The URL can be used to link to this page

Browse Search

Home My WebLink About20143246.tiff LOCAL AGENCY OFFER AMENDMENT Local Agency Offer Amendment C 030-059 In accordance with Section 7 of the Master Agreement 14 HA4 64551 ("Master Agreement") between the State of Colorado, Department of Transportation ("CDOT") and Weld County ("Local Agency"), the authorized person signing below for Local Agency hereby submits this Local Agency Offer Amendment to CDOT for modification of Task Order No. 20049ER1 ("Original Task Order") under the Master Agreement for the Flood Damaged Area in WCR 13 CR 26A Bridge over St. Vrain Creek ("Project Location"). All terms not defined in this Local Agency Offer Amendment shall have the meanings given in the Master Agreement and/or Original Task Order. The Local Agency hereby requests that the Original Task Order, and all prior amendments thereto, if any, be modified as follows: Exhibit C as revised to include the State match. In connection with this Local Agency Offer Amendment, the Local Agency approves the attached documents and incorporates them by reference, if applicable: • Task Order Scope • Task Order Budget • Local Agency Contract Administration Checklist • Damage Inspection Report (Form FHWA 1547) Local Agency hereby requests modification of the Original Task Order for the Project Location. Person signing for the Local Agency hereby swears and affirms that he/she are authorized to act on the Local Agency's behalf(as indicated In Exhibit B of the Master Agreement)and acknowledge that the State Is relying on his/her representation to that effect Seeedarielf Signature of Authorized Person (Local Agency) Office of Emergency Management - Director Title September 11, 2014 Date n C 2014-3246 �o-zo_aoiv et. -8Coo5/5 EZ 0010 Sheet of ua.o.wru'+ma Report Number: -- -- _ y,e,,.e.rthI DETAILED DAMAGE INSPECTION REPORT 20049 Wela_cnuntyigewelY _o1B-PR(Rlq AdriabFederal"trredee (Title 23, Federal-aid Highways) inspection Date: 10/30/2013 Location(Name of Road and Milepost) FHWA Disaster Number: 0013.1 Weld County Site 01 Federal-aid Route Number: County Road 13(CR26A Bridge)Over St.Vrain River 00013 Description of Damege (ONLY ONE REM MAY BF C IFCKFD) Ste: County: O FmerSency RePsit 0 Permanent%epee ❑ Deeds Reamel CO Weld Extreme rein amounts wed ibodr.brs that toadied oat the meth meant a aadich fee ameidwealy reo', Work Order Number: danega swot M itceen c asp aberecnq and dared NW of teethe,samye.Permanent rewkr we necessary to restore the lbal grading and roadside embankment areas to aeedYaate Meta Cat Estimate Description of Work to Date Cost (Egttlpnter&Labor and Materials) Unit Unit Price Quanta Completed ,Rernai Ing Major Earthwork Items CY $ 74.13 450 $ 33,357.20 Aggregate Base Course CY 0 $ - Surfacing-HMA TN 0 $ Surfacing-Concrete SY o- $ - Structure Repairs LS $ 22,200.00 _ 1 $ 22,200.00 Walls SF 00 $ - Drainage LF 0 $ - _ Misc.Items LS $ - 1 $ - General Construction Items LS $ 17,000.50 1 $ 17,00050 winter Work&Dewatering Items tS $ 7,255.77 1 $ 7,255.77 Minor Contract Revisions ,LS $ 11,972.02 1 $ 11,97102 Credit-(Pavement)Constructed in ER Project - . $ 83,213.05 Construction Estimate Subtotal $ 174,998.54 Right-of-Way $ 2,000.00 Preliminary Engineering $ 14,067.82 Construction Engineering $ 9,17835 Indirects S - Method ❑ Loral Form ❑ state Forces ID cowrie Estimated Project Total $ 200,244.92 Environmental Assessment Recommendation Prepared By: Date: ❑' categorical E'dusion O ENEIS Ryan Sisson,P.E. 02111/2014 Concurrence FHWA Engineer(Print Name): FHWA Engineer(Signature): Date: 9 Yes ❑ NO W. D. Daugherty, P. E. - 03/03/2014 Concurreynce State Engineer(Print Name): St to Engineer(St ature): bate: D"-Yes ❑ No Miranda Large,P.E. zjiI ' ii- Concurrence Local Agency(Print Name): Local Agency4Sl natur Doe: 4r Yes ❑ Noe.7 f "4 . !<<._—/./ " Q—/;J—/r FHWA USE ONLY Form FHWA-1547 FEMA Eligible. O Yes [f No COOT 113.2013 Revised 5/8/14 Sheet of Report Number: u.s.Transp Transportation or DETAILED DAMAGE INSPECTION REPORT 20049 Weld County_01A-ER Tranaporbtion _ Federal Highwayghway Administration (Title 23, Federal-aid Highways) Inspection Date: • 10/30/2013 • Location(Name of Road and Milepost) FHWA Disaster Number: CO-13-1 Weld County Site 01 Federal-aid Route Number: County Road 13(CR26A Bridge)Over St.Vrain River 00013 Description of Damage (ONLY ONE ITEM MAY BE CHECKED) State: County: El Emergency Repair ❑ Permanent Repair ❑ Debris Removal CO Weld Extreme rain amounts caused floodwaters that washed out the north roadway approach for approximately 600', Work Order Number: damaged scour protection at bridge abutments,and damaged 2600'of roadway shoulder. Emergency repairs to restore essential traffic are necessary for the roadway,subgrade,ABC,embankments,scour protection,and roadside appurtenances.Emergency repairs to protect the existing structure Include placing turf reinforcing,installing erosion controls,and seeding. Cost Estimate Description of Work to Date Cost (Equipment,Labor,and Materials) Unit Unit Price Quantity Completed Remaining Major Earthwork Items CY 0 0 _ Aggregate Base Course CY 0 0 Surfacing-HMA TN 0 0 Surfacing-Concrete SY 0 0 Structure Repairs LS 0 1 0 Walls SF 0 0 Drainage LF 0 0 Misc. Items LS 0 0 Engineering Services(See Attached) Per Rancty Jensen $ 30,412.00 ER Work to Protect the Structure (See attached) * " $ 152,926.17 • • ER Work to Restore Traffic(See attached) $ 727,075.00 Deduction-Debris Removal - $ (5,000.00) Deduction-PR Item (Pavement) _ $ (82,875.00) Project Total - Local Forces(See attached) _ $ 91,864.20 Deduction-PR Item (Pavement) $ (338.05) Construction Estimate Subtotal $ 914,064.32 Right-of-Way $ - * Indicates item reimbursed at 80/20 rate due to work Preliminary Engineering $ - occuring during the Emergency Repair Extension Construction Engineering $ - Indirects $ - _ Method Estimated Project Total $ 914,064.32 ❑ Local Forces ❑ State Forces R Contract Environmental Assessment Recommendation Prepared By: Date: 0 Categorical Exclusion ❑ EA/EIS Adam Hanks,P.E. 05/08/2014 - Concurrence FLlfirrgi �r(IQrIIjE.�Jap1e]:�� FHWA mIktilti)". �4c. JlJJr1hJ/1 LJ RI ou=WTrHWALak¢wNCO, WAFHWA 4ewoMCO, ® Yes ❑ No cn-JOtHUA0 KIEL Date:2014.05.12 08 3493 O6 W' Concurrence State Engineer(Print Name): Stet Engineer(Signs ure): Date: ['Yes ❑ No Miranda Lange,P.E. ! A,/A/J .5_121) 4- Concurrence Local gency Print Name): ��LocalllAuncy Sisnat re • Date: e }. /� [I]%es ❑ No �y 9,F.// r//.L//,/��' 1, tJ ' p --/7 FHWA USE ONLY Form FHWA-1547 FEMA Eligible: ❑ Yes ❑ No COOT 11.5.2013 For estimate purposes only. ALL reimbursements up through 3/30/14 are eligible for 100% . Any after are subject to regular reimbursable share. - Josh Kiel EXHIBIT C -FUNDING PROVISIONS Task Order#: 20049 ER1 Estimated Cost of Work Project Name: ERLA WCR 13 CR 26A BRIDGE OVR ST VRAIN The estimated total cost the Work is as follows: BUDGETED FUNDS a Federal Funds $887,746.00, (100%of Participating Costs) $761,138.00 (82.79%of Participating Costs) S 126.608.00 b Local Funds 5 13 159,50 (0%of Participating Costs) (8 605%of Participating Costs) ,$ 13,159.50 c State Funds 5 13,159.50 (8 605%of Participating Costs) $ 13,159.50 TOTAL BUDGETED FUNDS: $914,065.00 $ 914,065.00 2 'ESTIMATED PAYMENT TO LOCAL AGENCY•: a. Federal Funds Budgeted(la) 887,746.00 b. State Funds Budgeted(lc) k13 159 50 1 TOTAL ESTIMATED PAYMENT TO LOCAL AGENCY*:1$900,905.50 3 FOR CDOT ENCUMBRANCE PURPOSES Encumbered WBS Element Phase Function I'ay■ble Participating Percent■Re Budgeted Funds Funds"` Design 3020 ROW 3111/3114 (Aca eloc) ROW 3114 Incidentals Constl%) 3301 20049.10.50 Miscellaneous 3404 $ 914,065.00 $914,065.00 Utllties 3988 rnvironmental 3403 TOTAL ENCUMBERED FUNDS: $914,065.00 $914,065.00 'The"Total Estimated Payment to Local Agency"amount assumes that that the entire budgeted amount in Section 1 will be encumbered.Local Agency is not entitled to payment for any amounts that are not encumbered. "The Agreement Funds payable by the State to Local Agency pursuant to this Agreement is limited to the aggregate amount of encumbered funds identified in Section 3 above multiplied by the Payable Participating Percentage for Federal Funds or State Funds identified in Section 3. Page 1 of 2 Single Audit Act All state and local government and non-profit organizations receiving more than$500,000 from all funding sources defined as federal financial assistance for Single Audit Act of 1984,as amended (PL 98-502; PL 104-156)(collectively the"Single Audit Act"),purposes shall comply with the audit requirements of OMB Circular A-133 (Audits of States,Local Governments and Non-Profit Organizations)and OMB Circular A-133 Compliance Supplement,as amended.See also,49 CFR 18.20 through 18.26.The Single Audit Act requirements applicable to the Local Agency receiving Federal Funds are as follows: i. Expenditure less than$500,000 If the Local Agency expends less than $500,000 in Federal Funds(all federal sources, not just highway funds) in its fiscal year then this requirement does not apply. ii.Expenditure exceeding than $500,000-Highway Funds Only If the Local Agency expends more than$500,000 in Federal Funds, but only received federal highway funds(Catalog of Federal Domestic Assistance,CFDA 20.205)then a program specific audit shall be performed. This audit will examine the"financial" procedures and processes for this program area. iii. Expenditure exceeding than$500,000-Multiple Funding Sources If the Local Agency expends more than$500,000 in Federal Funds, and the Federal Funds are from multiple sources(FTA,HUD,NPS,etc.)then the Single Audit Act applies,which is an audit on the entire organization/entity. iv. Independent CPA • Single audit shall only be conducted by an independent CPA,not by an auditor on staff. An audit is an allowable direct or indirect cost. THE REST OF THIS PAGE INTENTIONALLY LEFT BLANK Page 2 of 2 Weld County Request for Reimbursement CDOT Project#C 030-059 Task Order#15 HA4 71566(SA 20049) Reimbursement Request#1 Request for Reimbursement Date 7/31/2014 Labor Equipment Material Contractor 202/Contracted Construction $ 493,673.77 203/Contracted Design $ 11,386.50 207/Field Testing $ 5,830.00 i 208/General Services(Engineering) $ 11,761.27 $ 539.50 209/Inspection $ 5,013.11 $ 518.00 I 210/Lab Testing $ 354.36 213/Right of Way $ 1,411.12 214/Right of Way Acquisition $ 500.00 217/Surveying $ 752.80 $ 84.00 219/General services(engineering companies) $ 8,364.28 221/Final Design $ 1,868.68 304/Mechanical Patching $ 141.30 306/Paving $ 196.75 401/Site Work $ 3,352.98 $ 1,592.00 $ 34,380.53 $ 22,078.25 411/Bridge Repair $ 8,827.88 600/Haul Solids $ 2,795.80 $ 5,340.00 $ 4,133.25 $ 10,912.25 603/Haul Liquids $ 94.00 $ 252.00 $ 8.40 800/Signing $ 442.01 $ 120.00 900/General Administration $ 13,205.12 901/Travel Time Employees $ 80.82 $ 90.00 902/Work Support Activities $ 443.98 $ 84.00 908/Traffic Control $ 874.54 $ 449.00 $ 40,919.96 $ 8,529.00 $ 47,350.06 $ 555,153.23 Total $ 651,952.25 A Not included in invoice by Weld County All labor by Weld County was excluded by Weld County $ 42,788.62 202/Contracted Construction $ 92,071.28 208/General Services(Engineering) ICON $ 666.50 ICON $ 2,115.00 ICON $ 66.00 $ 42,788.62 $ - $ - $ 94,918.78 B Not Included Total(A-B) $ 137,707.40 0 Requested Total $ 514,244.85 C Weld County Request for Reimbursement CDOT Project#C 030-059 Task Order#15 HA4 71566(SA 20049) Reimbursement Request#1 Request for Reimbursement Date 7/31/2014 Exceptions to the Invoice By CDOT ICON Invoice 11498 ICON Invoice Includes$244 for work from San Engineering;however their Invoice#765 doesn't include charges for this site. $ 244.00 $ 244.00 D Recommended Payment(C-D) $ 514,000.85 Weld County Request for Reimbursement COOT Project#C 030-059 Task Order#15 HA4 71566 Reimbursement Request#1 Request for Reimbursement Date 7/31/2014 Labor Equipment Material Contractor 202/Contracted Construction $ 92,071.28 203/Contracted Design $ 2,847.50 $ S $ $ 94,918.78 Total $ 94,918.78 A Not included in invoice by Weld County $ $ $ $ - 8 Not Included Total(A-8) $ - Requested Total $ 94,918.78 C Exceptions to the Invoice ICON invoice 11712 Invoice for$66 doesn't have proof of payment $ 66.00 $ 66.00 D Recommended Payment(C-D) $ 94,852.78 Hello