HomeMy WebLinkAbout060676-A1 - General - Contract - Federal Highway AdministrationCSC No. 60676-A1
AMENDMENT TO THE GRANT AGREEMENT
1. Federal Award No.
693JJ32440017
Amendment No. 0001
4. Award To
City of Fort Worth
200 Texas Street
Fort Worth, TX 76102
Unique Entity Id.: ENS6MKSIZL18
TIN No.: 756000528
6. Period of Performance
11/17/2023—11/17/2025
2. Effective Date 3. Assistance Listings No.
See No. 16 Below 20.939
5. Sponsoring Office
U.S. Department of Transportation
Federal Highway Administration
Office of Safety
1200 New Jersey Avenue, SE
HSSA-1, Mail Drop E71-117
Washington, DC 20590
7. Total Amount
Federal Share: $419,505.60
Recipient Share: $104,876.00
Other Federal Funds: $ 0.00
Other Funds: $ 0.00
Total: $524,381.60
8. Type of Agreement 9. Authority
Grant Section 24112 of the Infrastructure Investment and Jobs Act
(Pub. L. 117-58, November 15, 2021)
10. Procurement Request No.
HSA260111 CL
12. Submit Payment Requests To
See Article 5.
14. Description of the Amendment:
11. Federal Funds Obligated
$419,505.60
13. Accounting and Appropriations Data
15XO 173 E5 0.0000.05 5 SR 10500.5592000000.41010.61006600
The purpose of this amendment is to administratively close out the Grant Agreement. As a result of this
amendment, the total value of this agreement is shown in item No. 7 above.
The Recipient hereby provides a Release of Claims and agrees to release and discharge the Government from any
and all further obligations under this Grant Agreement. The Recipient and the Government represent and warrant
that the Recipient has completed all performance obligations required under this grant: including but not limited
to providing the Government with all required deliverables, reports, and/or any other information that may have
been required. The Recipient acknowledges and agrees that it has received Federal funds in the amount of
$419,505.60 for completing this Grant. This Amendment constitutes the entire agreement between the parties
with respect to the closeout of this Grant Agreement. The Grant Agreement is now closed.
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
1 of 2
RECIPIENT FEDERAL HIGHWAY ADMINISTRATION
15. Signature of Person Authorized to Sign 16. Signature of Agreement Officer
Signature
Name: Jesica McEachern
Title: Assistant City Manager
06/08/2026
Date Signature
Name: Veronica R. Jacobson
n_�o�asa
fORT��A'DPP
ATTEST:
Paa4n�os64d
Jannette Goodall
City Secretary
APPROVRECOA FNDED:
By: Lauren Prieur (Jun 3. 2026 07:54:22 CDT)
Lauren Prieur, P.E.
Director, Transportation and Public Works
APPROVED AS TO FORM AND LEGALITY
By: Douglas Black (Jun 2, 2026 16:18:22 CDT)
Douglas W Black
Sr. Assistant City Attorney
Contract Compliance Manager:
Title: Agreement Officer
M&C No.: 23-0891
M&C Date: October 17, 2023
Date
By signing, I acknowledge that I am the person responsible for the monitoring and administration of this contract,
in2 g q�uing all performance and reporting requirements.
Cfielse St. L((ouis (May 26, 2026 13:11:05 CDT)
Chelsea St. Louis, AICP
Sr. Capital Projects Officer
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
2 of 2
City of Fort Worth, Texas
Mayor and Council Communication
DATE: 10/17/23 M&C FILE NUMBER: M&C 23-0891
LOG NAME: 20SS4A COMP SAFETY ACTION PLAN FEDERAL GRANT AGREEMENT
SUBJECT
(ALL) Ratify Application for and Authorize Acceptance of the Safe Streets and Roads for All Grant with the United Stales Department of
Transportation and Federal Highway Administration in the Amount Up to $524,381.60 for the Citywide Safely Action Plan Project Which Includes
City Participation in the Amount of $104,876.00, Adopt Appropriation Ordinances and Amend the Fiscal Years 2024-2028 Capital Improvement
Program
RECOMMENDATION:
It is recommended that the City Council:
1. Ratify application for federal funds and authorize execution of the Federal Grant Agreement with the Federal Highway Administration for the
Safe Streets and Roads for All Discretionary Grant Program - SS4A Comp Safety Action Plan project (City Project No. 105099) in the
amount of $524,381,60, with Federal participation in the amount of $419,505.60 and city participation in the amount of $104,876.00;
2. Adopt the attached appropriation ordinance Increasing estimated receipts and appropriations in the Grants Capital Projects Federal
Fund, subject to the receipt of the grant, (1) in an amount up to $419,505.60 for Federal participation and (2) in the amount up to
$104,876.00 for City participation, transferred from the General Capital Projects Fund, for the purpose of funding the SS4A Comp Safety
�ction Plan project (City Project No.105099);
3. Adopt the attached appropriation ordinance adjusting estimated receipts and appropriations in the General Capital Projects Fund by
increasing estimated receipts and appropriations in SS4A Comp Safely Action Plan project (City Project No.105099) in the amount of
$104,876.00 and decreasing estimated receipts and appropriations in the Traffic System Maintenance programmable project (City Project
No. P00021) by the same amount, for the purpose of transferring to the Grants Capital Projects Fund for the required local match; and
4. Amend the Fiscal Years 2024-2028 Capital Improvement Program.
DISCUSSION:
The City of Fort Worth (City) Transportation and Public Works Department applied for and was awarded funds from the Federal Highway
Administration (FHWA) to develop a citywide Comprehensive Safety Action Plan through the Safe Streets and Roads for All discretionary grant
program. Development of the Comprehensive Safety Action Plan aligns with City Council Resolution No. 5149-11-2019, which affirms the City's
support for development of a Vision Zero based strategy to eliminate traffic related fatalities and serious injuries. The Plan will build on High -Injury
Network analysis completed In 2020, and will establish the City's Vision Zero commitment by recommending a portfolio of policies, programs, and
projects to reduce crashes, injuries and fatalities for all modes. The creation of this plan will qualify the City to compete for implementation projects
in future rounds of the Safe Streets and Roads for All program.
The purpose of this Mayor and Council Communication (M&C) Is to ratify application for and authorize acceptance of the Safe Streets and Roads
for All Grant with the Federal Highway Administration (FHWA), a division of the United States Department of Transportation. The agreement
details the responsibilities of both the City and FHWA in the development of the Comprehensive Safely Action Plan. This M&C also adopts an
appropriation ordinance to accept federal grant funds for the project.
Appropriations for the SS4A Comp Safety Action Plan project are as depicted below:
Fund
Funding Amount
Grants Capital Projects Federal Fund - Federal Participation
$419,505.60
Grants Capital Projects Federal Fund - City Participation
$104,876,00
Project Total
$524,381.60
Funding for this project was not Included in the Fiscal Years 2024-2028 Capital Improvement Program because the project and funding sources
were unknown at the time of its development. The action in this M&C will amend the Fiscal Years 2024-2028 Capital Improvement Program as
approved in connection with Ordinance 26453-09-2023.
Funding for the City participation for this grant is available In the Traffic System Maintenance programmable project.
Fund IlProject Amount
E1 90 IIP00021 Traffic System Maintenance II ($104,876.00)1
001 105099-SS4A Comp Safety Action Plan $104 876.00
Funding is budgeted in the TPW Dept Highway & Streets Department's Traffic System Maintenance programmable project within the General
Capital Projects Fund for the purpose of funding the SS4A Comp Safely Action Plan project.
Since no City salaries will be charged, indirect cost recovery does not apply.
Transportation and Public Works staff are initiating the procurement of consultant services to create the Comprehensive Safety Action Plan. The
project Is expected to start in the Winter of 2023 and be completed by the Fall of 2025.
The SS4A Comp Safety Action Plan Project is located in ALL COUNCIL DISTRICTS.
A Form 1295 is not required because: This contract will be with a governmental entity, state agency or public institution of higher education:
Federal Highway Administration
FISCAL INFORMATION / CERTIFICATION:
The Director of Finance certifies that upon approval of the above recommendations and adoption of the attached appropriation ordinances, funds
will be available in the current capital budget, as appropriated, in the Grants Capital Projects Federal Fund. The Transportation and Public Works
Department (and Financial Management Services) will be responsible for the collection and deposit of funds due to the City. Prior to an
expenditure being incurred, the Transportation and Public Works Department has the responsibllily to validate the availability of funds. This Is a
reimbursement grant.
Submitted for City Manager's Office by: William Johnson 5806
Originating Business Unit Head: Lauren Prieur 6035
Additional Information Contact: Martin Phillips 7861
Fort Worth City Urn"Ots EORTYO - RTH
Comprehensive Safety Action Plan -1,-
1".. A,
Jn
' �07
... . ........
4)
Ad,
PAIA.I..1
(123"
10
IUJ
00 ... ..... . ...
J77
X W.
LEGEND:
CITY LIMIT
- Gs'IfflounAp'll
(Mona Kane), Esd Kow. Esd (ThollAnd). NGCC,
ORDINANCE NO.26514-10-2023
AN ORDINANCE INCREASING ESTIMATED RECEIPTS AND
APPROPRIATIONS IN THE GRANTS CAPITAL PROJECTS FEDERAL FUND,
SUBJECT TO RECEIPT OF TIIE GRANT, IN THE AMOUNT UP TO $419,505.60,
FOR THE PURPOSE OF FUNDING SS4A COMP SAFETY ACTION PLAN
PROJECT (CITY PROJECT NO. 105099); PROVIDING FOR A SEVERABILITY
CLAUSE; MAKING TIIIS ORDINANCE CUMULATIVE OF PRIOR
ORDINANCES; REPEALING ALL ORDINANCES IN CONFLICT HEREWITH;
AND PROVIDING AN EFFECTIVE DATE,
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF FORT WORTH,
TEXAS:
SECTION 1.
That in addition to those amounts allocated to the various City departments for Fiscal Year 2023-2024 in the
Budget of the City Manager, there shall also be increased estimated receipts and appropriations in the Grants
Capital Projects Federal Fund, subject to the receipt of the grant, in the amount up to $419,505.60, for the
purpose of funding SS4A Comp Safety Action Plan project (City Project No. 105099).
SECTION 2.
That should any portion, section or part of a section of this ordinance be declared invalid, inoperative or void
for any reason by a court of competent jurisdiction, such decision, opinion or judgment sliall in no way impair
the remaining portions, sections, or parts of sections of this ordinance, which said remaining provisions sliall
be and remain in fill] force and effect.
SECTION 3.
That this ordinance shall be incorporated into the ordinance effecting the budget of the municipal government
of the City of Fort Worth for the ensuing Fiscal Year beginning October 1, 2023, and ending September 30,
2024, and all other ordinances and appropriations amending the same except in those instances where the
provisions of this ordinance are in direct conflict with such other ordinances and appropriations, in which
instance said conflicting provisions of said prior ordinances and appropriations are hereby expressly repealed.
SECTION 4.
This ordinance shall take effect upon adoption.
APPROVED AS TO FORM AND LEGALITY:
hfigi' I
om..:t(a<in,eon I&AGcor)
Assistant City Attorney
ADOPTED AND EFFECTIVE: October 17, 2023
CITY SECRETARY
Q�na h A ,
Jannette S. Goodall
City Secretary
-�
.'%i O o®d
0
/,P,4 ° 1
0 "° °0
�° 0
ORDINANCE NO.26515-10-2023
AN ORDINANCE ADJUSTING ESTIMATED RECEIPTS AND
APPROPRIATIONS IN THE GENERAL CAPITAL PROJECTS FUND, BY
INCREASING ESTIMATED RECEIPTS AND APPROPRIATIONS IN THE SS4A
COMP SAFETY ACTION PLAN PROJECT (CITY PROJECT NO. 105099) IN THE
AMOUNT OF $104,876,00 AND DECREASING ESTIMATED RECEIPTS AND
APPROPRIATIONS IN THE TRAFFIC SYSTEM MAINTENANCE
PROGRAMMABLE PROJECT (CITY PROJECT NO. P00021) BY THE SAME
AMOUNT; PROVIDING FOR A SEVERABILITY CLAUSE; MAILING THIS
ORDINANCE CUMULATIVE OF PRIOR ORDINANCES; REPEALING ALL
ORDINANCES IN CONFLICT HEREWITII; AND PROVIDING AN EFFECTIVE
DATE.
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF FORT WORTH,
TEXAS:
SECTION 1.
That in addition to those amounts allocated to the various City departments for Fiscal Year 2023-2024 in the
Budget of the City Manager, there shall also be adjusted estimated receipts and appropriations in the General
Capital Projects Fund, by increasing estimated receipts and appropriations in file SS4A Comp Safety Action
Plan project (City Project No. 105099) in the amount of $104,876.00 and decreasing estimated receipts and
appropriations in the Traffic System Maintenance programmable project (City Project No.P00021) by the
same amount.
SECTION 2.
That should any portion, section or part of a section of this ordinance be declared invalid, inoperative or void
for any reason by a court of competent jurisdiction, such decision, opinion or judgment shall in no way impair
the remaining portions, sections, or parts of sections of this ordinance, which said remaining provisions shall
be and remain in frill force and effect.
SECTION 3.
That this ordinance shall be incorporated into the ordinance effecting the budget of the municipal government
of the City of Fort Worth for the ensuing Fiscal Year beginning October 1, 2023, and ending September 30,
2024, and all other ordinances and appropriations amending the same except in those instances where the
provisions of this ordinance are in direct conflict with such other ordinances and appropriations, in which
instance said conflicting provisions of said prior ordinances and appropriations are hereby expressly repealed.
SECTION 4.
This ordinance shall take effect upon adoption.
APPROVED AS TO FORM AND LEGALITY:
Assistant City Attorney
ADOPTED AND EFFECTIVE: October 17, 2023
CITY SECRETARY
Jannette S. Goodall
City Secretary
0
Was
CSC No. 60676
1. Award No.
693JJ32440017
4. Award To
City of Fort Worth, Texas
200 Texas Street
Fort Worth, TX 76102
Unique Entity Id.: ENS6MKSIZL18
TIN No.: 756000528
6. Period of Performance
Effective Date of Award through 24
Months
2. Effective Date
See No. 17 Below
3. Assistance
Listings No.
20.939
5. Sponsoring Office
U.S. Department of Transportation
Federal Highway Administration
Office of Safety
1200 New Jersey Avenue, SE
HSSA-1, Mail Drop E71-117
Washington, DC 20590
7. Total Amount
Federal Share: $419,505.60
Recipient Share: $104,876.00
Other Federal Funds: $0
Other Funds: $0
Total: $524,381.60
8. Type of Agreement 9. Authority
Grant Section 24112 of the Infrastructure Investment
and Jobs Act (Pub. L. 117-58, November 15,
2021; also referred to as the "Bipartisan
Infrastructure Law" or "BIL")
10. Procurement Request No.
HSSP230386PR
12. Submit Payment Requests To
See article 20.
11. Federal Funds Obligated
$419,505.60
13. Payment Office
See article 20.
14. Accounting and Appropriations Data
15XOI 73E50.0000.055SR10500.5592000000.41010.61006600
15. Description of Project
Fort Worth Citywide Safety Action Plan
RECIPIENT
16. Signature of Person Authorized to Sign
L�L _
William ohnson (N v 14, 2023 07:iG CST)
Signature Date
Name: William Johnson
Title: Assistant City Manager
FEDERAL HIGHWAY ADMINISTRATION
17. Signature of Agreement Officer
HECTOR RAMON Digitally signed byHECrOR
RAMON SANTAMARIA
SANTAMARIA Date: 2023.11.17 10:22:33 -05'00'
Signature Date
Name: HectorR. Santamaria
Title: Agreement Officer
1 of 13
U.S. DEPARTMENT OF TRANSPORTATION
GRANT AGREEMENT UNDER THE
FISCAL YEAR 2022 SAFE STREETS AND ROADS FOR ALL GRANT PROGRAM
This agreement is between the [United States Department of Transportation (the "USDOT")]
[Federal Highway Administration (the "FHWA")] and the City of Fort Worth, TX (the
"Recipient").
This agreement reflects the selection of the Recipient to receive a Safe Streets and Roads for
All ("SS4A") Grant for the Fort Worth Citywide Safety Action Plan.
The parties therefore agree to the following:
ARTICLE 1
GENERAL TERMS AND CONDITIONS
1.1 General Terms and Conditions.
(a) In this agreement, "General Terms and Conditions" means the content of the document
titled "General Terms and Conditions Under the Fiscal Year 2022 Safe Streets and Roads
for All Grant Program," dated February 8, 2023, which is available at
hops://wNvNv.ti-anspoi-tation.goN,/grants/ss4a/grant-agreements. Articles 7-30 are in the
General Terms and Conditions. The General Terms and Conditions are part of this
agreement.
(b) The Recipient states that it has knowledge of the General Terms and Conditions.
Recipient also states that it is required to comply with all applicable Federal laws and
regulations including, but not limited to, the Uniform Administrative Requirements, Cost
Principles, and Audit Requirements for Federal Awards (2 CFR part 200); National
Environmental Policy Act (NEPA) (42 U.S.C. § 4321 et seq.); and Build America, Buy
America Act (BIL, div. G §§ 70901-27).
(c) The Recipient acknowledges that the General Terms and Conditions impose obligations
on the Recipient and that the Recipient's non-compliance with the General Terms and
Conditions may result in remedial action, termination of the SS4A Grant, disallowing
costs incurred for the Project, requiring the Recipient to refund to the FHWA the SS4A
Grant, and reporting the non-compliance in the Federal -government -wide integrity and
performance system.
2of13
ARTICLE 2
APPLICATION, PROJECT, AND AWARD
2.1 Application.
Application Title: Conduct a citywide Safety Action Plan building on previous work
with public involvement, collecting and analyzing detailed multimodal crash -data, and
identifying projects that reduce serious crashes.
Application Date: 9/15/2022
2.2 Award Amount.
SS4A Grant Amount: $419,505.60
2.3 Award Dates.
Period of Performance End Date: See section 6 on page 1
2.4 Budget Period.
Budget Period End Date: See section 6 on page 1
2.5 Action Plan Giant or Implementation Giant Designation.
Designation: Action Plan
2.6 Federal Award Identification Number. The Federal Award Identification
Number is listed on page 1, line 1,
ARTICLE 3
SUMMARY PROJECT INFORMATION
3.1 Summaiy of Project's Statement of Work.
The award will be used by the City of Fort Worth to develop a comprehensive safety
action plan.
3.2 Project's Estimated Schedule.
3of13
ACTION PLAN SCHEDULE
Milestone
Schedule Date
Planned Draft Action Plan Completion
Date:
14 months from Effective Date of Award
Planned Action Plan Completion Date:
20 months from Effective Date of Award
Planned Action Plan Adoption Date:
22 months from Effective Date of Award
Planned SS4A Final Report Date:
24 months from Effective Date of Award
3.3 Project's Estimated Costs.
(a) Eligible Project Costs
Eligible Project Costs
SS4A Grant Amount: $419,505.60
Other Federal Funds: $0.00
State Funds: $0.00
Local Funds: $104,876.00
In -Kind Match: $0.00
Other Funds: $0.00
Total Eligible Project Cost: $524,381,60
(b) Supplemental Estimated Budget
Cost Element
IF, Share
Non -Federal Share
Total Budget
Amount
Direct Labor
$0.00
$0.00
$0.00
Fringe Benefits
$0.00
$0.00
$0.00
Travel
$0.00
$0.00
$0.00
Equipment
$0.00
$0.00
$0.00
Supplies
$0.00
$0.00
$0.00
Contractual/Consultant
$419,505.60
$104,876.00
$524,381.60
Other
$0.00
$0.00
$0.00
Indirect Costs
$0.00
$0.00
$0.00
Total Budget
$419,505.60
$104,876.00
$524,381.60
4of13
ARTICLE 4
RECIPIENT INFORMATION
4.1 Recipient's Unique Entity Identifier.
ENS6MKS 1 ZL 18
4.2 Recipient Contact(s).
Chelsea St. Louis
Senior Capital Projects Officer
City of Fort Worth, TX
5001 James Avenue, Fort Worth TX, 76115
(817) 392-7978
Clielsea.st.lotiis@fortwortlitexas.gov
fortworthtexas.gov
4.3 Recipient ICey Pei-sonnel.
Name
Title or Position
Namoo Han
Professional Engineer
Chelsea St. Louis
Sr. Capital Projects Officer
Mike Landvik
Transportation Planning Manager
Kelly Porter
Assistant Public Works Director
4.4 USDOT Project Contact(s).
Meg Miller
Safe Streets and Roads for All Program Manager
Federal Highway Administration
Office of Safety
HSSA-1, Mail Stop: E71-117
1200 New Jersey Avenue, S.E.
Washington, DC 20590
202-366-8029
meg.miller@dot.gov
5of13
and
Hector R. Santamaria
Agreement Officer (AO)
Federal Highway Administration
Office of Acquisition and Grants Management
HCFA-33, Mail Stop E62-310
1200 New Jersey Avenue, S.E.
Washington, DC 20590
Hector.Santamaria@dot.gov
and
Mishel R. McCants
Agreement Specialist (AS)
Office of Acquisition and Grants Management
HCFA-33, Mail Stop E62-204
1200 New Jersey Avenue, S.E.
Washington, DC 20590
Mishel.McCants@dot.gov
and
Al Alonzi
Agreement Officer's Representative (AOR
Division Administrator
FHWA-TX Division
308 W. 8"' Street, Room 826
512-536-5902
al.alonzi@dot.gov
dot.gov
and
Lisa Larsen
TX Division Office Point of Contact
Special Programs Coordinator
FHWA-TX Division
300 E. 8th Street, Rom 826
512-536-5965
lisa.larsen@dot.gov
6of13
ARTICLE 5
USDOT ADMINISTRATIVE INFORMATION
5.1 Office for Subaward and Contract Authorization.
USDOT Office for Subaward and Contract Authorization: FHWA Office of Acquisition
and Grants Management
SUBAWARDS AND CONTRACTS APPROVAL
Note: See 2 CFR § 200.331, Subrecipient and contractor determinations, for definitions of
Subrecipient (who is awarded a subaward) versus contractor (who is awarded a contract).
Note: Recipients with a procurement system deemed approved and accepted by the Government
or by the AO are exempt from the requirements of this clause. See 2 CFR 200.317 through
200.327,
Note: This clause is only applicable to Action Plan Grants.
Unless described in the application and funded in the approved award, the Recipient must obtain
prior written approval from the AO for the subaward, transfer, or contracting out of any work
under this award above the Simplified Acquisition Threshold. This provision does not apply
to the acquisition of supplies, material, equipment, or general support services. Approval of
each subaward or contract is contingent upon the Recipient's submittal of a written fair and
reasonable price determination, and approval by the AO for each proposed contractor/sub-
recipient. Consent to enter into subawards or contracts will be issued through written
notification from the AO or a formal amendment to the Agreement.
The following subawards and contracts are currently approved under the Agreement by the AO.
This list does not include supplies, material, equipment, or general support services which are
exempt from the pre -approval requirements of this clause.
(Fill in at award or by amendment)
5.2 Reimbursement Requests
(a) The Recipient may request reimbursement of costs incurred in the performance of this
agreement if those costs do not exceed the finds available under section 2.2 and are
allowable under the applicable cost provisions of 2 C.F.R. Part 200, Subpart E. The
Recipient shall not request reimbursement more frequently than monthly.
(b) The Recipient shall use the DELPHI eInvoicing System to submit requests for
reimbursement to the payment office. When requesting reimbursement of costs
incurred or credit for cost share incurred, the Recipient shall electronically submit
supporting cost detai I with the SF 271 (Outlay Report and Request for Reimbursement
for Construction Programs) to clearly document all costs incurred.
7 of 13
(c) The Recipient's supporting cost detail shall include a detailed breakout of all costs
incurred, including direct labor, indirect costs, other direct costs, travel, etc., and the
Recipient shall identify the Federal share and the Recipient's share of costs. If the
Recipient does not provide sufficient detail in a request for reimbursement, the AO may
withhold processing that request until the Recipient provides sufficient detail.
(d) The USDOT shall not reimburse costs unless the Agreement Officer's Representative
'(the "AOR") reviews and approves the costs to ensure that progress on this agreement
is sufficient to substantiate payment.
(e) The USDOT may waive the requirement that the Recipient use the DELPHI eInvoicing
System. The Recipient may obtain waiver request forms on the DELPHI eInvoicing
website (httt)://www.dot.gov/cfo/delphi-einvoicing-system.html) or by contacting the
AO. A Recipient who seeks a waiver shall explain why they are unable to use or access
the Internet to register and enter payment requests and send a waiver request to
Director of the Office of Financial Management
US Department of Transportation,
Office of Financial Management B-30, Roorn W93-431
1200 New Jersey Avenue SE
Washington DC 20590-0001
91
DOTElectroiiicInvoicing@dot.gov.
If the USDOT grants the Recipient a waiver, the Recipient shall submit SF 271 s directly
to:
DOT/FAA
P.O. Box 268865
Oklahoma City, OK 73125-8865
Attn: Agreement Specialist
(f) The requirements set forth in these terms and conditions supersede previous financial
invoicing requirements for Recipients.
ARTICLE 6
SPECIAL GRANT TERMS
6.1 SS4A funds must be expended within five years after the grant agreement is executed and
DOT obligates the funds, which is the budget period end date in section 10.3 of the
Terms and Conditions and section [wherever the date it is in this agreement].
8of13
6.2 The Recipient acknowledges that the Action Plan will be made publicly available, and the
Recipient agrees that it will publish the final Action Plan on a publicly available website.
6.3 The Recipient demonstrates compliance with civil rights obligations and nondiscrimination
laws, including Titles VI of the Civil Rights Act of 1964, the Americans with Disabilities Act
(ADA), and Section 504 of the Rehabilitation Act, and accompanying regulations. Recipients
of Federal transportation funding will also be required to comply fully with regulations and
guidance for the ADA, Title VI of the Civil Rights Act of 1964, Section 504 of the
Rehabilitation Act of 1973, and all other civil rights requirements.
6.4 There are no other special grant requirements for this award.
9of13
ATTACHMENT A
PERFORMANCE MEASUREMENT INFORMATION
Study Area: City limits of Fort Worth
Baseline Measurement Date: 09/01/2023
Baseline Report Date: 10/1 /2023
Table 1: Performance Measure Table
Measure
Category and Description
Measurement
Frequency
Percent of Funds to Underserved
Equity
Communities: Funding amount (of total
End of period of
project amount) benefitting underserved
performance
communities, as defined by USDOT
Project Costs: Quantification of the cost
End of period of
Costs
of each eligible project carried out using
performance
the grant
Lessons Learned and Recommendations:
Lessons Learned and
Description of lessons learned and any
End of period of
Recommendations
recommendations relating to future
performance
projects of strategies to prevent death and
serious injury on roads and streets.
10 of 13
ATTACHMENT B
CHANGES FROM APPLICATION
INSTRUCTIONS FOR COMPLETING ATTACHMENT B: Describe all material
differences between the scope, schedule, and budget described in the application and the scope,
schedule, and budget described in Article 3. The purpose of this attachment B is to document the
differences clearly and accurately in scope, schedule, and budget to establish the parties'
knowledge and acceptance of those differences. See section 10.1.
Scope: N/A
Schedule: N/A
Budget: N/A
The table below provides a summary comparison of the project budget.
Fund Source
Application
$ %
Section 3.3
$ %
Previously Incurred Costs
Non -Eligible Project Costs
1iI I ll;�
;
�I
! . �
:I
,,.
I I '1 '
Federal Funds
Non -Federal Funds
Total Previously Incurred Costs
Future Eligible Project Costs
iij
SS4AFunds
Other Federal Funds
Non -Federal Funds
Total Future Eligible Project
Costs
Total Project Costs
I 1 of 13
ATTACHMENT C
RACIAL EQUITY AND BARRIERS TO OPPORTUNITY
1. Efforts to Improve Racial Equity and Reduce Barriers to Opportunity.
The Recipient states that rows marked with "X" in the following table are accurate:
A racial equity impact analysis has been completed for the Project. (Identil a
report on thal analysis or, if 770 report was produced, describe the analysis and
its results in the syl-?poi-flng narrative below.
The Recipient or a project partner has adopted an equity and inclusion
program/plan or has otherwise instituted equity -focused policies related to
x
project procurement, material sourcing, construction, inspection, hiring, or
other activities designed to ensure racial equity in the overall delivery and
implementation of the Project. (IdentijJ1 the relevant programs, plans, or
policies in the supporting narrative below.
The Project includes physical -barrier -mitigating land bridges, caps, lids, linear
parks, and multimodal mobility investments that either redress past barriers to
opportunity or that proactively create new connections and opportunities for
underserved communities that are underserved by transportation. (Identi) the
relevant investments in the su ortin narrative below.
The Project includes new or improved walking, biking, and rolling access for
individuals with disabilities, especially access that reverses the disproportional
impacts of crashes on people of color and mitigates neighborhood bifurcation.
(Identi l the nenv or improved access in the SUPP07-ting narrative below.
The Project includes new or improved freight access to underserved
communities to increase access to goods and job opportunities for those
underserved communities. (Identify the neiv or improved access in the
su orfin narrative beloiv.
The Recipient has taken other actions related to the Project to improve racial
equity and reduce barriers to opportunity, as described in the supporting
narrative below.
The Recipient has not yet taken actions related to the Project to improve racial
x
equity and reduce barriers to opportunity but, before beginning construction of
the project, will take relevant actions described in the supporting narrative
below
The Recipient has not taken actions related to the Project to improve racial
equity and reduce barriers to opportunity and will not take those actions under
this award.
2. Supporting Narrative.
The City of Fort Worth has a Diversity and Inclusion Department that maintains and
implements our city MBE/WBE program. They set MBE/WBE goals prior to
procurement and also review and approve MBE/WBE/DBE (whichever is applicable
based on funding source) participation prior to contract execution. This department also
12 of 13
conducts extensive outreach to MBE/WBE/DBE firms to increase participation and
improve the business equity program. Our previous high injury network document which
the Action Plan will build on considered equity and the Action Plan work will as well in
terms of data collection, outreach, project identification and recommendations.
13 of 13
ACCEPTED AND AGREED:
City:
By: Wiula n2,2024 11:58 CST)
Name: William Johnson
Title: Assistant City Manager
Date:
CITY OF FORT WORTH INTERNAL ROUTING PROCESS:
Approval Recommended:
A0. F.
By: Lau Prieur(Dec 19, 202313:08 CST)
Name: Lauren Prieur
Title: Transportation and Public Works
Director
Approved as to Form and Legality:
BY: DBlack(DecI9,202312:57CST)
ter✓
Name: Doug W Black
Title: Senior Assistant City Attorney
Contract Authorization:
M&C: M&C 23-0891 / October 17, 2023
Form 1295#: Not Applicable
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.
/�LJ. P7
By: CheIc a S:. LO WSID?c 15, 202311:55 CST)
Name: Chelsea St. Louis
Title: Sr. Capital Projects Officer
City Secretary:
By: U
Name: Jannette S. Goodall
Title: City Secretary
FORTWORTH.
Routing and Transmittal Slip
Transportation & Public Works
DOCUMENT
TITLE: Amendment to FHWA SS4A Agreement — Grant
Closeout
M&C: 23-0891 CPN: 105099 CSO:
DOC#:
Date: 5/26/2026
To:
Name
Department
Initials
Date Out
1.
Chelsea St. Louis
TPW - Signature
Reis- St.Louis
2.
Anna Benavides
TPW - Initial
3.
Martin Phillips
TPW - Initial
M
4.
Doug Black
CAO - Signature
o
5.
Lauren Prieur
TPW - Signature
6.
Jesica McEachern
CMO - Signature
7.
Katherine Cenicola
CSO - Initial
8.
Jannette Goodall
CSO - Signature
9.
Allison Tidwell
CSO
10.
Chelsea St. Louis
TPW
11.
12.
DOCUMENTS FOR CITY MANAGER'S SIGNATURE: All documents received from any and all
City Departments requesting City Manager's signature for approval MUST BE ROUTED TO THE
APPROPRIATE ACM for approval first. Once the ACM has signed the routing slip, David will review
and take the next steps.
NEEDS TO BE NOTARIZED: ❑YES ®No
RUSH: ❑YES ❑No SAME DAY: ❑YES ❑No NEXT DAY: [-]YES ❑No
ROUTING TO CSO: ®YES ❑No
Action Required:
❑ As Requested
❑ For Your Information
® Signature/Routing and or Recording
❑ Comment
❑ File
Thank you!
❑ Attach Signature, Initial and Notary Tabs
FORT WORTH.
City Secretary's Office
Contract Routing & Transmittal Slip
Contractor's Name: Federal Highway Administration
Subject of the Agreement: Safe Streets and Roads for All Grant Agreement Amendment
The purpose of the amendment is to administratively close out the grant.
M&C Approved by the Council? * Yes 9 No ❑
If so, the M&C must be attached to the contract.
Is this an Amendment to an Existing contract? Yes 8 No ❑ 60676 Al
If so, provide the original contract number and the amendment number.
Is the Contract "Permanent"? *Yes ❑ No 8
If unsure, see back page for permanent contract listing.
Is this entire contract Confidential? *Yes ❑ No 9 If only specific information is
Confidential, please list what information is Confidential and the page it is located.
Effective Date: 11/17/2023
If different from the approval date.
Expiration Date: 11/17/2025
If applicable.
Is a 1295 Form required? * Yes 8 No 0
*If so, please ensure it is attached to the approving M&C or attached to the contract.
Project Number: If'applicable. 105099
*Did you include a Text field on the contract to add the City Secretary Contract (CSC)
number? Yes 8 No ❑
Contracts need to be routed for CSO processing in the followingorder:
rder:
1. Katherine Cenicola (Approver)
2. Jannette S. Goodall (Signer)
3. Allison Tidwell (Form Filler)
*Indicates the information is required and if the information is not provided, the contract will be
returned to the department.