Emergency works event accept / decline form

(For State highways only)

May 2025: Updates made as part of Emergency works policies review 2024/25

Emergency Works Event Information
Event (use appropriate naming convention, RS or location)	[Insert name]
Region	Select
Date of event	Click here to enter a date.	Date Waka Kotahi informed	Click here to enter a date.
Event type Choose an item.	Site location [Please enter GPS coordinates / or specify region-wide]
Assumed type and scale of work Response ☐ Is there likely to be recovery? Yes ☐ No ☐ Estimated cost Estimated cost of event response if known: (must be >$100k to qualify for emergency works funding) ☐ <$1m ☐ $1m to $5m ☐ $5m to $15m ☐ >$15m Estimated cost of event recovery if known: (must be >$100k to qualify for emergency works funding) ☐ <$1m ☐ $1m to $5m ☐ $5m to $15m ☐ >$15m	Timeframe Note: It is expected response will be completed in 4 months. Please indicate the timeframe for recovery (if required) Less than 4 months ☐ 4 months to one year ☐ Over 1 year ☐ If greater than 1 year, please provide an explanation for this timeframe: e.g. outline uncertainties / risks:
Note: Within four weeks of an accepted emergency works event, a funding application must be submitted for approval in line with the process outlined in InfoHub. You will need to provide information about this timeframe as part of the application. It is expected that the Regional Asset Engineer will be involved in the initial application. Any recovery will be agreed as per the policy WC 141 Emergency works If the cost is below $100k please use WC 121 Environmental maintenance

Contact Information
Senior Network Manager	[insert]
DFA (if different from the Senior Network Manager)	[insert]
Accept/Decline section
Tick appropriate box:	Accept ☐	Based on the information currently available: I accept, the event described qualifies as emergency work and complies with the funding criteria in WC 141: Emergency works in PIKB (Next step: email this form to emergencyworks@nzta.govt.nz) Note that if the event is accepted but subsequently deemed not eligible any costs will need to be journalled back to WC 121.
Decline ☐	This event does not comply with the criteria required to confirm with PIKB for funding as emergency works.
Note: As part of the funding approval process, you will need to provide a description of the event and its impact to enable confirmation that the event meets the criteria in WC 141 and Section 20(4) of the Land Transport Management Act 2003.

Portfolio & programme controls team
Actions	Please set up a Response phase in SAP and send confirmation of the WBS to the RAE and the applicant.

Regional Asset Engineer
[insert name]	Date	Click here to enter a date.

Next steps

If accepted, please save in Sharepoint under a folder for this event and forward link to Emergency works inbox Emergencyworks@nzta.govt.nz