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Washington State
% Department of Transportation
Agency Grant County Public Works
Address
124 Enterprise Street
Ephrata, WA 98823
K20-058
Local Agency Agreement
CFDA No. 20.205
(Catalog or Federal Domestic Assistance)
Project No.
Agreement No.
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) 2 CFR Part 200, (4) 2 CFR Part 180 — certifying that the local agency is not
excluded from receiving Federal funds by a Federal suspension or debarment, (5) the policies and procedures promulgated by the
Washington State Department of Transportation, and (6) the federal aid project agreement entered into between the State and Federal
Govemment, 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 3 -NE Road Phase 2 (Q -NE to S -NE) Length 2,00
Termini 6.91 to 8.91
Description of Work
Work will include earthwork, drainage, HMA surface, traffic control and other items.
Project Agreement End Date December 31, 2023 Claiming Indirect Cost Rate
Proposed Advertisement Date July 13, 2020 []Yes ✓ No
Agency Official
By +"
Title �._ -Z
Board of County Commissioners
DOT Form 140-039
Revised 0312019
Washington State Department of Transportation
By
Director, Local Programs
Date Executed
Page 1
Type of Work
(t)
Estimated Tota!
Project Funds
Estimate u
(2)
Estimated Agency
Funds
n
(
EstimatedFederal
Funds
PE
a. A engy
%
b. Other
Federal Aid
c. Qther
Participation
d to
Ratio for PE
e. Total PE
Cost Estimate (a+b+c+d
0.00
0.00
0.00
Right of Way
f. Agency
%
a. Othor
Federal Aid
h. Other
Participation
L atate
Ratio for RW
1. Total
Cos -�
0.00
0.00
0.00
Construction
k. Contract
1,204,095.00
162,553.00
1,041,542.00
86.5
Other
m. Other
mn.
Federal Aid
Other
_
Participation
Agengy
112,532.00
15,192.00
97,340.00
Ratio for CN
Statep.
5,000.00
675.00
4,325.00
g. Total CN
Cost Estimate +m+n
1,321,627.00
178,420.00
1,143,207.00
r. Total P
Cost EsUmate
1,321,627.00
178,420.00
1,143,207.00
Agency Official
By +"
Title �._ -Z
Board of County Commissioners
DOT Form 140-039
Revised 0312019
Washington State Department of Transportation
By
Director, Local Programs
Date Executed
Page 1