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AG 11-184RETLJRl� TO: �, � � G� �' �, ExT: ,-, ,1 �:,�'- CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. �RIGINATING DEPT/DIV: PUBLIC WORKS / S T'!� 11 �� 2. ORIGINATING STAFF PERSON: ,, v k v� /' l(J �►"-fiLl EXT: Z.7 ZZ 3. DATE REQ. BY:LI�/�'1� 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 6( CONTRACT AMENDMENT (AG#�: �- ��� ❑ INTERLOCAL ❑ Oz'�x L o ctt 1/�c,G�,.�:, �rP�..,�...f - S�� r�lt.�s .�/e�. Z 5. PROJECT NAME: / � �t�/' � I w e,� v. ¢�i( t tMG�• �• rt, Sc („�,�� ���e, +�+� ��S ���v�� I 6. NAME OF CONTRACTOR: C� S]) d T� r ADDRESS: Eo(�'vny , e�r,ff>yhtK,�, t(,cccrlli� a+�Jt� � �r,y73u3i��S�.HI��l�+i 48i3�ELEPHONE: E-MAIL: ,. tiA � r Gi� � L,.c �Q : wa � e �� � SIGNATURE NAME: j/� }� ICr.n �� .. �s TITLE: �;' ,� c_4-s r- 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. / / B. TERM: COMMENCEMENT DATE: 9�/ y/I � COMPLETION DATE: U A! %^ ��A �t`l+� 9 s., 9. TOTAL COMPENSATION: $ U.� � q; C� G' � aS� �+,u� C� t (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY L OR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: ❑ YES O NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: lO. DOCUMENT / CONTRACT REVIEW 1�PROJECT MANAGER ❑ DIVISION MANAGER 8 DEPUTY DIRECTOR\', I � g1�j12, $ DIRECTOR� � � ❑ RISK MANAGEMENT (IF APPLICABLE) ❑ Law DE�r 11. COUNCIL APPROVAL (IF APPLICABLE) INITIAL / DATE REVIEWED IIVITIAL / DATE APPROVED �Gtw� 7� I � 12 �_ COMMITTEE APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING � SENT TO VENDOR/CONTRACTOR DATE SENT: 1�� ��� y ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS �{ Law DEpr � (.� � �C I � f� SIGNATORY ( AYOR oR D11tECTOx)'� j�c� J� .�"'CITY CLERK � ❑ AsscGrrED AG # .�SIGNED COPY RETURNED ❑ RETURN ONE ORIGINAL "Z"ORIGINALS C���. Siune �� INITIAL / DATE SIGNED �l - AG# DATE SENT: • �2 COUNCIL APPROVAL DATE: DATE REC'D: 11/ � � � Washington State �����, ; � Departmerrt of Twansportatio Local Agency Agreement Supplement Agency City of Federal Way Federal Aid Project Number Agreement Number LA The Local Agency requests to supplement the agreement entered into and executed on 9/ 14/20l 1 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 Supplement Number CFDA No. 2O.2OS Name Mark Twain Elementary School - Safe Routes to School Program Length 0. 30 Termini 25th Drive South Description of Work � No Change Reason for Supplement Show expenditures for Education and Enforcement Does this change require additional Right of Way or Easements? ❑ Yes � No Estimate of Funding T e of Work �'> c2> c3� ta> �s> yp Previous Supplement Estimated Total Estimated Agency Estimated A reemenUSu I. Pro'ect Funds Funds Federal Funds PE a. A enc 5,239.00 5,239.00 0.00 5,239.00 100 % b.Other Consultant 94,761.00 94.761.00 0.00 94,761.00 c. Other Local Ed & Enforce 28,000.00 28,000.00 28 000.00 Federal Aid d. State 2,000.00 2,000.00 2,000.00 Participation Ratio for PE e. Total PE Cost Estimate (a+b+c+d) 102 000.00 28 000.00 t30,000.00 28,000.00 102,000.00 Right of Way f. A enc % .Other Federal Aid h. Other Participation Ratio for RW �• State j. Total R/W Cost Estimate (f+g+h+i) Construction k. Contract 260,365.00 260,365.00 260,365.00 t. Other Agcy. nonparticpating 10,285.00 10,285.00 t0,285.00 100 % m.Other Federal Aid n. Other • Participation o. A enc 20,692.00 20,692.00 20,692.00 Ratio for CN . State 3.000.00 3,000.00 3,000.00 . Total CN Cost Estimate k+l+m+n+o 294 342.00 294 342.00 10 285.00 Z84 057.00 r. Total Pro'ect Cost Estimate e' The Local Agency further stipulates that pursuant to said Title 23, regulations and policies and proceaures, ana as a cvnaaion to payment of the Federal funds obligated, it accepts and will comply with the applicable provisions. Agency Official _ Washington State rtment of Tra portation By �� BY Title �{]. priP��31�r Director of Highways and Local Programs � �Q}�G � �� ��� Date Executed ��J � � 2��2 DOT Form 140-041 EF Revised 03/2011 RE'TURN TO: f � � EXT: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/D[V: PUBLIC WORKS / �'�l` C� �3 2. ORIGINATING STAFF PERSON: ��lM-� �U �� uj' EXT: Z� 2 '�' 3. DATE REQ. BY: ��P• �'/ 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 a HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) � ORDINANCE ❑ RESOLUTION � CONTRACT AMENDMENT (AG#): ��� ❑ INTERLOCAL Q OTHER Loi._s���� �4�P(v»i...� - S�/� ��rnih �' �i9 r� PROJECT NAME: �' /d�-rY Twx+ ^ It w.l�� y�'c �,,o • I�r. Qmv �'�s � n S� �imc� I Qne r'e.c �' NAME OF CONTRACTOR: !✓ S DD T '/ —� ADDRESS:�d Conyc��TKAw��s �/,,�.,1/� TELEPHONE: E-MAIL:_(',� �� d!SADT .�vt . Aa✓ F'AX- SIGNATURE N.4ME: �c�. � �tt.v. n� v,� TITLE: ic� c,�++r 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 DATE: q/ jy�I � COMPLETION DATE: LJ�JO� �v�n � G� TOTAL COMPENSATION: $ (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 AMOLJNT: $ IS SALES TAX OWED: ❑ YES ❑ NO IF YES, ❑ PURCHASING: PLEASE CHARGE TO: 10. DOCUMENT / CONTRACT REVIEW 1a'PROJECT MANAGER ❑ DIVISION MANAGER ,�' DEPUTY DIRECTOR 6r DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) ❑ Law DE�r 11. COUNCIL APPROVAL �IF APPLICABLE� INITIAL / DATE REVIEWED '-G�- r`" � �t /l Z �S 1 COMMITTEE APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING S' 3 L�� Z ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ Law DErr �'SIGNATORY (MAYOR OR DIRECTOR) ❑ CITY CLERK ❑ ASSIGNED AG # � SIGNED COPY RETURNED ❑ RETURN ONE ORIGINAL COMMENTS: r.__............. �., � �.....�... „ INITIAL / DATE SIGNED AG# � DATE SENT: ( d-I� " IZ PAID BY: O CONTRACTOR ❑ CITY I1IITIAL / DATE APPROVED COUNCIL APPROVAL DATE: DATE REC'D: � � 0 11/� � Washington State �� Departmer�t of Transportation Local Agency Agreement Supplement Agency Supplement Number Cit of Federal Wa 1 Federal Aid Project Number i Agreement Number CFDA No. 2�.2�5 SRTS-0443 005 LA-7572 Catal of Federal Domestic Assistance The Local Agency requests to supplement the agreement entered into and executed on 9/14/2011 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 Mark Twain Elementary School - Safe Routes to School Program �ength 0.03 Termini 25th Drive South Description of Work � No Change Reason for Supplement Authorize Construction Funding Does this change require additional Right of Way or Easements? ❑ Yes � No Estimate of Funding Type of Work �'> c c3> �a� �s> Previous Supplement Estimated Total Estimated Agency Estimated A reemenUSu I. Pro'ect Funds Funds Federal Funds PE a. A enc 7 239.00 - 2 000.00 5 239.00 0.00 5 239.00 100 % b. Other Consultant 94,761.00 94 761.00 0.00 94 761.00 c. Other Federal Aid d. State 2 000.00 2 000.00 2 000.00 Participation Ratio for PE e. Total PE Cost Estimate (a+b+c+d) 102 000.00 102,000.00 102,000.00 Right of Way f. A enc % .Other Federal Aid h. Other Participation Ratio for RW i. State j. Total R/W Cost Estimate (f+g+h+i) Construction k. Contract 260,365.00 260,365.00 260,365.00 I. Other Agcy. nonparticpating � 10,285.00 10,285.00 10,285.00 100 % m.Other _ _ Federal Aid n. Other _ Participation o. A enc 20,692.00 20,692.00 20 692.00 Ratio for CN p. State __ _ 3,000.00 3,000.00 3 000.00 . Total CN Cost Estimate k+l+m+n+o 294 42.00 294 342.00 � 10 285.00 284 057.00 r. Total Pro'ect Cost Estimate e+' The Local Agency fu�ther 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 Offici By _ _ Title Sk� prie�St r Ml3tnr __._ ���/����r,� ,'..�5 Washingt State Departme of Transportation By YJ ` Director of Highways and Local Programs J ��� �� 2Q�(j Date Executed DOT Fortn 140-041 EF Revised 03/2011 a RETURN TO: �,� ' �� �, , � i %� , EXT: `' , l �; =� ��` '� I CITY OF FEDERAL WAY LAW DEPARTMEN'1' ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / ORIGINATING STAFF PERSON:��i�� A�� S a�luL L, EXT: �Z�( �_J 3. DATE REQ. BY: 2. 4. TYPE OF DOCUMENT �CHECK ONE�: ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ� ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONALSERVICEAGREEMENT ❑ MAINTENANCEAGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS� ❑ ORDINANCE ❑ RESOLUTION ❑ CONTRACTAMENDMENT(AG#): O' INTERLOCAL ❑ OTHER �� "'� l 5. PROJECT NAME: �.��` - 6. NAME OF ADDRESS: ct SIGNATURE 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/ 1JB1 # , E�'• �_� 8. TERM: COMMENCEMENT DATE: 9. TOTAL COMPENSATION: $� O� j Q�����_ (INCLUDE EXPENSES AND SALES TAX, IF ANY� (IF CALCULATED ON HOURLY LABOR CHARGE - ATT H CH ULES OF EMPLOYEES TITLES AND HOLIDAY RATES� REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLARAMOUNT: $ IS SALES TAX OWED: ❑ YES � NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY COMPLETION DATE: TELEPHONE: F�: TITLE: ❑ PURCHASING: PLEASECHARGETO: 10. DOCUMENT / COIVTRACT REVIEW ❑ PROJECT MANAGER O DNISION MANAGER ❑ DEPUTY DIRECTOR ❑ DIRECTOR � RISK MANAGEMENT (IF APPLICABLE� 1�,3'� LAW DEPT �� � � � �r:�.�� - %� ��� — r�7_� INITIAL / DATE APPROVED 11. COUNCIL APPROVAL (IF APPLICABLE� COMMITTEE APPROVAL DATE:_ � `� 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: ❑ ATTACH: SIGNATUREAUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ LAW DEPT ❑ SIGNATORY (MAYOR OR DIRECTOR� ❑ CITY CLERK rol� �ASSIGNED AG # SIGNED COPY RETURNED ❑ RETURN ONE ORIGINAL INITIAL / DATE SIGNED AG# I - l DATE SENT: ��'S' L.� COUNCILAPPROVAL DATE: �I � � DATE REC'D: COMMENTS: A � EXECUTE" ° ORIGINALS �TWD 0� ��j �- V ��f--' � 1/9 .�.. - �� ,r�.,�� . � Washa�gton State � < <�, ,� � I Departme�rt of T�ansportation Agency City of Federal Way Address 33325 8th Avenue South Federal Way, WA 98003 Local Agency Agreement CFDA No. 20.205 (Catalog of Federal Domestic Assistance) Project No �'� � � y`r� ��°� Agreement No. 1 �� �� � �' For OSC WSDOT Use 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 fixnds which are to be obligated for the project may not exceed the amount shown herein on line r, column 3, without written authority by the State, subject to the approval of the Federal Highway Administration. All project costs not reimbursed by the Federal Government shall be the responsibility of the Local Agency. Project Description Name Mark Twain Elementary School - Safe Routes to School Program Length 0.03 Termini Description of Work This Project will install the following:(1) Advanced 20 mph Solar School Zone Flasher, (1) Advance School Zone Sign, (2) Solaz Powered LED Rectangular-shaped Rapid Flashing Beacons (RRFB) at the school zone crossing on Staz Lake Road, (2) Advanced School Crossing Signage, (2) Stop for Pedestrian Signage and pavement markings, (3) new crosswalk mazkings, (2) new stop lines, (6) ADA compliant ramps in the right ofway, E2) Speed radar Si�s on Star Lake Road in front of the school, (5) ADA compliant ramps on the school property, and complete construction of an 8-10 foot wide paved walkway approximately 485 in length &om the street to the stairs of the school building entrance. Estimate of Fundin Type of Work (�) (2) �3� Estimated Total Estimated Agency Estimated Project Funds Funds Federal Funds PE a. A en 7 239.00 7 239.00 100 % b. Other Consultant 94 761.00 94 761.00 c. Other Federal Aid d. State Participation Ratio for PE e. Total PE Cost Estimate a+b+c+d 102 000.00 102 000.00 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+l+m+n+o+ r. Total Pro'ect Cost Estimate e+'+ 102 000.00 102 000.00 Agency Offi ial Washington State Departme f ansportation By By Title �k' Priec , M��nr Director of Highways and Local Programs Date Executed v G � l� DOT Form 140-039 EF Revised 05/09 Construction Method of Financing (CheckMethodSelected) 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 $ at $ per month for months. Local Force or Local Ad and Award � Method C- Aaencv cost incurred with oartial 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 June 21 , 2011 , Resolution/Ordinance No. 11-608 Provisions I. Scope of Work The Agency shall provide all the work, labor, materials, and services necessary to perform the project which is described and set forth in detail in the "Project Description" and "Type of Work." When the State acts for and on behalf of the Agency, the State shall be deemed an agent of the Agency and shall perform the services described and indicated in "Type of Work" on the face of this agreement, in accordance with plans and specifications as proposed by the Agency and approved by the State and the Federal Highway Administration. When the State acts for the Agency but is not subject to the right of control by the Agency, the State shall have the right to perform the work subject to the ordinary procedures of the State and Federal Highway Administration. II. Delegation of Authority 1'he State is willing to fulfill the responsibilities to the Federal Government by the administration of this project. The Agency agrees that the State shall haue the full authority to carry out this administration. The State shall review, process, and appmve documents required for federal aid reimbursement in accordance with federal requirements. If the State advertises and awazds the contract, the State will further act for the Agency in all matters concerning the project as requested by the Agency. If the Local Agency advertises and awards the project, the State shall review the work to ensure conformity with the approved plans and specifications. III. Project Administration Certain types of work and services shall be provided by the State on this project as requested by the Agency and described in the Type of Work above. In addition, the State will fumish qualified personnel for the supervision and inspection of the work in progess. 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 costs of the project. IV. Availability of Records All project records in support of all costs incurced 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 Govemment at all reasonable times and shall be retained and made available for such inspection for a period of not less than three years from the final payment of any federal aid funds to the Agency. Copies of said records shall be fumished to the State and/or Federal Govemment upon request. V. Compliance with Provisions The Agency shall not incur any federal aid participation costs on any classification of work on this pmject until suthorized in writing by the State for each classification, The classifications of work for projects are: 1. Preliminary engineering. 2. Right of way acquisition. 3. Project construction. 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 year following the fiscal year in which the agreement is executed, the Agency wi11 repay to the State the sum or sums of federal funds paid to the Agency under the tertns of this agreement (see Section D�. The Agency agrees that all stages of construction necessary to provide the initially planned complete facility within the limits of this project will conform to at least the minimum values set by approved statewide design standards applicable to this class of highways, even though such additional work is financed without federal sid participation. The Agency agrees that on federal sid 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 Government. Nothing in this agreement shall be construed as a promise by the State as to the amount or nature of federal participation in this project. The Agency shall bill the state for federal aid project costs incurred in conformity with applicable federal and state laws. The agency shall minimize the time elapsed between receipt of federal aid funds and subsequent payment of incurred costs. Expenditures by the Loca1 Agency for maintenance, general administration, supervision, and other overhead shall not be eligible for federal participation unless a curcent 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 sudit. The State will pay for State incuned costs on the project. Following payment, the State shall bill the Federal Govemment for reimbursement of those costs eligible for federal participation to the e�Rent that such costs are attributable and properly allocable to this project. 1'he State shall bill the Agency for that portion of State costs which were not reimbursed by the Federal Government (see Section I3�. 1. Project Construction Costs Project construction financing will be accomplished by one of the three methods as indicated in this agreement. DOT Form 140-039 EF Revised 05/09 Method A— The Agency will place with the State, within (20) days after the execution of the construction contract, an advance in the amount of the Agency's share of the total construction cost based on the contract award. The State will notify the Agency of the exact amount to be deposited with the State. The State will pay all costs incurred under the conVact upon presentation of progress billings from the contractor. Following such payments, the State will submit a billing to the Federal Government for the federal aid participation 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 bil►ing showing the amount due the State or the amount due the Agency. This billing will be cleared by either a payment from the Agency to the State or by a refund from the State to the Agency. Method B— The Agency's share of the total construction cost as shown on the face of this agreement shall be withheld from its monthly fuel tax allotments. T'he face of this ageement establishes the months in which the withholding shall take place and the exact amount to be withheld each month. The e�ctent of withholding will be confirmed by letter from the State at the time of contract award. Upon receipt of progress billings from the contractor, the State will submit such billings to the Federal Govemment 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 e�rtent that such costs aze 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 share of eligible project costs up to the amount shown on the face of this agreement. At the time of audit, the Agency will provide documentation of all costs incurred on the project. The State shall bill the Agency for all costs incurred by the State relative to the project. The State shall also bill the Agency for the federal funds paid by the State to the Agency for project costs which are subsequently determined to be ineligible for federal participation (see Section I3�. VII. Audit of Federal Consultant Contracts The Agency, if services of a consultant are required, shall be responsible for sudit of the consultant's records to determine eligible federal aid costs on the project. The repoR 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 Intemal Audit Office in accordance with generally accepted governmental suditing standazds as issued by the United States General Accounting Office by the Comptroller General of the United States; WSDOT Manual M 27-50, Consukant 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 yeaz 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 repoR is transmitted prompUy to the State. IX. Payment of Billing The Agency agrees that if payment or arrangement for payment of any of the State's billing relative to the project (e.g., State force work, project cancellation, overpayment, cost ineligible for federal participation, etc.) is not made to the State within 45 days after the Agency has been billed, the State shall effect reimbursement of the total sum due from the regulaz monthly fuel tax allotments to the Agency from the Motor Vehicle Fund. No additional Federal project funding will be appmved until full payment is received unless otherwise directed the Director of Highways and Local Progams. 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 standards approved by the Federal Highway Administration and MUTCD. The Agency will, at its own expense, maintain the improvement covered by this agreement. XI. Indemnity The Agency shall hold the Federal Government and the State hazmless from and shall process and defend at its own expense all claims, demands, or suits, whether at law or equity brought against the Agency, State, or Federal Government, azising from the Agency's execution, perfortnance, or failure to perform any of the provisions of this agreement, or of any other agreement or contract connected with this ageement, 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 Govemment except as expressly provided herein. The Agency shall not discriminate on the basis of race, color, national origin, or sex in the award and performance of any USDOT-assisted contract and/or agreement or in the administration of its DBE program or the requirements of 49 CFR Part 26. The Agency shall take all necessary and reasonable steps under 49 CFR Part 26 to ensure nondiscrimination in the awazd and administration of USDOT-assisted contracts and agreements. The WSDOT's DBE program, as required by 49 CFR Part 26 and as approved by USDOT, is incorporated by reference in this agreement. Implementation of this program is a legal obligation and failure to carry out its terms shall be treated as a violation of this agreement. Upon notification to the Agency of its failure to carry out its approved program, the Departrnent may impose sanctions as provided for under Part 26 and may, in appropriate cases, refer the matter for enforcement under 18 U.S.C. 1001 and/or the Program Fraud Civil Remedies Act of 1986 (31 U.S.C. 3801 et seq.). The Agency hereby agrees that it will incorporate or cause to be incorporated into any contract for construction work, or modification thereof, as defined in the rules and regulations of the Secretary of Labor in 41 CFR Chapter 60, which is paid for in whole or in part with funds obtained from the Federal Govemment or borrowed on the credit of the Federal Govemment 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, insmimentality, or subdivision of such govemment which dces not participate in work on or under the contract. The Agency also agrees: (1) To assist and cooperate actively with the State in obtaining the compliance of contractors and subcontractors with the equal opportunity clause and rules, regulations, and relevant orders of the Secretary of Labor. (2) To 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 contract or contract modification subject to Executive Order 11246 of September 24, 1965, with a contractor debarred from, or who has not demonstrated eligibility for, govemment contracts and federally assisted construcrion 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 conVactors and subconUactors 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 Ageacy 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 Department of Justice for appropriate legal proceedings. XIII. Liquidated Damages The Agency hereby agrees that the liquidated damages provisions of 23 CFR Part 635, Subpart 127, as supplemented, relative to ffie amount of Federal participation in the pmject cost, shall be applicable in the event the contractor fails to complete the contract within the contract time. Failure to include liquidated damages provision will not relieve the Agency from reduction of federal participation in accordance with this paragraph. XIV. Termination for Public Convenience The Secretary of the Washington State Department of Transportation may terminate the contract in whole, or from time to time in part, whenever: (1) The requisite federal funding becomes unavailable through failure of appropriation or otherwise. (2) The conVactor is prevented from proceeding with the work as a direct result of an Executive Order of the President with respect to the prosecution of war or in the interest of national defense, or an Executive Order of the President or Governor of the State with respect to the preservation of energy resources. (3) The contractor is prevented from 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 primazily 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 and/or Causes of Action For the convenience of the parties to this contract, it is agreed that any claims and/or causes of action which the Local Agency has against the State of Washington, growing out of this contract or the project with which it is concerned, shall be brought only in the Superior Court for Thurston County. XVI. Certification Regarding the Restrictions of the Use of Federal Funds for Lobbying The approving authoriry certifies, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative ageement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit the Standard Form - LLL, "Disclosure Form to Report Lobbying," in accordance with iu instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiets (including subgrants, and contracts and subcontracts under grants, subgrants, loans, and cooperative agreements) which exceed $100,000, and thai all such subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification as a prerequisite for making or entering into this transacdon imposed by Section 1352, Title 31, U.S. Code. My 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