17-142.04 WSDOT: Barker BNSF Grade Separation . fl_ 1y-Q _ 04
`�- 4111111.
AGENCY
WI
Washington State Local A enc A reement Su lement
Department of Transportation Agency g PP
Agency Supplement Number
City of Spokane Valley 4
Federal Aid Project Number Agreement Number CFDA No. 20.205/20.933
REP&HLP-TIGERIX-4123(005) LA 9095 (Catalog of Federal Domestic Assistance)
The Local Agency requests to supplement the agreement entered into and executed on 7/21/2017
All provisions in the basic agreement remain in effect except as modified by this supplement.
The Local Agency certifies that it is not excluded from receiving Federal funds by a Federal suspension or debarment
(2 CFR Part 180).Additional changes to the agreement are as follows:
Project Description
Name Barker Road/BNSF Grade Separation Length 0.50 Miles
Termini BNSF to SR 290(Trent Ave)
Description of Work If No Change
Reason for Supplement
Increase PE and ROW funds based on actual costs.
Are you'claiming indirect cost rate? Yes ✓ No Project Agreement End Date 12/31/2022
Does this change require additional Right of Way or Easements?I I Yes ✓ No Advertisement Date:
Estimate of Funding
(1) (3) (4) (5)
Type of Work (2)
Previous Supplement Estimated Total Estimated Agency Estimated Federal
Agreement/Suppi. Project Funds Funds Funds
PE •% a.Agency 0.00
b.Other 0.00
Federal Aid c.Other 0.00
Participation 0.00
Ratio for PE d.State ♦
e.Total PE Cost Estimate(a+b+c+d) 0.00 0.00 : 10 iiiivilA. 0. 0 0.00
Right of Wayo f.Agency _
g.Other
Federal Aid 0 h.Other .00
Participation
Ratio for RW i.State /W 0.00
j.Total R Cost Estimate jf+g+h+� 0.00 0.00
0.00
0.00
Constructiono k.Contract 0.00 •
I.Other 0.00
m.Other . 0.00
Federal Aid n.Other 0.00
Participation 0.00
Ratio for CN a.Agency
p.State 0.00
q.Total CN Cost Estimate(k+I+m+n+o+pl 0.00 0.00 0.00 0.00 0.00
r.Total Project Cost Estimate(e+j+q) 0.00 0.00 0.00 0.00 0.00
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 Oficial Washingt t e Departure t of Transportation
By n„ 1-- ediat,%-- By
Title City Manager Director, Local rogram
Date Executed
- DOT Form 140-041 . B I ! 020
Page 1
Revised 03/2019
; 1lbbshington state
Dapartmant of Transportation
Exhibit'A'
Agency:City of Spokane Valley
Project Title:Barker Road/BNSF Grade Separation
Federal-Aid#:REP&HLP-TIGERIX-4123(005)
LAA#: LA 9095,Supplement No.4
Estimate of Funding
Type of Work (1) (2) (3) (4) (5) (6)
PREVIOUS AGREEMENT/ SUPPLEMENT ESTIMATED TOTAL ESTIMATED ESTIMATED ESTIMATED
SUPPLEMENT PROJECT FUNDS AGENCY FUNDS STATE FUNDS FEDERAL FUNDS
PE a. Agency(Leg.) $75,000.00 $75,000.00 $75,000.00
b. Agency(DEMO) $75,000.00 $75,000.00 $75,000.00
bb. Agency(Agency) $15,000.00 $15,000.00 $15,000.00
c. Other.Consultant(DEMO) $438,000.00 $438,000.00 $438,000.00
d. Other.Consultant(Leg.) $1,257,000.00 $1,257,000.00 $1,257,000.00
100% e. Other.Consultant(TIGER) $620,000.00 $620,000.00 $620,000.00
Federal Aid f. Other.Consultant(Agency) $120,000.00 $80,000.00 $200,000.00 $200,000.00
ff. Other.Lltility Relocations(Agency) $60,000.00 $60,000.00 $60,000.00
Participation g. State(DEMO) $70,000.00 $70,000.00 $70,000.00
Ratio for PE h. Total PE Cost Est.(a.thru g.) $2,655,000.00 $155,000.00 $2,810,000.00 $275,000.00 $1,332,000.00 $1,203,000.00
Right-of-Way I. Agency(Leg.) $14,000.00 -$6,000.00 $8,000.00 $8,000.00
j. Other.Consultant-Prof Services(Leg.) $115,000.00 $40,000.00 $155,000.00 • $155,000.00
k. Other Consultant-Prof Services(DEMO) $60,000.00 $60,000.00 $60,000.00
Idc Other.Consultant-Prof Services(Agency) $90,100.00 $34,900.60 $125,000.00 $125,000.00
I. Other.ROW Acquisitions(TIGER) $1,832,000.00 $1,832,000.00 $1,832,000.00
100% m. Other.ROW Acquisitions(DEMO) $76,921.00 -$34,000.00 $42,921.00 $42,921.00
Federal Aid n. Other.ROW Acquisitions(Agency) $91,991.00 $573,088.00 $665,079.00 $665,079.00
Participation o. State(Leg.) $39,000.00 -$34,000.00 $5,000.00 $5,000.00
oo. State:(DEMO) $34,000.00 $34,000.00 $34,000.00
Ratio for RW p. Total RIW Cost Est.(i.thru o.) $2,319,012.00 $607,988.00 $2,927,000.00 $790,079.00 $168,000.00 $1,968,921.00
Construction q. Contract(TIGER) $0.00 _
r. Contract(NHFB) $0.00
s. Contract(FMSIB) $0.00
t Contract(Eligible,Non-Participate) $0.00
u. Other.Utility Relocations(Agency) $0.00
uu. Other.Consultant(NHFB) $0.00
v. Other.Consultant(FMSIB) $0.00
Mirw. Agency(NHFB) $0.00
Federal Aid x Agency(FMSIB) $0.00
Participation y. State(Freight) $0.00
Ratio for ON z. Total Const Cost Est.(q.thru y.) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Total Project Cost Estimate(h+p+z) $4,974,012.00 $762,988.00 $5,737,000.00 $1,065,079.00 $1,500,000.00 $3,171,921.00
DOT Form 140-041
Revised 2015