CN-550000-ASP40-W0040000.pdf

STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION

RAILROAD CHANGE ORDER NUMBER 4

725-090-04A

RAIL

OGC – 12/23

Financial Project ID Roadway Description County Roadway ID Contract ID 441659-1-57-01 US 41/SR 45 Pasco 14010000 ASP40

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:

Construction, CEI, Flagging Services & Signal Work for a Resurfacing Project that runs adjacent to and through CSX ROW. This Change Order includes any other work deemed necessary for this project.

See Exhibit D for Crossing Locations & Mileposts.

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

3. The items of work covered by this Change Order are referenced to the Master Agreement of record dated 8/7/1972 and no Supplemental Agreement is required.

Agreement Type: Signals

B. 1. Reimbursement for the cost of this Railroad Work is to be in accord with the provisions set forth in Administrative Rule Chapter 14-57 Section .011(2) as:

a. ☐ NONREIMBURSABLE

b. ☒ REIMBURSABLE

(1) ☒ Force Account Method

(2) ☐ Lump Sum Method

(3) ☐ Third Party Contract Method

C. ESTIMATED COST OF WORK DUE TO THIS CHANGE ORDER

CHANGE

ORDER DESCRIPTION

PREVIOUSLY

AUTHORIZED WORK

AMOUNT(S)

NEW AUTHORIZED

WORK AMOUNT

Construction, CEI & Flagging Construction, CEI & Flagging Construction, CEI & Flagging Construction, CEI, Flagging & Signals

$30,000.00 $62,968.00 $51,651.00

$45,440.00

Total amount of work previously authorized………………………………………………………… $144,619.00 Total amount of new work authorized by this change order…………………………………………………………………… $45,440.00 Total amount of work authorized under agreement for this Financial Project ID……………………………………… $190,059.00 PROJECT TOTAL AMOUNT OF WORK AUTHORIZED TO DATE……………………………………………………………………… $190,059.00

Examined as to provisions and participating items of cost:

Recommended: ____________________ Approved: ____________________ Date Date

Kenneth Madden

District 7 Rail Administrator Justin Hall

Director of Transportation Development

Docusign Envelope ID: 64C2E63A-C2B7-47A5-A081-E641CCFB2CEC

09/13/2024 | 3:22 PM EDT 09/17/2024 | 8:11 AM EDT

725-090-04A

RAIL

OGC – 12/23

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.

OGC – 12/23

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.

OGC – 12/23

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.

ACCT. CODE : 709 - FL2828 Form Revision 03/13/24

BUY AMERICA

ESTIMATE SUBJECT TO REVISION AFTER: 7/1/2025 DOT NO.: Various

CITY: COUNTY: Pasco STATE: FL

ZONE: Florida SUB-DIV: Brooksville MILE POST: Various

AGENCY PROJECT NUMBER: FDOT 441659-1-57-01 (ASP40)

PRELIMINARY ENGINEERING:

212 Contracted & Administrative Engineering Services 19,572$

Subtotal 19,572$

CONSTRUCTION ENGINEERING/INSPECTION:

212 Contracted & Administrative Engineering Services 25,455$

Subtotal 25,455$

FLAGGING SERVICE: (Contract Labor) 70 Labor (Conductor-Flagman) 0 Days @ 350.00$ -$ 50 Labor (Foreman/Inspector) 40 Days @ 955.50$ 38,220$ 70 Additive 132.80% (Transportation Department) -$

50 Additive 167.90% (Engineering Department) 64,171$

Subtotal 102,391$

SIGNAL & COMMUNICATIONS WORK: 25,362$

TRACK WORK: -$

PROJECT SUBTOTAL: 172,781$

900 CONTINGENCIES: 10.00% 17,278$

PROJECT TOTAL: ***************************************************** 190,059$

CURRENT AUTHORIZED BUDGET: ***************************************************** 144,619$

TOTAL SUPPLEMENT REQUESTED: ***************************************************** 45,440$

DIVISION OF COST:

Agency 100.00% 45,440$

Railroad 0.00% -$

NOTE: Estimate is based on FULL CROSSING CLOSURE during work by Railroad Forces.

Office of Chief Engineer Public Projects--Jacksonville, Florida

Benesch Approved by: KSW CSXT Public Project Group

DATE: 02/16/23 REVISED: 07/01/24 DATE: 09/09/24

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

Land O'Lakes DESCRIPTION: REVISED #2: Preliminary Engineering, Construction Engineering & Inspection, and NIGHT-TIME

Flagging covering roadway resurfacing operations with tie-ins at Morgan Rd (624932W, SR 826.40), Private Crossing (621433V, SR 826.74), SR-54 (624933D, SR 826.87), Leonard Rd (624934K, SR 827.07), Dale Mabry Hwy (624935S, SR 827.27 & 624936Y, SR 827.39), Private Crossing in Lutz (624937F, SR 827.60) and Walmart Entrance (624939U, SR 827.93) by FDOT. Dale Mabry Hwy (624935S, SR 827.27) - Install longer gate arm to accommodate the new bike lane / roadway shift and a doll arm for the cantilever mast utilizing existing flashers.

CSX TRANSPORTATION

Outside Party Estimate

DOT: 624935S OP: FL2828

Summary

Material ………………………………………………………………………………………………………………………………………………………………………………………….$2,243

Sales Tax ………………………………………………………………………………………………………………………………………………………………………………………….$157

Labor:

Construction Labor (16 man-days) ………………………………………………………………………………………………………………………………………………………………………………………….$7,427

Shop Labor (0 man-days) ………………………………………………………………………………………………………………………………………………………………………………………….$0

Subsistence (0 man-days) ………………………………………………………………………………………………………………………………………………………………………………………….$0

Railroad Engineering, Construction ………………………………………………………………………………………………………………………………………………………………………………………….$1,114

Railroad Engineering, Preliminary ………………………………………………………………………………………………………………………………………………………………………………………….$145

Additives to Construction Labor ………………………………………………………………………………………………………………………………………………………………………………………….$12,470

Additives to Shop Labor ………………………………………………………………………………………………………………………………………………………………………………………….$0

Additives to Track Labor ………………………………………………………………………………………………………………………………………………………………………………………….$0

Additives to Engineering ………………………………………………………………………………………………………………………………………………………………………………………….$0

Equipment Expense (0 work days) ………………………………………………………………………………………………………………………………………………………………………………………….$0

Waste Management (4 work days) ………………………………………………………………………………………………………………………………………………………………………………………….$0

Contract Engineering ………………………………………………………………………………………………………………………………………………………………………………………….$473

Freight ………………………………………………………………………………………………………………………………………………………………………………………….$1,335

Poleline Removal ………………………………………………………………………………………………………………………………………………………………………………………….$0

AC Power Service ………………………………………………………………………………………………………………………………………………………………………………………….$0

Salvage ………………………………………………………………………………………………………………………………………………………………………………………….-$1

VAC TRUCK ………………………………………………………………………………………………………………………………………………………………………………………….$0

TOTAL ESTIMATE COST ………………………………………………………………………………………………………………………………………………………………………………………….$25,362

Date: 06/19/2024

Estimated By: Adam Ronsick

Note: This estimate should be considered void one year from date of estimate.

SR-45 (US-41) - ENG-07348 - FL2021095 - FL2828 - Estimate

CSX Project: FL2021095

Land O'Lakes, Florida

# Caterpillar - Confidential Green Estimate Output - Outside Party

Signal Project Estimation

65 2242.54

CATALOG_NUM QTY Unit Price COST SHORT_DESC

020.0052506.1 1 802.05 802.05

ARM GATE FIBERGLASS ASSY ADJ 29' TO 38' HI-INTENSITY GRADE REFLECTIVE INCL 3' ALUM SLEEVE,16' ALUM

BASE SECT,12' FRBG MID SECT,12' FRBG TIP SECT,3 GATE LTS W/WIRING HRNSS,3 SHEAR BLTS,SS ASSY HDWARE

PER SS222 NEG P/N 8003-38S3 (GATE ONLY)

020.0056424.1 2 89.31 178.62 BRACKET SIGN 10" MAST W/SPLIT BOLTS FOR ALL SIGNS REQUIRING 5/8" BOLT L&W P/N 7A1047-10X

020.0068740.1 1 149.00 149.00 BRACKET EXTENSION FOR HIGHWAY CROSSING LIGHT CROSS ARM ASSEMBLY LINCOLN IND. P/N 9418010109

020.3901895.1 1 122.43 122.43

TIP FLEX HWY CROSSING GATE 24 IN LONG ENGINEERING GRADE RED & WHITE STRIPES W/2 MTG BOLTS &

INSTALL INSTRUCTIONS ONE SMALL & ONE LARGE RIBBED ADAPTERS USE W/FIBERGLASS GATE ARMS TIP MADE

BY MARCUM DEVELOPMENT CO, MARCUM P/N RAC-230RFK

020.3930010.1 1 3.70 3.70

KIT GATE ARM WARNING STICKER KIT INCLUDES 1-EA 5"X3" STICKER 1-EA 5"X3" PADLOCK TAG 2-EA 11"X3"

STICKER PER SS222

020.3932537.1 1 986.74 986.74

COUNTERWEIGHT SAFETRAN 070755-38500X KIT 38 INCLUDES 1 EA 070920-LX LONG ARM SUPPORT 1 EA

070920-RX LONG ARM SUPPORT 7 EA 070755-4 COUNTERWEIGHTS 2EA 070757-26X STUD ASSY PLATE AND

HARDWARE FOR GATES FROM 29 TO 38

Field Material List for CSX Project: FL2021095 (Effective: 06/19/2024)

SR 827.27 - Location 1 - SR-45 (US-41)

# Caterpillar - Confidential Green Loc 1 Field Material

Signal Project Estimation

65 2242.54

CATALOG_NUM QTY Unit Price COST SHORT_DESC

Field Material List for CSX Project: FL2021095 (Effective: 06/19/2024)

SR 827.27 - Location 1 - SR-45 (US-41)

Total Cost: 2,242.54$

# Caterpillar - Confidential Green Loc 1 Field Material

FLORIDA DEPARTMENT OF TRANSPORTATION

FUNDS APPROVAL

ASP40

9/12/2024

CONTRACT INFORMATION

FUNDS APPROVAL INFORMATION

FUNDS APPROVED/REVIEWED FOR JASON ADANK, CPA, COMPTROLLER ON 9/12/2024

Action: Task Work Order

Reviewed or Approved: APPROVED

Organization Code: 55074010706

Expansion Option: A5

Object Code: 563000

Amount: $45,440.00

Financial Project: 44165915701

Work Activity (FCT): 127

CFDA:

Fiscal Year: 2025

Budget Entity: 55150200

Category/Category Year: 088716/25

Amendment ID: W004

Sequence: 00

User Assigned ID: CO#4

Enc Line (6s)/Status: 0004/04

Total Amount: $45,440.00

Contract: ASP40

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

Vendor Name: CSX TRANSPORTATION, INC.

Vendor ID: F546000720022

Beginning Date of This Agreement: 08/11/2021

Ending Date of This Agreement: 12/31/2050

Contract Total/Budgetary Ceiling:

Method of Procurement: R - RAILROAD/UTILITIES AGREEMENT

Description: PE Review of Project Plans Involving work within CSX ROW

Page1 of 1

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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?

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

Project Requirements:

Buy America

Additional procurement restrictions (Please describe below)

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)

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.)

Other If you selected Other, please describe below. Only complete this section if this project is associated with Federal and/or State funds.

Project Sponsor Bill To Information

Agency - Sponsor:

Billing Address:

Contact Name:

Phone:

E-mail:

Invoice Delivery Method:

Project Location:

Project Description:

Sponsor Project Ref.

Number (If applicable)

Signature of Applicant* Please sign, this form to the authorized CSX representative.

Name and Title of Applicant

Signature of Applicant Date:

*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.

Form Revision 7/ /23

Exhibit Roadway Crossing # Railroad MP ROW #

Private Road 624937F SR 827.60 N/A

Dale Mabry Highway 624936Y SR 827.39 14040-2201

Dale Mabry Highway 624935S SR 827.27 14040-2201

Private Road (Cox Lumber) 621433V SR 826.74 N/A

Morgan Road 624932W SR 826.40 14500-N/A

SR 54 624933D SR 826.87 14570-2250

Leonard Road 624934K SR 827.07 14717-N/A

Wal-Mart Way 624939U SR 827.93 14000-N/A