CN-550000-ASG70-00010000.pdf

Florida Department of Transportation

RON DESANTIS

GOVERNOR

801 N Broadway Avenue

Bartow, FL 33830

KEVIN J. THIBAULT, P.E.

SECRETARY

Safety, Innovation, Mobility, Attract, Retain & Train www.fdot.gov

April 7, 2020

Mr. Scott Willis

CSX Public Projects Manager

500 Water Street J-301

Jacksonville, FL 32202

RE: FPID: 447110-1-57-01, SR 15 (US 441) Signal Preemption for

FPID: 440791-1-52-01, Design Build Push Button Task IV

Crossing 628062L, RR MP SX 908.78

Change Order 1 and Plans Submittal

Mr. Willis, Enclosed is Change Order 1 for SR 15 (US 441) which crosses at grade crossing 628062L. As part of an upcoming Design Build Push Button (DBPB) task, FDOT is constructing a new traffic signal north of this crossing at NW 9th Street. As such we wish to connect for preemption at crossing 628062L. The project would install a pull box outside of CSX right of way for connection by CSX Signal Forces.

Included with the change order is a copy of the plans for review and comment prior to construction.

If you have any questions or concerns, feel free to contact me at 863-519-2739.

Sincerely, W. Kyle Green

Design/Construction Coordinator GEC

ATKINS on behalf of FDOT

Enclosure cc: Arlene Barnes, District Rail Administrator, FDOT

DocuSign Envelope ID: A61433D4-9CA7-4AE0-A7C1-F030A4AC0B7C

STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION

725-090-04B

RAIL

OGC – 03/15

RAILROAD CHANGE ORDER NO. 1

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

447110-1-57-01 SR 15 (US 441) Okeechobee 2 (91020-2201) N/A

A. 1. The CSXT, 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:

Preliminary engineering review and flagging coverage for crossing 628062L (RR MP SX 908.78) to provide signal pre-emption connection in coordination for new traffic signal installation on SR 15 (US 441) and NW 9th

Street. This change order includes any other work deemed necessary to complete the project.

2. Exhibit A is attached to the Railroad Change Order and made a 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. X ATTACHED

b. 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

PE Review and Flagging 50,000.00

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

Net Cost of Construction Changes, this order ………………………... $ $50,000.00

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

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

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

Estimated Cost of Work Authorized, to date………………………………………………….. $50,000.00

Examined as to provisions and participating items of cost:

Recommended: Approved: Approved: N/A Date Date Date

Exempt From FHWA Review Arlene G. Barnes

District Rail Administrator Paul A. Simmons

Modal Development Administrator Division Administrator

N/A

Federal Highway Administration

4/7/2020 | 2:31 PM EDT 4/7/2020 | 2:35 PM EDT

725-090-04B

RAIL OFFICE

OGC – 03/15

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.

FLORIDA DEPARTMENT OF TRANSPORTATION

FUNDS APPROVAL

ASG70

3/13/2020

CONTRACT INFORMATION

FUNDS APPROVAL INFORMATION

FUNDS APPROVED/REVIEWED FOR ROBIN M. NAITOVE, CPA, COMPTROLLER ON 3/13/2020

Action: Task Work Order

Reviewed or Approved: APPROVED

Organization Code: 55074010706

Expansion Option: A5

Object Code: 563000

Amount: $50,000.00

Financial Project: 44711015701

Work Activity (FCT): 127

CFDA:

Fiscal Year: 2020

Budget Entity: 55150200

Category/Category Year: 088716/20

Amendment ID: W001

Sequence: 00

User Assigned ID: CO#1

Enc Line (6s)/Status: 0001/04

Total Amount: $50,000.00

Contract: ASG70

Contract Type: AA - RR SIGNALS-PE/INSTAL (RR-SIG/PE)

Vendor Name: CSX TRANSPORTATION, INC.

Vendor ID: F546000720022

Beginning Date of This Agreement: 02/20/2020

Ending Date of This Agreement: 12/31/2050

Contract Total/Budgetary Ceiling:

Method of Procurement: R - RAILROAD/UTILITIES AGREEMENT

Description: Preemption Connection to DBPB TWO 15 Signal Installation

Page1 of 1

To: Kyle.Green@dot.state.fl.us

55014010106

Revised 1-11-16 Page 1 of 2

CSX TRANSPORTATION – GOVERNMENT COMPLIANCE DEPT

NEW PROJECT FORM

Okeechobee, Okeechobee County, FL Forest Lake Blvd. signal improvements, 628062L, SX-908.78

Agency Project Number 447110-1-57-01, contract ASG70 To ensure compliance with government reporting requirements, please provide the following information so that CSXT may accurately and appropriately setup and oversee the necessary accounting associated with the proposed project.

Please enter the below requested information and return this form to Eva Olsen (Eva_Olsen@csx.com) for handling with

CSXT:

1) Is the project Federally Funded? Yes No

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.

____ American Recovery and Reinvestment Act (ARRA)

____ Federal Emergency Management Agency (FEMA)

____ Federal Railroad Administration (FRA)

____ Federal Transit Administration (FTA)

____ Federal Highway Administration (FHWA)

____ Transportation Investment Generating Economic Recovery (TIGER)

____ Section 130

____ City ____ County __X__ State

____ Other (__________________________________)

3) Project Requirements ____ Procurement Restrictions (e.g. Buy America(n), Buy State, US Steel)

____ Procurement Restrictions Waiver

____ Suspended / Debarred

____ Davis-Bacon Act

_X__ E-Verify

____ Other (__________________________________)

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

Not Applicable __X__ Federal Audit _____ Florida Single Audit _____

Please specify:

____ OMB Circular A-133 ____ Uniform Guidance

(Florida Statute 215.97)

CSXT is not subject to the OMB A- 133, Uniform Guidance, and Florida Single Audit. Audit Status1, 2: CSFA# 3 __________

____ Vendor (CFDA# Not Required)

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

____ Recipient* (CFDA# Required _____)

____ Sub-Recipient* (CFDA# Required

1 Audit Status: If CSXT is subject to Federal Audit, please advise if CSXT is considered a Vendor (Contractor), Sub- Recipient or Recipient. The Federal Sub-Recipient and Vendor Determination Checklist is enclosed for reference.

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

3 CSFA Number: If CSXT 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.

5) Agency Contact and Federal Award Information

Name W. Kyle Green Phone 863-519-2386

Address 801 N. Broadway Avenue Email Kyle.Green@dot.state.fl.us

Bartow, FL 33803 Fed Award # ___________________________

Date of Award ___________________________

Revised 1-11-16 Page 2 of 2

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Crossing Number: 628062L - N PARROTT AVE Railroad Operating Company: CSX TRANSPORTATION, INC.

Local Street Name: N PARROTT AVE Crossing Status: OPEN--TRACK ACTIVE

Last Updated by Kyle Green on 4/6/2020 2:38:19 PM Safety Index Rank: 52

Railroad Responsible FRA Field

Crossing General 2 log entries available. View Log

Roadway Location

District 1 County (I.3) Okeechobee City (I.4) Okeechobee

IN CITY

NEAR CITY

State Route Number (I.6) SR-15

County Route Number (I.6) U.S. Route Number (I.6) US-441

Local Street Name (I.5) N PARROTT AVE

Railroad Local Street Name Block Number (I.5) 814

FDOT Bridge Number

Latitude (I.27) 27.251773

Longitude (I.28) -80.8299201

View location in Google Maps

Latitude/Longitude Source (I.29)

ACTUAL ESTIMATED

Is Crossing ID Posted? YES NO Roadway ID Number 91 / 92900 / 1

Highway Milepoint 907.778

Humped Crossing

Railroad Ownership

Railroad Operating Company CSX TRANSPORTATION, INC.

Parent Company CSX TRANSPORTATION, INC.

Crossing Owner Railroad Contact Phone Number 904-359-3100 Railroad Emergency Contact Number

800-232-0144

Roadway Ownership

Crossing Status OPEN--TRACK ACTIVE

OPEN--TRACK INACTIVE

CLOSED--TRACK REMOVED

CLOSED--ROADWAY REMOVED

Crossing Type (I.17) PUBLIC PRIVATE Public Access Allowed?

(I.20)

YES NO UNKNOWN

Crossing Purpose (I.18) Highway Vehicle Crossing Position vs.

Highway (I.19)

AT GRADE RR UNDER RR OVER

Maintenance Responsibility STATE COUNTY CITY PRIVATE State Annual Maintenance Percentage

Highway System (V.1)

Functional Classification of Road at Crossing (V.2)

Is the crossing on the State Highway System? (V.3)

YES NO

Regularly used by Hazmat Vehicles?

Yes No

Regular Emergency Services Route? (V.10)

Yes No

Is the crossing on the Strategic Intermodal System (SIS)?

YES NO

Roadway Agency Contact Phone Number (I.35)

850-414-4907

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800 N Parrott Ave, Okeechobee, FL 34972

752C+P2 Okeechobee, Florida

27°15'06.4"N 80°49'47.7"W

Crossing 628062L, FPID 447110-1 New Signal Preemption Connection

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