006-06 - WSDOT - Supplement / Change Order 2_ Menu
INaslrngton State
v/ Deparhneiift of Transpolrtadon Local Agency Agreement Supplement
Agency Supplement Number
Port Orchard 2
Federal Aid Project Number Agreement Number CFDA No. 20.205
STPE-STPUS-0166 008 LA 6165 (Catalog of Federal Domestic Assistance)
The Local Agency requests to supplement the agreement entered into and executed on June 14, 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
Day Street Pedestrian Pathway Length l mile
Termini Fredrick StreetWAnnapolis Foot Ferry Terminal on Sinclair Inlet
Description of Work ® No Change
Reason for Supplement
Obligate additional Right of Way funds
Are you claiming indirect cost rate? ❑ Yes ® No Project Agreement End Date
Does this change require additional Right of Way or Easements? ® Yes ❑ No Advertisement Date
F--r—wu-�
Type of Work
yp
Estimate of Funding
I (4) I (5)
Estimated Agency Estimated
Funds Federal Funds
(t) l
Previous
A reement/Su I.
(2)
Supplement
(3)
Estimated Total
Project Funds
PE a. Agency
295.000.00
295,000.00
295 000.00
100 % b. Other Eligible Non Federal
c. Other
49,834.00
49 834.00
49 834.00
Federal Aid d. State
5,000.00
5,000.00
5,000.00
Participation
Ratio for PE e. Total PE Cost Estimate (a+b+c+d)349
834.00
349,834.00
49,834.00
300,000.00
Right of Way f. Agency
489.699.00
1.543 239.00
2,032.938.
274 447.00
1.758 491.00
86.5 % Other Consultant
190 8 0
190
165,098.00
.
Federal Aid h. Other Eligible Non Federal
_
Participation
Ratio for RW i. State
10.0.00.00
-5 0 0.00
S 000.00
5.000-00
J. Total RNV Cost Estimate (f+g+h+i)
Construction k. Contract
I. Other
m.Other
n. Other
Federal Aid
Participation o. Agency
Ratio for CN p. State
q. Total CN Cost Estimate (k+l+m+n+o+D)
r. Total Pra ect Cost Estimate (e+'+
c. i
3,124,516,00
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.
Agen Official Washington State Department of Transportation
By _ By
Title"— IC•1'] —_ Director, Local Programs
Date Executed
DOT Form 140-041
Revised 04/2015
Zs�on,4.0 . Cry-] erk--
Page 1
Agency Supplement Number
Port Orchard 2
Federal Aid Project Number Agreement Number CFDA No. 20.205
STPE-STPUS-0166 008 LA 6165 omesticAssistance
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.
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.
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.
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.
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 Farm 140-041 Page 2
Revised 04/2015