CN-550000-ASX78-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

453831-1-57-01 Airport Rd. and N. Florida

Ave.

Polk

16220-2302 16210-2201

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:

Concrete panel materials to support CSX tie gang maintenance at crossing 624300N RRMP A854.75 and crossing 624163J RRMP A850.89. This change order includes any other work deemed necessary to complete the project.

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

08/07/1972 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. X ATTACHED

b. 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

Concrete panel materials 75,000.00

Sub-Totals ………………………………………………………………… $ $75,000.00

Net Cost of Construction Changes, this order ………………………... $ $75,000.00

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

Net Total Cost of Construction Changes, to date…………………………………………….. $0.00

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

Estimated Cost of Work Authorized, to date………………………………………………….. $75,000.00

Examined as to provisions and participating items of cost:

Recommended: Approved: Approved:

Date

Wendy Sands

District Rail Administrator

Paul Simmons Modal Development Administrator

Division Administrator

N/A

Federal Highway Administration

DocuSign Envelope ID: B445EFFE-3E08-45F4-B167-7B261827BCCF

09/27/2023 | 3:21 PM EDT 09/28/2023 | 10:26 AM EDT

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.

FLORIDA DEPARTMENT OF TRANSPORTATION

FUNDS APPROVAL

ASX78

9/26/2023

CONTRACT INFORMATION

FUNDS APPROVAL INFORMATION

FUNDS APPROVED/REVIEWED FOR JASON ADANK, CPA, COMPTROLLER ON 9/26/2023

Action: Task Work Order

Reviewed or Approved: APPROVED

Organization Code: 55014010106

Expansion Option: A5

Object Code: 563000

Amount: $75,000.00

Financial Project: 45383115701

Work Activity (FCT): 127

CFDA:

Fiscal Year: 2024

Budget Entity: 55150200

Category/Category Year: 088716/24

Amendment ID: W001

Sequence: 00

User Assigned ID: CO# 1

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

Total Amount: $75,000.00

Contract: ASX78

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

Vendor Name: CSX TRANSPORTATION, INC.

Vendor ID: F546000720022

Beginning Date of This Agreement: 09/25/2023

Ending Date of This Agreement: 12/31/2050

Contract Total/Budgetary Ceiling:

Method of Procurement: R - RAILROAD/UTILITIES AGREEMENT

Description: cROSSING PANEL REPLACEMENTS FOR 624300N & 624163J

Page1 of 1

To: Jennifer.Gaona@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

State Funds, DDR

E-Verify

Florida Department of Transportation

801 N Broadway Avenue, Bartow, FL 33830

Jennifer Gaona

863-608-5381 jennifer.gaona@dot.state.fl.us

Crossings 624300N RRMP A854.75 and 624163J A850.89

Airport Rd. and N. Florida Ave. Panel Replacements during Tie Gang

453831-1-57-01 (ASX78)

Jennifer Gaona, Rail Project Manager

09/27/2023 | 10:38 AM EDT

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Railroad

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Field Review

INTERSTATE NHS

NATIONAL HIGHWAY SYSTEM

FED AID HIGHWAY, NOT NHS

NON FEDERAL AID

Rural

Urban

INTERSTATE

PA-OTHER FREEWAY/EXPRESSWAY

PRINCIPAL ARTERIAL - OTHER

MINOR ARTERIAL

MAJOR COLLECTOR

MINOR COLLECTOR

LOCAL ACCESS

Crossing Number: 624300N - AIRPORT RD.

Railroad Operating Company: CSX TRANSPORTATION, INC.

Local Street Name: AIRPORT RD.

Crossing Status: OPEN--TRACK ACTIVE

Last Updated by Jessica Reyes on 9/27/2023 12:31:06 AM

Safety Index Rank: 71

Railroad Responsible FRA Field

RR Milepost: A | 854.75 |

Crossing General 3 log entries available. View Log

Roadway Location

District 1 County (I.3) Polk City (I.4) LAKELAND

IN CITY

NEAR CITY

State Route Number (I.6) SR572

County Route Number (I.6)

U.S. Route Number (I.6)

Local Street Name (I.5) AIRPORT RD.

Railroad Local Street Name

Block Number (I.5) 899

FDOT Bridge Number

Latitude (I.27) 28.0331908

Longitude (I.28) -82.0191719 View location in Google Maps

Latitude/Longitude Source

(I.29) ACTUAL ESTIMATED

Is Crossing ID Posted?

YES NO

Roadway ID Number 16 / 011 / 000

Linear Referencing System (LRS Route ID) (V.5)

16011000

Highway Milepoint 0.126

LRS Milepost (V.6) 0.128

Railway ID Number 16 / 92901 / 5

FDOT GIS RR Milepoint 854.806

Parcel Number

Railroad Ownership

Railroad Operating Company CSX TRANSPORTATION, INC.

Parent Company CSX TRANSPORTATION, INC.

Crossing Owner

Railroad Contact Phone Number 904-359-3100

Railroad Emergency Contact Number 800-232-0144

Roadway Ownership

Crossing Status

OPEN--TRACK ACTIVE

OPEN--TRACK INACTIVE

CLOSED--TRACK REMOVED

CLOSED--ROADWAY REMOVED

Crossing Type

(I.17) PUBLIC PRIVATE

Public Access Allowed? (I.20) YES NO UNKNOWN

Crossing Purpose (I.18)

Highway Vehicle

Crossing Position

vs. Highway (I.19) AT GRADE RR UNDER RR OVER

Maintenance Responsibility STATE COUNTY CITY PRIVATE

State Annual Maintenance Percentage

Highway System (V.1)

Functional Classification of Road at Crossing (V.2)

Is the crossing on the State Highway System? (V.3)

YES NO

Regularly used by Hazmat Vehicles? NO YES

Regular Emergency Services Route?

(V.10)

NO YES

Is the crossing on the Strategic Intermodal System

(SIS)?

NO YES

Roadway Agency Contact Phone Number (I.35)

850-414-4907

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Rail Highway Crossing Inventory Search Crossing Reports Library Projects Reference

General

Railroad

Road

Signs

Signals

Gates

Vicinity

Data

Incident

Comments

Photos

Field Review

INTERSTATE NHS

NATIONAL HIGHWAY SYSTEM

FED AID HIGHWAY, NOT NHS

NON FEDERAL AID

Rural

Urban

INTERSTATE

PA-OTHER FREEWAY/EXPRESSWAY

PRINCIPAL ARTERIAL - OTHER

MINOR ARTERIAL

MAJOR COLLECTOR

MINOR COLLECTOR

LOCAL ACCESS

Crossing Number: 624163J - N. FLORIDA AVE.

Railroad Operating Company: CSX TRANSPORTATION, INC.

Local Street Name: N. FLORIDA AVE.

Crossing Status: OPEN--TRACK ACTIVE

Last Updated by Jessica Reyes on 9/27/2023 12:31:05 AM

Safety Index Rank: 803

Railroad Responsible FRA Field

RR Milepost: A | 850.89 |

Crossing General 3 log entries available. View Log

Roadway Location

District 1 County (I.3) Polk City (I.4) LAKELAND

IN CITY

NEAR CITY

State Route Number (I.6) SR35

County Route Number (I.6)

U.S. Route Number (I.6) USB 98

Local Street Name (I.5) N. FLORIDA AVE.

Railroad Local Street Name

Block Number (I.5)

FDOT Bridge Number

Latitude (I.27) 28.0450014

Longitude (I.28) -81.9572394 View location in Google Maps

Latitude/Longitude Source

(I.29) ACTUAL ESTIMATED

Is Crossing ID Posted?

YES NO

Roadway ID Number 16 / 210 / 000

Linear Referencing System (LRS Route ID) (V.5)

16210000

Highway Milepoint 0.061

LRS Milepost (V.6) 0.060

Railway ID Number 16 / 92901 / 5

FDOT GIS RR Milepoint 850.943

Parcel Number

Railroad Ownership

Railroad Operating Company CSX TRANSPORTATION, INC.

Parent Company CSX TRANSPORTATION, INC.

Crossing Owner

Railroad Contact Phone Number 904-359-3100

Railroad Emergency Contact Number 800-232-0144

Roadway Ownership

Crossing Status

OPEN--TRACK ACTIVE

OPEN--TRACK INACTIVE

CLOSED--TRACK REMOVED

CLOSED--ROADWAY REMOVED

Crossing Type

(I.17) PUBLIC PRIVATE

Public Access Allowed? (I.20) YES NO UNKNOWN

Crossing Purpose (I.18)

Highway Vehicle

Crossing Position

vs. Highway (I.19) AT GRADE RR UNDER RR OVER

Maintenance Responsibility STATE COUNTY CITY PRIVATE

State Annual Maintenance Percentage

Highway System (V.1)

Functional Classification of Road at Crossing (V.2)

Is the crossing on the State Highway System? (V.3)

YES NO

Regularly used by Hazmat Vehicles? NO YES

Regular Emergency Services Route?

(V.10)

NO YES

Is the crossing on the Strategic Intermodal System

(SIS)?

NO YES

Roadway Agency Contact Phone Number (I.35)

850-414-4907

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Map data ©2023 Google 200 ft

28°01'59.5"N 82°01'09.0"W 28.033191, -82.019172

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Polk County, FL 33811

28°01'59.5"N 82°01'09.0"W

624300N

Map data ©2023 Google 200 ft

28°02'42.0"N 81°57'26.1"W 28.045001, -81.957239

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Downtown, Lakeland, FL 33815

28°02'42.0"N 81°57'26.1"W

624163J

/6 /2

:4

:4

P M

R E

V

IS

IO

N DESCRIPTION:

REVISION

LAST

ofSTANDARD PLANS

FY 2023-24 SHEETINDEX

21830-T01

RAILROAD (GRADE) CROSSING

11/01/17

GENERAL NOTES:

CROSSING SURFACES

STOP ZONE FOR RUBBER CROSSING

Type Definition

C

R

RA

Concrete

Rubber

Rubber/Asphalt

TA Timber/Asphalt

(mph)

Design Speed

(Distance From Stop)

Zone Length

250'

50 - 55

60 - 65

350'

500'

600'

45 Or Less considerations dictate otherwise.

chart may be used unless engineering or safety

Single track Type R Crossings within the zones on the 2.

future vehicular stop. Zone lengths are charted above.

crossings within zones for an existing or scheduled

Type R Crossings are NOT to be used for multiple track 1.

the edge of the travel way.

The Department will participate in crossing work, that requires adjustments to rail outside of the crossing, no more than 50 feet from 7.

Install pavement in accordance with the Specifications. 6.

appropriate material to allow unobstructed travel through the crossing in accordance with ADA requirements.

Sidewalks shall be constructed through the crossing between approach sidewalks of the crossing. Sidewalks shall be constructed with 5.

the crossing surface type shall be made a part of the installation agreement.

and/or the District Rail Office for concurrence along with the List of Railroad Crossing Products. The approved engineering drawings of

The Railroad Company shall submit engineering drawings for the proposed crossing surface type to the Construction Project Engineer 4.

to the District Offices as the list is updated.

The Central Rail Office will maintain a list of currently used Railroad Crossing Products and will periodically distribute the current list 3.

surface is constructed.

protect the crossing from low clearance vehicles and vehicular impacts until the construction project is completed and the final highway the approaches of the crossing to reduce vehicular impacts to the crossing. The transition pavement will be maintained as appropriate to

When a railroad grade crossing is located within the limits of a highway construction project, a transition pavement will be maintained at 2.

negotiated otherwise.

All pavement material, including that through the crossing, will be furnished and installed by the Department or its Contractor, unless

The Railroad Company will furnish and install all track bed (ballast), crossties, rails, crossing surface panels and accessory components. 1.

Notes:

/6 /2

:4

:4

P M

R E

V

IS

IO

N DESCRIPTION:

REVISION

LAST

ofSTANDARD PLANS

FY 2023-24 SHEETINDEX

22830-T01

RAILROAD (GRADE) CROSSING

11/01/19

¡ Pavement

Beveled Edge (1:4 Slope)

Shoulder Pavement

Edge Of Travel Way

Shoulder Line*

Pavement' Above

See 'Crossing Shoulder

Varies (2' Min.)

Or Signal And Gate

Railroad Signal, Gate

R

A I L R

O A

D

With RR Company)

Filter Fabric (Optional

Exist. Rdwy. Pavt.

Friction Course

Ballast Ballast

Crosstie

By Crossing Type)

Material (When Required

Cap Or Expansion

Friction Course

Exist. Rdwy. Pavt.

With RR Company)

Filter Fabric (Optional

Level

Crosstie

Grade

¡ Rail¡ Rail

¡ Track

¡ Railroad

¡ Pavement

2' Setback

Utility Strip

3' Curb Transition 3' Curb Transition

Concrete Curb And Gutter

Utility Strip

Beveled Edge (1:4 Slope)

Asphalt

Gutter

Concrete Curb And

Drop Curb Drop Curb

Extend Beyond Lip Of Gutter

Crossing Materials Do Not

Shoulder Pavement When

Match Adjacent Surface

Asphalt or Concrete to

Sidewalk or Trail

Type SP Asphalt (500 Lb/SY)

Overbuild Overbuild

Type SP Asphalt (500 Lb/SY)

Grade Level

HALF PLAN

CURBED ROADWAYS

ROADWAYS WITH FLUSH SHOULDERS

HALF PLAN

SECTION VIEW

TYPICAL CROSSING MATERIAL REPLACEMENT AT RR CROSSINGS VERTICAL ROADWAY ALIGNMENT THROUGH A RAILROAD CROSSING

4' For Median Shoulders.c.

(Regardless Of Approach Shoulder Pavement Width).

To 8' Maximum Width For Outside Shoulders 8' Or Wider b.

To Shoulder Line For Outside Shoulders Less Than 8' Wide.a.

(Except Area Occupied By Crossing Surfacing Material):

Crossing Shoulder Pavement

Flexible Pavement

Gate Or Signal And Gate

With Or Without Signal, 50' Min.

Crossing Materials

(W idth Varies)

(S e e

G e n e r a l

N o te

D e p a r tm e n t

P a r ti c ip a ti o n

M a x

12' Min.

50' Min.

(Full Depth Asphalt/Rubber Shown)

RR Crossing Varies

(1' To 4.5')

Varies

(1' To 4.5')

Varies is not level, will necessitate a site specific analysis for rail clearances.

grade to a level plane at the elevation of the rails. Rails that are superelevated, or a roadway approach section that superelevation makes a different level appropriate. Vertical curves should be used to traverse from the highway be more than 3 inches higher or lower than the top of the nearest rail at a point 30 feet from the rail unless track plane as the top of the rails for a distance of 2 feet outside the rails. The surface of the highway should also not

To prevent low-clearance vehicles from becoming caught on the tracks, the crossing surface should be at the same

30' 30'

2'2'

Varies (8' Min.)Varies (8' Min.)

Crossing Materials

(Width Varies)

S e e G e n e r a l

N o te

D e p a r tm e n t

P a r ti c ip a ti o n

M a x

V a rie s

V ar ie s crossing shoulder pavement.

be widened to accommodate type, the shoulder width is to is substandard for the facility

* Where the existing shoulder

-0

S e e I n d e x

V a r ie s

Index 509-070 gates or signals and gates see

For location of railroad signals, Note:

M a x

M a x