HomeMy WebLinkAboutContract 56652 DocuSign Envelope ID:AC3D150E-CACC-4E3B-A3C0-6B8B4DD40E20
CSC No.56652
NORTH CENTRAL TEXAS COUNCIL OF GOVERNMENTS
MINOR INTERSECTION IMPROVEMENT PROGRAM
AMENDMENT#1
AGREEMENT COVER SHEET
TYPE OF AGREEMENT: Subrecipient agreement for reimbursable activities to City of Fort Worth (DUNS
#: 073170458)
AGREEMENT NUMBER: TRN6415
SUBRECIPIENT AWARD AMOUNT: $350,000 ($311,231 FEDERAL + $38,769 LOCAL MATCH)
SUBRECIPIENT AGREEMENT PERIOD: July 13, 2020 through June 30, 2022
FUNDING SOURCE, FEDERAL AWARD IDENTIFICATION NUMBER (FAIN), PROJECT
DESCRIPTION, & FEDERAL AWARD PERFORMANCE PERIOD: NCTCOG has received multiple
CMAQ awards from the Federal Highway Administration (FHWA), through agreements executed with
TxDOT, to fund subrecipient awards associated with this program:
- an Agreement executed on July 13, 2018, and subsequently amended on August 16, 2019, for
the Regional Minor Intersection Improvement Program in the amount of$2,500,000 ($2,000,000
CMAQ + $250,000 State Match + $250,000 Local Participation). The period of performance for
NCTCOG's award is September 5, 2019 to August 31, 2023. FAIN Numbers: 4818028291-40E,
481802829M400, 481802829M40E, 481802829Z400, 693JJ2193000OZ400TX1902424
- an Agreement executed on August 30, 2016, and subsequently amended on August 19, 2019, for
the Emissions Reduction Strategies for Ozone Precursors Including Volatile Organic Compound
(VOC) Controls & Other Designated Pollutants in the amount of$1,000,000 ($1,000,000 CMAQ +
200,000 Transportation Development Credits). The period of performance for NCTCOG's award
is September 6, 2016 to August 31, 2021. FAIN Numbers: 481602686M400, 481802479Z400,
48180248OQ400
ASSISTANCE LISTING NAME & NUMBER: Highway Planning & Construction 20.205
NORTH CENTRAL TEXAS COUNCIL OF GOVERNMENTS
616 Six Flags Drive Project Manager.
Centerpoint II Gregory Masota
Arlington, Texas 76011 Transportation Planner III
gmasota0-nctcog.org
(817) 695-9264
CITY OF FORT WORTH
Aziz Rahman, PE, PTOE Project Manager.
Fort Worth, TX 76115 Aziz Rahman, PE, PTOE
Engineering Manager
Aziz.rahman(cD_fortworthtexas.go v
817-392-8653
FUNDING AGENCY
Texas Department of Transportation Project Manager.
2501 Southwest Loop 820 Theresa Poer
Fort Worth, Texas 76133-2300 Director of Transportation Operations
Project Manager: Minor Intersection Improvements
Theresa.Poer(a)txdot.qov
Jamye Sawey
Environmental Supervisor
Project Manager: Emissions Reduction Strategies
Jamye.Sawe y0_txdot.qov
OFFICIAL RECORD
Interlocal Cooperation Agreement—Amendment#1 CITY SECRETARY
NCTCOG and City of Fort Worth—TRN6416
Minor Intersection Improvement Program FT. WORTH, TX
DocuSign Envelope ID:AC3D150E-CACC-4E3B-A3C0-6B8B4DD40E20
AMENDMENT#1
TO
INTERLOCAL COOPERATION AGREEMENT
Between
THE NORTH CENTRAL TEXAS COUNCIL OF GOVERNMENTS
and
CITY OF FORT WORTH
for
MINOR INTERSECTION IMPROVEMENT PROGRAM
The North Central Texas Council of Governments, acting through Michael Eastland, its duly authorized
Executive Director, the foregoing party being hereinafter referred to as NCTCOG, and the City of Fort
Worth, the latter party being referred to hereinafter as the CITY, hereby make and enter the following
Amendment #1 to Agreement to continue efforts for the Implementation of the Minor Intersection
Improvement Program, originally executed on July 13, 2020. This Amendment is effective June 1, 2021.
The following Articles have been revised and shall replace like-labeled Articles included in the Original
Agreement. All other provisions of the Agreement and Appendices are unchanged and remain in full force
and effect.
ARTICLE 2. FUNDING
2.1. Award Amount. The total anticipated project cost $350,000. NCTCOG will reimburse
CITY'S eligible costs up to the Maximum Reimbursement Amount $311,231. The CITY
agrees to contribute, through in-kind contribution, $38,769. If CITY'S reimbursable costs
are less than the maximum reimbursement amount, the local contribution will be
proportional to final expenditures. Transportation Development Credits are not eligible for
reimbursement. The actual amount of reimbursement may be less than the Award Amount
and will be determined under the conditions of this Agreement. CITY shall be responsible
for any costs in excess of the Award Amount.
2.2. Indirect Costs. CITY'S indirect costs are ineligible under this agreement.
2.3. Compliance. All activities funded, operated, and maintained under this Agreement must be
in compliance with the Uniform Administrative Requirements, Cost Principles and Audit
Requirements for Federal Awards, 2 Code of Federal Regulations (CFR) 200 and other
Federal, State, and local law. Additionally, the CITY shall ensure compliance with funding
agency requirements set forth in Exhibit F.
ARTICLE 3. SCOPE OF WORK
3.1 Scope of Work. NCTCOG will provide reimbursement to CITY for CITY'S Improvements
under this Agreement, implemented through the Project, as detailed in Exhibit A.
3.2 Scope of Work Changes. Changes to the SCOPE must be agreed to by both Parties in
writing.
ARTICLE 4. TERM
4.1 Term. This Agreement shall take effect on the date executed by the Parties and shall
remain in effect until June 30, 2022. This Agreement shall automatically terminate upon
Interlocal Cooperation Agreement—Amendment#1 Page 2
NCTCOG and City of Fort Worth—TRN6415
Minor Intersection Improvement Program
DocuSign Envelope ID:AC3D150E-CACC-4E3B-A3C0-6B8B4DD40E20
completion of the Project, although there may be ongoing property management
requirements detailed in Article 6.2.
ARTICLE 5. REIMBURSEMENT AND REPORTING REQUIREMENTS
5.1 Payment. CITY will submit a Request for Reimbursement upon installation of scope
items at the locations identified in Attachment A. Any reimbursement under this
Agreement shall be payable only after eligible costs are approved by NCTCOG.
NCTCOG will approve payments as soon as practicable, but not later than forty-five (45)
days after a complete Request for Reimbursement has been received, provided that
complete and accurate supporting documentation has been submitted to NCTCOG.
Costs incurred prior to execution of this Agreement are not be eligible for reimbursement.
There shall be no obligation whatsoever to pay for performance of this Agreement from
the monies of NCTCOG, other than grant funds received by NCTCOG from NCTCOG
funding agency for the purposes of reimbursement under this Agreement. NCTCOG shall
provide CITY with written notice within five (5) business days after becoming aware that
grant funds received by NCTCOG from NCTCOG's funding agency for the purposes of
reimbursement under this agreement are no longer available for reimbursement to CITY.
At the end of NCTCOG's fiscal year, NCTCOG may request the CITY to provide an
estimate of expenses incurred. CITY shall provide timely responses to NCTCOG's
request for expenditure information.
5.2 Reimbursement. CITY shall submit its Reimbursement Request to NCTCOG at
TRGrants@nctcog.org. Requests for Reimbursement shall include CITY invoice printed on
letterhead, proof of payment, applicable receipts, a signature by a certifying official as
detailed in Article 5.3, and other supporting documentation. NCTCOG may deem a Request
for Reimbursement incomplete if the data and/or documentation are incomplete or
improper, or if the CITY fails to submit necessary reports or provide other information
requested by NCTCOG under the terms of this Agreement. NCTCOG may reject requests
for reimbursements which fail to demonstrate that costs are eligible for reimbursement
and/or which fail to conform to the requirements of this Agreement.
5.3 Certifying Official. As detailed in 5.2, the CITY is required to provide signed invoices. The
individual noted below has the authority, on behalf of the CITY, to certify and serve as the
signatory on invoices related to this project. By signing the invoice, Certifying Officials are
acknowledging review of invoices to ensure expenses included in the invoice are consistent
with the agreement, all services and costs are documented on the invoices are accurate
and eligible, and all subrecipient and contractors have been fully paid.
Any invoices received by NCTCOG without the signature of the individual noted below may
result in the invoice being returned unpaid.
Certifying Official:
Name: Aziz Rahman, PE, PTOE
Title: Engineering Manager
5.4 Eligible Expenses. Costs incurred by the CITY prior to final execution of this Agreement
are not eligible for reimbursement. NCTCOG may reject requests for reimbursement which
fail to demonstrate that costs are eligible for reimbursement and/or which fail to conform to
Interlocal Cooperation Agreement—Amendment#1 Page 3
NCTCOG and City of Fort Worth—TRN6415
Minor Intersection Improvement Program
DocuSign Envelope ID:AC3D150E-CACC-4E3B-A3C0-6B8B4DD40E20
the requirements of this Agreement. Eligible and allowable expenses are limited to costs
determined by NCTCOG in its sole discretion as eligible costs necessary to complete the
Project and consistent with cost principles established in 2 CFR 200, Subpart E. CITY staff
time is not eligible for reimbursement under this Award.
5.5 Availability of Funds. Any reimbursement under this Agreement shall be payable only
after eligible costs are approved by NCTCOG. This Agreement and all claims, suits, or
obligations arising under or related to this Agreement are subject to and limited to the receipt
and availability of funds which are received from the funding agency by NCTCOG dedicated
for the purpose of this Agreement.
5.6 Return of Funds. The CITY agrees to return funds received from NCTCOG for
reimbursement under this Agreement where the CITY has failed to comply with the
requirements set forth in this Agreement.
ARTICLE 8. MISCELLANEOUS PROVISIONS
8.1 Liability. The Parties agree that neither party is an agent, servant, employee of the other
party and each party agrees it is responsible for its individual acts and deeds, as well as the
acts and deeds of its contractors, employees, representatives, and agents.
8.2 Force Majeure. It is expressly understood and agreed by the parties to this Agreement
that, if the performance of any provision of this Agreement is delayed by force majeure,
defined as reason of war, civil commotion, act of God, governmental restriction, regulation
or interference, fire, explosion, hurricane, flood, failure of transportation, court injunction, or
any circumstances which are reasonably beyond the control of the party obligated or
permitted under the terms of this Agreement to do or perform the same, regardless of
whether any such circumstance is similar to any of those enumerated herein, the party so
obligated or permitted shall be excused from doing or performing the same during such
period of delay, so that the period of time applicable to such requirement shall be extended
for a period of time equal to the period of time such party was delayed. Each party must
inform the other in writing within reasonable time of the existence of such force majeure.
8.3 Property Insurance. The CITY must maintain sufficient property insurance or self-
insurance for the repair or replacement of any equipment/technology funded under this
Agreement, unless otherwise expressly agreed upon in writing by NCTCOG.
8.4 Captions. The captions, headings, and arrangements used in this Agreement are for
convenience only and shall not in any way affect, limit, amplify, or modify its terms and
provisions.
8.5 Disputes and Remedies. The CITY and NCTCOG shall negotiate in good faith toward
resolving any disputes that arise under this Agreement. This Agreement does not limit any
remedy or right under law available to a Party to enforce the terms herein.
8.6 Notice. All notices regarding this Agreement shall be in writing and shall be delivered to
the persons identified below:
Interlocal Cooperation Agreement—Amendment#1 Page 4
NCTCOG and City of Fort Worth—TRN6415
Minor Intersection Improvement Program
DocuSign Envelope ID:AC3D150E-CACC-4E3B-A3C0-6B8B4DD40E20
NCTCOG
Mailing Address:
Michael Morris, P.E.
Transportation Director
North Central Texas Council of Governments
616 Six Flags Drive
Centerpoint II
Arlington, Texas 76011
NCTCOG Project Manager
Gregory Masota
Transportation Planner III
North Central Texas Council of Governments
616 Six Flags Drive
Arlington, Texas 76011
LOCAL GOVERNMENT
Mailing Address:
Dana Burghdoff
Assistant City Manager
200 Texas Street
Fort Worth, TX 76102
Project Manager:
Aziz Rahman, PE, PTOE
Engineering Manager
5001 James Ave
Fort Worth, TX 76115
8.7 Governing Law and Venue. This Agreement shall be governed by and construed in
accordance with the laws of the State of Texas. The mandatory and exclusive venue for
the adjudication or resolution of any dispute arising out of this Agreement shall be in
Tarrant County, Texas.
8.8 Regional ITS Memorandum of Understanding. CITY agrees to exercise reasonable
good faith efforts to review, comment on and finalize with NCTCOG a Memorandum of
Understanding Between Dallas-Fort Worth Regional Intelligent Transportation System
Partners Concerning Guiding Principles for Multi-Agency Communication, Data and Video
Sharing.
ARTICLE 11. REQUIRED CLAUSES AND ASSURANCES
11.1 Equal Employment Opportunity. CITY shall not discriminate against any employee or
applicant for employment because of race, religion, color, sex, sexual orientation, gender
identity, or national origin. CITY shall take affirmative actions to ensure that applicants are
employed, and that employees are treated, during their employment, without regard to their
race, religion, color, sex, sexual orientation, gender identity or national origin. Such actions
shall include, but not be limited to, the following: employment, upgrading, demotion, or
transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other
forms of compensation; and selection for training, including apprenticeship.
11.2 Davis-Bacon Act. CITY agrees to comply with all applicable provisions of 40 USC §3141
— 3148.
Interlocal Cooperation Agreement—Amendment#1 Page 5
NCTCOG and City of Fort Worth—TRN6415
Minor Intersection Improvement Program
DocuSign Envelope ID:AC3D150E-CACC-4E3B-A3C0-6B8B4DD40E20
11.3 Contract Work Hours and Selection Standards. CITY agrees to comply with all
applicable provisions of 40 USC §3701 — 3708 to the extent this Agreement indicates any
employment of mechanics or laborers.
11.4 Rights to Invention Made Under Contract or Agreement. CITY agrees to comply with
all applicable provisions of 37 CFR Part 401.
11.5 Clean Air Act, Federal Water Pollution Control Act, and Energy Policy Conservation
Act. CITY agrees to comply with all applicable provisions of the Clean Air Act under 42
USC §7401 —7671, the Energy Federal Water Pollution Control Act 33 USC §1251 — 1387,
and the Energy Policy Conservation Act under 42 USC §6201.
11.6 Debarment/Suspension. CITY is prohibited from making any award or permitting any
award at any tier to any party which is debarred or suspended or otherwise excluded from
or ineligible for participation in federal assistance programs under Executive Order 12549,
Debarment and Suspension. CITY and its subcontractors shall comply with the special
provision "Certification Requirements for Recipients of Grants and Cooperative Agreements
Regarding Debarments and Suspensions"which is included as Exhibit B of this Agreement.
11.7 Restrictions on Lobbying. CITY is prohibited from using monies for lobbying purposes;
CITY shall comply with the special provision "Restrictions on Lobbying," which is included
as Exhibit C of this Agreement. CITY shall include a statement of compliance with the
Lobbying Certification and Disclosure of Lobbying Activities in applicable procurement
solicitations. Lobbying Certification and Disclosure of Lobbying Activities shall be completed
by subcontractors and included in subcontractor contracts, as applicable.
11.8 Procurement of Recovered Materials. CITY agrees to comply with all applicable
provisions of 2 CFR §200.322.
11.9 Buy America. The CITY agrees to comply with all Buy America requirements under 23
USC 313 and 23 CFR 635.410, which require a domestic manufacturing process for any
steel or iron products. The CITY must provide a Buy America Certification, example
Certification document attached as Exhibit D completed by the equipment manufacturer or
demonstrate that the Federal Highway Administration has granted a waiver of the Buy
America requirements.
11.10 Disadvantaged Business Enterprises (DBE). When issuing procurements under this
Agreement, the CITY shall include a Disadvantaged Business Enterprise goal of 7_7
'Percent'. The CITY shall not discriminate on the basis of race, color, national origin, or sex
in the performance of this contract. The CITY shall carry out applicable requirements of 49
CFR Part 26 and 2 CFR 200.321 in the award and administration of US Department of
Transportation assisted contracts. Failure by the CITY to carry out these requirements is a
material breach of this Agreement, which may result in the termination of this Agreement or
such other remedy as the recipient deems appropriate. The CITY shall make meaningful
good faith efforts towards attainment of DBE participation, consistent with guidelines
established in Exhibit A of 49 CFR Part 26. In review of procurement activities, NCTCOG
may require the CITY to document meaningful good faith efforts. Additionally, CITY will be
required to report DBE participation achieved to NCTCOG for this project.
11.11 Internal Compliance Program. NCTCOG has adopted an Internal Compliance Program
to prevent waste, fraud, or abuse. Contractors, agents, and volunteers can report suspected
waste, fraud, or abuse at: https://www.nctcog.org/agency-administration/comi)liance-
Interlocal Cooperation Agreement—Amendment#1 Page 6
NCTCOG and City of Fort Worth—TRN6415
Minor Intersection Improvement Program
DocuSign Envelope ID:AC3D150E-CACC-4E3B-A3C0-6B8B4DD40E20
portal. Additional information regarding the Internal Compliance Program is available at the
previous web address.
11.12 Prohibition on Chinese Telecommunication and Video Surveillance Services and
Equipment (NEW). Pursuant to Public Law 115-232 Section 889 and 2 CFR Part 200,
including §200.216 and §200.471, NCTCOG is prohibited from using federal funds to
procure, contract with entities who use, or extend contracts with entities who use certain
telecommunications and video surveillance equipment or services. The Subrecipient, and
its contractors, shall comply with the special provision "Prohibition on Certain
Telecommunications and Video Surveillance Services or Equipment" which is included as
Exhibit F of this Agreement. The Subrecipient shall notify NCTCOG if the Subrecipient, or
any of its contractors, cannot comply with the prohibition during the performance of this
Agreement.
11.13 Domestic Preference (NEW). As appropriate and to the extent consistent with law, the
CITY should, to the greatest extent practicable, provide a preference for the purchase,
acquisition, or use of goods, products, or materials produced in the United States
(including but not limited to iron, aluminum, steel, cement, and other manufactured
products). Consistent with §200.322, the following items shall be defined as: "Produced in
the United States" means, for iron and steel products, that all manufacturing processes,
from the initial melting stage through the application of coatings, occurred in the United
States. "Manufactured products" means items and construction materials composed in
whole or in part of non-ferrous metals such as aluminum; plastics and polymer-based
products such as polyvinyl chloride pipe; aggregates such as concrete; glass, including
optical fiber; and lumber. The requirements of this section must be included in all
subawards including all contracts and purchase orders for work or products under this
award.
EXHIBITS
Exhibit A: Exhibit A is revised and replaced with Exhibit A-1 Scope of Work
Exhibit F: Prohibited Telecommunications and Video Surveillance Services or Equipment Certification
Interlocal Cooperation Agreement—Amendment#1 Page 7
NCTCOG and City of Fort Worth—TRN6415
Minor Intersection Improvement Program
DocuSign Envelope ID:AC3D150E-CACC-4E3B-A3C0-6B8B4DD40E20
IN WITNESS WHEREOF, the Parties have executed this Amendment#1 to the Agreement.
NORTH CENTRAL TEXAS COUNCIL OF GOVERNMENTS
E
ocuSignad ay:
b, AS 10/8/2021
EZ2C.�-B.EF-GF�l2fi...
Mike Eastland Date
Executive Director
CITY OF FORT WORTH
Dana Burghdoff(0c 8,2021 5847 CDT)
Dana Burghdoff Date
Assistant City Manager
By: W)(Oa 5.2021 5:59 CDT)
William Johnson Date
Director, Transportation and Public Works
CONTRACT COMPLIANCE MANAGER:
By signing, I acknowledge that I am the person responsible for the monitoring and administration of this
contract, including ensuring all performance and reporting requirements.
By:AzizAziz Rahma p 14,20LY�✓YV 2 CDT)
Aziz Rahman Date
Engineering Manager
APPROVED AS TO FORM AND LEGALITY:
By;Mack(Oct 7,202117:58 CDT)
Douglas W. Black Date
Sr. Assistant City Attorney
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ATTEST: p 0°° °00���
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By: `{ 0 v o 0_
Ronald Gonzales �� o o �� Date
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Acting City Secretary d� 00000
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M&C M&C Date
OFFICIAL RECORD
Interlocal Cooperation Agreement—Amendment#1 CITY SECRETARY
NCTCOG and City of Fort Worth—TRN6416
Minor Intersection Improvement Program FT. WORTH, TX
DocuSign Envelope ID:AC3D150E-CACC-4E3B-A3C0-6B8B4DD40E20
EXHIBIT A-1
SCOPE OF WORK
Interlocal Cooperation Agreement—Amendment#1 Page 9
NCTCOG and City of Fort Worth—TRN6415
Minor Intersection Improvement Program
DocuSign Envelope ID:AC3D150E-CACC-4E3B-A3C0-6B8B4DD40E20
Traffic Sionall Hardware Upgrade rre - Fort Worth
s€�p� Traffic Signal Hardware Upgrade Project �65 locations)
TIP Code Traffic Signal Hardware Upgrades
11652
Scope
This project w iil add 4G modems and PTZ:a m eaas a n d rep lace old NEMA ca h inets with new cabinets and
controklers at 65 Iocatiom-
Progress Report Requirements
Status reports shall be submitted semi annually,first report due on April?(covering Oct 1st-mar 315t),and
second report due on October 7 icovering April]st-Sept 3Cth)of each fiscal year until campsetion of the Scope.
Reports shall include tale scope name,the date that the report is submitted,and a list of activities carried out
during-the reporting period.
Budget Information
Total Project Cost, $ 350,000.00
Maximum Reimbuersement, $ 311,231.00
Local Contribution: S 38,769.0U
Locations
Location Description of Work
Reach Street-Various locations(131 Procu re and install modems a nd PTZ cameras
N-Tarrant Pkwy-IH-35W to Parkwood Nil1(7) Frocu re and install modems and PTZ cameras
Trinity Blvd-920 to HWY 350 J1G) From re and install modems a nd PTZ cameras
Hwy 199-N.University to Trenderroot(8) Procure and install modems and PTZ cameras
Heritage Trace Pkwy-II L35W to Ray WKte 14� Procure and install modems and PTZ cameras
IH-30-Ea5tchanee Pkwy(1) Procure and install modems and PTZ cameras
IH-36-Hulen(1) Procure and install modems and PTZ cameras
1H-35-(Goiden Triangle&Basswood)(2) Procu re and install modems and PTZ cameras
1141 35-(2Sth&Northside)(2) Procure and install modems and PTZ cameras
Eastchase Pkwy-Brentwood Stair 8L EderAlle 2) Procure and install modems and PTZ cameras
Basswood 4Lb Teal(1] Procure and install modems and PTZ cameras
Western Center Lib Old Denton (1] Procure and install modems and P72 cameras
Cl ifford&I11-1,620(W]11) Procure and install modems and PTZ cameras
White SetlSemervt @ IH-Z2D(E l(11 Procure and instai11 modems and PTZ cameras
Brentwood Stair @ Woodhaven f Wi51on(1) Procu re and install modems and PU cameras
Bridge @ Woodhaven(1) Procure and install modems and PTZ cameras
Hulen @ Donnaley(1� Procure and install modems and PTZ cameras
Boat Club 9 Shadydell{it Prom re and install modems and PTZ cameras
University @ ti+W 7th St- 1] Procu re and install modems a nd PT2 cameras
Long Lib Clinton(1) Procu ra and install cabinets and€oretrallers
White Settlement @ Carroll(1) Procu re and install cabin ets and€ontfallers
Yu€carFbarthside @ GakfiurstSoenic(1) Procure and install cabinsts and controllers
1H-35 @ HWY 114(1) Procu re and insta[I cabi n ets and controllers
FH-820 @ Quebec St(1) Procu re and install cabi n ets and controllers
fH 311 @ Montgorktery(1) Procu re and install cabi n ets and contrallers
Interlocal Cooperation Agreement—Amendment#1 Page 10
NCTCOG and City of Fort Worth—TRN6415
Minor Intersection Improvement Program
DocuSign Envelope ID:AC3D150E-CACC-4E3B-A3C0-6B8B4DD40E20
EXHIBIT F
PROHIBITED TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT
CERTIFICATION
Interlocal Cooperation Agreement—Amendment#1 Page 11
NCTCOG and City of Fort Worth—TRN6415
Minor Intersection Improvement Program
EXHIBIT F
PROHIBITED TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT
CERTIFICATION
This Agreement is subject to the Public Law 115-232, Section 889, and 2 Code of Federal Regulations
(CFR) Part 200, including §200.216 and §200.471, for prohibition on certain telecommunications and
video surveillance or equipment.
Public Law 115-232, Section 889, identifies that restricted telecommunications and video surveillance
equipment or services (e.g., phones, internet, video surveillance, cloud servers) include the following:
A) Telecommunications equipment that is produced by Huawei Technologies Company or ZTE
Corporation (or any subsidiary or affiliates of such entities).
B) Video surveillance and telecommunications equipment produced by Hytera Communications
Corporations, Hangzhou Hikvision Digital Technology Company, or Dahua Technology Company
(or any subsidiary or affiliates of such entities).
C) Telecommunications or video surveillance services used by such entities or using such
equipment.
D) Telecommunications or video surveillance equipment or services produced or provided by an
entity that the Secretary of Defense, Director of the National Intelligence, or the Director of the
Federal Bureau of Investigation reasonably believes to be an entity owned or controlled by the
government of a covered foreign country.
The entity identified below, through its authorized representative, hereby certifies that no funds under this
Agreement will be obligated or expended to procure or obtain telecommunication or video surveillance
services or equipment or systems that use covered telecommunications equipment or services as a
substantial or essential component of any system, or as a critical technology as part of any system
prohibited by 2 CFR §200.216 and §200.471, or applicable provisions in Public Law 115-232 Section
889.
® The Subrecipient hereby certifies that it does comply with the requirements of 2 CFR §200.216 and
§200.471, or applicable regulations in Public Law 115-232 Section 889.
SIGNATURE OF AUTHORIZED PERSON: miti-9d"
NAME OF AUTHORIZED PERSON: Aziz Rahman
NAME OF COMPANY: City of Fort Worth
DATE: 11/2/2021
-OR-
❑ The Subrecipient hereby certifies that it cannot comply with the requirements of 2 CFR §200.216 and
§200.471, or applicable regulations in Public Law 115-232 Section 889.
SIGNATURE OF AUTHORIZED PERSON:
NAME OF AUTHORIZED PERSON:
NAME OF COMPANY:
DATE:
Interlocal Cooperation Agreement—Amendment#1 Page 12
NCTCOG and City of Fort Worth—TRN6415
Minor Intersection Improvement Program