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AG 13-127RETURN TO: �,,� �,�� EXT: �;� �-y CITY i�F FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATIIYG DEPT/DIV: ORIGINATING STAFF PERSON: �� � �'C�r� � EXT: � l Tv 3. DATE REQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESS[ONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ ORDINANCE ❑ RESOLUTION ❑ CONT T AMENDMENT (AG#): INTERLOCAL � �{OTHE� O(�� � � �. PROJECT NAME: �� �'0.�Q L�.�d YYI� ���2 �� I 6. NAME OF CONTRACTOR: W ' � �ro� ADDRESS: O �O TELEPHO . SIGNATURE NAME: FaY: TITLE: ��Y1C� l^ 7, EXHIBITS AND ATTACHMENTS: ❑ BCOPE, WORK OR SERVICES ❑ COMPENSATION � INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY T'O SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS �FW LICENSE # BL. EXP. 12/3l/ UBI # , E�• � � S. TERM: COMMEIVCEMENT DATE: � ` � � � � COMPLETION DATE: � � ✓O � � � 9. TOTAL COMPENSATION: $ � 1� �V (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCUL.ATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF ENIPLOYEES TITLES AND HOL[DAY RATES) REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CIT`. ❑ PURCHASING: PLEASE CHARGE TO: 10. DOCUMENT / CONTRACT RE IEVy e�PROJECT MANAGER ��2�'�� �} R �DEPUTY DIRECTOR �DIRECTOR e-�F�f Pvi�1�P 1� LAW DEPT �� i- 11. COUPICIL APPROi/AL (IF APPLICABLE) ���� � ' � � � �^�', �11 - _�- -�L�� a� COMMITTEE APPROVAL DATE: 1Z. CONTRACT SIGNATURE ROUTIPiG � SENT TO VENDOR/CONTRACTOR DATE SENT: � _ . TURE AUTHORITY, INSiJRr�.NCE CERTIFICATE, LICENSES, EXHIBITS --�-�7C�DEPT �SIGNATORY ( AYO UR�) �J,�,�,�J �CITY CLERK ASSIGNED AG # ,� SIGNED COPY RETLIRNED � ❑ RETURN ONE �ORlGINAL INITIAL / DATE SIGNE a�J A�# ���127 a DATE S FNT: (/' � T! '� �_ INITI.4L / DATE APPROVED COUNCIL APPROVAL DATE: DATE IZEC'D:�I) �i/ I-� w m � W A S H Z N G T O N Tra�f "fic Satfet�y C O M M I S S I O N SCHOOL ZONE - FLASHING LIGHTS PROPOSAL Advertising Procedures This proposal is being sent to a statewide list of prospective constituents. Washington Traffic Safety Commission PO Box 40944, Olympia, WA 98504-0944 Phone: 360.725.9883 FAX: 360.586.6489 School Zone Flashinq Liahts Grants Kathy Droke, Grant Manager kdrokeCc�wtsc. wa. qov Section 1 Authorization Applicant agency/organization: Citv of Federal Wav Name of school/school district: Sacaiawea Middle School / Federal Way Public Schools Applicant project director: Rick Perez, PE Citv Tra�c Enqineer Name Title 33325 8th Ave S Federal Way, WA 98003 ricl�perezCa�citvoffederalwav.com 253-835-2740 Address City, Zip E-mail Telephone Applicant agency/organization authorizing official (person with contracting authority if different#han above): Skip Priest Mavor Name Title skip.priest _citvoffederalway.com 253-835-2410 Address, if different than above City, Zip E-mail Telephone � ***********************************************,�*,�********************************************,�************** Grant Manager: Kathv Droke Planned Project Duration: From: Julv 1, 2013 To: June 30, 2014 Approved by Name: Darrin el Title: Director Signatur : �- � Date: � • 3 • �3 6 Section 2 Description of Activity 1. Please describe the proposed site(s) selected for the school zone flashing beacons. Describe the roads (i.e. lanes, markings, control devices, speed limit). Solar powered school zone flashing beacons will be installed on Dash Point Road for Sacajawea Middle School. Dash Point Road has one lane each direction with shoulders on both sides, posted speed 40 MPH. Within the school zone, 11`h Place S at Dash Point Road is signalized with crosswalks. Just west of the school zone, 9t" Place S at Dash Point Road is not signalized nor have crosswalks. The school zone is posted with non-flashing "SCHOOL 20 MPH WHEN CHILDREN ARE PRESENT" signs. 2. Please include information for the following data points regarding the respective school zones you are requesting this grant for. Please use the following table format for EACH school zone. 2012 (January to December) Average Speed 40 MPH Average Daily Traffic (ADT) 12,430 Fatalities � Serious Injuries 2 Number of Students Attending School 774 Number of Students that Walk or Bike to School 284 3. Please provide the proposed schedule for the following milestones? Date Hardware ordered 7/1/2013 Date Hardware received 9/1/2013 Date Installation scheduled 9/1/2013 Date Installation completed 10/10/2013 Other 7 Section 3 Budget Summary Provide a budget summary of the project. Equipment: (Up to $7,500.00 per school zone) Zone 1 S Dash Point Road Zone 2 (If applicable) Zone 3 (If applicabie) Zone 4 (if applicable) (Projects are not limited to 4 zones.) TOTAL REQUESTED: Amount Requested $ 7.500.00 $ $ $ a 7.500.00