CN-550000-AT096.pdf

STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION

710-010-04

UTILITIES

04/10

UTILITY WORK ORDER CHANGE NO. 1

Financial Project ID: 435803-1-56-03 Federal Project ID:

County: Palm Beach State Road No.: 9

District Document No: AT096

Utility Agency/Owner (UAO): AT&T

A.

1. The Agency is hereby authorized to observe the following changes in the plans and/or specifications to the subject Utility

Agreement, and to perform such work accordingly, further described as:

Relocation of facilities

2. The items of work covered by this Work Order Change are referenced to an Agreement of record dated August 6, 1974, and no Supplemental Agreement is required.

B.

1. The Utility Relocation Work is to conform to that shown by the utility adjustment plans as:

a. ATTACHED.

b. INCLUDED IN THE HIGHWAY CONTRACT PLANS.

2. The cost of this Utility Work is:

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:

ITEM NO. ITEM UNIT UNIT

PRICE

WORK ELIMINATED (-) ADDITIONAL WORK (+)

QUANTITY AMOUNT QUANTITY AMOUNT

Prelim Eng $5,500.00

Constr Eng $8,250.00

Constr Labor $22,000.00

Mats & Supplies $11,000.00

Contract Constr $5,500.00

Misc Exp $2,750.00

Sub-Totals............................................................................................... $55,000.00

Net Cost of Construction Changes, this order......................................... $55,000.00

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

Net Total Cost Construction Changes to Date........................................ $55,000.00

Contract Amount...................................................................................... $55,000.00

Estimated Cost of Work Authorized to Date............................................ $55,000.00

Recommended: Approved: Approved:

Date Date Date

District Utility Coordinator District Utility Engineer/Administrator Division Administrator

Federal Highway Administration

Kelly Armstrong Kadian McLean

Typed Name Typed Name Typed Name

Docusign Envelope ID: 8FDAAAD2-223F-456D-A4B6-7B576C4BF42C

09/03/2024 | 8:00 AM EDT 09/03/2024 | 9:40 AM EDT

REQUIRED CONTRACT PROVISIONS FOR FEDERAL AID CONTRACTS

(Appendix A of Assurances)

710-010-08

OGC-06/24

Financial Project ID: 435803-1-56-03 Federal Project ID:

County: Palm Beach State Road No.: 9

District Document No: AT096

Utility Agency/Owner (UAO): AT&T Florida, Inc.

During the performance of this Agreement, the Utility Agency Owner (UAO), for itself, its assignees and successors in interest (hereinafter referred to as the UAO), agrees as follows:

(1) Compliance with Regulations: The UAO will comply with the Regulations of the FLORIDA DEPARTMENT OF TRANSPORTATION (hereinafter referred to as the DEPARTMENT) relative to nondiscrimination in Federally-assisted programs of the DEPARTMENT (Title 49, Code of Federal Regulations, Part 21, hereinafter referred to as the "Regulations"), which are herein incorporated by reference and made a part of this contract.

(2) Nondiscrimination: The UAO, with regard to the work performed by it after award and prior to completion of the UAO work, will not discriminate on the ground of race, color or national origin in the selection and retention of subcontractors, including procurement of materials or leases of equipment. The UAO will not participate either directly or indirectly in the discrimination prohibited by Section 21.5 of the Regulations, including employment practices when the contract covers a program set forth in Appendix A & B of the Regulations.

(3) Solicitations: In all solicitations either by competitive bidding or negotiation made by the UAO for work to be performed under a subcontract, including procurement of materials and leases of equipment, each potential subcontractor or supplier shall be notified by the UAO of the UAO's obligations under this contract and the Regulations relative to nondiscrimination on the ground of race, color or national origin.

(4) “Buy America” Requirements: The UAO will use domestic steel and/or iron products incorporated into the finished work in compliance with the Buy America provisions of 23 CFR 635.410 as amended. As used in this provision, “steel and/or iron products” means manufactured products that are predominately steel and/or iron products and that are not otherwise exempt from Buy America requirements pursuant to rules and regulations of the Federal Highway Administration. As used in this provision, “domestic” means products that are manufactured in the United States which have not undergone any manufacturing process outside of the United States that modified the chemical content, physical shape or size, or final finish of a product, beginning with the initial melting and continuing through final shaping and coating. If a steel and/or iron product is taken outside the United States for any manufacturing process, it becomes foreign source steel and/or iron products. The UAO may incorporate into the finished work foreign source steel and/or iron products as long as the actual cost of such foreign products does not exceed 0.1% of the total amount of this Agreement, or $2,500.00 whichever is greater. The UAO will retain documentation verifying compliance with the Buy America provision of this Agreement for a period of 3 years after final payment of the finished work. Upon request, the UAO will provide the documentation verifying compliance with the Buy America provision of this Agreement.

(5) Additional “Buy America” Requirements: The UAO will comply with 2 CFR 184 and 2 CFR 200.322, which includes the Buy America Preferences for Infrastructure Projects of the Build America, Buy America Act (BABA) and Domestic Preferences for Procurements. The UAO will use Manufactured Products that are consumed in, incorporated into, or affixed to an infrastructure project that are manufactured in the United States, in accordance with BABA requirements and applicable waivers. The UAO will use non-ferrous metals, plastic and polymer-based products, glass, lumber, and drywall articles, materials, and supplies that are consumed in, incorporated into, or affixed to an infrastructure project that are manufactured in the United States, in accordance with BABA requirements.

As used in 2 CFR 184, “construction material” means materials that are predominately non-ferrous metals, plastic and polymer-based products, glass, optical fiber, fiber optic cable, lumber, and drywall articles, materials, and supplies that are not otherwise exempt from Buy America requirements pursuant to rules and regulations of the Federal Highway Administration. As used in this provision, “domestic” means construction materials that are manufactured in the United States which have not undergone any manufacturing process outside of the United States that modified the chemical content, physical shape or size, or final finish of a product, beginning with the initial melting and continuing through final shaping and coating or as defined in 2 CFR 184. If a construction material is taken outside the United States for any manufacturing process, it becomes foreign source construction material.

REQUIRED CONTRACT PROVISIONS FOR FEDERAL AID CONTRACTS

(Appendix A of Assurances)

710-010-08

OGC-06/24

The UAO will retain documentation verifying compliance with the Build America, Buy America provision of this Agreement for a period of 3 years after final payment of the finished work. Upon request, the UAO will provide the documentation verifying compliance with the Build America, Buy America provision of this Agreement. The UAO will provide a certification with the invoice that states the following: “The UAO certifies that all products that are predominately steel and/or iron are domestic products in compliance with the Buy America provisions of 23 CFR

635.410. The UAO certifies that all products that are predominately construction materials are domestic products in compliance with the Buy America provisions of 2 CFR 184. The UAO certifies that all manufactured products are domestic products in compliance with the Buy America provisions of 2 CFR 184 and applicable waivers.”

(6) Information and Reports: The UAO will provide all information and reports required by the Regulations, or orders and instructions issued pursuant thereto, and will permit access to its books, records, accounts, other sources of information, and its facilities as may be determined by the DEPARTMENT or the Federal Highway Administration to be pertinent to ascertain compliance with such Regulations, orders and instructions. Where any information required of the UAO is in the exclusive possession of another who fails or refuses to furnish this information, the UAO shall so certify to the DEPARTMENT or the Federal Highway Administration as appropriate, and shall set forth what efforts it has made to obtain the information.

(7) Sanctions for Noncompliance: In the event of the UAO's noncompliance with the nondiscrimination provisions of paragraphs (1) through (4), the DEPARTMENT shall impose such contract sanctions as it or the Federal Highway Administration may determine to be appropriate, including, but not limited to:

(a) withholding of payments to the contractor under the Agreement until the UAO complies; and/or

(b) cancellation, termination or suspension of the Agreement, in whole or in part.

(8) Incorporation of Provisions: The UAO will include the provisions of paragraph (1) through (6) in every subcontract, including procurement of materials and leases of equipment, unless exempt by the Regulations, order or instructions issued pursuant thereto. The UAO will take such action with respect to any subcontract, procurement or lease as the DEPARTMENT or the Federal Highway Administration may direct as a means of enforcing such provisions including sanctions for noncompliance; provided, however, that in the event the UAO becomes involved in, or is threatened with, litigation with a subcontractor, supplier or lessor as a result of such direction, the UAO may request the State to enter into such litigation to protect the interests of the State, and, in addition, the UAO may request the United States to enter into such litigation to protect the interests of the United States.

Rule 14-46.001 F.A.C. STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION

UTILITY WORK ESTIMATE

710-010-06

UTILITIES

12/16

FDOT PROJECT INFORMATION

Financial Project ID: 435803-1-52-01 Federal Project ID:

State Road Number: SR 9 at Northlake County: Palm Beach FDOT Plans Dated: 01/31/2024 District Document No.:

UTILITY AGENCY/OWNER (UAO)

Utility Company: AT&T Florida, Inc Job No. or Work Order No.: TBD UAO Project Rep: Garcia Ramnon Phone: 561-236-6730 E-mail: gr150m@att.com

UAO Field Rep: Mark Reach Phone: 561-373-4762 E-mail: mr9399@att.com

SECTION A: ITEMIZED COST ESTIMATE

Item Item Cost ($) Overhead (%)

(Must use “%” or “.”

i.e. 10% or .10)

Item Cost + Overhead ($)

Preliminary Engineering $5,000.00 10% $5,500.00 Right of Way Acquisition $0.00 10% $0.00 Construction Engineering $7,500.00 10% $8,250.00 Construction Labor $20,000.00 10% $22,000.00 Materials and Supplies $10,000.00 10% $11,000.00 Transportation & Equipment $0.00 10% $0.00 Contract Construction $5,000.00 10% $5,500.00 Miscellaneous Expenses $2,500.00 10% $2,750.00

Total Cost Estimate => $55,000.00

SECTION B: DEDUCTIONS SECTION C: REIMBURSEMENT

Item Item Value ($) Total Cost Estimate from

SECTION A => $55,000.00

Salvage Value $0.00 Total Deductions from

SECTION B => $0.00

Betterment $0.00

Extended Service Life $0.00 Total Reimbursement* => $55,000.00

Total Deductions => $0.00 *Update the estimated Total Reimbursement for changes in excess of 10%

UTILITY SIGNATURE

UAO Rep. Date 06 / 14 / 2024 Name Garcia Ramnon

Title Manager OSP Planning & Engineering Design