CN-550000-ASL10-00020000.pdf

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Master Agreement FL|ASL10|af55836ae8630ca25c323738f7db6f52
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ASL10
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Florida

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This document is a Railroad Change Order No. 3 issued by the State of Florida Department of Transportation (FDOT) involving CSX Transportation, Inc. The change order pertains to a project on State Road 655 (Recker Highway) in Polk County, with a financial project number of 436560-1-57-01. The document is part of an original Railroad Agreement dated 05/12/2021 and involves a grade separation project over railroad crossing number 623082F.

The change order modifies previous change orders by removing a specific paragraph and does not involve additional funding. The estimated cost of work remains at $800,000.00, with the work being reimbursable under the Force Account Method. The project involves preliminary engineering, flagging, construction engineering and inspection (CEI) services for a grade separation. The change order includes exhibits outlining requirements for E-Verify usage, Buy America compliance, and Title VI nondiscrimination assurances. The work is to be included in the highway contract plans and is classified as a grade separation project.

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STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION

RAILROAD CHANGE ORDER NO. 3

725-090-04A

RAIL

OGC – 1/21

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

Number FAP Number

436560-1-57-01 SR 655 (Recker Hwy) Polk 187 (16590-2150) 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:

This Change Order amends Railroad Change Order 1 and Railroad Change Order 2 to remove the second paragraph under A.1.This change order does not involve additional funding.

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 Original Agreement of record dated 05/12/2021 and no supplemental Agreement is required.

Original Type: Crossing Surface Signals Flagging

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

Preliminary Engineering, Flagging, CEI, and 800,000.00 0.00 Inspection Services

Sub-Totals ………………………………………………………………… $800,000.00 $0.00

Net Cost of Construction Changes, this order ………………………... $ $0.00

Cost of Construction Changes, previously ordered ………………….. $800,000.00 $800,000.00

Net Total Cost of Construction Changes, to date…………………………………………….. $800,000.00

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

Estimated Cost of Work Authorized, to date………………………………………………….. $800,000.00

Examined as to provisions and participating items of cost:

Recommended: Approved: Approved:

Date Date Date

Wendy Sands

District Rail Administrator

Paul Simmons Modal Development Administrator

Division Administrator

N/A

Federal Highway Administration

X Grade Separation

DocuSign Envelope ID: FAEF1BFD-ECC2-4AE1-81F1-2AA54DDF6DC9

3/7/2022 | 1:23 PM EST3/7/2022 | 10:37 AM EST

725-090-04A

RAIL

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.

RAILROAD CHANGE ORDER NO. 1

725-090-04A

RAIL

OGC – 1/21

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

43656015701 SR 655 Polk 187 (16590-2150) 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, Flagging, CEI and Inspection Services to construct a Grade Separation over crossing number 623082F, RRMP# A842.10, SR 655, Polk County. To include any other Rail work deemed necessary.

Project related items that are outside of designated Rail Department activities (such as Right of Way, Contamination, Utilities, etc.) will be handled between each respective CSX and FDOT specialized department under a separate OP number.

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 Original Agreement of record dated 05/12/2021 and no supplemental Agreement is required.

Original Type: Crossing Surface Signals Flagging X Grade Separation

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.

Sub-Totals ………………………………………………………………… Net Cost of Construction Changes, this order ………………………...

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

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

Contract Amount ………………………………………………………………………………… Estimated Cost of Work Authorized, to date…………………………………………………..

Examined as to provisions and participating items of cost:

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

Transit Programs Administrator Modal Development Administrator Exempt From FHWA Review

Division Administrator Federal Highway Administration

N/A

ITEM UNIT UNIT

PRICE

WORK ELIMINATED (-)

QTY AMOUNT

ADDITIONAL WORK (+)

QTY AMOUNT

Preliminary Engineering, Flagging, CEI and Inspection Services

600,000.00

$ $600,000.00 $ $600,000.00 $ $0.00

$600,000.00 $0.00

$600,000.00

DocuSign Envelope ID: B55FDE75-F2D9-4A6B-A917-789EC157E4A7

8/12/2021 | 8:21 PM EDT 8/13/2021 | 10:20 AM EDT

REVISED

By Phillip Chapman at 9:56 am, 3/7/22

RAILROAD CHANGE ORDER NO. 2

725-090-04A

RAIL

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

Number FAP Number

436560-1-57-01 SR 655 (Recker Hwy) Polk 187 (16590-2150) 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, Flagging, CEI and Inspection Services to construct a Grade Separation over crossing number 623082F, RRMP# A842.10, SR 655, Polk County. This change order includes any other work deemed necessary to complete the project.

Project related items that are outside of designated Rail Department activities (such as Right of Way, Contamination, Utilities, etc.) will be handled between each respective CSX and FDOT specialized department under a separate OP number.

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 Original Agreement of record dated 05/12/2021 and no supplemental Agreement is required.

Original Type: Crossing Surface Signals Flagging

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

Preliminary Engineering, Flagging, CEI and 600,000.00 200,000.00 Inspection Services

Sub-Totals ………………………………………………………………… $600,000.00 $200,000.00

Net Cost of Construction Changes, this order ………………………... $0.00 $200,000.00

Cost of Construction Changes, previously ordered ………………….. $600,000.00 $600,000.00

Net Total Cost of Construction Changes, to date…………………………………………….. $800,000.00

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

Estimated Cost of Work Authorized, to date………………………………………………….. $800,000.00

Examined as to provisions and participating items of cost:

Recommended: Approved: Approved:

Date Date Date

Wendy Sands

District Rail Administrator

Paul Simmons Modal Development Administrator

Division Administrator

N/A

Federal Highway Administration

DocuSign Envelope ID: 75A9A0BB-DA54-44A1-BCCE-AE8912012612

3/1/2022 | 4:48 PM EST 3/1/2022 | 4:59 PM EST

REVISED

By Phillip Chapman at 10:00 am, 3/7/22

Binder1
2022-3-3 446560-1 ASL10 CO#3.pdf
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:

C01 Revised Cover.pdf

ExtractPage2

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