

V 3311769 3.77% 299979

Total Maintenance Cost 9654694 11.00% 874519

Grand Total of maintenance

Yes NO
14. Whether the road has Geometrics as per Rural Roads Manual RRM / Latest Circulars of NRIDA.

Yes No
15.Whether C.D.works / Protection works are provided as per RRM / Latest Circulars of NRIDA/ Respective Codes of IRC.

16.Does the Estimation Conform to Standard Rate Analysis and SSR generated for the current Phase
Vetted at NRIDA Year
Yes No

17. Sources and the Lead distances of Materials are as under

 Material Source Lead Material Source Lead Distance
Distance
(Km)
Earth Arnoli 15 Cement Devigarh 5
Murrum (Subgrade) 0 Emulsion Panipat 107
Aggregate Burj Kotian 97 Bitumen Panipat 107
Sand Bhartgarh 128 Steel Devigarh 5

Certified that information provided is true

Prepared By Checked By Technical Scrutiny at STA

(Name) done by:

Counter Signatures of
Co-ordinator STA :

To be filled by State Technical Agency

Name of the STA:

Name of Road : Yes / NO to be filled by STA in own handwriting

18 Is the Proposed Road entered on the OMMAS under PMGSY III proposal module:
(Data entries to be verified by STA before Clicking the Propopsal)
19 Have you satisfied yourself that the proposed road is a part of DRRP
20 Are you satisfied with the following
Engineering Surveys (L section, X section on A3 size paper must be verified)
Soil/ Material Investigation ( CBR, Density, LL, PI, Gradation to be verified)
Whether Traffic Surveys / count has been done by third party
Hydraulic Studies.
( Catchment for structures with more than 2 Vents to be verified from topo sheet. Location and requirement of all CD
structures to be verified from L section )
21 In case , Traffic is projected beyond T 7 Category and road designed using IRC 37 are you satisfied with the
reason given by PIU
Whether 3rd party Traffic verification / Axle load Surveys carried out on such roads designed with more than 1
MSA traffic and carriageway width of 5.5 m
22 In case, sub grade CBR is less than 5; has Soil Stabilisation etc. been proposed

( If not , specific Reasons given by PIU)

23 Is the design of the following elements as per Rural Roads Manul / Circulars of NRIDA:

Alignment & Geometrics

Location and type of CD works and Side drains
Integration for Cross and longitudinal Drainage
Protection Works
24 Is the design of flexible Pavement as per IRC SP: 72- 2015 and design of Rigid Pavement as per IRC SP:62- 2014 .

Is the design of flexible Pavement as per IRC 37 2018 and design of Rigid Pavement as per IRC SP:58- 2002.

25 Does the proposal have provisions for

PMGSY Logo Sign Boards and Information Board
Km/Hm Stones
Guard Stones (where necessary )
Traffic Sign Boards (as necessary)
26 Are you satisfied with the Road safety provisions made in the DPR

Whether Road Safety Audit certificate attached in case of the proposed length is more than 5 Km

27 Secific Remarks, if any, by STA

( Specific remarks of STA about the overall project are necessary on each DPR)

Certified that the Design and Estimation for the Proposed Road work are based on the data and SSR provided by PIU Engineers . The Proposal after final Correction is
entered on the OMMAS.The Propasal may be considered for clearance.

Technical Scrutiny at STA done by:

Signature Co-ordinator STA:
Name Signature
Date Name

Date