HomeMy WebLinkAboutWashington State, Department of Transportation (WSDOT), Supplement No. 4 - 050817�Lb1mot Of Transportation
Local Agency Agreement Supplement
Agency
Supplement Number
Jefferson County Public Works
4
Federal Aid Project Number
Agreement Number
CFDA No. 20.205
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 0.30 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
Add $6,000 "State Eligible Non -Fed." PE funds for additional State expenses.
Are you claiming indirect cost rate? F-] Yes ✓ No Project Agreement End Date December 31, 2020
Does this change require additional Right of Way or Easements? ❑ 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 Washington tate epartment &T nsportation
—I
By
By
���✓l"c 1 Director, Local Pr gram
Chair, Board of Jefferson County Commissioners
Date Executed
DOT Form 140-041JUNE 1 2ar7 Page 1
Revised 05/2015
O
0
rCL
�N
Estimate of Fundin
(1)
(2)
(3)
(4)
(5)
Type of Work
Previous
Supplement
Estimated Total
Estimated Agency
Estimated Federal
Agreement/Suppl.
Project Funds
Funds
Funds
PE
86.5 a. Agency 0
393,546.00
0.00
393,546.00
53,129.00
340,417.00
%
b. Other Ped. & Bike Safety 100%
130,000.00
0.00
130,000.00
0.00
130,000.00
19 cc
Federal Aido
c. Other State Eligible Non -Fed.
0.00
6,000.00
6,000.00
6,000.00
0.00
a
Participation
m N
Ratio for PE d. State
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
6,000.00
539,546.00
60,479.00
479,067.00
Right of Wayo
0.00
f. Agency
a. Other
0.00
Federal Aid h. Other
0.00
Participation
Ratio for RW i. State
0.00
i. Total R/W Cost Estimate f +h+;
0.00
0.00
0.00
0.00
0.00
Construction k. Contract 6. 0
%
731,961.85
0.00
731,961.85
98,814.85
633,147.00
86.5
I. Other Ped. & Bike Safety 100%
172,457.50
0.00
172,457.50
0.00
172,457.50JU
0
m. Other Consultant Ped./Bike 100
37,856.50
0.00
37,856.50
0.00
37856.50
U_
Federal Aid n. Other
0.00
—
Participation
Ratio for CN o. Agency PED. 491KE SA 100%
101,200.00
0.00
101,200.00
0.00
101,200.00p.
m
,A.4
State S e
10,000.00
0.00
10,000.00
1,350.00
8,650.00
q. Total CN Cost Estimate k+1+m+n+o
1,053,475.85
0.00
1,053,475.85
100,164.85
953,311.00
r. Total Project Cost Estimate e
1,587,021.85
6,000.00
1,593,021.85
160,643.85
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 Washington tate epartment &T nsportation
—I
By
By
���✓l"c 1 Director, Local Pr gram
Chair, Board of Jefferson County Commissioners
Date Executed
DOT Form 140-041JUNE 1 2ar7 Page 1
Revised 05/2015
O
0
rCL
�N
Agency
Supplement Number
Jefferson County Public Works
4
Federal Aid Project Number
Agreement 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
Agenda Date: May 8, 2017
Subject: Local Agency Agreement Supplement #4
Washington State Department of Transportation
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 add $6,000 in Local Agency funds
for State staff expenses incurred during the Preliminary Engineering (PE) phase that exceeded the
previously obligated State amount.
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. WSDOT has requested that these funds be added to the
existing Local Agency Agreement now, at the end of the PE phase and prior to beginning
construction of the project.
Fiscal Impact/Cost Benefit Analysis: This Local Agency Supplement adds a total of $6,000.00 of
Local Agency funds for the PE phase.
Recommendation: The Chair of the Board is requested to sign the three original Local Agency
Agreement Supplement #4 documents and return all three documents to this department. One
fully executed original will be returned to the Board after execution by the Washington State Dept.
of Transportation.
Department Contact: John Wayand, Project Manager, 385-9377.
Rev' w d y:
P . ' Mort y, ministrator Date
CONTRACT WITH:
CONTRACT FOR:
CONTRACT REVIEW FORM 17 " y 9
Washington State Department of Transportation
(Contractor/Consultant)
Rick Tollefson Memorial Trail, Phase I TERM:
Project No. CRI 815
COUNTY DEPARTMENT: Public Works
For More Information Contact: John Wa and
APR
0.3 2017
Contact Phone #: 385-9377
ixl �' a`
F
RETURN TO: Tina A. RETURN BY:}'4�
(Person in Department)
(Date)
AMOUNT: $6,000.00 PROCESS:
Exempt from Bid Process
Consultant Selection Process
Revenue: 180000010.333.20.22
Cooperative Purchase
Expenditure: 180000010.595.00.65
Competitive Sealed Bid
Matching Funds Required: Yes
Small Works Roster
Sources(s) of Matching Funds FHWA 86.5% / Roads
Vendor List Bid
13.5% /State P/B 100%
X
Other
Supplement #4
Step 1: REVIEW BY S MENT
Review by:
Date Reviewed:
APPROVED FORM Returned for revision (See Comments)
Comments
Step 2: REVIEW BY PRO CUTI AT ORNEY
Review by: C Philip C. Hunsucker,
Chief Civil Deputy Prosecutor
Date Reviewed: Zy �7
APPROVED AS TO FORM Returned for revision (See Comments)
Comments
Step 3: (If required) DEPARTMENT MAKES REVISIONS & RESUBMITS TO
RISK MANAGEMENT AND PROSECUTING ATTORNEY
Step 4: CONTRACTOR/CONSULTANT SIGNS APPROPRIATE NUMBER OF
ORIGINALS P ` 24 Z� {+s'
Step 5: SUBMIT TO BOCC FOR APPROVAL `E r 7�` L`N C OU�,7%1
Submit originals and 8 copies of Contract, Review Form, and Agenda Bill to °Bfi3CC dffioe: L
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.)