CN-550000-ASJ22-W0010000.pdf

STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION

RAILROAD CHANGE ORDER NO. 1

725-090-04B

RAIL

OGC – 10/20

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

Number

FAP

Number

440251-1-57-01 SR 60/Brandon Blvd HILLSBOROUGH 10110-2111 N/A

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:

Preliminary Engineering, CEI & Flagging Services. This Change Order covers paving activities within

CSX ROW and all other minor repairs within and adjacent to the CSX ROW

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

09/15/1998 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 Preliminary Engineering 1 20,000.00 CEI & Flagging Services

Sub-Totals ………………………………………………………………… $ $20,000.00

Net Cost of Construction Changes, this order ………………………... $ $20,000.00

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

Net Total Cost of Construction Changes, to date…………………………………………….. $20,000.00

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

Estimated Cost of Work Authorized, to date………………………………………………….. $20,000.00

Examined as to provisions and participating items of cost:

Recommended:

Approved:

Approved:

Date

District Rail Administrator Steve Love

Director of Transportation Development Richard Moss

Division Administrator N/A

Federal Highway Administration

DocuSign Envelope ID: F5E088B6-1292-4B52-851E-B05444D279BD

12/9/2020 | 3:45 PM EST 12/9/2020 | 3:52 PM EST

KNPBAGD

Text Box Exempt from FHWA Review

KNPBAGD

Text Box x

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.

To: Kenneth.Madden@dot.state.fl.us

FLORIDA DEPARTMENT OF TRANSPORTATION

FUNDS APPROVAL

ASJ22

8/3/2020

CONTRACT INFORMATION

Contract: ASJ22

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

Method of Procurement: R - RAILROAD/UTILITIES AGREEMENT

Vendor Name: CSX TRANSPORTATION, INC.

Vendor ID: F546000720022

Beginning Date of This Agreement: 07/30/2020

Ending Date of This Agreement: 12/31/2050

Contract Total/Budgetary Ceiling:

Description: CO1 PE and flagging

FUNDS APPROVAL INFORMATION

FUNDS APPROVED/REVIEWED FOR ROBIN M. NAITOVE, CPA, COMPTROLLER ON 8/3/2020

Action: Task Work Order

Reviewed or Approved: APPROVED

Organization Code: 55074010706

Expansion Option: A8

Object Code: 563000

Amount: $20,000.00

Financial Project: 44025115701

Work Activity (FCT): 127

CFDA:

Fiscal Year: 2021

Budget Entity: 55150200

Category/Category Year: 088797/21

Amendment ID: W001

Sequence: 00

User Assigned ID: CO#1PE

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

Total Amount: $20,000.00

Page1 of 1 mailto:Kenneth.Madden@dot.state.fl.us

_____ Other

*By signing this form you are authorizing CSXT to incur costs and bill against this project. Should the project be canceled, CSXT will bill the Project Sponsor for the incurred costs. In the event the Project Sponsor is unresponsive for 90 days or more, the project will be closed;

and the Project Sponsor will be final billed for all project costs incurred.

Project Location:

Sponsor Project Ref.

Number (If applicable)

Signature of Applicant Date:

Project Description:

CSX is subject to a state single audit as a recipient or subrecipient of funds (The only states that should apply here are FL or NC. FL must provide completed form DFS-A2-NS.)

If you selected Other, please describe below.

Name and Title of Applicant

Please describe the funding source for this project (i.e. INFRA, Section 130, State, County, Private, etc.).

Contact Name:

Phone:

E-mail:

State Suspended and Debarred (Note - All federally funded projects are already monitored against the federal sus/deb listings)

Davis-Bacon (Please only check this box if this is a construction project that may be performed by an outside party)

Project Sponsor Bill To Information

Agency - Sponsor:

Billing Address:

Project Requirements:

CSX TRANSPORTATION – NEW PROJECT INITIATION FORM

Please provide the following information so that CSXT is able to accurately and appropriately process the project setup and billing.

Is this project associated with Federal funds?

Is this project associated with State funds?

Additional procurement restrictions (Please describe below)

Buy America

Form Revision 9/6/19

NO

YES

Rollup Rail Safety Hazard Elimination - RHH

Florida Department of Transportation District 7

11201 N. NcKinley Drive MS 7-500, Tampa, Fl 32612-6456

Steve C. Love, District Rail Administrator

813-975-6402

Steve.Love@dot.state.fl.us

SR 60/Brandon Blvd from Valrico Rd to Turkey Creek Rd

Preliminary Engineering Review, CEI & Flagging Services. This Project Covers paving within CSX ROW and all other minor repairs within and adjacent to CSX ROW.

440251-1-57-01

Steve C. Love, District Rail Administrator

12/9/2020 | 3:45 PM EST

VALRICO

Highway Speed:

Crossing Angle:

Street Types:

Thru Lanes:

Aux Lanes:

Hazmat Route?

Emergency Services Route?

Emergency Notification Signs:

Crossbuck(4x4 post):

Stop Sign:

Yield Sign:

Low Ground Clearance Signs:

Exempt Signs:

Trespass Signs:

W10-1

W10-2

W10-3

W10-4

W10-11

W10-12

R3-1a

R3-2a

R8-8

R8-9

R8-10

R8-10a

R10-6

R10-6a

R11-2

R15-2P

R15-6

R15-6a

R15-7

R15-7a

R15-8

Pvt Crossing

Look Out

R8-8 w/Beacon

W3-1

W3-3

W8-1

W10-8

W10-9

W10-9P

W10-11a

W10-11b

W10-13P

W10-14P

W10-14aP

W10-15P

Slow

W10-1w/Beacon

LED Signs

Surface Installment Date:

Surface Type:

Surface Condition:

Approach:

Vehicle Reaction:

Driver Reaction:

Rail/Pad Movement:

Maintenance Responsibility:

Roadway Paved:

Tracks run down street?

Sidewalks on Crossing Approach?

Sidewalks Thru Crossing?

Crossing illuminated?

Commerical Power?

Alternative Power?

Number of Bells:

Post Mounted Flashing Lights:

Roadway Gate Count:

Pedestrian Gate Count:

Gates:

Cantilevered Flashing Over Traffic:

Cantilevered Flashing Not Over Traffic:

Intersecting Roadway?

Signalized?

Interconnection:

Preemption:

Traffic Pre-Signals?

8" Count:

12" Count:

LED Count:

Train Speed Range:

Max Time Table Speed:

Day Thru/Switch:

Night Thru/Switch:

Train Service:

Passenger Count/Day:

Train Count Date:

Main Tracks:

Train Signals?

Train Signal Proximity:

Train Detection:

Rank 2018:

Rank 2017:

Rank 2016:

SR No.:

CR No.:

US No.:

Latitude:

Longitude:

RR Company:

Division Name:

Subdivision Name:

Branch Name:

RR Milepost:

Recommended Warning Device:

Incident History: 04/2018

IN CITY

PUBLIC AT GRADE Residental

30-59 DEG

NO

YES

YES

NO

LOS B = Vibrating

LOS A = No reaction

LOS A = Smooth

LOS A = Smooth

CONCRETE

GOOD

SR-60

SZ 802

1.48

VALRICO

JACKSONVILLE

CSX

35-40

0/3

0/2

NO

NO

None

Not Interconnected

NO

NO

YES

YES

YES

NO

STATE

YES

YES

YES

NO

05/01/2012

District: 7RR Street: Roadway: SR-60Crossing No: 624551H County: Hillsborough

Crossbuck Sign: 4

Install - Upgrade: -- 01/28/1992 Pvmt Mrk: STOPLINES AND XING SYMBOLS

33000 (2017)AADT:

Percent Trucks:

School Buses:

7 (2012)

0 (2019)

27.937800

-82.230000

CFL & G

Other Tracks:

2 Quad, Full Entrance, Median Gates

City: OPEN--TRACK ACTIVE

Event Recorder?

Traffic Signals Controlling?

Backlights, Incandescent

Incandescent

Team Members: Brian Hunter

Roberto Gonzalez

Dale Hanson

Kevin Dunn

James Andrews

Charles Rollins

Henry Parrish

Chris Wilson

Date: 05/23/2013

Team Recommendations: Keydown

Field Review Comments:

Freight

HWY

NODoes traffic queue across the tracks?