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AG 06-024�TURrr To: ��r� t1.��' � I'�'lC���� b ExT: �.-� ( CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATINGDEPT/DIV: PUBLIC WORKS /.J f d' P P� 2. ORIGINATING STAFF PERSON: I�� � 1 a 1.'1 (� f� 1> P('�S EXT: �?� 3 3. DATE REQ. BY: 4. TYPE OF DOCUMENT �CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT �E.G., RFB, RFP, RFQ� ❑ PUBLIC WORKS CONTRACT ❑ PROFESSIONALSERVICEAGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ REAL ESTATE DOCUMENT ❑ ORDINANCE �CONTR ❑ OTHER 5. PROJECT 6. NaME oF Co T�cTOx: W S DD� � f-� i a� w� N s u�cl L r7ca ��r D�r Fa �r S AnD�ss: a c k rr ' LP ��,PQr� � TELErxoNE: zo6 -�t�tD-�-(z3y E-NI�L: O � � ��/' ^_ c? F�: SiGNaTUxENaME: TiTLE: D,r l-fwu �F- Lo� Proar��,s 7. 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. / / 8. TERM: COMMENCEMENT DATE: �� / I�3I ZCT�� COMPLETION DATE: /�/r�{ 9. TOTAL COMPENSATION: $�rotk`�" ��a-y wt � u fSP i�c?+1`f �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 ❑ PURCHASING: PLEASE CHARGE TO: � ra w�7 � Q,.,.� ���S? c,.� Z;, � 10. DOCUMENT / CONTRACT REVIEW '�'PROJECT MANAGER ��MANAC'FR �tl � �DEPUTY DIRECTOR /✓1� � y ��� �DIRECTOR G�c �ef ��� � 1 — r n�i� Tlr.,,.,. 11 . COUNCILAPPRO VAL �IF APPLICABLE� ��.' �' ' � �� '1 � �1i1.�� " I � �� �ir�ij i � ... �. _r.� .� _ • �� ' COMMITTEE APPROVAL DATE: 12 . CONTRACT SIGNATURE ROUTING / �SENT TO VENDOR/CONTRACTOR DATE SENT: ����.� ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS INITIAL / DATE SIGNED ❑ L.aw DEPT �� �SIGNATORY �CM R DIRECTOR� . GJ� s G1 J � �y,�, � CITY CLERK �ASSIGNEDAG# AG# � '���� ,� SIGNED COPY RETURNED DATE SENT: ',Z (,P •�'� COUNCILAPPROVAL DATE: DATEREC'D: -��.�� � � I COMMENTS: ( EXECUTE "�" ORIGINALS C t��( 5 tq �i S T 1 r y�, 11/9 C:\Documents and Settingslbrianhr\Local Settings\Temporary Internet Files\Content.0utlook\U07KCQ36\PW Routing Form.doc ❑ SMALL OR LIMITEA PUBLIC WORKS CONTRACT ❑ MAINTENANCE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ SECURITY DOCUMENT �E.G. BOND RELATED DOCUMENTS� ❑ RESOLUTION � , A(�F,Nt,Y � iNashington State Departmer�t of Twansportation Local Agency Agreement Supplement Agency Supplement Number Ci of Federal Wa 4 Federal Aid Project Number Agreement Number CFDA No. 2�.205 STPUL 004 LA6026 Catalo of Federal Domestic Assistance The Local Agency desires to supplement the agreement entered into and executed on February 13 , 2006 All provisions in the basic agreement remain in effect except as expressly modified by this supplement. The changes to the agreement are described as follows: Project Description Name Pacific Highway South HOV Lanes Phase IV Length 0.95 Termini Dash Point Road to South 312th Street Description of Work � No Change Reason for Supplement Correct for overbilling on progress billing 19 while supplement 3 was in process Does this change require additional Right of Way or Easements? ❑ Yes � No Estimate of Fundi T�/p@ Of WOI'k Prev � Estimat > d Total Aareement/Suool. Supplement proiect Funds PE a. Agency 86.5 % b. other Consultant c.Other Non-Participat Federal Aid Participation d. State Ratio for PE e. Total PE Cost Estimate Right of Way f. Aqency 86.5 % g _ pther Consultant Federal Aid h. Other Non-Participatit Participation Ratio for RW i. State i. Total R/W Cost Estimate 100,000.00 1,209,394.00 19,500.00 100,000.00 1 209,394.00 2,500.00 22,000.00 2 500.00 1,331,394.00 231,214.00 2,715,587.00 Construction I. Other Consultant m. Other HSIP (100% n.Other Non-Particix 86.5 % Federal Aid Participation Ratio for CN 914,201.00 -231,214.00 3 682,987.00 384,971.00 384,971.00 150.00 243.00 (4) (5) ited Agency Estimated =unds Federal Funds 13,500.00 86,500.00 163,269.00 1 046,125.00 2,970.00 19,030.00 179,739.00 1,151,655.00 366,604.00 2 348,983.00 54 000.00 346 000.00 338. 2.162.00 2.G97.145.00 497.203.00 3,185,784.00 38,150.00 5,1 46 243.00 6,2 76391.00 8,484,E '1.00 333 0.00 500 i0.00 0.00 33 3.00 4C � r Total Project Cost Estimate (e+j+q) I 17 405 284 00 I I 17.405.284.00 I 9.464.70U.00 I 7.94U.584.U1 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 O�cial Washingtan State pa ment of Tran ortation B � �► �J �Il� By � . Title Director of Highways and L cal Programs MAY 1 2010 -Dtt�� ` Date Executed DOT Form 140-041 EF Revised 1/2007 RETURN TO: ��� CITI' OF FEDERAL WAY LAW DEPARTMENT FOR CONTRACT PREPARATION/DOCUMENT REVIEWISIGNATURE ROUTING SL� ORIGINATINGDEPT./DIV: �'(ft�JSfrQ��S 2. ORIGINATING STAFF PERSON: Q t lcti.-i �ZD ��f � S EXT. 2 72,3 3_ DATE [tEQ. BY:_ 4. TYPE OF DOCUMENT REQUESTED (CHECK ONE) ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ SMALL PUBLIC WORKS CONTRACT � PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT � GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG 0 REAL ESTATE DOCUMENT � SECURITY DOCUMENT �E.G. 80ND RELATED DOCUMENTS) ❑ ORDINANCE O SOLUTION \ �CONTRACT AMENDMENT (AG#): - OZ L � 1 ❑ OTHER � 5. PROJECTNAME: Pa.�i''�1C c�T�-uti1 S� HDU �cr-�t'S pl1aS? �Z 6. NAME OF CONTRACTOR: ADDRESS: l S�' � C SIGNATURE NAME: TITLE " �.D6-y `�D ?3y 7. EXHIBITS AND ATTACHMENTS: D scoP� WO R SERU[CES � COMPEIVSATION ❑ INSURANCE REQUIRE(viENTS/CERT�ICATE ❑ ALL OTHER REFERENCEB EXHIBITS O PROOF AUTHORITYTO SIGN ❑ REQU[{tED L[CENSES ❑ PRIOR CONTRACT/AMENDMENfS 8. TERM: COMMENCEMENT DATE: � CONNIPLETION DATE: �. TOTAL COMPENSATION $ (iNCLUDE E�cPErrsES aND Sat,ES T.ax, � arrY) (IF CALCUi.ATED ON HOURLY LABOR C[ - ACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURStYBLE EXPENSE: � YES ❑ tvo 1�5 MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED O YES IF YES, $ PAID BY: O CONTRACTOR o C[TY ❑ PURCHASING: PLEASE CHARGE TO: G� fa.�►� ret�� �o�crses C�-f ��PeK S�s — ,� l� t0. CONTRACT REVIEW �TIAL! D TE REVIEWED �PROJECT MANA�R �b ��� DIRECTOR 4�- Qr- �^— a �r /�k�rr*.rw�rnl?vin..r wnw. „ '**+*-�-*�1���jAj�J Z, 6 �o �o� � � � ulttLl. t V I ❑ RISK MANAGE1v�NT ([� �arPL[cASLE) a�t7�d' LAW - Z� .�6 � ll RACT SIGNATURE ROUTING SENT TO VENDOR/CONTRACTOR DATE SENT: c� � a ATTACH: SIGNATUREAUTHORITY, INSURANCE CERTIFICAT£, LI ENSE , EXH[BITS ❑� � I`�' SIGNATORY C1v1 �q � CITY Ci.ERK L ST 6� ASSIGNED AG# pQ SIGNED COPY RETURNED :OMMENTS: INITIALJ DATE SIGNED INITIAL / DATE APPROVED DATE REC' D: �� I�J 1 �� � � Washing�on St�te � �'�'��'CY� oepa��� of ���at�o„ Local Agency Agreement Supplement Agency Supplement Number Ci of Federal Wa 3 Federal Aid Project Number Agreement Number CFDA No. 20.205 STPUL 004 LA6026 Catal of Federal Domestic Assistance The Local Agency desires to Supplement the agreement entered into and executed on February 13, 2006 All provisions in the basic agreement remain in effect except as expressly modified by this supplement. The changes to the agreement are described as follows: Project Description � Name Pacific Highway south HOV Lanes Fhase IV Length 0.95 Termini Dash Point road to South 312th Street Description of Work � No Change Reason for Supplement Obligate Construction Funds Does this change require additional Type of Work PE a. Agency 86.5 % b.Other Consultant c.Other Non-Partic Federal Aid Participation d. State Ratio for PE e. Total PE Cost Estirc Right of Way f. Aaency 86.5 % g other Consultant Federal Aid h. Ofher Non-Partici� Participation Ratio for RW i. State Construction Consultant HSIP (100% Non-Particin 86.5 % Federal Aid Participafion Ratio for CN of Way or Easements? Previous A reemenUSu 1. 100,000.00 1,325,000.00 0.00 I5,000.00 �+c+d 1440 000.00 2,715,587.00 ❑ Yes � No Estimate of Fundi (2) (3) Supplement Estimated Total Pro'ect Funds l OQ000.00 -115 606.00 1 209 394.00 0.00 4,500.00 19,500.00 _> > > � n�_nn 1328.894.00 1.2 ( 4.00 3,914,201.00 384_971.00 150.00 I (4) (5) �ted Agency Estimated Funds Federal Fun 13 500.00 86 501 163.269.00 1,046,12: 16.867.00 1 2 484 373.00 335 390.00 2 148 983.00 400.000.00 54 000.00 346 000.00 5 000.00 675.00 4 325.00 3,914,201.00 528,417.00 3 385,784.00 384 971.00 51 971.00 333 000.00 500,000.00 0.00 500 000.00 7 924 040.00 7 924 040.00 38150.00 5,150.00 33,000.00 46 243.00 6,243.00 40,000.00 2_R07.605_00 R.S15.R21.00 4.291.784.00 r Total Project Cost Estimate (e+j+q) � 4 939 999 00 � 12 465 285 00 � 17.405Z84.00 � 9.464J00.00 I 7.940.584.0 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 Stat De "rtment of,�ransportation By n� J. Cr+ l�� -�'" Bv - .� Title Director of Highways a Local Programs 01 2010 ��J � �� Date Executed DOT Form 140-041 EF Revised 1/2007 �ATE iN: M I DATE OUT: TO: l� CITY OF FEDERAL WAY LAW DEPARTMENT REQUEST FOR CONTRACT PREPARATION/DOCUMENT REVIEW/SIGNATURE ROUTING SLIP i. ORIGINATING DEPT./DIV: E���U S e�3 r ORIGINATING STAFF PERSON: Q f i a �r R a�i e� EXT: L? Z-� 3. DATE REQ. BY: 4. TYPE OF DOCUMENT REQUESTED (CHECK ONE) PROFESSIONAL SERVICE AGREEMENT MAINTENANCE/LABOR AGREEMENT PUBLIC WORKS CONTRACT SMALL PUBLIC WORKS CONTRACT (c,ESS T[�nrr $ZOO,000� O PURCHASE AGREEMENT> (MATERIALS, SUPPLIES, EQU[PMENT) REAL ESTATE DOCUMENT 5. PROJECT NAME: a�; F i` 6. NAME OF��LjTRACTOR: '1�I S ADDRESS: SIGNATURE NAME: SECURITY DOCUMENT (e.c, ncxE��vT PERF/MAIN BOND; ASSIGNMENf OF FUNDS [N LIEU OF BOND) CONTRACTOR SELECTION DOCUMENT ��.c., t�a, a�r, [tFQ> CONTRACT AMENDMENT AG#: Q —p CDBG �OTHERC-.oca� f}q�eKcy rQ-a feew�p►ti� �cc�y �F�e,�T�Z 11 �J �t�,e vrsecl� ��s P�,as�_1 U( Das� p�- PcI S 3tz� �t' o�..e- Pro ra d�'�ia.+' '�'1.3D� Ol W 85a5/ 7 3 TELEPHONE �S'fP�o,l��n1.e_ �is.r TITLE-,�Q,/I�r�Q� rcm l�'U.n�cvnt�' 7. ATTACH ALL EXHIBITS AND CHECK BOR`� SCOPE OF SERVICES Ai,L-�3CHIBITS REFERENCED IN DOCUME INSURANCE CERTIFICATE DOCLJMENTAUTHORt�S'r.;" '"TURE t�ri or Ca Y}�-ac�,qv„c n dmu t, i �r-- 8. TERM: COMMENCEMENT DATE:��- o`�v�0 C01�3P�,'�ION DATE: /`I I� 9. TOTAL COMPENSATION rjA� ([rrcLUDE ExP�N�ES At �D�6 E�IF ANY� (IF CALCULATED ON HOURLY LABO RC ti1 fACH SCHEDULES OF EMPLOYEES TITLES AND HOLI TES) REIMBURSABLE EXPR YES NO IF YES, MAXIMUM DOLLAR AMOtJNT: IS SALES TAX OWFr�-- YES NO IF YES, PAID d CONTRACTOR CIT 10. CONTRACTREVIEW �PROJECT MANAGER �DIRECTOR J�[ ti RISK MANAGEMENT I�a A�6- �rwi 11. CONTRACT SIGNATURE ROUTING �CITY M:ANAGER r 12�z� ��ITY �LERK IGN COPY BACK TO ORGIN T G DEPT. �'ASSIGNED AG# O�o O PURCHASING: PLEASE CHAR TO: COMMENTS 1�� iJi_ INITIAL/DATE APPROVED 1 2 !o, e c,ar�l INITIAL/DATE APPROVBD I1�TITIAL/DATE APPROVED no�S toio9io2 Washington State Department of Transportation Local Agency Agreement Supplement Agency Supplement Number City of Federal Way 2 Federal Aid Project Number Agreement Number CFDA No. 20.2�5 STPUI.,-1013 (004) LA 6026 (Catalog of Federal �omestic Assistance) The Local Agency desires to supplement the agreement entered into and executed on February 13, 2006 All provisions in the basic agreement remain in effect except as expressly modified by this supplement. The changes to the agreement are described as follows: Project Description Name Pacific Highway South HOV Lanes Phase N Length 0.95 Termini Dash Point Road to South 312th Street Description of Work No Change Reason for Supplement Authorize ROW Funds Estimate of Funding Type of Work c2> Previous Supplement Estimated Total Estimated Agency Estimated A reemenUSu I. Pro'ect Funds Funds Federal Funds PE a. Agen 100,000.00 100,000.00 13,500.00 86,500.00 86.5 b.Other Consultant 1,325,000.00 1,325,000.00 178,875.00 1,146,125.00 c.Other Non-Participating 0.00 0.00 Federal Aid d. State 10,000.00 5,000.00 15,000.00 2,025.00 12,975.00 Participation Ratio for PE e. Total PE Cost Estimate (a+b+c+d) 1,435,000.00 5,000.00 1,440,000.0(1 194,400.00 1,245,600.00 Right of Way f. A ency 2,715,587.00 2,715,587.00 366,604.00 2,348,983.00 86.5 .O�her Consultant 400,000.00 400,000.00 54,000.00 346,000.00 Federal Aid h. Other Non-participating 379,412.00 379,412.00 379,412.00 0.00 Participation Ratio for RW i. State 5,000.00 5,000.00 675.00 4,325.00 Total R/W Cost Estimate f+ +h+i 3,499,999.00 3,499,999.00 800,691.00 2,699,308.00 Construc4ion k. Contract I. Other m. Other n. Other o. Agency Federal Aid p. State Participation Ratio for CN Total CN Cost Estimate k+l+m+n+o r. Total Project Cost Estimate !e+j+g� p� W 1,435,000.00 3,504,999.00 4,939,999.00 995,091.00 3,944,908.00 _._._._.._._.x 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 O' I Washington State De artment of T nsportation By By Title p�cistant C'ih� Mana�r/C'h� .r� atin� nfficer Assistant Secretary for ighways and Local Programs Emergen�� Manager Date Executed FEB 1 B 2009 DOT Form 140-041 EF Revised 4/2000 a c, o�� ��z� Washington State Departm+�nt of Transportation Psula J. Natnenond, P.E. Secretary of 7ransportadon March 23, 2009 Mr. Ken Miller, P. E. Public Works .Deputy Director City of Federal Way P. O. Box 9718 Federal Way, WA 98063-9718 Transportation Buildfey� 310 Maple Park Avenue S.E. P.O. Brnc 47300 Oly►r�Ia, WA 9850473U0 360-T05-7000 1'tY: 1-800-833-6388 www.M►sdoi.,Na.po�► �ty of Federal Way Pacific Highwxy South A4Y Lanea Pha.se 4 STPUL-1013(004) FUND AUTHORIZATION Dear Mr. Miller: RECEIVE� MAR 2 5 �9 LOCAL Pti�GRANAS We ha.ve received FHWA fund authorization, effective February 26, 2009, for this praject as follows: PHASE Right of Way TOTAI. FEDERAL SHARE 53,499,999 $2,699,348 Enclosed for your infoimation and fiie is a fvlly executed copy of Supplement NvYnber 2• to Local Ageacy Agrecment LA-6026 between the state and your agency. AII costs exce�ding those shown an this agre�ement are the sole responsibility of your agency. In addition, #his supplement modifies your PE funds to a total 0�$1,444,000 (51,245,6�0 federa! �shaze}. WSDOT authorization to proce�d with construction is contingent upon raceipt af your Right of Way Certification. You may pmcoed with the administration of t�uis project in accordance with your WSDOT approved Certification Acceptance agreement. s���iy, �j� ,,�1f f�t: Stephanie Tax Manage,r, Prggi�am Management Highways 8c L'ocal Programs Division ST jg:ac E,nclosure cc: Ed Conyers, Narthwest •Region Local Programs Engirieer, MS NB82-121 DATE IN: 1. 2. 4. 5. 6. 7. 8. DATE OUT: t( V\J rIA CITY OF FEDERAL WAY LA W.D.EEARTMENT REQUEST FOR CONTRACT PREPARATIONIDOCUMENT REVIEW/SIGNATURE ROUTING SLIP ORIGINATING DEPT.IDIV: QLO I ~ ORIGINATINGSTAFFPERSON:~' F? VY\.-k-i //1rt'U^-- EXT: OL10l-1 3. DATEREQ. BY: TYPE OF DOCUMENT REQUESTED (CHECK ONE) / J!obtrfs o PROFESSIONAL SERVICE AGREEMENT 0 SECURITY DOCUMENT (E.G. AGREEMENT & o MAINTENANCE/LABOR AGREEMENT PERFIMAIN BOND; ASSIGNMENT OF FUNDS IN LIEU OF BOND) o PUBLIC WORKS CONTRACT 0 CONTRACTOR SELECTION DOCUMENT o SMALL PUBLIC WORKS CONTRACT (E.G.,RFB,RFP,RFQ) aL tV/"\ (LESS THAN $200,000) 0 CONTRACT AMENDMENT AG#: (JtI(tI- ~1~) o PURCHASE AGREEMENT) 0 CDBG ~~ I (MATERIALS, SUPPLIES, EQUIPMENT) '1'OTHER Lo~ ~~ ~~ ~p}ev..x o REAL ESTATE DOCUMENT ' PROJECT NAME: PC\..c....~ NAME OF CONTRACTOR: ADDRESS: SIGNATURE NAME:- ATTACH ALL EXHIBITS AND CHECK BOXES 0 SCOPE OF SERVICES o INSURANCE CERTIFICATE 0 DOCUMENT AUTHORIZING SIGNATURE TERM: COMMENCEMENT DATE: ~l~ COMPLETION DATE: p/tr 9. TOTAL COMPENSATION $ N Lv+- (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: 0 YES 0 NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED 0 YES 0 NO IF YES, $ PAID BY: 0 CONTRACTOR 0 CITY 10. CONTRACT REVIEW if PROJECT MANAGER ftDIRECTOR l/ I Le J D, ~~1~~q/g~rENT t;ll. w;'-P0l 11. CONTRACT SIGNATURE ROUTING rI. LAW DEPARTMENT ~ CITY MANAGER {. ';?3-07 1-11 i7 I;l( CITY CLERK S. 03' 01 . ()$Oor II .D ;!€~E~~~= INITIAL/DATE APPROVED INITIAL/DATE APPROVED Tr"'L/ I / IO~C)7 7!J)./d. Z-) ;; '7 INITIAL/DATE APPROVED ~ I," -1/~ n lM}.-' ~.~l~' ~( ~ <gOQ:~q l"'q ~ ~~. 0 t"\C6'"jr--& ~~Zot.~ COMMENTS . \!l (\ ~~ Q...U..\W)c-'l~s 0.-' ~J.~o.Y \~ ~C'w..~ 07/05 - 1..- i)fi 'MIs - v " ,,' e e ~ ,,/I Washington State Department of Transportation Douglas B. MacDonald Secretary of Transportation March lJ, 2007 Transportation Building 310 Maple Park Avenue S.E. P.O. Box 47300 Olympia, WA 98504.7300 360-705.7000 TTY: 1-800.833.63813 w\w/.wsdOl.wa.gov Mr. Cary M. Roe, PE Public Works Director City of Federal Way PO Box 9718 Federal Way, WA 98063-9718 RECE9VFD MAR I 4 2007 I nrlJ. r opnr,p" 111/(' {~ Dear~ City of Federal Way Pacific Highway South HOV Lanes Phase IV STPUL-I013(004) FUND AUTHORlZA TION Enclosed for your information and file is a copy of Supplement Number 1 to Local Agency Agreement LA-6026 for the subject project between the state and your agency. This supplement modifies the funding for this project to the amounts shown below: PHASE Preliminary Engineering TOTAL $1,435,000 FEDERAL SHARE $1,241,275 All costs exce!eding those shown on this agreement are the sole responsibility of your agency. WSDOT authorization to proceed with construction is contingent upon receipt of your Right of Way Certification. I WSDOT authorization to proceed with right of way aldlor construction is contingent upon receipt and approval of your environmental docf~ents. You may proceed with the administration of this projbct in accordance with your WSDOT approved Certification Acceptance agreemeht. I I Sincerely, ~ Stephanie Tax Manager, Progr Management Highways & Loral Programs Division ST:dc:sas I E~~rure . i . _ .-. I -. ~.". ~.... -'-. :-;:-~~. -. -, l'~!~ :Y' "i?t ,.,. .:" ~:\ cc: _{~~~Th.\W~S~.]jJjlli_~' .M~.il~ I IOO@ SNO LLVM3dO MAli-! 90Rt Ott 90Z YV3 ZZ:RO LO/OC/CO \' .' e e ~ Yl, Washington Slate Department 0' Transporta Local Agency A~ eement Supplement Agency .f;:lty .?f Fe:~~.~<l:1 W.ay Federal Aid Project Number STPUL.1013(004) Agreement Number LA 6026 Supplement Number I CFDA No 20.205 (Calalog of Fede;al Domeslic AssislaoCe) The Local Agency desires to supplement the agreement entered into and e><eculed on February I J, 2006 .. ---. All provIsions In the basic agreemenl remain ;n effect except as expCf'1ssly modified b~' trlis sUflplemenl. The changes to the agreement are described as follows: Project Description Name ~acific H!gh~ay South HOV Lancs.~~~~~~~~_ .__.____.. Termini Dash Point Road to South 3 12to Street Length 0:95 ~ -0 't- ~ ~ Description of Work C81 No Change Reason for Supplement Authorize Additional Federal Funds I Estimate of Funding , ,...--- --. (2j- ------r-- (3)- --r (4' ._~ --- ----- - . . Type of Work : 01 (5) -t1J 30'1-5' PreVIous Supplement ! Estimated Total 1 Estimated Agency I E:shrnilted - I Agreement/SuDol. : PrOject Funds, Funds : Federal Funds PE a. Agency /2- , 100.000.00 I 100,000.00 ~ 13.50000' 86.500.00 i 86.5 % b. Other Consultant 11/1:3 i 499.346.00 825.654.00f 1.325.000.001 178,875.00/ 1,146.125.00 - c.Other Non-Participating I 925,654.00 i ------ -925,654.00. ~ Federal Aid d. Stale 11 '1--- ;----- ----,---------.--.. ! 10,000.00 ---~ 10.000.001 1,350.0~ ~.650.00 PartiCIpation I 1,435,000.00 I --. .-.--------- Ratio for PE e. fOlal PE Cost Estimate (a1-b+c+d) I 1.435,000.00 193, 725.UO I 1,!4I,275.00 , Right of Way f~ge[lcy i I I I .-"-T-- -i"...--:-._~ % I ~---~- . . _..- --.--. g. Other -C---- ---=~f--- j r-.--.... ._. Federal Aid h. Other . Participation - ---l=-~-=r=--~ Ratio for RW i. State I j. Total RM/ Cost Estimate (f+g+h+i) . , I I Construction k. Contract I ____l________ I ;r- f- f---- I. Other ---I -- .. m. Other i ' n. Other I % I - o. Agency ! Federal Aid I Participation p. State Ratio for eN q: Total CN Cost Estimate (k-tl"fllffi-tO-tp) r. Total Project Cost Estimate (e+j+ql 1,435,006.00 1,435,000.60 193,725.00 1,241,275.00 The local Agency further stipulates that pursuant to said Title 23. regulations and policies and procedures, and as a condilion to payment of the Federal funds obligated. it accepts andwi1l comply with the applicable provisions. CITY OF FEDERAL WAY NEAL l'::!4~A~ v& By APPR~-16 TO FORM: ~CC~ PATRICIA A. RICHARDSON, CITY ATIORNEY D<lle Executed ojl(!)G/~7 GOO~ SNO IJ,VM3dO MAiN 90g~ O~~ 90G KV~ Cz.:gO LO/OC/CO DATE IN: I DATE OUT: I TO: btt([e ~1 e l-{A 1lts-k/ CITY OF FEDERAL WAY LAW DEPARTMENT REQUEST FOR CONTRACT PREPARATION/DOCUMENT REVIEW/SIGNATURE ROUTING SLIP 1. 2. 4. 5. 6. 7. 8. pw l:S+ree+s . ~ A-I EmT-f?\ . ORIGINATING DEPT./DIV: ORIGINATING STAFF PERSON: EXT: ;} 1 :LJ~ 3. DATE REQ. BY: TYPE OF DOCUMENT REQUESTED (CHECK ONE) o PROFESSIONAL SERVICE AGREEMENT 0 SECURITY DOCUMENT (lOG AGREEMENT & o MAINTENANCE/LABOR AGREEMENT PERFIMAIN BOND; ASSIGNMENT OF FUNDS IN LIEU OF BOND) o PUBLIC WORKS CONTRACT 0 CONTRACTOR SELECTION DOCUMENT o SMALL PUBLIC WORKS CONTRACT (E.G., RFB, RFP, RFQ) { j (LESS THAN $200,000) 0 CONTRACT AMENDMENT AG#:..Otr /)()'y o PURCHASE AGREEMENT) 0 CDBG (MATERIALS,$UPPLIES,EQUJPMENT) ;&.OTHER 0 LOca/~en. CiJ. Feder-a1Atc1 o REAL ESTATE DOCUMENT ..--,:; . L . " .__ 0 lro~ 'Pros &reCTU 5 + PROJECT NAME: rete. 1-h.v,:130 ,I-J-oV LaY\..e.~ Pfl& Loe-a/ A.5~nc~ f-ttJreevn-en NAME OF CONTRACTOR: 'DOT- ADDRESS: N tU SIGNATURE NAME: TELEPHONE ,Jor"r t/{,0-9 7/0 TITLE P~am mnYi'1~r ATTACH ALL EXHIBITS AND CHECK BOXES 0 SCOPE OF SERVICES 0 ALL EXHIBITS REFERENCED IN DOCUMENT o INSURANCE CERTIFICATE 0 DOCUMENT AUTHORIZING SIGNATURE TERM: COMMENCEMENT DATE: H/A , IVIA , COMPLETION DATE: 9. TOTAL COMPENSATION $ t;!/ It (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARG e - AfTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: 0 YES 0 NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED 0 YES 0 NO IF YES, $ PAID BY: 0 CONTRACTOR 0 CIT 10. CONTRACT REVIEW ~PROJECT MANAGER ~ I / :L3/o~ ~IRECTOR 1/.24/or/ '0 RISK M,'\N..'\G~).n:;NT ...-I T. .. " --r"-!:l.l. "" Y" * (CS{)(ii 1/2..<./cl, 11. CONTRACT SIGNATURE ROUTING ~LA W DEPARTMENT' f:J4/ t Y j If 1--1/ o~. ~CITYMANAGER 1/:;,r;lc~ CITY CLERK ~/l { c It SIGN COpy BACK TO ORGINATING DEPT. -3 ~ASSIGNED AG# Db. OB,! TI PURCHASllJG. PLEASr, CIIARGE TO. ~Cil et1.!j us ._ .J COMMENT~ A~heJQ ~ p~- 4-<Q1 ..:311):\ \ uu 1:\!Dt\l ~(~lV1LLlLtI; 0J)VT.e ~,t- -hhilf\ ,'; IL<<~ " ~ INITIAL/DATE APPROVED INITIAL/DATE APPROVED 07/05 ,~ RECE\VED ~ ; ~- 1 2006 iZi Washington State Transportation Building \ r' !jull WORKS ~'I Department of Transportation f:;Ut:H/'IL .~i"\ U 310 Maple Park Avenue S.Er AOMINISTRATIONOIVISION Douglas B. MacDonald P.O. Box 47300 Ll (' Secretary of Transportation Olympia, WA 98504-7300 e C: ""I . 360-705-7000 '-lVlft~ ItllAI\. TTY: 1-800-833-6388 www.wsdot.wa.gov February 23, 2006 Mr. CaryM. Roe, PE Public Works Director City of Federal Way P. o. Box 9718 Federal Way, W A 98063-9718 City of Federal Way Pacific Highway South HOV Lane Phase IV STPUL-I013(004) ~ FUND AUTHORIZATION Dea~ We have received FHW A fund authorization, effective February 15, 2006, for this project as follows: PHASE TOTAL FEDERAL SHARE Preliminary Engineering $1,435,000 $440,584 Enclosed for your information and file is a fully executed copy of Local Agency Agreement LA-6026 between the state and your agency. You may proceed with the administration of this project in accordance with your WSDOT approved Certification Acceptance agreement. Sincerely, 01rL..; .L Stephanie Tax Manager, Program Management Highways & Local Programs Division ST:ds:ac Enclosure cc: Ed Conyers, Northwest Region Local Programs Engineer, MS NB82-I21 ~. . AGENCY W Washington State Local Agency Agreement ~" Department of Transportation Agency City of Federal Way CFDA No. 20.205 (Ca~log of ......, Dome,tic -'~""'ffl Address 33325 8th Avenue South Project No. 5-rf> ql-:.,'O/ 5 o~~_ P.O. Box 9718 Agreement No. _._ LA _6_0__ Federal Way, WA 98063-9718 For ase WSDOT Use Only The Local Agency having complied, or hereby agreeing to comply, with the tenns and conditions set forth in (I) Title 23, U.S. Code Highways, (2) the regulations issued pursuant thereto, (3) Office of Management and Budget Circulars A-102, A-87 and A-B3, (4) the policies and procedures promulgated by the Washington State Department of Transportation. and (5) 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 ofthe Federal Highway Administration. All project costs not reimbursed by the Federal Government shall be the responsibility of the Local Agency. Project Description Name Pacific Highway South HOV Lane Phase IV Length 0.95 miles Termini Dash Point Road to South 3 12th Street Description of Work This project will reconstruct portions and widen Pacific Highway South (SR 99) to provide HOV Lanes each direction, undergrounding the overhead utilities, curb and gutter, median, and sidewalks, Additional improvements include asphalt overlay, modification and interconnection of existing traffic signal systems, channelization, street lighting systems, implementing access management and drainage system improvements. Estimate of Funding Type of Work (1 ) (2) (3) Estimated Total Estimated Agency Estimated Project Funds Funds Federal Funds PE a. Agency -," ,- _/ 86.5 % b. Other Consultant 499,346.00 67,412.00 431,934.00 - --~ ".- c.Other Non-Participating 925,654.00 925,654.00 0.00 Federal Aid ,- n.. d. State 10,000.00 1,350.00 8,650.00 / Parlldpallon -~,~~. Rallo for PE e. Total PE Cost Estimate la+b+c+d) 1,435,000.00 994,416.00 440,584.00 / RIght of Way 1. Agency - ." ~,-,,-,- % g.Other - "".-....... h. Other .....','. -'-~ --~,~."'.' ..- Federal Aid i. State Parlldpallon ._, ... Ratio for RW i. Total R/W Cost Estimate (f+a+h+n ConstructIon k. Contract ^ ,...,...n_,.. - ~'.... n___ I. Other "- "'--~. ~~~..~- - "".... '-'-- m. Other ~_.,.. .._~"-.' ..-.,. _...,,-- -. n. Other -"'...~ .. ~,-,..,""" .. -- % o.Agency - ..~.,. .--- .."'.~ ~-"-'.",-. ~"'- Federal Aid p. State ParlldpaUon ----.~, ...~ ...'n__'__ Ratio for eN a. Total eN Cost Estimate lk+l+m+n+o+o) r. Total Project Cost EstImate (e+j+q) . 1,435,000.00 994,416.00 440.584.00 :.Shingt;;;r~:txportation ( - Assistant Seaetary for Highways and local' Programs APPROVED AS TO FORM: FEB 1 3 2005 ~1\~~h\\L 6v Date Executed 1 I IA A. R Hi\.. N, CITY ATIURNEY qonstruction Method of Financing (Check Method Selected) State Ad and Award o Method A - Advance Payment - Agency Share of total construction cost (based on contract award) D Method B - Withhold from gas tax the Agency's share of total construction cost (line 4, 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 comply with the applicable provisions set forth below. Adopted by official action on January 17 2006 , Resolution/Ordinance No. 06~469 Provisions I. scope of Work I. Preliminary engineering. The Agency shall provide all the work, labor, materials, and services necessary 2. Right of way acquisition. to perform the project which is described and set forth in detail in the "ProjecI 3. Project construction. Description" and "Type of Work" In the t\vent that right of way acquisition, or actual construction of the road, When the State acts for and on behalf of the Agency, the State shall be for which preliminary engineering is undertaken is not started by the closing of deemed an agent of the Agency and shall perform the services described and the tenth fiscal year following the fiscal year in which the agreemenl is indicated in "Type of Work" on the face of this agreement, in accordance with executed, the Agency will repay 10 the State the sum or sums of federal funds plans and specifications as proposed by the Agency and approved by the State paid to the Agency under the terms of this agreement (see Section IX). and the Federal Highway Administration. When the State acts for the Agency but is not subject to the right of control by The Agency agrees that all stages of construction necessary to provide the the Agency, the State shall have the right to perform the work subject to the initially planned complete facility within the limits of this project will conform ordinary procedures of the State and Federal Highway Administration. to at least the minimum values set by approved statewide design standards II. Delegation of Authority applicable to this class of highways, even though such additional work is financed without federal aid participation. The State is willing to fulfill the responsibilities to the Federal Governmcnt by The Agency agrees that on federal aid highway construction projects, the the administration of this project The Agency agrees that the State shall have the current federal aid regulations which apply to liquidated damages rclative to the full authority to carry out this administration. The State shall review, process, basis of federal participation in the project cost shall be applicable in the event and approve documents required for federal aid reimbursement in accordance the contractor fails to complete the contract within the contract time. with federal requirements. If the State advertises and awards Ihe contract, the State will further act for the Agency in all matters concerning the project as VI. Payment and Partial Reimbursement 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 The total cost of the project, including all review and engineering costs and specifications. other expenses of thc State, is to be paid by the Agency and by the Federal Government. Federal funding shall be in accordance with the Transportation III. Project Administration Equity Act for the 21st Century (TEA 21), as amended, and Office of Certain types of work and services shall be provided by the State on this Management and Budget circulars A-I02, A-87 and A-I33. The State shall not project as requested by the Agency and described in the Type of Work above. In be ultimately responsible for any of the costs of the project. The Agency shall be addition, the State will furnish qualified personnel for the supervision and ultimately responsible for all costs associated with the project which are not inspection of the work in progress. On Local Agency advertised and awarded reimbursed by the Federal Government. Nothing in this agreement shall be projects, the supervision and inspection shall be limited to ensuring all work is in construed as a promise by the State as to the amount or nature of federal conformance with approved plans, specifications, and federal aid requirements. participation in this project The salary of such engineer or other supervisor and all other salaries and costs The Agency shall bill the state for federal aid project costs inculTed in incurred by State forces upon the project will be considered a COSI thereof. All . conformity with applicable federal and state laws. The agency shall mimimize costs related to this project incurrcd by employees of the State in the customary the time elapsed between receipt of federal aid funds and subsequent payment of manner on highway payrolls and vouchers shall be charged as costs of the incurred costs. Expenditures by the Local Agency for maintenance, general project. administration, supervision, and olher overhead shall not be eligible for federal IV. Availability of Records participation unless an indirect cost plan has been approved by WSDOT. All project records in support of all CoSL~ incurrcd and actual expenditures kept The State will pay for Stale incurred costs on the project. Following payment, by the Agency are to be maintained in accordance with local government the State shall bill the Federal Government for reimbursement of those costs accounting procedures prescribed by the Washinglon State Auditor's Office, the eligible for federal participalion 10 Ihe extent that such costs are attributable and U.S. Department of Transportalion, and the Washington State Department of properly allocable to this project. The State shall bill the Agency for that portion Transportation. The records shall be open to inspection by the State and Federal of State costs which were not reimbursed by the Federal Government (see Government at all reasonable times and shall be retained and made available for Section IX). such inspection for a period of not less than Ihree years from the final payment of 1. Project Construction Costs any federal aid funds to the Agency. Copics of said records shall be furnished to the State and/or Federal Govcrnment upon request Project construclion financing will be accomplished by one of the Ihrcc V. Compliance with Provisions methods as indicated in this agrecment. The Agency shall not incur any fedcral aid participation costs on any classification of work on this project until authorized in writing by Ihe State for each classification. The classifications of work for projects are: ... DOT Fonn 140-039 EF 2 Revised 01/2004 , . Me~hod A ". The Agen1:y will place with the State, within (20) days after the X. Traffic Control, Signing, Marking, and Roadway eAecution of the construction contracl, an advance in the amount of the Agency's Maintenance 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 1be Agency will not pennil any changcs 10 bc made in the provisions for will pay all costs incurred under the contract upon presentation of progress parking regulations and traffic control on this project without prior approval of billings from the contractor. Following such payments, the State will submit a the State and Federnl Highway Administration. 1be Agency will not install or billing to Ihe Fcderal Govcrnmenl for the federal aid participation share of the permit to be installed any signs, signals, or markings not in confonnance with cos/. When the project is substantially completed and final actual costs of the the standards approved by the Federal Highway Administration and MUTeD. project can be delennined, the State will present the Agency with a final billing The Agency will, at its own expense, mainlain Ihe improvement covered by this showing the amount due the State or the amount due the Agency. This billing agreement. will be cleared by eilher a payment from Ihe Agency to Ihe State or by a refund XI. Indemnity from the State to the Agency. The Agency shall hold the Federal Government and the State harmless from Method 8 - The Agency's share of the lotal construction cost as shown on and shall process and defend at its own expense all claims, demands, or suits, the face of this agreement shall be withheld from its monthly fuel tax allotments, whether at law or equity brought against the Agency, State, or Federal The face of this agreement establishes the months in which the withholding shall Government, arising from the Agcncy's exccution, performance, or failure to take place and Ihe exact amount to bc withheld each month. The extent of perfonn any of the provisions of this agrecmcnl, or of any other agrecment or withholding will be conflnned by letter from thc State at the time of contract contract connected with this agrcement, or arising by reason of thc participation award. Upon rcceipt of progress billings from the contractor, the State will of the State or Federal Government in the projecl, PROVIDED, nothing herein submit such billings to the Federal Government for payment of its participating shall require the Agency to reimburse the State or the Federal Government for portion of such billings. damages arising OUI of bodily injury to persons or damage to property caused by or resulting from the sole negligence ofthc Federal Government or thc State. Method C - The Agency may submil vouchers 10 the Statc in thc fonnal prescribed by the State, in duplicate, not more than once per monlh for those XII. Nondiscrimination Provision costs eligible for Federal participation to the extent that such costs are directly No liability shall attach to the Stale or Federal Government except as attributable. and properly, ;illocable to this project. Expend.itures by the Local Agency for maintenance, general administration, supervision, and other overhead expressly provided herein. shall not be eligible for Federal participation unless claimed under a previously The Agency shall not discriminale on the basis of race, color, national origin, approved indirect cost plan. or sex in the award and perfonnance of any US DOT-assisted contract and/or The State shall reimburse the Agency for the Federal share of eligible project 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 costs up to the amount sllown on the face of this agreemen/. At the timc of audit, 49 CFR Part 26 to ensure nondiscrimination in the award and administration of the Agency will provide documentation of all costs incurred on the project. US DOT-assisted contracts and agreements. The WSDOT's DBE program, as The State shall bill the Agency for all costs incurred by the State relative to the 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 project. The State sllall also bill the Agency for the fcderal funds paid by the obligation and failure to carry out its terms shall be treated as a violation of this State to the Agency for project costs which are subsequently detennined to be agreement. Upon notification to the Agency of its failure to carry OUI its ineligible for federal participation (see Section IX). approved program, the Department may impose sanctions as provided for under VII. Audit of Federal Consultant Contracts 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. The Agency, if services of a consultant are required, shall be responsible for 3801 et seq.). audit of the consultant's records to determine eligible federal aid costs on the The Agency hereby agrees thaI it will incorporate or cause to be incorporaIcd project. The report of said audit shall be in the Agency's files and made available to the State and the Federal Government. into any contract for construction work, or modification thereof, as defined in the rules and regulations of the Secretary of Labor in 4 I CFR Chapter 60, which An audit shall be conducted by the WSDOT Internal Audit Office in is paid for in whole or in part with funds obtained from the Federal Government accordance with generally accepted governmental auditing standards as issued by or borrowed on tile credit of the Federal Government pursuant to a grant, the United States General Accounting Office by the Comptroller General of the contract, loan, insurance, or guarantee or understanding pursuant to any federal United States; WSDOT Manual M 27-50, Consultant Authorization, Selection, program involving such grant, contract, loan, insurance, or guarantee, the and Agreement Administration; memoranda of understanding between WSDOT required contract provisions for Federal-Aid Contracts (FHWA 1273), located in and FHWA; and Office of Management and Budget Circular A-133. Chapter 44 of the Local Agency Guidelines. If upon audit it is found that overpayment or participation of federal money in The Agency further agrees that it will be bound by the above equal ineligible items of cost has occurred, the Agency shall reimburse the State for the opportunity clause with respect to its own employment practices when it amount of such overpayment or excess participation (see Section IX). participates in federally assisted construction work: Provided, that if the . applicant so participating is a State or Local Government, the above equal VIII. Single Audit Act opportunity c1ausc is not applicable to any agency, instrumentality, or subdivision of such government which does nOI participate in work on or under The Agency, as a subrecipicnt of fedcral funds, shall adhere 10 Ihc federal the contract. Office of Management and Budget (OM B) Circular A-l33 as well as all The Agency also agrees: applicable fcderal and statc stalutes and regulations. A subreeipienl who (1) To assist and cooperate actively with the State in obtaining the expends $500,000 or more in federal awards from all sources during a given compliance of contractors and subcontractors with the equal opportunity c1ausc fiscal year shall have a single or program-specific audit perfonned f'Or that year and rules, regulations, and relevant orders of the Secretary of Labor. in accordance with the proviSions ofOMB Circular A~l33. Upon conclusion of the A~I 33 audit, the Agency shall be responsible for ensuring that a copy of the (2) To furnish the State such information as it may require for the report is transmitted promptly to the Statc. supervision of such compliance and that it will otherwise assist thc State in the discharge of its primary responsibilily for securing compliance. IX. Payment of Billing (3) To refrain from entcring into any contract or contract modification "[ne Agency agrees that if payment or arrangcmcnl for paymcnt of any of the subject to ExecUlive Order 11246 (If September 24, 1965, with a conlraClOr State's billing relative to the project (e.g., Stale force work, project cancellation, debarred from, or who has not demonstrated eligibility for, government overpayment, cost ineligible for federal participalion, etc.) is not made to the contracts and federally assisted construction contracts pursuant to the Executive State within 45 days after thc Agency has been billed, the State shall effeel Order. reimburscment of the total sum due from the regular monthly fuel tax allotments (4) To carry out such sanctions and penalties for violation of the equal to the Agency from the Motor Vehicle Fund. No additional Federal projccI funding will be approved until full payment is received unless otherwise directed opportunity clause as may be imposed upon eontraclors and subcontractors by the Assistant Secretary for Highways and Local Programs. the State, Federal Highway Administralion, or the Secretary of Labor pursuant to Part II, subpart D of the Executive Order. .. DOT FOfITl 140.Q39 EF 3 Revised 01/2004 ,~ . , ~ln ~dditiOl\, the Agency agrees that if it fails Of refuses to comply with these XV. Venue for Claims and/or Causes of Action undertakings, me State may take any or all of the following actions: For the convenience of the parties to this contract, it is agreed that any claims (a) Cancel, tenninate, or suspend this agreement in whole or in part; and/or causes of action which the Local Agency has against the Statc of Washington, growing out of this eontrael or the project with which it is (b) Refrain from extending any further assistance to the Agency under the concerned, shall be brought only in the Superior Court for Thurston County. program with respect to which the failure or refusal occurred unlil satisfactory XVI. Certification Regarding the Restrictions of the Use assurance of future compliance has been received from the Agency; and of Federal Funds for Lobbying (c) Refer the case to the Department of Justice for appropriate legal The approving authority certifies, to the best of his or her knowledge and proceedings, belief, that: XIII. Liquidated Damages (I) 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 The Agency hereby agrees that the liquidated damages provisions of 23 CFR influence an officer or employee of any federal agency, a member of Congress, Part 635, Subpart 127, as supplemented, relative to the amount of Federal an officer or employee of Congress, or an employee of a member of Congress in participation in the project COSI, shall be applicable in the event the contractor connection with the awarding of any fcdcral contract, thc making of any federal fails to complele Ihe contract within the contract time. Failure to include grant, the making of any federal loan, the entcring into of any cooperative liquidated damages provision will not relieve the Agency from reduction of agrcement, and the extension, continuation, renewal, amendment, or federal participation in accordance with this paragraph. modification of any federal contract, grant, loan, or cooperative agreement. XIV. Termination for Public Convenience (2) If any funds other than federal appropriated funds have been paid or will The Secretary of the Washinglon State Department of Transportation may be paid to any person for influencing or attempting to influence an officer Or tenninate the contracl in whole, Or from time to time in part, whenever: employee of any federal agency, a member of Congress, an officer or employee (I) The requisite federal funding becomes unavailable through failurc of of Congress, or an employee of a member of Congress in connection with Ihis federal contract, grant, loan, or cooperative agreement, the undersigned shall appropriation or otherwise. complete and submit the Standard Form - LLL, "Disclosure Fonn to Report (2) The contractor is prevented from proceeding witlllhe work as a direct Lobbying," in'accoraance with itsinstruetions. .. . 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 (3) The undersigned shall require that the language of this certification be or Govemor of the State with respect to the preservaIion of energy reSources. included in the award documents for all subawards at all tiers (including subgrants, and contracts and subcontracts under grants, subgrants, loans, and (3) The contractor is prevented from proceeding with the work by reason of a cooperative agreements) which exceed $100,000, and that all such subrecipients preliminary, special, or permanent restraining order of a court of competent shall certify and disclose accordingly. jurisdiction where the issuance of such order is primarily caused by the acts or This certification is a material representation of fact upon which reliance was omissions of persons or agencies other than the contractor. placed when this transactiOll was made or entered into. Submission of this (4) The Secretary determines that such termination is in the best interests of 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 the State. required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Additional Provisions ... DOT Fonn 140.{)39 EF 4 Revised 0112004 .