AG 21-124 - WSDOTRETURN TO: PW ADMIN EXT. 2700 ID #: 3883 / 3887
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT/Div: PUBLIC WORKS / CAPITAL PROJEG
2. ORIGINATING STAFF PEILSON; CHRI5TINE MULLEN EXT: x2723 3. DATE REQ. BY: -2-24f-b -2C72
3. TYPE OF DOCUMENT (CHECK ONE):
❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
❑ CONTRACT AmE-NDME-NT (AG#): ❑ INTERLOCAL
W OTHER LOCAL AGENCY AGREEMENT I FUNDING OBLIGATION PAPERWORK
3. PROJECTNAiTF: 5W DASH POINT RD * 47TH AVE 5W COMPACT ROUNDABOUT
S. NAME OFCOWMACfOR: W500T
ADDRESS: TELEPHONE:
E-MAIL: FAX:
SIGNATURE NAmL: TITLE:
6. 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/y UBI # , EXP.
7. TERM: COMMENCEMENT DATE: ONCE SIGNED COMPLETION DATE: 3 1 -DEC-2024 (FOR CN PHASE $ ONL
S. TOTAL COMPENSATION: $ 6110.0 a0- $970,400 (INCLUDE EXPENSES AND SALES TAX, IF ANY)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ `
IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY
RETAINAGE: RETA[NAGE AMOUNT: RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PIOVIDED
❑ PURCHASING: PLEASE CHARGE TO: r
9. DOCUMENT / CONTRACT REVIEW INITIAL. / ❑ T EYIF.LVED INITIAL / DArE APPROVED
A PROJECTMANAGER wK,
B DIVISION MANAGER 81-2t1812021 SL.L 13. .4 ?0.: i
11 DEPUTY DIRECTOR DSW2/19/2021 3 5 21
d DIRECTOR ��—
❑ RISK MANAGEMENT (IF APPLICABLE)
0 LAW DEPT ER 2/22121 ER 3/5/21
10. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
11. CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: 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 FF.F.I, FREE. TO SET NOTIFICATION MORE. TI IAN A MONTI I IN ADVANCE. IF COUNCIL, APPROVAL IS NEEDED.)
INITIAL/ DAIT SIGNED
❑ FINANCE. DEPARTMENT
❑ LAW DEPT
P-SIGNATORY (MAYOR OR DIRECTOR)
CITY CLERK — A �Ar--
❑ ASSIGNED AG # AG# 21-124
❑ SIGNED COPY RETURNED DATE SENT:
COMMENTS:
EXECUTE" "ORIGINALS W5DOT STANDARD FORM5 - WE CANNOT MODIFY 'Re-routing, because WSDOT agreed LO
LOCAL AGENCY AGREEMENT: MAYOR 51GN5 ON PAGE # I cover 100% of project cost, instead.
PR05PECTU5: EJ 51GN5 ON PAGE # 1. MAYOR 51GN5 ON PAGE #3
"MAY BE SIGNED WITH CERTIFIED ELECTRONIC SIGNATURES OR WITH BLJF- (NOT BLACK) INK
1F2020
Washington State
Department of Transportation
March 18, 2021
Mr. Edward Walsh
Public Works Director
City of Federal Way
33325 8th Avenue South
Federal Way, Washington 98003
Transportation Building
310 Maple Park Avenue S.E.
P.O. Box 47300
Olympia, WA 98504-7300
360-705-7000
TTY:1-800-833-6388
www.wsdot.wa.gov
City of Federal Way
47t' Ave. SW/SW Dash Point Rd.
Compact Roundabout
HSIP-OOOS(528)
FUND AUTHORIZATION
Dear Mr. Walsh:
We have received FHWA fund authorization, effective March 15, 2021, for this project as follows:
PHASE TOTAL FEDERALSHARE
Construction $970,400 $970,400
The following are required to ensure compliance with federal and state requirements:
• Advertisement of the project within six weeks of construction authorization.
• Submit the Award Data to the Region Local Programs Engineer prior to construction start.
• Show continuous project progress through monthly billings, until the project is complete.
Failure to show continuous progress may result in the project becoming inactive per 23 CFR
630.106(a) (5) and subject to de -obligation of all federal funds and agreement closure.
• Adhere to the Governor's Resuming Construction requirements.
Enclosed for your information and file is a fully executed copy of Supplement Number 1 to Local
Agency Agreement LA-9678 between WSDOT and your agency. All costs exceeding those shown
on this agreement are the sole responsibility of your agency. Any costs incurred after the Project
Agreement End Date shown on the supplement are not eligible for federal reimbursement. In
addition, all eligible costs incurred prior to the End Date must be billed within sixty (60) days of
the End Date or they are ineligible for federal reimbursement.
You may proceed with the administration of this project in accordance with your WSDOT approved
Certification Acceptance agreement.
Sincerely,
Stephanie Tax
Interim Director
Local Programs
ST:jg:ml
Enclosure
cc: Mehrdad Moini, Northwest Region Local Programs Engineer, MS NB82-121
IWWashington State Local Agency Agreement Supplement
IFUepartment of Transportation
Agency Supplement Number
City of Federal Way i0i
federalAI Project Number JAgreemiant Number CFDA No. 20.206
HSIP-OOOS(528) LA-9678 (Catalog of Federal Domestic Assistance)
The Local Agency requests to supplement the agreement number noted above.
All provisions in the basic agreement remain in effect except as modified by this supplement.
The Local Agency certifies that it is not excluded from receiving Federal funds by a Federal suspension or debarment
(2 CFR Part 180). Additional changes to the agreement are as follows:
Project Description
Name SW Dash Point Rd & 47th Ave SW Compact Roundabout
Termini SR MP 9.08
Description of Work ✓ No Change
Reason for Supplement
Obligate construction funds
Are you claiming indirect cost rate? UYes ,( No
Length N/A
Project Agreement End Date DEC 31, 2024
MAR 26 2021
Does this change require additional Rignt or
vvay or Casements-! ❑ Yes ✓ No Advertisement Date:
Estimate of Fundin
Type of Work
(1)
Previous
2
()
()
3 Estimated Total
4
Estimated Agency
5
Estimated Federal
Aareement/Suup I.
Supplement
Project Funds
Funds
Funds
PF
a.Agenoy
9,000.00
9,000.00
900.00
8,100.00
90 %
.0r
0.00
Federal Aid
c.OtherConsultant
140,000.00
140,000.00
14,000.00
126,000.00
Participation
Ratio for PE
d. tate
1,000.00
1,000.00
100.00
900.00
�. Total PE Cost Estimate +e id
150,000.00
0.00
150,000.00
15,000.00
135,000.00
Might of Wayo
0.00
{f. Agency
Other
0.00
Feoeral Aid
7 h r
0.00
Participation
0.00
Ratio for RW
i• State
t Estimate ff"+n
0.00
0.00
0.00
0.00
0.00
Construction
n tructio no
ntr t
797,900.00
797,900.00
0.00
797,900.00
{I, Other
0.00
im, Qther Consultant
106,800.00
106,800.00
0.00
106,800.00
Federal Aid
Other
0.00
Participation
Ratio for CN
A enc
62,700.00
62,700.00
0.00
62,700.00
to
3,000.00
3,000.00
0.00
3,000.00
a. Total CN stun k4-"n+n+o
0.00
970,400.00
970,400.00
0.00
970,400.00
Ir. ToW Pr ' tEstimate fs'+q)150,000.00
970,400.00
1,120,400.00
15,000.00
1,105,400.00
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,
Aitle
OraWashington StateDigitally signed by Stgphanle Tax
Department of Transportation StephanieTaxDate: 2021.03.11122637-Q8'00'
_r By Director, Local Program Ferrell. Mayor Date Executed 1 ` ZQLI
DOT Form 140-041 Page 1
Revised 1212020
Agency Supplement Number
City of Federal Way 01
Federal Aid Project Number JAgreement Number CFDA No. 20.205
IASIP-000%528) LA-9678 (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.
Vill. 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 12/2020