011-05 - WSDOT - Supplement / Change Order 3A"k,r n
Washington State
Department of Transportation Local Agency Agreement Supplement
Agency Supplement Number
Port Orchard _ 3
Federal Aid Project Number I Agreement Number CFDA No. 20.205
The Locab%ency desires to supplement the agreement entered into and executed on February 28, 2005
All provisions in the basic agreement remain in effect except as expressly modified by this supplement.
s:
The changes to the agreement are described as follows:
Project Description
Name Tremont Street Widening Length 0.65 Mile
Termini Port Orchard Boulevard to 0.1 mile pst SR 16
Description of Work ® No Change
Reason for Supplement
Obligate remaining Right of Way funds.
Does this change require additional Right of Way or Easements? ® Yes ❑ No
Type of Work
yp
Estimate of Funding
Previous
A reement/Su I.
(2)
Supplement
(3)
Estimated Total
Project Funds
(4)
Estimated Agency
Funds
(5)
Estimated
Federal Funds
PE a.Agency
3,000.00
3,000.00
405.00
2,595.00
86.5 % b. Other Consultant
677,000.00
677 000.00
91,395.00
585,605.00
c. Other
2,000.00
2,000.00
270.00
1,730.00
Federal Aid d. State
18,000.00
18,000.00
2,430.00
15,570.00
Participation
Ratio for PE e. Total PE Cost Estimate a+b+c+d
700 000.00
700,000.00
94,500.00
605,500.00
Right of Way f.Agency
883,749.00
186,412.00
1,070,161.00
144,472.00
925,689.00
86.5 % g—Mer50
000.00
50 000.00
6,750.00
43 250.00
Federal Aid h. Other
Participation
Ratio for RW i. State
10 000.00
10 000.00
1,350.00
8,650.00
.. Total R/W Cost Estimate f+ +h+i
Construction k. Contract
I. Other
m. Other
n. Other
o. A enc
Federal Aid
P. State
Participation
Ratio for CN q. Total CN Cost Estimate k+l+m+n+o+
r. Total Project Cost Estimate a+i+
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 a,pcepts and will comply with the applicable provisions.
Agency OfficiJ. �� Washington State Department of Transportation
By — , /�f'%— — By --
Title — M �Or ___ __ Director of Highways and Local Programs
April 30, 2008 Date Executed
DOT Form 140-041 EF
Revised 1/2007