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Home My WebLink AboutContract 55605DocuSign Envelope ID: 8CFC9FE1-A239-4361-B282-1FFBF80773F5 CSC No. 55605 TxDOT: Federal Highway Administration: CSJ # 0902-90-096 CFDA No. 20.205 District # 02 Fort Worth CFDA Title Highway Planning and Construction Code Chart 64 # 15000 Project Name N. Sylvania on Meacham Blvd- qFA Not Used ForResearch & Development Improve Traffic Signal STATE OF TEXAS § COUNTY OF TRAVIS § ADVANCE FUNDING AGREEMENT For Highway Safety Improvement Program Project Off-System THIS AGREEMENT (Agreement) is made by and between the State of Texas, acting by and through the Texas Department of Transportation called the "State", and the City of Fort Worth, acting by and through its duly authorized officials, called the "Local Government". The State and Local Government shall be collectively referred to as "the parties" hereinafter. WITNESSETH WHEREAS, federal law establishes federally funded programs fortransportation improvements to implement its public purposes, and WHEREAS, the Texas Transportation Code, Section 201.103 establishes that the State shall design, construct and operate a system of highways in cooperation with local governments, and Section 222.052 authorizes the Texas Transportation Commission to accept contributionsfrom political subdivisions for development and construction of public roads and the state highway system within the political subdivision, and WHEREAS, federal and state laws require local governments to meet certain contract standards relating to the management and administration of State and federal funds, and WHEREAS, the Texas Transportation Commission has codified 43 TAC, Rules 15.50-15.56 that describe federal, state, and local responsibilities for cost participation in highway improvement and other transportation projects, and WHEREAS, the Texas Transportation Commission passed Minute Order Numbers,115291,and 115814 authorizing the State to undertake and complete a highway improvement or other transportation project generally described as installation of new traffic signal. The portion of the project work covered by this Agreement is identified in the Agreement, Article 3, Scope of Work (Project), and WHEREAS, the Governing Body of the Local Government has approved entering into this Agreement by resolution, ordinance, or commissioners court order dated March 23, 2021, which is attached to and made a part of this Agreement as Attachment A, Resolution, Ordinance, or Commissioners Court Order (Attachment A). A map showing the Project location appears in Attachment B, Location Map Showing Project (Attachment B), which is attached to and made a part of this Agreement. �FFICIAL RECORD Page 1 of 15 I CITY SECRETARY AFA Lo n g G en FT. WORTH, TX DocuSign Envelope ID: 8CFC9FE1-A239-4361-B282-1FFBF80773F5 TxDOT: Federal Highway Administration: CSJ # 0902-90-096 CFDA No. 20.205 District # 02 Fort Worth CFDA Title Highway Planning and Construction Code Chart 64 # 15000 Project Name N. Sylvania on Meacham Blvd- qFA Not Used ForResearch & Development Improve Traffic Signal NOW, THEREFORE, in consideration of the premises and of the mutual covenants and agreements of the parties, to be by them respectively kept and performed as set forth in this Agreement, it is agreed as follows: AGREEMENT 1. Responsible Parties: For the Project covered by this Agreement, the parties shall be responsible for the following work as stated in the article of the Agreement referenced in the table below: 1 N/A Utilities Article 8 2. Local Government Environmental Assessment and Mitigation Article 9 3. Local Government Architectural and Engineering Services Article 11 4. State Construction Responsibilities Article 12 5. N/A Right of Way and Real Property Article 14 2. Period of the Agreement This Agreement becomes effective when signed by the last party whose signing makes the Agreement fully executed. This Agreement shall remain in effect until the Project is completed or unless terminated as provided below. 3. Scope of Work The scope of work forthe Project consists of traffic signal improvement at the intersection of Meacham Boulevard and North Sylvania Avenue. 4. Project Sources and Uses of Funds The total estimated cost of the Project is shown in Attachment C, Project Budget (Attachment C) which is attached to and made a part of this Agreement. A. If the Local Government will perform any work under this Agreement for which reimbursement will be provided by or through the State, the Local Government must complete training. If federal funds are being used, the training must be completed before federal spending authority is obligated. Training is complete when at least one individual who is working actively and directly on the Project successfully completes and receives a certificate for the course entitled "Local Government Project Procedures and Qualification for the Texas Department of Transportation" and retains qualification in accordance with applicable TxDOT procedures. Upon request, the Local Government shall provide the certificate of qualification to the State. The individual who receives the training certificate may be an employee of the Local Government or an employee of a firm that has been contracted by the Local Government to perform oversight of the Project. The State in its discretion may deny reimbursement if the Local Government has not continuously designated in writing a qualified individual to work actively on or to directly oversee the Project. Page 2 of 15 AFA Lo n g G en Rev 07/17/2019 DocuSign Envelope ID: 8CFC9FE1-A239-4361-B282-1FFBF80773F5 TxDOT: Federal Highway Administration: CSJ # 0902-90-096 CFDA No. 20.205 District # 02 Fort Worth CFDA Title Highway Planning and Construction Code Chart 64 # 15000 Project Name N. Sylvania on Meacham Blvd- qFA Not Used ForResearch & Development Improve Traffic Signal B. The expected cash contributions from the federal government, the State, the Local Government, or other parties are shown in Attachment C. The State will pay for only those Project costs that have been approved by the Texas Transportation Commission. For projects with federal funds, the State and the federal government will not reimburse the Local Government forany work performed before the federal spending authority is formally obligated to the Project by the Federal Highway Administration (FHWA). After federal funds have been obligated, the State will send to the Local Government a copy of the formal documentation showing the obligation of funds including federal award information. The Local Government is responsible for 100% of the cost of any work performed under its direction or control before the federal spending authority is formally obligated. C. Attachment C shows, by major cost categories, the cost estimates and the party responsible for performing the work for each category. These categories may include but are not limited to: (1) costs of real property; (2) costs of utility work; (3) costs of environmental assessment and remediation; (4) cost of preliminary engineenng and design; (5) cost of construction and construction management; and (6) any other local project costs. D. The State will be responsible for securing the federal and State share of the funding required forthe development and construction of the local Project. If the Local Government is due funds for expenses incurred, these fundswill be reimbursed to the Local Government on a cost basis. E. The Local Government will be responsible for all non-federal or non-State participation costs associated with the Project, unless otherwise provided for in this Agreement or approved otherwise in an amendment to this Agreement. For items of work subject to specified percentage funding, the Local Government shall only in those instances be responsible forall Project costs that are greater than the maximum State and federal participation specified in Attachment C and for overruns in excess of the amount specified in Attachment C to be paid by the Local Government. F. The budget in Attachment C will clearly state all items subject to fixed price funding, specified percentage funding, and the periodic payment schedule, when periodic payments have been approved by the State. G. When the Local Government bears the responsibilityforpaying cost overruns, the Local Government shall make payment to the State within thirty (30) days from the receipt of the State's written notification of additional funds being due. H. When fixed price funding is used, the Local Government is responsible forthe fixed price amount specified in Attachment C. Fixed prices are not subject to adjustment unless (1) differing site conditions are encountered; (2) further definition of the Local Government's requested scope of work identifies greatly differing costs from those estimated; (3) work requested by the Local Government is determined to be ineligible for federal participation; or (4) the adjustment is mutually agreed to by the State and the Local Government. I. Prior to the performance of any engineering review work by the State, the Local Government will pay to the State the amount specified in Attachment C. At a minimum, this amount shall equal the Local Government's funding share for the estimated cost of preliminary engineering performed or reviewed by the State for the Project. At least Page 3 of 15 AFA Lo n g G en Rev 07/17/2019 DocuSign Envelope ID: 8CFC9FE1-A239-4361-B282-1FFBF80773F5 TxDOT: Federal Highway Administration: CSJ # 0902-90-096 CFDA No. 20.205 District # 02 Fort Worth CFDA Title Highway Planning and Construction Code Chart 64 # 15000 Project Name N. Sylvania on Meacham Blvd- qFA Not Used ForResearch & Development Improve Traffic Signal sixty (60) days prior to the date set for receipt of the construction bids, the Local Government shall remit its remaining financial share for the State's estimated construction oversight and construction cost. J. The State will not execute the contract for the construction of the Project until the required funding has been made available by the Local Government in accordance with this Agreement. K. Whenever funds are paid by the Local Government to the State under this Agreement, the Local Government shall remit a check or warrant made payable to the "Texas Department of Transportation" or may use the State's Automated Clearing House (ACH) system for electronic transfer of funds in accordance with instructions provided by TxDOT's Finance Division. The funds shall be deposited and managed by the State and may only be applied by the State to the Project. L. The State will not pay interest on any funds provided by the Local Government. M. If a waiver for the collection of indirect costs for a service project has been granted under 43 TAC §15.56, the State will not charge the Local Government for the indirect costs the State incurs on the Project, unless this Agreement is terminated at the request of the Local Government prior to completion of the Project. N. If the Local Government is an Economically Disadvantaged County (EDC) and if the State has approved adjustments to the standard financing arrangement, this Agreement reflectsthose adjustments. O. Where the Local Government is authorized to perform services underthis Agreement and be reimbursed by the State, the Local Government is authorized to submit requests for reimbursement by submitting the original of an itemized invoice, in a form and containing all items required by the State, no more frequentlythan monthly and no later than ninety (90) days after costs are incurred. If the Local Government submits invoices more than ninety (90) days after the costs are incurred and if federal funding is reduced as a result, the State shall have no responsibility to reimburse the Local Government for those costs. P. Upon completion of the Project, the State will perform afinal accounting of the Project costs for all items of work with specified percentage funding. Any funds due by the Local Government, the State, or the federal government for these work items will be promptly paid by the owing party. Q. The state auditor may conduct an audit or investigation of any entity receiving funds from the State directly under this Agreement or indirectly through a subcontract under this Agreement. Acceptance of funds directly under this Agreement or indirectly through a subcontract under this Agreement acts as acceptance of the authority of the state auditor, under the direction of the legislative audit committee, to conduct an audit or investigation in connection with those funds. An entity that is the subject of an audit or investigation must provide the state auditor with access to any information the state auditor considers relevant to the investigation or audit. R. Payment under this Agreement beyond the end of the current fiscal biennium is subject to availability of appropriated funds. If funds are not appropriated, this Agreement shall be terminated immediately with no liability to either party. Page 4 of 15 AFA Lo n g G en Rev 07/17/2019 DocuSign Envelope ID: 8CFC9FE1-A239-4361-B282-1FFBF80773F5 TxDOT: Federal Highway Administration: CSJ # 0902-90-096 CFDA No. 20.205 District # 02 Fort Worth CFDA Title Highway Planning and Construction Code Chart 64 # 15000 Project Name N. Sylvania on Meacham Blvd- qFA Not Used ForResearch & Development Improve Traffic Signal 5. Termination ofThis Agreement This Agreement shall remain in effect until the Project is completed and accepted by all parties, unless: A. The Agreement is terminated in writing with the mutual consent of the parties; B. The Agreement is terminated by one party because of a breach, in which case any costs incurred because of the breach shall be paid by the breaching party; C. The Local Government elects not to provide funding after the completion of preliminary engineering, specifications, and estimates (PS&E) and the Project does not proceed because of insufficient funds, in which case the Local Government agrees to reimburse the State for its reasonable actual costs incurred during the Project; or D. The Agreement is terminated by the State because the parties are not able to execute a mutually agreeable amendment when the costs for Local Government requested items increase significantly due to differing site conditions, determination that Local government requested work is ineligible forfederal or state cost participation, or a more thorough definition of the Local Government's proposed workscope identifies greatly differing costs from those estimated. The State will reimburse Local Government remaining funds to the Local Government within ninety (90) days of termination; or E. The Project is inactive for thirty-six (36) consecutive months or longer and no expenditures have been charged against federal funds, in which case the State may in its discretion terminate this Agreement. 6. Amendments Amendments to this Agreement due to changes in the character of the work, terms of the Agreement, or responsibilities of the parties relating to the Project may be enacted through a mutually agreed upon, written amendment. 7. Remedies This Agreement shall not be considered as specifying the exclusive remedy for any agreement default, but all remedies existing at law and in equity may be availed of by either party to this Agreement and shall be cumulative. 8. Utilities The party named in Article 1, Responsible Parties, under AGREEMENT shall be responsible for the adjustment, removal, or relocation of utility facilities in accordance with applicable state laws, regulations, rules, policies, and procedures, including any cost to the State of a delay resulting from the Local GovernmenYs failure to ensure that utility facilities are adjusted, removed, or relocated before the scheduled beginning of construction. The Local Government will not be reimbursed with federal or State funds forthe cost of required utility work. The Local Government must obtain advance approval for any variance from established procedures. Before a construction contract is let, the Local Government shall provide, at the State's request, a certification stating that the Local Government has completed the adjustment of all utilities that must be adjusted before construction is commenced. Page 5 of 15 AFA Lo n g G en Rev 07/17/2019 DocuSign Envelope ID: 8CFC9FE1-A239-4361-B282-1FFBF80773F5 TxDOT: Federal Highway Administration: CSJ # 0902-90-096 CFDA No. 20.205 District # 02 Fort Worth CFDA Title Highway Planning and Construction Code Chart 64 # 15000 Project Name N. Sylvania on Meacham Blvd- qFA Not Used ForResearch & Development Improve Traffic Signal 9. Environmental Assessmentand Mitigation Development of a transportation project must comply with the National Environmental Policy Act and the National Historic Preservation Act of 1966, which require environmental clearance of federal-aid projects. The party named in Article 1, Responsible Parties, under AGREEMENT is responsible for the following: A. The identification and assessment of any environmental problems associated with the development of a local project governed by this Agreement. B. The cost of any environmental problem's mitigation and remediation. C. Providing any public meetings or public hearings required forthe environmental assessment process. Public hearings will not be held prior to the approval of the Project schematic. D. The preparation of the NEPA documents required for the environmental clearance of this Project. If the Local Government is responsible for the environmental assessment and mitigation, before the advertisement for bids, the Local Government shall provide to the State written documentation from the appropriate regulatory agency or agencies that all environmental clearances have been obtained. 10. Compliance with Accessibility Standards All parties to this Agreement shall ensure that the plans for and the construction of all projects subject to this Agreement are in compliance with standards issued or approved by the Texas Department of Licensing and Regulation (TDLR) as meeting or consistent with minimum accessibility requirements of the Americans with Disabilities Act (P.L. 101-336) (ADA). 11. Architectural and Engineering Services The party named in Article 1, Responsible Parties, under AGREEMENT has responsibility for the performance of architectural and engineering services. The engineering plans shall be developed in accordance with the applicable State's Standard Specifications for Construction and MaintenanceofHighways, Streetsand Bridges and the special specifications and special provisions related to it. For projects on the State highway system, the design shall, at a minimum conform to applicable State manuals. For projects not on the State highway system, the design shall, at a minimum, conform to applicable American Association of State Highway and Transportation Officials (AASHTO) design standards. In procuring professional services, the parties to this Agreement must comply with federal requirements cited in 23 CFR Part 172 if the Project is federally funded and with Texas Government Code 2254, Subchapter A, in all cases. Professional contracts for federally funded projects must conform to federal requirements, specifically including the provision for participation by Disadvantaged Business Enterprises (DBEs), ADA, and environmental matters. If the Local Government is the responsible party, the Local Government shall submit its procurement selection process for prior approval by the State. All professional services contracts must be reviewed and approved by the State prior to execution by the Local Government. Page 6 of 15 AFA Lo n g G en Rev 07/17/2019 DocuSign Envelope ID: 8CFC9FE1-A239-4361-B282-1FFBF80773F5 TxDOT: Federal Highway Administration: CSJ # 0902-90-096 CFDA No. 20.205 District # 02 Fort Worth CFDA Title Highway Planning and Construction Code Chart 64 # 15000 Project Name N. Sylvania on Meacham Blvd- qFA Not Used ForResearch & Development Improve Traffic Signal 12. Construction Responsibilities The party named in Article 1, Responsible Parties, underAGREEMENT is responsibleforthe following: A. Advertise for construction bids, issue bid proposals, receive and tabulate the bids, and award and administer the contract for construction of the Project. Administration of the contract includes the responsibilityforconstruction engineering and for issuance of any change orders, supplemental agreements, amendments, or additional work orders that may become necessary subsequent to the award of the construction contract. In order to ensure federal funding eligibility, projects must be authorized by the State prior to advertising for construction. B. If the State is the responsible party, the State will use its approved contract letting and award procedures to let and award the construction contract. C. If the Local Government is the responsible party, the Local Government shall submit its contract letting and award procedures to the State for review and approval prior to letting. D. If the Local Government is the responsible party, the State must concur with the low bidder selection before the Local Government can enter into a contract with the vendor. E. If the Local Government is the responsible party, the State must review and approve change orders. F. Upon completion of the Project, the party responsibleforconstructing the Projectwill issue and sign a"Notification of Completion" acknowledging the Project's construction completion and submit certification(s) sealed by a professional engineer(s) licensed in the State of Texas. G. For federally funded contracts, the parties to this Agreementwill comply with federal construction requirements cited in 23 CFR Part 635 and with requirements cited in 23 CFR Part 633, and shall include the latest version of Form "FHWA-1273" in the contract bidding documents. If force account workwill be performed, a finding of cost effectiveness shall be made in compliance with 23 CFR 635, Subpart B. 13. Project Maintenance The Local Government shall be responsible for maintenance of locally owned roads and locally owned facilities after completion of the work. The State shall be responsible for maintenance of the State highway system after completion of the work if the work was on the State highway system, unless otherwise provided for in existing maintenance agreements with the Local Government. 14. Right of Wayand Real Property The party named in Article 1, Responsible Parties, under AGREEMENT is responsibleforthe provision and acquisition of any needed right of way or real property. 15. Insurance If this Agreement authorizes the Local Government or its contractor to perform any work on State right of way, before beginning work, the entity performing the work shall provide the State with a fully executed copy of the State's Form 1560 Certificate of Insurance verifying the Page 7 of 15 AFA Lo n g G en Rev 07/17/2019 DocuSign Envelope ID: 8CFC9FE1-A239-4361-B282-1FFBF80773F5 TxDOT: Federal Highway Administration: CSJ # 0902-90-096 CFDA No. 20.205 District # 02 Fort Worth CFDA Title Highway Planning and Construction Code Chart 64 # 15000 Project Name N. Sylvania on Meacham Blvd- qFA Not Used ForResearch & Development Improve Traffic Signal existence of coverage in the amounts and types specified on the Certificate of Insurance forall persons and entities working on State right of way. This coverage shall be maintained until all work on the State right of way is complete. If coverage is not maintained, all work on State right of way shall cease immediately, and the State may recover damages and all costs of completing the work. 16. Notices All notices to either party shall be delivered personally or sent by certified or U.S. mail, postage prepaid, addressed to that party at the following address: Local Government: City of Fort Worth ATTN: Assistant City Manager 200 Texas Street Fort Worth, Texas 76102 Texas Department of Transportation ATTN: Director of Contract Services 125 E. 11 th Street Austin, TX 78701 All notices shall be deemed given on the date delivered in person or deposited in the mail, unless otherwise provided by this Agreement. Either party may change the above address by sending written notice of the change to the other party. Either party may request in writing that notices shall be delivered personally or by certified U.S. mail, and that request shall be carried out by the other party. 17. Legal Construction If one or more of the provisions contained in this Agreement shall for any reason be held invalid, illegal, or unenforceable in any respect, such invalidity, illegality, or unenforceability shall not affect any other provisions and this Agreement shall be construed as if it did not contain the invalid, illegal, or unenforceable provision. 18. Responsibilities of the Parties The State and the Local Government agree that neither party is an agent, servant, or 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. 19. Ownership of Documents Upon completion or termination of this Agreement, all documents prepared by the State shall remain the property of the State. All data and information prepared underthis Agreement shall be made available to the State without restriction or limitation on their further use. All documents produced or approved or otherwise created by the Local Government shall be transmitted to the State, in the format directed by the State, on a monthly basis or as required by the State. The originals shall remain the property of the Local Government. . Page 8 of 15 AFA Lo n g G en Rev 07/17/2019 DocuSign Envelope ID: 8CFC9FE1-A239-4361-B282-1FFBF80773F5 TxDOT: Federal Highway Administration: CSJ # 0902-90-096 CFDA No. 20.205 District # 02 Fort Worth CFDA Title Highway Planning and Construction Code Chart 64 # 15000 Project Name N. Sylvania on Meacham Blvd- qFA Not Used ForResearch & Development Improve Traffic Signal 20. Compliance with Laws The parties to this Agreement shall comply with all federal, state, and local laws, statutes, ordinances, rules and regulations, and the orders and decrees of any courts or administrative bodies or tribunals in any manner affecting the performance of this Agreement. When required, the Local Governmentshall furnish the State with satisfactory proof of this compliance. 21. Sole Agreement This Agreement constitutes the sole and only agreement between the parties and supersedes any prior understandings or written or oral agreements respecting the Agreement's subject matter. 22. Cost Principles In order to be reimbursed with federal funds, the parties shall comply with the cost principles established in 2 CFR 200 that specify that all reimbursed costs are allowable, reasonable, and allocable to the Project. 23. Procurementand PropertyManagementStandards The parties to this Agreement shall adhere to the procurement and property management standards established in 2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, and to the Texas Uniform Grant Management Standards. The State must pre-approve the Local Government's procurement procedures for purchases to be eligible for state or federal funds. 24. Inspection of Books and Records The parties to this Agreement shall maintain all books, documents, papers, accounting records, and other documentation relating to costs incurred underthis Agreement and shall make such materials available to the State, the Local Government, and, if federally funded, the FHWA and the U.S. Office of the Inspector General or their duly authorized representatives for review and inspection at its office dunng the Agreement period and forseven (7) years from the date of final reimbursement by FHWA underthis Agreementor until any impending litigation or claims are resolved. Additionally, the State, the Local Government, and the FHWA and their duly authorized representatives shall have access to all the governmental records that are directly applicable to this Agreement for the purpose of making audits, examinations, excerpts, and transcriptions. 25. Civil Rights Compliance The parties to this Agreement are responsible for the following: A. Compliance with Reaulations: Both parties will comply with the Acts and the Regulations relative to Nondiscrimination in Federally-assisted programs of the U.S. Department of Transportation (USDOT), the Federal Highway Administration (FHWA), as they may be amended from time to time, which are herein incorporated by reference and made part of this Agreement. B. Nondiscrimination: The Local Government, with regard to the work performed by it during the Agreement, will not discriminate on the grounds of race, color, or national Page 9 of 15 AFA Lo n g G en Rev 07/17/2019 DocuSign Envelope ID: 8CFC9FE1-A239-4361-B282-1FFBF80773F5 TxDOT: Federal Highway Administration: CSJ # 0902-90-096 CFDA No. 20.205 District # 02 Fort Worth CFDA Title Highway Planning and Construction Code Chart 64 # 15000 Project Name N. Sylvania on Meacham Blvd- qFA Not Used ForResearch & Development Improve Traffic Signal origin in the selection and retention of subcontractors, including procurementof materials and leases of equipment. The Local Government will not participate directly or indirectly in the discrimination prohibited by the Acts and the Regulations, including employment practices when the Agreement covers any activity, project, or program set forth in Appendix B of 49 CFR Part 21. C. Solicitations for Subcontracts. Including Procurement of Materials and Equipment: In all solicitations either by competitive bidding or negotiation made by the Local Government for workto be performed undera subcontract, including procurement of materials or leases of equipment, each potential subcontractoror supplierwill be notified by the Local Government of the Local Government's obligations under this Agreement and the Acts and Regulations relative to Nondiscrimination on the grounds of race, color, or national origin. D. Information and Reports: The Local Government will provide all information and reports required by the Acts, the Regulations, and directives issued pursuant thereto, and will permit access to its books, records, accounts, othersources of information, and facilities as may be determined by the State or the FHWA to be pertinent to ascertain compliance with such Acts, Regulations or directives. Where any information required of the Local Government is in the exclusive possession of another who fails or refuses to furnish this information, the Local Government will so certify to the State or the FHWA, as appropriate, and will set forth what efforts it has made to obtain the information. E. Sanctions for Noncompliance: In the event of the Local Government's noncompliance with the Nondiscrimination provisions of this Agreement, the State will impose such contract sanctions as it or the FHWA may determine to be appropriate, including, but not limited to: 1. withholding of payments to the Local Government under the Agreement until the Local Government complies and/or 2. cancelling, terminating, or suspending of the Agreement, in whole or in part. F. Incorporation of Provisions: The Local Government will include the provisions of paragraphs (A) through (F) in every subcontract, including procurementof materials and leases of equipment, unless exempt by the Acts, the Regulations and directives issued pursuant thereto. The Local Government will take such action with respect to any subcontract or procurement as the State or the FHWA may direct as a means of enforcing such provisions including sanctions for noncompliance. Provided, that if the Local Government becomes involved in, or is threatened with, litigation with a subcontractor or supplier because of such direction, the Local Government may request the State to enter into such litigation to protect the interests of the State. In addition, the Local Government may request the United States to enter into such litigation to protect the interests of the United States. 26. Pertinent Non-Discrimination Authorities During the performance of this Agreement, each party, for itself, its assignees, and successors in interest agree to comply with the following nondiscrimination statutes and authorities; including but not limited to: Page 10 of 15 AFA Lo n g G en Rev 07/17/2019 DocuSign Envelope ID: 8CFC9FE1-A239-4361-B282-1FFBF80773F5 TxDOT: Federal Highway Administration: CSJ # 0902-90-096 CFDA No. 20.205 District # 02 Fort Worth CFDA Title Highway Planning and Construction Code Chart 64 # 15000 Project Name N. Sylvania on Meacham Blvd- qFA Not Used ForResearch & Development Improve Traffic Signal A. Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat. 252), (pro- hibits discrimination on the basis of race, color, national origin); and 49 CFR Part 21. B. The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42 U.S.C. § 4601), (prohibits unfair treatment of persons displaced or whose property has been acquired because of federal or federal-aid programs and projects). C. Federal-Aid Highway Act of 1973, (23 U.S.C. § 324 et seq.), as amended, (prohibits discrimination on the basis of sex). D. Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. § 794 et seq.) as amended, (prohibits discrimination on the basis of disability); and 49 CFR Part 27. E. The Age Discrimination Act of 1975, as amended, (42 U.S.C. § 6101 et seq.), (prohibits discrimination on the basis of age). F. Airport and Airway Improvement Act of 1982, (49 U.S.C. Chapter 471, Section 47123), as amended, (prohibits discrimination based on race, creed, color, national origin, or sex). G. The Civil Rights Restoration Act of 1987, (PL 100-209), (Broadened the scope, coverage and applicability of Title VI of the Civil Rights Act of 1964, The Age Discrimination Act of 1975 and Section 504 of the Rehabilitation Act of 1973, by expanding the definition of the terms "programs or activities" to include all of the programs or activities of the federal-aid recipients, subrecipients and contractors, whether such programs or activities are federally funded or not). H. Titles II and III of the Americans with Disabilities Act, which prohibits discrimination on the basis of disability in the operation of public entities, public and private transportation systems, places of public accommodation, and certain testing entities (42 U.S.C. §§ 12131-12189) as implemented by Department of Transportation regulations at 49 C.F.R. parts 37 and 38. I. The Federal Aviation Administration's Nondiscrimination statute (49 U.S.C. § 47123) (prohibits discrimination on the basis of race, color, national origin, and sex). J. Executive Order 12898, Federal Actions to Address Environmental Justice in Minority Populations and Low-Income Populations, which ensures nondiscrimination against minority populations by discouraging programs, policies, and activities with disproportionately high and adverse human health or environmental effects on minority and low-income populations. K. Executive Order 13166, Improving Access to Services for Persons with Limited English Proficiency, and resulting agency guidance, national origin discrimination includes discrimination because of limited English proficiency (LEP). To ensure compliance with Title VI, the parties must take reasonable steps to ensure that LEP persons have meaningful access to the programs (70 Fed. Reg. at 74087 to 74100). L. Title IX of the Education Amendments of 1972, as amended, which prohibits the parties from discriminating because of sex in education programs or activities (20 U.S.C. 1681 et seq.). 27. Disadvantaged Business Enterprise (DBE) Program Requirements If federal funds are used: A. The parties shall comply with the Disadvantaged Business Enterprise Program requirements established in 49 CFR Part 26. Page 11 of 15 AFA Lo n g G en Rev 07/17/2019 DocuSign Envelope ID: 8CFC9FE1-A239-4361-B282-1FFBF80773F5 TxDOT: Federal Highway Administration: CSJ # 0902-90-096 CFDA No. 20.205 District # 02 Fort Worth CFDA Title Highway Planning and Construction Code Chart 64 # 15000 Project Name N. Sylvania on Meacham Blvd- qFA Not Used ForResearch & Development Improve Traffic Signal B. The Local Government shall adopt, in its totality, the State's federally approved DBE program. C. The Local Government shall incorporate into its contracts with subproviders an appropriate DBE goal consistent with the State's DBE guidelines and in consideration of the local market, project size, and nature of the goods or services to be acquired. The Local Government shall submit its proposed scope of services and quantity estimates to the State to allow the State to establish a DBE goal for each Local Government contract with a subprovider. The Local Government shall be responsible for documenting its actions. D. The Local Government shall follow all other parts of the State's DBE program referenced in TxDOT Form 2395, Memorandum of Understanding Regarding the Adoption of the Texas Department of Transportation's Federally-Approved Disadvantaged Business Enterprise by Entity, and attachments found at web address http://ftp.dot.state.tx.us/pub/txdot info/bop/dbe/mou/mou_attachments.pdf. E. The Local Government shall not discriminate on the basis of race, color, national origin, or sex in the award and performance of any U.S. Department of Transportation (DOT)- assisted contract or in the administration of its DBE program or the requirements of 49 CFR Part 26. The Local Government shall take all necessary and reasonable steps under 49 CFR Part 26 to ensure non-discrimination in award and administration of DOT-assisted contracts. The State's DBE program, as required by 49 CFR Part 26 and as approved by DOT, is incorporated by reference in this Agreement. Implementation of this program is a legal obligation and failure to carry out its terms shall be treated as a violation of this Agreement. Upon notification to the Local Government of its failure to carry out its approved program, the State may impose sanctions as provided for under 49 CFR Part 26 and may, in appropriate cases, refer the matter for enforcement under 18 U.S.C. 1001 and the Program Fraud Civil Remedies Act of 1986 (31 U.S.C. 3801 et seq.). F. Each contract the Local Government signs with a contractor (and each subcontract the prime contractor signs with a sub-contractor) must include the following assurance: The contracfor, sub-recipient, or sub-contractor shall not discriminate on the basis of race, color, national origin, or sex in the performance of this contract. The contractor shall carry out applicable requirements of 49 CFR Part 26 in the award and administration of DOT-assisted contracts. Failure by the contractor to carry out fhese 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. 28. Debarment Certifications If federal funds are used, the parties are prohibited from making any award at any tier to any party that is debarred or suspended or otherwise excluded from or ineligible for participation in Federal Assistance Programs under Executive Order 12549, "Debarment and Suspension." By executing this Agreement, the Local Government certifies that it and its principals are not currently debarred, suspended, or otherwise excluded from or ineligible for participation in Federal Assistance Programs under Executive Order 12549 and furthercertifies that it will not do business with any party, to include principals, that is currently debarred, suspended, or Page 12 of 15 AFA Lo n g G en Rev 07/17/2019 DocuSign Envelope ID: 8CFC9FE1-A239-4361-B282-1FFBF80773F5 TxDOT: Federal Highway Administration: CSJ # 0902-90-096 CFDA No. 20.205 District # 02 Fort Worth CFDA Title Highway Planning and Construction Code Chart 64 # 15000 Project Name N. Sylvania on Meacham Blvd- qFA Not Used ForResearch & Development Improve Traffic Signal otherwise excluded from or ineligible for participation in Federal Assistance Programs under Executive Order 12549. The parties to this Agreementshall require any party to a subcontract or purchase order awarded under this Agreementto certify its eligibility to receive federal funds and, when requested by the State, to furnish a copy of the certification. If state funds are used, the parties are prohibited from making any award to any party that is debarred under the Texas Administrative Code, Title 34, Part 1, Chapter 20, Subchapter G, Rule §20.585 and the Texas Administrative Code, Title 43, Part 1, Chapter 9, Subchapter G. 29. Lobbying Certification If federal funds are used, in executing this Agreement, each signatory certifies to the best of that signatory's knowledge and belief, that: A. No federal appropriated funds have been paid or will be paid by or on behalf of the parties to any person for influencing or attempting to influence an officeror employee of any federal agency, a Member of Congress, an officeror employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. B. If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with federal contracts, grants, loans, or cooperative agreements, the signatory for the Local Government shall complete and submit the Federal Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. C. The parties shall require that the language of this certification shall be included in the award documents for all sub-awards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and all sub-recipients shall certify and disclose accordingly. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Title 31 U.S.C. §1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. 30. Federal FundingAccountabilityand TransparencyAct Requirements If federal funds are used, the following requirementsapply: A. Any recipient of funds underthis Agreement agreesto comply with the Federal Funding Accountability and Transparency Act (FFATA) and implementing regulations at 2 CFR Part 170, including Appendix A. This Agreement is subject to the following award terms: http://www.qpo.gov/fdsys/pkg/FR-2010-09-14/pdf/2010-22705.pdf and http://www. qpo. gov/fdsys/pkg/FR-2010-09-14/pdf/2010-22706. pdf. B. The Local Government agrees that it shall: 1. Obtain and provide to the State a System for Award Management (SAM) number (Federal Acquisition Regulation, Part 4, Sub-part 4.11) if this award provides more Page 13 of 15 AFA Lo n g G en Rev 07/17/2019 DocuSign Envelope ID: 8CFC9FE1-A239-4361-B282-1FFBF80773F5 TxDOT: Federal Highway Administration: CSJ # 0902-90-096 CFDA No. 20.205 District # 02 Fort Worth CFDA Title Highway Planning and Construction Code Chart 64 # 15000 Project Name N. Sylvania on Meacham Blvd- qFA Not Used ForResearch & Development Improve Traffic Signal than $25,000 in federal funding. The SAM number may be obtained by visiting the SAM website whose address is: https://www.sam.gov/portal/public/SAM/ 2. Obtain and provide to the State a Data Universal Numbering System (DUNS) number, a unique nine-character numberthat allows federal government to track the distribution of federal money. The DUNS may be requested free of charge for all businesses and entities required to do so by visiting the Dun & Bradstreet (D&B) on-line registration website http://fedgov.dnb.com/webform; and 3. Report the total compensation and names of its top five executives to the State if: i. More than 80% of annual gross revenues are from the federal government, and those revenues are greater than $25,000,000; and ii. The compensation information is not already available through reporting to the U.S. Securities and Exchange Commission. 31. Single Audit Report If federal funds are used: A. The parties shall comply with the single audit report requirements stipulated in 2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. B. If threshold expenditures of $750,000 or more are met during the fiscal year, the Local Government must submit a Single Audit Report and Management Letter (if applicable) to TxDOT's Compliance Division, 125 East 11 th Street, Austin, TX 78701 or contact TxDOT's Compliance Division by email at singleaudits(a�txdot.gov. C. If expenditures are less than the threshold during the Local Government's fiscal year, the Local Government must submit a statement to TxDOT's Compliance Division as follows: "We did not meet the $ expenditure threshold and therefore, are not required to have a single audit performed for FY " D. For each year the Project remains open for federal funding expenditures, the Local Government will be responsible for filing a report or statement as described above. The required annual filing shall extend throughout the life of theAgreement, unless otherwise amended or the Project has been formally closed out and no charges have been incurred within the current fiscal year. 32. SignatoryWarranty Each signatory warrants that the signatory has necessary authority to execute this Agreement on behalf of the entity represented. Page 14 of 15 AFA Lo n g G en Rev 07/17/2019 DocuSign Envelope ID: 8CFC9FE1-A239-4361-B282-1FFBF80773F5 TxDOT: Federal Highway Administration: CSJ # 0902-90-096 CFDA No. 20.205 District # 02 Fort Worth CFDA Title Highway Planning and Construction Code Chart 64 # 15000 Project Name N. Sylvania on Meacham Blvd- qFA Not Used ForResearch & Development Improve Traffic Signal Each party is signing this Agreement on the date stated under that party's signature. oo��S�9�edbTHE STATE OF TEXAS �t,L�.tn,t,�%. �ft,Wa,V'f Sig n ature oo��S�g�edTHE LOCAL GOVERNMENT �� D�� Sig n ature Kenneth Stewart Typed orPrinted Name Director of Contract Services Typed or Printed Title 4/14/2021 Date Dana Burandoff Typed or Printed Name Assistant City Manager Typed or Printed Title 4/13/2021 Page 15 of 15 AFA Lo n g G en Date DS DS �{9 �� DS DS i�1d1�t,� MK �FFICIAL RECORD CITY SECRETARY FT. W�RTH, TX DocuSign Envelope ID: 8CFC9FE1-A239-4361-B282-1FFBF80773F5 TxDOT: Federal Highway Administration: CSJ # 0902-90-096 CFDA No. 20.205 District # 02- Fort Worth CFDA Title Highway Planning and Construction Code Chart 64 # 15000 Project Name N. Sylvania on Meacham Blvd- qFA Not Used ForResearch & Development Improve Traffic Signal ATTACHMENT A RESOLUTION, ORDINACE, OR COMMISSIONERS COURT ORDER A Resn�uti�� . �3�3-43-2421 A RESi1LUTli1l� r1UTHC7RILI?V{: E]iECEJTI{}R OF An ADY�#•'+10ED F[fHiDilV{� kGREEMENT V4'IT�I THE TEXAS DEPART�iE�1"T pF TRANSP(lltTaTl[)hi T,1' THR AA'fU[?ftiT �F 57G7,i1fi.00, UF 1�4'HICH L(}CAL PAR'P1C:lPA'i`lUN 1S 5�74,457.UU, FUR 'flfE 14�1k:AC41AM BT.Y1�. & NORTIi �YLYA:tiIA AY�. 1^FTER5ECTlOti jMPRO�'EhiEN'�5 PIt4�ECT WHFREAS, fcdcral law csta�lishes fedcrally fun��d pragrxms far tzan5p�rrEa[ion �mryrovcmen�s to omplcmcni i4s pub]ic purpasc; and WHEREAS, tha Texas Transportatian Code, 5ection 2�3.103 esta6lis�ies �.hat the Sta�c shali dc�ign, cunstrucl snd operalc a sy3lcm �f k�ighw�ys aud ro�ds in coDpera[ion wFth local go�ernmei�ts, and 5ectinn 222.(�52 authoriae� the Texas Departmcnt af �LRflS�7nTt�tiO❑ Comrniasinn ta accept cnntributinns from pnfiticaV subdiv"ssinna fnr Jcvclopmcnt and construclian of public roads wilhin pali[ical su6divisions; and WHEREAS, a 144aster Agreement 6etween [he Ci#y oF Fort Worfh {"Lacal C,overnment"j and the 5la�e o€Texas acling It�rough [ha Texas Daryanmcnt nf Transportatinn ("$tatc") has been approved u•iricri statcs ihe general terms and coeditions for Ad►�ance �unding Agreerncnts [AFA} for transportatian pra,jec�s aitid other projec�s: and WHF.REAS, khe Cily aF Fari Worth desires ta enter into an Advance Funding .agreement with the Texas Departmen[ o£ Trapspnrtalinn in �is� �mduni af 5?0?,116.�0, oF which $�U7,556,UU is Federal participalion, 525,093,�0 is state p�ftiGip�Li4n and �274.46"l.94 is tic}ca1 parlicipation fur rhe purpose af constructing the �leaeham Blvd. & l^forth 5ylvania Ave, Intarsactian Impro��crnents ProjGc#. ItiUW THEREFORE, 6E i'1' RESOLVEI] BY THF: CfTY CCaU�CZL DF THE CITY OF FOItT WURTN, THAT: Thc City �ianagcr is xuthoriied lo cxccule an Ad�ance Fundiog Agreament with the Texas deparnnent of Tranx�o-rtation in th� total cst3matet� amount nf �70T, I] 6.04 wi[h City psr¢icipstian in i�e esumsted amauni of �274,4G7.D� for ihe purpnse aC cons[r�cting t�r bieaeham BZvd_ & Tlor�h 5y�vania Ave. Intersecsiun �mprovemants Psoject. Adapted thiS 23'd day oiMarch 2621_ ATTEST �� I�iaty ]. I�ayser pF- �� City Scctetary ��;:- .,�y� �' h -� *`:_ :� �� Page1of1 AFA Lo n g G en Attac h men t A DocuSign Envelope ID: 8CFC9FE1-A239-4361-B282-1FFBF80773F5 TxDOT: Federal Highway Administration: CSJ # 0902-90-096 CFDA No. 20.205 District # 02 Fort Worth CFDA Title Highway Planning and Construction Code Chart 64 # 15000 Project Name N. Sylvania on Meacham Blvd- qFA Not Used ForResearch & Development Improve Traffic Signal ATTACHMENT B LOCATION MAP SHOWING PROJECT Meacham Boulevard @ North Sylvania Avenue .-.....-'..� iw.. '. i :ti� . ' ��,�� T *�:�A��«o,�� .. J ��„ di=—== _, � [�i' � `iYl�- 4 �R�6} � �4 y � � , ' ' ,: . I A � * ]- 4 l 4Y+ ��.�� A� ��1 i1r '^'�l. � I � 'y��' � . ' . � �--•"��i . ..J i� � �i.r�i: � ' . �'��,r :�- � ...� ��-- _'_.. � ,,�r�- �.��':-�' . _ :'�/ � �--�—_,., . � :.� - _.. _ . "��._,_ "_ " . ��%:x� . � •. �� f" �4r',,�-' r'��+,,,"+�;+i��';;�d"�,_,' -�._ �' ::� � � . � � €:;�-' - , i—�r. : i�i �' m` � '� ;i�,' , ��.'� ' 1�� _�q�' • ,-. ' ;� ! + '�� ' '`�� .; �.;�,,.. �. 1< ��l� . -.��r : _ �',-�.r �: k� '� r,.� �� ? a � ��:�,�.,�;�, -�,�;� . , �� , ,�� .:,� /, , �� + �. �; . . r�<tr y�� _, l�' � � � ! s i' .t' � ^ � ' ,1 '_a, �'fp �� k.,�i. J F� ,; � � .+ . . ; _ J : 'I y�i' . M �" .. � � 7+i:.f�,'� _ '�y} ti � _ . • ��, � a ' � — � �d 1=. �� 4y�., ! , �' � t �;.., f � s � � � �; r � �: �_ � - - '�* ��r .1 - ';� '. , . � � _ �oR.r.`�.�� r � `_ � � t�-- �_� • F•Yy� L �•r v4: - - � .�. s�.-�� ,/f�` � ~��. -.. _ . .`Ir e5'' ' �.R �Si � L � } � ' '. S • �� t, � _ � , ---tl� — . ��. � I ,� , _ C5J:6aoz-so-Oefi � �� ,_ , �• � ... � ,,�,w i ; . ' lrleaeharr� B�ud 4� :�'r. '• i +- � � h; !� . . ' eSJ.. a I — � . },'..'��' . � ,- : f � 1,�,�� ••a�• _ _ � ; , N Sylvanla k�a �'`i-� . -,.y+� , ��aa= ■ " , ti � ,� ti.i Mlle Radius �� `� ' � � ��+.Y �� i4 �`-_�S I ,�F�r�fi � �r �,M1j} . � w � —. — +j � I _` _ , '� k • � � j - . .� 7ir � � I � �rt � � ��. •_X. 4 � f � 4�� - ":� {� �'%y� � • _,� � � �� ., -, . � : � ,y� F.. '�� ;1�. •i �' I - - •.�+, �■ � - ti ^ry . �1��YI�'� �.� I �' r� �� :� }_'�''_ . . • � � _ _�_ �� ' ' ' , i � �� y ' `._�L u� ' -� � ' . _ ~ -i�' �' q� •'y��-' t�r r� �.•. -}•y'r►�: ��' .r�., - � � �b' . . , � : -_�.. �a..'�'`�4+' ��..��-' � � � h I�,r '__ t ��v7.! �� ' 1�.- ' i �i 4 /" r �`��., `t ,i�� . ,_�.�:� - �#! {{,, �+ .._ ��I . �f � '..y�s�� f � � � ' S '�;<� � # � �. r � -x.ti�. f 4 - .. I � 4� , w.i � . •i � : . r4; ' F'. " � � � j. -? .s _1� k} ��` �s.� � h� 5�i •�� f r- } }} � � � �'� � _ _ �'-0'F'-:._I.^...5.. +� � y,iL — � - �� :_..n�`+:#.!�. . , _� y..��:.,�....;� �;_ . ` .f } � � E. . t� L �� ` ` � r:Yr" - + �.� wt:�'' . ��1 S � '�'� l�� # i �•�� y � — —_ �a"�f �{"J'F�. ' r .` � ' x �, r.` �. _� � � �•� - �� J . _ . _ • S � _ a �, , �. �_.� � .�.._�,. � �.r{ . }`� L y . �' 1� L �.� •.t. ff 15 k�f '�4 � ' r 'I� ;''! 1 � kif��' _,.' �� ' I � � AFA Lo n g G en Page1of1 Attachment B DocuSign Envelope ID: 8CFC9FE1-A239-4361-B282-1FFBF80773F5 TxDOT: Federal Highway Administration: CSJ # 0902-90-096 CFDA No. 20.205 District # 02 Fort Worth CFDA Title Highway Planning and Construction Code Chart 64 # 15000 Project Name N. Sylvania on Meacham Blvd- qFA Not Used ForResearch & Development Improve Traffic Signal ATTACHMENT C PROJECT BUDGET Construction costs will be allocated based on 90% Federal funding and 10% Local Government funding until the federal funding reaches the maximum obligated amount. The Local Government will then be responsible for 100% of the costs overruns. Description otal ederal tate ocal Estimated artici ation artici ation artici ation ost /a Cost /a ost /o Cost Environmental (by 20,000 % $0 % 0 00% $20,000 Local Government Engineering by (Local 82,311 %$0 % 0 00% $82,311 Government Construction, Federal 452,840 0% $407,556 % 0 0°/o $45,284 funds b State Construction, Local 81,225 %$0 % 0 00% $81,225 funds (by State) Subtotal 636,376 $407,556 0 $228,820 Environmental Direct 1,000 %$0 % 0 00% $1,000 State Costs Right of Way Direct 1 %$0 % 0 00% $1 State Costs Engineering Direct 4,116 %$0 % 0 00% $4,116 State Costs Utility Direct State 1 %$0 % 0 00% $1 Costs Construction Direct 40,529 %$0 % 0 00% $40,529 State Costs Indirect State Costs 25,093 %$0 100°/o 25,093 % $0 TOTAL 707,116 $407,556 $25,093 $274,467 Initial payment by the Local Government to the State: $5,118.00 Payment by the Local Government to the State before construction: $167,038.00 Estimated total payment by the Local Government to the State $172,156.00 This is an estimate. The final amount of Local Government participation will be based on actual costs. Page 1 of 1 AFA Lo n g G en Attac h men t C DocuSign Envelope ID: 8CFC9FE1-A239-4361-B282-1FFBF80773F5 /_1�]%V[�1�11L1�]I►[el_[el:��► 1�� CSJ: 0902-90-096 PROJECT NAME: Meacham Blvd. and ADDITIONAL ROUTING SIGNATURES CITY OF FORT WORTH Contract Compliance Manager: By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensurin all�ee�grmance and reporting requirements. BY: "l � Jl�t, Yang Jin Engineering Manager, Transportation & Public Works Department Email: van�.iin@fortworthtexas.�ov APPROVAL RECOMMENDED: DocuSigned by: BY: �l�,lA.tM �1.. �DU,�t,Sbl�t, William M. Johnson, Director Transportation and Public Work Email: William.Johnson@fortworthtexas.�ov CONTRACT AUTHORIZATION M&C: Date Approved: Form 1295: N/A APPROVED AS TO FORM AND LEGALITY: DocuSigned by: BY: �b� 1/�c� Douglas W. Black Senior Assistant City Attorney Email: Dou�las.Black@fortworthtexas.�ov ATTEST AS TO CITY MANAGER SIGNATURE: DocuSigned by: BY: `� U U �� Mary J. Kayser City Secretary Email: Mary.Kayser@fortworthtexas.gov DS �� Ave. �FFICIAL RECORD CITY SECRETARY FT. W�RTH, TX Dacu�. � S E C U R E 6 Certificate Of Completion Envelopeld:8CFC9FE1A2394361B2821FFBF80773F5 Subject: DocuSign: AFA - Prime - City of Fort Worth - 0902-90-096 - Log# 43980 Source Envelope: Document Pages: 26 Signatures: 6 Certificate Pages: 6 Initials: 7 AutoNav: Enabled Envelopeld Stamping: Enabled Time Zone: (UTC-06:00) Central Time (US & Canada) Record Tracking Status: Original 4/8/2021 12:42:00 PM Holder: Lauren Dillon lauren.dillon@txdot.gov Signer Events Cynthia Don Cynthia. Don@txdot.gov Contract Specialist Texas Department of Transportation Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Yang Jin Yang.jin@fortworthtexas.gov Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 4/8/2021 1:54:09 PM ID:cde452b6-c49e-4b70-a647-c902fbd1131e William M. Johnson William.Johnson@fortworthtexas.gov TPW Director Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 11/12/2020 4:31:34 PM ID:5e794b5e-3b2f-4c9e-ad37-8c80acdfa681 Doug Black Doug.Black@fortworthtexas.gov Security Level: Email, Account Authentication (None) Status: Completed Envelope Originator: Lauren Dillon 125 E. 11 th Street Austin, TX 78701 lauren.dillon@txdot.gov IP Address: 204.64.21.251 Location: DocuSign Signature Timestamp os Sent: 4/8/2021 1:14:53 PM C� Viewed: 4/8/2021 1:43:56 PM Signed: 4/8/2021 1:46:00 PM Signature Adoption: Pre-selected Style Using IP Address: 204.64.21.251 C0°°"5'9"e°°Y: Sent: 4/8/2021 1:46:02 PM �� ,�Ua Viewed: 4/8/2021 1:54:09 PM aneco�oFasoaaes... Signed: 4/11/2021 10:07:39 AM Signature Adoption: Pre-selected Style Using IP Address: 209.194.29.100 CDocuSignetl by: �l�,tawt n'l-. �Du.ln,Sbin, DD66A6456E6D401... Signature Adoption: Pre-selected Style Using IP Address: 209.194.29.100 DocuSigned by: C�B858A28C� F . Signature Adoption: Pre-selected Style Using IP Address: 209.194.29.100 Sent:4/11/2021 10:07:41 AM Viewed: 4/12/2021 10:15:27 AM Signed: 4/12/2021 10:16:15 AM Sent: 4/12/2021 10:16:19 AM Viewed: 4/13/2021 6:07:42 PM Signed:4/13/2021 6:10:21 PM Electronic Record and Signature Disclosure: Accepted: 4/13/2021 6:07:42 PM ID:7d3273ee-45d1-4efe-b3ab-2983374e66a8 Signer Events Dana Burghdoff Dana.Burghdoff@fortworthtexas.gov Assistant City Manager Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 4/13/2021 8:07:13 PM ID:ac5ce263-2b79-4fb6-9c14-Of91169bee0c Mary Kayser Mary. Kayser@fortworthtexas.gov City Secretary Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 4/14/2021 7:22:40 AM ID:b7afec29-d8da-46c2-ae7d-9faf4f45685a Lauren Dillon lauren.dillon@txdot.gov Contract Specialist Texas Department of Transportation Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Kenneth Stewart ken neth.stewart@txdot.gov Director, Contract Services Texas Department of Transportation Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign In Person Signer Events Editor Delivery Events Agent Delivery Events Intermediary Delivery Events Certified Delivery Events Carbon Copy Events Yang Jin Yang.ji n@fortworthtexas.gov Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 4/14/2021 12:33:48 PM ID:078b5bcf-1858-4848-8424-7b3644bd7167 Signature �DocuSignetl by: � �� AC27A95F116A4A1... Signature Adoption: Pre-selected Style Using IP Address: 107.77.199.182 Signed using mobile DocuSigned by: [r U �� B745A799DiBD480... Signature Adoption: Uploaded Signature Image Using IP Address: 209.194.29.100 DS �� Signature Adoption: Pre-selected Style Using IP Address: 204.64.21.50 CDocuSigned by: �.�. ��/�- FICDASOFDBSC486... Signature Adoption: Pre-selected Style Using IP Address: 204.64.21.251 Signature Status Status Status Status Status ��PIED Timestamp Sent: 4/13/2021 6:10:24 PM Viewed: 4/13/2021 8:07:13 PM Signed:4/13/2021 8:08:41 PM Sent: 4/13/2021 8:08:45 PM Viewed: 4/14/2021 7:22:40 AM Signed: 4/14/2021 7:23:38 AM Sent: 4/14/2021 7:23:41 AM Viewed: 4/14/2021 9:57:55 AM Signed: 4/14/2021 9:58:58 AM Sent: 4/14/2021 9:59:01 AM Viewed: 4/14/2021 3:58:43 PM Signed: 4/14/2021 3:58:53 PM Timestamp Timestamp Timestamp Timestamp Timestamp Timestamp Sent: 4/14/2021 3:58:56 PM Carbon Copy Events Ngozi Lopez Ngozi. Lopez@txdot.gov Transportation Engineer Texas Department of Transportation Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 11/17/2017 7:51:19 AM ID:37355305-10f5-46c9-a587-784fad48bc9b Rose Rodriguez Rose. Rodriguez@txdot.gov Contract Administration Manager Texas Department of Transportation Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Mohammad AI Hweil Mohammad.AlHweil@txdot.gov Texas Department of Transportation Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Cynthia Don Cynthia. Don@txdot.gov Contract Specialist Texas Department of Transportation Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Witness Events Notary Events Envelope Summary Events Envelope Sent Certified Delivered Signing Complete Completed Status ��PIED ��PIED ��PIED ��PIED Signature Signature Status Hashed/Encrypted Security Checked Security Checked Security Checked Timestamp Sent: 4/14/2021 3:58:57 PM Sent: 4/14/2021 3:58:58 PM Sent: 4/14/2021 3:58:59 PM Sent: 4/14/2021 3:59:00 PM Timestamp Timestamp Timestamps 4/8/2021 1:14:53 PM 4/14/2021 3:58:43 PM 4/14/2021 3:58:53 PM 4/14/2021 3:59:00 PM Payment Events Status Timestamps Electronic Record and Signature Disclosure Electronic Record and Signature Disclosure created on: 1/9/2015 7:21:34 AM Parties agreed to: Yang Jin, William M. Johnson, Doug Black, Dana Burghdoff, Mary Kayser, Yang Jin, Ngozi Lopez ELECTRONIC RECORD AND SIGNATURE DISCLOSURE From time to time, Texas Department of Transportation (we, us or Company) may be required by law to provide to you certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically through your DocuSign, Inc. (DocuSign) Express user account. Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to these terms and conditions, please confirm your agreement by clicking the 'I agree' button at the bottom of this document. Getting paper copies At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. For such copies, as long as you are an authorized user of the DocuSign system you will have the ability to download and print any documents we send to you through your pocuSign user account for a limited period of time (usually 30 days) after such documents are first sent to you. After such time, if you wish for us to send you paper copies of any such documents from our office to you, you will be charged a$0.00 per-page fee. You may request delivery of such paper copies from us by following the procedure described below. Withdrawing your consent If you decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. How you must inform us of your decision to receive future notices and disclosure in paper format and withdraw your consent to receive notices and disclosures electronically is described below. Consequences of changing your mind If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. To indicate to us that you are changing your mind, you must withdraw your consent using the DocuSign 'Withdraw Consent' form on the signing page of your DocuSign account. This will indicate to us that you have withdrawn your consent to receive required notices and disclosures electronically from us and you will no longer be able to use your DocuSign Express user account to receive required notices and consents electronically from us or to sign electronically documents from us. All notices and disclosures will be sent to you electronically Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through your pocuSign user account all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us. How to contact Texas Department of Transportation: You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows: To contact us by email send messages to: kevin.setoda@txdot.gov To advise Texas Department of Transportation of your new e-mail address To let us know of a change in your e-mail address where we should send notices and disclosures electronically to you, you must send an email message to us at kevin.setoda@txdot.gov and in the body of such request you must state: your previous e-mail address, your new e-mail address. We do not require any other information from you to change your email address.. In addition, you must notify DocuSign, Inc to arrange for your new email address to be reflected in your pocuSign account by following the process for changing e-mail in DocuSign. To request paper copies from Texas Department of Transportation To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an e-mail to kevin.setoda@txdot.gov and in the body of such request you must state your e-mail address, full name, US Postal address, and telephone number. We will bill you for any fees at that time, if any. To withdraw your consent with Texas Department of Transportation To inform us that you no longer want to receive future notices and disclosures in electronic format you may: i. decline to sign a document from within your pocuSign account, and on the subsequent page, select the check-box indicating you wish to withdraw your consent, or you may; ii. send us an e-mail to kevin.setoda@txdot.gov and in the body of such request you must state your e-mail, full name, IS Postal Address, telephone number, and account number. We do not need any other information from you to withdraw consent.. The consequences of your withdrawing consent for online documents will be that transactions may take a longer time to process.. Required hardware and software O eratin S stems: Windows2000? or WindowsXP? Browsers (for SENDERS): Internet Ex lorer 6.0? or above Browsers (for SIGNERS): Internet Explorer 6.0?, Mozilla FireFox 1.0, NetSca e 7.2 (or above) Email: Access to a valid email account Screen Resolution: 800 x 600 minimum Enabled Security Settings: •Allow per session cookies •Users accessing the internet behind a Proxy Server must enable HTTP 1.1 settings via rox connection ** These minimum requirements are subject to change. If these requirements change, we will provide you with an email message at the email address we have on file for you at that time providing you with the revised hardware and software requirements, at which time you will have the right to withdraw your consent. Acknowledging your access and consent to receive materials electronically To confirm to us that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please verify that you were able to read this electronic disclosure and that you also were able to print on paper or electronically save this page for your future reference and access or that you were able to e-mail this disclosure and consent to an address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in electronic format on the terms and conditions described above, please let us know by clicking the 'I agree' button below. By checking the 'I Agree' box, I confirm that: • I can access and read this Electronic CONSENT TO ELECTRONIC RECEIPT OF ELECTRONIC RECORD AND SIGNATURE DISCLOSURES document; and • I can print on paper the disclosure or save or send the disclosure to a place where I can print it, for future reference and access; and Until or unless I notify Texas Department of Transportation as described above, I consent to receive from exclusively through electronic means all notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to me by Texas Department of Transportation during the course of my relationship with you. Signature: Email: tpwcontracts@fortworthtexas.gov