CN-550000-ASV01-W0020000.pdf

STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION

RAILROAD CHANGE ORDER NUMBER 2

725-090-04

RAIL

OGC – 12/23

Financial Project ID Roadway Description County Roadway ID Contract ID 445467-1-57-01 SR 60 Polk 16261000 ASV01

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 and flagging services for the installation of wireline conduit and resurfacing at grade separated crossing 624502L, RRMP SV 849.84, Polk County. This Change order includes any other work deemed necessary to complete this project.

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 Original Agreement of record dated 8/27/1998 and no Supplemental Agreement is required.

Agreement Type: Grade Separation

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

PE and wireline agreement review and execution PE and Flagging

$25,000.00 $ $16,474.00

Total amount of work previously authorized………………………………………………………… $25,000.00 Total amount of new work authorized by this change order…………………………………………………………………… $16,474.00 Total amount of work authorized under agreement for this Financial Project ID……………………………………… $0.00 PROJECT TOTAL AMOUNT OF WORK AUTHORIZED TO DATE……………………………………………………………………… $41,474.00

Examined as to provisions and participating items of cost:

Recommended: ____________________ Approved: ____________________ Date Date

Wendy Sands Paul Simmons

District Rail Administrator Modal Development Administrator

DocuSign Envelope ID: 19847F94-24E8-43F5-A7E3-3D30BAC37CDC

02/29/2024 | 1:22 PM EST 02/29/2024 | 4:26 PM EST

725-090-04

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.

To: Jennifer.Gaona@dot.state.fl.us

FLORIDA DEPARTMENT OF TRANSPORTATION

FUNDS APPROVAL

ASV01

2/29/2024

CONTRACT INFORMATION

Contract: ASV01

Contract Type:

Method of Procurement:

Vendor Name:

Vendor ID:

AC - RR CROSSING-PE/INSTAL (RR-XING/PE)

R - RAILROAD/UTILITIES AGREEMENT

CSX TRANSPORTATION, INC.

F546000720022

Beginning Date of This Agreement: 12/20/2022

Ending Date of This Agreement: 12/31/2050

Contract Total/Budgetary Ceiling:

Description: PE, Flagging and Wireline Agreement reviews

FUNDS APPROVAL INFORMATION

FUNDS APPROVED/REVIEWED FOR JASON ADANK, CPA, COMPTROLLER ON 2/29/2024

Action: Task Work Order

Reviewed or Approved: APPROVED

Organization Code: 55014010106

Expansion Option: A5

Object Code: 563000

Amount: $16,474.00

Financial Project: 44546715701

Work Activity (FCT):

CFDA:

Fiscal Year: 2024

Budget Entity: 55150200

Category/Category Year: 088716/24

Amendment ID: W002

Sequence: 00

User Assigned ID: CO# 2

Enc Line (6s)/Status: 0002/04

Total Amount: $16,474.00

Page1 of 1

ACCT. CODE : 709 - FL2976 Form Revision 4/21/2023

ESTIMATE SUBJECT TO REVISION AFTER: 1/28/2025 DOT NO.: 624502L

CITY: Bartow COUNTY: Polk STATE: FL

DESCRIPTION: PE, CE&I and flagging for N. Van Fleet Dr. resurfacing and wireline conduit installation

ZONE: Florida SUB-DIV: Valrico MILE POST: SV-849.84

AGENCY PROJECT NUMBER: FPN# 445467-1-57-01

PRELIMINARY ENGINEERING:

212 Contracted & Administrative Engineering Services $ 7,000

Subtotal $ 7,000

CONSTRUCTION ENGINEERING/INSPECTION:

212 Contracted & Administrative Engineering Services $ 17,600

Subtotal $ 17,600

FLAGGING SERVICE: (Contract Labor) 70 Labor (Conductor-Flagman) 0 Days @ $ 350.00 $ - 50 Labor (Foreman/Inspector) 10 Days @ $ 504.00 $ 5,040 70 Additive 126.00% (Transportation Department) $ - 50 Additive 160.00% (Engineering Department) $ 8,064

Subtotal $ 13,104

SIGNAL & COMMUNICATIONS WORK: $ -

TRACK WORK: $ -

PROJECT SUBTOTAL: $ 37,704

900 CONTINGENCIES: 10.00% $ 3,770

PROJECT TOTAL: ***************************************************** $ 41,474

CURRENT AUTHORIZED BUDGET: ***************************************************** $ 25,000 TOTAL SUPPLEMENT REQUESTED: ***************************************************** $ 16,474

DIVISION OF COST:

Agency 100.00% $ 16,474 Railroad 0.00% $ -

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

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

Office of Chief Engineer Public Projects--Jacksonville, Florida

Estimated prepared by: STV Wisely Approved by: KSW CSXT Public Project Group

DATE: 01/29/24 REVISED: 01/00/00 DATE: 02/12/24