HomeMy WebLinkAbout15-063 - WA State Department of Transportation (WSDOT) - Frank Zepp Bridge Maintenance Fundinggoashirigitan State
Portman" of Timm
n
15-063(a)
Council Approval N/A
Local Agency Agreement Supplement
Agency
City of Tukwila
Supplement Number
1
Federal Aid Project Number
BHM- 1274(009)
Agreement Number
LA 8599
CFDA No. 20.205
(Catalog of Federal Domestic Assistance)
e Local Agency requests to supplement the agreement entered into and executed on April 8, 2015
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 Frank Zepp Bridge Preventative Maintenance Project
Termini Sperry Dr S to SR 181 - West Valley Highway
Description of Work ✓ No Change
Reason for Supplement
Obligate Construction Funds
Are you claiming indirect cost rate? I Yes '4/ No
Does this change require additional Right of Way or Easements?
Length 0.04
Project Agreement End Date 06/30/2020
Yes ✓ No Advertisement Date: 02/20/2017
Type of Work
Estimate of Funding
(1)
Previous
Agreement/Suppl.
Supplement
(3)
Estimated Total
Project Funds
(4)
Estimated Agency
Funds
(5)
Estimated Federal
Funds
PE o a. Agenc
io y
12,897.00
12,897.00
1,290.00
11,607.00
b. Other
502,979.00
502,979.00
50,298.00
452,681.00
Federal Aid c. Other
Participation
0.00
Ratio for PE d. State
1,000.00
1,000.00
100.00
900.00
e. Total PE Cost Estimate (a+b+c+d)
516,876.00
0.00
516,876.00
51,688.00
465,188.00
Right of Way
f. Agency
0.00
q. Other
0.00
Federal Aid
Participation h. Other
0.00
Ratio for RW i. State
0.00
j. Total, R/W Cost Estimate (t+Q+h+i)
0.00
0.00
0.00
0.00.
0.00
Construction
k. Contract
%
2,136,320.00
2,136,320.00
2,136,320.00
I. Other Consultant
320,400.00
320,400.00
320,400.00
M. Other Agency non - participating
11,550.00
11,550.00
11,550.00
Federal Aid
Participation n. Other
0.00
Ratio for CN o. Agency
62,000.00
62,000.00
62,000.00
p. State
5,000.00
5,000.00
5,000.00
q. Total CN Cost Estimate (k+l+m+n+o+o)
0.00
2,535,270.00
2,535,270.00
11,550.00
2,523,720.00
r. Total Project Cost Estimate (e+i+q)
516,876.00
2,535,270.00
3,052,146.00
63,238.00
2,988,908.00
The Local Agency further stipulates that pursuant to said Title 23, regulations and policies and procedures and as a
condition to payment of the F- •eral funds obligated, it accepts and will co ply with th applicable pro :sions.
Agency Offici • 01� W. ington S ; to ' epartment of jr ansportation
By
Title Mayor, City of Tukwila Director, Local Pr.,' ram
Date Executed
DOT Form 140 -041
Revised 05/2015
FEB 1 7 2017
at16 /NA- -S
Page 1
Agency
City of Tukwila
Supplement Number
1
Federal Aid Project Number
BHM- 1274(009)
Agreement Number
LA 8599
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
15-063
rkt, ��., Council Approval 2/2/15 state Department of Transportation� Local Agency Agreement
•
Agency City of Tukwila CFDA No. 20.205
(Catalog of Federal D mesticAssi nce)
Address 6300 Southcenter Blvd. a/'u1_ 1I/7/1 aoct
Project No.
Suite 100 LA Agreement No. 859 9
Tukwila, WA 98188 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 notification.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 Frank Zepp Preventative Maintenance Project Length 0.04
Termini Sperry Dr S to SR 181 -West Valley Highway
Description of Work
Paint Structural Steel, overlay deck and replace the deck joint, and install seismic protection.
Proposed Advertisement Date: January 2016
Estimate of Funding
Type of Work (1) (2) (3)
Estimated Total Estimated Agency Estimated
Project Funds Funds Federal Funds
PE a.Agency 12,897.00 1,290.00 11,607.00
90 % b. Other Consultant 502,979.00 50,298.00 452,681.00
c. Other
Federal Aid d. State • 1,000.00 100.00 900.00
Participation
Ratio for PE e.Total PE Cost Estimate(a+b+c+d) 516,876.00 51,688.00 465,188.00
Right of Way f.Agency
_ g. Other
h. Other
Federal Aid
Participation i. State
Ratio for RW j.Total R/W Cost Estimate(f+g+h+i)
Construction k. Contract
I. Other
m. Other
n. Other
o.Agency
Federal Aid
Participation p. State
Ratio for CN q.Total CN Cost Estimate(k+I+m+n+o+p)
r.Total Project Cost Estimate(e+j+q) 516,876.00 51,688.0p 465,188.00
Agency Official Washington State I ' s artment of tT an,/ sportation
By 4 By %� � �r
Title Ti gurton Director of Local Programs
AR orMayor City of Tukwila Date Executed �1
DOT Form 140-039 EF 1 /51—o 2 �o//V/P" J
Revised 03/2014
Construction 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 gas tax the Agency's share of total construction cost (line 4, column 2) in the amount of
$ at $ per month for months.
Local Force or Local Ad and Award
® Method C - Aaencv cost incurred with partial reimbursement
The Local Agency further stipulates that pursuant to said Title 23, regulations and policies and procedures, and as
a condition to payment of the federal funds obligated, it accepts and will comply with the applicable provisions set
forth below. Adopted by official action on
Funding Acceptance by Council Motion 2/2/2015 , Resolution /Ordinance No.
Provisions
I. Scope of Work
The Agency shall provide all the work, labor, materials, and services necessary to perform the project which is described and set forth in detail in
the "Project Description" and "Type of Work."
When the State acts for and on behalf of the Agency, the State shall be deemed an agent of the Agency and shall perform the services described
and indicated in "Type of Work" on the face of this agreement, in accordance with plans and specifications as proposed by the Agency and approved
by the State and the Federal Highway Administration.
When the State acts for the Agency but is not subject to the right of control by the Agency, the State shall have the right to perform the work
subject to the ordinary procedures of the State and Federal Highway Administration.
IL 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 awards 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 qualified 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 all 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 Transportation, and the
Washington State Department of Transportation. The records shall be open to inspection by the State and Federal Government at all reasonable times
and shall be retained and made available for such inspection for a period of not less than three years from the final payment of any federal aid funds
to the Agency. Copies of said records shall be 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.
Once written authorization is given, the Agency agrees to show continuous progress through monthly billings. Failure to show continuous progress
may result the Agency's project becoming inactive, as described in 23 CFR 630, and subject to de- obligation of federal aid funds and /or agreement
closure.
If right of way acquisition, or actual construction of the road for which preliminary engineering is undertaken is not started by the close of the
tenth fiscal year following the fiscal year in which preliminary engineering phase was authorized, 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).
If actual construction of the road for which right of way has been purchased is not started by the close of the tenth fiscal year following the fiscal
year in which the right of way phase was authorized, 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).
DOT Form 140 -039 EF
Revised 03/2014
2
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 fails to complete the contract within the
contract time.
VI. Payment and Partial Reimbursement
The total cost of the project, including all review and engineering costs and other expenses of the State, is to be paid by the Agency and by the
Federal Government. Federal funding shall be in accordance with the Federal Transportation Act, as amended, 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 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 225 - Cost Principles for State, Local, and Indian Tribal 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 IX).
1. Project Construction Costs
Project construction financing will be accomplished by one of the three methods as indicated in this agreement.
Method A — The Agency will place with the State, within (20) days after the execution of the construction contract, an advance in the amount of
the Agency's share of the total construction cost based on the contract award. The State will notify the Agency of the exact amount to be deposited
with the State. The State will pay all costs incurred under the 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 costs 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 eligible for Federal participation unless
claimed under a previously approved indirect cost plan.
The State shall reimburse the Agency for the Federal share of eligible project costs up to the amount shown on the face of this agreement. At the
time of audit, the Agency will provide documentation of all costs incurred on the project.
The State shall bill the Agency for all costs incurred by the State relative to the project. The State shall also bill the Agency for the federal funds
paid by the State to the Agency for project costs which are subsequently determined to be ineligible for federal participation (see Section 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 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 all
applicable federal and state statutes and regulations. A subrecipient who expends $500,000 or more in federal awards from all sources during a
given fiscal year shall have a single or program - specific audit performed for that 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 by the Director of Local Programs.
DOT Form 140 -039 EF
Revised 03/2014
3
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, maintain
the improvement covered by this agreement.
XI. Indemnity
The Agency shall hold the Federal Government 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, 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 Government 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 of the Local Agency Guidelines.
The Agency further agrees that it will be bound by the above equal opportunity clause with respect to its own employment practices when it
participates in federally assisted construction work: Provided, that if the applicant so participating is a State or Local 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 of Labor pursuant to Part II, subpart D of the Executive Order.
In addition, the Agency agrees that if it fails or refuses to comply with these undertakings, the State may take any or all of the following
actions:
(a) Cancel, terminate, or suspend this agreement in whole or in part;
(b) Refrain from extending any further assistance to the 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 applicable in the event the contractor fails to complete the contract within the contract time. Failure
to include liquidated damages provision will not relieve the Agency from reduction of federal participation in accordance with this paragraph.
DOT Form 140 -039 EF
Revised 03/2014
4
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 is notified by the Federal Highway Administration that the project is inactive.
(5) The Secretary determines that such termination is in the best interests of the State.
XV. Venue for Claims and/or Causes of Action
For the convenience of the parties to this contract, it is agreed that any claims and /or causes of action which the Local Agency has against the
State of Washington, growing out of this contract or the project with which it is concerned, shall be brought only in the Superior Court for Thurston
County.
XVI. Certification Regarding the Restrictions of the Use of Federal Funds for Lobbying
The approving 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 influence an
officer or employee of any federal agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in
connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit the Standard Form - LLL,
"Disclosure Form to Report Lobbying," in accordance with 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.
DOT Form 140 -039 EF
Revised 03/2014
Additional Provisions
5
Washington State
�� Department of Transportation
Local Agency Federal Aid
Project Prospectus
DOT Form 140 -101 EF
Revised 04/2014
Page 1 of 3
• Previous Editions Obsolete •
Date
3/28/2013
Prefix
Route
( )
DUNS Number
Federal Aid
Project Number
BHM
1380
Federal Employer
Tax ID Number
91- 6001519
Local Agency
Project Number
91510406
( use Only
Agency
City of Tukwila
( CA Agency
Yes • No
Federal Program Title
20.205 • Other
Project Title
Frank Zepp Bridge Preventative Maintenance
Start Latitude N 47 -26 -28.38
Start Longitude W122 -14 -47.64
End Latitude N 47 -26 -28.34
End Longitude W122 -14 -44.93
Project Termini From - To
Sperry Dr S West Valley Hwy - SR181
Nearest City Name
Tukwila
Project Zip Code (+ 4)
98188
From To
Length of Project
0.04
Award Type
►=4 Local • Local Forces • State • Railroad
Federal Agency
►_� FHWA • Others
City Number
1320
County Number
17
County Name
King
WSDOT Region
Northwest Region
Congressional District
9
Legislative Districts
11
Urban Area Number
1
Phase
Total
Estimated Cost
(Nearest Hundred Dollar)
Local Agency
Funding
(Nearest Hundred Dollar)
Federal Funds
(Nearest Hundred Dollar)
Phase Start
Date
Month Year
P.E.
$516,900
$51,700
$465,200
April 2015
R/W
Const.
$2,534,800
$2,534,800
December 2015
Total
$3,051,700
$51,700
$3,000,000
Description of Existing Facility (Existing Design and Present Condition)
Roadway Width
71 feet
Number of Lanes
6
The existing structure is a 115 foot long by 87 foot wide steel girder bridge with a light weight concrete deck. The sufficiency
Rating is 73.95 and is considered in Good Condition. The existing deck has spalled and exposed reinforcing steel on the east end
and shows indications of immanent failure throughout. The reinforcement pattern is visible on the deck surface. The expansion
joint is an open finger joint that allows moisture and debris to freely collect on the bridge bearings. The structural steel is
uncoated weathering steel with surface deterioration but no section loss at this time. The bridge is number four on the City's
seismic vulnerability array with deficiencies in the abutment bearings, footing reinforcement and inadequate reinforcing steel
,1a1•lnnmant lantrth
Description of Proposed Work
Description of Proposed Work (Attach additional sheet(s) if necessary)
Paint the structural steel, overlay deck and replace deck joint, and install seismic protection.
Local Agency Contact Person
Grant Griffin
Title
Senior Program Manager
Phone
(206) 431 -2446
Mailing Address
6300 Southcenter Blvd, Suite 100
City
Tukwila
State
WA
Zip Code
98188
By . / `�!.` \lire
Project Prospectus Approval Approving Authority
Title Public Works Director Date 3(22 vs-
DOT Form 140 -101 EF
Revised 04/2014
Page 1 of 3
• Previous Editions Obsolete •
Agency
City of Tukwila
Project Title
Frank Zepp Bridge Preventative Maintenance
Date
3/28/2013
Type of Proposed Work
Project Type (Check all that Apply)
Roadway Width
71 Feet
Number of Lanes
6
• New Construction • Path / Trail
• 3 -R
e Reconstruction • Pedestrian / Facilities
• 2 -R
• Railroad • Parking
CI Other
Construction Will Be Performed By
Consultant
•
e Bridge
%
Geometric Design Data
Description
Others
Through Route
%
Crossroad
Federal
Classification
%
Construction Will Be Performed By
Consultant
•
Principal Arterial
Minor Arterial
oecor
t
Collector
ll
Major Collector
Minor Collector
Local Access
%
• Principal Arterial
o Urban
CI
►74 Urban
• Minor Arterial
• Rural
•
■Rural
• ■ Collector
• NHS
•
• NHS
• Major Collector
•
• Minor Collector
•
• Local Access
Terrain
• Flat
e
Roll
• Mountain
• Flat
• Roll • Mountain
Posted Speed
35
Design Speed
35
Existing ADT
33,500
Design Year ADT
51,500
Design Year
2025
Design Hourly Volume (DHV)
3350
Performance of Work
Preliminary Engineering Will Be Performed By
Consultant
Others
100
%
Agency
0
%
Construction Will Be Performed By
Consultant
Contract
100
%
Agency
0
%
Environmental Classification
❑ Class I - Environmental Impact Statement (EIS)
❑ Project Involves NEPA/SEPA Section 404
Interagency Agreement
❑ Class I11 - Environmental Assessment (EA)
❑ Project Involves NEPA/SEPA Section 404
Interagency Agreement
® Class II - Categorically Excluded (CE)
❑ Projects Requiring Documentation
(Documented CE)
Environmental Considerations
Preliminary - Non Anticipated
DOT Form 140 -101 EF
Revised 04/2014
Page 2 of 3
Agency
City of Tukwila
Project Title
Frank Zepp Bridge Preventative Maintenance
Date
3/28/2013
Right of Way
® No Right of Way Required
*All construction required by the
contract can be accomplished
within the existing right of way.
❑ Right of Way Required
❑ No Relocation
❑ Relocation Required
Description of Utility Relocation or Adjustments and Existing Major Structures Involved in the Project
FAA Involvement
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.
Agency City of Tukwila
By
Date
DOT Form 140 -101 EF
Revised 04/2014
Page 3 of 3
• Previous Editions Obsolete •