CN-550000-ASE76-W0020000.pdf

STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION

RAILROAD CHANGE ORDER NO. 2

725-090-04B

RAIL

OGC – 1/21

Financial Project Number Road Name or Number County Name Parcel & R/W

Number

FAP

Number

429251-1-57-01 I-75 (SR 93A) Hillsborough 1 (10075-ROPA) D720 031 B

A. 1. The CSX Transportation Inc Company is hereby authorized to observe the following changes in the plans and or specifications to the subject Railroad Agreement, and to perform such work accordingly, further described as:

PE, CEI, Flagging & Construction for Bridge Replacement Project over CSX Rail. This Change Order includes all work deemed necessary to complete this project.

Crossing # 621453G, RRMP: 874.10

2. Exhibit A, Exhibit B, and Exhibit C are attached to the Railroad Change Order and made part of the Original

Railroad Agreement.

3. The items of work covered by this Change Order are referenced to an Master Agreement of record dated

08/07/1972 and no supplemental Agreement is required.

Master Type: Crossing Surface Signals Preliminary Engineering

B. 1. The Railroad Relocation Work is to conform to that shown by the railroad adjustment plans as:

a. ATTACHED

b. X INCLUDED IN THE HIGHWAY CONTRACT PLANS

2. Reimbursement for the cost of this Railroad Work is to be in accord with the provisions set forth in Administrative Rule Chapter 14-57 as:

a. NONREIMBURSABLE – Section .011(2)

b. X REIMBURSABLE – Section .011(2)

(1) X Force Account Method

(2) Lump Sum Method

(3) Third Party Contract Method

C. ESTIMATED COST OF WORK DUE TO THIS CHANGE ORDER

ITEM

NO.

ITEM UNIT UNIT

PRICE

WORK ELIMINATED (-)

QTY AMOUNT

ADDITIONAL WORK (+)

QTY AMOUNT

1 PE, CEI & Flagging 1 50,000.00 1 856,319.00

Sub-Totals ………………………………………………………………… $50,000.00 $856,319.00

Net Cost of Construction Changes, this order ………………………... $ $806,309.00

Cost of Construction Changes, previously ordered ………………….. $ $50,000.00

Net Total Cost of Construction Changes, to date…………………………………………….. $856,319.00

Contract Amount ………………………………………………………………………………… $

Estimated Cost of Work Authorized, to date………………………………………………….. $856,319.00

Examined as to provisions and participating items of cost:

Recommended: Approved: Approved:

Date Date Date

District 7 Rail Administrator Kenneth Madden

Director of Transportation Development Richard Moss

Division Administrator N/A

Federal Highway Administration

DocuSign Envelope ID: B9267ACC-71A1-455A-B9D5-2425D03D4468

3/4/2022 | 2:55 PM EST 3/4/2022 | 3:03 PM EST

725-090-04B

RAIL

OGC – 1/21

EXHIBIT A

The Company shall:

1. utilize the U.S. Department of Homeland Security’s E-Verify system to verify the employment eligibility of all new employees hired by the Company during the term of the contract; and

2. include an express requirement in any subcontract that subcontractors performing work or providing services pursuant to the state contract utilize the U.S. Department of Homeland Security’s E-Verify system to verify the employment eligibility of all new employees hired by the subcontractor during the contract term.

EXHIBIT B

The Company shall:

1. adhere to all Buy America requirements (23 CFR 635.410) to ensure that all manufacturing processes of steel and iron occur in the United States; and

2. ensure that prefabricated items that contain steel must also comply with Buy America; and

3. provide Buy America certifications that include correct language, project information, and the material’s delivery date.

EXHIBIT C

The Company understands:

1. that while FHWA1273 does not apply to force account work performed by rail companies, FHWA-assistance is subject to Title VI (42 U.S.C. § 2000d et seq); and

2. requires appropriate assurances by providing an executed Title VI / Nondiscrimination Assurance, including Appendices A and E.

FLORIDA DEPARTMENT OF TRANSPORTATION

FUNDS APPROVAL

ASE76

3/2/2022

CONTRACT INFORMATION

FUNDS APPROVAL INFORMATION

FUNDS APPROVED/REVIEWED FOR ROBIN M. NAITOVE, CPA, COMPTROLLER ON 3/2/2022

Action: Task Work Order

Reviewed or Approved: APPROVED

Organization Code: 55074010706

Expansion Option: A5

Object Code: 563000

Amount: $806,319.00

Financial Project: 42925115701

Work Activity (FCT): 127

CFDA:

Fiscal Year: 2022

Budget Entity: 55150200

Category/Category Year: 088716/22

Amendment ID: W002

Sequence: 00

User Assigned ID: CO#2

Enc Line (6s)/Status: 0002/04

Total Amount: $806,319.00

Contract: ASE76

Contract Type: AC - RR CROSSING-PE/INSTAL (RR-XING/PE)

Vendor Name: CSX TRANSPORTATION, INC.

Vendor ID: F546000720022

Beginning Date of This Agreement: 07/18/2019

Ending Date of This Agreement: 12/31/2050

Contract Total/Budgetary Ceiling:

Method of Procurement: R - RAILROAD/UTILITIES AGREEMENT

Description: Preliminary Engineering review prior to construction

Page1 of 1

To: David.Grillo@dot.state.fl.us

ACCT. CODE : 709 - FL2560 Form Revision

10/04/21

ESTIMATE SUBJECT TO REVISION AFTER: 1/17/2023 DOT NO.:

621453G &

976908S

CITY: COUNTY: Hillsborough STATE: FL

ZONE: Florida SUB-DIV: Tampa Terminal MILE POST: A-874.10

AGENCY PROJECT NUMBER: FM# 429251-1

PRELIMINARY ENGINEERING:

212 Contracted & Administrative Engineering Services 30,000$

Subtotal 30,000$

CONSTRUCTION ENGINEERING/INSPECTION:

212 Contracted & Administrative Engineering Services 185,000$

Subtotal 185,000$

FLAGGING SERVICE: (Contract Labor)

70 Labor (Conductor-Flagman) 0 Days @ -$ -$

50 Labor (Foreman/Inspector) 430 Days @ 504.00$ 216,720$

70 Additive 137.00% (Transportation Department) -$

50 Additive 160.00% (Engineering Department) 346,752$

Subtotal 563,472$

SIGNAL & COMMUNICATIONS WORK: -$

TRACK WORK: -$

PROJECT SUBTOTAL: 778,472$

900 CONTINGENCIES: 10.00% 77,847$

PROJECT TOTAL: ***************************************************** 856,319$

CURRENT AUTHORIZED BUDGET: ***************************************************** 50,000$

TOTAL SUPPLEMENT REQUESTED: ***************************************************** 806,319$

DIVISION OF COST:

Agency 100.00% 806,319$

Railroad 0.00% -$

Office of Chief Engineer Public Projects--Jacksonville, Florida

J Brangenberg - STV Approved by: KSW CSXT Public Project Group

DATE: 01/17/22 REVISED: 01/00/00 DATE: 02/24/22

Estimated prepared by:

This estimate has been prepared based on site conditions, anticipated work duration periods, material prices, labor rates, manpower and resource availability, and other factors known as of the date prepared. The actual cost for CSXT work may differ based upon the agency's requirements, their contractor's work procedures, and/or other conditions that become apparent once construction commences or during the progress of the work

Tampa

DESCRIPTION: I-75 Deck Replacement and new Ramp B over CSXT. Flagging from March 2022 through Sept. 2023

(19 months).

ACCT. CODE : 709 - FL2560 Form Revision

Pub EB - FL EB3 (FL) 10/04/21

BUY AMERICA

ESTIMATE SUBJECT TO REVISION AFTER: 1/17/2023 DOT NO.: 621453G & 976908S

CITY: COUNTY: Hillsborough STATE: FL

ZONE: Florida SUB-DIV: Tampa Terminal MILEPOST: A-874.10

DRAWING NO.: __ DRAWING DATE: __

AGENCY PROJECT NUMBER: FM# 429251-1

PRELIMINARY ENGINEERING:

Contracted & Administrative Engineering Services 30,000$

Subtotal 30,000$

CONSTRUCTION ENGINEERING/INSPECTION:

Contracted & Administrative Engineering Services 185,000$

Subtotal 185,000$

FLAGGING SERVICE: (Contract Labor)

Labor (Conductor-Flagman) 0 Days @ -$

Labor (Foreman/Inspector) 430 Days @ 504.00$ 216,720$

Additive 137.00% (Transportation Department) -$

Additive 160.00% (Engineering Department) 346,752$

Subtotal 563,472$

COMMUNICATIONS WORK:

Temporary (Details Attached) -$

Permanent (Details Attached) -$

Subtotal -$

TRACK: LABOR

Traffic Control 0 MAN-HRS -$

Remove Existing Crossing 0 MAN-HRS -$

Renew Cross Ties 0 MAN-HRS -$

Renew Rail 0 MAN-HRS -$

Install OTM 0 MAN-HRS -$

Install Field Welds 0 MAN-HRS -$

Install Geo-Textile Fabric 0 MAN-HRS -$

Install Sub-Drains 0 MAN-HRS -$

Install Ballast 0 MAN-HRS -$

Line and Surface 0 MAN-HRS -$

Install Crossing Materials 0 MAN-HRS -$

Install Bituminous Pavement 0 MAN-HRS -$

______________________ 0 MAN-HRS -$

______________________ 0 MAN-HRS -$

______________________ 0 MAN-HRS -$

Clean-Up 0 MAN-HRS -$

Additive 160.00% -$

Subtotal -$

TRACK: MATERIAL BUY AMERICA

Cross Ties, Main Line 0 EA -$

Cross tie - pre-plated Not to be used for Public Projects 0 EA -$

DESCRIPTION: I-75 Deck Replacement and new Ramp B over CSXT. Flagging from March 2022 through Sept. 2023 (19 months).

Tampa

Cross-tie - Borate 0 EA -$

Crossties, 10' Length 0 EA -$

Tie plates 0 EA -$

Rail, 136RE, New 0 LF -$

Misc. OTM 0 LOT -$

Geo-Textile Fabric 0 RL -$

Sub-Drains 0 LF -$

Ballast - Car load 0 NT -$

Ballast - Trucked in 0 NT -$

Field Welds 0 EA -$

______________________ 0 ___ -$

______________________ 0 ___ -$

Concrete Full Width 0 TF -$

Concrete/Rubber Xing (CSX) 0 TF -$

Rubber Crossing, Full Depth 0 TF -$

Timber/Asphalt Crossing (CSX Standard) 0 TF -$

Bituminous Material 0 NT -$

Sales Tax on Material 7.00% -$

Material Handling 15.00% -$

Subtotal -$

CONTRACT:

Asphalt Paving (In Place) 0 NT -$

Disposal of Waste Materials 0 TF -$

Maintenance of Traffic 0 DAY -$

Subtotal -$

EQUIPMENT RENTAL: CSX vehicle and equipment rental included in overhead percentage -$

Subtotal Use for extraordinary rental or unique Service Contract -$

WORK TRAIN: 0 DAY -$

Subtotal -$

SALVAGE:

Rail 0 NT -$

OTM 0 NT -$

Subtotal -$

SIGNAL WORK: BUY AMERICA

Material - Field & Consumables -$

Material - Sales Tax -$

Material - Shop -$

Construction Labor -$

Shop Labor -$

RR Engineering,Preliminary -$

RR Engineering,Construction -$

Additives to Construction Labor -$

Additives to Shop Labor -$

Additives to Engineering -$

Equipment Expense -$

Waste Management -$

Contract Engineering -$

Freight -$

AC Power Service -$

Salvage -$

Other -$

Subtotal -$

PROJECT SUBTOTAL: 778,472$

CONTINGENCIES: 10.00% 77,847$

PROJECT TOTAL: ***************************************************** 856,319$

CURRENT AUTHORIZED BUDGET: ***************************************************** 50,000$

TOTAL SUPPLEMENT REQUESTED: ***************************************************** 806,319$

DIVISION OF COST:

Agency 100.00% 806,319$

Railroad 0.00% -$

October 7, 2021 - Office of Director - CSXT Public Projects, Jacksonville, Florida

Estimated prepared by: J Brangenberg - STV Approved by: KSW Project Manager - Public Projects

DATE: 01/17/22 REVISED: DATE: 02/24/22

This estimate has been prepared based on site conditions, anticipated work duration periods, material prices, labor rates, manpower and resource availability, and other factors known as of the date prepared. The actual cost for CSXT work may differ based upon the agency's requirements, their contractor's work procedures, and/or other conditions that become apparent once construction commences or during the progress of the work

If ther please describe here:

Not Applicable _____ Florida Single Audit _____ CSX is not subject to the Single Audit.

Federal Audit _____ (Florida Statute 215.97)

Single Audit Status ¹ ² :

CSFA # ³

5) Agency

*Phone:

*Email

Date:

Recipient. The Federal Sub-Recipient and Vendor Determination Checklist is enclosed for reference.

² CFDA Number: If CSX is subject to the Federal Single Audit, please provide the Catalog of Federal Domestic Assistance (CFDA) number.

³ CSFA Number: If CSX is subject to the Florida Single Audit, please provide the Catalog of State Financial Assistance (CSFA) number.

*Please Note: Per 2 CFR 200.425(a), CSXT can recover Federal Audit costs directly through this project.

For Audit related questions, contact GBCompliance@csx.com.

*4) Single Audit Type: Please advise if the project is subject to single audit requirements by completing the appropriate box below (complete only one box).

CSX TRANSPORTATION – GOVERNMENT BILLING DEPT

NEW PROJECT FORM

To ensure compliance with Federal requirements, please provide the following information so that CSXT may accurately and appropriately setup and handle the necessary accounting associated with the proposed project.

*1) Is the project Federally Funded?

*2) Funding Source: If the project is funded by multiple sources please provide the approximate anticipated percentage of the total project cost to be paid by each source.

*3) Project Requirements

Note: This audit is not related to the project specific audit performed by your agency.

Vendor (CFDA # Not Required)

Recipient (CFDA # )

Sub-Recipient (CFDA # )

Signature of Applicant:

Signature of Applicant Please sign, print , and e-mail this form to the authorized CSX representative

*Legal Address (1):

*Name: Federal Award #:

Date of Award:

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