13-100.00 WSDOT: Sullivan UP Tracks Concrete Replacement� Washington�e
AGENCY
�I/ Department of Transportation Local Agency Agreement Supplement
Agency
Supplement Number
City of Spokane Valley
1
Federal Aid Project Number
Agreement Number
CFDA No. 20.205
BHM -4103 6600
LA -7913
(Catalog of Federal Domestic Assistance
The Local Agency requests to supplement the agreement entered into and executed on March 5, 2013
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 Sullivan UP Tracks UC (S Bound) Length 0.03 mi.
Termini (d UPRR
Description of Work ® No Change
Reason for Supplement
Request release of construction funds
Does this change require additional Right of Way or Easements? ❑ Yes ® No
Type of Work
Estimate of Funding
(1)
Previous
A reement/Su I.
(2)
Supplement
(3)
Estimated Total
Project Funds
(4)
Estimated Agency
Funds
(5)
Estimated
Federal Funds
PE a. Agency
6,750.00
6,750.00
6,750.00
100 % b. Other Consultant
33,600.00
33,600.00
33,600.00
c. Other
Federal Aid d. State
Participation
1,000.00
1,000.00
1,000.00
Ratio for PE e. Total PE Cost Estimate (a +b +c +d)
41350.00
41,350.00
41,350.00
Right of Way f. Agency
.Other
Federal Aid h. Other
Participation
Ratio for RW i. State
j. Total RAN Cost Estimate (f +g +h +i)
Construction k. Contract
193,204.00
193,204.00
193,204.00
I. Other Consultant Services
10,972.00
10,972.00
10,972.00
100 % m. Other
Federal Aid n. Other
Participation o. Agency
28,000.00
28,000.00
28,000.00
Ratio for CN p. State
2,000.00
2,000.00
2,000.00
q. Total CN Cost Estimate k+l+m+n+o
234 176.00
234 176.00
1
234 176.00
r. Total Project Cost Estimate e'
41,350.00
234,176,001
7 2
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 Official Washington
�% / / Washington Stake epartment o ransportation
BY ?�r�r.�/ "�!/� 7'12 ! / / 3 BY t
Title Puhlic Works Director Director of Highways arfd Local Programs MAY 3 0 2013
Date Executed
DOT Form 140 -041 EF
Revised 03/2011
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