Backup Documents 03/22/2016 Item #16A11 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO �� A
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 SRT5/ ��
4. BCC Office Board of County .D7 b
Z
Commissioners c- -3\7_Ab
5. Minutes and Records Clerk of Court's Office 3/2_ 3:2 pir
PRIMARY CONTACT INFORMATION
�1Iib
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 . •.. :-.. - o .• ::- 'a
Contact/ Department ``-b�,v%‘ .\\\ ts /t.r -7-52- Crn
Agenda Date Item was March 22,2016 t Agenda Item Number 16A11
Approved by the BCC
Type of Document Resolution/Joint Participation Agreement Number of Original One
Attached Documents Attached
PO number or account n/a
number if document is
to be recorded 77,t‘p—
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 l ^SWF
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 S'__
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!
Tr
8. The document was approved by the BCC on and all changes made during SRT
the meeting have been incorporated in the attached document. The County a�
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 they, •
Chairman's signature.
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I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
ORIGINAL DOCUMENTS CHECKLIST & ROUTING1L6
A
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT T vv
ll
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.
**Nt8VWINUZ:gUk
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 routinglines#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 SRT
04/4
4. BCC Office Board of County bV
Commissioners \rc/
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 '.• .• - .••.;=
Contact/ Department --\:),:70-\\c.\,. /—Frrsns,Arc:\ 252.- O"k-"l
Agenda Date Item was March 22,2016 i Agenda Item Number 16A11
Approved by the BCC •
Type of Document Resolution/Joint Participation Agreement Number of Original .=\.CSL\01r.
Attached Documents Attached t•, .r �v >t-fNC)44CS
PO number or account n/a
number if document is c=`�
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
signed by the Chairman,with the exception of most letters,must be reviewed and signed 1
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 and all changes made during SRT
the 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 the
Chairman's signature.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9,03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
Oouurity of Collier
1bA11
CLERK OF THE)CIRUIT COURT
Dwight E. Brock COLLIER COU14,TY COf*THOUSE Clerk of Courts
�
Clerk of Courts 3315 TAMIAMI TRL E STE 102:, P.O.BOX 413044 Accountant
NAPLES,FLORIDA `•
,- NAPLES,FLORIDA Cut odian of County Funds
34112-5324 �_) ;34101-3044 tY
March 29, 2016
Jim Martin, Local Program Coordinator
FDOT District#1 Office
801 N. Broadway Avenue
Bartow, FL 33830
Re: Resolution 2016-50: Authorizing A Joint Participation Agreement between
the Board of County Commissioners of Collier County Florida and Florida
Department of Transportation providing for up to $759,125 in reimbursement
surrounding the State Highway System Signal Priority Preemption Expansion
Project (FM #435335-1-58-01)
Mr. Martin,
Attached for further processing are two (2) certified copies of the resolution and
three (3) original copies of the accompanying agreement referenced above, approved
by the Collier County Board of County Commissioners on Tuesday, March 22, 2016.
If your office requires further information, please feel free to contact our office at
239-252-8406.
Thank you,
DWIGHT E. BROCK, CLERK
Ann Jennejohn,
Deputy Clerk
Attachments (3)
Phone- (239) 252-2646 Fax- (239) 252-2755
Website- www.CollierClerk.com Email- CollierClerk @collierclerk.com
16A11
RESOLUTION NO. 2016 - 5 0
A RESOLUTION BY THE BOARD OF COUNTY COMMISSIONERS, COLLIER COUNTY
FLORIDA, APPROVING, AND AUTHORIZING ITS CHAIRMAN TO EXECUTE A JOINT
PARTICIPATION AGREEMENT WITH THE STATE OF FLORIDA DEPARTMENT OF
TRANSPORTATION PERTAINING TO THE COUNTY WIDE STATE HIGHWAY
SYSTEM SIGNAL PRIORITY PREEMPTION EXPANSION PROJECT (FM #435338 -1 -58-
0l ).
WHEREAS, the Florida Department of Transportation (hereafter, the FDOT) is prepared to commence
the County Wide State Highway System Signal Priority Preemption Expansion project (FM #435338- 1- 58 -01)
in accordance with its Five Year Work Program (the "Project "); and
WHEREAS, the implementation of the Project is in the interests of FDOT and the Collier County Board
of County Commissioners (the `Board ") and it is most practical, expeditious and economical for Collier County
to perform the services necessary to complete the Project; and
WHEREAS, on March 2016, the Board approved a Joint Participation Agreement with the
Florida Department of Transportation establishing the terms, conditions, funding and implementation of the
Project where Collier County would furnish the services required to complete the Project with reimbursement by
the State up to the funded amount of $759, 125.00; and
WHEREAS, the Board finds that the Agreement should be executed by its Chair and that this action is
in the public interest and benefits the citizens of Collier County, Florida.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, that:
1. The Board of County Commissioners approves and authorizes its Chair to sign the Joint Participation
Agreement with the Florida Department of Transportation pertaining to FM #435338- 1- 58 -01.
2. The Collier County Clerk is directed to forward a certified copy of this Resolution along with the
attached Joint Participation Agreement for execution by FDOT.
3. This Resolution shall take effect immediately upon adoption.
THIS RESOLUTION ADOPTED after motion, second, and majority vote favoring same, this
7-7 rjc� day of March, 2016.
ATTEST:
DWIGHT E. BROCK, Clerk
By:
�lerk
Atte'
signature only.,
Ap roved as to form and legality:
1Y
Sbeft R. Teach,
Deputy County Attorney
BOARD OF COUNTY COMMISSIONERS
OF COLLIER OUNTY, FLORIDA
By:
Donna Piala, Chair
Item # Jil:► . `
T
Agenda
Date
Date
Recd
v
puty lek)
s1
16A11
Financial Management No.: 435338-1-58168-01
1 Fund: DDR Function: 215
FLAIR Approp: 088717
Agency: Collier County
FLAIR Obj,: 134000
Contract No:
Contract Amount: $759,125
Org. Code: 55014010106
Vendor No.: F59-6000558102
JOINT PARTICIPATION ACREEMENT
BETWEEN
THE STATE OF FLORIDA DEPARTMENT OF' TRANSPORTATION
AND
COLLIER COUNTY
This Agreement, made and entered into this day of 2016, by and
between the STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION (hereinafter
referred to as the DEPARTMENT) and the COLLIER COUNTY, a political subdivision of the
State of Florida, existing under the Laws of Florida, (hereinafter referred to as the LOCAL
GOVERNMENT),
WITNESSETH:
WHEREAS, the Parties have been granted specific Legislative Authority to enter into this
Agreement pursuant to Section 339.12, Florida Statutes; and
WHEREAS, the LOCAL GOVERNMENT by Resolution No. 2016-50 dated the
day of 4m 2016 a copy of which is attached hereto and made a pan hereof, has
authorized its Chairman or designee to execute this Agreement on its behalf.
WHEREAS, the DEPARTMENT is prepared, in accordance with its Five Year Work
Program, to undertake the Project described as the "County Wide State Highway System Signal
Priority Preention �
E2� -2016, said Project being known as FM
_f, in Fiscal Year 20015 15
#435338-1-58-01, hereinafter referred to as the "Project"; and
WHEREAS, the Project is on the State Highway System, is not revenue producing and is
contained in the adopted Five Year Work Program; and
WHEREAS, the implementation of the Project is in the interests of both the DEPARTMENT
and the LOCAL GOVERNMENT and it would be most practical, expeditious, and economical for
the LOCAL GOVERNMENT to perform the services to complete the Project.
WHEREAS, the intent of this Agreement is to establish the terms and conditions of the
funding and the production of this Project; and
H
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NOW, THEREFORE, in consideration of the mutual benefits to be derived from the joint
participation of this Agreement, the parties agree as follows:
1. TERM
A. The terns of this Agreement shall begin upon the date of signature of the last party to
sign. The LOCAL GOVERNMENT agrees to complete the Project by December 31 2018, in
accordance with the schedule described and contained in Exhibit "C" attached hereto and by this
reference made a part hereof.. If the LOCAL GOVERNMENT does not complete the Project within
the time period allotted, this Agreement will expire on the last day of the scheduled completion, as
provided in this paragraph unless an extension of the time period is requested by the LOCAL
GOVERNMENT and granted in writing by the DEPARTMENT prior to the expiration of the
Agreement. Expiration of this Agreement will. be considered termination of the Project. After the
Project is complete, the term of this Agreement shall continue in effect and be binding on the parties
in perpetuity for maintenance responsibilities of the LOCAL GOVERNMENT.
2. SERVICES AND PERFORMANCES
A. The LOCAL GOVERNMENT shall furnish the services to construct the Project. The
project consist of- acquisition and installation of a sigrial priority preemption system complete with
confirmation lights at as many of the sixty -seven L67 signalized intersections on the State Highway
System located in Collier County as possible up to the funded amount of $759,125.00, and
otherwise, the LOCAL GOVERNMENT shall perform all other necessary work to complete the
Project, as specified in Exhibit "A", Scope of Services attached hereto and by this reference made a
part hereof. Nothing herein shall be construed as requiting the LOCAL GOVERNMENT to
perform any activity which is outside of the scope of services of the Project.
B. The LOCAL GOVERNMENT agrees to undertake the Project in accordance with
DEPARTMENT standards and specifications, Greenbook and all applicable federal, state and local
statutes, rules and regulations.
C. E- VERIFY
Vendors/Contractors shall utilize the U.S. Department of Homeland Security's E-Verify system to
verify the employment eligibility of all new employees hired by the Vendor/Contractor during the
term of the contract.
Wk
ME
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Vendors/Contractors shall expressly require any subcontractors pertbrming work or providing
services pursuant to the state contract to likewise utilize the U.S, Department of Homeland
Security's E-Verify system to verify the employment eligibility of all new employees hired by the
subcontractor during the contract term.
D. This Agreement shall act to supersede the normal requirements of the LOCAL
GOVERNMENT to secure separate DEPARTMENT pen-nits for drive-way connection, right of
way utilization, storm-water discharge and utilities. and this Agreement is deemed to constitute such
permits.
E. The LOCAL GOVERNMENT shall be responsible for obtaining clearances/permits
required for the construction of the Project frorn the appropriate permitting authorities.
F. The LOCAL GOVERNMENT shall receive a Notice to Proceed from the
DEPARTMENT'S Project Manager, Jim Martin at (863) 519-2665 or from an appointed
designee. Any work 12erforined prior to the issuance of the Notice to Proceed is not subiect to
reimbursement. The LOCAL GOVERNMENT shall also obtain approval of their MOT schedule
and coordinate construction schedule including pre-construction meeting invitation with Eunice
Usher at Fort Myers Operation (239) 985-7852 or from an appointed designee.
G. The LOCAL GOVERNMENT shall hire a DEPARTMENT prequalified contractor
using the LOCAL GOVERNMENT'S normal bid procedures to perform the work for the Project.
H. The LOCAL GOVERNMENT shall be responsible to ensure that the work tinder this
Agreement is performed in accordance with the approved construction documents, and that it will
meet all applicable standards and that the work is performed in accord with the Terms and
Conditions contained in Exhibit "D".
1. Upon request, the LOCAL GOVERNMENT agrees to provide progress reports to the
DEPARTMENT in the standard format used by the LOCAL GOVERNMENT and at intervals
established by the DEPARTMENT. The DEPARTMENT will be entitled at all times to be advised,
at its request, as to the status of work being done by the LOCAL GOVERNMEN'r and of details
thereof. Coordination shall be maintained by the LOCAL GOVERNMENT with representatives of
the DEPARTMENT.
J. Upon completion of the work authorized by this Agreement, the LOCAL
GOVERNMENT shall notify the DEPARTMENT in writing of the completion,, and for all work
that originally required certification by a Professional Engineer, this notification shall contain an
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Engineers Certification of Compliance, signed and sealed by a Professional Engineer, Exhibit "E",
The certification shall state that work has been completed in compliance with the Project
construction plans and specifications. If any deviations are found from the approved plans, the
certification shall include a list of all deviations along with an explanation that justifies the reason to
accept each deviation.
3. COMPENSATION AND REIMBURSEMENT
A. The Department agrees to compensate the LOCAL GOVERNMENT for services
described in Exhibit A — Scope of Services, The Method of Compensation is included as Exhibit B.
B. The LOCAL GOVERNMENT shall provide quantifiable, measurable, and verifiable
units of deliverables. Each deliverable must specify the required minimum level of service to be
performed and the criteria for evaluating successful completion. The Project, identified as Project
Number 435338-1-58/68-01, and the quantifiable, measurable, and verifiable units of deliverables
are described more fully in Exhibit A -- Scope of Services. (Section 287.058(1)(d) and (e), F. S)
C. Invoices shall be submitted by the LOCAL GOVERNMENT in detail sufficient for a
proper pre-audit and post audit based on the quantifiable, measurable and verifiable units of
deliverables as established in Exhibit A -- Scope of Services. Deliverables must be received and
accepted in writing by the Department's Project Manager prior to payments. (Section 287058
(1) (a), F.,,V.)
D. Supporting documentation must establish that the deliverables were received and
accepted in writing by the LOCAL GOVERNMENT and must also establish that the required
minimum level of service to be performed based on the criteria for evaluating successful completion
as specified in Exhibit A — Scope of Services was met.
E. 'Mere shall be no reimbursement for travel expenses under this Agreement,
F. Payment shall be made only after receipt and approval of goods and services unless
advance payments are authorized by the Chief Financial Officer of the State of Florida under
Chapters 215 and 216, F.S.- If the DEPARTMENT determines that the performance of the
LOCAL GOVERNMENT is unsatisfactory, the DEPARTMENT shall notify the LOCAL
GOVERNMENT of the deficiency to be corrected, which correction shall be made within a time
frame to be specified by the DEPARTMENT. The LOCAL GOVERNMENT shall, within five days
after notice from the DEPARTMENT, provide the DEPARTMENT with a corrective action plan
9
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describing how the LOCAL GOVERNMENT will address all issues of contract non- performance,
unacceptable performance, failure to meet the minimum performance levels, deliverable
deficiencies, or contract non-compliance. If the corrective action plan is unacceptable to the
DEPARTMENT, the LOCAL GOVERNMENT shall be assessed a non-performance retainage
equivalent to 10% of the total invoice amount. The retainage shall be applied to the invoice for the
then-current billing period. The retainage shall be withheld until the LOCAL GOVERNMENT
resolves the deficiency. If the deficiency is subsequently resolved, the LOCAL GOVERNMENT
may bill the DEPARTMENT for the retained amount during the next billing period. If the LOCAL
GOVERNMENT is unable to resolve the deficiency, the funds retained may be forfeited at the end
of the AgrecnieWs term. (Section 287.058(1)(h), F.S.)
The LOCAL GOVERNMENT providing goods and services to the DEPARTMENT should be
aware of the following time frames. Inspection and approval of goods or services shall take no
longer than 5 working days unless the bid specifications, purchase order, or contract specifies
otherwise. (Any deviations should be referenced in the agreement or an addendum in accordance
with Section 2.1 -) The DEPARTMENT has 20 days to deliver a request for payment (voucher) to
the Department of Financial Services. The 20 days are measured from the latter of the date the
invoice is received or the goods or services are received, inspected, and approved. (Section
21.5.422(1), F.S.)
If a payment is not available within 40 days, a separate interest penalty at a rate as established
pursuant to Section 55.03(1), F.S., will be due and payable, in addition to the invoice amount, to the
LOCAL GOVERNMENT. Interest penalties of less than one (1) dollar will not be enforced unless
the LOCAL GOVERNMENT requests payment. Invoices that have to be returned to a LOCAL
GOVERNMENT because of LOCAL GOVERNMENT preparation errors will result in a delay in
the payment. The invoice payment requirements do not start until a properly completed invoice is
provided to the Department. (Section 215.422(3) (b), F.S.)
A Vender Ombudsman has been established within the Department of Financial Services. The
duties of this individual include acting as an advocate for LOCAL GOVERNMENT who may be
experiencing problems in obtaining timely payment(s) from a state agency, The Vendor
Ombudsman may be contacted at (850) 413-5516 or by calling the Division of Consumer Services
at 1-877-693-5236, (Section 215.422(5) and (7), F.S.)
C
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G. Records of costs incurred under the terms of this Agreement shall be maintained and
made available upon request to the DEPARTMENT at all times during the period of this Agreement
and after final payment is made. Copies of these documents and records shall be furnished to the
DEPARTMENT upon request. Records of costs incurred include the LOCAL GOVERNMENT
general accounting records and the project records, together with supporting documents and records,
of the contractor and all subcontractors performing work on the project, and all other records of the
Contractor and subcontractors considered necessary by the Department for a proper audit of costs.
(Section 287,0580), F.S.)
H. In the event this contract is for services in excess of $25,000.00 and a term lbr a
period of more than I Year, the provisions of Section 339.135(6)(a), F.S., are hereby incorporated:
"The Department, during any fiscal year, shall not expend money, incur any liability, or enter into
any contract which, by its terms, involves the expenditure of money in excess of the amounts
budgeted as available for expenditure during such fiscal year. Any contract, verbal or written, made
in violation of this subsection is null and void, and no money may be paid on such contract. The
Department shall require a statement from the Comptroller of the Department that such funds are
available prior to entering into any such contract or other binding commitment of fiuids. Nothing
herein contained shall prevent the making of contracts for periods exceeding I year, but any contract
so made shall be executory only for the value of the services to be rendered or agreed to be paid for
in succeeding fiscal years; and this paragraph shall be incorporated verbatim in all contracts of the
Department which are for an amount in excess of $25,000.00 and which have a term for a period of
more than I year."
1. The DEPARTMENT's obligation to pay is contingent upon an annual appropriation
by the Florida Legislature. (Section 216.311, F.S.)
J. The LOCAL GOVERNMENT shall:
1. Utilize the U.S. Department of Homeland Security's E-Verify system to
verify the employment eligibility of all new employees hired by the LOCAL
GOVERNMENT during the term of the contract; and
2. Expressly require any contractors and subcontractors performing work or
providing services pursuant to the state contract to likewise utilize the U.S.
Department of Homeland Security's E-Verify system to verify the
W
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employment eligibility of all new employees hired by the subcontractor
during the contract term. (E.vecutive Order A7utnber 2011-02)
K. The Other Party agrees to comply with Section 20.055(5), F.S., and to incorporate in
all subcontracts the obligation to comply with Section 20.05.5(5), F.S.
4. COMPLIANCE WITH LAWS
A. The LOCAL GOVERNMENT shall 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 LOCAL, GOVERNMENT in conjunction with this Agreement. Failure by the
LOCAL GOVERNMENT to grant such public access shall be grounds for immediate unilateral
cancellation of this Agreement by the DEPARTMENT.
B. The LOCAL GOVERNMENT shall comply with all federal, state and local laws and
ordinances applicable to the work or payment for work thereof. The LOCAL GOVERNMENT
shall not discriminate on the grounds of race, color, religion, sex or national origin in the
perforinance of work under this Contract.
C. No funds received pursuant to this Agreement may be expended for lobbying the
Legislature, the judicial branch, or a state agency.
D. The LOCAL GOVERNMENT and the DEPARTMENT agree that the LOCAL
GOVERNMENT, its employees, and subcontractors are not agents of the DEPARTMENT as a
result of this Contract.
5. TERMINATION AND DEFAULT
A. This Agreement may be cancelled by the DEPARTMENT in whole or in part at any
time the interest of the DEPARTMENT requires such termination. The DEPARTMENT also
reserves the right to seek tennination or cancellation of this Agreement in the event the LOCAL
GOVERNMENT shall be placed in either voluntary or involuntary bankruptcy. The
DEPARTMENT further reserves the right to terminate or cancel this Agreement in the event an
assignment is made for the benefit of creditors. This contract may be cancelled by the LOCAL
GOVERNMENT upon sixty (60) days written notice to the DEPARTMENT,
B. If the DEPARTMENT determines that the performance of the LOCAL
GOVERNMENT is not satisfactory, the DEPARTMENT shall have the option of (a) immediately
terminating the Agreement, or (b) notifying the LOCAL GOVERNMENT of the deficiency with a
requirement that the deficiency be corrected within a specified time, otherwise the Agreement will
16A11
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be terminated at the end of such time, or (c) taking whatever action is deemed appropriate by the
DEPARTMENT.
C. If the DEPARTMENT requires termination of the Agreement for reasons other than
unsatisfactory perfan-nance of the LOCAL GOVERNMENT, the DEPARTMENT shall notify the
LOCAL GOVERNMENT of such termination, with instructions to the effective date of termination
or specify the stage of work at which the Agreement is to be terminated.
D. If the Agreement is terminated before performance is completed, the LOCAL
GOVERNMENT shall be paid only for that work satisfactorily performed for which costs can be
substantiated, Such payment, however, may not exceed an amount which is the same percentage of
the contract price as the amount of work satisfactorily completed is a percentage of the total work
called for by this Agreement. All work in progress will become the property of the DEPARTMENT
and will be turned over promptly by the LOCAL GOVERNMENT,
6. MISCELLANEOUS
A. All words used herein in the singular form shall extend to and include the plural. All
words used in the plural form shall extend to and include the singular. All words used in any gender
shall extend to and include all genders.
B. The DEPARTMENT shall not be obligated or liable hereunder to any party other
than the LOCAL GOVERNMENT.
C. In no event shall the making by the DEPARTMENT of any payment to the LOCAL
GOVERNMENT constitute or be construed as a waiver by the DEPARTMENT of any breach of
covenant or any default which may then exist, oil the part of the LOCAL GOVERNMENT, and the
making of such payment by the DEPARTMENT while any such breach or default shall exist shall in
no way impair or prejudice any right or remedy available to the DEPARTMENT with respect to
such breach or default.
D. This document incorporates and includes all prior negotiations, correspondence,
conversations, agreements, or understanding.-, applicable to the matters, contained herein, and the
parties agree that there are no commitments, agreements or understandings concerning the subject
matter of this Agreement that are not contained in this document. Accordingly, it is agreed that no
deviation from the terms hereof shall be predicated upon any prior representation or agreements
whether oral or written. It is further agreed that no modification, amendment or alteration in the
N
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terms or conditions contained herein shall be effective unless contained in a written document
executed with the same formality and of equal dignity herewith.
E. All tracings, plans specifications, maps, models, reports, or other work product
prepared or obtained under this Agreement shall be considered works made for hire for the
DEPARTMENT and the LOCAL GOVERNMENT and shall at all times be and remain the property
of the DEPARTMENT and the LOCAL GOVERNMENT' without restriction or limitation on their
use,
F. This Agreement shall be governed by and interpreted in accordance with the laws of
the State of Florida. Any provision herein determined by a court of competent jurisdiction, or any
other legally constituted body having jurisdiction, to be invalid or unenforceable shall be severable
and the remainder of this Agreement shall remain in full force and effect, provided that the
invalidated or unenforceable provision is not material to the intended operation of this Agreement.
G. This Agreement shall be effective upon execution by both parties and shall continue
in effect and be binding oil the parties until the Project is completed, any subsequent litigation is
complete and terrilinated, final costs are known, and legislatively appropriated reimbursements, if
approved, are made by the DEPARTMENT. The DEPARTMENT may, at any stage, amend or
terminate the Project in whole or in part if the DEPARTMENT determines that such action is in the
best interest of the public. However, the COUNTY'S obligation to maintain the PROJECT after
completion shall survive the term of this Agreement.
it. PUBLIC ENTITY CRIME INFORMATION AND ANTI-DISCRIMINATION
STATEMENT: A person or affiliate who has been placed on the convicted vendor list following a
conviction for a public entity crime may not submit a bid on a contract to provide any goods or
services to a public entity, may not submit a bid on a contract with a public entity for the
construction or repair of a public building or public work, may not submit bids on leases of real
property to a public entity, may not be awarded or perform work as a contractor, supplier,
subcontractor, or consultant under a contract with any public entity, and may not transact business
with any public entity in excess of the threshold amount provided in Section 287.017, for
CATEGORY Two for a period of thirty-six (36) months from the date of being placed on the
convicted vendor list. An entity or affiliate who has been placed on the discriminatory vendor list
may not submit a bid on a contract to provide any goods or services to a public entity, may not
N
16A1i
FM#435338-1-58/68-01
Collier County
Page 1.0 of I I
submit a bid on a contract with a public entity for the construction or repair of a public building or
public work, may not submit bids on leases of real property to a public entity, may -not be awarded
or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any
public entity, and may not transact business with any public entity.
L All notices required pursuant to the terms hereof shall be sent by First Class United
States Mail. Unless prior written notification of an alternate address for notices is sent, all notices
shall be sent to the following addresses:
Florida Department of Transportation
Collier Count
Jim Martin
-V
Anthony hawaja
Local Program Coordinator
Engineer and Traffic Operations
—.4-SN—ef
801 N. Broadway Av�e
2885 South I-Iorseshoe Drive
Bartow, Florida 33830
Naples, FL 34104
J. Exhibits A, B, C, and D are attached hereto and incorporated by reference.
14
1 6 A 1 1
Ftv14435338-1-58/68-0 1
Collier County
Page 11 of 11
IN WITNESS WHEREOF, COLLIER COUNTY has caused this Agreement to be executed in its
behalf, by the Chairman or its Designee, and the FLORIDA DEPARTMENT OF
TRANSPORTATION has caused this Agreement to be executed in its behalf through its District
Secretary or authorized Designee: This Agreement shall become effective on:
Department to enter date
COLLIER COUNTY, FLORIDA
ATTi T',I '%..'%; ..%-1 ., t.,
c:L.6.,
'r..4. Aoo*4., •• ',- •
CL RK 4410144'''' (SEAL)
IDS
CHAIR AN OR DESIGNEE ...____ _
BOARD OF COUNTY COMMISSIONERS
Attest as t4Cha1etrOlial
signature only. It\nouvi-4 -BF--2_0 I lefbop,r,ck. FN 0:\t"1/4.
DATE PRINT NAME DATE
COUNTY LEGAL
REVIE : 61 lit,
BY: 4
e /
,DA`cE
3/1 6
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
ATTEST
BY:
EXECUTIVE SECRETARY (SEAL) DISTRICT SECRETARY OR DESIGNEE
DISTRICT ONE
PRINT NAME DATE PRINT NAME DATE
FLA. DEPT. OF TRANS. LEGAL ,74..--- _,,),4
AVAILABILITY OF FUNDS APPROVAL:
REVIEW:
BY:
DATE DATE
CO
16A11
FM #43 5338 -1- 58/68 -01
Collier County
EXHIBIT "A"
SCOPE OF SERVICES
Financial Management Number: 435338-1-58168-01
County Wide State Highway System Signal Priority Preemption Expansion
The purpose of this Exhibit is to describe the scope of work and the responsibilities of Collier
County in connection with the acquisition and installation of a signal priority preemption system
complete with confirmation lights at all signalized intersections on the State Highway System
located in Collier County. 'File attached list identifies the sixty-seven (67) intersection locations
included in the scope. Several of the intersections are scheduled for construction or are currently
under construction. Review of these locations is required to ensure conformity and uniformity as
part of this county wide improvement to the State Highway System. The general objective is for
Collier County to provide contract administration, management services, construction
engineering inspection services and quality acceptance reviews of all work associated with the
acquisition and installation of the associated improvements at as many of the sixty-seven (67)
intersection locations as possible up to the funded amount of $759,125,00. The services
performed shall be in accordance with all applicable Florida Department of Transportation
manuals, guidelines and specifications.
Each approach to the sixty-seven (67) signalized intersections referenced below shall be
provided with emergency vehicle preemption. The installations shall be compatible with the
existing Collier County GTT Opticoin Infrared Emergency Vehicle Preemption System.
• Use GTT Opticom Model 138 detector cable manufacturer or equivalent cable approved
by the detector manufacturer.
• Use GTT Opticoni Model 764 multirnode phase selector.
• Use GTT Opticom Model 700 Series infrared detectors.
• Emergency vehicle preemption detector cables shall be continuous from the controller
assembly to the preemption detector
• Each vehicle approach shall be wired separately and combined in the controller assembly
to obtain the specific sequence of operation as shown on the plans.
• Each approach to a signalized intersection shall be equipped with a Preemption
Confirmation Light.
• The emergency vehicle confirmation light shall be installed according to the Collier
County Signalization Technical Special provisions "Typical Emergency Vehicle Detector
with Confinnation Light Detail" sheet.
• The confirmation beacon shall consist of a PAR 38 white LED flood lamp (90 watt
equivalent) for each direction of traffic.
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• The lamp shall have an adjustable mount with a weatherproof enclosure for cable
splicing,
• All hardware shall be cast aluminum, malleable iron, powder coated steel, and/or
stainless steel.
• Holes drilled into signal poles, mast arms, or posts shall require rubber grommets to
prevent chafing of wires.
• Use either polyethylene insulated, polyvinyl chloride jacketed signal cable conforming to
the requirements of the International Municipal Signal Association, Inc. (IMSA)
Specification No. 19-1 or polyethylene insulated, polyethylene jacketed signal cable
conforming to the requirements of IMSA Specification No. 20-1.
• Use signal cable with 5 conductors of stranded copper, No. 14 AWG for 1-way
confirmation light installation.
• Use signal cable with 7 conductors of stranded copper, No. 14 AWG or for 2-way
confirmation light installation.
• Signal cables shall be continuous from controller assembly to the preemption
confirmation light disconnect box.
• The controller assembly shall include an emergency vehicle confirmation light panel
installed according to the Collier County Signalization Technical Special provisions
"Emergency Confirmation Light Wiring with Solid State or Electromechanical Relay
Interface Panel Detail" sheet.
• The preempted movement shall be indicated by a steady indication on the confirmation
beacon and the stopped preempted movements shall be indicated by a flashing
confirmation beacon indication.
List of Signalized Intersections on the State Highway System in Collier County
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.. .. . ......... .... .. . ..... ...
-- ------
Signal
Number of
Arterial Name
i Intersection
Type
Approaches
1
1 29 (15 ST N)
Immokalee Dr
TS
4
2
29 (15 ST N)-
Lake Trafford Rd
TS
4
3
29 (Main Street)
1 st Street N
TS
4
4
29 (Main Street)
9th Street N
TS
4
5
29 South
Farm Workers Village
SCH
4
6
Collier Blvd
Capri Blvd (952)
TS
3
7
Collier Blvd
Davis Blvd
TS
3
8
Collier Blvd . .
1-75 N
.... . ....... .......
TS
3
9
Collier Blvd
1-75S
TS
3
10
...
Collier Blvd
... . . .............. ...
Mainsail Dr (Marco Airport)
TS
3
11
Collier Blvd
Manatee Rd
TS
3
12
Collier Blvd
Walmart S of US 41
TS
3
13
Davis Blvd
1 Airport Pulling Rd
L TS
1 4
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I
14
15
16
. . ..... 1.7-
18
Davis Blvd
Davis Blvd
Davis Blvd
_-Davis Blvd
Davis Blvd
County Bern Rd
Kings Way
Lakewood Blvd
Radio -Rd
I Santa Barbara Blvd
TS
TS
TS
T�
3
4 A i
4
19
Davis Blvd
Shadowlawn Dr
T S
_j
4
20
Golden Gate Pkwy
1-75 E
TS
3
21
Golden Gate Pkwy
1-75 W
TS
3
22
Immokalee Rd
1-76 E & W
TS
6
23
Pine Ridge Rd
1-75 E & W
TS
6
24
US 41 (Tamiami Trail N)
91st Ave/Strada PI
TS
4
25
US 41 (Tamiami Trail N)
Immokalee Rd
TS
4
26
US 41 (Tamiami Trail N)
Imperial Golf Course Blvd
TS
3
27
28
US 41 (Tamiami Trail N)
US 41 (Tam!
Old 41
Pelican Bay Blvd N
TS
TS
4
4
29
US 41 (Tamiami Trail N)
j Pelican Bay Blvd S
TS
3
30
US 41 (Tamiami Trail N)
Pelican Marsh Dr/99th Ave N
TS
4
31
US 41 (Tamiami Trail N)
Pine Ridge Rd
TS
4
32
US 41 (Tamiami Trail N)
I Vanderbilt Beach Rd
TS
4
33
US 41 (Tamiami Trail N) I
Wiggins Pass Rd
TS
4
34
US 41 (Tamiami Trail S)
Airport Pulling Rd
TS
4
35
US 41 (Tamiami Trail S)
Barefoot Williams Rd
TS
2
Wtl 36
US 41 (Tamiami Trail S)
Bayshore Dr/Shadowlawn Dr
TS
4
37
US 41 (Tamiami Trail S)
Broward St
TS
4
38
US 41 (Tamiami Trail S)
Collier Blvd
TS
4
39
'1 US 41 (Tamiami Trail S)
Commercial Dri Palm St
TS
4
40 i
41
US 41 (Tamiami Trail S)
US 41 (Tamiami Trail S)
Espinal Blvd (Courthouse Shadows)
Guilford Rd
TS
f S
4
4
42
US 41 (Tamiami Trail S)
Lakewood Blvd
TS
4
43
US 41 (Tamiami Trail S)
Manatee Rd
SCH
3
44
US 41 (Tamiami Trail S)
Palm Dr
TS
4
45
US 41 (Tamiami Trail S)
Price St/Triangle Blvd
Ts
4
46
US 41 (Tamiami Trail S)
Rattlesnake Hammock Rd
TS
4
47
US 41 (Tamiami Trail S)
St Andrews Blvd
TS
4
48
US 41 (Tarniam! Trail N)
. . ........
10th St S
TS
4
49
US 41 (Tamiami Trail N)
26th Ave N
TS
3
50
US 41 (Tamiami Trail N)
3rd Ave S
TS
4
US 41 (Tamiami Trail N)
4th Ave N
TS
4
52
US 41 (Tamiami Trail N)
5th Ave S i
TS
4
53
US 41 (Tamiami Trail N)
7th Ave N
TS
4
54
US 41 (Tamiami Trail N)
Central Ave
TS
4
55
US 41 (Tamiami Trail N)
Fleischman Blvd/Orchid Dr u
TS
4
56
US 41 (Tamiami Trail N)
Golden Gate Pkwy
TS 1
4
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°
Collier County
57 US 41 (Tamiami Trail N) Granada Blvd/Neopolitan Way TS 4
58 US41 (yamiamiTrail N) Harbour Dr TS l 3
59 US41 (TamiamiTrail N) Moorings Line Dr TS 4
60 US41ODomiamiTrail N> Morningside Dr TS 4
61 US 41 (Tai TN) TS 4
62 UG41 (TemimmiTrail N) Park Shore TS 4
--'
63 US 41 (Tamiami Trail N) Shady ResLn/Old Trail Dr | TS 4
64 US 41 (Tamiami Tril S) 10th St S TS 4
65 US 41 (Tamiami Trail S) Davis 8hd:Smnd�0p�rGt TS 4
---'--- -- |
66 WS41 (TamiamiTrail B) Goodlette Frank Rd TS 4
67 UG41 (TemiamiTrail S) River Point Dr TS 4
Traffic Signal TS .
School Sinm| SCH
4nf4iPage
*10\
*��� �
ibAll
EXHIBIT "B"
ESTIMATED SCHEDULE OF FUNDING
Financial Management Number: 435338-1-58-01
By and through this Joint Participation Agreement with Collier County, the DEPARTMENT
agrees to reimburse Collier County Lip to, but not to exceed $759,125.00 (Seven hundred, flfty
nine thousand, one hundred 6venty five dollars) programmed in FY 201512016 for actual cost
incurred on this Project, excluding Collier County's overhead.
Rest of this page intentionally left blank.
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EXHIBIT "C"
ESTIMATED PROJECT PRODUCTION SCHEDULE
Financial Management Number: 435338-1-58/68-01
• Construction Contract to be awarded by: August 15,2016
• Construction to be completed by: December 31, 2018
I
lofliP age
16A11
EXHIBIT 44D99
TERMS & CONDITIONS OF CONSTRUCTION
1. The LOCAL GOVERNMENT is authorized, subject to the conditions set forth herein,
to perform all activities necessary for the construction of the Project (as described more fully in
Exhibit "A"). The Project shall be constructed in accordance with construction plans and
specifications to be approved by the DEPARTMENT and consistent with the requirements of the
DEPARTMENT. The plans shall include an appropriate plan for maintenance of traffic. Should
any significant (as defined by §43 of Standard Specifications for Road and Bridge Construction,
2010, and as amended from time to time) changes to the plans be required during construction of
the Project,. the LOCAL GOVERNMENT shall be required to notify the DEPARTMENT of the
changes and receive approval from the DEPARTMENT prior to the changes being constructed.
The DEPARTMENT reserves the right to adjust the plans to meet the requirements of permits.
The LOCAL GOVERNMENT shall be responsible to maintain the area of the Project at all times
during construction of the Project. All payment and performance bonds shall name the
DEPARTMENT as an additional obligee. All warranties on any product or material used in
construction of said Project shall be in favor of the DEPARTMENT. The LOCAL
GOVERNMENT shall assure that the Engineer of Record performs all necessary post-design
services that may be required.
2. The LOCAL GOVERNMENT shall have the affirmative responsibility to locate all
existing utilities, both aerial and underground and that all utility locations shall be represented on
the construction. plans. All utility conflicts shall be fully resolved directly with the applicable
utility. The LOCAL GOVERNMENT shall be obligated to design around any utility installation
for which the conflict cannot be resolved. Said utility work shall be deemed to be undertaken on
behalf of and for the benefit of the DEPARTMENT and the LOCAL GOVERNMENT shall assure
that utility work schedules are obtained for the Project.
3. The work performed pursuant to this Agreement may require authorization under the
Clean Water Act, by the U.S. Environmental Protection Agency for Storm Water Discharges
from construction sites. The LOCAL GOVERNMENT is responsible for obtaining the National
Pollutant Discharge Elimination System Pen-nit and all other necessary permits for construction
of the Project. When applicable, such permits will be processed in the name of the
DEPARTMENT; however, in such event, the LOCAL GOVERNMENT will comply with all
terms and conditions of such permit in construction of the subject facilities.
4. It is expressly agreed by the parties that this Agreement creates a permissive use only
and that neither the granting of the permission herein to use DEPARTMENT and/or LOCAL
GOVERNMENT right-of-way nor the placing of facilities upon DEPARTMENT and/or LOCAL
GOVERNMENT land shall operate to create or vest any property right in the LOCAL
GOVERNMENT and/or the DEPARTMENT except as otherwise provided in separate
agreements.
Page I of 3
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6. The DEPARTMENT shall appoint and authorize a single individual to serve as the
DEPARTMENT'S representative to coordinate and manage the DEPARTMENT review of
LOCAL GOVERNMENT activities pursuant to this Agreement. The LOCAL GOVERNMENT
shall provide a current construction schedule to the DEPARTMENT'S representative and shall
notify the representative at least 48 hours in advance of starting proposed work and again
immediately upon completion of work.
7. The LOCAL GOVERNMENT shall hire a contractor using the LOCAL
GOVERNMENT'S normal bid procedures to perform the construction work for the Project
8. The LOCAL GOVERNMENT shall require the LOCAL GOVERNMENT'S
contractor to post a bond in accordance with Section 337.18, Florida Statutes.
9. The LOCAL GOVERNMENT shall not modify the intent of the design plans or the
maintenance of traffic concept without appropriate submission by the Engineer of Record (the
"Engineer") and approval by the DEPARTMENT. Provided, however, in the event of an
emergency, the LOCAL GOVERNMENT shall immediately make any necessary changes and
notify the DEPARTMENT and the Engineer of Record after the modifications,
10. The DEPARTMENT may request and shall be granted a conference with the LOCAL
GOVERNMENT and at the LOCAL GOVERNMENTS option, the LOCAL GOVERNMENT'S
CEI firm, to discuss any part of the Project activities that the DEPARTMENT determines to be
inconsistent with the approved design plans and specifications. The LOCAL GOVERNMENT
will monitor the corrective action and provide the DEPARTMENT status reports at such intervals
as are reasonable, based on the corrective action undertaken, and the DEPARTMENT may, but is
not obligated to, review independently the progress of the corrective action. Provided however, if
the DEPARTMENT determines a condition exists which threatens the public's safety, the
DEPARTMENT may, at its discretion, issue an immediate stop work order.
11. The LOCAL GOVERNMENT shall have the continuous obligation to monitor the
maintenance of traffic and construction operation during the course of the Project so that the safe
and efficient movement of the traveling public is maintained. The LOCAL GOVERNMENT is
further obligated to make such changes to the maintenance of traffic plans as may be necessary.
During construction, the LOCAL GOVERNMENT shall take measures, including the placing
and display of safety devices that are necessary in order to safely conduct the public through the
Project area in accordance with the latest and current version of the Federal Highway
Administration Manual on Uniform Traffic Control Devices for Streets and Highways, and the
DEPARTMENT'S 2010 Standard Specifications for Road and Bridge construction and the
DEPARTMENT'S 2010 Roadway and Traffic Design Standards, and as those sources may be
amended from time to time, The LOCAL GOVERNMENT may assign the responsibility of this
paragraph to the Contractor or its' CEI for the construction of the Project.
12, Prior to the Project bidding, the LOCAL GOVERNMENT shall provide a project
schedule that includes, at a minimum, the date the Project will be advertised for bid, the bid
opening date, the award date and the date of the preconstruction conference.
13. It is understood and agreed that the rights and privileges herein set out are granted only
to the extent of the DEPARTMENTS light, title and interest in the land to be entered upon and
Page 2 of 3
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16A11
used by the LOCAL GOVERNMENT. Any additional right or privilege required to undertake
and to complete construction of the Project shall be secured by the LOCAL GOVERNMENT.
14. Upon completion of the work in accord with the Plans, the LOCAL GOVERNMENT
shall furnish a set of "as- built" plans certified by the Engineer of Record/CEJ that the necessary
improvements have been completed in accordance with the Plans as the same may be modified
in accord with the terms of this Agreement. This certification shall include a statement that
necessary inspections, tests, and physical measurements have been made, and that all materials
entering into the work conform to the Plans, conform to the applicable specifications contained
in the Standard Specifications for Road and Bridge Construction, 2010 edition as amended, or
otherwise conform to or meet generally accepted professional practices. Additionally, the
LOCAL GOVERNMENT shall assure that all post construction survey documentation required
by Florida Statutes is completed and evidence of such is provided to the DEPARTMENT in a
manner acceptable to the DEPARTMENT. Upon acceptance of right•of-way documents, then
the Project shall be deemed accepted by the DEPARTMENT,
15. In the event contaminated soil is encountered by the LOCAL GOVERNMENT or
anyone within the DEPARTMENT" right of way, the LOCAL GOVERNMENT shall immediately
cease work and notify the DEPARTMENT. The DEPARTMENT shall coordinate with the
appropriate agencies and notify the LOCAL GOVERNMENT of any required action related
thereto.
16. It is acknowledged by the parties that construction plans and specifications are still
being prepared by the LOCAL GOVERNMENT' as of the date of this Agreement. Construction of
the Project will not commence until the DEPARTMENT has approved the construction plans and
specifications as provided for in Paragraph I and all required right-of-way has been properly
obtained and certified (if applicable) as such by the DEPARTMENT's Right of Way Manager.
17. If applicable, the LOCAL GOVERNMENT shall assure that load ratings are submitted
on any vehicular bridge prior to the final submission of the structure plans for DEPARTMENT
review. Structures shall not be opened to traffic until a signed and sealed final bridge load rating
that meets the Florida legal loads standard is complete.
Page 3 of 3
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EXHIBIT "E"
NOTICE OF COMPLETION
JOINT PARTICIPATION AGREEMENT
Between
THE STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
And
COLLIER COUNTY
PROJECT DESCRIPTION: County Wide State Highway System Signal Priority Preemption
Expansion
FINANCIAL MANAGEMENT ID# 4353 )8-1-58-01
In accordance with the Terms and Conditions of the JOINT PARTICIPATION AGREEMENT,
the undersigned hereby provides notification that the work authorized by this Agreement is
complete as of 20
By: _
Name:
Title:
ENGINEER'S CERTIFICATION OF COMPLIANCE
In accordance with the Terms and Conditions of the JOINT PARTICIPATION AGREEMENT,
the undersigned hereby certifies that all work which originally required certification by a
Professional Fnginecr has been completed in compliance with the Project construction plans and
specifications. If any deviations have been made from the approved plans, a list of all deviations,
along with an explanation that justifies the reason to accept each deviation, will be attached to this
Certification. Also, with submittal of this certification, the LOCAL GOVERNMEN-I'shall furnish
the DEPARTMENT a set of "as- built" plans certified by the Engineer of Record/CEI.
SEAL.
By: . P.E.
Name:
Date:
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