AG 03-009 - WSDOT - HIGHWAYS/LOCAL PROGRAM RETURN TO: S EXT: 9705
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 ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES/CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT(E.G.BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
CONTRACT AMENDMENT(AG#):_03-009 ❑ INTERLOCAL
❑ OTHER CERTIFICATION AGREEMENT QUALIFICATION AGREEMENT
5. PROJECT NAME:CERTIFICATION ACCEPTANCE QUALIFICATION AGREEMENT(ORIGINAL AG#03-009)
6. NAME OF CONTRACTOR:WSDOT HIGHWAYS AND LOCAL PROGRAMS
ADDRESS:ED CONYERS,WSDOT H&LP,NW REGION,PO Box 330310,SEATTLE,WA 98155 TELEPHONE:206-440-3585
E-MAIL:CONYERE@WSDOT.WA.GOV 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:UPON EXECUTION COMPLETION DATE:UPON COMPLETION
9. 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 AMOUNT: $
IS SALES TAX OWED: ❑YES ❑NO IF YES,$ PAID BY: ❑CONTRACTOR ❑CITY
❑ PURCHASING: PLEASE CHARGE To:N/A
10. DOCUMENT/CONTRACT REVIEW INITIAL/DATE REVIEWED INITIAL/DATE APPROVED
❑ PROJECT MANAGER
A DIVISION MANAGER S AL/iS
be DEPUTY DIRECTOR J/ir/I
gr DIRECTOR S12 /)tf-
,1 ❑ RISK MANAGEMENT (IF APPLICABLE)
,7'1`1 LAW DEPT y�500/15.
11. COUNCIL APPROVAL(IF APPLICABLE) COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE:
12. CONTRACT SIGNAI URE ROUTING /A l /
�SENTTOVENDOR/CONTRACTOR DATE SENT: DATE REC'D: (/'f�J/5
❑ ATTACH: SIGNATURE AUTHORITY,INSURANCE CERTIFICATE,LICEN ES,EXHIBITS !` `
INITIAL/DATE SIGNED
❑ LAW DEPT
5129, SIGNATORY(QM O iIRECTOR) gl Ai. /I
❑ CITY CLERK
1/1 kSSIGNEDAG# AG# D3—DO�
4IGNED COPY RETURNED DATE SENT: /C°i
❑RETURN ONE ORIGINAL
COMMENTS:�`,`,
EXECUTE"cf22 ORIGINALS
THIS IS TO UPDATE THE LAST SUPPLEMENT TO THE CERTIFICATION AGREEMENT TO ALLOW FOR SIGNATURE BASED ON THE MAYOR'S
DESIGNATION OF AUTHORITY TO SIGN.
THIS IS A STATE DOCUMENT WE CANNOT REVISE,PER LAST REVISION,NO"APPROVED AS TO FORM"IS REQUIRED.
11/9
A■► Certification Acceptance
eWashington State
Department of Transportation Qualification Agreement
Agency City of Federal Way Agency No. 443
Address 33325 Rth Avenue South
Federal Way, WA 98O03-6375
The agency agrees to comply with the following requirements when developing all Federal Highway
Administration (FHWA) projects under Full CA status.
1. Adherence to the Local Agency Guidelines and all policies and procedures promulgated by the Washington
State Department of Transportation (WSDOT)which accomplish the policies and objectives set forth in Title 23,
U.S. Code, Highways, and the regulations issued pursuant thereto.
2. The overall approval authorities and conditions will be as follows:
a. The project prospectus will be reviewed and approved by the following official.
Public Works Director or Street Systems Manager
Position Title Only
b. The local agency agreement will be reviewed and approved by the following official or officials.
Mayor or Public Works Director
Position Title or Titles Only
c. The designs and environmental documents will be reviewed and approved by the following state of
Washington registered Professional Civil Engineer.
Public Works Director or Street Systems Manager
Position Title Only
d. The hearing's findings (if required)will be reviewed and approved by the following official or officials.
Public Works Director or Street Systems Manager
Position Title or Titles Only
e. The contract plans, specifications, and estimate of cost will be reviewed and approved by the following
state of Washington registered Professional Engineer.
Public Works Director or Street Systems Manager
Position Title or Titles Only
f. Agreements will be signed by the following responsible local official:
(1) Railroad Mayor
Position Title Only
(2) Utility Mayor
Position Title Only
(3) Consultant Mayor
Position Title Only
(4) Technical Services Mayor
Position Title Only
g. The award of contract will be signed by the following responsible local official.
Public Works Director or Street systems Manager
Position Title Only
h. All projects will be constructed in conformance with the Washington State Department of Transportation/
American Public Works Association (WSDOT/APWA) current Standard Specifications for Road, Bridge, and
Municipal Construction and such specifications that modify these specifications as appropriate. Multimodal
enhancement projects shall be constructed in conformance with applicable state and local codes.
DOT Form 140-043 EF
Revised 10/2006
i. The contract administration will be supervised by the following state of Washington registered Professional
Civil Engineer
Public Works Director or Street Systems Manager
Position Title Only
j. Construction administration and material sampling and testing will be accomplished in accordance with the
Local Agency Guidelines.
3. The agency agrees that they have the means to provide adequate expertise and will have support staff available
to perform the functions being subdelegated. The support staff may include consultant or state services.
4. The agency agrees that the signature on each project prospectus and local agency agreement will be
consistent with section 2 above.
5 All projects under Certification Acceptance shall be available for review by the FHWA and the State at any
time and all project documents shall be retained and available for inspection during the plan development and
construction stages and for a three year period following acceptance of the project by WSDOT.
6 Approval of the local agency certification by the Director of Local Programs may be rescinded at any time
upon local agency request or if, in the opinion of the Director of Local Programs, it is necessary to do so. The
rescission may be applied to all or part of the programs or projects approved in the local agency certification.
•
'errell, ayor Date
Washington State Department of Transportation
Appreved By.
• 1F •C At A Co - 1q-15
Director, Local Programs Kathleen B.Davis Date
7)(-)r. Yu-,�
RETURN TO:
"''� EXT: ''G/ '"� � �
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT/DIV: PUBLIC WORKS / ��^�t? -I S
2. ORIGINATING STAFF PERSON: .� I)1�� (- lL r!"C y EXT: Z��7 � 3. DATE REQ. BY: �/}Y'
�
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
I� CONTRACT MEND NT (Asi#�: D�'" vV � ❑ INTER
6�'OTHER ��� �i�CG..�`� O`^ cr� t9 Jc. vi�Z. �it�✓�t� ll��� � c."}-i C3 ., �/'E�M�w� -
PROJECT
v
�
� � �,
NAME OF NTRACTOR: G✓ L� — % •�• � c
ADDRESS: • U• K�b'� �,�,� ,�I l� . _ �L I 3'' - �-1 17
E-M�L: '/
SIGNATURE NAME: K.:.N•��,[.C... � V I�S
'I�LEPHONE:
F.�:
TITLE: �;�e��.r
7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMI'ENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL
OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN O REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS
CFW LICENSE # BL, EXP. 12/31/ UBI # , EXP. / /
8. TERM: COMMENCEMENT DATE: COMPLETION DATE:
9. 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 AMOUNT: $
IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY
❑ PURCHASING: PLEASE CHARGE TO: N'�
lO. DOCUMENT / CONTRACT REVIEW
t�PROJECT MANAGER
❑ DIVISION MANAGER
L$"'DEPUTY DIRECTOR
L�DIRECTOR
❑ RISK MANAGEMENT (IF APPLICABLE�
15Y LAW DEPT
11. COUNCIL APPROVAL (IF APPLICABLE�
IIVITIAL / DATE REVIEWED
� / S" z,
V
�� 3-2-13-
COMMITTEE APPROVAL DATE:
12. CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: /2� I� Z
❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
INITIAL / DATE SIGNED
o Law DEr'r
§�" SIGNATORY (MAYOR OR DIRECTOR�
❑ CITY CLERK
❑ ASSIGNED AG #
� SIGNED COPY RETURNED
❑ RETURN ONE ORIGINAL
K�«
(� , �Q� ! lJ 4.7Gt ►1.Irt
/' ,
L i� �� f.�1 V`f��.� l..G��` ����
..� v f �
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h s
t/ /�
r IQ-,�n .n �.t� �.s �o rioo w, n��`
f
AG# ('� ` �'Ot� �Q
DATE SENT:
ti i�-cz e�h��ce
� : .� �. -tin � S e
� �� -�
IrTITIAL / DATE APPROVED
COUNCIL APPROVAL DATE:
DATE REC'D:
11/9
�
Washington State
�� Department of Transportation
Agency City of Federal Way
Add1'e8s 33325 Rth Avenne �nnth
-.- . . •:11 •
Certification Acceptance
Qualification Agreement
Agency No. 443
The agency agrees to comply with the following requirements when developing all Federal Highway
Administration (FHWA) projects under Full CA status.
1. Adherence to the Local Agency Guidelines and all policies and procedures promulgated by the Washington
State Department of Transportation (WSDOT) which accomplish the policies and objectives set forth in Title 23,
U.S. Code, Highways, and the regulations issued pursuant thereto.
2. The overall approval authorities and conditions will be as follows:
a. The project prospectus will be reviewed and approved by the following official.
Public Works Director or Street Systems Manager
Position Title Only
b. The local agency agreement will be reviewed and approved by the following o�cial or officials.
Mayor
Position Title or Titles Only
c. The designs and environmental documents will be reviewed and approved by the following state of
Washington registered Professional Civil Engineer.
Public Works Director or Street Systems Manager
Position TiUe Only
d. The hearing's findings (if required) will be reviewed and approved by the following official or officials.
Public Works Director or Street Systems Manager
Position TiUe or TiUes Only
e. The contract plans, specifications, and estimate of cost will be reviewed and approved by the following
state of Washington registered Professional Engineer.
Public Works D'uector or Street Systems Manager
Position Title or Titles Only
f. Agreements will be signed the following responsible local official:
(1) Railroad
(2) Utility
Mayor
Position Title Only
Mayor
Position Title Only
(3) Consultant Mayar
Position Title Only
(4) Technical Services Mayor
Position Title Only
g. The award of contract will be signed by the following responsible local official.
Public Works Director or Street Systems Manager
Position Title Only
h. All projects will be constructed in conformance with the Washington State Department of Transportation/
American Public Works Association (WSDOT/APWA) current Sfandard Spec�cations for Road, Bridge, and
Municipal Construction and such specifications that modify these specifications as appropriate. Multimodal
enhancement projects shall be constructed in conformance with applicable state and local codes.
DOT Form 140-043 EF
Revised 10/2006
The contract administration will be supervised by the following state of Washington registered Professional
Civil Engineer.
Public Works Director or Street Systems Manager
Position Title Only
j. Construction administration and material sampling and testing will be accomplished in accordance with the
Loca/ Agency Guidelines.
3. The agency agrees that they have the means to provide adequate expertise and will have support staff available
to perform the functions being subdelegated. The support staff may include consultant or state services.
4. The agency agrees that the signature on each project prospectus and local agency agreement will be
consistent with section 2 above.
5. All projects under Certification Acceptance shall be available for review by the FHWA and the State at any
time and all project documents shall be retained and available for inspection during the plan development and
construction stages and for a three year period following acceptance of the project by WSDOT.
6. Approval of the local agency certification by the Director of Highways and Local Programs may be
rescinded at any time upon local agency request or if, in the opinion of the Director of Highways and Local
Programs, it is necessary to do so. The rescission may be applied to all or part of the programs or projects
approved in the local agency certification.
ip nes , or
Washingtan State Department of Transportation
Appro�red By:
(�
� �•
Direc or, Highways and Local Programs
3/�1 �.
Date
�-g-12
Date
DOT Form 140-043 EF
Revised 10/2006
DAn.o, T / TO: KV)jstC1l Kelse)j fov Al BVjÆtev
d/ /fJ Y
CITY OF FEDERAL WAY LAW D EP AR TMENT
REQUEST FOR CONTRACT PREPARATIONIDOCUMENT REVIEW/SIGNATURE ROUTING SLIP
I.
ORIGINATING DEPT.lDIV: PW/STR,çBTS
2,
4,
5.
6.
7,
8,
9.
10.
11.
ORIGINATING STAFF PERSON AL BMTFR
EXT: 40')5
3. DATE REQ, BY:
TYPE OF DOCUMENT REQUESTED (CHECK ONE)
OPROFESSIONAL SERVICE AGREEMENT
OMAINTENANCE/LABOR AGREEMENT
OPUBLIC WORKS CONTRACT
OSMALL PUBLIC WORKS CONTRACT
(LESS THAN $200,000)
OPURCHASE AGREEMENT)
(MATERIALS, SUPPLIES, EQUIPMENT)
OSECURITY DOCUMENT (EG, AGREEMENT &
PERF/MAIN BOND; ASSIGNMENT OF FUNDS IN LIEU OF BOND)
OCONTRACTOR SELECTION DOCUMENT
(EG, RFB, RFP, RFQ)
OCONTRACT AMENDMENT
0 CDBG
C2j OTHER CSRTIFICATION ACCH'TANCS
Q.w\LlFICATION AC¡RSSMSNT
AG#:
OREAL ESTATE DOCUMENT
PROJECT NAME: CSRTIFICATION ACCSPTANCS Q.w\LlFlcATlm,1 AC:;RSSMSNT (FSI>5RAL CiRANTS)
NAME OF CONTRACTOR: WSÞOT - HigVlWC1i::J5 § Loc.C1L i>VOgVC1V1ÆS
ADDRESS TELEPHONE
SIGNATURE NAME: TITLE: DIRECTOR. I-tIC;HWAYS S LOCAL PRoC;.
ATTACH ALL EXHIBITS AND CHECK BOXES OSCOPE OF SERVICES C2jALL EXHIBITS REFERENCED IN DOCUMENT
O,NSURANCE CERTIFICATE ODOCUMENT AUTHORIZING SIGNATURE
TERM: COMMENCEMENT DATE:
COMPLETION DATE:
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: 0 YES 0 NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED 0 YES 0 NO IF YES, $ PAID BY: 0 CONTRACTOR 0 CIT
CONTRACT REVIEW INI
[gJPROJECT MANAGER (AL) (UJ..., l?ii7/rrz-
[gJDIVISION MANAGER (MARWAN)
C2jDIRECTOR
ORISK MANAGEMENT
C2jLAW
INITIALIDATE APPROVED
(Z 1rJ-/n....
TL(ft-tcL-----
INITIALIDATE APPROVED
CONTRACT SIGNATURE ROUTING
[gJLAW DEPARTMENT
C2jCITYMANAGER , ~ 7~ /
<.J:)et'IY' CLERK . ' (7/ () i
[gJSIGNCOPYBACKTOORGINATINGDE~,.e:Jk rt-O '
[gJASSIGNED AG# 03 -ODt /
OPURCHASING: PLEASE CHA GE TO: N fA ~ I A L
OTO BE RECORDED ' U 1'\ I \.J II '-¡
COMMENTS
Please see attached documents, FYI. This was the previously executed agreement (AG 92-232).
Certification Acceptance Qualification Agreement
AG /f-o3 -DOC¡
AGENCY City of Federal Way
AGENCY NO. 443
The agency agrees to comply with the following requirements when developing all Federal Highway Administration
(FHW A) projects wider Full CA status.
1. Adherence to the Local Agency Guidelines and all policies and procedures promulgated by the Washington
State Department of Transportation (WSDOT) which accomplish the policies and objectives set forth in Title
23, D.S, Code, Highways, and the regulations issued pursuant thereto.
2. The overall approval authorities and conditions will be as follows:
a.
The project prospectus will be reviewed and approved by the following official.
Public Works Director or Street Svstems Mana!!er
Position Title Only
b. The local agency agreement will be reviewed and approved by the following official or officials.
City Mana!!er
Position Title Only
c,
The designs and environmental documents will be reviewed and approved by the following stale of
Washington registered Professional Civil Engineer,
Public Works Director or Street Systems Mana!!er
Position Title Only
d.
The hearing's findings (if required) will be reviewed and approved by the following official or officials.
Public Works Director or Street Systems Mana!!er
Position Title or Titles Only
e,
The contract plans, specifications and estimate of cost will be reviewed and approved by the following stale
of Washington registered Professional Engineer,
Public Works Director or Street Systems Mana!!er
Position Title or Titles Only
f.
Agreements will be signed by the following responsible local official.
(I) Railroad
Citv Manaeer
Position Title Only
City Mana!!er
Position Title Only
Citv Manaeer
Position Title Only
City Mana!!er
PosiIion Title Only
(2) Utility
(3) Consultant
(4) Technical Services
g, The award of contract will be signed by the following responsible local official.
Public Works Director or Street Systems Mana!!er
Position Title Only
h. All projecIs will be construcIed in conformance with the Washington State Department of
Transportation! American Public Works Association (WSDOTI APW A) current Standard Specifications for
Road, Bridge, and Municipal Construction and such specifications that modify these specifications as
appropriaIe. Multimodal enhancement projects shall he constructed in conformance with applicable state
and local codes,
Local Agency Guidelines
September 2002
ORIGINAL
10(2
Certification Acceptance Qualification Agreement
i,
The contract administration will be supervised by the following state of Washington registered Professional
Civil Engineer.
Public Works Director or Street Svstems Mana~er
Position Title Only
j,
Construction administration and material sampling and testing will be accomplished in accordance with the
WSDOT Construction Manual and the Local Agency Guidelines.
3. The agency agrees that they have the means to provide adequate expertise and will have support staff available
to perfonn the functions being subdelegated. The support staff may include consullant or state services.
4. The agency agrees that the signature on each project prospectus and local agency agreement will be consistent
with section 2 above.
5. All projects under Certification Acceptance shall be available for review by the FHW A and the stale at any time
and all project documents shall be retained and available for inspection during the plan development and
construction stages and for a three year period following acceptance of the project by WSDOT.
6. Approval of the local agency certification by the AssisIant Secretary for Highways and Local Programs may be
rescinded at any time upon local agency request or if, in the opinion of the Assistant SecreIary for Highways
and Local Programs, it is necessary to do so, The rescission may be applied to all or part of the programs or
projects approved in the local agency certification.
I L-- ¡; 107
Date I
\}-\1-/0;f-
Date
WASHINGTON STATE DEPARTMENT
OF TR<\..1'</SPORT A nON
Approved By:
/liQ3
Date
f~-"
I "
(
-""',17
\'1
1J
Local Agency Guidelines
September 2002
20(2
&h¡
......
::r- Washington State
~II Department of Transportation
Douglas B. MacDonald
Secretary of Transportation
November 18, 2002
Transportation Buildin~
310 Maple Park Avenue S,EI1ECEIVE[
P,O. Box 47300
Olympia, WA 98504-7300
360-705-7000 ~"'" ',~
~~~~~f~;~~J~tEhi\L WÞ,ì
:,rWI'J'~Tq\T
CA Agencies
Re: Certification Acceptance (CA) Agreement Update
In reviewing our Certification Acceptance (CA) Agreement files, we haveve noticed that
the agreements are outdated, including some dating back to 1979. In order to update
those agreements, adjust to changes in federal requirements, and conform to your CUITent
organization, we are requesting that you submit updated CA agreements. Please include
the following, as described per chapter 13 of the LAG Manual:
.
Certification Acceptance Agreement
Table of Organization
.
Please submit these documents through your Region by January 31, 2003. We have
provided a Word copy of a blank CA Agreement (September 2002) on our web site at
www.wsdotwa.gov/TNODerations/LAG/CA.htm, If you have any questions, contact
your Regional Local Programs Engineer.
Thank you for helping us to assure success and continuation of the federal aid program
on your behalf.
~a-u:
Kathleen B. Davis
Director
Highways & Local Programs Division
KBD:aok:ac
cc: Region Local Programs Engineers
City of Federal Way. Public Works Department
33530 First Way South' PO Box 9718' Federal Way, WA 98063-9718
Phone 253-661-4131 . Fax 253-661-4129 . www,ci.federal-wav,wa,us
LETTER OF TRANSMITTAL
Date: December 19, 2002
To:
WSDOT
Attn: Kathleen B. Davis
Transportation Building
310 Maple Park Avenue SE
PO Box 47300
Olympia, WA 98504-7300
From: Tracy Moore for Al Emter
RE:
Certification Acceptance Qualification Agreement (Federal Grants)
TRANSMITTED As CHECKED BELow:
¡g¡ For Your Review 0 As Requested 0 Please Return
0 For Your Approval 0 For Your Information 0 Other
0 For Your Action 0 Under Separate Cover 0 Via
ITEMS/COPIES DESCRIPTION
1 Original of Certification Acceptance Qualification Agreement (Federal Grants)
COMMENTS:
Please sign, date and return at your earliest convenience. Once fully executed a signed copy will be sent to you.
Thank you.
cc: Project File
Day File
k:lformsltransmittal
,. .
f,:'; < I ,., " '"
,"'"
AG 92~~~~DIXJ.3"
WASHINGTON STATE DEPARTMENT OF TRANSPORTATION
CERTIFICATION ACCEPTANCE QUALIFICATION AGREEMENT
AGENCY
City of F~eral Way
AGENCY NO.
The noted agency hereby agrees to comply willi IIIe Collowing requirementS when developing all projectS on Cederal aid highway
sysrems except IIIelnterstate System:
I. The Local Agency Guidelines and all policies and procedures promulgated by IIIe Washingron Stale Dcp:u1ment 01 Tl1lns,
portation which accomplish IIIe policies and objectives set ConI1 in Ti~e 23, U.S. Code, Highways, and lhe regulations issued
pursuant lllCICIO.
2. The overallapprovalauIhorities and conditions will be as Collows:
a. The designs will be reviewed and approved by IIIe Collowing stale 01 Washioglon regislered ProCessional Ci\'iI Engine<r.
Public Works Director and Street System... Manager
Position Title Only
b. The hearing's findings (if required) will be reviewed and approved by the Collowing official or officials.
Public Works Director and Street Systems Manager
Position Ti~e or Ti~es Only
c. The conllaCl plans, specifications and estimate oC cost will be reviewed and approved by the Collowing state of
Washington registered ProCessional Engineer.
Public Works Director and Street Systems Manager
Position TItle or Titles Only
d. AgreementS will be signed by IIIe Collowing responsible local orncw:
(1) Railroad Public Works Director' and Street Systems Manager
Position TItle Only
Public Works Director and Street Systems Manager
Position Title Only
City Manaoec
Position Title Only
Citx Manaqer
Position Title Only
.. The award oC conlraCI will be signed by the following responsible local órncial.
(2) Utility
(3) Consullanl
(4) Technical Services
C;~y M~Mgpr
Position Title Only
f. All projects wIll be comInICted in conformance willi the WashIngton Stale Deparlmenl oCTransponation/American
Public Works Association (WSOOT/APW A) =1 Standard SpecirlC8lions for Road, Bridge, and Municipal
Construction and such specifications that modify Ihese specifications as appropriate.
g. The conlract administr2lion will be supervised by IIIe Collowing state ofWashin:ron registered ProCessional Civil
Engineer" .
Public Works Director and Street Systems Manager
Position TItle Only
h. ConstruCtion administl1ltion and material sampling and testing will be accompli.bed in accordancc wi~1 Ihc WSDOT
Construction !\tan..1 and the Local Agency Guidelines.
3. The agency agrees thaI they h3ve the mans 10 provide adequate expcni.. and will h:1ve support suiC avaiiahlelO perCorm
the Cunctions being subdeJegatcd. The suppon staff may include consultanl or stale services.
~œ IfWA W
Jun. ""
,/
.
'.,
-..
APPENDIX 1-3-'
-.
J, The noted agency a¡:rees to submillhe names of the approving aulhoritics noted in Secti0l12 above wilh each project
ProSP«Ius.
5.
All projects under Certification Acceptance shail be available for review by lhe FHW A and !he sta~ at any time and an
projw doc uments shall be retained and available for inspection during lhe plan cleveIopmenI and construction stages and for
a thrce ~'C3T period following acceptance of the projecI by FHW A.
The SUIt Aid En¡;ineer's approval of !he local agency certification may be rescinded at any time upon request by !he local
agency or if. in Ihe Sta~ Aid Engineer', opinion, it is IW'.ccssary 10 do so. The rescission may be appUC/,' 10 all or part of !he
programs or projects approved in lhelocaJ agency certilication.
6,
CITY OF FEDERAL WAY
lo~A<
all, City MaRi'ger I
Approved By:
N STATE DEPARTMENT
OF TRANSPORTATION
?Q~ ~<-
State Aid Engineer ...
Carolyn A. Lake, City Attorney
1I/24/Q2.
Da~
*Note:
This CA approval is limited
and each project must be submi tted
to the District 1 Local Programs
Engineer for approval on a project
by project basis to administer under
CA procedures.
1,3.1;VLAG1
..j
Jun. '986
~'\.'f
"'--\,h ,\
~,(J) Ú1~~ i 2
'-I\:..\..,¡j;~.......~c~~~
-.
,..
r
I
.
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November 20 1992
The Honorable Robert E. Stead
Mayor of Federal Way
33530 1st Way South
Federal Way, WA 98003
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City of Federal Way
Approval of Certification
Acceptance Application
Dear Mayor Stead:
The Certification Acceptance Committee has com,eleted its evaluation of the
qualifications, experience, and knowledge of the City s engineering staff based on
the meeting of November 5, 1992, We are pleased to advise you that effective
November 16, 1992, your agency has been granted Umited Certification
Acceptance status for the administration of Federal Highway Administration
funded projects. This means you must request approval to manage these projects
on a project-by-project basis.
Please pay particular attention to the Local Agency Guidelines for developing and
administering FHWA funded projects, The guidelines contain the required
procedures that must be followed to ensure full Federal participation in your
projects, Your WSDOT District Local Programs Office will assist the City in the
development and administration of projects through meetings and periodic
documentation reviews. Should you require any assistance, please do not
hesitate to contact your District Local Programs Engineer.
In accordance with your CA Agreemunt, your projects will be subject to periodic
Project Management Reviews by WSDOT and FHWA.
A copy of the fully executed "Certification Acceptance Qualification Agreement" is
enclosed.
DBI:ds
DLM
Enclosure
cc: Barry Morehead, FHWA
Terry Paananen, Dist 1 MS: NB82/121
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DENNIS ~w.M t;~
Assistant Secretary
Local Programs
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