022-21 - WSDOT - Contract Local Agency AgreementWashington State
T! Department of Transportation
Agency City of Port Orchard
Address
Attn. K. Chris Hammer, PE - Assistant City Engineer
216 Prospect Street
Port Orchard, WA 98366
Local Agency Agreement
CFDA No. 20.205
(Catalog or Federal Domestic Assistance)
Project No.
Agreement No.
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 Part 200, (4) 2 CFR Part 180 — certifying that the local agency is not
excluded from receiving Federal funds by a Federal suspension or debarment, (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 City-wide Street Lighting Study
Termini City limits
Description of Work
Length N/A
The project includes, lighting level data, validate and amend data, develop GIS model for analysis and study, and develop a report to
identify and prioritize improvements to address deficiencies.
Project Agreement End Date September 30, 2021
Proposed Advertisement Date N/A
Claiming Indirect Cost Rate
✓ Yes [:]No
Estimate
of Funding
(2)
(3)
Type of Work
tj
Estimated Total
Estimated Agency
Estimated Federal
Project Funds
Funds
Funds
PE a�Agency 10,000.00
0.00
10,000.00
b. Other Consultant 40,000.00
0.00
40,000.00
Federal Aid c Other
0.00
5,000.00
IParticipation
AState
5,000.00
(Ratio for PE
e. Total PE Cost Estimate a+b+c«d
55,000.00
0.00
55,000.00
Right of Way f. Agency
% g. Other
Federal Aid
h Other
Participation
Ratio for RW i•-State
0.00
0.00
0.00
'. TotaLRM Cost Estimate r +h+
Construction k Contract
(.Other
m._Other
(Federal Aid n. 0 ther
Participation
o.Agency
(Ratio for CN
p. State
0.00
0.00
g. Total CN Cost Estimate It +m+n+o
0.00
r. Total Project Cost Estimate fe'+Q)55,000.00
0.00
55,000.00
Agency Official
By
Title Mayor
Washington State
Department of Transportation
By Director, Local Program
Date Executed
DOT Form 140-039 Page 1
Revised 1212020