13-102.00 WSDOT: Argonne Mullan Corridor Safety ProjectAGENCY
of
oitan Local Agency Agreement Supplement
Agency
Supplement Number
City of Spokane Valle
(S)
Previous
A reement/Su I.
Federal Aid Project Number
Agreement Number
CFDA No. 20.205
HSIP -0005 325
LA -7846
(Catalop of federal Domestic Assistance
The Local Agency requests to supplement the agreement entered Into and executed on December 19, 2012
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 Argonne - Mullan Safety Project length N/A
Termini See attached vicinity map
Description of Work ® No Change
Reason for Supplement
To authorize construction funds.
Does this change require additional Rlght of Way or Easements? ❑ Yes ® No
T Of Work
y�
Estimate of Funding
(S)
Previous
A reement/Su I.
(2)
Supplement
(3)
Estimated Total
Pro ect Funds
(4)
Estimated Agency
Funds
(5)
Estimated
Federal Funds
PE a. Agency
100 % b. Other
8,720.00
8,720.00
0.00
8,720.00
c. Other
Federal Aid
d. State
11000.00
1,000.00
0.00
1,000.0
Participation
Ratio for PE e. Total PE Cost Estimate (a +b +c +d)
9,720.00
9,720.00
9,720.00
Right of Way f. Agency
.Other
Federal Aid h. Other
Participation
Ratio for RW I. State
1. Total R!W Cost Estimate (f +g +h +l)
Construction k. Contract
I. Other -County
5,686.00
5,686.00
5,686.00
m. Other - Equipment
1,497.00
1,497.00
1,497.00
100 %
Federal Aid n. Other - Materials
Participation o. Agency
57,720.00
57,720.00
57 720.0
3,240.00
3240.00
3,240.00
Ratio for CN , State
2,655,00
2,6 5.00
2 655.00
q. Total CN Cost Estimate k+i+m+n
70 798.00
70 798.00
7079800
r. Total Pro ect Cost Estimate e
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
By
Title f ll!Q -1 k!r LL>
// ?,
DOT Form 140.041 EF
Revised 0312011
Washington State lrleparfiment of Transp ation
By
Director of Highways and Loco Programs
Date Executed
JUN 2 0 2013
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