14-195.00 WSDOT Pines Rd Grace Ave Supplement 1 AGENCY
Ai
W7ilissileigton State
Ai Deparboat of Wansportation Local Agency Agreement Supplement
Agency Supplement Number
City of Spokane Valley I
Federal Aid Project Number • Agreement Number CFDA No. 20.205
HSIP-0027(013) LA-7796 (Catalog of Federal Domestic Assistance)
The Local Agency requests to supplement the agreement entered into and executed on \O \\ 8`\Z
All provisions in the basic agreement remain in effect except as modified by this supplement.
The changes to the agreement are as follows:
Project Description
Name Pines Rd and Grace Ave Intersection Safety Project Length 740+/-
Termini SR 27 MP 87.24 and MP 87.38
Description of Work ® No Change
Widen SR 27 with a center turn lane
Reason for Supplement
Request ROW funds
Does this change require additional Right of Way or Easements? 0 Yes ®No Advertisement Date:
Estimate of Funding
Type of Work (1) (2) (3) (4) (5)
Previous Supplement Estimated Total Estimated Agency Estimated
Agreement/Suppl. Project Funds Funds Federal Funds
PE a.Agency 67,200.00 67,200.00 67,200.00
100 % b.Other
c.Other
Federal Aid d.State 1,000.00 1,000.00 1,000.00
Participation
Ratio for PE e.Total PE Cost Estimate(a+b+c+d) 68,200.00 68,200.00 68,200.00
Right of Way f.Agency 242,416.00 242,416.00 242,416.00
100 % g.Other ROW Consultant 36.584.00 36,584.00 36,584.00
Federal Aid h. Other
Participation
Ratio for RW i.State 1.000.00 1,000.00 1,000.00
J.Total RNV Cost Estimate(f+g+h+i) 280.000.00 280.000.00 280.000.00
Construction k.Contract
I. Other
% m.Other
Federal Aid n.Other
Participation o.Agency
Ratio for CN p.State
q.Total CN Cost Estimate(k+l+rn+n4o+p)
r.Total Project Cost Estimate(e4j+q) 68.200.00 280.000.00 348.200.00 348.200.00
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 applicabl- •rovisi,ns. r
Agency Official Washin• •n State b - !artment of Tr, sportation
By .‘1,/e4%" By _ __r/1•�'-- •
Title P/1/ 1(4-5 Dii CTQK- Director of Local Progra s
OCT 151014
Date Executed
DOT Form 140-041 EF
Revised 03/2014