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AG 13-069 RETURN TO: PW ADMIN EXT: 2700 ID#: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS/ 7 �� ` 2. ORIGINATING STAFF PERSON: © y 141" / �L'tk_t L1 EXT: 2 7 L -- 3. DATE REQ.BY: JS4 P 3. TYPE OF DOCUMENT(CHECK ONE): o CONTRACTOR SELECTION DOCUMENT(E.G.,RFB,RFP,RFQ) o PUBLIC WORKS CONTRACT 0 SMALL OR LIMITED PUBLIC WORKS CONTRACT o PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT o GOODS AND SERVICE AGREEMENT 0 HUMAN SERVICES/CDBG o REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT(E.G.BOND RELATED DOCUMENTS) o ORDINANCEj I t. o RESOLUTION B CONTRACT JENDMVNT(AG#): ❑ INTERLOCAL N. OTHER C!' -vvve4.1{- /► , I (�- 6014 s f/-'th 1. A <c'. 4. PROJECT NAME: i3.. 4' Ji, 4-w Li 5 61 fi 5. NAME OF I N �-' ADDRESS: - _ k �� ° L?�h►/ L I),p )C/ Ni,./Rept;,I,(In6cx TELEPHONE:_. E-MAIL: �7 i 5t.r�b'k . �`✓6�' '7 fi/S - FAX: SIGNATURE NAME: g en I In q f �G�t:.� TITLE: ))/-2 c 1"1j 6. EXHIBITS AND ATTACHMENTS:0 SCOPE,WORK OR SERVICES o COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS CFW LICENSE# BL,EXP.12/31/ UBI# ,EXP. / / 7. TERM: COMMENCEMENT DATE: 141441' MM"'U P e-k (1 7 0 I '3 COMPLETION DATE: (JrL.. CAjs�- I' /,'v� 8. TOTAL COMPENSATION:$ UN CiAL c" //G..??/3/( (INCLUDE EXPENSES AND SALES TAX,IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE-ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: o YES ❑NO IF YES,MAXIMUM DOLLAR AMOUNT: $ (� c GLtry..I c'" IS SALES TAX OWED: o YES ❑NO IF YES,$ PAID BY: o CONTRACTOR ❑CITY RETAINAGE: RETAINAGE AMOUNT: ❑RETAINAGE AGREEMENT(SEE CONTRACT) OR ❑RETAINAGE BOND PROVIDED T o PURCHASING: PLEASE CHARGE TO: J O6 - `"QC1 `df+ —5'I}""5(9 6. ) 9. DOCUMENT/CONTRACT REVIEW INITIAL/DATE REVIEWED INITIAL/DATE APPROVED PF PROJECT MANAGER 3 VV t //L.,/I o DIVISION MANAGER DEPUTY DIRECTOR .1,9,4 .N.31>)'( ' -'- (-021 ill 'at DIRECTOR 9 4 -'- (0(29 ❑ RISK MANAGEMENT (IF APPLICABLE) •Q1 LAW DEPT 10. COUNCIL APPROVAL(IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE: SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE: p� 11. CoNCT SIGNATURE ROUTING ❑SENT TO VENDOR/CONTRACTOR DATE SENT: 7-10—1S DATE REC'D: o ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE,LICENSES,EXHIBITS ❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 MONTH PRIOR TO EXPIRATION DATE (INCLUDE DEPT.SUPPORT STAFF IF NECESSARY AND FEEL FREE TO SET NOTIFICATION MORE THAN A MONTH IN ADVANCE IF COUNCIL APPROVAL IS NEEDED.) INITIAL/DATE SIGNED r ▪-P+N NCE DEPARTMENT ( f C^ -I' J U M 1 �1 SIGNATOR AYO' S' DIRECTOR) -ILINIEllfflArl • CITY CLERK `, E3f , i `.7 ci 1SP�.ASSIGNED AG# AG• r ❑ SIGNED COPY RETURNED DATE SENT: / NS ❑RETURN ONE ORIGINAL COMMENTS: EXECUTE"I.,"ORIGINALS 1/2018 StateV v71 ' ' "' a Local Agency Agreement Supplement DeparbnenAgency Supplement Number City of Federal Way 3 Federal Aid Project Number Agreement Number CFDA No. 20.205 STPUL-0099(126) LA-7948 (Catalog of Federal Domestic Assistance) The Local Agency requests to supplement the agreement entered into and executed on 3/2.1/13 All provisions in the basic agreement remain in effect except as modified by this supplement. The change to the agreement are as follows: Project Description Name Pacific Highway S HOV Lanes Phase V(S 340th St to S 359th St) Length 1.2 Termini Description of Work ✓ No Change Reason for Supplement Revise funding amounts to increase WSDOT inspection funds availability and re-allocate unused funds from previous phases. Are you claiming indirect cost rate? Yes / No Project Agreement End Date 12/31/2019 Does this change require additional Right of Way or Easements? Yes ✓ No Advertisement Date:7/1/2016 Estimate of Funding 5,e. 41k cd1 wile„,f Type of Work (1) (2) (3) (4) (5) Previous Estimated Total Estimated Agency Estimated Federal 9 Y Agreement/Suppl. Supplement Project Funds Funds Funds PE 0.00 86.5 "/o a.Agency b. Other Consultant 0.00 Federal Aid c.Other Non-Participating 0.00 Participation Ratio for PE d. State 0.00 e.Total PE Cost Estimate(a+b+c+d) 0.00 0.00 0.00 0.00 0.00 Right of Way f Agency 0.00 86.5 % g.Other Consultant 0.00 Federal Aid h.Other Non-Participating 0.00 Participation Ratio for RW i.State 0.00 j.Total R/W Cost Estimate 0+01+;1 0.00 0.00 0.00 0.00 0.00 Construction k.Contract 0.00 86.5 % I.Other Non-Participating 0.00 m.Other Contract Util non-part 0.00 Federal Aid n.Other Consultant 0.00 Participation Ratio for CN o.Agency 0.00 p.State 0.00 q.Total CN Cost Estimate(k+++m+n+o+p) 0.00 0.00 0.00 0.00 0.00 r.Total Project Cost Estimate(e+i+a) 0.00 0.00 0.00 0.00 0.00 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. Agenc, • cial Washing o to e Departmen •f Transportation Title � Director, Local rogram Fe 7ell,Mayor Date Executed AUG 0 1 2018 DOT Form 140-041 Page 1 Revised 05/2015 Agency Supplement Number City of Federal Way 3 Federal Aid Project Number Agreement Number CFDA No. 20.205 STPUL-0099(126) LA-7948 (Catalog of Federal Domestic Assistance) VI. Payment and Partial Reimbursement The total cost of the project, including all review and engineering costs and other expenses of the State, is to be paid by the Agency and by the Federal Government. Federal funding shall be in accordance with the Federal Transportation Act, as amended, 2 CFR Part 200. The State shall not be ultimately responsible for any of the costs of the project. The Agency shall be ultimately responsible for all costs associated with the project which are not reimbursed by the Federal Government. Nothing in this agreement shall be construed as a promise by the State as to the amount or nature of federal participation in this project. The Agency shall bill the state for federal aid project costs incurred in conformity with applicable federal and state laws. The agency shall minimize the time elapsed between receipt of federal aid funds and subsequent payment of incurred costs. Expenditures by the Local Agency for maintenance, general administration, supervision, and other overhead shall not be eligible for federal participation unless a current indirect cost plan has been prepared in accordance with the regulations outlined in 2 CFR Part 200- Uniform Admin. Requirements, Cost Principles and Audit Requirements for Federal Awards, and retained for audit. The State will pay for State incurred costs on the project. Following payment, the State shall bill the Federal Government for reimbursement of those costs eligible for federal participation to the extent that such costs are attributable and properly allocable to this project. The State shall bill the Agency for that portion of State costs which were not reimbursed by the Federal Government(see Section IX). VII. Audit of Federal Consultant Contracts The Agency, if services of a consultant are required, shall be responsible for audit of the consultant's records to determine eligible federal aid costs on the project. The report of said audit shall be in the Agency's files and made available to the State and the Federal Government. An audit shall be conducted by the WSDOT Internal Audit Office in accordance with generally accepted governmental auditing standards as issued by the United States General Accounting Office by the Comptroller General of the United States; WSDOT Manual M 27-50, Consultant Authorization, Selection, and Agreement Administration; memoranda of understanding between WSDOT and FHWA; and 2 CFR Part 200.501 -Audit Requirements. If upon audit it is found that overpayment or participation of federal money in ineligible items of cost has occurred, the Agency shall reimburse the State for the amount of such overpayment or excess participation. IX. Payment of Billing The Agency agrees that if payment or arrangement for payment of any of the State's billing relative to the project(e.g., State force work, project cancellation, overpayment, cost ineligible for federal participation, etc.) is not made to the State within 45 days after the Agency has been billed, the State shall effect reimbursement of the total sum due from the regular monthly fuel tax allotments to the Agency from the Motor Vehicle Fund. No additional Federal project funding will be approved until full payment is received unless otherwise directed by the Director, Local Programs. Project Agreement End Date-This date is based on your projects Period of Performance (2 CFR Part 200.309). Any costs incurred after the Project Agreement End Date are NOT eligible for federal reimbursement.All eligible costs incurred prior to the Project Agreement End Date must be submitted for reimbursement within 90 days after the Project Agreement End Date or they become ineligible for federal reimbursement. VIII. Single Audit Act The Agency, as a subrecipient of federal funds, shall adhere to the federal regulations outlined in 2 CFR Part 200.501 as well as all applicable federal and state statutes and regulations.A subrecipient who expends $750,000 or more in federal awards from all sources during a given fiscal year shall have a single or program-specific audit performed for that year in accordance with the provisions of 2 CFR Part 200.501. Upon conclusion of the audit, the Agency shall be responsible for ensuring that a copy of the report is transmitted promptly to the State. XVII. Assurances Local Agencies receiving Federal funding from the USDOT or its operating administrations (i.e., Federal Highway Administration, Federal Transit Administration, Federal Aviation Administration) are required to submit a written policy statement, signed by the Agency Executive and addressed to the State, documenting that all programs, activities and services will be conducted in compliance with Section 504 and the Americans with Disabilities Act(ADA). DOT Form 140-041 Page 2 Revised 05/2015 4116. IV Department of Transportation Federal Aid Nubmer: STPUL-0099(126) Agreement Number: LA-7948 Project Title: Pacific Highway S HOV Lanes Phas V(S 340th St to S 359th St) Supplement Number: 3 Estimate of Funding Type of Work (1) (2) (3) (4) (5) PREVIOUS AGREEMENT/ SUPPLEMENT ESTIMATED TOTAL ESTIMATED ESTIMATED SUPPLEMENT PROJECT FUNDS AGENCY FUNDS FEDERAL FUNDS P.E. a. Agency: $150,000.00 $150,000.00 $20,250.00 $129,750.00 86.5% b. Consultant $1,559,104.00 $1,559,104.00 $210,479.00 $1,348,625.00 Federal Aid c. Other(Non-Participate) $265,896.00 $247,406.00 $513,302.00 $513,302.00 d State $25,000.00 ($5,089.00) $19,911.00 $2,688.00 $17,223.00 e Total PE Cost Est.(a thru e) $2,000,000.00 $242,317.00 $2,242,317.00 $746,719.00 $1,495,598.00 Right of Way f Agency $704,878.00 $704,878.00 $95,159.00 $609,719.00 87% g Other-Consultant $607,268.00 ($2,443.00) $604,825.00 $81,651.00 $523,174.00 Federal Aid h Other(Non-Participate) $1,822,185.00 $91,420.00 $1,913,605.00 $1,913,605.00 Participation i State $5,000.00 ($5,000.00) Ratio for RW j Total R/W Cost Est.(f thru j) $3,139,331.00 $83,977.00 $3,223,308.00 $2,090,415.00 $1,132,893.00 Construction k Contract $7,000,000.00 ($27,652.00) $6,972,348.00 $941,267.00 $6,031,081.00 I Other(Non-Participation) $10,002,210.00 $159,297.00 $10,161,507.00 $10,161,507.00 m Utility(Non-Participation) $2,970,214.00 $2,970,214.00 $2,970,214.00 86.5% n Consultant $1,000,000.00 $1,000,000.00 $135,000.00 $865,000.00 Federal Aid o Agency $82,485.00 $82,485.00 $11,135.00 $71,350.00 Participation p State (State Funds) $10,000.00 $40,184.00 $50,184.00 $6,775.00 $43,409.00 q Satate Service(Non Participate) $50,000.00 $50,000.00 $50,000.00 Ratio for CN r Total Const.Cost Est.(k thru q) $21,064,909.00 $221,829.00 $21,286,738.00 $14,275,898.00 $7,010,840.00 r.Total Project Cost Estimate(e+j+p) $26,204,240.00 1 $548,123.00 $26,752,363.00 $17,113,032.00 $9,639,331.00 RETURN TO: )3 prayrui rt EXT: 2 ( 29 `r CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / STREETS 2. ORIGINATING STAFF PERSON: JOHN MULKEY 4. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ ❑ GOODS AND SERVICE AGREEMENT ❑ ❑ REAL ESTATE DOCUMENT ❑ EXT: 2722 3. DATE REQ. Bv:ASAP ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT MAINTENANCE AGREEMENT HUMAN SERVICES / CDBG SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ ORDINANCE ❑ RESOLUTION �Q► CONTRACT AMENDMENT (AG #):13 -069 ❑ INTERLOCAL }OTHER SUPPLEMENT No. 2 - CONSTRUCTION OBLIGATION AND RIGHT OF WAY FUNDS ADDED 5. PROJECT NAME: PACIFIC HIGHWAY S HOV LANES PHASE V ( S 340TH ST. TO S 3551•1H ST.) 6. NAME OF CONTRACTOR: WSDOT. ADDRESS: ED CONYERS1, H &LP, WSDOT NW REGION, P.O. Box 330310, SEATTLE, WA 98155 TELEPHONE:206 -440 -3585 E -MAIL: FAX: SIGNATURE NAME: KATHLEEN DAVIS TITLE: DIRECTOR 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. UBI # , EXP. 8. TERM: COMMENCEMENT DATE: MARCH 21, 2013 COMPLETION DATE: UPON COMPLETION 9. TOTAL COMPENSATION: $7,000,000.00 /$9,631,0OTOTALT0 CITY (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: $17,215.33 (UNCHANGED) IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE To: 306 -4400- 170 -595- 30-650 10. DOCUMENT / CONTRACT REVIEW PROJECT MANAGER ❑ DIVISION MANAGER I. DEPUTY DIRECTOR p DIRECTOR ❑ RISK MANAGEMENT OF APPLICABLE) s, LAW DEPT 11 ' , • OVAL IF INITIAL / DATE REVIE)JVED INITIAL / DATE APPROVED 1• • I \: 1I 1 4 ■ Tr. • .. ; .. 1 C11) S-54) !s 12. CONTRACT SIGNATURE ROUTING n ,, SENT TO VENDOR/CONTRACTOR DATE SENT: 5 2 I tj w ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS INITIAL / DATE SIGNED ❑ LAW DEPT C 4 ��t. SIGNATORY ( ) j] CITY CLERK ASSIGNED AG # SIGNED COPY RETURNED ❑ RETURN ONE ORIGINAL COMMENTS: EXECUTE " 2 " ORIGINALS Z 110 iii i► 11' ••I • • - DATE REC' D: 7 1 1 t Illy 3 CITY SIGNS 1ST, PLEASE RETURN TO JOHN FOR COVER LETTER OBLIGATION OF FUNDS FOR CONSTRUCTION AND ADDING RIGHT OF WAY FUNDS 11/9 ,1) Department Local Agency Agreement Supplement Agency Federal Way Supplement Number 2 Federal Aid Project Number STPUL - 0099(126) Agreement Number LA -7948 CFDA No. 20.205 (Catalog of Federal Domestic Assistance) The Local Agency requests to supplement the agreement entered into and executed on 3/4/2013 All provisions in the basic agreement remain in effect except as modified by this supplement. The change to the agreement are as follows: Project Description Name Pacific Highway S HOV Lanes Phase V (S 340th St to S 359th St) Termini S 340th Street to S 359th Street Description of Work ✓ No Change Length 1.2 Reason for Supplement To obligate Construction funding and increase local funds to Right of Way phase for increased ROW cost. Are you claiming indirect cost rate? Yes ✓ No Does this chance require additional Right of Way or Easements? Project Agreement End Date 12/31/2019 Yes ✓ No Advertisement Date: 7/1/2016 Type of Work • Estimate of Funding (1) Previous Agreement/Suppl. 2 Supplement (3) Estimated Total Project Funds (4) Estimated Agency Funds (5) Estimated Federal Funds PE a. Agency 150,000.00 150,000.00 20,250.00 129,750.00 86.5 % b. Other Consultant 1,559,104.00 1,559,104.00 210,479.00 1,348,625.00 Federal Aid c. Other Non-Participating 265,896.00 265,896.00 265,896.00 Participation Ratio for PE d. State 25,000.00 25,000.00 3,375.00 21,625.00 e. Total PE Cost Estimate (a+b+c+d) 2,000,000.00 0.00 2,000,000.00 500,000.00 1,500,000.00 Right of Way f Agency 704,878.00 704,878.00 95,159.00 609,719.00 86.5 % 9. Other Consultant 607,268.00 607,268.00 81,981.00 525,287.00 Federal Aid h. Other Non - Participating 1,322,185.00 500,000.00 1,822,185.00 1,822,185.00 Participation Ratio for RW L State 5,000.00 5,000.00 675.00 4,325.00 j. Total R/W Cost Estimate (f+a+h+i) 2,639,331.00 500,000.00 7,000,000.00 3,139,331.00 7,000,000.00 2,000,000.00 945,000.00 1,139,331.00 6,055,000.00 Construction k. Contract 86.5 I. Other non - participating 10,002,210.0 10,002,210.00 10,002,210.00 m. Other Contract Util non -part 2,970,214.00 2,970,214.00 2,970,214.00 Federal Aid n. Other Consultant 1,000,000.00 1,000,000.00 135,000.00 865,000.00 Participation Ratio for CN o. Agency 82,485.00 82,485.00 11,135.00 71,350.00 p. State 10,000.00 10,000.00 1,350.00 8,650.00 q. Total CN Cost Estimate (k+I+m+n+o +A) 0.00 21,064,909.01 21,064,909.00 14,064,909.00 7,000,000.00 r. Total Project Cost Estimate (e +i+g) 4,639,331.00 21,564,909.01 26,204,240.00 16,564,909.00 9,639,331.00 The Local Agency further stipulates condition to payment of the Federal Agency Offi_al By Title Jim F or DOT Form 140 -041 Revised 05/2015 that pursuant to funds obligated, said Title 23, regulations and policies and procedures and as a it accepts and will comply with the applicable provisions. Washington State Depajtment of Transportation cfro/4 'rector, Local Program Date Executed JUN 2 3 2016 Page 1 Agency • Federal Way Supplement Number 2 Federal Aid Project Number STPUL- 0099(126) Agreement Number LA -7948 CFDA No. 20.205 (Catalog of Federal Domestic Assistance) VI. Payment and Partial Reimbursement The total cost of the project, including all review and engineering costs and other expenses of the State, is to be paid by the Agency and by the Federal Government. Federal funding shall be in accordance with the Federal Transportation Act, as amended, 2 CFR Part 200. The State shall not be ultimately responsible for any of the costs of the project. The Agency shall be ultimately responsible for all costs associated with the project which are not reimbursed by the Federal Government. Nothing in this agreement shall be construed as a promise by the State as to the amount or nature of federal participation in this project. The Agency shall bill the state for federal aid project costs incurred in conformity with applicable federal and state laws. The agency shall minimize the time elapsed between receipt of federal aid funds and subsequent payment of incurred costs. Expenditures by the Local Agency for maintenance, general administration, supervision, and other overhead shall not be eligible for federal participation unless a current indirect cost plan has been prepared in accordance with the regulations outlined in 2 CFR Part 200 - Uniform Admin. Requirements, Cost Principles and Audit Requirements for Federal Awards, and retained for audit. The State will pay for State incurred costs on the project. Following payment, the State shall bill the Federal Government for reimbursement of those costs eligible for federal participation to the extent that such costs are attributable and properly allocable to this project. The State shall bill the Agency for that portion of State costs which were not reimbursed by the Federal Government (see Section IX). VII. Audit of Federal Consultant Contracts The Agency, if services of a consultant are required, shall be responsible for audit of the consultant's records to determine eligible federal aid costs on the project. The report of said audit shall be in the Agency's files and made available to the State and the Federal Government. An audit shall be conducted by the WSDOT Internal Audit Office in accordance with generally accepted governmental auditing standards as issued by the United States General Accounting Office by the Comptroller General of the United States; WSDOT Manual M 27 -50, Consultant Authorization, Selection, and Agreement Administration; memoranda of understanding between WSDOT and FHWA; and 2 CFR Part 200.501 - Audit Requirements. If upon audit it is found that overpayment or participation of federal money in ineligible items of cost has occurred, the Agency shall reimburse the State for the amount of such overpayment or excess participation. IX. Payment of Billing The Agency agrees that if payment or arrangement for payment of any of the State's billing relative to the project (e.g., State force work, project cancellation, overpayment, cost ineligible for federal participation, etc.) is not made to the State within 45 days after the Agency has been billed, the State shall effect reimbursement of the total sum due from the regular monthly fuel tax allotments to the Agency from the Motor Vehicle Fund. No additional Federal project funding will be approved until full payment is received unless otherwise directed by the Director, Local Programs. Project Agreement End Date - This date is based on your projects Period of Performance (2 CFR Part 200.309). Any costs incurred after the Project Agreement End Date are NOT eligible for federal reimbursement. All eligible costs incurred prior to the Project Agreement End Date must be submitted for reimbursement within 90 days after the Project Agreement End Date or they become ineligible for federal reimbursement. VIII. Single Audit Act The Agency, as a subrecipient of federal funds, shall adhere to the federal regulations outlined in 2 CFR Part 200.501 as well as all applicable federal and state statutes and regulations. A subrecipient who expends $750,000 or more in federal awards from all sources during a given fiscal year shall have a single or program- specific audit performed for that year in accordance with the provisions of 2 CFR Part 200.501. Upon conclusion of the audit, the Agency shall be responsible for ensuring that a copy of the report is transmitted promptly to the State. XVII. Assurances Local Agencies receiving Federal funding from the USDOT or its operating administrations (i.e., Federal Highway Administration, Federal Transit Administration, Federal Aviation Administration) are required to submit a written policy statement, signed by the Agency Executive and addressed to the State, documenting that all programs, activities and services will be conducted in compliance with Section 504 and the Americans with Disabilities Act (ADA). DOT Form 140 -041 Page 2 Revised 05/2015 RETURN TO: EXT: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / STREETS 2. ORIGINATING STAFF PERSON: JOHN MULKEY EXT: 2722 3. DATE REQ. BY:ASAP 4. TYPE OF DOCUMENT (CHECK ONE: ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ ❑ PROFESSIONAL SERVICE AGREEMENT ❑ ❑ GOODS AND SERVICE AGREEMENT ❑ ❑ REAL ESTATE DOCUMENT ❑ ❑ ORDINANCE ❑ ❑ CONTRACT AMENDMENT (AG#): 13-069 ❑ �NOTHER SUPPLEMENT NO. 1 — RIGHT OF WAY OBLIGATION 5. PROJECT NAME: SMALL OR LIMITED PUBLIC WORKS CONTRACT MAINTENANCE AGREEMENT HUMAN SERVICES / CDBG SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) RESOLUTION INTERLOCAL TO 6. NAME OF CONTRACTOR: WSDOT. ADDRESS: ED CONYERSI, H &LP, WSDOTNW REGION, P.O. Box 330310, SEATTLE, WA 98155 TELEPHONE: 206-440-3 5 85 E -MAIL: FAX: SIGNATURE NAME: KATHLEEN DAVIS TITLE: DIRECTOR 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. UBI # , EXP. 8. TERM: COMMENCEMENT DATE: MARCH 21, 2013 COMPLETION DATE: UPON COMPLETION TOTAL COMPENSATION: $1,139,331.00/$2,639,33 .00TOTAL (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: $17,215.33 (UNCHANGED) IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE To: 306 - 4400 - 170 - 595 -30 -650 10. DOCUMENT / CONTRACT REVIEW i;L"PROJECT MANAGER sL DIVISION MANAGER 5z DEPUTY DIRECTOR q DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE 9 LAW DEPT INITIAL/ DATE REVIEWED O 11.- Gulud -11 A RRRQ A Crc n o ;..!, � �, E COMMITTEE APPROVAL DATE: ��jj T 12. CONTRACT SIGNATURE ROUi`ING iG ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ LAW DEPT SIGNATORY (CM OR (RECTOR ❑ CITY CLERK ASSIGNED AG # SIGNED COPY RETURNED ❑ RETURN ONE ORIGINAL COMMENTS: EXECUTE" 2 "ORIGINALS CITY SIGNS IIT, PLEASE RETURN TO JOHN FOR COVER LETTER OBLIGATION OF FUNDS FOR RIGHT OF WAYACQUISITION INITIAL/ DATE APPROVED COUNCIL APPROVAL DATE: I IAL/ DATE SIGNED )01,6114 AG# DATE SENT: 1 DATE REC'D: 11/9 C IWashington State Department of Transportation r Local Agency Agreement Supplement Agency Supplement Number City of Federal WWI — - 1 Federal Aid Project Number Agreement Number CFDA No. 20.205 STPUL -0099 126 LA -7948 (Catalog of Federal Domestic Assistance The Local Agency requests to supplement the agreement entered into and executed on 3/4/2013 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 Pacific Highway South HOV Lanes Phase V (S 340th St to S 359th St) Termini S 340th Street to S 359th Street Description of Work ® No Change Reason for Supplement Obligation of Funds for Right of Way nnac this rhnnna ranuira nrtrtitinnal Rinht of Wav or FasemPnts? I J Yes ® No Length 1.20 The Lo 1 Agency further stipulates that pursuant to said Title 23, regulations and policies and procedures, and as a condition to pay a of the Federal funds obligated, it accepts and will comply with the applicable prov' ions. A nc fficial Wa hington Stat D �artment of nsportation By By Title �lloi�m P E_ -_ __ -- Director of Highways nd Local Programs Public- Works-Director - -- - -- - -- -- - -- -- Date Executed OCT 2014 DOT Form 140 -041 EF Revised 03/2011 Estimate of Funding _ _ (�) (2) (3) (4) (5) Estimated Type of Work yp Previous Supplement Estimated Total Estimated Agency Agreement/Suppl. Project Funds Funds Federal Funds PE a. Agency 150,000.00 - —__ _ 150,000.00 20,250.00 _ 129,750.00 86.5 % b. Other Consultant 1,559,104.00 1,559,104.00 210,479.00 _ _ 1,348,625.00 c. Other Non-Participating 265,896.00 265,896.00 265 896.00 _ _ Federal Aid d. State 25,000.00 25,000.00 — 3,375.00 21,625.00 Participation -- - -- - -- - Ratio for PE e. Total PE Cost Estimate (a +b +c +d) 2,002±2100i 2,000,000.00 500,000.00 1,500,000.00 Right of Way f_A Re ncy 704,878.00 704,878.00 95,159.00 609,719.00 86.5 % g. Other Consultant _ _ __607 268.00 - 607,268.00 81 981.00 525,287.00 Federal Aid h. Other Non -Partic atin _ -__- Participation -- -- -p -� Ratio for RW i. State 5,000.001 - - --_ 5,000.00 675.00 _ 4,325.00 j. Total R/W Cost Estimate (f +g +h +i) 2.639 331,001 Construction k. Contract I. Other m. Other — - n. Other Federal Aid Participation o. Agency Ratio for CN pState =- -- - - - - — - - - -- -- - - - - g. Total CN Cost Estimate k+l+m+n+o r. Total Project Cost Estimate a +' 2.000,00 0.00 2,639.33 4,639,331 0 1 The Lo 1 Agency further stipulates that pursuant to said Title 23, regulations and policies and procedures, and as a condition to pay a of the Federal funds obligated, it accepts and will comply with the applicable prov' ions. A nc fficial Wa hington Stat D �artment of nsportation By By Title �lloi�m P E_ -_ __ -- Director of Highways nd Local Programs Public- Works-Director - -- - -- - -- -- - -- -- Date Executed OCT 2014 DOT Form 140 -041 EF Revised 03/2011 � Washington State TI/ Department of Transportation Lynn Peterson Secretary of Transportation Mr. Marwan Salloum, PE Deputy Public Works Director City of Federal Way 33325 8th Avenue South Federal Way, WA 98003 Dear Mr. Salloum: Transportation Building 310 Maple Park Avenue S.E. PO. Box 47300 Olympia, WA 98504 -7300 360- 705 -7000 November 10, 2014 TTY: 1- 800 -833 -6388 www.wsdot.wa.gov is I jam NOV 14 2014 City of Federal Way PUBLIC WORKS Pacific Highway S HOV Lanes DEPARTMENT Ph. 5 (340th to 359h) STPUL- 0099(126) FUND AUTHORIZATION We have received FHWA fund authorization, effective November 4, 2014, for this project as follows: PHASE TOTAL FEDERALSHARE Right of Way $2,639,331 $1,139,331 As a condition of authorization you must show continuous project progress through monthly billings, until your project is complete. Failure to show continuous progress may result in your project becoming inactive per 23 CFR 630.106(a) (5) and subject to de- obligation of all federal funds and agreement closure. FHWA requires projects utilizing federal funds for preliminary engineering or right of way to advance to construction. If this project is unable to proceed to construction, any expended federal funds must be repaid. Enclosed for your information and file is a fully executed copy of Supplement Number 1 to Local Agency Agreement LA -7948 between the state and your agency. All costs exceeding 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. You may proceed with the administration of this project in accordance with your WSDOT approved Certification Acceptance agreement. l Sincer Stephani Tax Manager, Program Management Local Programs ST:ds:ac Enclosure cc: Ed Conyers, Northwest Region Local Programs Engineer, MS NB82 -121 RETURN TQ: `� EXT: Z '7 � Z CITY �F FEDERAL VVAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATIIVG DEPT/DIY: PUBLIC WORKS /��G� 2. ORIGINATIIYG STAFF PERSON: �+ �� ii � V�1 tG.c VI EXT:' ��,�� 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 ❑ PROFESS[ONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT � GOODS AND SERVICE AGREEN[ENT ❑ HUMAN SERVICES / CDBG � REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) � ORDINANCE ❑ RESOLUTION ❑ CONTRACT AMENDMEN"[' (AG#): ❑ INTERLOCAL pL O�cxER �„fzc�, �,e�—��.iYf�{_�- �. PROJECT NAME: Q0.� ►���,��,?h�� � Ol�.� i�'OV L..�..1'�-S Q� �� V 6, TELEPHONE: Fax: TITLE: ��_ 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 # • E�• � �_ S. TERM: COMMENCEMENT DATE: COMPLETZON DATE: 9. TOTAL COMPENSATION: $���a� �C�y���'+����„_ (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOL[DAY RATES) REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIML7M DOLLAR AMOUNT: $ IS SALES TAX OWED: ❑ YE5 0 NO [F YES, $ ❑ PURCHASING: PLEASE CHARGE TO: �Y�t,C� ICR�M�oW%^`�^ 10. DOCUMENT / COIYTRACT REVIE�Y � PROJECT MANAGER R �DEPUTY DIRECTOR t/Y1A,Y'WR�'� Q(DIRECTOR C„�yrv� n w,r v�. • � �BLE) Q-�i3L.�i'►PT ` 11. COUiYCIL APPROVAL (IF APPLICABLE) PAID BY: ❑ CONTRACTOR ❑ CITY INITIAL / DATE REVIEWED INITIAL / DATE APPROVED Q�.�2 2�1t3 'ZZ. � COMMITTEE APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTIPIG ❑ SENT T'O VENDOR/CONTRACTOR DATE SENT; ,�IZS/I3 a ATTACH: SIGNATURE AUTHORITY, INSURr�NCE CERTtFtCATE, LICENSES, EXHIBITS ❑ L.aw DEr'r �SIGNATORY�R DIRECTOR) CITY CLERK a �D l� � ASSIGNED AG # � SIGNED COPY KETiIRNED � -rr��a��t�c�----- � INIT�IALA / DATE SIGNED -�%!/Gt�l� Z//z5/ _ (�.11f�1 AG# 1 ��(,pG�_ DATE SENT: %I R • 1 � COUNCIL APPROVAL DATE: DATE REC'D: � �Washington State Department of Transportation Lynn Peterson Secretary of Transportation Apri14, 2013 Mr. Marwan Salloum, PE Public Works Director City of Federal Way PO Box 9718 Federal Way, Washington 98063-9718 Transportation Building 310 Maple Park Avenue S.E. PO. Box 47300 Olympia, WA 98504-7300 360-705-7000 RECEIvEa TfY: 1-800-833-6388 www.wsdot.wa.gov City of Federal Way Pacific Highway S HOV Lanes Ph. 5(S 340t" to S 359te) STPUL-0099(126) FUND AUTHORIZATION Dear Mr. Salloum: APR 0 8 2013 PARKp&�P�CF�w,ORKB We have received FHWA fund authorization, effective March 25, 2013, for this project as follows: PHASE TOTAL Preliminary Engineering $2,000,000 FEDERALSHARE $1,SQ0,000 Enclosed for your information and file is a fully executed copy of Local Agency Agreement LA- 7948 between the state and your agency. All costs exceeding those shown on this agreement are the sole responsibility of your agency. FHWA requires projects utilizing federal funds for preliminary engineering or right of way to advance to construction. If this project is unable to proceed to construction, any expended federal funds must be repaid. WSDOT authorization to proceed with right of way and/or construction is contingent upon receipt and approval of your environmental documents. WSDOT authorization to proceed with construction is contingent upon receipt of your Right of Way Certification. You may proceed with the administration of this project in accordance with your WSDOT approved Certification Acceptance agreement. Sinc ely, � _ � Stephani Tax Manager, Program Management Highways & Local Programs ST:jg:ac Enclosure cc: Ed Conyers, Northwest Region Local Programs Engineer, MS NB82-121 �, � hingto� o ate� r. Partme nspOrtat�On � Agency City of Federal Way �� �� Address 33325 Ei�hth Avenue South Federal Way, WA 98003 Local Agency Agreement CFDA No. 20.205 (Catalog of Federal Domestic Assistance) Project No. �� ��� — Agreement No. � S �4 �� For OSC WSDOT Use Only The Local Agency having complied, or hereby agreeing to comply, with the terms and conditions set forth in (1) Title 23, U.S. Code Highways, (2) the regulations issued pursuant thereto, (3) 2 CFR 225, (4) Office of Management and Budget Circulars A-102, and A-133, (5) the policies and procedures promulgated by the Washington State Department of Transportation, and (6) the federal aid project agreement entered into between the State and Federal Government, relative to the above project, the Washington State Department of Transportation will authorize the Local Agency to proceed on the project by a separate notifcation. Federal funds which are to be obligated for the project may not exceed the amount shown herein on line r, column 3, without written authority by the State, subject to the approval of the Federal Highway Administration. All project costs not reimbursed by the Federal Government shall be the responsibility of the Local Agency. Project Description Name Pacifc Highway South HOV Lanes Phase V(S 340th St to S 359th St) Length 120 Miles Termini S 340th Street to S 359th Street Description of Work The intent of this project is to improve safety and mobility of users on Pacific Highway South (SR 99) from S 340th Street to S 359th Street. The project scope includes reconstructing portions of and widening Pacific Highway South (SR 99), providing HOV lanes, curb, gutter and sidewalk on both sides, medians, landscaping, new and modifed signal systems, channelization, street lighting systems, undergrounding the overhead utilities, and drainage system improvements. Estimate of Fundin Type of Work (�> (2> (3� Estimated Total Estimated Agency Estimated Project Funds Funds Federal Funds PE a. A enc 150 000.00 20,250.00 129 750.00 86.5 % b. Other Consultant 1 559 104.00 210 479.00 l 348 625.00 c. Other Non-Partici atin 265 896.00 265 896.00 0.00 Federal Aid d. State 25,000.00 3,375.00 21,625.04 Participation Ratio for PE e. Total PE Cost Estimate a+b+c+d 2 000 000.00 500 000.00 1 500 000.00 Right of Way f. A en % .Other eonsultant h. Other Federal Aid i. State Participation , Ratio for RW '. To4al R!W Cost Estimate f+ +h+i Construction k. Contract I. Other King County 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+•+ 2 000 000.00 500 000.00 1500 000.00 Agency Offi ial Washington Stat De artment of T nsportation By By I Title �kin Priect, Mayor Director of Highways and Local Programs �p,R � � 2013 Date Executed DOT Form 140-039 1 Revised 09/20 , �:onstruction 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 const�uction cost (line 4, column 2) in the amount of $ at $ per month for months. Local Force o� Local Ad and Award � Method C- Aaencv cost incurred with �artial reimbursement The Local Agency further stipulates that pursuant to said Title 23, regulations and po�icies 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 15 2013 , Resolution/Ordinance No. 13-628 Provisions 1. Scope of Work The Agency shall provide all the work, labor, materials, and services necessary to perform the project which is described and set forth in detail in the "Project Description" and "Type of Work." When the State acts for and on behalf of the Agency, the State shall be deemed an agent of the Agency and shall perform the services described and indicated in "Type of Work" on the face of this agreement, in accordance with plans and specifications as proposed by the Agency and approved by the State and the Federal Highway Administration. When the State acts for the Agency but is not subject to the right of control by the Agency, the State shall have the right to perform the work subject to the ordinary procedures of the State and Federal Highway Administration. II. Delegation of Authority The State is willing to fulfill the responsibilities to the Federal Government by the administration of this project. The Agency agrees that the State shall have the full authority to carry out this administration. The State shall review, process, and approve documents required for federal aid reimbursement in accordance with federal requirements. If the State advertises and 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 furnish qualifed 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 ali work is in conformance with approved plans, specifications, and federal aid requirements. The salary of such engineer or other supervisor and all other salaries and costs incurred by State forces upon the project will be considered a cost thereof. All costs related to this project incurred by employees of the State in the customary manner on highway payrolls and vouchers shall be charged as costs of the project. IV. Availability of Records All project records in support of all costs incurred and actual expenditures kept by the Agency are to be maintained in accordance with local government accounting procedures prescribed by the Washington State Auditor's Office, the U.S. Department of Transportatiory 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 availabte for such inspection for a period of not less than three years from the f►nal 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 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 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 construction necessary to provide the initially planned complete facility within the limits of this project will conform to at least the minimum values set by approved statewide design standards applicable to this class of highways, even though such additional work is financed without federal aid participation. The Agency agrees that on federal aid highway construction projects, the current federal aid regulations which apply to liquidated damages relative to the basis of federal participation in the project cost shall be applicable in the event the contractor faiis to complete the contract within the contract time. VI. Payment and Partial Reimbursement The total cost of the project, including all review and engineering costs and other expenses of the State, is to be paid by the Agency and by the Federal Government. Federal funding shall be in accordance with the Federal Transportation Act, as amended, 2 CFR 225 and Office of Management and Budget circulars A-102 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 Federa( 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. DOT Form 140-039 EF 2 Revised 09l2011 The Agency shall bill the state for federal aid project costs incurred in conformity with applicable federal and state laws. The agency shall minimize the time elapsed between receipt of federal aid funds and subsequent payment of incurred costs. Expenditures by the Local Agency for maintenance, general administration, supervision, and other overhead shall not be eligible for federal participation unless a current indirect cost plan has been prepared in accordance with the regulations outlined in 2 CFR 225 - Cost Principles for State, Local, and Indian Tribai Government, and retained for audit. The State will pay for State incurred costs on the project. Following payment, the State shall bill the Federal Government for reimbursement of those costs eligible for federal participation to the extent that such costs are attributable and properly allocable to this project. The State shall bill the Agency for that portion of State costs which were not reimbursed by the Federal Government (see Section 1X). 1. Project Construction Costs Project construction financing will be accomplished by one ofthe three methods as indicated in this agreement. Method A— The Agency will piace with the State, within (20) days after the execution of the construction contract, an advance in the amount of the Agency's share of the total construction cost based on the contract award. The State will notify the Agency of the exact amount to be deposited with the State. The State will pay all costs incurred under the contract upon presentation of progress billings from the contractor. Following such payments, the State will submit a billing to the Federal Government for the federal aid participation share of the cost. When the project is substantially completed and final actual costs of the project can be determined, the State will present the Agency with a final billing showing the amount due the State or the amount due the Agency. This billing will be cleared by either a payment from the Agency to the State or by a refund from the State to the Agency. Method B— The Agency's share of the total construction cost as shown on the face of this agreement shall be withheld from its monthly fuel tax allotments. The face of this agreement establishes the months in which the withholding shall take place and the exact amount to be withheld each month. The extent of withholding will be confirmed by letter from the State at the time of contract award. Upon receipt of progress billings from the contractor, the State will submit such billings to the Federal Government for payment of its participating portion of such billings. Method C— The Agency may submit vouchers to the State in the format prescribed by the State, in duplicate, not more than once per month for those costs eligible for Federal participation to the extent that such cnsts are directly attributable and properly allocable to this project. Expenditures by the Local Agency for maintenance, general administration, supervision, and other overhead shall not be eligibte 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 ofall costs incurred on the project. The State shall bitl 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 consultanrs records to determine eligible federal aid eosts on the project. The report of said audit shall be in the Agency's files and made available to the State and the Federal Government. An audit shall be conducted by the WSDOT [nternal Audit Office in accordance with generally accepted governmental auditing standards as issued by the United States General Accounting Office by the Comptroller General of the United States; WSDOT 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) Circular A-133 as well as alt 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 Circular 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 project (e.g., State force work, project cancellation, overpayment, cost ineligible for federal participation, etc.) is not made to the State within 45 days after the Agency has been billed, the State shall effect reimbursement of the total sum due from the regular monthly fuel tax allotments to the Agency from the Motor Vehicle Fund. No additional Federal project funding will be approved until full payment is received unless otherwise directed 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 parking regulations and traffic control on this project without prior approval of the State and Federal Highway Administration. The Agency will not install or permit to be installed any signs, signals, or markings not in conformance with the standards approved by the Federal Highway Administration and MUTCD. The Agency will, at its own expense, mamtai.n the improvement covered by this agreement. XI. Indemnity The Agency shall hold the Federal Govemment and the State harmless from and shall process and defend at its own expense all claims, demands, or suits, whether at law or equity brought against the Agency, State, or Federal Government, arising from the Agency's execution, DOT Form 140-039 EF Revised 09/2011 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 Government or the State. XII. Nondiscrimination Provision No liability shall attach to the State or Federal Government except as expressly provided herein. The Agency shall not discriminate on the basis of race, color, national origin, or sex in the award and performance of any USDOT-assisted contract and/or agreement or in the administration of its DBE program or the requirements of 49 CFR Part 26. The Agency shall take all necessary and reasonable steps under 49 CFR Part 26 to ensure nondiscrimination in the award and administration of USDOT-assisted contracts and agreements. The WSDOT's DBE program, as required by 49 CFR Part 26 and as approved by USDOT, is incorporated by reference in this agreement. Implementation of this program is a legal obligation and failure to carry out its terms 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 18 U.S.C. 1001 and/or the Program Fraud Civil Remedies Act of 1986 (31 U. S.C. 3801 et seq.). The Agency hereby agrees that it will incorporate or cause to be incorporated into any contract for construction work, or modification thereof, as defined in the rules and regulations of the Secretary of Labor in 41 CFR Chapter 60, which is paid for in whole or in part with funds obtained from the Federal Government or borrowed on the credit of the Federal Government pursuant to a grant, contract, loan, insurance, or guarantee or understanding pursuant to any federal program involving such grant, contract, loan, insurance, or guarantee, the required contract provisions for Federal-Aid Contracts (FHWA 1273), located in Chapter 44 ofthe Local Agency Guidelines. The Agency further agrees that it will be bound by the above equal opportunity clause with respect to its own employment practices when it participates in federally assisted construction work: Provided, that if the applicant so participating is a State or Local Government, the above equal opportunity clause is not applicable to any agency, instrumentality, or subdivision of such government which does not participate in work on or under the contract. The Agency also agrees: (1) To assist and cooperate actively with the State in obtaining the compliance of contractors and subcontractors with the equal opportunity clause and rules, regulations, and relevant orders of the Secretary of Labor. (2) To furnish the State such information as it may require for the supervision of such compliance and that it will otherwise assist the State in the discharge of its primary responsibility for securing compliance. (3) To refrain from entering into any contract or contract modification subject to Executive Order 11246 of September 24, 1965, with a contractor debarred from, or who has not demonstrated eligibility for, government contracts and federally assisted construction contracts pursuant to the Executive Order. (4) To carry out such sanctions and penalties for violation of the equal opportunity clause as may be imposed upon contractors and subcontractors by the State, Federal Highway Administration, or the Secretary ofLabor pursuant to Part II, subpart D of the Executive Order. In addition, the Agency agrees that if it fai(s 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 Department of Justice for appropriate legal proceedings. XIII. Liquidated Damages The Agency hereby agrees that the liquidated damages provisions of 23 CFR Part 635, Subpart 127, as supplemented, relative to the amount of Federal participation in the project cost, shall be applicabte in the event the contractor fails to complete the contract within the contract time. Failure to include liquidated damages provision will not retieve the Agency from reduction of federal participation in accordance with this paragraph. XIV. Termination for Public Convenience The Secretary of the Washington State Department of Transportation may terminate the contract in whole, or from time to time in part, whenever: (1) The requisite federal funding becomes unavailable through failure of appropriation or otherwise. (2) The contractor is prevented from proceeding with the work as a direct result of an Executive Order of the President with respect to the prosecution of war or in the interest of national defense, or an Executive Order of the President or Governor of the State with respect to the preservation of energy resources. (3) The contractor is prevented from proceeding with the work by reason of a preliminary, special, or permanent restraining order of a court of competent jurisdiction where the issuance of such order is primarily caused by the acts or omissions of persons or agencies other than the contractor. (4) The Secretary 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 Loca1 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. DOT Form 740-039 EF 4 Revised 09/2011 XVI. Certification Regarding the Restrictions of the Use of Federal Funds for Lobbying The approving authority certifies, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influenee an o�cer or employee of any federal agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with this federal contract, .grant, loan, or cooperative agreement, the undersigned shall complete and submit the Standard Form - LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subgrants, and contracts and subcontracts under grants, subgrants, loans, and cooperative agreements) which exceed $100,000, and that all such subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification as a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Additional Provisions DOT Form 140-039 EF Revised 09/2011 � Washington State - � Departmerrt of Transportation Route Federal Aid Local Agency Proiect Number 306-4400-165 r WSDOT 1 `Use Only� Local Agency Federal Aid Project Prospectus Date 2/22/2013 Central Contractor Registration Exp.Date 4/2/2013 Federai Employer Tax ID Number 91-1462550 Agency Federal Program Title City of Federal Way �� 20.205 ❑ Other Project Title Start Latitude N47-17-50.45 Start Longitude W122-18-48.74 Pacific Highway South HOV Lanes Phase V(S 340 St to S 359th St) End Latitude N47-16-50.54 End Longitude W122-18-23.41 Project Termini From -- To I Nearest City Name Project Zip Code S 340th Street S 359th Street Ci of Federal Wa 98003 From: To: Length of Project Award Type 1.2 Miles �� Local ❑ Local Forces ❑ State ❑ Railroad Federal Agency City Number County Number County Name WSDOT Region � FHWA ❑ Othe'rs 0443 17 _ Kin Northwest Re ion Congressional District Legislative Districts Urban Area Number TMA / MPO / RTPO 9 30 ' 1 PSRC Total Local Agency Federal Funds Phase Start Phase Estimated Cost Funding Date Nearest Hundred Dollar Nearest Hundred Dollar Nearest Hundred Dollar Month Year P.E. $2,000,000 $SOOZ000 $1 500 000 06/2013 R/W $2 639 331 _$1 5002000_ $1 139 331 03/2014 Const. Total $4 639 331 $2 000 000 $2 639 331 Description of Roadway Width 60 Facit Existing Design and Present Cond Number of Lanes 5 Pacitic Highway South is a principle arterial with 2 lanes in each direction. A center left or two-way left turn lane, and paved shoulders. The adjoining and surrounding area are densely developed and populated. The facility experience extremely high accident rates. Driveway access are frequently undefined, pedestrian facilities are sporadic and the shoulders are used for parking. Description of Proposed Work Description of Proposed Work (Attach additional sheet(s) if necessary) The intent of this project is to improve the safety and mobility of users on Pacific Highway South (SR 99) from S 340th Street to S 359th Street. The project scope includes reconstructing portions of and widening Pacifc Highway South (SR 99), providing HOV lanes, curb, gutter and sidewalk on both sides, medians, landscaping, new and modified signal systems, channelization, street lighting, undergrounding the overhead utilities, and drainage system improvements. Local Agency Contact Person Marwan Salloum Mailing Address 33325 8th Ave S Project Prospectus Approval Title Deputy Public Works City Federal Wa gy � State WA Approving , Title Depulry Public Works Director Date Phone 253-835-2720 Zip Code 98047 DOT Form 140-101 EF Page 1 of 3 ♦ Previous Editions Obsolete ♦ Revised 12/2012 Agency City of Federal Way Project Title Date Pacific Highway South HOV Lanes Phase V(S 340 St to S 359th St) 2�22/2013 Type of Proposed Work Project Type (Check all that Apply) ❑ New Construction ❑ Path / Trail � Reconstruction � Pedestrian / Facilities ❑ Railroad ❑ Parking ❑ Bridge ►�� '�■ ')�/ • - Roadway Width 40 FT Number of Lanes 2 Geometric Design Data Descri tion Throu h Route Crossroad � Principal Arterial � Principal Arterial Federal � Urban ❑ Minor Arterial � Urban � Minor Arterial ❑ Collector � Collector Functional ❑ Rural ❑ Rural ❑ Major Collector ❑ Major Collector Classification ❑ NHS ❑ Minor Collector ❑ NHS ❑ Minor Collector ❑ Local Access ❑ LQ�aI Access Terrain ❑ Flat � Roll ❑ Mountain ❑ Flat � Roll ❑ Mountain Posted S eed 40 MPH north and 50 MPH south of S 356th 25-35 MPH Desi n S eed 40 MPH Existin ADT 33 000 5 000-20 000 Desi n Year ADT 40 000-65 000 7 000-25 000 ----------_ - ---- -- Desi n Year 2035 2035 Design Hourly Volume (DHV} 3,800 600-2,100 Performance of Work Preliminary Engineering Will Be PerFormed By Consultant/Agency Construction Will Be PerFormed By Environmental Classification ❑ Final � Preliminary ❑ Class I- Environmental Impact Statement (EIS) ❑ Project Involves NEPA/SEPA Section 404 Interagency Agreement ❑ Class III - Environmental Assessment (EA} ❑ Project Involves NEPA/SEPA Section 404 Interagency Agreement Environmental Considerations No major concerns Others 90 % Contract % � Class II - Categorically Excluded (CE) � Projects Requiring Documentation (Documented CE) DOT Form 140-101 EF Page 2 of 3 Revised 12/2012 Agency 10 % Agency % Agency City of Federal W Project Title Date Pacitic Highway South HOV Lanes Phase V(S 340 St to S 359th St) 2/22/2013 Right of Way ❑ No Right of Way Required � Right of Way Required ' All construction required by the ❑ Relocation Required contract can be accomplished � No Relocation within the existinq riqht of way. Description of Utility Relocation or Adjustments and Existing Major Structures Involved in the Project Utility relocation or adjustment will be required for the following utilities: PSE (power and gas), Century Link, Comcast, and Lakehaven Utility District. The utility companies will be responsible for the utility relocation and adjustments under an existing franchise agreement. FAA Invotvement 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 it's designee, and is not inconsistent with the agency's comprehensive plan for community development. Date 2 25� Z1J/'� Agency City of Federal W By DOT Form 140-101 EF Revised 12/2012 Page 3 of 3 ♦ Previous Editions Obsolete ♦ City of Federal Way Pacific Highway South HOV Lanes Phase V 5 340th Street to S 359th Street Cost Estimate for Design Phase 1 Consultant Costs Item Description Hours Avg. Rate of Pay Estimated Cost 1 Project Management 1000 $60 $60,000 2 Utility Design 1000 $50 $50,000 3 Geotechnical Exploration/Design 750 $40 $30,000 4 Environmental/Permitting 1600 $40 $64,000 5 Right-of-Way Preliminary Plans 450 $45 $20,250 6 Surveying 350 $40 $14,000 7 P�ans, Specifications and Estimates 7000 $40 $280,000 Totals 12150 $518,250 Overhead Cost 160% $829,200 Fixed Fee 30% $155,475 Reimbursables Reproduction $30,000 Title Reports $25,000 Mileage $1,500 Total $56,500 Total Consultant $1,559,425 2 Aeencv Costs Item Description Hours Avg. Rate of Pay Estimated Cost 1 Project Management 2000 550 $100,OQ0 2 Plan Review 1500 $50 $75,000 3 VE Study 200 $SO $10,000 4 King County Review 450 $50 $22,500 5 Mileage $288 Totals 4150 $207,788 Overhead Cost 100� $207,788 Total Agency $415,576 3 State Costs Item Description Hours Avg. Rate of Pay Estimated Cost 1 State 250 $50 $12,500 Totals 250 $12,500 Overhead Cost 1009� $12,500 Total State $25,000 Total Preliminary Engineering $Z,�,�1 CROSS SECTION TYPE A 4 LANES + HOV + MEDIAN 3' g' 6'** 12'(14'*) 11' 11' 11' 6' 12' 11' 12'(14'* 6,** 8, 3, UHI. �d�walk Plant� NOV Left Turn HOV Planf�r Sidewalk Utp SMP �—� Z�—I— � G�—"I—'I Z'__I Shi Median (where LT not nesded) 86'(90'*) 120'(124''�) MINIMUM PAVEMENT SECTION PRINCIPAL 0.30' HMA CL. 1/2". PG 64-22 0.85' HMA CL. 1", PG 64-22 0.50' CSTC NOTES: " ON STATE HIGHWAYS WSDOT REQUIRES OUTSIDE HOV LANES TO BE 14 FEET. •* PIANTER STRIP DIMENSION IS MEASURED FROM THE SIOEWALK TO THE FACE OF CURB. REV:FEBRUARY ����°"/°O PUBLIC DWG. NO. � � � � woRKS ARTERIAL 3-2A ', Exhibit A � ��- , � ; Vicinity Map ' � �� Federal Way ,_ '��_�����_�� , .. . L�- -- --r - - - -' �J- �-�----- �u � Pac�f�c H�ghway South � � � ����� H OV Lanes Phase V'�� ; � 5 34°T� 5T ��� �---�_ _� � i _� j __ __ -, _ -- N ��1 �i wi Q, �.. NI �� � �-- � -----� - — � -� � � `� �__ __ �� � S 344 ��H ST � � , � z ;' � fk� �� _ , , v �; � 1 � ----- - � � �� �� S 340th - S 359th S 356TH ST , ;--- �� � � I � I�L� �-' ( �, V� �� � �c ; Q'�`� i Q � �: i i�` -- - --� � i � �/ , 359TH � '�%,� _��' ��, ���; � � , ; � I � ��' I / -' � �''' � % !/ / '' ' i - /� � � � � J,' _ "��y � 1 � � � - _; i -T- � � i - i � _ �_ � � �1 , �� � � ' _ � � �� I (� �� A �� �_ ,I� i ! , ; � C `CITY OF Federal February 25, 2013 Mr. Ed Conyers, PE Local Programs Engineer WSDOT NW Region PO Box 330310 Seattle, WA 98133-9710 CITY HALL W� 33325 8th Avenue South Y Federal Way, WA 98003-6325 (253) 835-7000 www. ciiyoffederalway. com RE: Pacific Highway South HOV Lanes I'hase V(S 340 St to S 359eh St) Local Agency Agreement and Local Agency Federal Aid Project Prospectus Dear Mr. Conyers: Enclosed are the signed Local Agency Agreements and Local Agency Federal Aid Project Prospectus for the above noted project. Jade Mott has previously reviewed and requested signed documents be sent to expedite execution, If you need additional information, please contact me at (253) 835-2722. Sincerely, .�' �i� John Mulkey, PE Street Systems Project Engineer JM:mj Enclosures: (1) Local Agency Federal aid Project Prospectus (2) Local Agency Agreement cc: Grant File, 2011 City Safety Program Day File J:\STREETS\GRANTS\Graxit Applications�2012\SR 99 Ph V\Regional applicarion\5R 999 Phase V Prospectus and Local Agency Agreement 2- 25-13.docx