CN-550000-AT176-W0010000.pdf

STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION

RAILROAD CHANGE ORDER NUMBER 1

725-090-04A

RAIL

OGC – 12/23

Financial Project ID Roadway Description County Roadway ID Contract ID

446272-1-57-01 SR 676/CAUSEWAY BLVD FROM W

OF US 301 TO E OF US 41/50 ST

Hillsborough 10250000 AT176

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, PE, Nighttime Flagging, Inspections and General Administration for Resurfacing Project in CSX ROW Crossing # 624815B RRMP: AZA 881.86

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 Click or tap to enter a date. and no Supplemental Agreement is required.

Agreement Type: Crossing Surface

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

1 Construction, PE, Nighttime Flagging, Inspections and General Administration for Resurfacing Project in CSX ROW

$ $141,487.00

Total amount of work previously authorized………………………………………………………… $

Total amount of new work authorized by this change order…………………………………………………………………… $141,487.00

Total amount of work authorized under agreement for this Financial Project ID……………………………………… $141,487.00

PROJECT TOTAL AMOUNT OF WORK AUTHORIZED TO DATE……………………………………………………………………… $141,487.00

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: 844C0F60-F9E8-4D4B-8118-DCC6D359DE14

12/13/2024 | 3:16 PM EST 12/16/2024 | 7:49 AM EST

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.

FLORIDA DEPARTMENT OF TRANSPORTATION

FUNDS APPROVAL

AT176

12/11/2024

CONTRACT INFORMATION

FUNDS APPROVAL INFORMATION

FUNDS APPROVED/REVIEWED FOR JASON ADANK, CPA, COMPTROLLER ON 12/11/2024

Action: Task Work Order

Reviewed or Approved: APPROVED

Organization Code: 55014010106

Expansion Option: A9

Object Code: 563000

Amount: $141,487.00

Financial Project: 44627215701

Work Activity (FCT): 127

CFDA:

Fiscal Year: 2025

Budget Entity: 55150200

Category/Category Year: 088797/25

Amendment ID: W001

Sequence: 00

User Assigned ID: CO#1

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

Total Amount: $141,487.00

Contract: AT176

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

Vendor Name: CSX TRANSPORTATION, INC.

Vendor ID: F546000720022

Beginning Date of This Agreement: 12/03/2024

Ending Date of This Agreement: 12/31/2050

Contract Total/Budgetary Ceiling:

Method of Procurement: R - RAILROAD/UTILITIES AGREEMENT

Description: Nighttime flagging services, construction engineering & inspections and general administration

Page1 of 1

To: Sandra.Guerrero@dot.state.fl.us

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, and e‐mail 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 7/18/23

If Email or Mail & Email is selected, please enter Email address(es) here:

Note: this is the agency that will be paying the invoice.

Note: this is the address to send the invoice for payment.

DDR - District Dedicated Revenue - State Funds 100%

Florida Department of Transportation

11201 N. McKinley Drive; MS 7-501, Tampa, Florida 33612

Kenneth Madden

813-975-6407

Kenneth.Madden@dot.state.fl.us

D7RailInvoices@dot.state.fl.us

SR 676/Causeway Blvd From W of US 301 to E of US 41/50 St

Pavement Only Resurface (Flex) 446272-1

Kenneth Madden - Rail Administrator

No

Yes

Email

12/13/2024 | 3:16 PM EST

446272-1: SR 676 / Causeway Blvd From W of US 301 to E of US 41 / 50 St Project Location Map

624815B

ACCT. CODE : 709 - FL3058 Form Revision

Pub EB - FL EB3 (FL) 03/13/24

Buy America

ESTIMATE SUBJECT TO REVISION AFTER: 10/25/2025 DOT NO.: 624815B

CITY: COUNTY: Hillsborough STATE: FL

ZONE: Florida SUB-DIV: Tampa Terminal MILEPOST: AZA 881.86

DRAWING NO.: __ DRAWING DATE: __

AGENCY PROJECT NUMBER: FDOT 446272-1-57-01 (ASX48)

PRELIMINARY ENGINEERING:

212 Contracted & Administrative Engineering Services 25,000$

Subtotal 25,000$

CONSTRUCTION ENGINEERING/INSPECTION:

212 Contracted & Administrative Engineering Services 23,960$

Subtotal 23,960$

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$

COMMUNICATIONS WORK:

Temporary (Details Attached) -$

Permanent (Details Attached) -$

Subtotal -$

TRACK: LABOR

50 Traffic Control 0 MAN-HRS 42.00$ -$

50 Remove Existing Crossing 0 MAN-HRS 42.00$ -$

50 Renew Cross Ties 0 MAN-HRS 42.00$ -$

50 Renew Rail 0 MAN-HRS 42.00$ -$

50 Install OTM 0 MAN-HRS 42.00$ -$

50 Install Field Welds 0 MAN-HRS 42.00$ -$

50 Install Geo-Textile Fabric 0 MAN-HRS 42.00$ -$

50 Install Sub-Drains 0 MAN-HRS 42.00$ -$

50 Install Ballast 0 MAN-HRS 42.00$ -$

50 Line and Surface 0 MAN-HRS 42.00$ -$

50 Install Crossing Materials 0 MAN-HRS 42.00$ -$

50 Install Bituminous Pavement 0 MAN-HRS 42.00$ -$

50 ______________________ 0 MAN-HRS 42.00$ -$

50 ______________________ 0 MAN-HRS 42.00$ -$

50 ______________________ 0 MAN-HRS 42.00$ -$

50 Clean-Up 0 MAN-HRS 42.00$ -$

50 Additive 167.90% -$

Subtotal -$

TRACK: MATERIAL

220 Cross Ties, Main Line 0 EA 44.00$ -$

220 Cross tie - pre-plated Not to be used for Public Projects 0 EA -$ -$

220 Cross-tie - Borate 0 EA 56.00$ -$

220 Crossties, 10' Length 0 EA 55.00$ -$

DESCRIPTION: Preliminary and Construction Engineering Estimate for the roadway resurfacing at Causeway Blvd (SR 676) by FDOT to include nighttime flagging services, construction engineering & inspections and general administration.

Tampa

220 Tie plates 0 EA 10.51$ -$

220 Rail, 136RE, New 0 LF 21.00$ -$

220 Misc. OTM 0 LOT -$ -$

210 Geo-Textile Fabric 0 RL 930.00$ -$

210 Sub-Drains 0 LF 6.00$ -$

220 Ballast - Car load 0 NT 12.00$ -$

220 Ballast - Trucked in 0 NT 45.00$ -$

220 Field Welds 0 EA 100.00$ -$

______________________ 0 ___ -$ -$

______________________ 0 ___ -$ -$

210 Concrete Full Width 0 TF 250.00$ -$

210 Concrete/Rubber Xing (CSX) 0 TF 200.00$ -$

210 Rubber Crossing, Full Depth 0 TF 325.00$ -$

210 Timber/Asphalt Crossing (CSX Standard) 0 TF 42.00$ -$

210 Bituminous Material 0 NT -$

210 Sales Tax on Material 7.00% -$

210 Material Handling 15.00% -$

Subtotal -$

CONTRACT:

215 Asphalt Paving (In Place) 0 NT 165.00$ -$

241 Disposal of Waste Materials 0 TF 15.00$ -$

215 Maintenance of Traffic 0 DAY 350.00$ -$

Subtotal -$

241 EQUIPMENT RENTAL: CSX vehicle and equipment rental included in overhead percentage -$

Subtotal Use for extraordinary rental or unique Service Contract -$

50 WORK TRAIN: 0 DAY 2,100.00$ -$

Subtotal -$

SALVAGE:

228 Rail 0 NT 65.00$ -$

228 OTM 0 NT 75.00$ -$

Subtotal -$

SIGNAL WORK:

210 Material - Field & Consumables -$

210 Material - Sales Tax -$

220 Material - Shop -$

60 Construction Labor -$

65 Shop Labor -$

200 RR Engineering,Preliminary -$

200 RR Engineering,Construction -$

60 Additives to Construction Labor -$

65 Additives to Shop Labor -$

200 Additives to Engineering -$

241 Equipment Expense -$

241 Waste Management -$

212 Contract Engineering -$

211 Freight -$

216 AC Power Service -$

228 Salvage -$

900 Other -$

Subtotal -$

PROJECT SUBTOTAL: 151,351$

900 CONTINGENCIES: 10.00% 15,135$

PROJECT TOTAL: ***************************************************** 166,487$

CURRENT AUTHORIZED BUDGET: ***************************************************** 25,000$

TOTAL SUPPLEMENT REQUESTED: ***************************************************** 141,487$

DIVISION OF COST:

Agency 100.00% 141,487$

Railroad 0.00% -$

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

Office of Director - CSXT Public Projects, Jacksonville, Florida

Estimated prepared by: Benesch Approved by: KSW Project Manager - Public Projects

DATE: 11/04/24 REVISED: DATE: 11/05/24

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

ACCT. CODE : 709 - FL3058 Form Revision

Pub EB - FL EB3 (FL) 03/13/24

Buy America

ESTIMATE SUBJECT TO REVISION AFTER: 10/25/2025 DOT NO.: 624815B

CITY: COUNTY: Hillsborough STATE: FL

ZONE: Florida SUB-DIV: Tampa Terminal MILEPOST: AZA 881.86

DRAWING NO.: __ DRAWING DATE: __

AGENCY PROJECT NUMBER: FDOT 446272-1-57-01 (ASX48)

PRELIMINARY ENGINEERING:

212 Contracted & Administrative Engineering Services 25,000$

Subtotal 25,000$

CONSTRUCTION ENGINEERING/INSPECTION:

212 Contracted & Administrative Engineering Services 23,960$

Subtotal 23,960$

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$

COMMUNICATIONS WORK:

Temporary (Details Attached) -$

Permanent (Details Attached) -$

Subtotal -$

TRACK: LABOR

50 Traffic Control 0 MAN-HRS 42.00$ -$

50 Remove Existing Crossing 0 MAN-HRS 42.00$ -$

50 Renew Cross Ties 0 MAN-HRS 42.00$ -$

50 Renew Rail 0 MAN-HRS 42.00$ -$

50 Install OTM 0 MAN-HRS 42.00$ -$

50 Install Field Welds 0 MAN-HRS 42.00$ -$

50 Install Geo-Textile Fabric 0 MAN-HRS 42.00$ -$

50 Install Sub-Drains 0 MAN-HRS 42.00$ -$

50 Install Ballast 0 MAN-HRS 42.00$ -$

50 Line and Surface 0 MAN-HRS 42.00$ -$

50 Install Crossing Materials 0 MAN-HRS 42.00$ -$

50 Install Bituminous Pavement 0 MAN-HRS 42.00$ -$

50 ______________________ 0 MAN-HRS 42.00$ -$

50 ______________________ 0 MAN-HRS 42.00$ -$

50 ______________________ 0 MAN-HRS 42.00$ -$

50 Clean-Up 0 MAN-HRS 42.00$ -$

50 Additive 167.90% -$

Subtotal -$

TRACK: MATERIAL

220 Cross Ties, Main Line 0 EA 44.00$ -$

220 Cross tie - pre-plated Not to be used for Public Projects 0 EA -$ -$

220 Cross-tie - Borate 0 EA 56.00$ -$

220 Crossties, 10' Length 0 EA 55.00$ -$

DESCRIPTION: Preliminary and Construction Engineering Estimate for the roadway resurfacing at Causeway Blvd (SR 676) by FDOT to include nighttime flagging services, construction engineering & inspections and general administration.

Tampa

220 Tie plates 0 EA 10.51$ -$

220 Rail, 136RE, New 0 LF 21.00$ -$

220 Misc. OTM 0 LOT -$ -$

210 Geo-Textile Fabric 0 RL 930.00$ -$

210 Sub-Drains 0 LF 6.00$ -$

220 Ballast - Car load 0 NT 12.00$ -$

220 Ballast - Trucked in 0 NT 45.00$ -$

220 Field Welds 0 EA 100.00$ -$

______________________ 0 ___ -$ -$

______________________ 0 ___ -$ -$

210 Concrete Full Width 0 TF 250.00$ -$

210 Concrete/Rubber Xing (CSX) 0 TF 200.00$ -$

210 Rubber Crossing, Full Depth 0 TF 325.00$ -$

210 Timber/Asphalt Crossing (CSX Standard) 0 TF 42.00$ -$

210 Bituminous Material 0 NT -$

210 Sales Tax on Material 7.00% -$

210 Material Handling 15.00% -$

Subtotal -$

CONTRACT:

215 Asphalt Paving (In Place) 0 NT 165.00$ -$

241 Disposal of Waste Materials 0 TF 15.00$ -$

215 Maintenance of Traffic 0 DAY 350.00$ -$

Subtotal -$

241 EQUIPMENT RENTAL: CSX vehicle and equipment rental included in overhead percentage -$

Subtotal Use for extraordinary rental or unique Service Contract -$

50 WORK TRAIN: 0 DAY 2,100.00$ -$

Subtotal -$

SALVAGE:

228 Rail 0 NT 65.00$ -$

228 OTM 0 NT 75.00$ -$

Subtotal -$

SIGNAL WORK:

210 Material - Field & Consumables -$

210 Material - Sales Tax -$

220 Material - Shop -$

60 Construction Labor -$

65 Shop Labor -$

200 RR Engineering,Preliminary -$

200 RR Engineering,Construction -$

60 Additives to Construction Labor -$

65 Additives to Shop Labor -$

200 Additives to Engineering -$

241 Equipment Expense -$

241 Waste Management -$

212 Contract Engineering -$

211 Freight -$

216 AC Power Service -$

228 Salvage -$

900 Other -$

Subtotal -$

PROJECT SUBTOTAL: 151,351$

900 CONTINGENCIES: 10.00% 15,135$

PROJECT TOTAL: ***************************************************** 166,487$

CURRENT AUTHORIZED BUDGET: ***************************************************** 25,000$

TOTAL SUPPLEMENT REQUESTED: ***************************************************** 141,487$

DIVISION OF COST:

Agency 100.00% 141,487$

Railroad 0.00% -$

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

Office of Director - CSXT Public Projects, Jacksonville, Florida

Estimated prepared by: Benesch Approved by: KSW Project Manager - Public Projects

DATE: 11/04/24 REVISED: DATE: 11/05/24

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