AG 23-245 - WSDOTRETURN TO: PW ADMIN EXT: 2700 ID #: 4312
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT/DIV: PUBLIC WORKS / Traffic
2. ORIGINATING STAFF PERSON: Soma Chattopadhyay EXT: 2748 3. DATE REQ. BY: 10/19/23
3. TYPE OF DOCUMENT (CHECK ONE):
O CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
p PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
❑ CONTRACT AMENDMENT (AG#): ❑ INTERLOCAL
0 OTHER (WSDOT) - Local Agency Agreement
4. PROJECT NA► E: S stemic High Friction Surface Treatments - Request Preliminary Engineering Funds
S. NAME OF CONTRACTOR: WSDOT
ADDRESS: TELEPHONE:
E-MAIL: FAX:
SIGNATURE NAME: TITLE:
6. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER
REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS
CFW LICENSE # BL, EXP. 12/31/ UBI # , EXP.
7. TERM: COMMENCEMENT DATE Nk 7-5 COMPLETION DATE: 12/31 /27
8. TOTAL COMPENSATION: $ 100,000.00 (They pay us) (INCLUDE EXPENSES AND SALES TAX, IF ANY)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY
RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED
d PURCHASING: PLEASE CHARGE TO; 0 — 0
9. DOCUMENT / CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
8 PROJECT MANAGER SC/ 281h S.p12023
8 DIVISION MANAGER RAP/11 Oct 2023
d DEPUTY DIRECTOR DSW +on
6 DIRECTOR
❑ RISK MANAGEMENT (IF APPLICABLE)
d LAW DEPT KVA 10/16/2023
10. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
11. CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: kO vi Z DATE REC' D:
❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSLS, EXHIBITS
❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR I MONTH PRIOR TO EXPIRATION DATE
(INCLUDE DEPT. SUPPORT STAFF IF NECESSARY AND FEEL FREE TO SET NOTIFICATION MORE THAN A MONTH IN ADVANCE IF COUNCIL APPROVAL IS NEEDED.)
INITIAL / DATE SIGNED
❑ FINANCE DEPARTMENT
❑ LAW DEPT
tp=SIGNATORY (MAYOR OR DIRECTOR)
❑ CITY CLERK
❑ ASSIGNED AG # AG# "'
❑ SIGNED COPY RETURNED DATES NT: t /.I
COMMENTS: lv'"q
EXECUTE" " ORIGINALS
I!-02U
W7Washington State
Department of Transportation
November 28, 2023
Mr. Edward Walsh, PE
Public Works Director
City of Federal Way
33325 8' Avenue South
Federal Way, Washington 98003
Transportation Building
310 Maple Park Avenue S.E.
P.O. Box 47300
Olympia, WA 98504-7300
360-705-7000
TrY.1-800-833-6388
www.wsdot.wa.gov
City of Federal Way
High Friction Surface Treatment.
HSIP-OOOS(673)
FUND AUTHORIZATION
Dear Mr. Walsh:
We have received FHWA fund authorization, effective November 21, 2023, for this project as
follows:
PHASE TOTAL
Preliminary Engineering $100,000
FEDERALSHARE
$100,000
As a condition of authorization, you must show continuous project progress through monthly
billings, until your project is complete. Failure to show continuous progress may result in your
project becoming inactive per 23 CFR 630.106(a) (5) and subject to de -obligation of all federal funds
and agreement closure.
Enclosed for your information and file is a fully executed copy of Local Agency Agreement
LA10753 between WSDOT and your agency. All costs exceeding those shown on this agreement
are the sole responsibility of your agency. Any costs incurred after the Project Agreement End
Date shown on the agreement are not eligible for federal reimbursement. In addition, all eligible
costs incurred prior to the End Date must be billed within sixty (60) days of the End Date or they
are ineligible for federal reimbursement.
FHWA requires projects utilizing federal funds for preliminary engineering or right of way to
advance to construction. If this project is unable to proceed to construction, any expended federal
funds must be repaid.
WSDOT authorization to proceed with right of way and/or construction is contingent upon receipt
and approval of your environmental documents.
You may proceed with the administration of this project in accordance with your WSDOT approved
Certification Acceptance agreement.
Sincerely,
SE e� Taut
Stephanie Tax. .
Manager, Program Management
Local Programs
ST.jg:ml
Enclosure
cc: Mehrdad Moini, Northwest Region Local Programs Engineer, MS NB82-121
Washington State
Department of Transportation
Agency City of Federal Way
Address 33325 8th Ave S
Federal Way
WA 98003
Local Agency Agreement
CFDA No. 20.206. Highway Planning and Construction
(Catalog of Federal Domestic Assistance)
Project No. HSIP-OOOS(673)
Agreement No. 4A 10 71�3
For WSDOT Use Only
The Local Agency having complied, or hereby agreeing to comply, with the terms and conditions set forth in (1) Title 23, U.S. Code
Highways, (2) the regulations issued pursuant thereto, (3) 2 CFR Part 200, (4) 2 CFR Part 180 — certifying that the local agency is not
excluded from receiving Federal funds by a Federal suspension or debarment, (5) the policies and procedures promulgated by the
Washington State Department of Transportation, and (6) the federal aid project agreement entered into between the State and Federal
Government, relative to the above project, the Washington State Department of Transportation will authorize the Local Agency to
proceed on the project by a separate notification. Federal funds which are to be obligated for the project may not exceed the amount
shown herein on line r, column 3, without written authority by the State, subject to the approval of the Federal Highway Administration.
All project costs not reimbursed by the Federal Government shall be the responsibility of the Local Agency.
Project Description
Name Systemic High Friction Surface Treatment Improvements
Length 0.37 miles
Termini various
Description of Work
Install high friction surface treatment at 16 Ave S-curve, east of SR 99; SR 509 curve, at 26th PI SW; SR 509 curve, west of
Redondo Way S; 10th Ave SW curve, south of SW 335th St; S349th St/Weyerhaeuser Way S-curve, east of 30th Ave S; S 372nd
Way/12th Ave S-curve, north of S 373rd St.
Project Agreement End Date 12/31/27 Claiming Indirect Cost Rate
Proposed Advertisement Date [_]Yes ✓ No
stimate Fu dln
(1)
Estimated Total
(2)
Estimated Agency
(3)
Estimated Federal
Type of Work
Project Funds
Funds
Funds
PE a. AgeAgen
17,000.00
17,000.00
100 % b Other Consultant Participation
64,980.00
64,980.00
(Federal Aid c. Other pavement testing
15,020.00
15,020.00
(Participation d.-SJ@te Serykes
3,000.00
3,000.00
(Ratio for PE . Total PE Qgsl Es 'e
100,000.00
0.00
100,000.00
Right of Way f n
Other
iFederal Aid
h. Other
Participation
Ratio for RW L State $ervices
T RAN a 1: +h+i
0.00
0.00
0.00
onstruction k. Contract
%I.QJgr
( r
FederatAid
r
Participation
Ratio for CN
p- State Services
g. !QJaJ QN Cut Esfirnatek4l+m+n 1
0.00
0.00
1 0.00
Eslimgte r
100,000.00
0.00
1 100,000.00
Agency offf
By
Title May
Agency Date
DOT Form 140-D39
Revised 04/2022
Washington State Department of Transportation
By Stephanie Digitally signed 6y5tep1W.Tax
Director, Local Programs Tax Dale:2023.11.1015:73:44 oe•OD'
Date Executed
9
Page 1
A111111111111►
Washington State
Department of Transportation
Agency City of Federal Way
Address 33325 8th Ave S
Federal Way
WA 98003
Local Agency Agreement
CFDA No. 20.205 - Highway Planning and Construction
(Catalog of Federal Domestic Assistance)
I
Project No.
Agreement No.
For WSDOT Use Only
The Local Agency having complied, or hereby agreeing to comply, with the terms and conditions set forth in (1) Title 23, U.S. Code
Highways, (2) the regulations issued pursuant thereto, (3) 2 CFR Part 200, (4) 2 CFR Part 180 — certifying that the local agency is not
excluded from receiving Federal funds by a Federal suspension or debarment, (5) the policies and procedures promulgated by the
Washington State Department of Transportation, and (6) the federal aid project agreement entered into between the State and Federal
Government, relative to the above project, the Washington State Department of Transportation will authorize the Local Agency to
proceed on the project by a separate notification. Federal funds which are to be obligated for the project may not exceed the amount
shown herein on line r, column 3, without written authority by the State, subject to the approval of the Federal Highway Administration.
All project costs not reimbursed by the Federal Government shall be the responsibility of the Local Agency.
Project Description
Name Systemic High Friction Surface Treatment Improvements
Length 0.37 miles
Termini various
Description of Work
Install high friction surface treatment at 16 Ave S-curve, east of SR 99; SR 509 curve, at 26th PI SW; SR 509 curve, west of
Redondo Way S; 10th Ave SW curve, south of SW 335th St; S349th St/Weyerhaeuser Way S-curve, east of 30th Ave S; S 372nd
Way/12th Ave S-curve, north of S 373rd St.
Project Agreement End Date 12/31/27
Proposed Advertisement Date
Claiming Indirect Cost Rate
❑ Yes ( No
Estimate
f Fundin i
(1)
(2) (3)
Type of Work
Estimated Total
Estimated Agency Estimated Federal
Proiect Funds
Funds Funds
IPE a. Agency
17,000.00
17,000.00
0
100 o b. Other Consultant Participation
64,980.00
64,980.00
(Federal Aid c. Other pavement testing
15,020.00
15,020.00
(Participation d. State Services
3,000.00
3,000.00
Ratio for PE
e. Total PE Cost Estimate a
100,000.00
0.00
100,000.00
Right of Way f Agency
.Other
Federal Aid
h. Oth r
Participation
Ratio for RW i. State Services
. Total R/W Cost Estimate r +hA)
0.00
0.00
0.00
Construction k. Contract
%1.Other
m. Other
Federal Aid n. Other
Participation o. A enc
Ratio for CN
p. State Services
q. Total CN Cost Estimate k+l+m+n+o
0.00
0.00
0.00
r. Total Proiect Cost Estimate
100,000.00
1 0.00
1 100,000.00
Agency off!
By
Title May
;�q
Agency Date / e I, - 7"
DOT Form 140-039
Revised 04/2022
Washington State Department of Transportation
By
Director, Local Programs
Date Executed
Page 1
Construction Method of Financing (Check Method Selected)
State Ad and Award
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
V 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
comply with the applicable provisions set forth below. Adopted by official action on
November 15 , 2022 , Resolution/Ordinance No. Resolution 22-834
Provisions
I. Scope of Work
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
services described and indicated in "Type of Work" on the face of this agreement, in accordance with plans and specifications as
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
The State is willing to fulfill the responsibilities to the Federal Government by the administration of this project. The Agency agrees
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
awards the project, the State shall review the work to ensure conformity with the approved plans and specifications.
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
Type of Work above. In addition, the State will fumish qualified personnel for the supervision and inspection of the work in progress. On
Local Agency advertised and awarded projects, the supervision and inspection shall be limited to ensuring all work is in conformance
with approved plans, specifications, and federal aid requirements. The salary of such engineer or other supervisor and all other salaries
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
with local government accounting procedures prescribed by the Washington State Auditor's Office, the U.S. Department of
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
three years from the final payment of any federal aid funds to the Agency. Copies of said records shall be fumished to the State and/or
Federal Government upon request.
V. Compliance with Provisions
The Agency shall not incur any federal aid participation costs on any classification of work on this project until authorized in writing
by the State for each classification. The classifications of work for projects are:
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
close of the tenth fiscal year following the fiscal year in which preliminary engineering phase was authorized, the Agency will repay to
the State the sum or sums of federal funds paid to the Agency under the terms of this agreement (see Section IX).
If actual construction of the road for which right of way has been purchased is not started by the close of the tenth fiscal year
following the fiscal year in which the right of way phase was authorized, the Agency will repay to the State the sum or sums of federal
DOT Form 140-039 Page 2
Revised D412022
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,
even though such additional work is financed without federal aid participation -
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 property 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
Project construction financing will be accomplished by one of the three methods as indicated in this agreement.
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
share of the cost. When the project is substantially completed and final actual costs of the project can be determined, the State will
present the Agency with a final billing showing the amount due the State or the amount due the Agency. This billing will be cleared by
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
amount to be withheld each month. The extent of withholding will be confirmed by letter from the State at the time of contract award.
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
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 Manuai
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 (see Section IX).
Vill. 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
DOT Form 140-039 Page 3
Revised 0412022
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
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 60 days after the Project Agreement End Date or they
become ineligible for federal reimbursement.
X. Traffic Control, Signing, Marking, and Roadway Maintenance
The Agency will not permit any changes to be made in the provisions for parking regulations and traffic control on this project
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 cant' out its terms
shall be treated as a violation of this agreement. Upon notification to the Agency of its failure to carry out its approved program, the
Department may impose sanctions as provided foi 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.)
The Agency hereby agrees that it will incorporate or cause to be incorporated into any contract for construction work, or modification
thereof, as defined in the rules and regulations of the Secretary of Labor in 41 CFR Chapter 60, which is paid for in whole or in part with
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
practices when it participates in federally assisted construction work: Provided, that if the applicant so participating is a State or Local
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.
The Agency also agrees:
(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.
(3) To refrain from entering into any contract or contract modification subject to Executive Order 11246 of September 24, 1965, with
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 Il, 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
following actions:
(a) Cancel, terminate, or suspend this agreement in whole or in part;
(b) Refrain from extending any further assistance to the Agency under the program with respect to which the failure or refusal
occurred until satisfactory assurance of future compliance has been received from the Agency; and
DOT Form 140-039 Page 4
Revised 04/2022
(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
part, whenever:
(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.
(4) The Secretary is notified by the Federal Highway Administration that the project is inactive.
(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.
XVI. Certification Regarding the Restrictions of the Use of Federal Funds for Lobbying
The approving authority certifies, to the best of his or her knowledge and belief, that:
(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or
attempting to influence an officer or employee of any federal agency, a member of Congress, an officer or employee of Congress, or
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,
or modification of any federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to
influence an officer or employee of any federal agency, a member of Congress, an officer or employee of Congress, or an employee
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.
(3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at
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.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into.
Submission of this certification as a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S.
Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not mare than
$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 Page 5
Revised 0412022
Washington State
AML
GADepartment of Transportation
Local Agency Federal Aid
Project Prospectus
Prefix
Route
( )
Date
9/22/2023
Federal Aid
DUNS Number
61-250-9901
Project Number
Local Agency
FW-50
WSDO y 1
Federal Employer
91-1462550
Project Number
Use Only J
Tax ID Number
Agency
CAAgency
Federal Program Title
City of Federal Way
❑✓ Yes ❑ No
0✓ 20.205 ❑ Other
Project Title
Start Latitude N 47.319351
Start Longitude W-122.365718
Systemic High Friction Surface Treatment Improv
End Latitude N 47.288296
End Lon itude W-122.292754
Project Termini From -To
Nearest City Name
Project Zip Code (+4)
various
Federal Way, All within city limits
98003-6325
Begin Mile Post
End Mile Post
Length of Project
Award Type
various
various
0.37 miles
❑✓ Local ❑ Local Forces ❑ State ❑ Railroad
County Number County Name
Route ID
Begin Mile Point
End Mile Point
City Number
various
various
443
17 King
WSDOT Region Legislative District(s) Congressional District(s) Urban Area Number
Northwest Region 30 9 80389
Total Local Agency Phase Start
Federal Funds
Phase Estimated Cost Funding Date
Nearest Hundred Dollar Nearest Hundred Dollar Nearest Hundred Dollar i Month Year
P. E.
$100,000
$100,000
9 2023
RM
Const.
$852,000
$852,000
5 2024
Total
$ 952,000
$ 952,000
Description of Existing Facility (Existing Design and Present Condition)
Roadway Width Number of Lanes
various various
The existing facilities have horizontal curves and s-curves which are high collision locations. The surfaces of
the pavement are all asphalt. There are no high -friction surfaces installed now.
Description of Proposed Work
Description of Proposed Work (Attach additional sheet(s) if necessary)
Install high friction surface treatment at 16th Ave S-curve, east of SR 99; SR 509 curve, at 26th PI SW; SR
509 curve, west of Redondo Way S; 10th Ave SW curve, south of SW 335th St; S349th St/Weyerhaeuser
Way S-curve, east of 30th Ave S; S 372nd Way/12th Ave S-curve, north of S 373rd St.
Local Agency Contact Person Title
Phone
Rick Perez City Traffic Engineer
253-853-2740
Mailing Address City
State
Zip Code
33325 8th Avenue South Federal Way
WA
98003-6325
By 'ram
Project Prospectus Approving Authority
Title Public Works Director Date t01) (' )20
DDT Form 14o-101
Revised 01/2022 Previous Editions Obsolete
Agency Project Title Date —]
City of Federal Way Systemic High Friction Surface Treatment In 9/22/2023
Type of Proposed Work
Project Type (Check all that Apply)
❑ New Construction ❑ Path / Trail ❑ 3-R
❑ Reconstruction ❑ Pedestrian / Facilities ❑ 2-R
❑ Railroad ❑ Parking ❑✓ Other
❑ Bridge
Geometric Design Data
Roadway Width Number of Lanes
N/A N/A
Description
Through Route
Crossroad
❑ Principal Arterial
❑✓ Principal Arterial
Federal
❑✓ Urban
Minor Arterial
Urban
❑ Minor Arterial
Functional
❑ Rural
Collector
❑ Rural
❑ Collector
Classification
NHS
❑ Major Collector
NHS
❑Major Collector
❑ Minor Collector
❑ Minor Collector
❑ Local Access
❑ Local Access
Terrain
❑✓ Flat Roll [:]Mountain
❑ Flat
❑ Roll Mountain
Posted Speed
N/A
N/A
Design Speed
N/A
N/A
Existing ADT
various
N/A
Design Year ADT
various
N/A
Design Year
2023
2023
Design Hourly Volume (DHV)
various
various
Performance of Work
Preliminary Engineering Will Be Performed By
I Consultant
Construction Will Be Performed By
Contractor
Environmental Classification
❑ Class I - Environmental Impact Statement (EIS)
❑ Project Involves NEPA/SEPA Section 404
Interagency Agreement
❑ Class 11.1 - Environmental Assessment (EA)
❑ Project Involves NEPA/SEPA Section 404
Interagency Agreements
Environmental Considerations
none
Others
Agency
100 %
0 %
Contract
Agency
100 %
. 0 %
❑✓ Class II - Categorically Excluded (CE)
❑✓ Projects Requiring Documentation
(Documented CE)
Previous Editions Obsolete
Revised 01/2022
Agency Project Title Date
City of Federal Way Systemic High Friction Surface Treatment In 9/22/2023
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 existing right of way.
Utilities Railroad
❑✓ No utility work required 0✓ No railroad work required
❑ All utility work will be completed prior to the start ❑ Ali railroad work will be completed prior to the start of
of the construction contract the construction contract
❑AII utility work will be completed in coordination ❑AII 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
none
FAA Involvement
Is any airport located within 3.2 kilometers (2 miles) of the proposed project? ❑ Yes ❑✓ No
Remarks
n/a
This project has been reviewed by the legislative body of the administration agency or agencies, or ii s
designee, and is not inconsistent with the agency's comprehensive plan for community development.
Date ! p%7 9 3
Agency City of Federal
By -
airperson
DOT Form 140-101
Revised 01/2022 Previous E itions Obsolete
Page 3
DESIGN COST ESTIMATE
High Friction Surface Treatments (6 locations)
CONSULTANT AGENCY I WSDOT
DESIGN COST ESTIMATE
Engineering (AVG)
Pavement Tester
WSDOT
Total
$190.00
$15,020.00
$170.00
$3,000.00
Project Management
40
80
Basemap
24
Surveying
40
Pavement Design
12
Curb Ramps Design
40
Temporary Erosion/Water Polluti
5
Traffic Control Plan
8
Channelization
8
Review
16
16
CAD Drawing
90
Special Provisions
35
Quanity Estimate
16
Advertising
4
4
Printing
4
Total Hours =
342
100
Total Cost =
$64,980.001
$15,020.001
$17,000.001
$3,000.00
$100,000.00
Note: Work of similar scope and §ize in the past
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YSTEMIC HIGH FRICTION SURFACE Federal Way
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Local Programs Authorization Package Checklist
Agency: City of Federal
Project Title: Systi
Fed Aid/State Project #:
is High Friction Surface Treatment Improvements
By Phase (check all that apply)
Funding Re uest PL* PE**
RW CN
New Phase Authorization
Phase Modification
13
IE
El
E
Non -Funding Request
*PL- Planning. Used for stand-alone planning and study projects.
**PE- Preliminary Engineering. This is the full design phase of a construction project. Once PE is authorized,
the construction phase must be completed, or all federal expenditures must be repaid.
Miscellaneous Items
In addition to this checklist, all Region submittals must utilize the standard Region IDC, memo, or cover letter
If authorizing a subsequent phase on an existing project, has at least one bill for the prior phase been fully processed by
Local Programs (Posted date is present in SPORT)? If not, supplement can't be processed.
Has the scope changed (description of work, limits, staging, RW needs, etc.) since previous submittal?
Project Prospectus (DOT Form 140-101) - LAG Chapter 21
Are all three pages of the current form included?
Does information (title, termini, description, RW needs, cost, etc.) agree with STIP/LAA/NEPA-CE?
Is the project description written such that the project scope is clear to an average person?
Are pages 1 and 3 signed?
If the LPE or another agency is acting as CA, enter CA agency name below and include copy of CA agreement (LOU, MOU, etc)
CA Agency:
Are the Latitude and Longitudes (decimal format preferred) included and correct?
Are Congressional and Legislative Districts included and correct?
Project Zip Code includes the +4?
Are estimated costs included for all phases of the project?
Are the Functional Classification and Urban/Rural designation correct?
Are the Right of Way, Utilities, and Railroad sections filled out,
Typical Sections & Vicinity Map - LAG Chapter 21
When necessary, are the Vicinity Map(s) and Roadway Section(s) included?
Can someone unfamiliar with the project's location easily tell where it's located using the vicinity map!
Are the project limits clearly marked on the map?
Does the section include all elements, with dimensions, of the roadway prism?
Are section changes, if applicable, throughout the project limits noted/displayed?
Agency
Y/N
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
EJ
Y
Y
Y
Y
Region HQ
Check Check
F1
Y/N Y/N
STIP/Funding Documentation - LAG Chapter 12 [__1 71
Is the currently approved STIP page included? Y
Does STIP information (termini, description, etc.) match the LAA and Prospectus? Y
Is the phase being authorized (or a later phase) programmed in the STIP? Y
Is funding from all requested programs shown in the STIP? Y
Are the requested funds supported by the STIP? Y
If funded through a HQ managed program (ex. Bridge, HSIP), is the award letter included when these funds arefirst obligated?
If funded through a HQ managed program, does the submitted scope match the project summary scope?
Local Agency Agreement (DOT Forms 140-039 & 140-041) - LAG Chapter 22
Is at least one LAA or LAA supplement, with an original signature, included?
Current form used? (check revision date at bottom left)
All pages of Agreement included?
Are the Agency information, Project #, LAA #, Supplement #, and date of original agreement execution correct?
Does project information (title, termini, length, description, etc.) agree with STIP/Prospectus/NEPA-CE?
Authorization Package Checklist WSDOT/Local Programs 1 of 2
Local Programs Authorization Package Checklist
Lcxi 'AlMy Agreement (DOT Forms 40-039 & 140-041) -l apter i[CCi'(IIT.)
Agency
❑
Region HQ
Check Check
❑ ❑
Is the reason for supplement accurate and up to date?
Is the Project Agreement End Date (month, day, and year) included? Does it follow LAG guidance?
Y
When not authorizing a new phase, is the end date the same as shown on the previous agreement?
If not, is adequate justification (see LAG 22.3) included to support changing the end date?
Is the Advertisement Date (month, day, and year) Included? is it within 6 weeks of estimated CN authorization?
If the ICR box is checked 'Yes', is the agency's current approved/self-certifed rate documentation provided? It must clearly show
a single rate to be used, the imeframe it covers, and the actual signature of approval/self-certification.
if corrections made, are they initialed? If made by WSDOT is permission from Agency provided?
Are all federal aid participation ratios being used listed?
If de -obligating funds on any line, does It reduce obligation below expenditures?
Are amounts calculated correctly and shown in the correct columns?
PV me h Estimate -,LAG ���I�fic
❑
❑ ❑
Is a Documented Cost Estimate included for each phase requesting/changing funds?
Are total dollars on the LAA supported by the phase estimates?
y
Does the estimate sufficiently demonstrate how the costs were determined?
Y
Right of Way - LAG Chapter 25
❑
❑ ❑
If authorizing RW, is a true cost estimate summary sheet included?
Does the true cost estimate summary sheet support RW amounts shown on the LAA?
If authorizing RW and Relocation is required, is the signature page of the approved Relocation Plan included:
If authorizing M. isthe Local Programs approved RW Certification Included?
N/A
N/A
N/A
N/A
If RW acquired under the Government Acquisitions Provision, is approval documentation included?
N/A
Environmental Documentation/Approval (NEPA) - LAG Chapter 24
❑
❑ ❑
Is an approved NEPA package (at least signature page) included?
No
Does the desalption of work match the Prospectus/LAA%5TIP?
yes
Is the footprint of the project within the limits of the NEPA approval?
yes
Do the NEPA-CE Part 3 RW responses agree with the STIP and Prospectus?
yes
Is the approval date within the last 3 years?
If approval is older than 3 years, has the approval been re-evaluated by the environmental engineer?
yes
N/A
DBE Goals (LAG Chapter 26) - Tied Bid (LAG Chapter 44) - Local Forces (LAG Chapter 61)
❑
❑ ❑
If authorizing construction, is the DBE goal letter/e-mail included, or are the goals in SPORT%
If construction Includes a tied bid project, is the approved PIF Included or noted in SPORT?
If construction by Local Forces, is the approved PIF included or noted in SPORT?
PROJECT NOTES (Provide additional information or explanation as necessary)
Authorization Package Checklist WSDOT/Local Programs 2 of 2