Backup Documents 09/23/2014 Item #16C3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO C
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1.
2.
3. County Attorney Office County Attorney Office 9/23/14
c
4. BCC Office Board of County j \h
Commissioners Y ,V lam/ (1`211-3\y-k
5. Minutes and Records Clerk of Court's Office
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the
addressees above,may need to contact staff for additional or missing information.
Name of Primary Staff Nathan Beals, ublic Utilities Planning . Phone Number 252-2583
Contact/ Department
Agenda Date Item was 9/23/14 ' Agenda Item Number 16-C-3
Approved by the BCC
Type of Document Tern orary Use Permit Number of Original 2 Resolutions
Attached 0 at 4- IR( Documents Attached 4 Agreements
PO number or account n/a—See attached email for account number
number if document is for required certified copies
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A" in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature? SRT
2. Does the document need to be sent to another agency for additional signatures? If yes, SRT
provide the Contact Information(Name;Agency;Address; Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be SRT
signed by the Chairman, with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's SRT
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the SRT
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's SRT
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip SRT
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on 9/23/14 and all changes made during the SRT
meeting have been incorporated in the attached document. The County Attorney's
Office has reviewed the changes, if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the ,
BCC, all changes directed by the BCC have been made,and the document is ready for •
Chairman's signature.
PLEASE CONTACT NATHAN BEALS (2583) WHEN READY. FDOT IS ' • G IT UP FROM
HIM TOMORROW.
i•P„r,,-,e/rn„„t„Fnrn,c/RC('P,rn,c/nrioinai Flnolimpnte a,.,tiro Cl;,, MAN nri,,inai 0(V 05 QP.,,cr,A I ')K 0a P PI71CPA )n 0c•pP„■rP,1 I 1/10/11
16C3
MEMORANDUM
Date: September 23, 2014
To: Nathan Beals, Project Engineer
Public Utilities Engineering Dept.
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: Resolution 2014-191/Temporary Use Permit
Attached is one (1) original resolution and three (3) certified resolutions and
four (4) original agreements of the document referenced above, (Item #16C3)
approved by the Board of County Commissioners on September 23, 2014.
Please forward to FDOT for additional signatures and return a fully executed
original agreement back to the Minutes & Records Department to be kept in
the Board's Official Records.
If you have any questions, please contact me at 252-8411.
Thank you.
Attachments
16C 3 .
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
RESOLUTION 2 01 4-1 91 Forth No.
UTILITY AGREEMENT Utthties
Rev.00100
Financial Project ID:429120-1-52-01 Federal Project ID: NIA
County/Section No: Collier State Road No.84 ,
District Document No: 1
Utility Agency/Owner(UAO):Collier County Water-Sewer District
WHEREAS, the STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION, hereinafter referred to as the
"FOOT", proposes to construct or reconstruct a transportation facility identified above, hereinafter referred to as the
"Project"; and
WHEREAS, in order for the FOOT to proceed with the Project, it is necessary for Collier County Water-Sewer
District, hereinafter referred to as the"UAO",to execute and deliver to the FOOT the agreement identified as Utility Work
Agreement(at UAO's Sole Expense),hereinafter referred to as the"Agreement";
NOW,THEREFORE,BE R RESOLVED BY THE UAO:
That(Name)Tom Henning, Chairman of the Collier County Board of County Commissioners and ex-officio the
governing board of the Collier County Water-Sewer District be hereby authorized and directed to execute and deliver the
Agreement to the FOOT.
A certified copy of this Resolution is to be forwarded to the FOOT along with the executed Agreement.
ON MOTION of Commissioner , seconded by Commissioner , the above resolution was
introduced and passed by the UAO on the 3 day o , year of `r, --.
ATTEST:` ' BOARD OF COUNTY COMMISSIONERS, COLLIER COUNTY,
DWI T E. BROC LEES( ' AS THE GOVERNING BODY OF COLLIER COUNTY AND
y \ FLORIDA,
� EX-OFFICIO HE GOV.,-NING BOARD OF THE COLLIER COUNTY
WATER-SEWER DIST I 1 T
� P,UTY LERK /
est as to�' alrman s
signature only. By £- 1■
Tom Henning, C ' IR 1 • ` '
Ap oval for form n legal Sufficiency: /
i
c- -e-tj .e...a..-1.
Scott Teach
Deputy County Attorney
I
qjt
16C3
Form No.710-010-55
Utilities
10/04
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
UTILITY WORK AGREEMENT
(at UAO's Sole Expense)
Financial Project ID: 429120-1-52-01 Federal Project ID: NIA
County: Collier (03001) State Road No.: 84
District Document No: 1
Utility Agency/Owner(UAO): Collier County Water-Sewer District
THIS AGREEMENT, entered into this day of , year of , by and
between the STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION, hereinafter
referred to as the "FDOT, and Collier County, hereinafter referred to as the "UAO";
WITNESSETH:
WHEREAS, the UAO owns or desires to install certain utility facilities which are located
on the public road or publicly owned rail corridor identified below, hereinafter referred to as the
"Facilities" (said term shall be deemed to include utility facilities as the same may be relocated,
adjusted, or placed out of service); and
WHEREAS, the FDOT, is currently engaging in a project which involves constructing,
reconstructing, or otherwise changing a public road and other improvements located on a
public road or publicly owned rail corridor identified as Davis Boulevard, State Road No.84,
hereinafter referred to as the "Project"; and
WHEREAS, the Project requires the location (vertically and/or horizontally), protection,
relocation, installation, adjustment, or removal of the Facilities, or some combination thereof,
hereinafter referred to as "Utility Work"; and
WHEREAS, under the law of the State of Florida, the Utility Work must be performed at
the sole cost and expense of the UAO; and
WHEREAS, the FDOT and the UAO desire to enter into an agreement which
establishes the terms and conditions applicable to the Utility Work;
NOW, THEREFORE, in consideration of the premises and the mutual covenants
contained herein, the FDOT and the UAO hereby agree as follows:
1. Performance of Utility Work
a. The UAO shall perform the Utility Work in accordance with the utility relocation
schedule attached hereto as Exhibit A and by this reference made a part hereof
(the Schedule) and the plans and specifications for the Utility Work which have
been previously approved by the FDOT (the Plans), said Plans being incorporated
herein and made a part hereof by this reference. If the Schedule and the Plans
have not been prepared as of the date of the execution of this Agreement, then the
Utility Work shall be performed in accordance with the Plans, and the Schedule
that are hereafter prepared in compliance with the notice previously sent to the
Page 1 of 10
16C3
Form No.710-010-55
Utilities
10/04
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
UTILITY WORK AGREEMENT
(at UAO's Sole Expense)
UAO which established the terms and conditions under which those documents
are to be prepared. The FDOT's approval of the Plans shall not be deemed to be
an adoption of the Plans by the FDOT nor a substitution for the proper exercise of
engineering judgment and the UAO shall at all times remain responsible for any
errors or omissions in the Plans. The Utility Work shall include all Facilities located
on the Project and neither the failure of the UAO to include all of the Facilities in
the Schedule, nor the Plans, nor the failure of the FDOT to identify this omission
during its review of the Plans shall relieve the UAO of the obligation to make those
Facilities part of the Utility Work. Time shall be of the essence in complying with
the total time shown by the Schedule for the Utility Work as well as any and all
interim time frames specified therein. The Utility Work shall be performed in a
manner and using such methods so as to not cause a delay to the FDOT or its
contractors in the prosecution of the Project. The UAO shall be responsible for all
costs incurred as a result of any delay to the FDOT or its contractors caused by
errors or omissions in the Plans or the Schedule (including location of the Facilities
and the proper inclusion of all Facilities as part of the Utility Work as stated above);
failure to perform the Utility Work in accordance with the Plans and Schedule; or
failure of the UAO to comply with any other obligation under this Agreement or
under the law.
b. All Utility Work shall be performed by UAO's own forces or its contractor at the
UAO's sole cost and expense. The UAO shall be responsible for obtaining any
and all permits that may be necessary to perform the Utility Work. The FDOT's
Engineer (as that term is defined by the FDOT's Standard Specifications for Road
and Bridge Construction) has full authority over the Project and the UAO shall be
responsible for coordinating and cooperating with the FDOT's Engineer. In so
doing, the UAO shall make such adjustments and changes in the Plans and
Schedule as the FDOT's engineer shall determine are necessary for the
prosecution of the Project and shall stop work or modify work upon order of the
FDOT's engineer as determined by the FDOT's engineer to be necessary for
public health, safety or welfare. The UAO shall not be responsible for the cost of
delays caused by such adjustments or changes unless they are attributable to the
UAO pursuant to subparagraph 1 a.
c. After the FDOT has received a proper Schedule and Plans, the FDOT will issue a
notice to the UAO which authorizes the Utility Work to proceed. The UAO shall
notify the appropriate FDOT office in writing prior to beginning the Utility Work and
when the UAO stops, resumes, or completes the Utility Work. The Utility Work
shall be performed under the conditions of, and upon completion of the Utility
Work, the Facilities shall be deemed to be located on the public road or publicly
owned rail corridor under and pursuant to, the Utility Permit N/A (Note: Intent of
this line is to allow either attachment of or separate reference to the permit).
2. Claims Against UAO
a. In the event the FDOT's contractor provides a notice of intent to make a claim
Page 2 of 10
16C3
Form No.710-010-55
Utilities
10/04
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
UTILITY WORK AGREEMENT
(at UAO's Sole Expense)
against the FDOT relating to the Utility Work, the FDOT will, in accordance with
the FDOT's procedure, notify the UAO of the notice of intent and the UAO will
thereafter keep and maintain daily field reports and all other records relating to the
intended claim.
b. In the event the FDOT's contractor makes any claim against the FDOT relating to
the Utility Work, the FDOT will notify the UAO of the claim and the UAO will
cooperate with the FDOT in analyzing and resolving the claim within a reasonable
time. Any resolution of any portion of the claim directly between the UAO and the
FDOT's contractor shall be in writing, shall be subject to written FDOT
concurrence and shall specify the extent to which it resolves the claim against the
FDOT.
3. Out of Service Facilities
No Facilities shall be left in place on FDOT's Right of Way after the Facilities are no
longer active (hereinafter Placed out of service/Deactivated) unless specifically
identified as such in the Plans. The following terms and conditions shall apply to
Facilities Placed out of service/Deactivated, but only to said Facilities Placed out of
service/Deactivated:
a. The UAO acknowledges its present and continuing ownership of and responsibility
for Facilities Placed out of service/Deactivated.
b. The FDOT agrees to allow the UAO to leave the Facilities within the right of way
subject to the continuing satisfactory performance of the conditions of this
Agreement by the UAO. In the event of a breach of this Agreement by the UAO,
the Facilities shall be removed upon demand from the FDOT in accordance with
the provisions of subparagraph 3. e. below.
c. The UAO shall take such steps to secure the Facilities and otherwise make the
Facilities safe in accordance with any and all applicable local, state or federal laws
and regulations and in accordance with the legal duty of the UAO to use due care
in its dealings with others. The UAO shall be solely responsible for gathering all
information necessary to meet these obligations.
d. The UAO shall keep and preserve all records relating to the Facilities, including,
but not limited to, records of the location, nature of, and steps taken to safely
secure the Facilities and shall promptly respond to information requests
concerning the Facilities that are Placed out of service/Deactivated of the FDOT or
other permittees using or seeking use of the right of way.
e. The UAO shall remove the Facilities upon 30 days prior written request of the
FDOT in the event that the FDOT determines that removal is necessary for FDOT
use of the right of way or in the event that the FDOT determines that use of the
right of way is needed for other active utilities that cannot be otherwise
Page 1 of 10
C:3)
16C3 --
Form No.710-010-55
Utilities
10/04
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
UTILITY WORK AGREEMENT
(at UAO's Sole Expense)
accommodated in the right of way. In the event that the Facilities that are Placed
out of Service/Deactivated would not have qualified for reimbursement under this
Agreement, removal shall be at the sole cost and expense of the UAO and without
any right of the UAO to object or make any claim of any nature whatsoever with
regard thereto. In the event that the Facilities that are Placed out of
Service/Deactivated would have qualified for reimbursement only under Section
337.403 (1)(a), Florida Statutes, removal shall be at the sole cost and expense of
the UAO and without any right of the UAO to object or make any claim of any
nature whatsoever with regard thereto because such a removal would be
considered to be a separate future relocation not necessitated by the construction
of the project pursuant to which they were Placed out of service/Deactivated, and
would therefore not be eligible and approved for reimbursement by the Federal
Government. In the event that the Facilities that are Placed out of
service/Deactivated would have qualified for reimbursement for other reasons,
removal of the out of service Facilities shall be reimbursed by the FDOT as though
the Facilities had not been Placed out of service/Deactivated. Removal shall be
completed within the time specified in the FDOT's notice to remove. In the event
that the UAO fails to perform the removal properly within the specified time, the
FDOT may proceed to perform the removal at the UAO's expense pursuant to the
provisions of Sections 337.403 and 337.404, Florida Statutes.
f. Except as otherwise provided in subparagraph e. above, the UAO agrees that the
Facilities shall forever remain the legal and financial responsibility of the UAO.
The UAO shall reimburse the FDOT for any and all costs of any nature whatsoever
resulting from the presence of the Facilities within the right of way. Said costs
shall include, but shall not be limited to, charges or expenses which may result
from the future need to remove the Facilities or from the presence of any
hazardous substance or material in the Facilities or the discharge of hazardous
substances or materials from the Facilities. Nothing in this paragraph shall be
interpreted to require the UAO to indemnify the FDOT for the FDOT's own
negligence; however, it is the intent that all other costs and expenses of any nature
be the responsibility of the UAO.
4. Default
a. In the event that the UAO breaches any provision of this Agreement, then in
addition to any other remedies which are otherwise provided for in this Agreement,
the FDOT may exercise one or more of the following options, provided that at no
time shall the FDOT be entitled to receive double recovery of damages:
(1) Terminate this Agreement if the breach is material and has not been cured
within 60 days from written notice thereof from the FDOT.
(2) Pursue a claim for damages suffered by the FDOT.
(3) Suspend the issuance of further permits to the UAO for the placement of
Page 4of10
16C3
Forth No.710-010.55
U1itlties
10/04
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
UTILITY WORK AGREEMENT
(at UAO's Sole Expense)
Facilities on FDOT property if the breach is material and has not been cured
within 60 days from written notice thereof from the FDOT until such time as
the breach is cured.
(4) Pursue any other remedies legally available.
(5) Perform any work with its own forces or through contractors and seek
repayment for the cost thereof under Section 337.403(3), Florida Statutes.
b. In the event that the FDOT breaches any provision of this Agreement, then in
addition to any other remedies which are otherwise provided for in the Agreement,
the UAO may exercise one or more of the following options:
(1) Terminate this Agreement if the breach is material and has not been cured
within 60 days from written notice thereof from the UAO.
(2) Pursue any other remedies legally available.
c. Termination of this Agreement shall not relieve either party from any obligations it
has pursuant to other agreements between the parties and from any statutory
obligations that either party may have with regard to the subject matter hereof.
5. Indemnification
FOR GOVERNMENT-OWNED UTILITIES:
To the extent provided by law, the UAO shall indemnify, defend, and hold harmless the
FDOT and all of its officers, agents, and employees from any claim, loss, damage, cost,
charge, or expense arising out of any acts, action, error, neglect, or omission by the
UAO, its agents, employees, or contractors during the performance of the Agreement,
whether direct or indirect, and whether to any person or property to which FDOT or said
parties may be subject, except that neither the UAO, its agents, employees, or
contractors will be liable under this section for damages arising out of the injury or
damage to persons or property directly caused by or resulting from the negligence of
the FDOT or any of its officers, agents, or employees during the performance of this
Agreement.
When the FDOT receives a notice of claim for damages that may have been caused by
the UAO in the performance of services required under this Agreement, the FDOT will
immediately forward the claim to the UAO. The UAO and the FDOT will evaluate the
claim and report their findings to each other within fourteen (14) working days and will
jointly discuss options in defending the claim. After reviewing the claim, the FDOT will
determine whether to require the participation of the UAO in the defense of the claim or
to require the UAO to defend the FDOT in such claim as described in this section. The
FDOT's failure to notify the UAO of a claim shall not release the UAO from any of the
requirements of this section. The FDOT and the UAO will pay their own costs for the
evaluation, settlement negotiations, and trial, if any. However, if only one party
Page 5 of 10
1603
Form No.710-010-55
UUNlies
10!04
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
UTILITY WORK AGREEMENT
(at UAO's Sole Expense)
participates in the defense of the claim at trial, that party is responsible for all costs.
FOR NON-GOVERNMENT-OWNED UTILITIES;
The UAO shall indemnify, defend, and hold harmless the FDOT and all of its officers,
agents, and employees from any claim, loss, damage, cost, charge, or expense arising
out of any acts, action, error, neglect, or omission by the UAO, its agents, employees,
or contractors during the performance of the Agreement, whether direct or indirect, and
whether to any person or property to which FDOT or said parties may be subject,
except that neither the UAO, its agents, employees, or contractors will be liable under
this section for damages arising out of the injury or damage to persons or property
directly caused by or resulting from the negligence of the FDOT or any of its officers,
agents, or employees during the performance of this Agreement.
The UAO's obligation to indemnify, defend, and pay for the defense or at the FDOT's
option, to participate and associate with the FDOT in the defense and trial of any
damage claim or suit and any related settlement negotiations, shall arise within fourteen
(14) days of receipt by the UAO of the FDOT's notice of claim for indemnification to the
UAO. The notice of claim for indemnification shall be served by certified mail. The
UAO's obligation to defend and indemnify within fourteen (14) days of such notice shall
not be excused because of the UAO's inability to evaluate liability or because the UAO
evaluates liability and determines the UAO is not liable or determines the FDOT is
solely negligent. Only a final adjudication or judgment finding the FDOT solely
negligent shall excuse performance of this provision by the UAO. The UAO shall pay
all costs and fees related to this obligation and its enforcement by the FDOT. The
FDOT's delay in notifying the UAO of a claim shall not release UAO of the above duty
to defend.
6. Force Majeure
Neither the UAO nor the FDOT shall be liable to the other for any failure to perform
under this Agreement to the extent such performance is prevented by an act of God,
war, riots, natural catastrophe, or other event beyond the control of the non-performing
party and which could not have been avoided or overcome by the exercise of due
diligence; provided that the party claiming the excuse from performance has (a)
promptly notified the other party of the occurrence and its estimate duration, (b)
promptly remedied or mitigated the effect of the occurrence to the extent possible, and
(c) resumed performance as soon as possible.
7. Miscellaneous
a. The Facilities shall at all times remain the property of and be properly protected
and maintained by the UAO in accordance with the then current Utility
Accommodation Manual and the current utility permit for the Facilities.
b. Pursuant to Section 287.058, Florida Statutes, the FDOT may unilaterally cancel
Page 6 of 10
16C3
Form No.710-010-55
Utilities
10/04
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
UTILITY WORK AGREEMENT
(at UAO's Sole Expense)
this Agreement for refusal by the UAO to allow public access to all documents,
papers, letters, or other material subject to the provisions of Chapter 119, Florida
Statutes, and made or received by the UAO in conjunction with this Agreement.
c. This Agreement constitutes the complete and final expression of the parties with
respect to the subject matter hereof and supersedes all prior agreements,
understandings, or negotiations with respect thereto, except that the parties
understand and agree that the FDOT has manuals and written policies and
procedures which shall be applicable at the time of the Project and the relocation
of the Facilities and except that the UAO and the FDOT may have entered into
joint agreements for Utility Work to be performed by FDOT's highway contractor.
To the extent that such a joint agreement exists, this Agreement shall not apply to
Facilities covered by the joint agreement. Copies of FDOT manuals, policies, and
procedures will be provided to the UAO upon request.
d. This Agreement shall be governed by the laws of the State of Florida. Any
provision hereof found to be unlawful or unenforceable shall be severable and
shall not affect the validity of the remaining provisions hereof.
e. Time is of the essence in the performance of all obligations under this Agreement.
f. All notices required pursuant to the terms hereof may be sent by first class United
States Mail, facsimile transmission, hand delivery, or express mail and shall be
deemed to have been received by the end of five business days from the proper
sending thereof unless proof of prior actual receipt is provided. The UAO shall
have a continuing obligation to notify each District of the FDOT of the appropriate
persons for notices to be sent pursuant to this Agreement. Unless otherwise
notified in writing, notices shall be sent to the following addresses:
If to the UAO:
Nathan Beals
Collier County Public Works
3339 East Tam iami Trail, Suite 303
Naples, Florida 34112
If to the FDOT:
Florida Department of Transportation
801 North Broadway Boulevard (MS 1-11)
P. O. Box 1249
Bartow, Florida 33830-1249
8. Certification
This document is a printout of an FDOT form maintained in an electronic format and all
Page 7 of 10
16C3
Form No.710-010-55
Utilities
10/04
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
UTILITY WORK AGREEMENT
(at UAO's Sole Expense)
revisions thereto by the UAO in the form of additions, deletions, or substitutions are
reflected only in an Appendix entitled Changes to Form Document and no change is
made in the text of the document itself. Hand notations on affected portions of this
document may refer to changes reflected in the above-named Appendix but are for
reference purposes only and do not change the terms of the document. By signing this
document, the UAO hereby represents that no change has been made to the text of this
document except through the terms of the appendix entitled "Changes to Form
Document."
Page 8 of 10
tttttttti■
16C3
Form No.710-010-55
Utilities
10/04
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION •
UTILITY WORK AGREEMENT
(at UAO's Sole Expense)
You MUST signify by selecting or checking which of the following applies:
No changes have been made to this Form Document and no Appendix entitled
"Changes to Form Document" is attached.
❑ No changes have been made to this Form Document, but changes are included
on the attached Appendix entitled "Changes to Form Document."
IN WITNESS WHEREOF, the parties hereto have executed this Agreement effective the day
and year first written.
UTILITY: Collier Coun ater-S*Veer District
BY: (Signature) DATE: 9/23/14
.10M ial ING
(Typed Name: ) BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA,AS THE
(Typed Title: )CHAIRMAN EX-OFFICIO GOVERNING BOARD OF THE
COLLIER COUNTY WATER-SEWER DISTRICT
Recommend Approval by the District Utility Office
BY: (Signature) DATE:
FDOT Legal review
BY: (Signature) DATE:
District Counsel
STATE OF FLORIDA
DEPARTMENT OF TRANSPORTATION
BY: (Signature) DATE:
(Typed Name: Chris Smith)
(Typed Title: Director of Transportation
Development)
• ••ro as to d legality
ATTEST`
DWI E. BR K, CLERK "
Scott R. Teach, Deputy County Attorney
Page 9 of 10 r
as,to Chairman's
, ,,Inature ooh/:
1 6 C 3
Form No.710-010-55
UtihtiI$
10104
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
UTILITY WORK AGREEMENT
(at UAO's Sole Expense)
FEDERAL HIGHWAY ADMINISTRATION (if applicable)
BY: DATE:
(Typed Name: N/A)
1
(Typed Title: N/A)
Page 10 of 10
1603
Rule 14-46 STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 710-010.05
UTILITY WORK SCHEDULE UTILITIES
12109
Page 1 of 3
Financial Project ID:429120-1-52-01 _ Federal Project ID:N/A
County:Collier(03001) State Road No.:84
District Document No: 1
Utility Agency/Owner(UAO):Collier County(Utilities)
A. Summary of Utility Work And Execution
Estimated Time
(calendar days)
Total Time Prior To FOOT Project Construction 0
Total Time During FDOT Project Construction 28
This document has been developed as the method for a Utility Agency/Owner(UAO)to transmit to the Florida Department of Transportation
(FOOT), the FDOTs Contractor, and other right-of-way users, the location, relocation, adjustment, installation, andlor protection of their
facilities,on this FDOT project. The following data is based on FDOT preliminary construction plans dated May 2014 . Any deviation by the
FOOT or its contractor from the plans, as provided, may render this work schedule null and void. Upon notification by FDOT of such
change,this utility may require additional days for assessment and negotiation of a new work schedule. This UAO is not responsible for
events beyond the control of the UAO that could not reasonably be anticipated by the UAO and which could not be avoided by the UAO with
the exercise of due diligence at the time of the occurrence.The UAO agrees to notify the Department in wilting prior to starting, stopping,
resuming,or completing work.
UAO Project Representative: Nathan Beals,PMP Telephone Number: 239-252-2583
UAO Field Representative: Nathan Beals,PMP Telephone Number: 239-252-2583
This document is a printout of an FOOT form maintained in an electronic format and all revisions thereto by the UAO in the form of
additions, deletions or substitutions are reflected only in an Appendix entitled"Changes to Form Document"and no change is made in the
text of the document itself. Hand notations on affected portions of this document may refer to changes reflected in the above-named
Appendix but are for reference purposes only and do not change the terms of the document. By signing this document, the UAO hereby
represents that no change has been made to the text of this document except through the terms of the appendix entitled"Changes to Form
Document".
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❑Appendix"Changes to Forms Document is attached. _Number of Attachment Pages.
• • r.r e t: **Engineer of Record(EOR): • Acceptance by District Utilities:
(Signature) (Signature) (Signature)
Nathan Beals, PMP Ryan Lazenby,P.E. Shirley McCrary
(Printed Name) (Printed Name) (Printed Name)
Project Manager Engineer of Record District Utility Administrator
(Title) (Tide) (Title)
08/14/14
(Date) (Date) (Date)
(**When requested by the District,the EOR will attest to compatibility of plans,specifications and Utility Work Schedule)
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