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Home My WebLink About20143250.tiff LOCAL AGENCY OFFER AMENDMENT Local Agency Offer Amendment C 030-064 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. 20054ER1 ("Original Task Order") under the Master Agreement for the Flood Damaged Area in WCR 54 CR 13A Bridge over Big Thompson River ("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 hislher representation to that effect. Pied/4j' Signature of Authorized Person (Local Agency) Office of Emergency Management - Director Title September 11, 2014 Date 2014-3250 C� et :: �m !O-2o 2°N `866465 Co07O Sheet of Report Number. U.R Department et DETAILED DAMAGE INSPECTION REPORT 200s4_wele_County_o6&Plt(alK) Transportation - Fede r ',alle;'' (Title 23, Federal-aid Highways) Inspection Date: 10/30/2013 - Location(Name of Road and Milepost) FHWA Disaster Number: CD-13-1 Weld County Site 06 Federal-aid Route Number: County Road 54(CR13A Bridge)Over Big Thompson River 00054 Description of Damage (ONLY ONE ITEM MAY BE CHECKED) State: County: 0 Emergency Reims 0 Permanent Repair ❑ Debris Removal CO Weld Extreme rain amounts caused floodwater that washed out the roadway and abutment backat at the east abutments; Work Order Number: overtopped the roadway and dunned gap feet of shoulder,embankment,and pavement;and damaged scour protection elements at the abutments In the main channel at the bridge.Permanent repairs are necessary to dewater, remove emergency materials,pavement and restore the bridge barknll and scour protection to pre-dbartecondition once emergency repairs are complete. Cost Estimate Description of Work to Date Cost (Cquipmamt,Labor,and Materials) Unit Unit Price Quantity.Completed Remaining Major Earthwork Items CY , $ 110.80 40 $ 4,432.00 Aggregate Base Course CY o $ - Surfacing-HMA TN 0 _ Surfacing-Concrete SY p- 0 $ - Structure Repairs IS $ 88,800.00 1 $ 88,800.00 v Walls SF 0 $ - Drainage LF 0 $ - Misc.Items L5 $ 3,000.00 1 $ 3,000.00 General Construction Items _l5 $ 29,446.99 1 $ 29,446.99 Winter Work&Dewatering Items LS $ 12,567.90 1 $ 12,567.90 Minor Contract Revisions LS $ 20,737.03 1 _ $ 20,737.03 Credit-(Pavement)Constructed In ER Phase $ 3,474.74 Construction Estimate Subtotal $ 162,458.66 Right-of-Way $ 2,000.00 Preliminary Engineering $ 24,14759 Construction Engineering $ 15,898.39 Indirects, _$ - Method Estimated Project Total $ 204,504.65 ❑ Loud Forces ❑ State Forces ❑ Contract Environmental Assessment Recommendation Prepared By: Date: 9 Categorical Exdidon 0 ENE15 Ryan Sisson,P.E. 02/11/14 Concurrence FHWA Engineer(Print Name): FHWA Engineer(Signature): Date: 9 Yes ❑ No W. D. Daugherty,P. E. it it„. ., — 03/03/2014 Concurr ce State Engineer(Print Name): State Engineer(Signature): Date: pigin es 0 No Miranda Lange,P.E. ' /��_ ,.,IN:6 t� It-- Concurrence Local,$j$ency Print Name): lot I Agen Signature): 1 : ® Yes 0 No k)wk ti./bi 4,S;I( _ ni.�.l L J—4.,2 c FHWA USE ONLY Form FHWA-1547 FEMA Eligible: 0 Yes 0 No CDOT 11.5.2013 • EXHIBIT C -FUNDING PROVISIONS Task order#: 20054 ER1 Estimated Cost of Work Project Name; ERLA WCR 54 CR 13A BRDGE OVER BIG T • • The estimated total cost the Work is as follows: t BUDGETED FUNDS a, Federal Funds $ 124,215.00 (100%of Participating Costs) $46.174.00 (82.79%of Participating Costs) $78.041.00 E Local Funds $8 111 50 (0%of Participating Costs) (8.605%of Participating Costs) $8.1 11,50 c. State Funds $8,111.50 • (8.605%of Participating Costs) $8,111.50 TOTAL BUDGETED FUNDS: $ 140,438.00 $ 140438.00 2 IESTIMATED PAYMENT TO LOCAL AGENCY*: a, Federal Funds Budgeted(la) 124,215.00 b. State Funds Budgeted(Ic) 8111 50 f TOTAL ESTIMATED PAYMENT TO LOCAL AGENCY*:[$ 132,326.50 I 3 FOR CDOT ENCUMBRANCE PURPOSES Encumbered WBS Element Phase Function Payable Participating Percentage Budgeted Funds Funds"" Design 3020 ROW 3111/3114 (Acs/Relod ROW 3114 _ Incidentals • Const 1%) 3301 • 20054.10.50 Miscellaneous 3404 $ 140,438.00 $140,438.00 Willies 3988 Environmental 3403 TOTAL ENCUMBERED FUNDS: $ 140,438.00 $ 140,438.00 *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-I33 (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 030-064 Task Order# 15 HA4 71579 Reimbursement Request#1 Request for Reimbursement Date 7/31/2014 Labor Equipment Material Contractor 202/Contracted Construction $ 71,460.99 207/ Field Testing $ 150.22 $ 28.00 208/General Services(Engineering) $ 3,468.25 $ 25,594.54 209/Inspection $ 260.42 # $ 45.50 210/Lab Testing $ 157.69 301/Class A Patching $ 1,955.55 $ 548.00 $ 870.10 304/ Mechanical Patching 307/Shoulder Work $ 94.20 $ 240.00 314/ Hauling Asphalt 401/Site Work $ 1,928.73 $3,726.00 $ 1,218.75 410/Tree Trimming with Contractor 411/ Bridge Repair $ 1,581.73 $1,168.00 $2,017.91 600/Hauling Solids $ 849.61 $1,342.50 $1,392.36 $ 675.00 800/Signing $ 284.86 $ 128.00 805/Sign Production $ 29.74 900/General Administration $ 144.49 $ 238.12 901/Travel Time Employees $ 581.16 $ 267.00 902/Work Support Activities $ 611.10 907/Mobilization of Equipment $ 88.53 $ 189.00 $12,186.28 $7,682.00 $4,518.49 $ 98,949.28 Total $ 123,336.05 A Not included in invoice by Weld County All labor by Weld County was excluded by Weld County $12,186.28 202/Contracted Construction $ 71,460.99 208/General Services(Engineering) Ayres(amount estimated from detail sheet) $ 4,186.83 Ayres(amount estimated from detail sheet) $ 3,982.50 $12,186.28 $ - $ - # $ 79,630.32 B Not Included Total (A-B) $ 91,816.60 Requested Total $ 31,519.45 C Weld County Request for Reimbursement CDOT Project#C 030-064 Task Order It 15 HA4 71579 Reimbursement Request#1 Request for Reimbursement Date 7/31/2014 Exceptions to the Invoice by CDOT Ayres Invoice 153005 Mileage paid at$.77/mile 77.71 Miles C $ 0.21 $ 16.32 (Pay mileage at$.56/mile) Equipment Rent $ 536.75 $ 536.75 (Equipment Rent not allowed by Weld County Contract) Martin Materials Invoice 12288899 $ 870.11 (Insufficient backup to show that the asphalt was delivered to the site.Check backup needs to be verified.) Pete Lien &Sons Invoice 13POS/112634 $ 171.00 (No evidence this was delivered to the project) Pete Lien &Sons Invoice 13POS/112366 $ 171.00 (No evidence this was delivered to the project) Pete Lien &Sons Invoice 13P05/112367 $ 171.00 (No evidence this was delivered to the project) Pete Lien &Sons Invoice 13P05/112368 $ 171.00 (No evidence this was delivered to the project) Pete Lien &Sons Invoice 13P05/112414 $ 138.28 (No canceled check) Pete Lien &Sons Invoice 13POS/112417 $ 162.91 (No canceled check) Pete Lien &Sons Invoice 13POS/112418 $ 156.52 (No evidence this was delivered to the project) Pete Lien &Sons Invoice 13P05/112474 $ 269.50 (No evidence this was delivered to the project) Pete Lien &Sons Invoice 13POS/112495 $ 148.31 (No evidence this was delivered to the project) Pete Lien &Sons Invoice 13P05/112496 $ 146.83 (No evidence this was delivered to the project) Pete Lien &Sons Invoice 13POS/112498 $ 153.67 (No evidence this was delivered to the project) Pete Lien &Sons Invoice 13POS/112502 $ 157.89 (No evidence this was delivered to the project) $ 3,441.09 D Recommended Payment(C-D) $ 28,078.36 Weld County Request for Reimbursement CDOT Project#C 030-064 Task Order#15 HA4 71579(SA 20054) Reimbursement Request#2 Request for Reimbursement Date 7/31/2014 Labor Equipment Material Contractor 202/Contracted Construction $ 71,460.99 207/ Field Testing $ 150.22 $ 28.00 208/General Services(Engineering) $ 3,468.25 $ 25,594.54 209/Inspection $ 260.42 # $ 45.50 210/Lab Testing $ 157.69 301/Class A Patching $ 1,955.55 $ 548.00 $ 870.10 304/ Mechanical Patching 307/Shoulder Work $ 94.20 $ 240.00 314/ Hauling Asphalt 401/Site Work $ 1,928.73 $3,726.00 $ 1,218.75 410/Tree Trimming with Contractor 411/Bridge Repair $ 1,581.73 $1,168.00 $2,017.91 600/Hauling Solids $ 849.61 $1,342.50 $1,392.36 $ 675.00 800/Signing $ 284.86 $ 128.00 805/Sign Production $ 29.74 900/General Administration $ 144.49 $ 238.12 901/Travel Time Employees $ 581.16 $ 267.00 902/Work Support Activities $ 611.10 907/Mobilization of Equipment $ 88.53 $ 189.00 $12,186.28 $7,682.00 $4,518.49 $ 98,949.28 Total $ 123,336.05 A Not included in invoice by Weld County All labor by Weld County was excluded by Weld County $12,186.28 Claimed on Invloice#1 $ 31,519.45 208/General Services(Engineering) Ayres(amount estimated from detail sheet) $ 4,186.83 Ayres(amount estimated from detail sheet) $ 3,982.50 $12,186.28 $ - $ - # $ 39,688.78 B Not Included Total (A-B) $ 51,875.06 Requested Total $ 71,460.99 C Weld County Request for Reimbursement CDOT Project#C 030-064 Task Order#15 HA4 71579 (SA 20054) Reimbursement Request#2 Request for Reimbursement Date 7/31/2014 Exceptions to the Invoice by CDOT None $ $ - D Recommended Payment(C-D) $ 71,460.99 Hello