HomeMy WebLinkAboutWashington State, Department of Transportation (WSDOT), Supplement No. 3 - 021317f" -) oc�ij 0 - k;f) I J '--kr �N - aae
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� Washington State
VI/ Department of Transportation
Local Agency Federal Aid
Project Prospectus
DOT Form 140-101
Revised 04/2015
Previous Editions Obsolete
age!
Prefix
Route
( )
Date
1/17/2017
Federal Aid
STPR-2016(018)
DUNS Number
179278197
Project Number
Local Agency
18018150
r WSDOT 1
Federal Employer
91-6001322
Project Number
` Use Only J
Tax ID Number
Agency
CAAgency
Federal Program Title
Jefferson County Public Works
❑✓ Yes ❑ No
❑✓ 20.205 ❑ Other
Project Title
Start Latitude N 48.02033
Start Longitude W 122.77331
Rick Tollefson Trail - Ph. I (Chimacum Valley)
End Latitude N 48.02060
End Lon itude w 122.76779
Project Termini From -To
Nearest City Name
Project Zip Code (+4)
H.J. Carroll Park Old Hadlock Road
Port Hadlock
98339
Begin Mile Post
End Mile Post
Length of Project
Award Type
0.00
0.33
1725 feet of new trail
❑✓ Local ❑ Local Farces ❑ State ❑ Railroad
Route ID
Begin Mile Point
End Mile Point
City Number
County Number
County Name
16
Jefferson
WSDOT Region
Legislative District(s)
Congressional Districts)
Urban Area Number
Olympic Region
24
6
Total
Local Agency
Federal Funds
Phase Start
Phase
Estimated Cost
Funding
Date
Nearest Hundred Dollar
Nearest Hundred Dollar
Nearest Hundred Dollar)__Month
Year
P. E.
533500
54500
479000
03 09
R/W
40000
40000
0
08 12
Const.
1053500
100200
953300
03 17
Total
1627000
194700
1432300
Description of Existing Facility (Existing Design and Present Condition)
Roadway Width
Number of Lanes
Present condition: Rural/Residential area. This project is a new multi -use trail, see description below.
Description of Proposed Work
Description of Proposed Work (Attach additional sheet(s) if necessary)
Design, acquisition of Right of Way, and construction of a 10 foot wide multi -use trail with 2 foot wide
shoulders on a new alignment. Trail requires one bridge over Chimacum Creek. The trail is part of a
non -motorized transportation network.
Local Agency Contact Person
Title
Phone
John Wayand
Project Manager
360-385-9377
Mailing Address
City
StateZip
Code
623 Sheridan Street
Port Townsend
WA.
98368
By
Project Prospectus Approving Authority
Title County Engineer ate/M
DOT Form 140-101
Revised 04/2015
Previous Editions Obsolete
age!
J,
Agency
Project Title
Date
Jefferson County Public Works
Rick Tollefson Trail - Ph. I (Chimacum Valli
1/17/2017
Type of Proposed Work
Roadway Width
Number of Lanes
Project Type (Check all that Apply)
❑✓ New Construction F✓ Path / Trail
❑ 3-R
14 feet
i
❑ Reconstruction 7✓ Pedestrian / Facilities
❑ 2-R
❑ Railroad ❑ Parking
❑ Other
❑ Bridge
Geometric Design Data
Description Through Route
Crossroad
❑ Principal Arterial
❑ Principal Arterial
Federal ❑ Urban
❑ Minor Arterial
❑ Urban
❑ Minor Arterial
Functional El Rural
El Collector
❑Rural
❑ Collector
CIaSSIflCatlOn NHS
Major Collector
[:]F-1Minor
F] NHS
F-1Major Collector
Collector
❑ Minor Collector
❑ Local Access
❑ Local Access
Terrain
❑ Flat Roll ❑ Mountain
❑ Flat ❑ Roll ❑ Mountain
Posted Speed
N/A
N/A
N/A
N/A
Design Speed
Existing ADT
N/A
N/A
Design Year ADT
N/A
N/A
Design Year
N/A
N/A
Design Hourly Volume (DHV)
N/A
N/A
Performance of Work
Preliminary Engineering Will Be Performed By
Others Agency
Agency
50 % 50 %
Construction Will Be Performed By
Contract Agency
Contractor
100 % 0
Environmental Classification
❑ Class I - Environmental Impact Statement (EIS)
Class III - Categorically Excluded
(CE)
❑ Project Involves NEPA/SEPA Section 404
✓ Projects Requiring
Documentation
Interagency Agreement
(Documented CE)
❑ Class III - Environmental Assessment (EA)
❑ Project Involves NEPA/SEPA Section 404
Interagency Agreements
Environmental Considerations
Creek crossing and wetland buffers.
See attached Final Environmental Classification Summary form.
DOT Form 140-101 Page 2
Revised 04/2015 Previous Editions Obsolete
Agency Project Title Date
Jefferson County Public Works Rick Tollefson Trail - Ph. I (Chimacum Vab 1/17/2017
Right of Way
❑ No Right of Way Needed [ Right of Way Needed
All construction required by the No Relocation ❑ Relocation Required
contract can be accomplished
within the exiting right of way.
Utilities _ Railroad
❑ No utility work required Z No railroad work required
✓' All utility work will be completed prior to the start ❑ All railroad work will be completed prior to the start of
of the construction contract the construction contract
❑ All utility work will be completed in coordination ❑ All the railroad work will be completed in coordination
with the construction contract with the construction contract
Description of Utility Relocation or Adjustments and Existing Major Structures Involved in the Project
Relocation of one minor power pole with service lines and one service waterline by Jefferson County PUD.
FAA Involvement
Is any airport located within 3.2 kilometers (2 miles) of the proposed project? ❑ Yes [ No
This project has been reviewed by the legislative body of the administration agency or agencies, or it's
designee, and is not inconsistent with the agency's comprehensive plan for community development.
Agency Jefferson County
Date By
DOT Form 140-101
Revised 04/2015
CIA
Mayor/Chairperson ,q
Previous Editions Obsolete 1� Page 3
I
e
Adftk
MPWashington State Local Agency Agreement Supplement
Department of TransportaVon
pplement Number
Jefferson County Public Works
3
Federal Aid Project Number Agreement Number CFDA No. ZO.Z05
STPR-2016(018) LA6612 (Catalog of Federal Domestic Assistance)
The Local Agency requests to supplement the agreement entered into and executed on April 3, 2008
All provisions in the basic agreement remain in effect except as modified by this supplement.
The change to the agreement are as follows:
Project Description
Name Rick Tollefson Trail - Phase One (Chimacum Valley) Length o.30 MILES
Termini HJ Carroll Park to Old Hadlock Rd
Description of Work ✓ No Change
Design, acquisition of Right of Way, and construction of a 10 foot wide multi -use trail with 2 foot wide shoulders on a new
alignment. Trail requires one bridge over Chimacum Creek. The trail is part of a non -motorized transportation network.
Reason for Supplement
Obligate funds for construction phase.
Are you claiming indirect cost rate? ❑ Yes ✓ No Project Agreement End Date December 31, 2020
Does this chance reauire additional Rioht of Wav or Easements? n Yes ✓ No Advertisement Date: March 29, 2017
The Local Agency further stipulates that pursuant to said Title 23, regulations and policies and procedures, and as a
condition to payment of the Federal funds obligated, it accepts and will comply with the applicable provisions.
Agency Official Washingt n t Department Transportation
Z
,,.�G /
By � v�� By 9 APR 1 017
Title Chair, Boar of Jefferson County Commissioners Director, Local ro ram
Date Executed
DOT Form 140-041 11-m- , '.3 '6'Page 1
Revised 05/2015 �Z Q
Estimate of Fundin
(1)
(3)
(4)
(5)
Type of Work
Previous
2
Estimated Total
Estimated Agency
Estimated Federal
Agreement/Suppi.
Supplement
Project Funds
Funds
Funds
a
86.5
a.A enc °
393,546.00
0.00
393,546.00
53,129.00
340,417.00
86.5 .1
b. Other Ped. & Bike Safety 100%
130,000.00
0.00
130,000.00
0.00
130,000.00
0
Federal Aid c. Other
0.00
0.00
0.00
0.00
0.00
Participation
Ratio for PE d. State Gr
10,000.00
0.00
10,000.00
1,350.00
8,650.00
e. Total PE Cost Estimate a+b+c+d
533,546.00
0.00
533,546.00
54,479.00
479,067.00
Right of Wao
y
0.00
f. Agency
a
q. Other
0.00
Federal Aid h. Other
0.00
Participation
0.00
Ratio for RW i. State
Total RNV Cost Estimate t +h+;
0.00
0.00
0.00
0.00
0.00
Construction
% k. Contract 6.
0.00
731,961.85
731,961.85
98,814.85
633,147.00
86.5
I. Other Ped. & Bike Safety 100%
0.00
172,457.50
172,457.50
0.00
172,457.50
0
m. Other Consultant PEP, /BIKE t00%
0.00
37,856.50
37,856.50
0.00
37856.50
Federal Aid n. Other
0.00
Participation
Ratio for CN o. A enc BIKE FETY 100-6/6
0.00
101,200.00
101,200.00
0.00
101,200.00
M
p. State $ rpR 8 6. 9 0/.
0.00
10,000.00
10,000.00
1,350.00
8,650.00
q. Total CN Cost Estimate k+l+m+n+o
0.00
1,053,475.85
1,053,475.85
100,164.85
953,311.00
r. Total Project Cost Estimate a
533,546.00
1,053,475.85
1,587,021.85
154,643.85
1,432,378.00
The Local Agency further stipulates that pursuant to said Title 23, regulations and policies and procedures, and as a
condition to payment of the Federal funds obligated, it accepts and will comply with the applicable provisions.
Agency Official Washingt n t Department Transportation
Z
,,.�G /
By � v�� By 9 APR 1 017
Title Chair, Boar of Jefferson County Commissioners Director, Local ro ram
Date Executed
DOT Form 140-041 11-m- , '.3 '6'Page 1
Revised 05/2015 �Z Q
Agency ,Supplement Number
Jefferson County Public Works 3
Federal Aid Project Number lAgreement Number CFDA No. 20.205
STPR-2016(018) LA6612 (Catalog of Federal Domestic Assistance)
VI. Payment and Partial Reimbursement
The total cost of the project, including all review and engineering costs and other expenses of the State, is to be paid
by the Agency and by the Federal Government. Federal funding shall be in accordance with the Federal Transportation
Act, as amended, 2 CFR Part 200. The State shall not be ultimately responsible for any of the costs of the project. The
Agency shall be ultimately responsible for all costs associated with the project which are not reimbursed by the Federal
Government. Nothing in this agreement shall be construed as a promise by the State as to the amount or nature of federal
participation in this project.
The Agency shall bill the state for federal aid project costs incurred in conformity with applicable federal and state laws.
The agency shall minimize the time elapsed between receipt of federal aid funds and subsequent payment of incurred
costs. Expenditures by the Local Agency for maintenance, general administration, supervision, and other overhead
shall not be eligible for federal participation unless a current indirect cost plan has been prepared in accordance with
the regulations outlined in 2 CFR Part 200 - Uniform Admin. Requirements, Cost Principles and Audit Requirements for
Federal Awards, and retained for audit.
The State will pay for State incurred costs on the project. Following payment, the State shall bill the Federal Government
for reimbursement of those costs eligible for federal participation to the extent that such costs are attributable and properly
allocable to this project. The State shall bill the Agency for that portion of State costs which were not reimbursed by the
Federal Government (see Section IX).
VII. Audit of Federal Consultant Contracts
The Agency, if services of a consultant are required, shall be responsible for audit of the consultant's records to determine
eligible federal aid costs on the project. The report of said audit shall be in the Agency's files and made available to the
State and the Federal Government.
An audit shall be conducted by the WSDOT Internal Audit Office in accordance with generally accepted governmental
auditing standards as issued by the United States General Accounting Office by the Comptroller General of the United
States; WSDOT Manual M 27-50, Consultant Authorization, Selection, and Agreement Administration; memoranda of
understanding between WSDOT and FHWA; and 2 CFR Part 200.501 - Audit Requirements.
If upon audit it is found that overpayment or participation of federal money in ineligible items of cost has occurred, the
Agency shall reimburse the State for the amount of such overpayment or excess participation.
IX. Payment of Billing
The Agency agrees that if payment or arrangement for payment of any of the State's billing relative to the project (e.g.,
State force work, project cancellation, overpayment, cost ineligible for federal participation, etc.) is not made to the State
within 45 days after the Agency has been billed, the State shall effect reimbursement of the total sum due from the regular
monthly fuel tax allotments to the Agency from the Motor Vehicle Fund. No additional Federal project funding will be
approved until full payment is received unless otherwise directed by the Director, Local Programs.
Project Agreement End Date - This date is based on your projects Period of Performance (2 CFR Part 200.309).
Any costs incurred after the Project Agreement End Date are NOT eligible for federal reimbursement. All eligible costs
incurred prior to the Project Agreement End Date must be submitted for reimbursement within 90 days after the Project
Agreement End Date or they become ineligible for federal reimbursement.
VIII. Single Audit Act
The Agency, as a subrecipient of federal funds, shall adhere to the federal regulations outlined in 2 CFR Part 200.501 as
well as all applicable federal and state statutes and regulations. A subrecipient who expends $750,000 or more in federal
awards from all sources during a given fiscal year shall have a single or program -specific audit performed for that year in
accordance with the provisions of 2 CFR Part 200.501. Upon conclusion of the audit, the Agency shall be responsible for
ensuring that a copy of the report is transmitted promptly to the State.
XVII. Assurances
Local Agencies receiving Federal funding from the USDOT or its operating administrations (i.e., Federal Highway
Administration, Federal Transit Administration, Federal Aviation Administration) are required to submit a written policy
statement, signed by the Agency Executive and addressed to the State, documenting that all programs, activities and
services will be conducted in compliance with Section 504 and the Americans with Disabilities Act (ADA).
DOT Form 140-041 Page 2
Revised 05/2015
Department of Public Works
O Consent Agenda
Page 1 of 1
Jefferson County
Board of Commissioners
Agenda Request
To: Board of Commissioners
Philip Morley, County Administrator
From: Monte Reinders, P.E., Public Works Director/County Engineer/ A,-'
Agenda Date: February 13, 2017
Subject: Local Agency Agreement Supplement #3 and Local Agency Federal Aid Project
Prospectus with the Washington State Department of Transportation
for The Rick Tollefson Memorial Trail, Phase I, Co. Project No. CR1815
Statement of Issue: Execution of a Local Agency Agreement Supplement with the Washington
State Dept. of Transportation (WDSOT) is necessary in order to obligate construction phase funds
from two existing grants for the Rick Tollefson Memorial Trail, Phase I project. The two grant
funds are the Federal Highway Administration (FHWA), Surface Transportation Program (STP -R) and
the Washington State Pedestrian &t Bike Safety Program. The updated Project Prospectus is
required to be submitted as documentation with the Supplement #3 document.
Analysis/Strategic Goals/Pro's Et Con's:
The Rick Tollefson Memorial Trail, Phase I project will construct a multi -use trail connecting HJ
Carroll Park with Old Hadlock Road crossing the Chimacum Valley. This project is included in
Jefferson County's 2017-2022 Transportation Improvement Program as item No. 5 and in the 2017
Annual Construction Program as item No. 5. Formal obligation by FHWA of the existing grant
funding for the construction phase is necessary before proceeding with the construction work.
Fiscal Impact/Cost Benefit Analysis: This Local Agency Supplement obligates a total of
$953,311.00 of Federal and State funding for the construction phase. The FHWA STP -R grant is for
$641,797.00 with a participation ratio of 86.5% and the State Pedestrian Et Bike Safety Program
grant is for $311,514 with a participation ratio of 100%. Jefferson County's Local Funds share is
$100,164.85 with a participation ratio of 13.5%.
Recommendation: The Board is requested to sign the three original Local Agency Agreement
Supplement #3 documents and the three original Project Prospectus documents and return all six
documents to this department. One fully executed original of each document will be returned to
the Board after execution by the Washington State Dept. of Transportation.
Department Contact: John Wayand, Project Manager, 385-9377.
e iew By:
Philip M e , County ini trator
Date
CONTRACT REVIEW FORM
CONTRACT WITH: Washington State Department of Transportation
(Contractor/Consultant)
CONTRACT FOR: Rick Tollefson Memorial Trail, Phase I TERM:
Project No. CR1815
COUNTY DEPARTMENT: Public Works
For More Information Contact: John Wayand JAN 23 2017
Contact Phone #: 385-9377
RETURN TO: Tina A. RETURN BY: 2/6/17
(Person in Department) (Date)
AMOUNT: $953,311.00
Revenue:
Expenditure:
Matching Funds Required;
Sources(s) of Matching Funds
180000010.333.20.22
180000010.595.00.65
Yes
FHWA 86.5% / Roads
13.5% /State P/B 100%
Supplement #3 and Project Prospectus
Step 1: REVIEW BY
Review by:
Date Reviewed:
APPROVED FORM
Comments
PROCESS: Exempt from Bid Process
Consultant Selection Process
Cooperative Purchase
Competitive Sealed Bid
Small Works Roster
Vendor List Bid
X Other
Returned for revision (See Comments)
Step 2: REVIEW BY PROSECUTI�P, Review by:
Date Reviewed:
APPROVED AS TO FORM Returned for
Com ents
TTORNEY
ae—' f -
e
ion n (See Comments)
M
Michael Haas
Step 3:
(If required) DEPARTMENT MAKES REVISIONS & RESUBMITS TO
UJ
RISK MANAGEMENT AND PROSECUTING ATTORNEY
r--
a
M�
N
o tep 4:
CONTRACTOR/CONSULTANT SIGNS APPROPRIATE NUMBER OF
U
a z
ORIGINALS
Ui
E.+.UJ
T step 5:
SUBMIT TO BOCC FOR APPROVAL
aSubmit
originals and 8 copies of Contract, Review Form, and Agenda Bill to BOCC Office.
Place "Sign Here" markers on all places the BOCC needs to sign.
_
MUST be in BOCC Office by 5 p.m. TUESDAY for the following Monday's agenda.
(This
form to stay with contract throughout the contract review process.)