011-05 - WSDOT - Contract Amendment 1ANIL
� Washington State
-I4 bQpartment of Transportation Local Agency Agreement Supplement
a '
Agency
Supplement Number
Port Orchard
1
Federal Aid Project Number
Agreement Number
CFDA No. 20.205
STPUS-6610(004)
LA 5855
(Catalog of Federal Domestic Assistance)
The Local Agency 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.
The changes to the agreement are described as follows:
Project Description
Name Tremont Street Widening Length .65 Mile
Termini Port Orchard Blvd to .1 mile past SR 16
Description of Work ® No Change
Reason for Supplement
The City will utilize the additional funds to complete the design work and to contract with a right-of-way agent to prepare the
right-of-way acquisition documents.
Does this chanae require additional Right of Way or Easements? ❑ Yes ® No
Type of Work
ip
Estimate of Funding
(t)
Previous
Agreement/Suppl.
(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
86.5 010 b.Other
442,000.00
235,000.00
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
3,000.00
15,000.00
18,000.00
2,430.00
15,570.00
Participation
Ratio for PE e. Total PE Cost Estimate (a+b+c+d)
450,000.00
250,000.00
700,000.00
94,500.00
605,500.00
Right of Way f. Agency
.Other
Federal Aid h. Other
Participation
Ratio for RW i. State
j. Total R/W Cost Estimate f+ +h+i
Construction k. Contract
I. Other
m. Other
n. Other
o. Agenc
Federal Aid p, State
Participation
Ratio for CN q. Total CN Cost Estimate k+l+m+n+o+
r. Total Project Cost Estimate a+'+
450,000.001
250,000.00
700,000.00.
94,500.00
605,500.00
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.
Agency Official Washington State p ment of Tran ortation
By C;t %� /h Cif By — ---
Title M ex- Director of Highways and Loc I Programs 052007
Date Executed --
DOT Form 140.041 EF
Revised 1/2007