CN-550000-ASS19-W0010000.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

441387-1-57-01

US 41/SR 45 & PASEO

DEL MAR BOULEVARD

HILLSBOROUGH

10500-XSOB &

10060-2211 D720 029 B

A. 1. The CSX TRANSPORTATION 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:

Resurfacing and roadway rehabilitation and sidewalk construction for a project adjacent to the CSX Right of Way. This change order covers all work deemend necessary to complete the project.

*Crossing #624773S, Paseo Del Mar Boulevard, RRMP: AZA 892.96 *Crossing #624780C, US 41/SR 45, RRMP: AZA 890.00 Note: Tampa Electric Company (TECO) is responsible to the CEI & Flagging Services for Crossing #624780C, RRMP AZA 890.00, a permitted spur that crosses US 41 to the North.

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

8/7/1972 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. 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 Construction, Flagging & CEI 1 55,178.00

Sub-Totals ………………………………………………………………… $ $55,178.00

Net Cost of Construction Changes, this order ………………………... $ $55,178.00

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

Net Total Cost of Construction Changes, to date…………………………………………….. $55,178.00

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

Estimated Cost of Work Authorized, to date………………………………………………….. $55,178.00

Examined as to provisions and participating items of cost:

Recommended: Approved: Approved:

Date Date Date

Kenneth Madden District 7 Rail Administrator

Richard Moss PE Director of Transportation

Development

Division Administrator N/A

Federal Highway Administration

DocuSign Envelope ID: 7D300E40-5C79-438B-A462-D44FDE3D59BB

5/3/2022 | 9:44 AM EDT 5/3/2022 | 9:48 AM EDT

725-090-04B

RAIL

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EXHIBIT A

The Company shall:

1. utilize the U.S. Department of Homeland 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 E-Verify system to verify the employment eligibility of all new employees hired by the subcontractor during the contract term.

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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 inclu delivery date.

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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 - FL2596 Form Revision 12/22/21

BUY AMERICA

ESTIMATE SUBJECT TO REVISION AFTER: 4/22/2023 DOT NO.: 624773S/624780C

CITY: COUNTY: Hillsborough STATE: FL

ZONE: Florida SUB-DIV: Palmetto MILE POST: AZA 892.96

AGENCY PROJECT NUMBER: FDOT 441387-1-57-01 (ASG16) AZA 890.00

PRELIMINARY ENGINEERING:

212 Contracted & Administrative Engineering Services 16,000$

Subtotal 16,000$

CONSTRUCTION ENGINEERING/INSPECTION:

212 Contracted & Administrative Engineering Services 27,200$

Subtotal 27,200$

FLAGGING SERVICE: (Contract Labor)

70 Labor (Conductor-Flagman) 0 Days @ 350.00$ -$

50 Labor (Foreman/Inspector) 40 Days @ 504.00$ 20,160$

70 Additive 137.00% (Transportation Department) -$ 50 Additive 160.00% (Engineering Department) 32,256$

Subtotal 52,416$

SIGNAL & COMMUNICATIONS WORK: -$

TRACK WORK: -$

PROJECT SUBTOTAL: 95,616$

900 CONTINGENCIES: 10.00% 9,562$

PROJECT TOTAL: ***************************************************** 105,178$

CURRENT AUTHORIZED BUDGET: ***************************************************** 50,000$ TOTAL SUPPLEMENT REQUESTED: ***************************************************** 55,178$

DIVISION OF COST:

Agency 100.00% 55,178$ 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 - CDS Approved by: KSW CSXT Public Project Group

DATE: 04/22/22 REVISED: 01/00/00 DATE: 04/25/22

Tampa DESCRIPTION: Preliminary Engineering, Construction Engineering & Inspection, and Flagging Services for roadway miling, resurfacing, striping with dynamic envelope, pipe boring, and sidewalk construction at Apollo Beach Blvd (6243773S/AZA 892.96) and roadway milling, resurfacing, and striping with dynamic envelope at US 41/SR 45 (624780C/AZA 890.00) all within the CSXT right of way.

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

FLORIDA DEPARTMENT OF TRANSPORTATION

FUNDS APPROVAL

ASS19

4/29/2022

CONTRACT INFORMATION

FUNDS APPROVAL INFORMATION

FUNDS APPROVED/REVIEWED FOR ROBIN M. NAITOVE, CPA, COMPTROLLER ON 4/29/2022

Action: Task Work Order

Reviewed or Approved: APPROVED

Organization Code: 55074010706

Expansion Option: A5

Object Code: 563000

Amount: $55,178.00

Financial Project: 44138715701

Work Activity (FCT): 127

CFDA:

Fiscal Year: 2022

Budget Entity: 55150200

Category/Category Year: 088716/22

Amendment ID: W001

Sequence: 00

User Assigned ID: CO#1

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

Total Amount: $55,178.00

Contract: ASS19

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

Vendor Name: CSX TRANSPORTATION, INC.

Vendor ID: F546000720022

Beginning Date of This Agreement: 04/27/2022

Ending Date of This Agreement: 12/31/2050

Contract Total/Budgetary Ceiling:

Method of Procurement: R - RAILROAD/UTILITIES AGREEMENT

Description: PE, CEI & Flagging Services for Resurfacing Project Adjacentto CSX Rail

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To: David.Grillo@dot.state.fl.us

441387-1 - Project Location Map - Crossing# 624773S

441387-1 - Project Location Map - Crossing# 624780C