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AG 10-068RETURN TO: � /� � � � v� COMPLETION DATE: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / `.�� Y j:=- t�) ORIGINATING STAFF PERSON:� Q_ � A� l ��Z� ,�� ':7 C-_ (1_ \� EXT: �,.� 2 2 3. DATE REQ. BY: TYPE OF DOCUMENT (CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ� ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ 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#�: ��.-._ t% � i=- ❑ INTERLOCAL ❑ OTHER �. +%C_t�.._L ��j.�L.v� t +-, iY'�.r=. Ce_i_ �'h,.rv.:� `;a�x� G �i _w�r`.-� �!� � 5. PROJECT NAME: ) .-� 6. : . \" NAME OF CONTRACTOR: �;� t, j f����55:���7 � C'r i ���✓"�� . �}f ��'����5 F Idf�i�t..ir� i E-MAiL: SIGNATURE NAME: S� rt' `:iJ�n r. �,, . � C� � TELEPHONE: Zvl�, �I �1? � �T 3 Y Fax: TITLE��i � '�'_I.,}�� �.�t � ��cu�S 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. / /_ TERM: COMMENCEMENT 9. TOTAL COMPENSATION: $ �1('GL n� «�„�.,,�j�, r C z.�,�,,�� (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: �'���� �r� w. �� ,;' So w�- T lO. DOCUMENT / CONTRACT REVIEW ❑ PROJECT MANAGER ❑ DNISION MANAGER r,� DEPUTY DIRECTOR �� ( � DIRECTOR ❑ RISK MANAGEMENT �IF APPLICABLE� ❑ LAW DEPT 11. COUNCIL APPROVAL (IF APPLICABLE� EXT: I I��'I� �,AL / DATE REVIEWED � I �,� t f� � � � C' 11 COMMITTEE APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING �{ ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: ;/ �� ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ LAW DEPT � ,0"SIGNATORY AY�c'6R DIRECTOR� �� '�� �'�CITY CLERK �ASSIGNED AG # p�IGNED COPY RETURNED ❑ RETURN ONE ORIGINAL COMMENTS: � � r ^-------« �' INITIAL / DATE SIGNED /1/1 - - ��N(� aG# tc�°ore�SG DATE SENT: � � I ' { I INITIAL / DATE APPROVED COUNCIL APPROVAL DATE: DATE 11 /9 � �.z� Washington State �� Departme�rt of Transportation Local Agency Agreement Supplement Agency Supplement Number Cit of Federal Wa 3 Federal Aid Project Number Agreement Number CFDA No. 2�.2�5 STPUL 1020 O 10 LA 7164 Catalo of Federal Domestic Assistance The Local Agency requests to supplement the agreement entered into and executed on April 7, 2010 All provisions in the basic agreement remain in effect except as modified by this supplement. The changes to the agreement are as follows: Project Description Name I-5 Southbound Ramp @ S 320th Street Length 0.25 mi Termini Description of Work � No Change Reason for Supplernent Update the Construction Agency to include Federal Funds. Revised Estimated Agency Fund (column 4) and Estimated Federal Funds (column 5) for Construction Agency (line o), revised Construction Contract (line k) and Construction Non-Participating (line m). Does this change require additional Right of Way or Easements? ❑ Yes � No Estimate of Funding T e of Work �'> c2> �3� c4� c5� yp Previous Supplement Estimated Total Estimated Agency Estimated A reemenUSu I. Pro'ect Funds Funds Federal Funds PE a. Agency 0.00 0.00 86.5 % b. Other Consultant - GCA 6435 425,058.00 425,058.00 57,383.00 367,675.00 c. Other GCA 6435 203,5 10.00 2 03,510.00 203 510.00 0.00 Federal Aid d. Stat 5,000.00 5,000 675.00 4,325.00 Participation — -- Ratio for PE e. Total PE Cost Estimate (a+b+c+d) 633 568.00 633,568.00 261,568.00 372,000.00 Right of Way f. Agency _ % g Oth er _ Federal Aid h. Other Participation -- Ratio for RW �� State ___ j. Total R/W Cost Estimate (f+g+h+i) Construction k. Contract 2,889,441.00 -203,490.00 2,685,951.00 362,603.00 2,323,348.00 I. Other GCA 6680 367,424.00 367,424.00 49,602.00 317,822.00 86.5 % m. Other Non-Participating_ 62,146.00 203,490.00 265,636.00 265,636.00 0.00 Federal Aid n_O _ _ _ Participation o. Agency 203,489.00 203,489.00 _ 27,471.00 176,018.00 Ratio for CN p Stat 12,500.00 12,500.00 1, 688.00 10,812.00 . Total CN Cost Estimate k+l+m+n+o+ 3 535 000.00 3 535 000.00 707 000.00 2 828 000.00 r. Total Pro'ect Cost Estimate e+'+ 4 4 1 2 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 provi 'ons. Agency Off' ial Washington State Depa ent of Trans ation � . By By Title Skip i'r�est,�3tor Director of Highways and Local rograms AUG 2 3 2011 r?arP' — Date Executed DOT Form 140-041 EF Revised 03/2011 RETURN TO: EXT: �;�C �� CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / S� f�' e'� S 2. ORIGINATING STAFF PERSON: � i^ t c( vi R_(" I�7 � r�""�' � EXT: 2 7 Z�_ 3. DATE REQ. BY: 4. TYPE OF DOCUMENT �CHECK ONE�: o CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT O ❑ PROFESSIONALSERVICEAGREEMENT ❑ ❑ GOODS AND SERVICEAGREEMENT ❑ ❑ REAL ESTATE DOCUMENT ❑ ❑ ORDINANCE ❑ �CONTRACT AMENDMENT (AG#�: /("'��-,/'j/,� � ( ❑ 0 OTHER L�Jr.a' / � P �r r��1 � a YP N un � ��7` � SMALL OR LIMITED PUBLIC WORKS CONTRACT MAINTENANCE AGREEMENT HUMAN SERVICES / CDBG SECURITY DOCjdMENT (E.G. BOND RELATED DOCUMENTS� RESOLUTION INTERLOCAL 5. PROJECT NAME: Z� S� 5 V .3 ��'� �' S�f e e"'I' �n u'f L� �/ C� H n� �>� r�a u-r t� 6. NAME OF CONTRACTOR: ADDxES: E-Ma1L: SIGNATU � TELEPHONE: ��''6 "`W C>� `� 73 � Fax: TITLE: � i r-� L-c c= C� tbq ra+.r• s 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION o 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:�� Z�'°? 1 D COMPLETION DATE: /Y A 9. TOTAL COMPENSATION: $ G y�� vt -� /? r i+M Io u j�� �K P rt.T �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: e� 2�� e*-� b�n� wte N- � lO. DOCUMENT / CONTRACT REVIEW � PROJECT MANAGER ❑ DNISION MANAGER ,,'F�DEPUTY DIRECTOR �DIRECTOR n T�-S=SF-�ix°ii�io�*'��T �iRAPPTT!'eurL'1 J �PT 11 . COUNCIL APPROVAL �IF APPLICABLE� I AL/DATEREVIEWED ,1/r�, � e� t r -� � . COMMITTEE APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: Z Z-� I� ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, XHI ITS INITIAL / DATE SIGNED � S GN� oxv MAYOR o �Di�������� � ��� � ��._-� ,�- _ .______ _. � _ ( cTOx) �_ _ ... f1 �� l ( 3� 25 � ITY CLERK r � ASSIGNED AG $# AG# SIGNED COPY RETURNED DATE SENT: �' 2� �'� ❑ RETURN ONE ORIGINAL COMMENTS: ,-..��..T� �� <., �� vL s �- t r INITIAL / DATEAPPROVED APPROVAL DATE: REC' il/9 � � Washingfon State Department of Transportation ��ir I�J �' 1. Local Agency Agreement Supplement Agency Supplement Number C itY of Federal Wa�_ __ ___ __ ___ 2 Federal Aid Project Number � Agreement Number CFDA No. 2�.205 STPUL l 020 O 10 LA 7l 64 Catalo of Federal DomesticAssistance The Local Agency desires to supplement the agreement entered into and executed on April 7, 2010 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 1-5 Southbound Ramp @ S 320th Street Length 0.25 mi Termini Description of Work � No Change Reason for Supplement Allocatin� funds for reimbursement of construction phase. Does this change require additional Right of Way or Easements? ❑ Yes � No Estimate of Fundin ------- ------------ _ _ _— - T e of Work ��� j c2� (3) (4) yp Previous Estimated Total Estimated Agency ' AqreementlSuppL' Supplement proiect Funds Funds PE a. _Ayency----------- --= -' � '--------- 0.00 86.5 % b Other Consultant -GCA 6435 !_ 425 058 00�_ _ I 4�� 058.00� �7.383.00 -- -- _ __ ._.--- --- --- -- - c. Other GCA 6435 203 SI0.00 �� 203 510.00 '� 203.S10.00 Federal Aid � � d. State - ----- ---- - - - �.000.�0'~ � 000.00 ' 675.00 Participation — --- --- ---� - ---t-- — ;-- Ratio for PE e. Total PE Cost Estimate (a+b+c+dl ' 633.568.00 I ; 633,_568.00 ! 261,568.00 Right of Way f. Agency_____ % FederalAid 9-.Q -- PaRicipation h,__Other __ __.,_ Ratio for RW !, State i. Total WW Cost (5) Estimated Federal Funds ---- 0.00 __ 367.675.00 __ 0.00 4.325.00 372,000.00 Construction k. Co_ntract__ __ ___ __ , 2.889 441.00 2_889 44 L00 , 390.075.00y 2_499366.00 I. Other -- -- — _ - _-_ �_ -- �-- - - - -- . - - ---- -� 317_82 GCA 6680 �67.4�4.00 '� 367 424.00 49.602 00' --- -- -- m.Other Non-Participatin, 62.146.OQ' 62_146.00, 62.146.00' 0.00 � � ' _ _ ____ -- .. — --�-.. _ ----- n Other ; � - -- -- -- _ _ — -_. -� - - __ -- - - -- 86.5 % o Agency -_- j 203 484.00 20� 489.00 2 00 ' Q00 ____ Federal Aid _ -- -- -- ,- - — — -- - -- - - ,— — ___ Participation P- State 12 �00.00 1� �OOA� 1.688 00 ' 10.812.00 Ratio for CN Total CN Cost Estimate k+l+m+nio '� 3 535 000.00 I 3 535 000.00 ' 707 000.00? 2 828 000.00 r. Total Pro'ect Cost Estimate e' 633 568.00' 3 535 000.00 '' 4 168 568.00 ' 968 568.00 200 000.00 The Local Agency further stipulates that pursuant to said Title 23, regulations and policies and procedures, and as a condition to payment of the Federal funds obligated, it accepts and will comply with the applicable provisions. B genc icial NA �/� B ashington State artment of Tr nsportation Y � �� � Y ____ _____._ _ ___ __-___ ___ _ --- __ _ _ . Title DirecFOr oi P�r�s.pul�li.c_1b!orks�& Fmersency M�mt ____ Director of Highways an Local Programs Date. _ �� Z��L� ____ _------ -- - — - Date Executed - - ----- -��-o-�-L�l DOT Form 140-041 EF Revised 1/2007 RETURN TO: D1 fie re p.,k- il'izte % EXT: ,,'2: ( i CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATINGDEPT/DIV: PUBLIC WORKS / S T 2. ORIGINATING STAFF PERSON: g r ■ct vl R-0 CJ € k EXT: 27 z 3 3. DATE REQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE: ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ 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 #): 10 --O (es ❑ INTERLOCAL AL ❑ OTHER moo( °.vt i j aKCl rePi.4 t✓ i^+ S p r F- Pyr r f 5. PROJECT NAME: - C S L 9 S r 3 � S+ r e e+ , Ii -i c( uri ( - 9 7 ) Rip 6. NAME OF CONTRACTOR: f-(J S 00 ADDRESS: c if , ( (4 Cmi Pc'S — e_r,cAj P r rcttfriS +- tgfiwPer TELEPHONE: F O(.0'4 - 173q E -MAIL: P V ) 33O3 - 5 t-J J °! 7 I() FAX: SIGNATURE NAME: S +e P i-v-t.k t Ti a x TITLE: D r r w L-0c Pry ra 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: 4 1/7/ e-at 0 COMPLETION DATE: At 4 9. TOTAL COMPENSATION: $ GJavi+ R e,rwtlju.rst',C.t.evt (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: tom- rcu, + i e 1 ti-t ld u. CV L44 evt 10. DOCUMENT / CONTRACT REVIEW I / DAT • RE EWED INITIAL/ DATE APPROVED X PROJECT MANAGER 1,141111MIFT ex: t t"? n Diw A T.r lAc7E L' DEPUTY DIRECTOR f'-4e t r wet t t `A` qa DIRECTOR ^DDT v�N` +�3 /L.a •9 RISK MANAGEMENT (IF ..- Tz� —/ ,- n I A3 DEPT 11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: '5�1 /I D DATE RECD: r---->. ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS INITIAL / DATE SIGNED .�r.,^x�TrDD�T SIGNATORY (C . R DIRECTOR) ail 111.1117 J 1'L ❑ CITY CLERK N IN ❑ ASSIGNED AG # AG# i( ((t) ❑ SIGNED COPY RETURNED DATE SENT: 3.2 • ‘k ❑ RETURN ONE ORIGINAL COMMENTS: EXECUTE " a" ORIGINALS (, 14 5 tG r1 S 1 T f J ,J i L , ,�3 :4 . J\; , � ti 1 / 4p, . 11/9 C: \Documents and Settings\brianhr \Local Settings \Temporary Internet Files \Content.Outlook \UO7KCQ36 \PW Routing Form.doc o � Aft Washington State kCENC �// Department of Transportation Local Agency Agreement Supplement Agency Supplement Number City of Federal Way 1 Federal Aid Project Number Agreement Number CFDA No. 20.205 STPUL 1020(010) LA 7164 (Catalog of Federal Domestic Assistance) The Local Agency desires to supplement the agreement entered into and executed on April 7, 2010 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 I -5 Southbound Ramp @ S 320th Street Length 0.25 mi Termini Description of Work ® No Change Reason for Supplement Allocating funds for reimbursement of design costs under agreement GCA 6435 • Does this change require additional Right of Way or Easements? ❑ Yes 0. No Estimate of Funding Type of Wk ( ( (3) (4) (5) yp or Previous Supplement Estimated Total Estimated Agency Estimated Agreement/Suppl. Project Funds Funds Federal Funds PE a. Agency 425,058.00 - 425,058.00 0.00 0.00 0.00 b. Other Consultant -GCA 6435 425,058.00 425,058.00 , 57,383.00 367,675.00 c. Other GCA 6435 203,510.00 203,510.00 203,510.00 0.00 Federal Aid d. State 5,000.00 5,000.00 675.00 4,325.00 Participation Ratio for PE e. Total PE Cost Estimate (a +b +c +d) 430,058.00 203,510.00 633,568.00 261,568.00 372,000.00 Right of Way f. Agency % g Other Federal Aid h. Other Participation Ratio for RW i. State _ j. Total R/W Cost Estimate (f +g +h +i) Construction k. Contract I. Other m. Other n. Other o. Agency Federal Aid Participation p. State Ratio for CN q. Total CN Cost Estimate (k+l+m+n+o+p) r. Total Project Cost Estimate e ' , • 1 I : Li 1 i I i , , : 1 1 , : Li 7 III II 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 I epa of Tran i Title City Manager/Pnlice Chief Director of Highways and L•cal Programs I IH I r� 2010 Date Executed J/0 /.1`)/,& Date Executed l IH L DOT 140 - EF C opy Revised 1/2020 07 RETLJRN TO: EXT: � CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATINGDEPT/DIV: PUBLIC WORKS / SfireQ 2. ORIGINATING STAFF PERSON: f' lct R e9 �� EXT: � 7� 3 3. DATE REQ. BY: 4. TYPE OF DOCUMENT �CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT �E.G, RFB, RFP, RFQ� ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT �E.G. BOND RELATED DOCUMENTS� 0 ORDINANCE ❑ RESOLUTION O CONTRACT AMENDMENT �AG#�: ❑ , / f / �OTHER ���� e�.cT a r o � . a� � O b � � aaT_ �v ot �S � H �u�,� � ( �P�t Era� � U-t�s-c $. pROJECT NAME: �— � V �� OtTI� 1[J ['9 tt vtc� �n w1 A C�3 .s e� 2.� � �Y'P 6. NAME OF �"niv�ru erTnu • �"�� 1 ADDRESS: SIC�NATURE TELEPHONE: 7. E%IiIBITS AND ATTACHMENTS: ❑ SCOP$ WORK OR VICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF O UTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS cFw ucErrsE # s . 12/31/ usi # , � / / 8. TERM: COMMENCEMENT DATE: ,"'" �/ COMPLETION DATE:�, � ,I:1(lv �, C_JN 1 V1� �1 �� v 9. TOTAL COMPENSATION: � �� "� '�INCLUDE EXPENSES AND SALES TAX, IF ANY� �IF CALCULATED ON HOURLY LABOR CHARGE - TACH SC ES MPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: ❑ YES o IF YES, MAXIMUM DOLLAR AMOUNT: $ � IS SALES TAX OWED: ❑ YES NO IF YES, $ PAID BY: O CONTRACTOR ❑ CITY ❑ PuRC�sirra: P1.EasE CxaxaE To: CZ e c�, lokr s.� +�eK-�— o P c i e c -E` de s�a �i 3b CQ - g - 1`� �—�' 10. DOCUMENT / CONTRACT REVIEW `� PROJECT MANAGER �IVISION MANAGER �DEPUTY DIRECTOR ❑ DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE� ,3 ��� �r.aw nErr 11. COUNCILAPPRO VAL (IF APPLICABLE� I / Da'['E RE EWED INITIAL / DATE APPROVED �.-� � ,� _3 �/�� /C� COMMITTEEAPPROVALDATE: 3 r l D COUNCILAPPROVALDATE: �/ 2.01 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: O ATTACH: SIGNATUREAUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS INITIAL / DATE SIGNED ❑ Law DEpr �IGNATORY (CM R DIRECTOR� � • / � � � i�� cr� C� u A ¢�AssiGrrEnAG# AG# C - C COPY RETURNED DATE SENT: • I .`l O ❑ RETURN ONE ORIGINAL COMMENTS: D� REC'n: �� D C:10ocuments and Settings\brianhrlLocal Settings\Temporary Intemet Fi�es\Content.0utlook\UO7KCQ361PW Routing Form.dx • 11/9 . � ��°�� `,�n���, '�'�� Local Agency Agreement Agency City of Federal W ay Address PO Box 9718 Federal Way, WA 98063-9718 CFDA No. 20.205 (Catalog of Federal Domestic Assistance) / Project No. ST�Jt.. —(O 2o C� l o� Agreement No. L-� � � � � `�" 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) Office of Management and Budget Circulars A-102, A-87 and A-133, (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, columrr 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 I-5 Southbound Ramp @ S 320th Street Length 0.25 mi Termini Description of Work The I-5 South Bound Ramp @ S 320th Street Project adds additional right and left turn lanes on the south bound access ramp from I-5 to S 320th Street, including and not limited to walls, storm facilities, paving and pavement markings, signal modifications, and shoulder work. Estimate of Fundin Type of Work (� ) (2) (3� Estimated Total Estimated Agency Estimated Pro'ect Funds Funds Federal Funds PE a. A enc 425 058.00 57 383.00 367 675.00 86.5 % b.Other c. Other Federal Aid d. State 5,000.00 675.00 4,325.00 Participation Ratio for PE e. Total PE Cost Estimate a+b+c+d 430 058.00 58 058.00 372 000.00 Right of Way f. A enc % .Other h. Other Federal Aid i. State Participation Ratio for RW '. Total R/W Cost Estimate f+ +h+i Construction k. Contract I. Other m. Other n. Other % o. A enc Federal Aid , State Participation Ratio for CN . Total CN Cost Estimate k+�+m+n+o+ r. Total Pro'ect Cost Estimate e+'+ 430 058.00 58 058.00 372 000.00 Agency O�cial � By Title 3�?/1�a Washington State Depaytment of Transportation _ ,�i By t Director of Highways and Local Programs ApR Q 7 2010 Date Executed DOT Form 140-039 EF Revised 05/09 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 qas tax the Aqencv's share of total construction cost (line 4, column 2) in the amount of $ Local Force or Local Ad and Award at $ per month for � Method C- Aaencv cost incurred with �artial reimbursement � � .. months. 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 March 16 , 2010 , Resolution/Ordinance No. 10-577 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 ofthis agreement, in accordance with plans and specifications as proposed by the Agency and approved by the Stste 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. 11. 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 pmject as requested by the Agency. If the Local Agency adveRises and awards the project, the State shall review the work to ensure conformity with the approved plans and specifications. 111. 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 furnish 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 salazies 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 wsts 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 tlu�ee years from the Final payment of any federal aid funds to the Agency. Copies of said records shall be furnished 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 aze: 1. Preliminary engineering. 2. Right of way acquisition. 3. Project construction. In the event that right of way acquisition, or actual construction of the road, for which preliminary engineering is undertaken is not started by the closing of the tenth fiscal yeaz following the fiscal year in which the agreement is executed, 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). The Agency agrees that all stages of conshuction 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 desig► standards applicable to this class of highways, even though such additional work is fmanced 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, and Office of Management and Budget circulars A-102, A-87 and A-133. 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 Govemment. Nothing in this agreement shall be construed as a pmmise 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 wsts 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 the federal Office of Management & Budget (OMB) circulaz A-87, and retained for audit. The State will pay for State incurred costs on the project. Following payment, the State shall bill the Federal Government for reimbursement of those costs eligible for federal participation to the extent that such costs are attributable and properly allocable to this project. The State shall bill the Agency for that portion of State costs which were not reimbursed by the Federal Govemment (see Section IX). 1. Project Construction Costs Project construction financing will be accomplished by one of the duee methods as indicated in this agreement. DOT Fortn 140-039 EF Revised 05/09 Method A— T.,�ie Agency will place with the State, within (20) days after the executidn of the construction conttact, an advance in the amount of the Agency's shaze 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 wntractor. Following such payments, the State will submit a billing to the Federal Govemment for the federal aid participation shaze 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 cleazed by either a payment from the Agency to the State or by a refund from the State to the Agency. Met6od 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 allotrnents. 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 awazd. Upon receipt of pmgress 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 extentthat such wsts are directly amibutable 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 shaze 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 consultanYs 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 Govemment. An audit shall be conducted by the WSDOT Internal Audit Office in accordance with generally accepted governmental suditing standards as issued by the United States General Accounting Office by the Comptroller General of the United States; WSDOT Manual M 27-50, Consultant Authorization, Selection, and Agreement Administration; memoranda of understanding between WSDOT and FHWA; and Office of Management and Budget Circular A-133. 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). VIII. Single Audit Act The Agency, as a subrecipient of federal funds, shall adhere to the federal Office of Management and Budget (OMB) Circulaz A-133 as well as all applicable federal and state statutes and regulations. A subrecipient who expends $500,000 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 OMB Circulaz A-133. Upon conclusion of the A-133 audit, the Agency shall be responsible for ensuring that a copy of the report is transmitted 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 pmject (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 taac allotrnents to the Agency from the Motor Vehicle Fund. No additional Federal project funding will be approved until full payment is received unless otherwise directed the Director of Highways and Local Programs. X. Traffic Control, Signing, Marking, and Roadway Maintenance The Agency will not permit any changes to be made in the provisions for pazking 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 mazkings not in conformance with the standazds 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 harn►less &om and shall process and defend at its own expense all claims, demands, or suiu, whether at law or equity brought against the Agency, State, or Fedeial 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 Govemment for damages arising out of bodily injury to persons or damage to property caused by or resulting from the sole negligence of the Federal Govemment 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, nationa( origin, or sex in the awazd 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. 1'he 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 progam is a legal obligation and failure to carry 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 for under Part 26 and may, in appropriate cases, refer the matter for enforcement under 1 S 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 mles and regulations of the Secretary of Labor in 41 CFR Chapter 6Q which is paid for in whole or in part with funds obtained from the Federal Govemment 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 Govemment, the above equal opportunity clause is not applicable to any agency, instrumentality, or subdivision of such govemment 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 opporiunity clause and rules, regulations, and relevant orders of the Secretary of Labor. (2) To fumish 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 conUact or contract modification subject to Executive Order 11246 of September 24, 1965, with a contractor debarred from, or who has not demonstrated eligibility for, govemment contracts and federally assisted construction contracts pursuant to the Executive Order. (4) To carry out such sanctions and penalties for violation of the equal opportunity clause as may be imposed upon contractors and subcontractors by the State, Federal Highway Administration, or the Secretary of Labor pursuant to Part II, subpart D of the Executive Order. DOT Form 140-039 EF Revised 05/09 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 (c) Refer the case to the Deparknent of Justice for appropriate legal proceedings. XIII. Liquidated Damages The Agency heteby 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. Failwe 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 Departrnent of TranspoRation may terminate the contract in whole, or from time to time in part, whenever: (1) The requisite federal fiu►ding 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 waz or in the interest of national defense, or an Executive Order of the President or Govemor of the State with respect to the preservation of energy resources. (3) The contractor is prevented &om pmceeding 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 determines that such termination is in the best interests of the State. XV. Venue for Claims a�d/or Causes of Action r -s � 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 lrnowledge 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 awazding 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 Standazd 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 awazd 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 thaf all such subrecipients shall certify and disclose accordingly. This ceRification 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 more than $100,000 for each such failure. Additional Provisions DOT Form 140-039 EF Revised 05/09 � � Wasltington State Department of '�lransportation Prefix Federal Aid STPUL P ' Local Agency FW-12 G.n e..4 AL �mher Local Agency Federal Aid Project Prospectus 1013 � Date 3/17/2010 /wSDOT\ Federal Employer 91-1462550 luse OnIy/ Tax ID Number .,�.. - � " — Agency Federal Program Title City of Federal Way � 20.205 ❑ Other Project Title Start Latitude N47 18 54.83 Start Longitude W 122 17 58.49 I-5 Southbound Ramp @ S 320th Street End Latitude N End Lon itude W Project Termini From To From: To: Length of Project Award Type 0.25 mi � Local ❑ Local Forces ❑ State ❑ Raiiroad Federal Agen City Number County Number County Name WSDOT Region � FHWA � Others 0443 17 Kin Northwest Re 'on Congressional District Legislative Districts Urban Area Number TMA / MPO / RTPO 9 3p 1 PSRC -� � o� .,� �-���'-���., �-�e u ds r �` �� '��ia'�e � � eares�W��as� � ' �� Ef� �Ein� �� �: � s �� , ' �� a � . � � � � d �rea b�3(fa . � � : ` � � Nea`'�esf H��ie FDo�far � � �I�e�re�� �IEihtlr� �II� _ �., :�. �,.I�f�nt� �; � .-.aFi � � � i�eA �� e ..� P.E. $432 000 $60 000 $372 000 04/2010 R/VN Const. $4 368 OUO $1 540 000 $2 828 000 06/2011 Total $4 800 000 $1 600 000 $3 200 000 ' ` .,,��., _�, . � y .s+�, ., e � � . ,,� ... �SCi'� � t��` �Xt�g���1 Ili EXis�in Desi n an�i �r�sen� �on�,.�.�o � - �:: - Roadway Width Number of Lanes 36 ft 3 The existing southbound off ramp form I-5 to S 320th Street consists of two right-tum lanes (southbound to westbound) and one left-turn lane (southbound to eastbound). The ramp intersection at South 320th Street is signal controlled. Currently, this ramp operates at LOS D and is forecast to reach LOS F in 6 years. Queues essentially block access to teh City and block southbound traffic on mainline I-5. D�scr� `roii.���,�o"`*o�ei�� �� � ,.,� �4�. ��.y.,r: � Description of Proposed Work (Attach additional sheet(s) if necessary) The I-5 South Bound Ramp @ S 320th Street project adds additional right and left turn lanes on the south bound access ramp form I-5 to S 320th Street, including and no limited to walls, storm facilities, paving and pavement mazkings, signal modifications, and shoulder work. Local Agency Contact Person Mailing Address PO Box 9718 Project Prospectus Approval Title Title Phone City State Zip Code Fe ral Wa WA 98063-9718 � Approving Authority Public Works Director Date 3/17/2010 DOT Re .�a2008 F Page 1 of 3 Agency Project Title Date City of Federal Way I-5 Southbound Ramp @ S 320th Street 3/17/2010 — �ype ot:r�oposect worK � Project Type (Check all that Apply) ; ❑ New Construction ❑ Path / Trail � Reconstnaction ❑ Pedestrian / Facilities ❑ Railroad ❑ Parking ❑ Bridge ❑ 3-R ❑ 2-R ❑ Other �. �. :: �..� a � Roadway Width Number of Lanes 60 ft (72 ft) 5 _._ ,,..� � , _.,... �< � _ �, -�� ,���_��� ��, :,., �; � �, � � ,� � � � >� �� � ��, ` Descri tion Throu h Route Crossroad � Principal Arterial � Principal Arterial Federal � Urban � Minor Arterial � Urban ���nor Arterial FUt1Ct1011a� ❑ Collector ❑ Collector ❑ Major Collector ❑ Major Collector Classification ❑ RU�aI ❑ Minor Collector ❑ Rural ❑ Minor Collector ❑ Access StreeURoad ❑ Access StreeURoa�l Terrain ❑ Flat � Roll ❑ Mountain � Flat ❑ RoU ❑ Mountain Posted S eed 60 m h 35 m h Desi n S ed 40 m h Existin ADT Desi n Year ADT Desi n Year Desi n Hourl Volume (DH� ❑ Final � Preliminary ❑ Class I- Environmental Impact Statement (EIS) ❑ Project Involves NEPA/SEPA Section 404 Interagency Agreement ❑ Class I I I- Environmental Assessment (EA) ❑ Project Involves NEPAlSEPA Section 404 In Agreement � Class II - Categorically Excluded (CE) � Projects Requiring Documentation (Documented CE) Environmental Considerations The requirements of the Endangered Species Act will be met. ppT Fam �aa�o� EF Page 2 of 3 Revised 7/2008 Agency Project Title Date City of Federal Way I-5 Southbound Ramp @ S 320th Street 3/17/2010 Righ# of Way, ,,. .4. � No Right of Way Required ❑ Right of Way Required * All construction required by the contract can be accomplished ❑ No Relocation ❑ Relocation Required within the existinq riqht of way. Description of Utility Relocation or Adjustments and Existing Major Structures Involved in the Project No Utility Relocation is anticipated for this project. Only local storm water improvements will be made. Any utilities will be adjusted to the grade of the new pavement. =AA Involvement Is any airport located within 3.2 kilometers (2 miles) of the proposed project? ❑ Yes � No Remarks � This project has been reviewed by the legislative body of the administration agency or agencies, or iYs designee, and is not inconsistent with the agency's comprehensive plan for community development. Date March 17, 2010 By ppT Form 140-101 EF Revised 7/2008 Agency City of Federal Way Page 3 of 3 ;--_ ��i ��i�J/v Wilson, City 1Vlanager/Police Chief