CN-550000-ASF88-W0020000.pdf

STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION

RAILROAD CHANGE ORDER NO. 1

725-090-04B

RAIL

OGC – 1/21

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

Number

FAP

Number

43982615701 SR 555 at Spirit Lake Road Polk 1 (16030-6106) N/A

A. 1. The Florida Midland Railroad, 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:

Flashing Lights and Gates relocations/reinstallation to accommodate Phase 2 thru Phase 9 of roadway construction work at Railroad Crossing No. 623052N, RRMP No. AW 846.78, and Railroad Crossing No.

623053V, RRMP No. AW 846.80, SR 555 (US 17) at Spirit Lake Road, Bartow, Polk County, Florida. To include any other Railroad work deemed necessary for this project.

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

2-19-1988 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

Material, Labor, Equipment 210,000.00

Sub-Totals ………………………………………………………………… $ $210,000.00

Net Cost of Construction Changes, this order ………………………... $ $210,000.00

Cost of Construction Changes, previously ordered ………………….. $ $0.00

Net Total Cost of Construction Changes, to date…………………………………………….. $210,000.00

Contract Amount ………………………………………………………………………………… $0.00

Estimated Cost of Work Authorized, to date………………………………………………….. $210000.00

Examined as to provisions and participating items of cost:

Recommended: Approved: Approved: N/A

Date

Exempt From FHWA Review

District Rail Administrator

Modal Development Administrator

Division Administrator

N/A

Federal Highway Administration

DocuSign Envelope ID: 9535F082-D713-419F-A099-90605571BDD2

1/27/2021 | 11:29 AM EST 1/27/2021 | 1:56 PM EST

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

ASF88

1/27/2021

CONTRACT INFORMATION

FUNDS APPROVAL INFORMATION

FUNDS APPROVED/REVIEWED FOR ROBIN M. NAITOVE, CPA, COMPTROLLER ON 1/27/2021

Action: Task Work Order

Reviewed or Approved: APPROVED

Organization Code: 55014010106

Expansion Option: A5

Object Code: 563000

Amount: $210,000.00

Financial Project: 43982615701

Work Activity (FCT): 127

CFDA:

Fiscal Year: 2021

Budget Entity: 55150200

Category/Category Year: 088716/21

Amendment ID: W003

Sequence: 00

User Assigned ID: CO#1

Enc Line (6s)/Status: 0003/04

Total Amount: $210,000.00

Contract: ASF88

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

Vendor Name: FLORIDA MIDLAND RAILROAD CO, IN

Vendor ID: F581758851001

Beginning Date of This Agreement: 11/13/2019

Ending Date of This Agreement: 11/13/2029

Contract Total/Budgetary Ceiling:

Method of Procurement: R - RAILROAD/UTILITIES AGREEMENT

Description: 439826- Florida Midland, US 17, Polk County

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To: Lisa.Petro@dot.state.fl.us