HomeMy WebLinkAboutNaylor Creek Culvert Replacement Department of Public Works
O Consent Agenda
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Jefferson County
Board of Commissioners
Agenda Request
To: Board of Commissioners
Mark McCauley, County Administrator /
From: Monte Reinders, P.E., Public Works Director/County Engineer
Agenda Date: August 7, 2023 (((•••���
Subject: Washington State Department of Transportation (WSDOT) Local
Agency Agreement and Project Prospectus for Naylors Creek at
West Valley Road and Gibbs Lake Road Culvert Replacements
Statement of Issue: The BOCC approved and signed the attached Local Agency
Agreement with WSDOT required to obtain construction phase federal funding for the
Naylors Creek at West Valley Road and Gibbs Lake Road Culvert Replacements at the
July 3, 2023 meeting. Due to WSDOT required revisions, the agreement must be
resigned and resubmitted.
Analysis/Strategic Goals/Pro's Et Con's: The Naylors Creek at West Valley Road and
Gibbs Lake Road Culvert Replacements Project are identified as Project # 10 and # 11
in the adopted 2023 - 2028 Transportation Improvement Program. The project will
replace two deteriorating metal pipe fish passage barrier culverts with larger precast
concrete structures that are not barriers to fish passage.
Fiscal Impact/Cost Benefit Analysis: The agreement amount of $1,913,000 is for
construction and will require no local match.
Recommendation: Public Works recommends that the Board reexecute the attached
Local Agency Agreement original with WSDOT, and return the document to Public
Works for further processing.
Department Contact: Bruce Patterson, P.E., Project Manager, 385-9169.
Reviewed By:
Mark McCauley, unty Administrator Date
CONTRACT REVIEW FORM Clear Form
(INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITH: WSDOT State Funding Agreement Contract No: —
Contract For: Naylors Creek W Valley&Gibbs Lake Culverts Term: 12/31/2027 7s
COUNTY DEPARTMENT: Public Works
Contact Person: Chris Spall (PW Admin) Bruce Patterson(PW Engineering)
Contact Phone: 360-385-9160 360-385-9169
Contact email: cspall@co.jefferson.wa.us bpatterson@co.jefferson.wa.us
AMOUNT: $1,913,000 PROCESS: Exempt from Bid Process
Revenue: 18033320-333131-20590 Cooperative Purchase
Expenditure: 180-Roads Competitive Sealed Bid
Matching Funds Required: None Small Works Roster
Sources(s)of Matching Funds County Road(if required) Vendor List Bid
Fund# 180-Roads RFP or RFQ
Munis Org/Obj Other:
APPROVAL STEPS:
STEP 1: DEPARTMENT CERTIFIES COMPLIAN ' WITH JCC 3.55.080 AND CH TIER 42.23 RCW.
CERTIFIED: ❑ N/A:RE 7 Z8 Z
Signature f LYate
STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE
COUNTY (CONTRACTOR) HAS rEN nRRED BY ANY FEDERAL, STATE, OR LOCAL
AGENCY.
CERTIFIED: ❑ N/A: F 4;2,
Signature Date
7STEP : RISK MANAGEMENT REVIEW(will be added electronically through Lasertiche):
Electronically approved by Risk Management on 8/2/2023.
STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 8/2/2023.
State language - cannot change.
STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND
PROSECUTING ATTORNEY(IF REQUIRED).
STEP 6: CONTRACTOR SIGNS
STEP 7: SUBMIT TO BOCC FOR APPROVAL
1
August 2, 2023
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Method A - Advance Payment - Agency Share of total construction cost (based on contract award)
Method B - Withhold from gas tax the Agency’s share of total construction coast (line 5, column 2) in
the amount of
at $ per month for months.
Local Force or Local Ad and Award
Method C - Agency cost incurred with partial reimbursement
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
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No.
Provisions 6FRSH RI
RUN The Agency shall provide all the work, labor, materials, and services necessary to perform the project which is described and
set forth in detail in the “Project Description” and “Type of
Work.” When the State acts for and on behalf of the Agency, the State shall be deemed an agent of the Agency and shall perform
the VHUYLFHV GHVFULEHG DQG LQGLFDWHG LQ 7\SH RI RUN´RQ WKH IDFH RI WKLV DJUHHPHQW LQ DFFRUGDQFH ZLWK SODQV DQG VSHFL¿FDWLRQV
DV proposed by the Agency and approved by the State and the Federal Highway
Administration. When the State acts for the Agency but is not subject to the right of control by the Agency, the State shall have the right to
perform the work subject to the ordinary procedures of the State and Federal Highway
Administration. II. Delegation of
Authority 7KH 6WDWH LV ZLOOLQJ WR IXO¿OO WKH UHVSRQVLELOLWLHV WR WKH HGHUDO RYHUQPHQW E\WKH DGPLQLVWUDWLRQ RI WKLV SURMHFW 7KH JHQF\
DJUHHV that the State shall have the full authority to carry out this administration. The State shall review, process, and approve
documents required for federal aid reimbursement in accordance with federal requirements. If the State advertises and awards the contract,
the State will further act for the Agency in all matters concerning the project as requested by the Agency. If the Local Agency advertises
and DZDUGV WKH SURMHFW WKH 6WDWH VKDOO UHYLHZ WKH ZRUN WR HQVXUH FRQIRUPLW\ZLWK WKH DSSURYHG SODQV DQG VSHFL¿
FDWLRQV III. Project
Administration Certain types of work and services shall be provided by the State on this project as requested by the Agency and described in
the 7\SH RI RUN DERYH Q DGGLWLRQ WKH 6WDWH ZLOO IXUQLVK TXDOL¿HG SHUVRQQHO IRU WKH VXSHUYLVLRQ DQG LQVSHFWLRQ RI WKH ZRUN LQ SURJUHVV
2Q Local Agency advertised and awarded projects, the supervision and inspection shall be limited to ensuring all work is in
conformance ZLWK DSSURYHG SODQV VSHFL¿FDWLRQV DQG IHGHUDO DLG UHTXLUHPHQWV 7KH VDODU\RI VXFK HQJLQHHU RU RWKHU VXSHUYLVRU DQG DOO RWKHU
VDODULHV and costs incurred by State forces upon the project will be considered a cost thereof. All costs related to this project incurred
by employees of the State in the customary manner on highway payrolls and vouchers shall be charged as costs of the
project. IV. Availability of
Records All project records in support of all costs incurred and actual expenditures kept by the Agency are to be maintained in
accordance ZLWK ORFDO JRYHUQPHQW DFFRXQWLQJ SURFHGXUHV SUHVFULEHG E\WKH DVKLQJWRQ 6WDWH XGLWRU¶V 2 FH WKH 8 6
HSDUWPHQW RI Transportation, and the Washington State Department of Transportation. The records shall be open to inspection by the
State and Federal Government at all reasonable times and shall be retained and made available for such inspection for a period of not
less than WKUHH HDUV IURP WKH QDO SD\PHQW RI DQ\IHGHUDO DLG IXQGV WR WKH JHQF\RSLHV RI VDLG UHFRUGV VKDOO EH IXUQLVKHG WR WKH 6WDWH
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upon request. V. Compliance
with Provisions 7KH JHQF\VKDOO QRW LQFXU DQ\IHGHUDO DLG SDUWLFLSDWLRQ FRVWV RQ DQ\FODVVL¿FDWLRQ RI ZRUN RQ WKLV SURMHFW XQWLO DXWKRUL]HG
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SURMHFWV DUH 1.
Preliminary engineering. 2. Right of
way acquisition. 3.
Project construction. Once written authorization is given, the Agency agrees to show continuous progress through monthly billings. Failure
to show continuous progress may result the Agency’s project becoming inactive, as described in 23 CFR 630, and subject to de-
obligation of federal aid funds and/or
agreement closure. If right of way acquisition, or actual construction of the road for which preliminary engineering is undertaken is not started
by the FORVH RI WKH WHQWK VFDO HDU IROORZLQJ WKH VFDO HDU LQ ZKLFK SUHOLPLQDU\HQJLQHHULQJ SKDVH ZDV DXWKRUL]HG WKH JHQF\ZLOO
UHSD\WR the State the sum or sums of federal funds paid to the Agency under the terms of this agreement (see
Section IX). I DFWXDO FRQVWUXFWLRQ RI WKH URDG IRU ZKLFK ULJKW RI ZD\KDV EHHQ SXUFKDVHG LV QRW VWDUWHG E\WKH FORVH RI WKH WHQWK
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RI IHGHUDO DOT Form
140-039 Revised
04/2022
Page 2 January 6 2003 Certification Acceptance
funds paid to the Agency under the terms of this agreement (see Section IX).
The Agency agrees that all stages of construction necessary to provide the initially planned complete facility within the limits of this
project will conform to at least the minimum values set by approved statewide design standards applicable to this class of highways,
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The Agency agrees that on federal aid highway construction projects, the current federal aid regulations which apply to liquidated
damages relative to the basis of federal participation in the project cost shall be applicable in the event the contractor fails to complete
the contract within the contract time.
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).
1. Project Construction Costs
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Method A – The Agency will place with the State, within (20) days after the execution of the construction contract, an advance in the
amount of the Agency’s share of the total construction cost based on the contract award. The State will notify the Agency of the exact
amount to be deposited with the State. The State will pay all costs incurred under the contract upon presentation of progress billings
from the contractor. Following such payments, the State will submit a billing to the Federal Government for the federal aid participation
VKDUH RI WKH FRVW KHQ WKH SURMHFW LV VXEVWDQWLDOO\FRPSOHWHG DQG QDO DFWXDO FRVWV RI WKH SURMHFW FDQ EH GHWHUPLQHG WKH 6WDWH ZLOO
SUHVHQW WKH JHQF\ZLWK D QDO ELOOLQJ VKRZLQJ WKH DPRXQW GXH WKH 6WDWH RU WKH DPRXQW GXH WKH JHQF\7KLV ELOOLQJ ZLOO EH FOHDUHG E\
either a payment from the Agency to the State or by a refund from the State to the Agency.
Method B – The Agency’s share of the total construction cost as shown on the face of this agreement shall be withheld from its
monthly fuel tax allotments. The face of this agreement establishes the months in which the withholding shall take place and the exact
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Upon receipt of progress billings from the contractor, the State will submit such billings to the Federal Government for payment of its
participating portion of such billings.
Method C – The Agency may submit vouchers to the State in the format prescribed by the State, in duplicate, not more than once
per month for those costs eligible for Federal participation to the extent that such costs are directly attributable and properly allocable
to this project. Expenditures by the Local Agency for maintenance, general administration, supervision, and other overhead shall not be
eligible for Federal participation unless claimed under a previously approved indirect cost plan.
The State shall reimburse the Agency for the Federal share of eligible project costs up to the amount shown on the face of this
agreement. At the time of audit, the Agency will provide documentation of all costs incurred on the project. The State shall bill the
Agency for all costs incurred by the State relative to the project. The State shall also bill the Agency for the federal funds paid by the
State to the Agency for project costs which are subsequently determined to be ineligible for federal participation (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
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Government.
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27 DQG DQG 5 3DUW
XGLW 5HTXLUHPHQWV 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 (see
Section IX). 9,,,6LQJOH
XGLW FW 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 GXULQJ D JLYHQ VFDO HDU VKDOO KDYH D VLQJOH RU SURJUDP VSHFL¿F DXGLW SHUIRUPHG IRU WKDW HDU LQ DFFRUGDQFH ZLWK WKH
SURYLVLRQV RI CFR Part 200.501. Upon conclusion of the audit, the Agency shall be responsible for ensuring that a copy of the report
is transmitted DOT Form
140-039 Revised
04/2022
promptly to the State.
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
WKH JHQF\KDV EHHQ ELOOHG WKH 6WDWH VKDOO H HFW UHLPEXUVHPHQW RI WKH WRWDO VXP GXH IURP WKH UHJXODU PRQWKO\IXHO WD[DOORWPHQWV
WR 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 60 days after the Project Agreement End Date or
they become ineligible for federal
reimbursement. 7UD F RQWURO 6LJQLQJ 0DUNLQJ DQG
5RDGZD\0DLQWHQDQFH 7KH JHQF\ZLOO QRW SHUPLW DQ\FKDQJHV WR EH PDGH LQ WKH SURYLVLRQV IRU SDUNLQJ UHJXODWLRQV DQG WUD F FRQWURO
RQ WKLV SURMHFW without prior approval of the State and Federal Highway Administration. The Agency will not install or permit to be
installed any signs, signals, or markings not in conformance with the standards approved by the Federal Highway Administration and
MUTCD. The Agency will, at its own expense, maintain the improvement covered
by this
agreement. XI. Indemnity The Agency shall hold the Federal Government and the State harmless from and shall process and defend at
its own expense all claims, demands, or suits, whether at law or equity brought against the Agency, State, or Federal Government,
arising from the Agency’s execution, performance, or failure to perform any of the provisions of this agreement, or of any other
agreement or contract connected with this agreement, or arising by reason of the participation of the State or Federal Government in
the project, PROVIDED, nothing herein shall require the Agency to reimburse the State or the Federal Government for damages arising out of
bodily injury to persons or damage to property caused by or resulting from the sole negligence of the Federal Government
or the State.
XII. Nondiscrimination Provision No liability shall attach to the State or Federal Government except as
expressly provided herein. The Agency shall not discriminate on the basis of race, color, national origin, or sex in the award and performance
of any USDOT-assisted contract and/or agreement or in the administration of its DBE program or the requirements of 49 CFR Part
26. The Agency shall take all necessary and reasonable steps under 49 CFR Part 26 to ensure nondiscrimination in the award
and administration of USDOT-assisted contracts and agreements. The WSDOT’s DBE program, as required by 49 CFR Part 26 and as
approved by USDOT, is incorporated by reference in this agreement. Implementation of this program is a legal obligation and failure to carry
out its terms VKDOO EH WUHDWHG DV D YLRODWLRQ RI WKLV DJUHHPHQW 8SRQ QRWL¿FDWLRQ WR WKH JHQF\RI LWV IDLOXUH WR FDUU\RXW LWV
DSSURYHG SURJUDP WKH Department may impose sanctions as provided for under Part 26 and may, in appropriate cases, refer the matter
for enforcement under 18 U.S.C. 1001 and/or the Program Fraud Civil Remedies Act of 1986 (31 U.S. C.
3801 et seq.). 7KH JHQF\KHUHE\DJUHHV WKDW LW ZLOO LQFRUSRUDWH RU FDXVH WR EH LQFRUSRUDWHG LQWR DQ\FRQWUDFW IRU FRQVWUXFWLRQ ZRUN
RU PRGL¿FDWLRQ WKHUHRI DV GH¿QHG LQ WKH UXOHV DQG UHJXODWLRQV RI WKH 6HFUHWDU\RI DERU LQ 5 KDSWHU ZKLFK LV SDLG IRU LQ ZKROH RU
LQ SDUW ZLWK funds obtained from the Federal Government or borrowed on the credit of the Federal Government pursuant to a
grant, contract, loan, insurance, or guarantee or understanding pursuant to any federal program involving such grant, contract, loan,
insurance, or guarantee, the required contract provisions for Federal-Aid Contracts (FHWA 1273), located in Chapter 44 of the
Local Agency Guidelines. The Agency further agrees that it will be bound by the above equal opportunity clause with respect to
its own employment SUDFWLFHV ZKHQ LW SDUWLFLSDWHV LQ IHGHUDOO\DVVLVWHG FRQVWUXFWLRQ ZRUN 3URYLGHG WKDW LI WKH DSSOLFDQW VR SDUWLFLSDWLQJ LV D
6WDWH RU RFDO Government, the above equal opportunity clause is not applicable to any agency, instrumentality, or subdivision
of such government which does not participate in work on or
under the contract. 7KH
JHQF\DOVR DJUHHV 1) To assist and cooperate actively with the State in obtaining the compliance of contractors and subcontractors
with the equal opportunity clause and rules, regulations, and relevant orders of the
Secretary of Labor. 2) To furnish the State such information as it may require for the supervision of such compliance and that it will
otherwise assist the State in the discharge of its primary responsibility
for securing compliance. 7R UHIUDLQ IURP HQWHULQJ LQWR DQ\FRQWUDFW RU FRQWUDFW PRGL¿FDWLRQ VXEMHFW WR HFXWLYH 2UGHU
RI 6HSWHPEHU ZLWK a contractor debarred from, or who has not demonstrated eligibility for, government contracts and
federally assisted construction contracts pursuant to
the Executive Order. 4) To carry out such sanctions and penalties for violation of the equal opportunity clause as may be
imposed upon contractors and subcontractors by the State, Federal Highway Administration, or the Secretary of Labor pursuant to Part II, subpart
D of
the Executive Order. In addition, the Agency agrees that if it fails or refuses to comply with these undertakings, the State may take any or
all of
the IROORZLQJ DFWLRQV D DQFHO WHUPLQDWH RU VXVSHQG WKLV DJUHHPHQW LQ ZKROH
RU LQ SDUW b) Refrain from extending any further assistance to the Agency under the program with respect to which the
failure or refusal RFFXUUHG XQWLO VDWLVIDFWRU\DVVXUDQFH RI IXWXUH FRPSOLDQFH KDV EHHQ UHFHLYHG IURP
WKH JHQF\DQG DOT
Form 140-039
Revised 04/
c) Refer the case to the Department of Justice for appropriate legal proceedings.
XIII. Liquidated Damages
The Agency hereby agrees that the liquidated damages provisions of 23 CFR Part 635, Subpart 127, as supplemented, relative to
the amount of Federal participation in the project cost, shall be applicable in the event the contractor fails to complete the contract within
the contract time. Failure to include liquidated damages provision will not relieve the Agency from reduction of federal participation in
accordance with this paragraph.
XIV. Termination for Public Convenience
The Secretary of the Washington State Department of Transportation may terminate the contract in whole, or from time to time in
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1) The requisite federal funding becomes unavailable through failure of appropriation or otherwise.
2) The contractor is prevented from proceeding with the work as a direct result of an Executive Order of the President with
respect to the prosecution of war or in the interest of national defense, or an Executive Order of the President or Governor of
the State with respect to the preservation of energy resources.
3) The contractor is prevented from proceeding with the work by reason of a preliminary, special, or permanent restraining
order of a court of competent jurisdiction where the issuance of such order is primarily caused by the acts or omissions of
persons or agencies other than the contractor.
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5) The Secretary determines that such termination is in the best interests of the State.
XV. Venue for Claims and/or Causes of Action
For the convenience of the parties to this contract, it is agreed that any claims and/or causes of action which the Local Agency
has against the State of Washington, growing out of this contract or the project with which it is concerned, shall be brought only in the
Superior Court for Thurston County.
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7KH DSSURYLQJ DXWKRULW\FHUWL¿HV WR WKH EHVW RI KLV RU KHU NQRZOHGJH DQG EHOLHI WKDW
1R IHGHUDO DSSURSULDWHG IXQGV KDYH EHHQ SDLG RU ZLOO EH SDLG E\RU RQ EHKDOI RI WKH XQGHUVLJQHG WR DQ\SHUVRQ IRU LQÀXHQFLQJ RU
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RQJUHVV RU an employee of a member of Congress in connection with the awarding of any federal contract, the making of any federal
grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, RU PRGL¿FDWLRQ RI DQ\IHGHUDO FRQWUDFW JUDQW ORDQ RU
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RU DQ HPSOR\HH of a member of Congress in connection with this federal contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit the Standard Form - LLL, “Disclosure Form to Report Lobbying,” in
accordance with its instructions. 7KH XQGHUVLJQHG VKDOO UHTXLUH WKDW WKH ODQJXDJH RI WKLV FHUWL¿FDWLRQ EH LQFOXGHG LQ WKH DZDUG GRFXPHQWV
IRU DOO VXEDZDUGV DW all tiers (including subgrants, and contracts and subcontracts under grants, subgrants, loans,
and cooperative agreements) which exceed $100,000, and that all such subrecipients shall
certify and disclose accordingly. 7KLV FHUWL¿FDWLRQ LV D PDWHULDO UHSUHVHQWDWLRQ RI IDFW XSRQ ZKLFK UHOLDQFH ZDV SODFHG ZKHQ WKLV WUDQVDFWLRQ ZDV
PDGH RU HQWHUHG LQWR 6XEPLVVLRQ RI WKLV FHUWL¿FDWLRQ DV D SUHUHTXLVLWH IRU PDNLQJ RU HQWHULQJ LQWR WKLV WUDQVDFWLRQ LPSRVHG E\
6HFWLRQ 7LWOH 8 6 RGH Q\SHUVRQ ZKR IDLOV WR OH WKH UHTXLUHG FHUWL¿FDWLRQ VKDOO EH VXEMHFW WR D FLYLO SHQDOW\RI QRW OHVV WKDQ
DQG QRW PRUH WKDQ 100,000
for each
such failure. 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). Additional Provisions
DOT Form 140-
039 Revised
Instructions
1. Agency Name and Billing Address – Enter the Agency of primary interest which will become a party to the agreement.
2. Project Number – Leave blank. This number will be assigned by WSDOT.
3. Agreement Number – Leave blank. This number will be assigned by WSDOT.
4.
a. Project Description – Enter the project name, total length of the project (in miles), and a brief description of the termini. Data
entered here must be consistent with the name, length, and termini noted in the STIP and Project Prospectus
Example: (Name) “Regal Road”, (Length) “1.2 miles”, (Termini) “Smith Road to Main Street”
b. Description of Work – Enter a concise statement of the major items of work to be performed. Statement must be consistent
with the description of work noted in the STIP and Project Prospectus.
Example:2YHUOD\5HJDO 5RDG LQVWDOO FXUE JXWWHU DQG VLGHZDON LOOXPLQDWLRQ DQG WUD F VLJQDO DW WKH LQWHUVHFWLRQ RI
5HJDO Road and Dakota
Avenue.” c. Project Agreement End Date – Enter the Project Agreement End Date (mm/dd/yy). This date is based on the project’s
Period of Performance (2 CFR 200.
309). For Planning Only projects – WSDOT recommends agencies estimate the end of the project’s period of performance and
add three years to determine the “Project Agreement End
Date”. For PE and RW – WSDOT recommends agencies estimate when the phase will be completed and add three years
to determine the “Project Agreement End Date”. For Construction – WSDOT recommends agencies estimate when
construction will be completed and add three years to determine the “Project Agreement End
Date”. d. Proposed Advertisement Date – At construction authorization only, enter the proposed project
advertisement date (mm/dd/
yy). e. Claiming Indirect Cost Rate – Check the Yes box if the agency will be claiming indirect costs on the project. For
those projects claiming indirect costs, supporting documentation that clearly shows the indirect cost rate being utilized must
be provided with the local agency agreement. Indirect cost rate approval by your cognizant agency or through your agency’
s VHOI FHUWL¿FDWLRQ DQG VXSSRUWLQJ GRFXPHQWDWLRQ LV UHTXLUHG WR EH DYDLODEOH IRU UHYLHZ E\6'27 DQG RU 6WDWH
XGLWRU Check the No box if the agency will not be claiming indirect costs on the project. See section 23.5 for additional
guidance. 4. 7\SH RI RUN DQG XQGLQJ 5RXQG DOO GROODU DPRXQWV WR WKH QHDUHVW ZKROH
GROODU a. PE – Lines a through d show Preliminary Engineering costs for the project by type of work (e.g., consultant, agency,
state services,
etc.). Federal aid participation ratio for PE – enter ratio for PE lines with amounts in column
3. Line a – Enter the estimated amount of agency work in columns 1 through
3. Line b & c – Identify user, consultant, etc., and enter the estimated amounts in columns 1 through
3. Line d – State Services. Every project must have funding for state services. Enter the estimated amounts in columns
1 through
3. Line e – Total of lines a + b + c +
d. b. Right of Way – If a Right of Way phase is authorized on the project, the appropriate costs are shown in lines f through
i. Federal aid participation ratio for RW – enter ratio for RW lines with amounts in column
3. Line f – Enter the estimated amount of agency work in columns 1 through
3. Line g & h – Identify user, consultant, etc., and enter the estimated amounts in columns 1 through
3. Line i – State Services. Every project must have funding for state services. Enter the estimated amounts in columns
1 through
3. Line j – Total of lines f + g + h +
i. c. Construction – Lines k through p show construction costs for the project by type of work (e.g., contract, consultant,
agency, state services,
etc.). Federal aid participation ratio for CN – enter ratio for CN lines with amounts in column
3. DOT Form 140-
039 Revised 04/
2022 Page
Line k – Enter the estimated cost of the contract.
LQHV O P Q – Enter other estimated costs such as utility and construction contracts or non-federally matched
contract costs.
Line o – Enter estimated costs of all construction related agency work.
Line p – State Services. Every project must have funding for state services. Enter the estimated amounts in columns 1
through 3.
Line q – Total Construction Cost Estimate. Total of lines k + l + m + n + o +p.
d. Total Project Cost Estimate
Line r – Total Cost Estimate of the Project. Total of lines e + j + q.
Please remember, if the federal aid participation rate entered is not the maximum rate allowed by FHWA, then the
participation rate entered becomes the maximum rate allowed.
6. 6LJQDWXUHV Q DXWKRUL]HG R FLDO RI WKH ORFDO DJHQF\VLJQV WKH DJUHHPHQW DQG HQWHUV WKHLU WLWOH DQG GDWH RI VLJQDWXUH PP
GG yy). Note: Do NOT enter a date on the Date Executed
line. 7. Method of Construction Financing KRRVH WKH PHWKRG RI QDQFLQJ IRU WKH FRQVWUXFWLRQ SRUWLRQ RI WKH
SURMHFW a. Method “A” is used when the state administers the contract for the
agency. b. Method “B” is also used when the state administers the contract for the
agency. c. Method “C” is used with projects administered by the local agency. The agency will submit billings monthly through
the state to FHWA for all eligible costs. The billings must document the payment requests from the contractor. If state-
force work, such as audit and construction engineering, is to receive federal participation, it will be billed to the agency and
FHWA simultaneously at the indicated ratio. To show continuous progress agencies should bill monthly until agreement is
closed. 8. Resolutions/Ordinances – When someone other than the County Executive/Chairman, County Commissioners/Mayor
is authorized to sign the agreement, the agency must submit to WSDOT with the agreement a copy of the Resolution/
Ordinance designating that
individual. 9. Parties to the Agreement – Submit one originally signed agreement form to the Region Local Programs Engineer. It
is the responsibility of the local agency to submit an additional, originally signed agreement form if they need an
executed DJUHHPHQW IRU WKHLU OHV 7KH DJUHHPHQW LV UVW H[HFXWHG E\WKH DJHQF\R FLDO V DXWKRUL]HG WR HQWHU LQWR
WKH DJUHHPHQW W LV WKHQ WUDQVPLWWHG WR WKH VWDWH IRU H[HFXWLRQ E\RFDO 3URJUDPV 7KH DJUHHPHQW LV GDWHG DW WKH WLPH RI QDO H[
HFXWLRQ E\
Local Programs. DOT Form
140-039 Revised
04/2022