011-05 - WSDOT - Supplement / Change Order 5Washington State
Department of Transportation
Agency
Port Orchard
Federal Aid Project Number
STPUS - 6610(004)
Local Agency Agreement Supplement
Agreement Number
LA 5855
Supplement
CFDA No. 20.205
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 0.65 miles
Termini Port Orchard Boulevard to SR 16
Description of Work ® No Change
Reason for Supplement
Obligate funding.
r)noc thim rrhnnnR ranidra nrlditinnal Right of Wav or Easements? ❑ Yes ® No
T of Work
Ty e
Estimate of Funding
(1) (2) ! (3)
Previous Supplement Estimated Total
Agreement/Suppl. Project Funds
(4) (5)
Estimated Agency Estimated
Funds Federal Funds
PE a.Agency
3,000.00
3,000.00
405.00
2,595.00
86.5 % b.Other Consultant
677,000.00
300,000.00
977,000.00
131 895.00
845105.00
c.Other
2,000.00
2,000.00
270.00
1730.00
Federal Aid d. State
18 000.00
18 000.00
2,430.00
15,570.00
Participation
Ratio for PE a Total PE Cost Esttrr)a a+b+c+d
700 000.00
300 000.00
1,000,000.00
135,000.00
865,000.00
Right of Way f, A -.2
1,070,161.00
1,185 462.00
2,255,623.00
364,509.00
1,951,114.00'
86.5 %
50 000.00
50 000.00
6 730.00
43,250.00
Federal Aid Other Eligible Non Federal Funds
Participation h.
Ratio for RW i. state
'. Total R/W Cost Estimate f+ +h+i
Ibr�l )�� rIT6+R4Q AA
_ _ 10 000.00
ibror
10 00.00
1,350.00
8 650.00
Construction,. Contract _
L Other
m. Other
n. Other
% o, Agengy-
Federal Aid
Participation State
Ratio for CN g. Total CN Cost Estimate k+l+ +n+o
1, 2-001] tlV'O
2-13311 (oyl
32VI m 2--7
2 7
/ S'° l, y5'0
3 33
r. Total Project Cost Estimate e
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 obli ted,.1 accepts and will comply with the applicable provisions.
Agency 0 icial.- ,. Washington State Department of Transportation
r
By By — -
Title Director of Highways and Local Programs
Fehr„__ __aq—U, 20 10 Date Executed
DOT Form 140-041 EF
Revised 1/2007
ANOW
w shift Local Agency Agreement Supplement
► gency &Rftmwd Nrrr*w
Pat OnA d 5
Federal Aid Project N urrdxw AgFeemerd Niaidm CFOA No. 20-M /
STT US - 6610f0041 LA 5355 of Farewl k�noe�
The Lodi Agency desires b a4wieumt the agreement errher A W and empr#eld on reunimay- �
Al p w sions b the basic agreement remain it effed erMO W ftWM* rr DCWAe_d by fht seppiemenL
The otr 1 911 b to agr wmt are domed = fofiurrs
Nww Tremont sheet Wi& ing U
Tom*li Pat Or6ud Boulevard to SR 16
Oe�cripiian of Wof ® No Umgp
Ralson for Pon - a f
OM*ft addWKngd rWit-d-wzy fizding
/I I
0.65 miles
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The Local Ayency fiffffm #v t prram t to said The 23, regulations and policies and PMM&rnes, and as a corrdrfM
b peynw t of fhe Federal finds cd*Oed, it and wi wnq* w'M ft appieble pFovbk ns.
Aqei",Offic;W oon side DeQarbrile d of T
BY
Toe MHYM PM TesrePM
DOT F ml i4o-mi EFA'
ReAed irzaor ,
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Dior of 11 gtmap and Lod Pr WB= ,
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MMC, City Clerk