HomeMy WebLinkAboutAdden 1 CAG-00-045 Adden #1-03
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Washington State lWal Agency Federal Aid
Department of Transportation Project Prospectus
Prefix Route ( )
Federal Aid F 3/12/2003
Project Number
Local Agency (WSDOT) Federal Employer 91-6001271
Project Number `Use Only Tax ID Number
A ency Federal Program Title
City of Renton ® 20.205 ❑ 20.209 ❑ Other
Project Title
Strander Boulevard/SW 27th Street Connection
P 'ect Termini From To
Vroest Valley Highway (SR-181) East Valley Road
From: To: Length of Project Award Type
1.35 miles ® Local ❑ Local Forces ❑ State ❑ Railroad
Federal Agency City Number County Number County Name WSDOT Region
® FHWA ❑ Others 1070 17 King 1
Congressional District Legislative Districts Urban Area Number TMA/MPO/RTPO
9 11 1 PSRC
ea�rest�andredpta ; ;a res uri reel 1 a (Netu ttac) Eh r
P.E. $861,923 $116,360 $745,563 4/1/03
R/W
Const.
Total $861,923 $116,360 $745,563
Roadway Width Num er o Lanes
36-44 feet 0 and 3 and 4 lanes
The existing facility, SW 27th Street, consists of a two-lane with a center left-turn lane to a four-lane
arterial from East Valley Road to Oakesdale Avenue SW. No roadway exists from Oakesdale Avenue SW
to West Valley Highway(SR-181)on SW 27th Street to connect to Strander Boulevard.
Roadway Width r of Lanes
®New Construction ❑3-R ❑2-R 60-70 feet Numbe 5 and 6
This project will connect Strander Blvd. in Tukwila to SW 27th St. in Renton, establishing a new arterial
roadway between West Valley Hwy. and Oakesdale Ave. SW, and widen the existing SW 27th St. between
Oakesdale Ave. SW and East Valley Rd. This phase will produce the following: Memorandums of
Agreement,NEPA/SEPA Environmental Impact Statement(as needed),preliminary railroad bridge design,
and the Hydraulic Report.
Local Agency Contact Person Title Phone
Sharon Griffin Program Development Coordinator 425.430.7232
Mailing Address City State Zip Code
1055 South Grady Way Renton WA 98055
Design Approval By ApproftV PdAMnty'LZ'� 'a�- �
(CA Agencies Only) Title po
Tran rtation Design Supervisor Date
DOT Form 140-101 EF Page 1 of 3
Revised 4/2000
• i
JA ency Project Title Date
�ity of Renton Strander Boulevard/SW 27th Street Connection 3/12/2003
Description Through Route Crossroad
®Principal Arterial- ®Principal Arterial
Federal ®Urban ❑Minor Arterial ®Urban ❑Minor Arterial
[3 Collector ❑Collector
Functional ❑Major Collector ❑Major Collector
Classification ❑Rural [3 Minor Collector ❑Rural ❑Minor Collector
❑Access Street/Road ❑Access Street/Road
Terrain ®Flat ❑Roll ❑Mountain ®Flat ❑Roll ❑Mountain
Posted Speed mP
Design Speed mP
Existing ADT
Design Year ADT
Design Year
Design Hourly Volume(DHV)
: �d� �ear�Xpelrtenee �.
Property Injury Accidents Fatal Accidents
Year Damage Number of Number of Number of Number of Total Number
of Accidents
Accidents Accidents Injuries Accidents Fatalities
ME
r
"� dl�;utril��er ofA�+;�ttliits r tltab]e�oml_ack�of ��i�i��h, ����iosed�K°"owe°�'� `t�
Preliminary Engineering Will Be Performed By Others Agency
Consultant and Agency 99 %. 1 %
Construction Will Be Performed By Contract Agency
Contractor 100 % %
®Final ❑Preliminary
® Class I-Environmental Impact Statement(EIS) ❑ Class II-Categorically Excluded(CE)
® Project Involves NEPA/SEPA Section 404 ❑ Projects Requiring Documentation
Interagency Agreement (Documented CE)
❑ Class III-Environmental Assessment(EA)
❑ Project Involves NEPA/SEPA Section 404
Interagency Agreement
Environmental Considerations
An environmental impact statement(EIS)will be completed for the project,as needed. The project is expected to
decrease SOV and increase HOV mode use,which in turn should reduce air pollution and roadway runoff
pollution,reduce energy use and avoid environmental impacts caused by building new SOV facilities. Some
wetland encroachment may occur due to widening; any wetland impacts be mitigated.
* A portion of the project will construct a new arterial connection;therefore,there is no existing accident history
for all of the proposed facilities.
DOT Form 140-101 EF Page 2 of 3
Revised 4/2000
i
Appendix 21.41 Prospectus Submittal Checklist
Local Agency: City of Renton Project Identification: Strander Blvd./SW 27th St.
Use this sheet as a cover sheet to the project prospectus package.Place an"X"in the right column to denote items
included. If not applicable,state N/A.Include in the cover letter a comment explaining the action taken on each
item as appropriate. Note later with an"L"if the information will be supplied at a future date.
Application:
1. Project Prospectus(Chapter 21.1) X
2. Vicinity Map �-
................................................................................................................................................
................................................................
3. Typical Roadway Section
4. Typical Bridge Section �-
5. Local Agency Agreement(Chapter 22)
6. TIP/STIP Inclusion(MPO/County/Agency,selected/limited to$) �-
Supporting Data:
7. Safety Checklist-A Supplement to the Project Prospectus for 2-R and 3-R Projects(Appendix 41.71) NA
g. Photos(Railroad Crossing,ER Event Sites, as required) �-
9. Deviation Request and Deviation Analysis Form to Justify Request(reference Appendix 41.72) Rf�
10. Environmental Considerations(Chapter 24)
a. Class II Categorically Excluded(CE)-Environmental Classification Summary(ECS)
b. Class III Environmental Assessment(EA)
c. Class I Environmental Impact Statement(EIS)
d. SEPA Checklist
e. NEPA/SEPA/Section 404 Interagency Working Agreement
£ Evolutionarily Significant Unit(ESU)Determination of Effect Concurrence
11. Hearing Notices(Chapter 43) �-
a. Transcript of Hearing
12. Location and Design Approval(Chapter 43)
13. Right-of-Way Requirements(Chapter 25)
a. Relocation Plan
b. Right-of-Way Plans
c. Right-of-Way Project Funding Estimate or True Cost Estimate
d. Request Right-of-Way Fund Authorization
14. Right-of-Way Certification(Chapter 25)
15. Agreements/Easements with Railroads,Utilities,and Other Agencies(Chapter 32)
16. FAA Notification(FAA Form 7460-1)(Chapter 24) N
17. Tied Bids(Chapter 44) Nth
Remarks:
t � • II
A envy Project Title Date
�ity of Renton Strander Boulevard/SW 27th Street Connection 3/12/2003 -
❑No Right of Way Required ®Right of Way Required
*All construction required by the
®
contract can be accomplished No Relocation El Relocation Required
within the existing right of way.
Description of Utility Relocation or Adjustments and Existing Major Structures Involved in the Project
Some utility adjustments are anticipated due to roadway widening.
FAA Involvement
Is any airport located within 3.2 kilometers(2 miles)of the proposed project? ❑ Yes ® No
Remarks
This project has been reviewed by the legislative body of the administration agency or agencies, or it's designee, and
is not inconsistent with the agency's comprehensive plan for community development.
Agency City of Renton
Date By
Mayor/Chairperson
ATTEST:
Michele Neumann, Deputy City Clerk
DOT Form 140-101 EF Page 3 of 3
Revised 4/2000 9
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SRI-
_ AGENCY CAG-00-045 Adden #1-03
'�� D
'Vl�ashington State epartment of"Transport•n Loc Agency Agreement_ _
Agency . City of Renton CFDA No. 20.205
(Catalog of Federal Domestic Assistance)
Address 1055 South Grady Way Project No. 5 1 7'Q L- 6F J Z?//(�� C0�
Renton, WA 98055 Agreement No. &A 55
For OSC WSDOT Use Only
The Local Agency having complied,or hereby agreeing to comply,with the terms and conditions set forth in(1)Title 23,U.S.Code Highways,(2)the regulations
issued pursuant thereto,(3)Office of Management and Budget Circulars A-102,A-87 and A-133,(4)the policies and procedures promulgated by the Washington
State Department of Transportation,and(5)the federal aid project agreement entered into between the State and Federal Government,relative to the above project,
the Washington State Department of Transportation will authorize the Local Agency to proceed on the project by a separate notification.Federal funds which are to
be obligated for the project may not exceed the amount shown herein on line r,column 3,without written authority by the State,subject to the approval of the Federal
Highway Administration.All project costs not reimbursed by the Federal Government shall be the responsibility of the Local Agency.
Project Description
Name Strander Boulevard/SW 27th Street Connection Length 1.2 miles
Termini West Valley Highway(SR-181)to East Valley Highway
Description of Work
This project will connect Strander Blvd. in Tukwila to SW 27th St. in Renton, establishing a new arterial roadway
between West Valley Hwy. and Oakesdale Ave. SW, and widen the existing SW 27th St. between Oakesdale Ave. SW
and East Valley Rd. This phase will produce the following: Memorandums of Agreement,NEPA/SEPA
Environmental Impact Statement(as needed),preliminary railroad bridge design, and the Hydraulic Report.
Estimate of Funding
Type of Work (�) (2) (3)
Estimated Total Estimated Agency Estimated
Project Funds Funds Federal Funds
PE a.Agency 10,000.00 1,350.00 8,650.00
86.5 % b.Other Consulitant 846,923.00 114,335.00 732,588.00
c. Other
Federal Aid d. State 5,00 . 0 .0 4,325. 0
Participation
Ratio for PE e.Total PE Cost Estimate(a+b+c+d) 861,923.00 116,360.00 745,563.00
Right of Way f.Agency
OX g. Other
h. Other
Federal Aid i. State
Participation
Ratio for RW j.Total R/W Cost Estimate(f+g+h+i)
Construction k. Contract
i. Other
m. Other
n. Other
o.Agency
Federal Aid p. State
Participation
Ratio for CN q.Total CN Cost Estimate(k+l+m+n+o+p) i
r.Total Project Cost Estimate(e+j+q) 1 861,923.001 116,360.00 745,563.00 J
Agency O ial Washington State Department of Transportation
By By
Title Jesse Tanner, 4. yOr Assistant Secretary for Highways and Local Programs
ATTEST:
Date Execute MY 0 7 2003
Michele Neumann, Deputy Uity er
DOT
Form 140-039 EF
Revised 10/01
onsfrtretion Method of Finano (Check Method Selected) •
State Ad and Award
I
❑Method A-Advance Payment-Agency Share of total construction cost(based on contract award)
❑Method B-Withhold from gas tax the Agency's share of total construction cost(line 4,column 2)in the amount of
$ at$ per month for months.
Local Force or Local Ad and Award
®Method C-Agency cost incurred with partial reimbursement
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 set
forth below.Adopted by official action on
August 5 2002 Resolution/Ordinance No. 3584
Provisions
I. Scope Of Work 1.Preliminary engineering.
The Agency shall provide all the work,labor,materials,and services 2.Right of way acquisition.
necessary to perform the project which is described and set forth in detail in 3.Project construction.
the"Project Description"and"Type of Work."
In the event that right of way acquisition,or actual construction of the road,for
When the State acts for and on behalf of the Agency,the State shall be which preliminary engineering is undertaken is not started by the closing of the
deemed an agent of the Agency and shall perform the services described and tenth fiscal year following the fiscal year in which the agreement is executed,the
indicated in"Type of Work"on the face of this agreement,in accordance with Agency will repay to the State the sum or sums of federal funds paid to the
plans and specifications as proposed by the Agency and approved by the State Agency under the terms of this agreement(see Section IX).
and the Federal Highway Administration.
When the State acts for the Agency but is not subject to the right of control The Agency agrees that all stages of construction necessary to provide the
by the Agency,the State shall have the right to perform the work subject to the initially planned complete facility within the limits of this project will conform to
ordinary procedures of the State and Federal Highway Administration. at least the minimum values set by approved statewide design standards
applicable to this class of highways,even though such additional work is financed
II. Delegation of Authority without federal aid participation.
The State is willing to fulfill the responsibilities to the Federal Government The Agency agrees that on federal aid highway construction projects,the
by the administration of this project.The Agency agrees that the State shall current federal aid regulations which apply to liquidated damages relative to the
have the full authority to carry out this administration.The State shall review, basis of federal participation in the project cost shall be applicable in the event the
process,and approve documents required for federal aid reimbursement in contractor fails to complete the contract within the contract time.
accordance with federal requirements.If the State advertises and awards the VI. Payment and Partial Reimbursement
contract,the State will further act for the Agency in all matters concerning the
project as requested by the Agency.If the Local Agency advertises and awards The total cost of the project,including all review and engineering costs and
the project,the State shall review the work to ensure conformity with the other expenses of the State,is to be paid by the Agency and by the Federal
approved plans and specifications. Government.Federal funding shall be in accordance with the Transportation
Equity Act for the 21st Century(TEA 21),as amended,and Office of
III. Project Administration Management and Budget circulars A-102,A-87 and A-133.The State shall
Certain types of work and services shall be provided by the State on this not be ultimately responsible for any of the costs of the project.The Agency
project as requested by the Agency and described in the Type of Work above. shall be ultimately responsible for all costs associated with the project which
In addition,the State will furnish qualified personnel for the supervision and are not reimbursed by the Federal Government.Nothing in this agreement
inspection of the work in progress.On Local Agency advertised and awarded shall be construed as a promise by the State as to the amount or nature of
projects,the supervision and inspection shall be limited to ensuring all work is federal participation in this project.
in conformance with approved plans,specifications,and federal aid The Agency shall bill the state for federal aid project costs incurred in
requirements.The salary of such engineer or other supervisor and all other conformity with applicable federal and state laws. The agency shall mimimize
salaries and costs incurred by State forces upon the project will be considered a the time elapsed between receipt of federal aid funds and subsequent payment of
cost thereof.All costs related to this project incurred by employees of the State incurred costs. Expenditures by the Local Agency for maintenance,general
in the customary manner on highway payrolls and vouchers shall be charged as administration,supervision,and other overhead shall not be eligible for federal
costs of the project. participation unless an indirect cost plan has been approved by WSDOT.
IV. Availability Of Records The State will pay for State incurred costs on the project.Following
All project records in support of all costs incurred and actual expenditures payment,the State shall bill the Federal Government for reimbursement of
kept by the Agency are to be maintained in accordance with local those costs eligible for federal participation to the extent that such costs are
government accounting procedures prescribed by the Washington State attributable and properly allocable to this project.The State shall bill the
Auditor's Office,the U.S.Department of Transportation,and the Washington Agency for that portion of State costs which were not reimbursed by the
State Department of Transportation.The records shall be open to inspection Federal Government(see Section IX).
by the State and Federal Government at all reasonable times and shall be 1. Project Construction Costs
retained and made available for such inspection for a period of not less than
three years from the final payment of any federal aid funds to the Agency. Project construction financing will be accomplished by one of the three
Copies of said records shall be furnished to the State and/or Federal methods as indicated in this agreement.
Government upon request.
V. Compliance with Provisions
The Agency shall not incur any federal aid participation costs on any
classification of work on this project until authorized in writing by the State
for each classification.The classifications of work for projects are:
DOT Form 140-039 EF 2
Revised 10/01
Methotl Az—The Agency will place with the ithin(20)days after X. Traffic Control,loing, Marking,and Roadway
'the execution of the construction contract,an advn the amount of the
Agency's share of the total construction cost based on the contract award. Maintenance
The State will notify the Agency of the exact amount to be deposited with the The Agency will not permit any changes to be made in the provisions for
State.The State will pay all costs incurred under the contract upon parking regulations and traffic control on this project without prior approval of
presentation of progress billings from the contractor.Following such the State and Federal Highway Administration. The Agency will not install or
payments,the State will submit a billing to the Federal Government for the permit to be installed any signs,signals,or markings not in conformance with the
federal aid participation share of the cost.When the project is substantially standards approved by the Federal Highway Administration and MUTCD. The
completed and final actual costs of the project can be determined,the State Agency will,at its own expense,maintain the improvement covered by this
will present the Agency with a final billing showing the amount due the State agreement.
or the amount due the Agency.This billing will be cleared by either a XI. Indemnity
payment from the Agency to the State or by a refund from the State to the
Agency. The Agency shall hold the Federal Government and the State harmless from
and shall process and defend at its own expense all claims,demands,or suits,
Method B— The Agency's share of the total construction cost as shown whether at law or equity brought against the Agency,State,or Federal
on the face of this agreement shall be withheld from its monthly fuel tax Government,arising from the Agency's execution,performance,or failure to
allotments.The face of this agreement establishes the months in which the perform any of the provisions of this agreement,or of any other agreement or
withholding shall take place and the exact amount to be withheld each month. contract connected with this agreement,or arising by reason of the participation
The extent of withholding will be confirmed by letter from the State at the of the State or Federal Government in the project,PROVIDED,nothing herein
time of contract award.Upon receipt of progress billings from the contractor, shall require the Agency to reimburse the State or the Federal Government for
the State will submit such billings to the Federal Government for payment of damages arising out of bodily injury to persons or damage to property caused by
its participating portion of such billings. or resulting from the sole negligence of the Federal Government or the State.
Method C—The Agency may submit vouchers to the State in the format No liability shall attach to the State or Federal Government except as expressly
prescribed by the State,in duplicate,not more than once per month for those provided herein.
costs eligible for Federal participation to the extent that such costs are XII. Nondiscrimination Provision
directly attributable and properly allocable to this project.Expenditures by The Agency shall not discriminate on the basis of race,color,national origin,
the Local Agency for maintenance,general administration,supervision,and or sex in the award and performance of any USDOT-assisted contract and/or
other overhead shall not be eligible for Federal participation unless claimed agreement or in the administration of its DBE program or the requirements of 49
under a previously approved indirect cost plan. CFR Part 26. The Agency shall take all necessary and reasonable steps under 49
The State shall reimburse the Agency for the Federal share of eligible CFR Part 26 to ensure nondiscrimination in the award and administration of
project costs up to the amount shown on the face of this agreement.At the USDOT-assisted contracts and agreements. The WSDOT's DBE program,as
time of audit,the Agency will provide documentation of all costs incurred on required by 49 CFR Part 26 and as approved by USDOT,is incorporated by
the project. reference in this agreement. Implementation of this program is a legal obligation
and failure to carry out its terms shall be treated as a violation of this agreement.
The State shall bill the Agency for all costs incurred by the State relative Upon notification to the Agency of its failure to carry out its approved program,
to the project.The State shall also bill the Agency for the federal funds paid the Department may impose sanctions as provided for under Part 26 and may,in
by the State to the Agency for project costs which are subsequently appropriate cases,refer the matter for enforcement under 18 U.S.C. 1001 and/or
determined to be ineligible for federal participation(see Section IX). the Program Fraud Civil Remedies Act of 1986(31 U.S.C.3801 et seq.).
VII. Audit of Federal Consultant Contracts
The Agency,if services of a consultant are required,shall be responsible The Agency hereby agrees that it will incorporate or cause to be incorporated
for audit of the consultant's records to determine eligible federal aid costs on into any contract for construction work,or modification thereof,as defined in the
the project. The report of said audit shall be in the Agency's files and made rules and regulations of the Secretary of Labor in 41 CFR Chapter 60,which is
available to the State and the Federal Government. paid for in whole or in part with funds obtained from the Federal Government or
borrowed on the credit of the Federal Government pursuant to a grant,contract,
An audit shall be conducted by the WSDOT Internal Audit Office in loan,insurance,or guarantee or understanding pursuant to any federal program
accordance with generally accepted governmental auditing standards as involving such grant,contract,loan,insurance,or guarantee,the required contract
issued by the United States General Accounting Office by the Comptroller provisions for Federal-Aid Contracts(FHWA 1273),located in Chapter 44 of the
General of the United States;WSDOT Manual M 27-50,Consultant Local Agency Guidelines.
Authorization,Selection,and Agreement Administration;memoranda of The Agency further agrees that it will be bound by the above equal
understanding between WSDOT and FHWA;and Office of Management opportunity clause with respect to its own employment practices when it
and Budget Circular A-133. participates in federally assisted construction work: Provided,that if the
If upon audit it is found that overpayment or participation of federal applicant so participating is a State or Local Government,the above equal
money in ineligible items of cost has occurred,the Agency shall reimburse opportunity clause is not applicable to any agency,instrumentality,or
the State for the amount of such overpayment or excess participation(see subdivision of such government.which does not participate in work on or under
Section 1X). the contract.
VIII. Single Audit Act The Agency also agrees:
The Agency,as a subrecipient of federal funds,shall adhere to the federal (1) To assist and cooperate actively with the State in obtaining the compliance
Office of Management and Budget(OMB)Circular A-133 as well as all of contractors and subcontractors with the equal opportunity clause and rules,
applicable federal and state statutes and regulations. A subrecipient who regulations,and relevant orders of the Secretary of Labor.
expends$300,000 or more in federal awards from all sources during a (2) To furnish the State such information as it may require for the supervision
given fiscal year shall have a single or visions of audit performed of such compliance and that it will otherwise assist the State in the discharge of
for that year in accordance with the provisions of OMB Circular A-133.
Upon conclusion of the A-133 audit,the Agency shall be responsible for its primary responsibility for securing compliance.
ensuring that a copy of the report is transmitted promptly to the State. (3) To refrain from entering into any contract or contract modification subject
to Executive Order 11246 of September 24,1965,with a contractor debarred
IX. Payment of Billing from,or who has not demonstrated eligibility for,government contracts and
The Agency agrees that if payment or arrangement for payment of any of federally assisted construction contracts pursuant to the Executive Order.
the State's billing relative to the project(e.g.,State force work,project
cancellation,overpayment,cost ineligible for federal participation,etc.)is (4) To carry out such sanctions and penalties for violation of the equal
not made to the State within 45 days after the Agency has been billed,the opportunity clause as may be imposed upon contractors and subcontractors by the
State shall effect reimbursement of the total sum due from the regular State,Federal Highway Administration,or the Secretary,of Labor pursuant to Part
monthly fuel tax allotments to the Agency from the Motor Vehicle Fund. II,subpart D of the Executive Order.
No additional Federal project funding will be approved until full payment is
received unless otherwise directed the Assistant Secretary for Highways and
Local Programs.
DOT Form 140-039 EF 3
Revised 10/01
' In addition;the Agency agrees that if it fails or s to comply with these XV. Venue for Clai&nd/or Causes of Action
undertakings,the State may take any or all of the following actions: For the convenience of the parties to this contract,it is agreed that any
(a) Cancel,terminate,or suspend this agreement in whole or in part; claims and/or causes of action which the Local Agency has against the State of
Washington,growing out of this contract or the project with which it is
(b) Refrain from extending any further assistance to the Agency under the concerned,shall be brought only in the Superior Court for Thurston County.
program with respect to which the failure or refusal occurred until satisfactory
assurance of future compliance has been received from the Agency;and XVI. Certification Regarding the Restrictions Of the Use
(c) Refer the case to the Department of Justice for appropriate legal Of Federal Funds for Lobbying
proceedings. The approving authority certifies,to the best of his or her knowledge and
belief,that:
XIII. Liquidated Damages (1) No federal appropriated funds have been paid or will be paid,by or on
The Agency hereby agrees that the liquidated damages provisions of 23 behalf of the undersigned,to any person for influencing or attempting to
CFR Part 630,Subpart 305,as supplemented,relative to the amount of influence an officer or employee of any federal agency,a member of Congress,
Federal participation in the project cost,shall be applicable in the event the an officer or employee of Congress,or an employee of a member of Congress in
contractor fails to complete the contract within the contract time. Failure to connection with the awarding of any federal contract,the making of any federal
include liquidated damages provision will not relieve the Agency from grant,the making of any federal loan,the entering into of any cooperative
reduction of federal participation in accordance with this paragraph. agreement,and the extension,continuation,renewal,amendment,or modification
XIV. Termination for Public Convenience of any federal contract,grant,loan,or cooperative agreement.
The Secretary of the Washington State Department of Transportation may (2) If any funds other than federal appropriated funds have been paid or will
terminate the contract in whole,or from time to time in part,whenever: be paid to any person for influencing or attempting to influence an officer or
employee of any federal agency,a member of Congress,an officer or employee
(1) The requisite federal funding becomes unavailable through failure of of Congress,or an employee of a member of Congress-in connection with this
appropriation or otherwise. federal contract,grant,loan,or cooperative agreement,the undersigned shall
(2) The contractor is prevented from proceeding with the work as a direct complete and submit the Standard Form-LLL,"Disclosure Form to Report
result of an Executive Order of the President with respect to the prosecution Lobbying,"in accordance with is irstnrctions.
of war or in the interest of national defense,or an Executive Order of the (3) The undersigned shall require that the language of this certification be
President or Governor of the State with respect to the preservation of energy included in the award documents for all subawards at all tiers(including
resources. subgrants,and contracts and subcontracts under grants,subgrans,loans,and
(3) The contractor is prevented from proceeding with the work by reason cooperative agreements)which exceed$100,000,and that all such subrecipiens
of a preliminary, shall certify and disclose accordingly.
p ary,special,or permanent restraining order of a court of
competent jurisdiction where the issuance of such order is primarily caused This certification is a material representation of fact upon which reliance was
by the acts or omissions of persons or agencies other than the contractor. placed when this transaction was made or entered into. Submission of this
certification as a prerequisite for making or entering into this transaction
imposed by Section 1352,Title 31,U.S.Code. Any person who fails to file the
(4) The Secretary determines that such termination is in the best interests required certification shall be subject to a civil penalty of not less than$10,000
of the State. and not more than$100,000 for each such failure.
Additional Provisions
DOT Form 140-039 EF 4
Revised 10/01