1-2025034 Volunteer Driver Program Exhibit A - Quarterly Report.xlsx
XLSX spreadsheet 25 KB Posted
- Attached to
- Volunteer Driver Program for ADRC
- Solicitation number
- 2025034
- Issued by
- Waukesha County, Wisconsin
About this file
This document is a Quarterly Ridership Report template from the Wisconsin Department of Transportation (WisDOT) for the Chapter 85.21 Volunteer Driver Program, specifically tailored for Waukesha County. The report is designed to track quarterly ridership data for transportation services, with reporting periods covering each quarter of the year and due dates 30 days after each quarter's end (April 30, July 31, October 31, and January 31). The template requires detailed tracking of one-way trips categorized by passenger type (seniors, disabled individuals) and trip purpose (medical, employment, nutrition, education, social/recreational, personal business), with counties required to complete yellow-highlighted fields for up to 8 projects, with an additional sheet available for more projects.
The report mandates comprehensive expense and service tracking, including total expenses, trip miles, and hours of service, with a specific definition of senior age (in this case, 60+). The data must be submitted by an approved county official, and if projects are contracted to a third party, the provider submits data to the county for review and consolidated submission. The report supports the Waukesha County Department of Health and Human Services' Aging and Disabilities Resource Center (ADRC) Volunteer Driver Program, which aims to provide transportation services to seniors and individuals with disabilities. Submission of the completed Excel format report is to be made electronically to Specialized.Transit@dot.wi.gov, ensuring accurate and timely documentation of transportation services.
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Reporting Guidelines Requirements
1. Each county must supply a quarterly ridership count for each project listed in the 85.21 state aid application.
- You will need to complete all YELLOW fields for each project. Hint: Select "Enter" to move down one cell; select the key "Tab" to move across one cell.
- The sheet labeled "85.21 Quarterly Report" will hold up to 8 projects. If you have more than 8 projects, please use the "Additional projects" sheet; any totals from this additional sheet will be calculated on the main report to show one final total for the entire county. 2. Sections A & B: Only include trips transporting passengers (do not include trips to maintenance, car wash, etc).
3. This report should be submitted within 30 days following each quarter – please see “reporting period” on the report form for specific due dates.
4. The report should be submitted by an approved County official only. If the county’s projects are contracted to a third party via contract or intragovernmental agreement, the provider would submit the data to the county. After review for accuracy, the county would combine into one report form and submit to WisDOT prior to the due date.
Definitions
1. Section A – This section you will report the number of one-way rides based on type of passenger (i.e. if you define a senior as being 55 years old and you take a 57 year old in a wheelchair to the doctor and then back home, you would count this as 2 rides “Senior, non-ambulatory”).
| a. “Senior, ambulatory” – An individual, defined as a “senior” by your program, that is able to walk. | |
| b. “Senior, non-ambulatory” – An individual, defined as a “senior” by your program, that is unable to walk. | |
| c. “Disabled, non-senior, ambulatory” – An individual with a disability, that is not considered a “senior” and is able to walk. | |
| d. “Disabled, non-senior, non-ambulatory” – An individual with a disability, that is not considered a “senior” and is unable to walk. | |
| e. “Other” – Any rider that does not fall within the above categories. | |
| f. “Section A Total” – this number should equal total number of rides and be the sum of columns in Section A. | |
| 2. Section B – This section you will break down each ride (one-way) by the purpose for the ride |
(i.e. if you take someone to the doctor and then back home, you would count this as 2 rides under medical).
| a. “Section B Total” – this number should equal total number of rides and be the sum of columns in Section B. | |
| 3. Section C – | |
| a. “Definition of Senior” – Please enter the youngest age you would consider a rider to be a senior. (i.e. 55) | |
| b. “Total Expenses” - Total expenses are based on the amount of the service reported for the period. Total should include cost of operating, |
maintaining, administration, insurance, labor and storage.
| c. “Total Trip Miles” - The total mileage operated for this vehicle during the reporting period. |
| d. “Total Hours of Service” - Total number of Hours this vehicle operated during the reporting period. |
Contact Info and Report Submittal:
Specialized.Transit@dot.wi.gov
&"Arial,Bold"&14Chapter 85.21 for Counties - QUARTERLY RIDERSHIP REPORT&"Times New Roman,Regular"&10 &"Arial,Regular"DT1611 revised 04/2023 &"Arial,Regular"Wisconsin Department of Transportation
&"Arial,Regular"&12&A &P of &N mailto:specialized.transit@dot.wi.gov%C2%A0
85.21 Quarterly Report
| County | WAUKESHA | Year | 2025 | ||
| County official | Reporting Period | ||||
| (please select one of the following) | x | 1st Quarter (Jan-Mar; due April 30) | |||
| Phone No. | 2nd Quarter (April - June; due July 31) | ||||
| 1. Read GUIDELINES 2. Complete all YELLOW fields ("Tab" to move across, "Enter" to move down) | 3rd Quarter (July - Sept; due Oct 31) | ||||
| 3. EMAIL completed form in an Excel format to Specialized.Transit@dot.wi.gov | 4th Quarter (Oct - Dec; due Jan 31) |
Project 1 Project 2 Project 3 Project 4 Project 5 Project 6 Project 7 Project 8 County Total (both pages) Name of project (as listed in annual application) Provider (if other than county agency)
| Section A – One-way trips by Passenger Type | |||||||||||
| Senior, ambulatory | 0 | ||||||||||
| Senior, non-ambulatory | 0 | ||||||||||
| Disabled,non-senior,ambulatory | 0 | ||||||||||
| Disabled,non-senior, non-ambulatory | 0 | ||||||||||
| Other | 0 | ||||||||||
| Section A TOTAL | |||||||||||
| 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | ||||
| Section B – One-way trips by Purpose | |||||||||||
| Medical | 0 | ||||||||||
| Employment | 0 | ||||||||||
| Nutrition | 0 | ||||||||||
| Education/Training | 0 | ||||||||||
| Social/Recreational | 0 | ||||||||||
| Personal Business | 0 | ||||||||||
| Other | 0 | ||||||||||
| Section B TOTAL | |||||||||||
| 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | |||
| Section C | |||||||||||
| Definition of Senior (i.e. 55) | 60+ | 60+ | 60+ | 60+ | 60+ | 60+ | 0 | 0 | N/A | ||
| Total Expenses | $ - 0 | ||||||||||
| Total Trip Miles | 0 | ||||||||||
| Total Hours of Service | |||||||||||
| Comments / Notes: |
(not required)
| County | WAUKESHA | Year | 2025 | Page 2 - Additional Projects | ||
| County official | 0 | Reporting Period | ||||
| (please select one of the following) | x | 1st Quarter (Jan-Mar; due April 30) | ||||
| 0 | Phone | 2nd Quarter (April - June; due July 31) | ||||
| *Complete all YELLOW fields - Please use for additional projects only* | 3rd Quarter (July - Sept; due Oct 31) | |||||
| 3. EMAIL completed form in an Excel format to specialized.transit@dot.wi.gov | 4th Quarter (Oct - Dec; due Jan 31) |
| Project 9 | Project 10 | Project 11 | Project 12 | Project 13 | Project 14 | Project 15 | Project 16 | Project 17 | |
| Name of project |
(as listed in annual application) Provider (if other than county agency)
| Section A – One-way trips by Passenger Type | ||||||||||
| Senior, ambulatory | ||||||||||
| Senior, non-ambulatory | ||||||||||
| Disabled,non-senior,ambulatory | ||||||||||
| Disabled,non-senior, non-ambulatory | ||||||||||
| Other | ||||||||||
| Section A TOTAL | ||||||||||
| (must equal total of Section B) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | |
| Section B – One-way trips by Purpose | ||||||||||
| Medical | ||||||||||
| Employment | ||||||||||
| Nutrition | ||||||||||
| Education/Training | ||||||||||
| Social/Recreational | ||||||||||
| Personal Business | ||||||||||
| Other | ||||||||||
| Section B TOTAL | ||||||||||
| (must equal total of Section A) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | |
| Section C | ||||||||||
| Definition of Senior (i.e. 55) | ||||||||||
| Total Expenses | ||||||||||
| Total Trip Miles | ||||||||||
| Total Hours of Service |
&"Arial,Bold"&12Ch. 85.21 for Counties - 2025 QUARTERLY RIDERSHIP REPORT&"Times New Roman,Regular"&10 &"Arial,Regular" &"Arial,Regular"Wisconsin Department of Transportation
&"Arial,Regular"&12Ch. &A &P of &N
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